bluuebunny/crossref_metadata_2025 huggingface dataset:
Learning Turkish
Authors: Spitzer Leo , Atak Tülay
Published: September 2011

Emigration is translation. Written by Leo Spitzer in 1934, “Learning Turkish” offers a glimpse into the historical circumstances of his and other German academics' exile in Istanbul—an exile that plays a foundational role in comparative literature, as Erich Auerbach, Edward Said, Aamir Mufti, and Emily Apter have argued. Spitzer's attempt to analyze the characteristics of the Turkish language while that language was transforming amplifies recent critical attempts to understand “modern Turkey's nation-based and state-directed poiesis” (Yaeger 11). Bridging the gap between exile in Istanbul and the modern Turkish language, “Learning Turkish” introduces complexity to contemporary paradigms of global comparatism and identifies symptoms of literary studies' relocation to the context of a new nation-state; the article exemplifies the complicity between local nationalisms and cultural imperialisms and illuminates, on a personal level, how linguistic estrangement becomes a way of negotiating the experience of deportation, of emigration, and of the foreignness of adoptive cultures for Spitzer.
Concepts of Survival following Critical Illness
Authors: Endacott Ruth
Published: September 2011

The end point of critical illness most commonly used as a proxy for survival is discharge from the intensive care unit (ICU). Survival, however, is a far more complex phenomenon; patients who achieve discharge from ICU are very rarely left unchanged by their experience. An intensive care stay can have lasting effects on physical and psychological functioning; surviving the ICU stay is just one milestone on a longer journey. In this article different conceptual approaches to survival in the intensive care field are examined. Comparison is drawn between survival measures identified as important by patients and family members and those that are routinely captured in post-ICU care and post-hospital follow-up clinics. The case is made for routine assessment of survival indicators, such as symptom distress and anxiety/depression, following critical illness.
DNA Methylation and the HOXC6 Paradox in Prostate Cancer
Authors: Vinarskaja Anna , Yamanaka Masanori , Ingenwerth Marc , Schulz Wolfgang A.
Published: September 2011

Overexpression of the classical homeobox transcription factor HOXC6 is frequent in prostate cancers and correlates with adverse clinical parameters. Since surprisingly many HOXC6 target genes are downregulated in prostate cancer, it has been posited that oncogenic effects of HOXC6 in prostate cancer may be unmasked by concurrent epigenetic downregulation of target genes exerting tumor suppressive effects. To test this hypothesis, we have studied the expression of three HOXC6 target genes, CNTN1 (encoding a cell adhesion protein), DKK3 and WIF1 (encoding WNT growth factor antagonists) as well as DNA methylation of DKK3 and WIF1. HOXC6 upregulation and association with poor prognosis were confirmed in our tissue series. The three target genes were each significantly downregulated in cancer tissues and expression of each one correlated inversely with that of HOXC6. Cases with lower WIF1 expression showed significantly earlier recurrence (p = 0.021), whereas no statistical significance was reached for CNTN1 and DKK3. Hypermethylation of DKK3 or WIF1 gene promoters was observed in a subset of cancers with downregulated expression, but was often weak. Our data support the hypothesis that HOXC6 target genes exerting tumor-suppressive effects are epigenetically downregulated in prostate cancer, but DNA methylation appears to follow or bolster rather than to cause their transcriptional inactivation.
Cost Benefit Analysis of Using Clean Energy Supplies to Reduce Greenhouse Gas Emissions of Global Automotive Manufacturing
Authors: Zhai Qiang , Cao Huajun , Zhao Xiang , Yuan Chris
Published: September 2011

Automotive manufacturing is energy-intensive. The consumed energy contributes to the generation of significant amounts of greenhouse gas (GHG) emissions by the automotive manufacturing industry. In this paper, a study is conducted on assessing the application potential of such clean energy power systems as solar PV, wind and fuel cells in reducing the GHG emissions of the global auto manufacturing industry. The study is conducted on the representative solar PV, wind and fuel cell clean energy systems available on the commercial market in six representative locations of GM’s global facilities, including the United States, Mexico, Brazil, China, Egypt and Germany. The results demonstrate that wind power is superior to other two clean energy technologies in the economic performance of the GHG mitigation effect. Among these six selected countries, the highest GHG emission mitigation potential is in China, through wind power supply. The maximum GHG reduction could be up to 60 tons per $1,000 economic investment on wind energy supply in China. The application of wind power systems in the United States and Germany could also obtain relatively high GHG reductions of between 40–50 tons per $1,000 economic input. When compared with wind energy, the use of solar and fuel cell power systems have much less potential for GHG mitigation in the six countries selected. The range of median GHG mitigation values resulting from solar and wind power supply are almost at the same level.
Therapeutic Drug Monitoring of the Newer Anti-Epilepsy Medications
Authors: Krasowski Matthew D.
Published: September 2011

In the past twenty years, 14 new antiepileptic drugs have been approved for use in the United States and/or Europe. These drugs are eslicarbazepine acetate, felbamate, gabapentin, lacosamide, lamotrigine, levetiracetam, oxcarbazepine, pregabalin, rufinamide, stiripentol, tiagabine, topiramate, vigabatrin and zonisamide. In general, the clinical utility of therapeutic drug monitoring has not been established in clinical trials for these new anticonvulsants, and clear guidelines for drug monitoring have yet to be defined. The antiepileptic drugs with the strongest justifications for drug monitoring are lamotrigine, oxcarbazepine, stiripentol, and zonisamide. Stiripentol and tiagabine are strongly protein bound and are candidates for free drug monitoring. Therapeutic drug monitoring has lower utility for gabapentin, pregabalin, and vigabatrin. Measurement of salivary drug concentrations has potential utility for therapeutic drug monitoring of lamotrigine, levetiracetam, and topiramate. Therapeutic drug monitoring of the new antiepileptic drugs will be discussed in managing patients with epilepsy.
A Distance-Aware Replica Adaptive Data Gathering Protocol for Delay Tolerant Mobile Sensor Networks
Authors: Feng Yong , Gong Haigang , Fan Mingyu , Liu Ming , Wang Xiaomin
Published: September 2011

In Delay Tolerant Mobile Sensor Networks (DTMSNs) that have the inherent features of intermitted connectivity and frequently changing network topology it is reasonable to utilize multi-replica schemes to improve the data gathering performance. However, most existing multi-replica approaches inject a large amount of message copies into the network to increase the probability of message delivery, which may drain each mobile node’s limited battery supply faster and result in too much contention for the restricted resources of the DTMSN, so a proper data gathering scheme needs a trade off between the number of replica messages and network performance. In this paper, we propose a new data gathering protocol called DRADG (for Distance-aware Replica Adaptive Data Gathering protocol), which economizes network resource consumption through making use of a self-adapting algorithm to cut down the number of redundant replicas of messages, and achieves a good network performance by leveraging the delivery probabilities of the mobile sensors as main routing metrics. Simulation results have shown that the proposed DRADG protocol achieves comparable or higher message delivery ratios at the cost of the much lower transmission overhead than several current DTMSN data gathering schemes.
Adaptive Momentum-Based Motion Detection Approach and Its Application on Handoff in Wireless Networks
Authors: Chung Tein-Yaw , Chen Yung-Mu , Hsu Chih-Hung
Published: September 2011

Positioning and tracking technologies can detect the location and the movement of mobile nodes (MNs), such as cellular phone, vehicular and mobile sensor, to predict potential handoffs. However, most motion detection mechanisms require additional hardware (e.g., GPS and directed antenna), costs (e.g., power consumption and monetary cost) and supply systems (e.g., network fingerprint server). This paper proposes a Momentum of Received Signal Strength (MRSS) based motion detection method and its application on handoff. MRSS uses the exponentially weighted moving average filter with multiple moving average window size to analyze the received radio signal. With MRSS, an MN can predict its motion state and make a handoff trigger at the right time without any assistance from positioning systems. Moreover, a novel motion state dependent MRSS scheme called Dynamic MRSS (DMRSS) algorithm is proposed to adjust the motion detection sensitivity. In our simulation, the MRSSand DMRSS-based handoff algorithms can reduce the number of unnecessary handoffs up to 44% and save battery power up to 75%.
Nurse Planner Roles and Functions
Authors: DeSilets Lynore D. , Dickerson Pamela S.
Published: September 2011

The responsibilities of a nurse planner are crucial to the creation and development of both accredited and approved continuing education activities. The nurse planner serves as a repository for accreditation criteria and is charged with the oversight of identifying learning needs, identifying content experts, developing content and teaching strategies, and designing evaluation methodologies for activities that carry contact hour credit. This column describes the components of the role and identifies ways they can be operationalized.
Calcaneal Reconstruction for the Late Complication of Calcaneus Fracture
Authors: Young Ki Won , Lee Kyung Tai , Lee Young Koo , Jang Mun Suk , Yoon Jun Hee , Kim Jun Ho
Published: September 2011

Calcaneal fracture is the most common fracture in the tarsal bones. Treatment is difficult because the patterns of fracture are various and complications occur frequently. The purpose of this study was to evaluate the clinical results of calcaneal reconstruction for chronic complications after calcaneal fracture.

From September 2001 to November 2004, calcaneal reconstruction was performed in 24 patients (25 feet). We reviewed 21 patients (22 feet) who could be followed up >2 years postoperatively. Patients who underwent subtalar arthrodesis and simple bone resection were excluded. Patients who underwent calcaneal sliding osteotomy were included. Nineteen men and 2 women ranged in age from 27 to 54 years (mean, 44.4 years). The mean interval between the first operation and reconstructive operation was 11.2 months (range, 3–31 months). The mean follow-up period after calcaneal reconstruction was 29.8 months (range, 24–38 months). Böhler angle, calcaneal pitch, and talocalcaneal height were checked pre- and postoperatively.

The most common patient report was pain on the inferior aspect of the lateral malleolus (16 patients) and calcaneal tuberosity (3 patients). All the mean values of talocalcaneal height, calcaneal pitch, and Böhler angle improved, which was statistically significant. In the postoperative period, 10 patients were very satisfied, 9 were satisfied, and 3 were not satisfied. Although pain did not completely resolve, all patients were satisfied postoperatively.
Retrospective Comparison of H-graft and Posterior Vertebral Graft Procedures for the Treatment of Thoracolumbar Burst Fractures
Authors: Huang Fei , Zhu Qing-san , Li Ya-nan , Chen Ji-ge , Zhao Dong-ming , Yang Yong , Wu Hua
Published: September 2011

A retrospective cohort study was conducted to compare fusion rates achieved by H-grafts, posterior vertebral grafts, and no graft for the surgical treatment of thoracolumbar fractures. Ninety-two patients were included in this study. The patients fell into 1 of 3 groups: those who received H-grafts (n=36), posterior vertebral grafts (n=30), and no graft (n=26). Mean follow-up was 38 months (range, 24–51 months). All operations were performed by a single senior surgeon. All patients underwent operative treatment with posterior reduction and instrumentation. Radiographic parameters, estimated blood loss, operative time, and length of hospital stay were compared among patients in the 3 graft groups. Differences were assessed using unpaired
t
tests.
P
values <.05 were considered significant. We found no significant difference among groups in age, fracture location, or type of fracture. Patients who received H-grafts or posterior vertebral grafts achieved solid fusion, but spontaneous fusion occurred in only 2 patients who received no bone graft. Most patients with neurological deficits showed significant neurological improvement. Operative time and estimated blood loss were significantly lower in the no-graft group than in the H-graft and posterior vertebral graft groups (
P
<.05). Mean loss of correction, operative time, and estimated blood loss were lower for patients who received H-grafts than for those who received posterior vertebral grafts (
P
<.05). The use of an atlas fixation system in combination with a posterior H-graft for the treatment of thoracolumbar fracture is a stable and reliable method that effectively prevents inner fixation failure and reduces bone loss and anisotropy.
Avascular Necrosis of the Femoral Head in Children With Acute Lymphoblastic Leukemia: A 4- to 9-year Follow-up Study
Authors: Madadi Firooz , Shamsian Bibi Shahin , Alavi Samin , Madadi Firoozeh , Eajazi Alireza , Aslani Afshin
Published: September 2011

Avascular necrosis of the femoral head is usually seen in children aged 1.5 to 10 years, reaching a peak incidence between the ages of 4 and 9. Avascular necrosis of the femoral head is a known complication of corticosteroid therapy in acute lymphoblastic leukemia. There are few reports in the literature regarding the natural history of this condition, and there is no consensus on its management. This study examined the natural history of avascular necrosis of the femoral head in children with leukemia.

From 1993 to 2006, a total of 865 children with acute lymphoblastic leukemia were admitted to the hematology-oncology ward of a children’s hospital. The diagnosis of acute lymphoblastic leukemia was established by bone marrow aspiration. Based on clinical and radiographic findings, avascular necrosis of the femoral head was found in 7 patients; these patients underwent follow-up for 4 to 9 years. Avascular necrosis of the femoral head was clinically symptomatic in all of the children, and they had advanced radiographic collapse of the femoral head. However, the head of the femur was not at risk in any patient based on clinical and radiographic findings. Patients received supportive treatment such as abduction brace and physiotherapy. After 4 to 9 years of follow-up, clinical and radiographic results were satisfactory. Provided that the head of the femur is not at risk, avascular necrosis of the femoral head in children with acute lymphoblastic leukemia may be successfully managed with nonoperative care.
Radiographic Results of an Accelerometer-based, Handheld Surgical Navigation System for the Tibial Resection in Total Knee Arthroplasty
Authors: Nam Denis , Cross Michael , Deshmane Prashant , Jerabek Seth , Kang Michael , Mayman David J.
Published: September 2011

In total knee arthroplasty (TKA), intramedullary and extramedullary tibial alignment guides are not proven to be highly accurate in obtaining alignment perpendicular to the mechanical axis in the coronal plane. The objective of this study was to determine the accuracy of an accelerometer-based, handheld surgical navigation system in obtaining a postoperative tibial component alignment within 2° of the intraoperative goal in both the coronal and sagittal planes. A total of 151 TKAs were performed by 2 surgeons using a handheld surgical navigation system to perform the tibial resection. Postoperatively, standing anteroposterior hip-to-ankle radiographs and lateral knee-to-ankle radiographs were performed to determine the varus/valgus alignment and the posterior slope of the tibial components relative to the mechanical axis in both the coronal and sagittal planes. Findings showed that 95.3% of the tibial components were placed within 2° of the intraoperative goal in the coronal plane and 96.1% of the components were placed within 2° of the intraoperative goal in the sagittal plane. Overall, mean postoperative lower-extremity alignment was −0.3°±2.1°, with 97% of patients having an alignment within 3° of a neutral mechanical axis. The handheld surgical navigation system improves the accuracy of the tibial resection and subsequent tibial component alignment in TKA. It is able to combine the accuracy of computer-assisted surgery systems with the ease of use and familiarity of conventional, extramedullary alignment systems, and the ability to adjust both the coronal and sagittal alignments intraoperatively may prove clinically useful in TKA.
Assessment of Prosodic Communicative Efficiency in Parkinson's Disease As Judged by Professional Listeners
Authors: Martens Heidi , Van Nuffelen Gwen , Cras Patrick , Pickut Barbara , De Letter Miet , De Bodt Marc
Published: September 2011

This study examines the impact of Parkinson's disease (PD) on communicative efficiency conveyed through prosody. A new assessment method for evaluating productive prosodic skills in Dutch speaking dysarthric patients was devised and tested on 36 individuals (18 controls, 18 PD patients). Three professional listeners judged the intended meanings in four communicative functions of Dutch prosody: Boundary Marking, Focus, Sentence Typing, and Emotional Prosody. Each function was tested through reading and imitation. Interrater agreement was calculated. Results indicated that healthy speakers, compared to PD patients, performed significantly better on imitation of Boundary Marking, Focus, and Sentence Typing. PD patients with a moderate or severe dysarthria performed significantly worse on imitation of Focus than on reading of Focus. No significant differences were found for Emotional Prosody. Judges agreed well on all tasks except Emotional Prosody. Future research will focus on elaborating the assessment and on developing a therapy programme paralleling the assessment.
From primordial curse to eschatological restoration: Ecological challenges from Genesis 3:14�20 and Romans 8:18�25
Authors: Folarin George O.
Published: September 2011

This work employs a comparative study of the theologies of Genesis 3:14�20 and Romans 8:18�25 as it relates to the problem of ecological imbalance. It attempts to re-interpret from a Christian theological point of view the primary and the secondary causes of decay from Genesis and the implications of those for the ecosystem, identifies Paul�s eschatological theology of restoration, and then re-reads the import of his eschatological hope in Romans for the restoration of the creation. By inter-acting the curse theology of Genesis 3 with the restorative theology of Romans 8, the work shows the drift of the �very good� world from its initial, harmonious state to its present state of chaos and the challenge to redress the contemporary ecological imbalance.
The adsorption of peroxynitric acid on ice between 230 K and 253 K
Authors: Ulrich T. , Ammann M. , Leutwyler S. , Bartels-Rausch T.
Published: September 2011

Abstract. Peroxynitric acid uptake to ice and snow has been proposed to be a major loss process from the atmosphere with impacts on the atmospheric oxidation capacity. Here we present results from a laboratory study on the interaction of peroxynitric acid with water ice at low concentrations. Experiments were performed in a coated wall flow tube at atmospheric pressure and in the environmentally relevant temperature range of 230 K to 253 K. The interaction was found to be fully reversible and decomposition was not observed. Analysis based on the Langmuir adsorption model showed that the partitioning of peroxynitric acid to ice is orders of magnitude lower than of nitric acid and similar to nitrous acid partitioning behavior. The partition coefficient (KLinC) and its temperature dependency can be described by 3.74×10−12×e(7098/T) [cm]. Atmospheric implications are discussed and show that the uptake to cirrus clouds or to snow-packs in polar areas is an important sink for peroxynitric acid in the environment.
The evolution of microphysical and optical properties of an A380 contrail in the vortex phase
Authors: Gayet J.-F. , Shcherbakov V. , Voigt C. , Schumann U. , Schäuble D. , Jessberger P. , Petzold A. , Minikin A. , Schlager H. , Dubovik O. , Lapyonok T. , Krämer M. , Kübbeler M.
Published: September 2011

Abstract. The contrail from a large-body A380 aircraft has extensively been probed in the vortex and early dispersion regime with in situ instruments to measure microphysical and optical properties of contrail ice particles on the DLR research aircraft Falcon. Concentrations up to 340 cm−3 of ice particles with diameters d >0.9 μm and extinction coefficients up to 7.0 km−1 were measured inside the plume. Initially the primary vortices were sampled about 270 m below the A380 flight altitude at contrail ages of 70 to 120 s in ice subsaturated conditions, followed by measurements in the secondary wake with contrail ages of 120 to 220 s at conditions near ice saturation. In the primary vortices the mean effective diameter was 3.5 μm and the maximum ice water content (IWC) was 7.0 mg m−3 increasing with altitude and ice saturation in the secondary wake to 4.8 μm and 10.0 mg m−3. The asymmetry parameter was found to decrease systematically with contrail age (and altitude) from 0.87 to 0.80 indicating that ice crystals become more and more aspherical during ice crystal growth. In addition, an inversion approach was used to retrieve the ice particle size distribution and the partitioning between spherical and aspherical particles. In the young primary vortex 100% of the ice particles were of spherical shape, whereas partitioning coefficients of 68% and 44% were found in the more aged secondary wake. The extrapolation of our results to older contrails under similar meteorological conditions suggests that contrails with ages over 5 min may be dominated by aspherically-shaped ice particles typical for natural mid latitude cirrus.
Emulating Atlantic overturning strength for low emission scenarios: consequences for sea-level rise along the North American east coast
Authors: Schleussner C. F. , Frieler K. , Meinshausen M. , Yin J. , Levermann A.
Published: September 2011

Abstract. In order to provide probabilistic projections of the future evolution of the Atlantic Meridional Overturning Circulation (AMOC), we calibrated a simple Stommel-type box model to emulate the output of fully coupled three-dimensional atmosphere-ocean general circulation models (AOGCMs) of the Coupled Model Intercomparison Project (CMIP). Based on this calibration to idealised global warming scenarios with and without interactive atmosphere-ocean fluxes and freshwater perturbation simulations, we project the future evolution of the AMOC mean strength within the covered calibration range for the lower two Representative Concentration Pathways (RCPs) until 2100 obtained from the reduced complexity carbon cycle-climate model MAGICC 6. For RCP3-PD with a global mean temperature median below 1.0 °C warming relative to the year 2000, we project an ensemble median weakening of up to 11% compared to 22% under RCP4.5 with a warming median up to 1.9 °C over the 21st century. Additional Greenland meltwater of 10 and 20 cm of global sea-level rise equivalent further weakens the AMOC by about 4.5 and 10%, respectively. By combining our outcome with a multi-model sea-level rise study we project a dynamic sea-level rise along the New York City coastline of 4 cm for the RCP3-PD and of 8 cm for the RCP4.5 scenario over the 21st century. We estimate the total steric and dynamic sea-level rise for New York City to be about 24 cm until 2100 for the RCP3-PD scenario, which can hold as a lower bound for sea-level rise projections in this region, as it does not include ice sheet and mountain glacier contributions.
Laminar and weakly turbulent oceanic gravity currents performing inertial oscillations
Authors: Wirth A.
Published: September 2011

Abstract. The small scale dynamics of a weakly turbulent oceanic gravity current is determined. The gravity current considered is initially at rest and adjusts by performing inertial oscillations to a geostrophic mean flow. The dynamics is explored with a hierarchy of mathematical models. The most involved are the fully 3-D Navier-Stokes equations subject to the Boussinesq approximation. A 1-D and 0-D mathematical model of the same gravity current dynamics are systematically derived. Using this hierarchy and the numerical solutions of the mathematical models, the turbulent dynamics at the bottom and the interface is explored and their interaction investigated. Three different regimes of the small scale dynamics of the gravity current are identified, they are characterised by laminar flow, coherent roll vortices and turbulent dynamics with coherent streaks and bursts. The problem of the rectification of the turbulent fluxes, that is how to average out the fluctuations and calculate their average influence on the flow is considered. It is shown that two different regimes of friction are superposed, an Ekman friction applies to the average geostrophic flow and a linear friction, not influenced by rotation, to the inertial oscillations. The combination of the two makes the bulk friction non-local in time for the 0-D model. The implications of the results for parametrisations of the Ekman dynamics and the small scale turbulent fluxes in the planetary boundary layer are discussed.
The Continuing Education of Faculty as Teachers at a Mid-sized Ontario University
Authors: Carter Lorraine M , Brockerhoff-Macdonald Bettina
Published: September 2011

The findings outlined in this paper are the result of focus groups conducted with faculty at a mid-sized Ontario university. These nine faculty, all of whom have received awards of excellence from their university for their teaching, shared their insights about how they developed as teachers over time. More specific topics explored were as follows: how they first learned about teaching; how they continue to learn about teaching; resources that might have helped early in their teaching careers at the university; and advice they have about teaching for new university teachers, mid-career teachers, and teachers approaching retirement. While many of the observations offered here are specific to Ontario and some of the literature review is North American in focus, the paper offers valuable insights into how faculty learn to be teachers which may be helpful to universities around the world.
Cet article présente les résultats d’entrevues menées avec des groupes de discussion composés de membres du corps professoral d’une université ontarienne de taille moyenne. Les 9 professeurs participant ont tous reçu des prix d’excellence de leur université pour leur enseignement. Lors de ces rencontres, ils ont expliqué comment ils ont évolué à titre d’enseignants au fil du temps. Les sujets particuliers suivants ont été abordés : leurs premiers apprentissages en matière d’enseignement; leurs apprentissages subséquents; les ressources qui les ont aidés tôt dans leur carrière d’enseignant à l’université; les conseils qu’ils ont à offrir aux enseignants universitaires qui viennent de débuter leur carrière, à ceux qui sont à mi-parcours et à ceux qui approchent de la retraite. L’article fournit un aperçu utile sur la façon dont les membres du corps enseignant apprennent à devenir des enseignants. Même si bon nombre des observations présentées sont spécifiques à l’Ontario et si une partie de la recension des écrits est d’origine nord-américaine, ces informations peuvent servir aux universités à l’échelle internationale.
Is routine viral screening useful in patients with recent‐onset polyarthritis of a duration of at least 6 weeks? Results from a nationwide longitudinal prospective cohort study
Authors: Varache Sophie , Narbonne Valérie , Jousse‐Joulin Sandrine , Guennoc Xavier , Dougados Maxime , Daurès Jean Pierre , Devauchelle‐Pensec Valerie , Saraux Alain
Published: September 2011

Objective

To study the contribution of routine viral screening tests in patients with early rheumatoid arthritis (RA) or a potential for progressing to RA.

Methods

Eight hundred thirteen patients with swelling of at least 2 joints for at least 6 weeks and a symptom duration of less than 6 months in the ESPOIR cohort were screened for parvovirus B19 (IgG and IgM anti–parvovirus B19 antibodies), hepatitis B virus (HBV; hepatitis B surface antigen), hepatitis C virus (HCV; anti‐HCV antibodies), and human immunodeficiency virus (HIV; anti–HIV‐1 and ‐2 antibodies).

Results

Parvovirus B19 testing was performed in 806 patients and showed longstanding immunity in 574 (71.2%) and no antibodies in 223 (27.7%). Among the 9 remaining patients (7 IgG positive/IgM positive, 1 IgG negative/IgM positive, and 1 IgG indeterminate/IgM positive), only 2 (0.25%; 95% confidence interval [95% CI] 0–0.99%) had a positive polymerase chain reaction test for parvovirus B19; these patients (women ages 34 and 40 years) had no extraarticular signs. HIV seroprevalence was 0.12% (n = 1 of 813; 95% CI 0.01–0.8%) and HCV seroprevalence was 0.86% (n = 7 of 808, 95% CI 0.38–1.86%). HCV‐related arthritis was diagnosed in 4 patients (0.5%). HCV‐seropositive patients had significantly higher transaminase levels than the other patients (P = 0.001), with no significant differences for the other laboratory data. HBV seroprevalence was 0.12% (n = 1 of 808; 95% CI 0.01–0.8%); the positive HBV status was known before study inclusion, and the patient had no diagnosis of HBV‐related arthritis. Finally, routine viral testing identified 2 patients with parvovirus B19 infection and 3 with HBV infection (0.6%; 95% CI 0.2–1.5%). Cost was €85.05 per patient (total €68,720).

Conclusion

Routine serologic testing did not contribute substantially to the diagnosis in this context.
Long‐term outcomes and costs of an integrated rehabilitation program for chronic knee pain: A pragmatic, cluster randomized, controlled trial
Authors: Hurley M. V. , Walsh N. E. , Mitchell H. , Nicholas J. , Patel A.
Published: September 2011

Objective

Chronic joint pain is a major cause of pain and disability. Exercise and self‐management have short‐term benefits, but few studies follow participants for more than 6 months. We investigated the long‐term (up to 30 months) clinical and cost effectiveness of a rehabilitation program combining self‐management and exercise: Enabling Self‐Management and Coping of Arthritic Knee Pain Through Exercise (ESCAPE‐knee pain).

Methods

In this pragmatic, cluster randomized, controlled trial, 418 people with chronic knee pain (recruited from 54 primary care surgeries) were randomized to usual care (pragmatic control) or the ESCAPE‐knee pain program. The primary outcome was physical function (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC] function), with a clinically meaningful improvement in physical function defined as a ≥15% change from baseline. Secondary outcomes included pain, psychosocial and physiologic variables, costs, and cost effectiveness.

Results

Compared to usual care, ESCAPE‐knee pain participants had large initial improvements in function (mean difference in WOMAC function −5.5; 95% confidence interval [95% CI] −7.8, −3.2). These improvements declined over time, but 30 months after completing the program, ESCAPE‐knee pain participants still had better physical function (difference in WOMAC function −2.8; 95% CI −5.3, −0.2); lower community‐based health care costs (£−47; 95% CI £−94, £−7), medication costs (£−16; 95% CI £−29, £−3), and total health and social care costs (£−1,118; 95% CI £−2,566, £−221); and a high probability (80–100%) of being cost effective.

Conclusion

Clinical and cost benefits of ESCAPE‐knee pain were still evident 30 months after completing the program. ESCAPE‐knee pain is a more effective and efficient model of care that could substantially improve the health, well‐being, and independence of many people, while reducing health care costs.
Relationship between accelerometer‐based measures of physical activity and the Yale Physical Activity Survey in adults with arthritis
Authors: Semanik Pamela , Lee Jungwha , Manheim Larry , DiPietro Loretta , Dunlop Dorothy , Chang Rowland W.
Published: September 2011

Objective

To evaluate the correlation between the Yale Physical Activity Survey (YPAS) scores and objective accelerometer measures of time spent in light intensity physical activities, moderate to vigorous intensity physical activities, and moderate to vigorous activities in bouts lasting at least 10 minutes.

Methods

This study analyzed baseline data from 171 persons with rheumatoid arthritis (RA) and 139 persons with osteoarthritis (OA) in a randomized clinical trial (Increasing Motivation for Physical Activity in Arthritis Clinical Trial). Persons fulfilling the 1987 American College of Rheumatology criteria for RA and persons with symptomatic radiologic knee OA (Kellgren/Lawrence class ≥2) wore an accelerometer for 7 days, then responded to the YPAS questionnaire and questions regarding demographics (age, sex, and race) and health factors (body mass index, disease status [Health Assessment Questionnaire/Western Ontario and McMaster Universities Osteoarthritis Index], comorbidities, pain, and function). Spearman's correlation coefficients were estimated between each YPAS summary measure and accelerometer measures.

Results

In the RA participants, the strongest correlation was between the YPAS activity dimensions summary index (Y‐ADSI) and average daily minutes of bouted moderate/vigorous activity (r = 0.51). Additionally, the Y‐ADSI correlated significantly with both objectively measured average daily accelerometer counts (r = 0.45) and average daily minutes of moderate/vigorous activity (r = 0.43). For OA participants, a similar pattern emerged: the Y‐ADSI had significant correlations with average daily minutes of bouted moderate/vigorous activity (r = 0.36), average daily minutes of moderate/vigorous activity (r = 0.31), and average daily counts (r = 0.24).

Conclusion

For both the RA and OA groups, the Y‐ADSI had the strongest significant correlations with objectively measured physical activity, which supports Y‐ADSI use as a tool for clinical applications and in rheumatology research.
Impact of educational and patient decision aids on decisional conflict associated with total knee arthroplasty
Authors: de Achaval Sofia , Fraenkel Liana , Volk Robert J. , Cox Vanessa , Suarez‐Almazor Maria E.
Published: September 2011

Objective

To examine the impact of a videobooklet patient decision aid supplemented by an interactive values clarification exercise on decisional conflict in patients with knee osteoarthritis (OA) considering total knee arthroplasty.

Methods

A total of 208 patients participated in the study (mean age 63 years, 68% female, and 66% white). Participants were randomized to 1 of 3 groups: 1) educational booklet on OA management (control), 2) patient decision aid (videobooklet) on OA management, and 3) patient decision aid (videobooklet) + adaptive conjoint analysis (ACA) tool. The ACA tool enables patients to consider competing attributes (i.e., specific risks/benefits) by asking them to rate a series of paired comparisons. The primary outcome was the decisional conflict scale ranging from 0–100. Differences between groups were analyzed using analysis of variance and Tukey's honestly significant difference tests.

Results

Overall, decisional conflict decreased significantly in all groups (P < 0.05). The largest reduction in decisional conflict was observed for participants in the videobooklet decision aid group (21 points). Statistically significant differences in pre‐ versus postintervention total scores favored the videobooklet group compared to the control group (21 versus 10) and to the videobooklet plus ACA group (21 versus 14; P < 0.001). Changes in the decisional conflict score for the control group compared to the videobooklet decision aid + ACA group were not significantly different.

Conclusion

In our study, an audiovisual patient decision aid decreased decisional conflict more than printed material alone or the addition of a more complex computer‐based ACA tool requiring more intense cognitive involvement and explicit value choices.
Joint‐pain comorbidity, health status, and medication use in hip and knee osteoarthritis: A cross‐sectional study
Authors: Hoogeboom Thomas J. , den Broeder Alfons A. , Swierstra Bart A. , de Bie Rob A. , van den Ende Cornelia H. M.
Published: September 2011

Objective

To determine the prevalence of joint‐pain comorbidities in individuals with hip or knee osteoarthritis (OA) and to assess the differences in the characteristics of people with and without joint‐pain comorbidities.

Methods

In this cross‐sectional study, individuals referred to secondary care for treatment of hip/knee OA completed questionnaires to determine sociodemographic characteristics, disease‐related outcomes, and joint‐pain comorbidities. Joint‐pain comorbidity was defined as pain perceived in a joint, other than the index joint, for more than half of the days in the preceding month. To compare differences in patient‐ and disease‐related characteristics between participants with and without joint‐pain comorbidities, we performed analyses of covariance and logistic regression.

Results

A total of 401 individuals, 117 with hip OA and 284 with knee OA, returned the questionnaire (82% response rate); the mean ± SD age was 58 ± 13 years and 58% of the responders were women. Fifty‐eight percent of the participants reported symptoms in ≥1 other joint. Participants with joint‐pain comorbidities were more likely to be women, less educated, and have more medical comorbidities. Individuals with joint‐pain comorbidities reported unfavorable outcomes on pain, functioning, fatigue, distress, and health‐related quality of life compared with patients without joint‐pain comorbidities (P < 0.001 for all). Moreover, use of nonsteroidal antiinflammatory drugs (P = 0.038), opioids (P = 0.010), and supplements (P = 0.019) was higher in the group with joint‐pain comorbidities.

Conclusion

Our results indicate that individuals with joint‐pain comorbidities represent a clinically relevant and large subgroup of people with OA of the knee or hip. We recommend addressing joint‐pain comorbidities in both research and clinical practice.
Evolution of disease burden over five years in a multicenter inception systemic lupus erythematosus cohort
Authors: Urowitz M. B. , Gladman D. D. , Ibañez D. , Fortin P. R. , Bae S. C. , Gordon C. , Clarke A. , Bernatsky S. , Hanly J. G. , Isenberg D. , Rahman A. , Sanchez‐Guerrero J. , Wallace D. J. , Ginzler E. , Alarcón G. S. , Merrill J. T. , Bruce I. N. , Sturfelt G. , Nived O. , Steinsson K. , Khamashta M. , Petri M. , Manzi S. , Ramsey‐Goldman R. , Dooley M. A. , van Vollenhoven R. F. , Ramos M. , Stoll T. , Zoma A. , Kalunian K. , Aranow C.
Published: September 2011

Objective

We describe disease activity, damage, and the accrual of key autoantibodies in an inception systemic lupus erythematosus (SLE) cohort.

Methods

The Systemic Lupus International Collaborating Clinics (SLICC) International Research Network, comprising 27 centers from 11 countries, has followed an inception cohort of SLE patients yearly according to a standardized protocol. Of these patients, 298 were followed for a minimum of 5 years and constitute the study population. Disease activity was assessed using the SLE Disease Activity Index 2000 (SLEDAI‐2K) and damage was assessed using the SLICC/American College of Rheumatology Damage Index (SDI). Antinuclear antibody (ANA), anti‐DNA, and anticardiolipin antibody (aCL) levels and lupus anticoagulant were assessed yearly. Descriptive statistics were generated and repeated‐measures general linear models were used to evaluate SLEDAI‐2K and SDI over time between whites and nonwhites.

Results

Of the 298 patients, 87% were women, 55% were white, 12% were African American, 14% were Asian, 16% were Hispanic, and 2% were categorized as “other.” At enrollment, the mean age was 35.3 years, the mean SLEDAI‐2K score was 5.9, and the mean disease duration was 5.5 months. Mean SLEDAI‐2K scores decreased in the first year and then remained low. SLEDAI‐2K scores were significantly lower at each year in whites compared to nonwhites. Mean SDI scores increased progressively over 5 years; there was no significant difference between whites and nonwhites. As expected, ANA positivity was high and anti‐DNA positivity was relatively low at enrollment, and both increased over 5 years. Although lupus anticoagulant increased slightly over 5 years, aCL positivity did not.

Conclusion

Disease activity in newly diagnosed patients decreases over their first 5 years, while damage increases. Antibody positivity ran variable courses over this period.
Assessment of health‐related quality of life as an outcome measure in granulomatosis with polyangiitis (Wegener's)
Authors: Tomasson Gunnar , Boers Maarten , Walsh Michael , LaValley Michael , Cuthbertson David , Carette Simon , Davis John C. , Hoffman Gary S. , Khalidi Nader A. , Langford Carol A. , Mcalear Carol A. , McCune W. Joseph , Monach Paul A. , Seo Philip , Specks Ulrich , Spiera Robert , St. Clair E. William , Stone John H. , Ytterberg Steven R. , Merkel Peter A.
Published: September 2011

Objective

To assess a generic measure of health‐related quality of life (HRQOL) as an outcome measure in granulomatosis with polyangiitis (Wegener's) (GPA).

Methods

Subjects were participants in the Wegener's Granulomatosis Etanercept Trial (WGET) or the Vasculitis Clinical Research Consortium Longitudinal Study (VCRC‐LS). HRQOL was assessed with the Short Form 36 (SF‐36) health survey that includes physical and mental component summary scores (PCS and MCS, respectively). Disease activity was assessed with the Birmingham Vasculitis Activity Score for Wegener's Granulomatosis (BVAS/WG).

Results

The data from 180 subjects in the WGET (median followup 2.3 years, mean number of visits 10) and 237 subjects in the VCRC‐LS (median followup 2.0 years, mean number of visits 8) were analyzed. A 1 unit increase in the BVAS/WG corresponded to a 1.15 unit (95% confidence interval [95% CI] 1.02, 1.29) decrease for the PCS and a 0.93 (95% CI 0.78, 1.07) decrease for the MCS in the WGET, and to a 1.16 unit decrease for the PCS (95% CI 0.94, 1.39) and a 0.79 unit decrease for the MCS (95% CI 0.51, 1.39) in the VCRC‐LS. In both arms of the WGET study, SF‐36 measures improved rapidly during the first 6 weeks of treatment followed by gradual improvement among patients achieving sustained remission (0.5 improvement in PCS per 3 months), but worsened slightly (0.03 decrease in PCS every 3 months) among patients not achieving sustained remission (P = 0.005).

Conclusion

HRQOL, as measured by the SF‐36, is reduced among patients with GPA. SF‐36 measures are modestly associated with other disease outcomes and discriminate between disease states of importance in GPA.
The Manufacture of Resorbable Suture Material from Magnesium – Drawing and Stranding of Thin Wires
Authors: Seitz Jan‐Marten , Utermöhlen Dennis , Wulf Eric , Klose Christian , Bach Friedrich‐Wilhelm
Published: September 2011

With the aid of multiple wire drawing passes, the magnesium alloys ZEK100, MgCa0.8, and AL36 were reduced to monofilament wires possessing diameters between 0.5 and 0.1 mm. These filaments were subsequently twisted into poly‐filament suture material using stranding. In order to analyze the microstructural constituents and the mechanical‐tribological properties, metallographic specimens were prepared and tensile tests were performed on both monofilament as well as poly‐filament wire strands. Appropriate parameters were ascertained for the wire drawing process with regard to forming rate, temperature, and heat treatment. During the investigations, the alloy ZEK100 exhibited particularly interesting mechanical properties which, owing to its high tensile strengths (up to 550 MPa for monofilament) and fracture strains (up to 30% for poly‐filament), are comparable to those of conventional polymer‐based suture materials. In addition to this, integrating a core (internal, individual wire) into the poly‐filament mesh of wire strands represents an interesting alternative for future research in which structures composed of different materials, and the advantages of combining their properties are brought into particular focus.
Preparation and Characterization of Molecularly Imprinted Polymeric Nanoparticles for Atrial Natriuretic Peptide (ANP)
Authors: Wang Chunyan , Howell Mark , Raulji Payal , Davis Yvonne , Mohapatra Subhra
Published: September 2011

Natriuretic peptide receptor A (NPRA), the receptor for the cardiac hormone atrial natriuretic peptide (ANP), is expressed abundantly on cancer cells and disruption of ANP‐NPRA signaling inhibits tumor burden and metastasis. Since antagonists of NPRA signaling have not provided reproducible results, we reason that a synthetic neutralizing antibody to ANP, which has high selectivity and affinity for ANP, can be used to regulate ANP levels and attenuate NPRA signaling. In this study, we prepare molecularly imprinted polymeric nanoparticles (MIPNPs) for ANP using a short peptide of ANP as the template and determine their binding affinity and selectivity. The MIPNPs are prepared by precipitation polymerization using NH2–SLRRSS–CONH2, which is a short peptide from ANP, as a template, methacrylic acid and N‐isopropylacrylamide as functional monomers, and bis‐acrylamide as a crosslinker. The average diameters of the MIPNPs and of non‐imprinted nanoparticles (NIPNPs) in water are 215.8 ± 4.6 nm and 197.7 ± 3.1 nm respectively. The binding‐isotherm analysis shows that the MIPNPs have a much‐higher binding affinity for the template peptide and ANP than the NIPNPs. Scatchard analysis gives an equilibrium dissociation constant, Kd, of 7.3 × 10−6 M with a binding capacity of 106.7 μmol g−1 for the template peptide and a Kd of 7.9 × 10−6 M with a binding capacity of 36.0 μmol g−1 for the ANP. Measurements of the binding kinetics reveal that MIPNPs reach protein‐adsorption equilibrium in 30 min. The MIPNPs are found to have a high specificity for ANP with little affinity for BSA or scrambled ANP peptide. The MIPNPs also recognize and adsorb ANP in cell‐culture medium spiked with ANP and in human plasma. Taken together, these results indicate that the MIPNPs have a high affinity and selectivity for ANP and can be used as a synthetic antibody for modulating ANP‐NPRA signaling in cancers.