bluuebunny/crossref_metadata_2025 huggingface dataset:
Larger biopsies evaluation of transient elastography for detecting advanced fibrosis in patients with compensated chronic hepatitis B
Authors: Chen Yong Peng , Liang Xie Er , Zhang Qi , Peng Jie , Zhu You Fu , Wen Wei Qun , Hou Jin Lin
Published: March 2012

Background and Aim:  Although larger biopsies sample had been recommended for the study of non‐invasive liver fibrosis assessment, few studies with larger biopsies for transient elastography (TE) detecting liver fibrosis had been reported. The present study tries to re‐evaluate the performance of TE for detecting advanced fibrosis (≥F3) with larger biopsies in patients with compensated chronic hepatitis B.

Methods:  A total of 375 compensated patients were analyzed, who had undergone liver biopsy, reliable TE and routine blood tests.

Results:  The area under the receiver operating characteristic curve (AUC) was influenced by liver biopsy sample: 0.873 (95% confidence interval 0.838–0.909) in total patients, 0.880 (0.844–0.917) in length ≥ 15 mm, 0.897 (0.863–0.932) in length ≥ 20 mm and 0.911 (0.874–0.949) in length ≥ 25 mm. In patients with sample length ≥ 20 mm, the cutoffs to exclude and confirm advanced fibrosis were 7.1 kPa and 12.7 kPa, respectively. Stratified by alanine aminotransferase of two times the upper limit of normal (ALT 2 × ULN), transient elastography detecting advanced fibrosis with the most efficiency by 72.5% of patients obviated from liver biopsy. In patients with normal bilirubin and ALT < 2 × ULN, the area was 0.921 (0.860–0.982), and cutoffs for excluding and confirming diagnosis were 7.4 kPa and 10.6 kPa, respectively; 80% of patients could be classified with or without advanced fibrosis (AF). In patients with normal bilirubin and ALT ≥ 2 × ULN, the corresponding numbers were 0.885 (0.824–0.947), 7.5 kPa, 12.7 kPa and 79.2%, respectively.

Conclusions:  Inadequate sample study would underestimate the efficiency of TE on detecting advanced fibrosis. With ALT 2 × ULN stratified cutoffs, TE determined nearly 80% of patients with normal bilirubin as AF or non‐AF and obviated them from liver biopsies.
Is myomectomy always the best choice for infertile women with symptomatic uterine fibroids?
Authors: Tropeano Giovanna , Romano Domenico , Mascilini Floriana , Gaglione Raffaele , Amoroso Sonia , Scambia Giovanni
Published: March 2012

Uterine artery embolization (UAE) is still regarded by most gynaecologists as contraindicated for women with symptomatic fibroids and otherwise unexplained infertility. For such patients, myomectomy is the usual option. We performed UAE as treatment of menorrhagia in an infertile woman with multiple subserosal and intramural fibroids who had previously failed multiple myomectomy. UAE resulted in durable symptom relief and substantial reduction of the uterine and fibroid size. The patient conceived spontaneously 20 months after UAE and progressed through pregnancy uneventfully. At 38 weeks of gestation, she underwent elective cesarean section and delivered a normal, healthy, 3180‐g fetus without complications. The present case demonstrates that in symptomatic women with multiple subserosal and intramural fibroids and otherwise unexplained infertility, UAE may have symptomatic and reproductive outcomes superior to those of myomectomy.
Preoperative plasma fibrinogen, platelet count and prognosis in epithelial ovarian cancer
Authors: Qiu Jian , Yu Yanping , Fu Yunfeng , Ye Feng , Xie Xing , Lu Weiguo
Published: March 2012

Aim:  The aim of the present study was to investigate the correlation between fibrinogen level, platelet count and prognosis in patients with epithelial ovarian cancer (EOC).

Material and Methods:  Preoperative fibrinogen level and platelet count in 136 EOC patients and 146 patients with benign ovarian tumor, and their associations with clinicopathologic parameters and survival in EOC patients, were retrospectively analyzed.

Results:  The fibrinogen level in EOC was higher than that in benign patients (3.95 ± 1.37 g/L versus 2.88 ± 0.6 g/L, P < 0.001), and 36.0% (49/136) of EOC patients had hyperfibrinogenemia (fibrinogen >4.0 g/L). The platelet count in EOC was higher than that in benign patients (251.5 ± 89.4 × 109/L versus 206.7 ± 49.0 × 109/L P < 0.001), and 7.4% (10/136) of EOC patients had thrombocytosis (platelet count >400 × 109/L). Hyperfibrinogenemia was associated with International Federation of Gynecologists and Obstetricians (FIGO) stage, non‐optimal cytoreduction and poor chemo‐response, but not with histologic type and grade, CA‐125 level, chemotherapy method, and age. EOC patients with advanced disease showed higher rate of elevated thrombocyte count than patients with early disease (30.7% versus 8.3%, P = 0.002). The rate of thrombocytosis was higher in patients with hyperfibrinogenemia than in those with normal fibrinogen (9/10 versus 1/10, P < 0.001). A significant correlation between platelet count and fibrinogen level was observed in EOC patients (P < 0.001). In multivariate analysis, overall survival was influenced by tumor stage (P < 0.001), chemotherapy with taxane (P < 0.001) and fibrinogen level (P = 0.004), and disease‐free survival was only influenced by tumor stage (P < 0.001).

Conclusion:  Our findings suggest that hyperfibrinogenemia may be a predictor for poor chemo‐response and have a potential role as independent prognostic factors in EOC patients.
Large parasitic myomas in abdominal subcutaneous adipose tissue along a previous myomectomy scar
Authors: Yanazume Shintaro , Tsuji Takahiro , Yoshioka Takako , Yamasaki Hideki , Yoshinaga Mitsuhiro , Douchi Tsutomu
Published: March 2012

The incidence of iatrogenic parasitic uterine myomas associated with the use of a laparoscopic morcellator has been increasing over the past decade. Recently, we encountered a very rare case with a large parasitic myoma measuring 12 cm in diameter in the abdominal subcutaneous adipose tissue along an abdominal longitudinal surgical scar. The patient had twice undergone abdominal myomectomy for multiple fundal myomas. This is the first report describing a case with as large a parasitic myoma presenting in the suprafascial adipose tissue under the surgical scar after laparotomy. In such a case demonstrating a solid tumor of unknown cause after a gynecologic surgical procedure, a parasitic myoma must be included in the differential diagnosis.
Value of three‐dimensional contrast‐enhanced power Doppler ultrasound for characterizing adnexal masses
Authors: Huchon Cyrille , Metzger Ulrike , Bats Anne‐Sophie , Bensaid Cherazade , Chatellier Gilles , Azizi Michel , Lefrère‐Belda Marie‐Aude , Dujardin Arnaud , Bernard Jean‐Pierre , Lécuru Fabrice
Published: March 2012

Aims:  The aim of this study was to assess the diagnostic performance of 3‐D contrast‐enhanced power Doppler ultrasonography (3‐D CEPDUS) for differentiating benign and malignant adnexal masses.

Material and Methods:  Consecutive patients with adnexal masses were included prospectively and underwent 2‐D ultrasonography and 3‐D CEPDUS in a tertiary centre in Paris, France. The main outcome measure was the diagnostic accuracy of 3‐D CEPDUS to diagnose malignant and borderline adnexal masses. The reference standard was the final histological examination. Two‐dimensional ultrasonography and 3‐D CEPDUS were compared using semiquantitative scores. Three‐dimensional CEPDUS assessed vessel density, vessel pattern, and three vascular indexes in a 5‐mL region of interest (vascularization index [VI], flow index [FI], and vascularization flow index [VFI]). The 2‐D and 3‐D examinations were done by different sonographers who were blinded to the other test. The pathologist was blinded to ultrasonography findings.

Results:  Of 99 patients, 88 had benign tumors and were compared to the 11 patients with borderline (n = 5) or malignant (n = 6) tumors. The sensitivity of the subjective 2‐D score was 55% (95% confidence interval [CI], 25–84) and specificity 94% (95%CI, 89–99). The sensitivity of the subjective 3‐D score was 82% (95%CI, 58–100) and specificity 90% (95%CI, 83–96). Improvement of detection of malignant or borderline tumors by subjective 3‐D score was 150%. Vessel density and patterns were not more efficient than the subjective 3‐D score. The mean vascular index values were significantly different between benign and borderline/malignant groups: VI, 7.2 versus 35.5 (P < 0.0001); FI, 37.0 versus 48.2 (P = 0.003); and VFI, 2.9 versus 17.6 (P < 0.0001), respectively.

Conclusions:  3‐D CEPDUS improves detection of malignant and borderline adnexal masses.
External hemipelvectomy as treatment for solitary coxofemoral metastasis from endometrial carcinoma: Case report and review of the literature
Authors: Vizzielli Giuseppe , Fanfani Francesco , Costantini Barbara , Gallotta Valerio , Scambia Giovanni , Fagotti Anna
Published: March 2012

The best treatment for bone metastasis from endometrial cancer as a presenting feature is unclear. We report the first case in the literature of coxofemoral metastases from endometrial cancer treated by surgical approach. Then, after a careful review of the literature, we discuss the best therapeutic option for this subset of patients. A 62‐year‐old woman with pain, erythema and swelling of the left leg and no history of postmenopausal bleeding underwent biopsy of the leg, which revealed a moderately differentiated endometrial carcinoma, infiltrating muscle and adipose tissues. There were no other sites of distal spread. A literature review was conducted by searching the items ‘endometrial cancer’ and ‘bone metastasis’ in MEDLINE and EnBase up to September 2010. The patient was treated with neoadjuvant chemotherapy, but she did not show a clinical response. By considering her prognosis and quality of life, we decided to perform for the first time a total abdominal hysterectomy with bilateral salpingo‐oophorectomy in addition to an external hemipelvectomy with a limb amputation and partial ilium and pubic preservation. Thirty months after the procedure the patient is still alive. No other similar results are present in the literature. Patients in good clinical condition with a single bone metastasis of endometrial cancer should be treated aggressively with surgery, as survival can be extended with an acceptable quality of life.
Long‐term follow‐up after anterior sphincter repair: influence of age on functional outcome
Authors: Warner M. W. , Jones O. M. , Lindsey I. , Cunningham C. , Mortensen N. J.
Published: March 2012

Aim  Anterior sphincter repair has been advocated for women with anterior sphincter defects and faecal incontinence. There have been a number of reports of deterioration in functional outcome from anal sphincter repair over the long‐term and of inferior outcomes in older patients. This study set out to examine these issues in a specialist tertiary referral unit.

Method  Patients having a sphincter repair were identified from a prospectively collected database. The information within the database was expanded by the use of a postal questionnaire and structured review of the case notes. The questionnaire incorporated commonly used validated scoring systems as well as subjective questions.

Results  One hundred and thirteen patients were identified, of whom 66 (58%) responded. Of these patients, four had incomplete medical notes, leaving 62 (55%) with both returned questionnaires and complete medical notes. Forty‐eight (72%) patients reported subjective initial improvement in their symptoms, though only 37 (56%) believed themselves improved at long‐term follow‐up (median 8.8 years; range 1.1–13.6 years). Incontinence and quality of life scores mirrored these patients’ subjective responses. The median age of those patients reporting a subjective improvement at long‐term follow‐up was 38, compared with 56 in those who thought they were not improved (P < 0.001).

Conclusions  Outcome from anal sphincter repair deteriorates with time. Subjective outcome is worse in older patients who additionally tend to have worse incontinence scores and quality of life measures.
Functional analyses of the mutation nt‐128 T→G in the hepatocyte nuclear factor‐1α promoter region in Chinese diabetes pedigrees
Authors: Fang Q. , Chen S. , Wang Y. , Jiang S. , Zhang R. , Hu C. , Wang C. , Liu F. , Xiang K. , Jia W.
Published: March 2012

Aims  Hepatocyte nuclear factor‐1α (HNF‐1α) regulates the expression of genes encoding proteins involved in glucose metabolism and insulin secretion. Mutations in the HNF‐1α gene cause maturity‐onset diabetes of the young Type 3. However, the mechanism leading to this disease has not been completely ascertained. Previously, we found a novel mutation in the regulatory element of the human HNF‐1α gene in two Chinese diabetes pedigrees. The nucleotide at position ‐128 T was substituted by G (nt‐128 T→G). In this study, we analysed the functional defect of nt‐128 T→G in HNF‐1α transcription activity.

Methods  Luciferase reporter gene assays were carried out to examine the functional characteristics of this mutant. Electrophoretic mobility shift assays and chromatin immunoprecipitation were performed to confirm the binding of nuclear proteins to oligonucleotides.

Results  The variant construct (nt‐128 T→G) had a 1.65‐fold increase in promoter activity compared with that of the wild‐type construct in HepG2 cells and a 1.33‐fold increase in MIN6 cells, respectively. The variant resided at a FOXA/HNF‐3 binding site identified by a series of competitive electrophoretic mobility shift assays and antibody supershift analyses. The assays showed a differential binding affinity in the wild‐type and the nt‐128 T→G mutant fragments by FOXA/HNF‐3. Chromatin immunoprecipitation indicated that FOXA/HNF‐3 bound to this region in vivo. One nucleotide substitution in the FOXA/HNF‐3 site in the human HNF‐1α regulatory element caused an increase of HNF‐1α transcriptional activity.

Conclusions  Our data suggested that this substitution in the promoter region affects DNA–protein interaction and HNF‐1α gene transcription. The mutant may contribute to the development of diabetes in these two nt‐128 T→G pedigrees of Chinese.
Effectiveness of peer‐led self‐management coaching for patients recently diagnosed with Type 2 diabetes mellitus in primary care: a randomized controlled trial
Authors: van der Wulp I. , de Leeuw J. R. J. , Gorter K. J. , Rutten G. E. H. M.
Published: March 2012

Diabet. Med. 29, e390–e397 (2012)

Aims  To study the effectiveness of a peer‐led self‐management coaching intervention in recently diagnosed patients with Type 2 diabetes.

Methods  Randomized controlled trial of recently diagnosed patients with Type 2 diabetes from 54 participating general practices. The intervention group received three home visits by an experienced peer (expert patient) who adhered to the recommended treatment and lifestyle guidelines. Together with their expert patient, participants set feasible goals and these were evaluated in the next visit. Participants in the control group received care as usual. At baseline, 3 months and 6 months post‐intervention, participants completed a questionnaire measuring changes in self‐efficacy, coping, physical activity, dietary habits, psychological well‐being, depressive symptoms and diabetes related distress.

Results  In total, 327 patients were eligible for inclusion in the study of which 133 consented to participate. In participating patients, self‐efficacy, coping and saturated fat intake improved significantly over time. Analyses of participants with low self‐efficacy at baseline (25th percentile: 44) revealed a significant time × group difference, F = 3.71; P = 0.03. Participants who reported low psychological well‐being at baseline increased substantially throughout the study (F = 23.84; P < 0.01) but no significant time × group differences were found.

Conclusions  A peer‐led self‐management coaching programme for recently diagnosed patients with Type 2 diabetes improved self‐efficacy of patients experiencing low self‐efficacy shortly after diagnosis.
Diabetic retinopathy screening: perspectives of people with diabetes, screening intervals and costs of attending screening
Authors: Yeo S. T. , Edwards R. T. , Luzio S. D. , Charles J. M. , Thomas R. L. , Peters J. M. , Owens D. R.
Published: March 2012

Diabet. Med. 29, 878–885 (2012)

Aims  To obtain the views of people with diabetes about the provision of diabetic retinopathy screening services; and the interval of screening.

Methods  Between October 2009 and January 2010, people with diabetes attending diabetic retinopathy screening clinics across Wales were asked to complete a questionnaire comprising of two parts: the first asking about their health, diabetes history, demographic characteristics and views about the diabetic retinopathy screening service, and the second asking about the costs of attending the screening.

Results  The response rate was 40% (n = 621) from 1550 questionnaires distributed at diabetic retinopathy clinics, with 600 complete responses analysed. Respondents had a mean known duration of diabetes of 8.5 years (sd 7.8) and had attended for screening on average 3.2 times (sd 1.6) in the last 5 years. Sixty‐eight per cent (n = 408) of respondents reported having their eyes screened approximately once a year. Eighty‐five per cent (n = 507) felt that they should have their eyes screened every year. However, 65% (n = 390) of respondents would accept screening at 2‐ or 3‐year intervals if medical evidence showed that it was safe. The reported personal costs incurred by respondents attending diabetic retinopathy screening were low.

Conclusion  Our study suggests that people with diabetes undergoing diabetic retinopathy screening would accept a greater screening interval, provided that adequate clinical evidence and medical reassurance were given.
Prevalence of ketoacidosis at diagnosis of childhood onset Type 1 diabetes in Wales from 1991 to 2009 and effect of a publicity campaign
Authors: Lansdown A. J. , Barton J. , Warner J. , Williams D. , Gregory J. W. , Harvey J. N. , Lowes L. ,   on behalf of the Brecon Group
Published: March 2012

Diabet. Med. 29, 1506–1509 (2012)

Aims  To determine the proportion of cases of childhood Type 1 diabetes that present with ketoacidosis and any temporal trend. To assess the impact of a publicity campaign promoting earlier diagnosis.

Methods  We used an all‐Wales register of incident cases with data on 2046 children from 1991 to 2009. The proportion with ketoacidosis at diagnosis was compared with the Yorkshire Childhood Diabetes Register. On World Diabetes Day posters were sent to every pharmacy, school and general practitioner surgery across Wales and radio interviews given. A questionnaire survey was conducted in Gwent to assess penetrance of the campaign.

Results  Annually, in 1991–2009 the proportion presenting with ketoacidosis varied between 20% and 33% (mean 25%) with no change over time. Similar proportions occurred in Yorkshire. Ketoacidosis was more common before age 5 years (37% of cases) than at age 5–9 years (20%) or 10–14 years (23%) (P < 0.001). From November 2006–2007 30% of cases presented with ketoacidosis and from November 2007–2008 25% cases presented with ketoacidosis. After the campaign (November 2008–2009) 26% presented with ketoacidosis (P = 0.72). The information had reached a low proportion of families. General practitioners referred immediately cases that presented to them.

Conclusions  Over 20 years in Wales there has been no change in the proportion of children with Type 1 diabetes initially presenting with ketoacidosis. This presentation occurs in a higher proportion of new cases aged under 5 years. Publicity to increase awareness did not reduce the proportion with ketoacidosis at diagnosis in Wales. We need to get the educational message through to parents to reduce ketoacidosis at presentation.
Fasting plasma glucose 6–12 weeks after starting insulin glargine predicts likelihood of treatment success: a pooled analysis
Authors: Karl D. , Zhou R. , Vlajnic A. , Riddle M.
Published: March 2012

Diabet. Med. 29, 933–936 (2012)

Aims  To evaluate whether fasting plasma glucose values measured early during insulin therapy can identify patients with Type 2 diabetes who may not achieve adequate glycaemic control after 6 months and will require additional treatment.

Methods  Patient‐level data from seven prospective, randomized, controlled studies using treat‐to‐target methods were pooled to evaluate the efficacy of insulin glargine. Fasting plasma glucose was measured at baseline, week 6 or 8 (6/8) and week 12. HbA1c was measured at week 24 to assess glycaemic control.

Results  One thousand and thirty‐six patients (56% male, 81% white) were included in the analysis (mean age 56.3 years; duration of diabetes 8.4 years). Baseline mean fasting plasma glucose was 11.2 mmol/l and mean HbA1c was 73 mmol/mol (8.8%). After 24 weeks of treatment, mean HbA1c decreased to 53 mmol/mol (7.0%); 56% of patients reached a target HbA1c≤ 53 mmol/mol (7.0%). Significant correlations with week 24 HbA1c were obtained for fasting plasma glucose measured at week 6/8 and week 12 (r = 0.32; P < 0.0001 for both). Patients with fasting plasma glucose > 10 mmol/l at week 6/8 or week 12 were significantly less likely to achieve the HbA1c target at the end of treatment than patients with fasting plasma glucose < 8.9 mmol/l (P < 0.0001 for both). If fasting plasma glucose was > 10 mmol/l at week 6/8 or week 12, patients had only a 27% chance of reaching the HbA1c goal.

Conclusions  Fasting plasma glucose remaining > 10 mmol/l after 6–12 weeks of glargine therapy indicates that reaching target HbA1c≤ 53 mmol/mol (7.0%) is unlikely and calls for individualized attention to consider further therapeutic options.
The First Quarter Century of the GASB (1984–2009): A Perspective on Standard Setting (Part One)
Authors: ROYBARK HELEN M. , COFFMAN EDWARD N. , PREVITS GARY J.
Published: March 2012

The Governmental Accounting Standards Board (hereafter GASB or Board) was established in April 1984 as the authoritative accounting standard‐setting body for United States state and local governmental entities. There are over 87,000 state and local entities in the country, and for the most part these entities are required to comply with the generally accepted accounting principles established by the GASB; hence, the work of the GASB is significant.

On 30 June 2009, the GASB completed its twenty‐fifth year of standard setting. Because of the Board's influence and the importance of its mission, an increased understanding of the GASB and its accomplishments during its first 25 years of existence is important.

This is the first of two papers which together provide a complete sequential treatment of the GASB's operational history through the end of its first quarter century. This first paper begins with an historical perspective about municipal accounting issues from colonial times to 1934. The origin of professional self‐determining standards is the feature of the next section, identifying standard‐setting bodies that contributed to municipal accounting from 1934 to 1984. The early activities of the Board are then reviewed. Two appendices are provided to detail the composition of the Board during its first quarter century, along with biographical information about the early Board members and later Chair and Vice Chair personnel. This segment concludes with a review of the relationship of other governmental standard setting bodies at the federal level and the international level.
Benchmark Management During Australia's Transition to International Accounting Standards
Authors: BENTWOOD SOPHIE , LEE PHILIP
Published: March 2012

Practitioners and commentators have raised concerns that Australian companies exploited opportunities to benchmark manage during the transition to international financial reporting standards (IFRS). However, as yet, no paper has explored this possibility. This study analyses the reconciliations of AGAAP into AIFRS for 457 companies listed on the ASX 500. Results show that 16.85% of companies provided erroneous information of a material nature in their reconciliations and that, on the balance of probabilities, 5.03% of companies in the sample managed their prior year's earnings benchmarks. This has implications for countries considering whether to adopt IFRS and countries which have already established timetables for their transitions.
THE DEBATE ABOUT THE REVIVED BRETTON‐WOODS REGIME: A SURVEY AND EXTENSION OF THE LITERATURE
Authors: Hall Stephen G. , Tavlas George S.
Published: March 2012

This paper surveys the literature dealing with the thesis put forward by Dooley, Folkerts‐Landau and Garber (DFG) that the present constellation of global exchange‐rate arrangements constitutes a revived Bretton‐Woods regime. DFG also argue that the revived regime will be sustainable, despite its large global imbalances. While much of the literature generated by DFG's thesis points to specific differences between the earlier regime and revived regime that render the latter unstable, we argue that an underlying similarity between the two regimes renders the revived regime unstable. Specifically, to the extent that the present system constitutes a revived Bretton‐Woods system, it is vulnerable to the same set of destabilizing forces – including asset‐price bubbles and global financial crises – that marked the latter years of the earlier regime, leading to its breakdown. We extend the Markov switching model to examine the relation between global liquidity and commodity prices. We find an evidence of commodity‐price bubbles in both the latter stages of the earlier Bretton‐Woods regime and the revived regime.
The Ethical Deficit of the United Kingdom's Proposed Universal Credit: Pimping the Precariat?
Authors: DEAN HARTLEY
Published: March 2012

Universal Credit is a proposed means‐tested cash benefit scheme in the UK that will serve, inter alia, to top‐up the wages of low‐paid workers. This article will argue first, that the moral justification for the scheme that is offered by the UK government is specious; second that the reconfiguration of existing wage top‐ups may be counterproductive and will in any event do little, if anything, to promote the work ethic; third, that the new scheme will not relieve but add to the injustices borne by the ‘precariat’ (the workers engaged in low‐paid precarious employment); finally, that far from having a justifiable moral purpose, Universal Credit is ethically flawed.
The Media, the Peace Dividend and ‘Bread and Butter’ Politics
Authors: MCLAUGHLIN GREG , BAKER STEPHEN
Published: March 2012

In December 2007, Northern Ireland's newly elected First and Deputy First Ministers, Ian Paisley and Martin McGuinness, were pictured sitting happily together on a read leather sofa at the new IKEA superstore in Belfast. It was an image that served as a powerful symbol of the region's political transformation and economic optimism. Yet, within months of this photo opportunity, global financial crisis and economic recession shattered hopes that a meaningful, economic ‘peace dividend’ would underpin the new political dispensation. This article takes a critical look at the media's role in conflict transformation in Northern Ireland; how they projected new and more positive images of life in the region and chronicled the daily business of ‘bread and butter politics’. However, it also identifies chronic decline among some sections of the regional media, particularly Belfast's daily newspapers, just when they are needed to monitor and debate political decision‐making in a time of austerity.
Debating the ‘Stalemate’: A Response to Dr Dixon
Authors: BEW JOHN , FRAMPTON MARTYN
Published: March 2012

This article responds to the critique of our work offered by Paul Dixon in this issue of Political Quarterly. We correct the numerous inaccuracies and straightforward errors in his work, which, in our view, distort and misrepresent our arguments.
Nonlinear spectral density estimation: thresholding the correlogram
Authors: Paparoditis Efstathios , Politis Dimitris N.
Published: March 2012

Traditional kernel spectral density estimators are linear as a function of the sample autocovariance sequence. The purpose of this article is to propose and analyse two new spectral estimation methods that are based on the sample autocovariances in a nonlinear way. The rate of convergence of the new estimators is quantified, and practical issues such as bandwidth and/or threshold choice are addressed. The new estimators are also compared with traditional ones using flat‐top lag‐windows in a simulation experiment involving sparse time‐series models.
Measuring nonlinear dependence in time‐series, a distance correlation approach
Authors: Zhou Zhou
Published: March 2012

We extend the concept of distance correlation ofSzekelyet al.(2007)and propose the auto distance correlation function (ADCF) to measure the temporal dependence structure of time‐series. Unlike the classic measures of correlations such as the autocorrelation function, the proposed measure is zero if and only if the measured time‐series components are independent. In this article, we propose and theoretically verify a subsampling methodology for the inference of sample ADCF for dependent data. Our methodology provides a useful tool for exploring nonlinear dependence structures in time‐series.
A similarity‐based approach to time‐varying coefficient non‐stationary autoregression
Authors: Lieberman Offer
Published: March 2012

We suggest in this article a similarity‐based approach to time‐varying coefficient non‐stationary autoregression. In a given sample, the model can display characteristics consistent with stationary, unit root and explosive behaviour, depending on the similarity between the dependent variable and its past values. We establish consistency of the quasi‐maximum likelihood estimator of the model, with a general norming factor. Asymptotic score‐based hypothesis tests are derived. The model is applied to a data set comprised of dual stocks traded in NASDAQ and the Tokyo Stock Exchange.
Nuclear and mitochondrial DNA reveals significant intraspecific genetic differentiation of tokay gecko in southern China and northern Vietnam
Authors: Wang G. , Peng Q. , Wu L. , Wang T. , Peng R. , Li L. , Zeng X. , Zou F.
Published: March 2012

The common tokay gecko (Gekko gecko gecko) is widely distributed across southern China, Vietnam and other countries in Southeast Asia. It includes two distinct morphological forms with largely allopatric distributions, which are referred to as the black‐spotted tokay and the red‐spotted tokay. Considering their different morphological features and distributions, a question has been proposed by taxonomists and still not resolved: do these two forms belong to one subspecies? Previous studies indicated a high genetic variability between them, but did not give a consistent conclusion regarding their taxonomic status. In this work, we employed two mitochondrial genes (cytochrome c oxidase subunit I and cytochrome b) and nine microsatellite DNA loci to explore the phylogenetic relationship and population genetic structure in the two forms from southern China and northern Vietnam. MtDNA results revealed four deeply divergent lineages. Red‐spotted tokays were clustered into one lineage, and black‐spotted tokays were clustered into three lineages. Microsatellite DNA results confirmed significant levels of genetic differentiation between the red‐spotted tokay lineage and one black‐spotted tokay lineage, consistent with the mtDNA pattern. In conclusion, considering both morphological and genetic information, we suggest that the red‐spotted tokay lineage and one of the black‐spotted tokay lineages have probably differentiated into two subspecies. However, more extensive sampling and genetic information are needed to further understand the taxonomic relationships of tokay gecko, particularly the three lineages within the black‐spotted tokay.
Ambulatory activity of children with cerebral palsy: which characteristics are important?
Authors: VAN WELY LEONTIEN , BECHER JULES G , BALEMANS ASTRID C J , DALLMEIJER ANNET J
Published: March 2012

Aim  To assess ambulatory activity of children with cerebral palsy (CP), aged 7 to 13 years, and identify associated characteristics.

Method  Sixty‐two children with spastic CP (39 males, 23 females; mean age 10y 1mo, SD 1y 8mo; age range 7–13y), classified as Gross Motor Function Classification System (GMFCS) levels I to III, participated. Ambulatory activity was measured during 1 week with a StepWatch activity monitor as steps per day, and time spent at medium and high step rates. Multiple linear regression analyses were performed following a backward selection procedure until only independent variables with p<0.05 remained in the model. Ambulatory activity outcome parameters served as dependent variables, and disease, personal, and environmental characteristics as independent variables. Ambulatory activity was corrected for body height.

Results  Children took more steps during school days (5169 steps, SD 1641) than during weekend days (4158 steps, SD 2048; p<0.001). Higher GMFCS level, bilateral CP, and higher age were associated with lower ambulatory activity on school days (R2 ranged from 43–53%), whereas bilateral CP, higher age, and no sport club participation were associated with lower ambulatory activity in the weekend (R2 ranged from 21–42%). Correcting for body height decreased the association with age.

Interpretation  Interventions should focus at increasing physical activity at the weekend for children with bilateral spastic CP.
A new peculiar dinosaur egg, Sankofa pyrenaica oogen. nov. oosp. nov. from the Upper Cretaceous coastal deposits of the Aren Formation, south‐central Pyrenees, Lleida, Catalonia, Spain
Authors: LÓPEZ‐MARTÍNEZ NIEVES , VICENS ENRIC
Published: March 2012

Abstract:  A new type of small, ovoid dinosaur egg, Sankofa pyrenaica oogen. nov. oosp. nov., with a prismatic type eggshell is described from upper Cretaceous (upper Campanian–Maastrichtian) deposits of the Montsec area, South Pyrenean Central Unit, Lleida, Catalonia, Spain. This egg type was sub‐vertically laid in only two rich monospecific sites of a single stratigraphic layer from coastal deposits of the Aren Formation, interpreted as an emerged beach ridge of a barrier island – lagoon depositional system. The size and shape of these eggs with their asymmetric poles are roughly similar to modern hen eggs, which is unusual in the Cretaceous fossil egg record. Its phylogenetic position clusters with bird and Troodontid eggs. A morphospace analysis of egg shapes shows the similarity of the new egg to a Campanian fossil bird egg from Argentina, both being intermediate between modern‐bird eggs and extinct nonavian theropod eggs. However, the eggshell microstructure of Sankofa pyrenaica differs from that of bird eggs in its incipient squamatic texture. It has a peculiar pattern of interlocking small crystals in the middle of the palisade layer, instead of the thick squamatic structure commonly present in modern avian eggshells. This new egg type is attributed to a small theropod, probably with a single oviduct like birds and whose mosaic distribution of features is a combination between that of birds and nonavian theropods. This enhances the arguments supporting the close phylogenetic relationships between both groups.
Weight gain in pregnancy: a survey of current practices in a teaching hospital
Authors: Stewart Zoe A. , Wallace Euan , Allan Carolyn
Published: March 2012

One hundred and three obstetric and midwifery staff at a university teaching hospital were surveyed about knowledge and practices with regard to counselling women about appropriate gestational weight gain. Seventy‐seven percent of staff reported advising women about weight gain in pregnancy under some circumstances, but only 22% set specific weight or weight gain targets. Seventy‐nine percent of staff considered their training in this aspect of antenatal care to be inadequate. Further education and support of medical and nursing staff are needed to ensure guidelines for weight management in pregnancy are optimally implemented.
Knowledge of abortion law and provision of abortion services amongst tertiary students in Far North Queensland
Authors: Phillips Tegan , Eltherington Jessica , de Costa Caroline , Woods Cindy
Published: March 2012

Abortion is an important health issue for Australian women, yet there are large variations across Australia in abortion service provision and in state laws regulating abortion practice. We conducted a survey of tertiary students in Far North Queensland to ascertain their knowledge of local abortion services and of abortion law in Queensland. Important gaps were demonstrated in their knowledge of the law and of the availability of abortion services.
Carvedilol Attenuates the Progression of Alcohol Fatty Liver Disease in Rats
Authors: Liu Jinyao , Takase Izumi , Hakucho Ayako , Okamura Nanako , Fujimiya Tatsuya
Published: March 2012

Background

Hepatosteatosis is an essential step in liver disease progression. However, the mechanisms that mediate the progression of hepatosteatosis and the optimal inhibitor of them remain largely unclear. The sympathetic nervous system (SNS) is responsible for the lipid metabolism and the accumulation of collagen that occurs in an injured liver. Medicines that inhibit this pathway may be a relevant treatment for the hepatosteatosis, and then reduce the liver injury that progresses through the stage of steatosis to fibrosis.

Methods

Using an ethanol‐liquid‐diet‐fed rat model of alcohol fatty liver disease (AFLD), we studied the effects of carvedilol, which can block the SNS completely via β1, β2, and α1 adrenergic receptors, on the sympathetic tone, hepatosteatosis, and fibrosis based on histological, immunohistochemical, Western blot, and reverse transcriptase polymerase chain reaction analyses.

Results

Carvedilol inhibited the ethanol‐induced whole‐body and hepatic sympathetic activities based on the serum 3‐methoxy‐4‐hydroxyphenylglycol level and hepatic tyrosine hydroxylase expression. Carvedilol attenuated the hepatosteatosis, as evidenced by reduced hepatic triglyceride level and the accumulation of fatty droplets within hepatocytes, down‐regulated fatty acid synthase and sterol regulatory element binding protein‐1, and up‐regulated peroxisome proliferator‐activated receptor‐α. No fibrosis signs were shown in our rat model. Carvedilol inhibited ethanol‐induced the thickening of zone 3 vessel walls, reduced the activation of hepatic stellate cells (HSCs), and decreased the induction of collagen, transforming growth factor β1, and tissue inhibitor of metalloproteinases‐1. Tumor necrosis factor α (TNF‐α) was expressed on the activated HSCs and inhibited by carvedilol based on the immunohistochemical double staining analysis.

Conclusions

Ethanol metabolism‐induced lipogenesis may trigger the SNS‐activated HSCs feedback loop, and then induct the activated HSCs and the activated HSCs–derived TNF‐α, the mediator of lipogenesis, overproduction. Carvedilol may block this feedback loop via antisympathetic activity and demonstrate its preventive role on the development of hepatosteatosis in rat with AFLD.
Concepts for Designing and Fabricating Metal Implant Frameworks for Hybrid Implant Prostheses
Authors: Drago Carl , Howell Kent
Published: March 2012

Edentulous patients have reported difficulties in managing complete dentures; they have also reported functional concerns and higher expectations regarding complete dentures than the dentists who have treated them. Some of the objectives of definitive fixed implant prosthodontic care include predictable, long‐term prostheses, improved function, and maintenance of alveolar bone. One of the keys to long‐term clinical success is the design and fabrication of metal frameworks that support implant prostheses. Multiple, diverse methods have been reported regarding framework design in implant prosthodontics. Original designs were developed empirically, without the benefit of laboratory testing. Prosthetic complications reported after occlusal loading included screw loosening, screw fracture, prosthesis fracture, crestal bone loss around implants, and implant loss. Numerous authors promoted accurately fitting frameworks; however, it has been noted that metal frameworks do not fit accurately. Passively fitting metal implant frameworks and implants have not been realized. Biologic consequences of ill‐fitting frameworks were not well understood. Basic engineering principles were then incorporated into implant framework designs; however, laboratory testing was lacking. It has been reported that I‐ and L‐beam designs were the best clinical option. With the advent of CAD/CAM protocols, milled titanium frameworks became quite popular in implant prosthodontics. The purpose of this article is to discuss current and past literature regarding implant‐retained frameworks for full‐arch, hybrid restorations. Benefits, limitations, and complications associated with this type of prosthesis will be reviewed. This discussion will include the relative inaccuracy of casting/implant fit and improved accuracy noted with CAD/CAM framework/implant fit; cantilever extensions relative to the A/P implant spread; and mechanical properties associated with implant frameworks including I‐ and L‐beam designs. Guidelines will be proposed for use by clinicians and laboratory technicians in designing implant‐retained frameworks.
Creating Customer Value in Participating Life Insurance
Authors: Gatzert Nadine , Holzmüller Ines , Schmeiser Hato
Published: March 2012

Abstract

The value of a life insurance contract may differ depending on whether it is looked at from the customer's point of view or that of the insurance company. We assume that the insurer is able to replicate the life insurance contract's cash flows via assets traded on the capital market and can hence apply risk‐neutral valuation techniques. The policyholder, on the other hand, will take risk preferences and diversification opportunities into account when placing a value on that same contract. Customer value is represented by policyholder willingness to pay and depends on the contract parameters, that is, the guaranteed interest rate and the annual and terminal surplus participation rate. The aim of this article is to analyze and compare these two perspectives. In particular, we identify contract parameter combinations that—while keeping the contract value fixed for the insurer—maximize customer value. In addition, we derive explicit expressions for a selection of specific cases. Our results suggest that a customer segmentation in this sense, that is, based on the different ways customers evaluate life insurance contracts and embedded investment guarantees while ensuring fair values, is worthwhile for insurance companies as doing so can result in substantial increases in policyholder willingness to pay.
In the Wake of the Spill: Environmental Views Along the Gulf Coast
Authors: Hamilton Lawrence C. , Safford Thomas G. , Ulrich Jessica D.
Published: March 2012

Objectives

We analyze patterns in environmental views of Gulf Coast residents, in the wake of the 2010 oil spill. To what extent do spill‐related and other environmental views vary with individual characteristics, personal experience with the spill, or characteristics of place?

Methods

About 2,000 residents of selected coastal regions in Louisiana and Florida were interviewed by telephone in late summer 2010.

Results

One‐quarter of the respondents said that their environmental views had changed as a result of the spill. Despite reporting more change, more spill effects, and greater threats from climate‐induced sea‐level rise, Louisiana respondents were less likely to support a deepwater moratorium, alternative energy, or resource conservation.

Conclusions

Results are consistent with real effects from the spill. Differences between Louisiana and Florida respondents are not explained by spill effects or individual characteristics, however. The patterns reflect biophysical differences of the coastlines that shaped their socioeconomic development.
Structural and Spectroscopic Studies of Hydroxyapatite Nanorods  Formed via Microwave‐Assisted Synthesis Route
Authors: Mishra Vijay K. , Srivastava Sunil K. , Asthana Birendra P. , Kumar Devendra
Published: March 2012

In the present investigation Hydroxyapatite [Ca10(PO4)6(OH)2:(HAp)] nanorods were synthesized using microwave irradiation technique taking ethylene diamine tetra‐acetic acid as a complexing reagent. Hydroxyapatite precursor obtained using microwave irradiation was subjected to differential thermal analysis. Later it was calcined in the temperature range 450°C–900°C. The crystal, grain, and bonding structures of resulting HAp were characterized structurally using X‐ray diffraction and scanning electron microscopy (SEM) techniques and spectroscopically using Fourier transform infrared (FT‐IR) and Raman techniques. The structural and spectroscopic characterizations of precursor revealed the formation of hydrated HAp. SEM images of the specimens calcined at 600°C and 900°C are presented. This study clearly reveals that nanorods are not formed below 700°C and nanorods are formed only after heat treatment of HAp precursor at 700°C and above. The diameter of nanorods was estimated to be ~200 nm. No nanostructures were found to be formed if the precursor is calcined below 700°C. FT‐IR and Raman spectra of HAp samples obtained after calcinations at 700°C and above further confirm the formation of HAp nanorods.
Nano‐Hafnium Diboride Powders Synthesized Using a Spark Plasma Sintering Apparatus
Authors: Wang Hailong , Lee Sea‐Hoon , Kim Hai‐Doo
Published: March 2012

Nano‐hafnium diboride powder was synthesized by boro/carborthermal reduction process of HfO2 using a spark plasma sintering (SPS) apparatus. The agglomerated product was found to be 1–2 μm in size, which was composed with small primary particles of 100–200 nm in size. The particle size of HfO2 played an important role to produce the nano‐boride powder. In addition, the grain growth of HfB2 could be effectively suppressed by using SPS due to the fast heating rate. The synthesized powder had a low oxygen content (~0.66 wt%). Excessive B4C and C were necessary during the boro/carborthermal reduction in HfO2 process because of the volatilization of boron as a form of B2O3 and the reduction in residual HfO2.
High Ki‐67 expression in diffuse large B‐cell lymphoma patients with non‐germinal center subtype indicates limited survival benefit from R‐CHOP therapy
Authors: Li Zhi‐Ming , Huang Jia‐Jia , Xia Yi , Zhu Ying‐Jie , Zhao Wei , Wei Wen‐Xiao , Jiang Wen‐Qi , Lin Tong‐Yu , Huang Hui‐Qiang , Guan Zhong‐Zhen
Published: March 2012

Objectives:  Rituximab has significantly improved the survival of patients with DLBCL, especially those with non‐germinal center B‐cell‐like (non‐GCB) subtype. The impact of Ki‐67 expression, an index of proliferation, on the clinical outcomes of patients with DLBCL has largely been unexplored. This study aimed to investigate whether Ki‐67 expression is an indicator of outcome in DLBCL patients (especially non‐GCB DLBCL patients) treated with standard chemotherapy combined with rituximab.

Methods:  Expression of Ki‐67 protein was examined immunohistochemically in 118 tumor specimens from patients newly diagnosed with DLBCL and treated with R‐CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone).

Results:  Overall survival (OS) and progression‐free survival (PFS) were lower in patients with high Ki‐67 expression than in those with low Ki‐67 expression (3‐year OS: 65.2% vs. 81.7%, P = 0.030; 3‐year PFS: 56.4% vs. 73.3%, P = 0.020), similar in patients with GCB subtype and those with the non‐GCB subtype (OS: P = 0.330; PFS: P = 0.287). According to Ki‐67 expression status by immunophenotype subgroups, patients with high Ki‐67 expression in non‐GCB subgroup had the most unfavorable PFS and OS, comparing with the other three subgroups (P = 0.004 and P = 0.002, respectively). In multivariate analysis, non‐GCB with high Ki‐67 expression was an independent prognostic predictor of inferior survival in DLBCL patients treated with R‐CHOP.

Conclusion:  For DLBCL patients with non‐GCB DLBCL and high Ki‐67 expression, the survival benefit from R‐CHOP therapy is limited.