bluuebunny/crossref_metadata_2025 huggingface dataset:
SimpleFlow: A Non‐iterative, Sublinear Optical Flow Algorithm
Authors: Tao Michael , Bai Jiamin , Kohli Pushmeet , Paris Sylvain
Published: June 2012

Optical flow is a critical component of video editing applications, e.g. for tasks such as object tracking, segmentation, and selection. In this paper, we propose an optical flow algorithm called SimpleFlow whose running times increase sublinearly in the number of pixels. Central to our approach is a probabilistic representation of the motion flow that is computed using only local evidence and without resorting to global optimization. To estimate the flow in image regions where the motion is smooth, we use a sparse set of samples only, thereby avoiding the expensive computation inherent in traditional dense algorithms. We show that our results can be used as is for a variety of video editing tasks. For applications where accuracy is paramount, we use our result to bootstrap a global optimization. This significantly reduces the running times of such methods without sacrificing accuracy. We also demonstrate that the SimpleFlow algorithm can process HD and 4K footage in reasonable times.
Rasterized Bounding Volume Hierarchies
Authors: Novák Jan , Dachsbacher Carsten
Published: June 2012

We present the rasterized bounding volume hierarchy (RBVH), a compact data structure that accelerates approximate ray casting of complex meshes and provides adjustable level of detail. During construction, we identify subtrees of BVHs containing surfaces that can be represented by height fields. For these subtrees the conventional ray‐surface intersection, which possibly involves a large number of triangles, is replaced by a simple ray marching procedure to find the intersection with the surface. We describe GPU algorithms for construction, ray casting, and data querying of the RBVH that achieve comparable or higher performance than state of the art acceleration structures for triangle meshes. Moreover, RBVHs provide an inherent surface parameterization for storing data on the surfaces and natively handle triangle and point‐based surface representations. We also show that RBVHs support adaptive level‐of‐detail and can be combined with traditional BVHs to handle complex scenes.
Practical Spectral Photography
Authors: Habel Ralf , Kudenov Michael , Wimmer Michael
Published: June 2012

We introduce a low‐cost and compact spectral imaging camera design based on unmodified consumer cameras and a custom camera objective. The device can be used in a high‐resolution configuration that measures the spectrum of a column of an imaged scene with up to 0.8 nm spectral resolution, rivalling commercial non‐imaging spectrometers, and a mid‐resolution hyper spectral mode that allows the spectral measurement of a whole image, with up to 5 nm spectral resolution and 120×120 spatial resolution. We develop the necessary calibration methods based on halogen/fluorescent lamps and laser pointers to acquire all necessary information about the optical system. We also derive the mathematical methods to interpret and reconstruct spectra directly from the Bayer array images of a standard RGGB camera. This objective design introduces accurate spectral remote sensing to computational photography, with numerous applications in color theory, colorimetry, vision and rendering, making the acquisition of a spectral image as simple as taking a high‐dynamic‐range image.
Data‐Driven Estimation of Cloth Simulation Models
Authors: Miguel E. , Bradley D. , Thomaszewski B. , Bickel B. , Matusik W. , Otaduy M. A. , Marschner S.
Published: June 2012

Progress in cloth simulation for computer animation and apparel design has led to a multitude of deformation models, each with its own way of relating geometry, deformation, and forces. As simulators improve, differences between these models become more important, but it is difficult to choose a model and a set of parameters to match a given real material simply by looking at simulation results. This paper provides measurement and fitting methods that allow nonlinear models to be fit to the observed deformation of a particular cloth sample. Unlike standard textile testing, our system measures complex 3D deformations of a sheet of cloth, not just one‐dimensional force‐displacement curves, so it works under a wider range of deformation conditions. The fitted models are then evaluated by comparison to measured deformations with motions very different from those used for fitting.
Automatically Rigging Multi‐component Characters
Authors: Bharaj Gaurav , Thormählen Thorsten , Seidel Hans‐Peter , Theobalt Christian
Published: June 2012

Rigging an arbitrary 3D character by creating an animation skeleton is a time‐consuming process even for experienced animators. In this paper, we present an algorithm that automatically creates animation rigs for multi‐component 3D models, as they are typically found in online shape databases. Our algorithm takes as input a multi‐component model and an input animation skeleton with associated motion data. It then creates a target skeleton for the input model, calculates the rigid skinning weights, and a mapping between the joints of the target skeleton and the input animation skeleton. The automatic approach does not need additional semantic information, such as component labels or user‐provided correspondences, and succeeds on a wide range of models where the number of components is significantly different. It implicitly handles large scale and proportional differences between input and target skeletons and can deal with certain morphological differences, e.g., if input and target have different numbers of limbs. The output of our algorithm can be directly used in a retargeting system to create a plausible animated character.
Rationalization of Triangle‐Based Point‐Folding Structures
Authors: Zimmer Henrik , Campen Marcel , Bommes David , Kobbelt Leif
Published: June 2012

In mechanical engineering and architecture, structural elements with low material consumption and high load‐bearing capabilities are essential for light‐weight and even self‐supporting constructions. This paper deals with so called point‐folding elements – non‐planar, pyramidal panels, usually formed from thin metal sheets, which exploit the increased structural capabilities emerging from folds or creases. Given a triangulated free‐form surface, a corresponding point‐folding structure is a collection of pyramidal elements basing on the triangles. User‐specified or material‐induced geometric constraints often imply that each individual folding element has a different shape, leading to immense fabrication costs. We present a rationalization method for such structures which respects the prescribed aesthetic and production constraints and finds a minimal set of molds for the production process, leading to drastically reduced costs. For each base triangle we compute and parametrize the range of feasible folding elements that satisfy the given constraints within the allowed tolerances. Then we pose the rationalization task as a geometric intersection problem, which we solve so as to maximize the re‐use of mold dies. Major challenges arise from the high precision requirements and the non‐trivial parametrization of the search space. We evaluate our method on a number of practical examples where we achieve rationalization gains of more than 90%.
Exploring Shape Variations by 3D‐Model Decomposition and Part‐based Recombination
Authors: Jain Arjun , Thormählen Thorsten , Ritschel Tobias , Seidel Hans‐Peter
Published: June 2012

We present a system that allows new shapes to be created by blending between shapes taken from a database. We treat the shape as a composition of parts; blending is performed by recombining parts from different shapes according to constraints deduced by shape analysis. The analysis involves shape segmentation, contact analysis, and symmetry detection. The system can be used to rapidly instantiate new models that have similar symmetry and adjacency structure to the database shapes, yet vary in appearance.
Linear Analysis of Nonlinear Constraints for Interactive Geometric Modeling
Authors: Habbecke Martin , Kobbelt Leif
Published: June 2012

Thanks to its flexibility and power to handle even complex geometric relations, 3D geometric modeling with nonlinear constraints is an attractive extension of traditional shape editing approaches. However, existing approaches to analyze and solve constraint systems usually fail to meet the two main challenges of an interactive 3D modeling system: For each atomic editing operation, it is crucial to adjust as few auxiliary vertices as possible in order to not destroy the user's earlier editing effort. Furthermore, the whole constraint resolution pipeline is required to run in real‐time to enable a fluent, interactive workflow. To address both issues, we propose a novel constraint analysis and solution scheme based on a key observation: While the computation of actual vertex positions requires nonlinear techniques, under few simplifying assumptions the determination of the minimal set of to‐be‐updated vertices can be performed on a linearization of the constraint functions. Posing the constraint analysis phase as the solution of an under‐determined linear system with as few non‐zero elements as possible enables us to exploit an efficient strategy for the Cardinality Minimization problem known from the field of Compressed Sensing, resulting in an algorithm capable of handling hundreds of vertices and constraints in real‐time. We demonstrate at the example of an image‐based modeling system for architectural models that this approach performs very well in practical applications.
Signal Pattern Recognition for Damage Diagnosis in Structures
Authors: Qiao Long , Esmaeily Asad , Melhem Hani G.
Published: June 2012

Abstract:  A signal‐based pattern‐recognition approach is used for structural damage diagnosis with a single or limited number of input/output signals. The approach is based on extraction of the features of the structural response that present a unique pattern for each specific damage case. In this study, frequency‐based features and time–frequency‐based features were extracted from measured vibration signals by Fast Fourier Transform (FFT) and continuous wavelet transform (CWT) to form one‐dimensional or two‐dimensional patterns, respectively. Three pattern‐matching algorithms including correlation, least‐square distance, and Cosh spectral distance were investigated for pattern matching. To demonstrate the validity of the approach, numerical and experimental studies were conducted on a simple three‐story steel building. Results showed that features of the signal for different damage scenarios could be uniquely identified by these transformations, and suitable correlation algorithms could perform pattern matching that identified both damage location and damage severity. Meanwhile, statistical issues for more complex structures as well as the choice of wavelet functions are discussed.
D. Z. Phillips on God and Evil
Authors: Davies Brian
Published: June 2012

This paper notes and discusses some key arguments in Part One of The Problem of Evil and the Problem of God by D. Z. Phillips. With an eye on some texts of Thomas Aquinas, I reject Phillips's view that belief in divine omnipotence leads to absurd claims concerning God, but I defend his rejection of anthropomorphism when it comes to talk of God, and, with qualifications, I defend and elaborate on his suggestion that God is not a moral agent. I also commend his critique of certain well‐known theodicies (e.g. that provided by Richard Swinburne), although I challenge his appeal to what he calls “the grammar of God.”
A spatially explicit assessment of within‐season changes in environmental suitability for farmland birds along an altitudinal gradient
Authors: Brambilla M. , Falco R. , Negri I.
Published: June 2012

The intra‐seasonal adjustment in site selection, and hence in distribution of multi‐brooded avian species, is a poorly investigated topic of potentially high relevance for conservation. This phenomenon may be especially important among multi‐brooded species occurring in habitats undergoing large modifications. We used correlative species distribution models to carry out a spatially explicit assessment of variation in habitat suitability between early and late periods of the breeding season for four European farmland passerine species (woodlark Lullula arborea, skylark Alauda arvensis, cirl Emberiza cirlus and corn bunting E. calandra). We counted birds at transects (surveyed in early and late season) in Northern Apennines (Lombardy, Italy), and modelled their spatial distribution with MaxEnt, separately for early and late season periods. A comparison of predicted environmental suitability (ES) at occurrence sites showed significant differences between early and late period ES at both early and late occurrence sites. Three species showed differences in elevation between early and late occurrence sites. The proportion of 1‐ha cells predicted as potentially suitable during the entire breeding season ranged from 29.3% (corn bunting) to 52.8% (woodlark) of the at least once suitable cells. In multi‐brooded birds, a dynamic pattern of species occurrence may be likely and particularly important in farmland habitats along altitudinal gradients. The resulting within‐season switches in habitat and distribution could be widespread among farmland birds and could have critical implications for their conservation. Moreover, such habitat switches provide an additional reason for preserving habitat heterogeneity. The intra‐seasonal variation in habitat association/distribution should become a focal topic for researchers.
Effects of matrix composition and configuration on forest bird movements in a fragmented Afromontane biodiversity hot spot
Authors: Aben J. , Adriaensen F. , Thijs K. W. , Pellikka P. , Siljander M. , Lens L. , Matthysen E.
Published: June 2012

Persistence of forest‐dependent species in fragmented landscapes strongly relies on sufficient dispersal between patches, making it important to understand how animal movements are affected by the intervening matrix. Movements can be influenced through selection or avoidance of land cover based on their perceived suitability for foraging or providing cover. The composition and configuration of the matrix will, therefore, most likely be an important factor to consider when estimating connectivity between patches. To address this, we performed translocation experiments to understand how forest birds used different land cover types in a fine‐grained matrix of a fragmented Afromontane biodiversity hot spot (Taita Hills, Kenya). Our results revealed that use of land cover types for both the forest specialist Cabanis's greenbul Phyllastrephus cabanisi and for the forest generalist white‐starred robin Pogonocichla stellata was disproportional to their availability. However, this effect was influenced by matrix configuration; in patchy matrices, land cover selection was more pronounced compared with more uniform matrices, especially for the forest specialist. At the scale of movement steps, risk avoidance seemed to be a strong factor in the route decisions for both species. Observed steps contained on average lower proportions of open land cover and did less frequently intersect built‐up areas than expected. P. stellata did not differentiate between the alternative land cover types, whereas P. cabanisi preferred steps that contained more indigenous forest. The observed negative relationship between degree of forest dependency and matrix permeability implies that for members of the Taita bird community, which are even more dependent on intact forest habitat (i.e. the critically endangered Taita thrush Turdus helleri), current permeability of the matrix may be even lower. Matrix restoration to improve connectivity may, therefore, be a crucial instrument for the long‐term survival of forest‐dependent species in these fragmented Afromontane landscapes.
Defining the normal acetabular vault in adult males and females using a novel three‐dimensional model
Authors: Barsoum Wael K. , Smith Travis , Buller Leonard , Klika Alison , Mavroudis Constantine , Bryan Jason
Published: June 2012

The management and quantification of bone loss is a major challenge in primary and revision total hip replacement. Defining the normal three‐dimensional (3D) anatomy of the acetabular vault could aid in assessing pathologic changes and in designing prosthetic joint components. We performed a quantitative assessment of normal 3D acetabular vault structure to define the shape and location of weight‐bearing acetabular bone referred to as the vault. Images from 70 normal hip computed tomography images were used to define the 3D acetabular vault anatomy and develop a 3D model. Variation in vault shape was quantified by measuring the distance between every surface point on a subject’s hemipelvis and the reference vault. Variation among different hip alignments was assessed using 19 scans from subjects with varus, valgus and dysplastic hip morphologies. The acetabular vault model had 96.6% (95% CI: 91.7–101.5), 97.8% (95% CI: 94.5–101.1) and 96.4% (95% CI: 98.7–94.1) of the surface points within 3 mm of normal male, normal female and abnormal hip specimens, respectively. Comparison of acetabular vault model fit between gender and hip types revealed that it was only significantly different between normal males and normal females (P = 0.0194) and between normal males and dysplastic females (P = 0.0377). A conserved 3D acetabular vault shape and location exists that can accommodate various hip morphologies. Defining a normal vault may increase the precision with which hip pathology can be identified and may also serve as a preoperative assessment tool for planning total hip arthroplasty.
Randomized controlled double‐blind trial of optimal dose methylphenidate in children and adolescents with severe attention deficit hyperactivity disorder and intellectual disability
Authors: Simonoff Emily , Taylor Eric , Baird Gillian , Bernard Sarah , Chadwick Oliver , Liang Holan , Whitwell Susannah , Riemer Kirsten , Sharma Kishan , Sharma Santvana Pandey , Wood Nicky , Kelly Joanna , Golaszewski Ania , Kennedy Juliet , Rodney Lydia , West Nicole , Walwyn Rebecca , Jichi Fatima
Published: June 2012

Background:  Attention deficit hyperactivity disorder is increased in children with intellectual disability. Previous research has suggested stimulants are less effective than in typically developing children but no studies have titrated medication for individual optimal dosing or tested the effects for longer than 4 weeks.

Method:  One hundred and twenty two drug‐free children aged 7–15 with hyperkinetic disorder and IQ 30–69 were recruited to a double‐blind, placebo‐controlled trial that randomized participants using minimization by probability, stratified by referral source and IQ level in a one to one ratio. Methylphenidate was compared with placebo. Dose titration comprised at least 1 week each of low (0.5 mg/kg/day), medium (1.0 mg/kg/day) and high dose (1.5 mg/kg/day). Parent and teacher Attention deficit hyperactivity disorder (ADHD) index of the Conners Rating Scale‐Short Version at 16 weeks provided the primary outcome measures. Clinical response was determined with the Clinical Global Impressions scale (CGI‐I). Adverse effects were evaluated by a parent‐rated questionnaire, weight, pulse and blood pressure. Analyses were by intention to treat. Trial registration: ISRCTN 68384912.

Results:  Methylphenidate was superior to placebo with effect sizes of 0.39 [95% confidence intervals (CIs) 0.09, 0.70] and 0.52 (95% CIs 0.23, 0.82) for the parent and teacher Conners ADHD index. Four (7%) children on placebo versus 24 (40%) of those on methylphenidate were judged improved or much improved on the CGI. IQ and autistic symptoms did not affect treatment efficacy. Active medication was associated with sleep difficulty, loss of appetite and weight loss but there were no significant differences in pulse or blood pressure.

Conclusions:  Optimal dosing of methylphenidate is practical and effective in some children with hyperkinetic disorder and intellectual disability. Adverse effects typical of methylphenidate were seen and medication use may require close monitoring in this vulnerable group.
The effect of maternal characteristics and gestational diabetes on birthweight
Authors: Makgoba M , Savvidou MD , Steer PJ
Published: June 2012

Please cite this paper as: Makgoba M, Savvidou MD, Steer PJ. The effect of maternal characteristics and gestational diabetes on birthweight. BJOG 2012;119:1191–1197.

Objective  To examine the effect of maternal characteristics, including advancing maternal age, body mass index (BMI), racial origin and development of gestational diabetes mellitus (GDM), on birthweight and the interactions between these factors.

Design  Retrospective analysis of prospectively collected data.

Setting  Fifteen maternity units in North West London, between 1988 and 2000.

Population  A cohort of 130 549 pregnant women.

Methods  Multivariate regression analysis.

Outcome measures  Birthweight z‐scores in non‐GDM and GDM groups within three main racial groups (white European, black and South Asian women).

Results  Babies born to women with GDM were heavier compared with those born to women with no GDM in all racial groups. In black women with GDM the birthweight z‐scores were 0.805 higher, in South Asian women the scores were 0.618 higher and in white European women the scores were 0.437 higher, compared with the respective non‐GDM group (P < 0.001 for both comparisons versus white European women), and these differences were much greater at high rather than at low maternal BMIs. Advancing maternal age, increasing BMI, highest diastolic blood pressure, Castair’s index, racial group and presence of GDM or smoking were each, individually, significantly associated with birthweight z‐scores (P < 0.001 for all variables). After adjusting for possible confounding factors, BMI was positively associated with birthweight z‐scores within all racial groups (P < 0.001 for all), irrespective of glycaemic status, but its effect was much greater in women with GDM, particularly in those of non‐White origin. After adjusting for possible confounding factors, advancing maternal age was only positively associated with birthweight in women of white European and South Asian racial origin who did not suffer from GDM (P < 0.001 for both).

Conclusion  Gestational diabetes mellitus strongly accentuates the effect of maternal BMI on birthweight, especially within non‐white populations.
Influence of fetal glutathione S‐transferase copy number variants on adverse reproductive outcomes
Authors: Bustamante M , Danileviciute A , Espinosa A , Gonzalez JR , Subirana I , Cordier S , Chevrier C , Chatzi L , Grazuleviciene R , Sunyer J , Ibarluzea J , Ballester F , Villanueva CM , Nieuwenhuijsen M , Estivill X , Kogevinas M
Published: June 2012

Please cite this paper as: Bustamante M, Danileviciute A, Espinosa A, Gonzalez JR, Subirana I, Cordier S, Chevrier C, Chatzi L, Grazuleviciene R, Sunyer J, Ibarluzea J, Ballester F, Villanueva CM, Nieuwenhuijsen M, Estivill X, Kogevinas M. Influence of fetal glutathione S‐transferase copy number variants on adverse reproductive outcomes. BJOG 2012;119:1141–1146.

A nested case–control association study was designed to investigate the influence of maternal and fetal copy number variants (CNVs) on reproductive outcomes. Genotypes of ten CNVs encompassing GST and CYP genes were assessed. Significant associations were only found for child CNV genotypes. In particular, the child GSTM1 insertion allele was associated with prematurity protection (odds ratio, 95% CI: 0.67, 0.51–0.89; P < 0.01), whereas the child GSTT2B insertion allele was associated with an increased risk of being small for gestational age (odds ratio, 95% CI: 1.33, 1.07–1.67; P = 0.01). The study highlights the role of the fetal genome in prenatal development and also the need to analyse CNVs in a systematic manner.
Abuse from in‐laws and associations with attempts to control reproductive decisions among rural women in Côte d’Ivoire: a cross‐sectional study
Authors: Gupta J , Falb K , Kpebo D , Annan J
Published: June 2012

Please cite this paper as: Gupta J, Falb K, Kpebo D, Annan J. Abuse from in‐laws and associations with attempts to control reproductive decisions among rural women in Côte d'Ivoire: a cross‐sectional study. BJOG 2012;119:1058–1066.

Objective  To document the lifetime prevalence of abuse from in‐laws (both nonphysical maltreatment and physical violence), the forms of in‐law abuse and reproductive control, and the relationship between experiences of in‐law abuse and reproductive control among partnered women in rural Côte d'Ivoire.

Design  Cross‐sectional study using baseline data (October 2010) from a randomised controlled trial examining socio‐economic interventions on reduction of violence against Ivorian women.

Setting  Rural Côte d'Ivoire.

Population  A total of 981 Ivorian women aged 18 years and older who reported having a male partner and a current source of stable income.

Methods  Bivariate and multivariable logistic regression.

Main outcome measures  Lifetime, in‐law‐perpetrated reproductive control.

Results  More than one in four (27.0%) women reported experiencing lifetime in‐law abuse. In adjusted logistic regression analysis, in‐law abuse was significantly associated with in‐law‐perpetrated reproductive control (adjusted odds ratio 6.9; 95% confidence interval 3.9–12.2; P < 0.0001). Religion and having fewer pregnancies were also associated with reporting in‐law‐perpetrated reproductive control.

Conclusions  Increased efforts are needed to involve in‐laws in programmes that seek to reduce gender‐based violence against women and improve women’s reproductive health.
Caregiving appraisal and disease activity in early inflammatory arthritis
Authors: Purden Margaret , Mustafa Sally S. , Looper Karl J. , Zelkowitz Phyllis ,   McGill Early Arthritis Research Group, Baron Murray
Published: June 2012

Scand J Caring Sci; 2013; 27; 156–164

Caregiving appraisal and disease activity in early inflammatory arthritis

Objective:  The caregiving process accompanying inflammatory arthritis can be stressful to both caregivers and care recipients. In this study, we examined how caregiving involvement and caregiving appraisal as perceived by both patients and their caregiving spouses relate to disease activity and mental health of patients in early inflammatory arthritis.

Methods:  Patients in the early phase (> 6 weeks, <18 months duration) of inflammatory arthritis were recruited from a larger early inflammatory arthritis registry, which recorded sociodemographic data and disease characteristics. Disease activity was measured with the Disease Activity Score in 28 joints (DAS28). Current depressive symptoms were measured using the Center for Epidemiologic Studies – Depression Mood Scale. Patient and spouse perceived caregiving involvement and caregiving appraisal were assessed using the Caregiving Involvement Questionnaire and Caregiving Appraisal Scale, respectively.

Results:  The study sample consisted of 73 patients living with spouse. Mean age was 54 years, 64.4% were women and mean illness duration was 7.48 months. Patients’ positive caregiving appraisal was associated with less disease activity (DAS28) (p = 0.003) and less total depressive mood (p < 0.001). In multivariate analysis, patients’ appraisal of the caregiving context was negatively associated with disease activity (DAS28) after controlling for caregiving involvement and depression (p = 0.035).

Conclusion:  This study indicates that, in early inflammatory arthritis, patients’ caregiving appraisal might be important to consider when assessing disease activity. Clinicians are encouraged to include both patients and their spouse caregivers in interventions.
Is There a Statistical Relationship between Economic Crises and Changes in Government Health Expenditure Growth? An Analysis of Twenty‐Four European Countries
Authors: Cylus Jonathan , Mladovsky Philipa , McKee Martin
Published: June 2012

Objective

To identify whether, by what means, and the extent to which historically, government health care expenditure growth in Europe has changed following economic crises.

Data Sources

Organization for Economic Cooperation and Development Health Data 2011.

Study Design

Cross‐country fixed effects multiple regression analysis is used to determine whether statutory health care expenditure growth in the year after economic crises differs from that which would otherwise be predicted by general economic trends. Better understanding of the mechanisms involved is achieved by distinguishing between policy responses which lead to cost‐shifting and all others.

Findings

In the year after an economic downturn, public health care expenditure grows more slowly than would have been expected given the longer term economic climate. Cost‐shifting and other policy responses are both associated with these slowdowns. However, while changes in tax‐derived expenditure are associated with both cost‐shifting and other policy responses following a crisis, changes in expenditure derived from social insurance have been associated only with changes in cost‐shifting.

Conclusions

Disproportionate cuts to the health sector, as well as reliance on cost‐shifting to slow growth in health care expenditure, serve as a warning in terms of potentially negative effects on equity, efficiency, and quality of health services and, potentially, health outcomes following economic crises.
Re‐Examining the Significance of Surgical Volume to Breast Cancer Survival and Recurrence versus Process Quality of Care in Taiwan
Authors: Kuo Raymond N. , Chung Kuo‐Piao , Lai Mei‐Shu
Published: June 2012

Objective

This study explored the association of surgical volume versus process quality with breast cancer survival and recurrence.

Data Sources/Study Setting

Population‐based cancer registration data and National Health Insurance claim data.

Study Design

This population‐based study linked Taiwan's Cancer Database with Taiwan's National Health Insurance Database to collect data on all patients diagnosed with breast cancer in 2003–2004 who received surgical treatment.

Principal Findings

This study included 6,396 female breast cancer patients, reported by 26 hospitals. After controlling for patient and provider characteristics, Cox's regression models did not reveal any association between a physician's surgical volume and breast cancer recurrence or survival, although hospital volume was marginally associated with positive 5‐year recurrence (HR: 1.001, 95%CI: 1.000, 1.001). After controlling for hospital or physician volume of surgery, we found a significant association between quality of care and both 5‐year survival and recurrence. Random effects were also identified between patients and providers based on 5‐year survival and 5‐year recurrence.

Conclusions

Process quality of care was significantly more related to survival or recurrence than to surgical volume. The random effects found within hospital‐patient clustered data indicated that the effect of the clustered feature of this data should be considered when performing volume‐outcome related studies.
The Urban‐Rural Disparity in Nursing Home Quality Indicators: The Case of Facility‐Acquired Contractures
Authors: Bowblis John R. , Meng Hongdao , Hyer Kathryn
Published: June 2012

Objective

To identify and quantify the sources of the urban‐rural disparity in facility‐acquired contracture rates in nursing homes.

Data Sources

Survey inspection data of U.S. nursing homes from 1999 to 2008 and standardized national rural definition file from the Rural‐Urban Commuting Area Codes.

Study Design

We estimated regressions of facility‐level contracture rate as a function of urban‐rural categories (urban, micropolitan, small rural town, and isolated small rural town) and other related facility characteristics to identify size of the urban‐rural disparity. We used Blinder–Oaxaca decomposition techniques to determine the extent to which the disparity is attributable to the differences in facility and aggregate resident characteristics.

Principal Findings

Rural nursing homes have higher contracture rates than urban nursing homes. About half of the urban‐rural disparity is explained by differences in observable characteristics among urban and rural nursing homes. Differences in staffing levels explain less than 5 percent of the disparity, case‐mix explains 6–8 percent, and structure and operational characteristics account for 10–22 percent of the disparity.

Conclusion

While a lower level and quality of staffing are a concern for rural nursing homes, facility structure and funding sources explain a larger proportion of the urban‐rural disparity in the quality of care.
The Cost of an Additional Disability‐Free Life Year for Older Americans: 1992–2005
Authors: Cai Liming
Published: June 2012

Objective

To estimate the cost of an additional disability‐free life year for older Americans in 1992–2005.

Data Source

This study used 1992–2005 Medicare Current Beneficiary Survey, a longitudinal survey of Medicare beneficiaries with a rotating panel design.

Study Design

This analysis used multistate life table model to estimate probabilities of transition among a discrete set of health states (nondisabled, disabled, and dead) for two panels of older Americans in 1992 and 2002. Health spending incurred between annual health interviews was estimated by a generalized linear mixed model. Health status, including death, was simulated for each member of the panel using these transition probabilities; the associated health spending was cross‐walked to the simulated health changes.

Principal Findings

Disability‐free life expectancy (DFLE) increased significantly more than life expectancy during the study period. Assuming that 50 percent of the gains in DFLE between 1992 and 2005 were attributable to increases in spending, the average discounted cost per additional disability‐free life year was $71,000. There were small differences between gender and racial/ethnic groups.

Conclusions

The cost of an additional disability‐free life year was substantially below previous estimates based on mortality trends alone.
RECOVERevidence and knowledge gap analysis on veterinaryCPR. Part 2: Preparedness and prevention
Authors: McMichael Maureen , Herring Jennifer , Fletcher Daniel J. , Boller Manuel ,   the RECOVER Preparedness and Prevention Domain Worksheet Authors
Published: June 2012

Objective

To systematically examine the evidence on the effect of prevention and preparedness measures on outcomes in veterinary cardiopulmonary resuscitation and to determine knowledge gaps.

Design

Standardized, systematic evaluation of the literature, categorization of relevant articles according to level of evidence and quality, and development of consensus on conclusions for application of the concepts to clinical practice. Relevant questions were answered on a worksheet template and reviewed by theReassessmentCampaign onVeterinaryResuscitation (RECOVER) prevention and preparedness domain members, by theRECOVERcommittee, and opened for comments by veterinary professionals for 3 months.

Setting

Academia, referral practice, and general practice.

Results

Nine worksheets were prepared to determine the extent to which preparation of the environment (charts, visual aids, etc) and personnel (training, debriefing, etc) are beneficial in improving return of spontaneous circulation.

Conclusions

Of the questions evaluated, only the association between anesthesia‐related cardiopulmonary arrest and better outcomes was supported by strong evidence. There is some evidence from the human literature that the use of cognitive aids, standardized didactic, and hands‐on training with high‐fidelity simulators, team and leadership training, and post‐cardiac arrest debriefing improve adherence to cardiopulmonary resuscitation guidelines and, in some cases, patient outcomes. Veterinary studies investigating these issues are lacking, and development of initial guidelines is a crucial first step.
RECOVER evidence and knowledge gap analysis on veterinary CPR. Part 4: Advanced life support
Authors: Rozanski Elizabeth A. , Rush John E. , Buckley Gareth J. , Fletcher Daniel J. , Boller Manuel ,   the RECOVER Advanced Life Support Domain Worksheet Authors
Published: June 2012

Objective

To systematically evaluate the evidence of the effect of advanced life support techniques on outcome in veterinary cardiopulmonary resuscitation (CPR) and to outline knowledge gaps.

Design

Standardized, systematic evaluation of the literature, categorization of relevant articles according to level of evidence and quality, and development of consensus on conclusions for application of the concepts to clinical practice.

Setting

Academia, referral practice, and general practice

Results

Sixteen population, intervention, control group, outcome questions were evaluated to determine if recommendations could be made concerning drug therapy, including vasopressors, vagolytics, corticosteroids, reversal agents, buffer therapy, and correction of electrolyte disturbances. Electrical defibrillation strategies as well as other advanced interventions such as open‐chest CPR, impedance threshold devices, and special considerations regarding anesthesia‐related cardiopulmonary arrest (CPA) were also investigated.

Conclusions

There is strong evidence supporting the use of standard‐dose (0.01 mg/kg) epinephrine in CPR, as well as early electrical defibrillation for animals experiencing CPA due to ventricular fibrillation or pulseless ventricular tachycardia, preferentially using a biphasic defibrillator. For CPA due to certain causes and with the availability of advanced postcardiac arrest support, open chest CPR is preferred. Many knowledge gaps regarding other pharmacologic and advanced therapies were identified, and further studies are recommended to better systematically address these questions.
RECOVERevidence and knowledge gap analysis on veterinaryCPR. Part 1: Evidence analysis and consensus process: collaborative path toward small animalCPRguidelines
Authors: Boller Manuel , Fletcher Daniel J.
Published: June 2012

Objective

To describe the methodology used by the Reassessment Campaign on Veterinary Resuscitation (RECOVER) to evaluate the scientific evidence relevant to small animalCPRand to compose consensus‐based clinicalCPRguidelines for dogs and cats.

Design

This report is part of a series of 7 articles on theRECOVERevidence and knowledge gap analysis and consensus‐based small animalCPRguidelines. It describes the organizational structure ofRECOVER, the evaluation process employed, consisting of standardized literature searches, the analysis of relevant articles according to study design, species and predefined quality markers, and the drafting of clinicalCPRguidelines based on these data. Therefore, this article serves as the methodology section for the subsequent 6RECOVERarticles.

Setting

Academia, referral practice.

Results

RECOVERis a collaborative initiative that systematically evaluated the evidence on 74 topics relevant to small animalCPRand generated 101 clinicalCPRguidelines from this analysis. All primary contributors were veterinary specialists, approximately evenly split between academic institutions and private referral practices. The evidence evaluation and guideline drafting processes were conducted according to a predefined sequence of steps designed to reduce bias and increase the repeatability of the findings, including multiple levels of review, culminating in a consensus process. Many knowledge gaps were identified that will allow prioritization of research efforts in veterinaryCPR.

Conclusions

Collaborative systematic evidence review is organizationally challenging but feasible and effective in veterinary medicine. More experience is needed to refine the process.
TNF‐α neutralization improves experimental hepatopulmonary syndrome in rats
Authors: Liu Li , Liu Nan , Zhao Zhi , Liu Jiabao , Feng Yingmei , Jiang Huiqing , Han Delan
Published: June 2012

Background/Aim

TNF‐α is increased in hepatopulmonary syndrome (HPS). Pentoxifylline (PTX) mitigated experimental HPS through the inhibition of TNF‐α. However, PTX has pleiotropic effects besides the inhibition of TNF‐α. This study is to neutralize TNF‐α with specific monoclonal antibody to TNF‐α (TNF‐α McAb) to investigate the effect of TNF‐α on HPS.

Materials and methods

Hepatopulmonary syndrome was induced by common bile duct ligation (CBDL); controls were sham operated. The endpoints were 1, 2, 3, 4 and 5 weeks after surgery. 99mTechnetium‐macroaggregated albumin (Tc‐MAA) was to evaluate intrapulmonary arteriovenous shunts; Portal venous pressure, cardiac output and mean blood pressure (MAP) were also measured. Serum was for Alanine transaminase (ALT), endotoxin, TNF‐α and nitric oxide (NO) measurements, liver for histology, lung for histology and iNOS, PI3K/Akt expression assay.

Results

Portal vein pressure was significantly elevated and MAP decreased in CBDL rats. Tc‐MAA was mainly located in lung and very weak in brain in sham group and mainly in brain of CBDL rats. TNF‐α McAb significantly decreased the radioactivity in the brain, reduced cardiac output, increased MAP and systemic vascular resistance (SVR) in CBDL animals. Serum ALT, endotoxin, TNF‐α and NO were significantly increased. TNF‐α McAb significantly decreased these serum indices in CBDL rats. TNF‐α McAb significantly alleviated liver damage, decreased alveolar‐arterial gradient and inhibited iNOS, PI3K/Akt and p‐Akt expression in lung tissue. Furthermore, TNF‐α McAb significantly attenuated the inflammatory response in lung.

Conclusion

TNF‐α McAb improves HPS in cirrhotic rats; this effect is likely mediated through the inhibition of TNF‐α PI3K/Akt‐NO pathway.
The use of a rigid disc to protect exposed structures in wounds treated with negative pressure wound therapy: Effects on wound bed pressure and microvascular blood flow
Authors: Anesäter Erik , Borgquist Ola , Torbrand Christian , Roupé K. Markus , Ingemansson Richard , Lindstedt Sandra , Malmsjö Malin
Published: June 2012

There are increasing reports of deaths and serious complications associated with the use of negative pressure wound therapy (NPWT). Bleeding may occur in patients when NPWT is applied to a wound with exposed blood vessels or vascular grafts, possibly due to mechanical deformation and hypoperfusion of the vessel walls. Recent evidence suggests that using a rigid barrier disc to protect underlying tissue can prevent this mechanical deformation. The aim of this study was to examine the effect of rigid discs on the tissue exposed to negative pressure with regard to tissue pressure and microvascular blood flow. Peripheral wounds were created on the backs of eight pigs. The pressure and microvascular blood flow in the wound bed were measured when NPWT was applied. The wound was filled with foam, and rigid discs of different designs were inserted between the wound bed and the foam. The discs were created with or without channels (to accommodate exposed sensitive structures such as blood vessels and nerves), perforations, or a porous dressing that covered the underside of the discs (to facilitate pressure transduction and fluid evacuation). When comparing the results for pressure transduction to the wound bed, no significant differences were found using different discs covered with dressing, whereas pressure transduction was lower with bare discs. Microvascular blood flow in the wound bed decreased by 49 ± 7% when NPWT was applied to control wounds. The reduction in blood flow was less in the presence of a protective disc (e.g., −6 ± 5% for a dressing‐covered, perforated disc, p = 0.006). In conclusion, NPWT causes hypoperfusion of superficial tissue in the wound bed. The insertion of a rigid barrier counteracts this effect. The placement of a rigid disc over exposed blood vessels or nerves may protect these structures from rupture and damage.
Assessment of replication rates of human keratinocytes in engineered skin substitutes grafted to athymic mice
Authors: Boyce Steven T. , Rice Rachel K. , Lynch Kaari A. , Supp Andrew P. , Swope Viki B. , Kagan Richard J. , Supp Dorothy M.
Published: June 2012

Stable closure of skin wounds with engineered skin substitutes (ESS) requires indefinite mitotic capacity to generate the epidermis. To evaluate whether keratinocytes in ESS exhibit the stem cell phenotype of label retention, ESS (n = 6–9/group) were pulsed with 5‐bromo‐2'‐deoxyuridine (BrdU) in vitro, and after grafting to athymic mice (n = 3–6/group). Pulse and immediate chase in vitro labeled virtually all basal keratinocytes at day 8, with label uptake decreasing until day 22. Label retention in serial chase decreased more rapidly from day 8 to day 22, with a reorganization of BrdU‐positive cells into clusters. Similarly, serial chase of labeled basal keratinocytes in vivo decreased sharply from day 20 to day 48 after grafting. Label uptake was assessed by immediate chases of basal keratinocytes, and decreased gradually to day 126, while total labeled cells remained relatively unchanged. These results demonstrate differential rates of label uptake and retention in basal keratinocytes of ESS in vitro and in vivo, and a proliferative phenotype with potential for long‐term replication in the absence of hair follicles. Regulation of a proliferative phenotype in keratinocytes of ESS may improve the biological homology of tissue‐engineered skin to natural skin, and contribute to more rapid and stable wound healing.
Increasing the presence of biofilm and healing delay in a porcine model of MRSA‐infected wounds
Authors: Roche Eric D. , Renick Paul J. , Tetens Shannon P. , Ramsay Sarah J. , Daniels Egeenee Q. , Carson Dennis L.
Published: June 2012

Data supporting the concept that microbial biofilms are a major cause of non‐healing ulcers remain limited. A porcine model was established where delayed healing resulted from methicillin‐resistant Staphylococcus aureus (MRSA) infection in full‐thickness wounds. At the end of one study a wound remaining open was sampled and a MRSA strain was isolated. This pig‐passaged strain was used as the inoculating strain in several subsequent studies. The resulting MRSA wound infections exhibited a greater, more stable tissue bioburden than seen in studies using the parent strain. Furthermore, wounds infected with the passaged strain experienced a greater delay in healing. To understand whether these changes corresponded to an increased biofilm character of the wound infection, wound biopsy samples from studies using either the parent or passaged MRSA strains were examined microscopically. Evidence of biofilm was observed for both strains, as most samples at a minimum had multiple isolated, dense microcolonies of bacteria. However, the passaged MRSA resulted in bacterial colonies of greater frequency and size that occurred more often in concatenated fashion to generate extended sections of biofilm. These results provide a model case in which increasing biofilm character of a wound infection corresponded with a greater delay in wound healing.