bluuebunny/crossref_metadata_2025 huggingface dataset:
Childhood growth and age at diagnosis with Type 1 diabetes in Colorado young people
Authors: Vehik K. , Hamman R. F. , Lezotte D. , Norris J. M. , Klingensmith G. J. , Dabelea D.
Published: August 2009

Objective  Studies have suggested that the age at diagnosis of Type 1 diabetes (T1D) is decreasing over time. The overload hypothesis postulates that risk factors, such as accelerated growth, may be responsible for this decrease. We assessed changes in age, body mass index (BMI), weight and height at diagnosis with T1D in non‐Hispanic white (NHW) and Hispanic (HISP) young people from Colorado, using data from the IDDM Registry and SEARCH Study.

Methods  In three time periods, 656 (1978–1983), 562 (1984–1988) and 712 (2002–2004) young people aged 2–17 years were newly diagnosed with T1D. Age, weight, height and presence of diabetic ketoacidosis (DKA) at diagnosis with T1D were obtained from medical records. Trends over the three time periods were assessed with regression analyses.

Results  Age at diagnosis decreased by 9.6 months over time (P = 0.0002). Mean BMI standard deviation score (SDS), weight SDS and height SDS increased over time (P < 0.0001), while prevalence of DKA decreased (P < 0.0001). Increasing height over time accounted for 15% (P = 0.04) of the decreasing age at diagnosis with T1D.

Conclusions  Our study provides evidence that increased linear growth, but not increased BMI or weight over time, may account, at least in part, for the younger age at diagnosis of T1D in Colorado children. This finding supports the hypothesis that increasing environmental pressure resulting from changes in potentially preventable risk factors may accelerate the onset of T1D in children.
Potential impact of the Choices Programme on nutrient intakes in the Dutch population
Authors: Roodenburg A. J. C. , Temme E. H. M. , Davies O. Howell , Seidell J. C.
Published: August 2009

In May 2006, the Choices Programme was launched in The Netherlands – products can qualify for a health stamp by meeting pre‐set nutritional criteria. Currently, more than 120 partners in food manufacturing, retail and catering have joined the initiative. There is an increasing recognition and appreciation of the health stamp by consumers. Moreover, the initiative has given a clear incentive to participating companies to reformulate products to give them a healthier profile. The objective of the present study is to assess the potential effect on nutrient intakes in the Dutch population after replacing normally consumed foods in diets with foods that are eligible to carry a Choices stamp.

Usual nutrient intakes were calculated using deterministic modelling with the Monte Carlo risk assessment model. Inputs for the modelling were food intakes (Dutch Food Consumption Survey 2003) and composition of foods from the Dutch food composition database. For a selection of nutrients, three scenarios were calculated and compared: (1) nutrient intakes ‘as measured’, based on the original Dutch Food Consumption Survey data; (2) replacement of all non‐complying foods, where possible, with a food complying with the Choices criteria; and, because this could lead to a decreased energy intake, (3) same as (2) but nutrient intakes corrected for the difference in energy content between the original and the replacement food.

Calculations of usual intake distributions showed that energy intakes were reduced by 15% by replacing normally consumed foods with foods carrying the Choices stamp. Intakes of nutrients with a maximal intake limit were also reduced (between −23% for sodium and −63% for trans fatty acids). Intakes of nutrients with a minimal intake limit increased (between +5% for folic acid and +28% for fibre), except for carbohydrate (−16%) and unsaturated fatty acids (polyunsaturated fatty acids −1% and monounsaturated fatty acids −28%). When the data were corrected for energy intake, the difference was still apparent, but smaller for the nutrients with maximal intake limits and larger for most of the nutrients with minimal intake limits, except for carbohydrate and unsaturated fatty acids.

From the results, it can be concluded, based on data from the Dutch Food Consumption Survey 2003, that replacing normally consumed foods in the diet with foods that carry the Choices health stamp can potentially lead to substantial improvements in nutrient intakes. These results demonstrate the potential positive impact of the Choices Programme on nutrient intakes in the Dutch population.
World Bank Influence and Institutional Reform in Argentina
Authors: Tuozzo Maria F.
Published: August 2009

During the 1990s, reforms concerned with ‘good governance’ became popular with multilateral and bilateral lenders. This trend was led by the World Bank, which claimed that in order to achieve economic development, institutions mattered. This article looks at governance reforms in Argentina, specifically in the judicial sector, and contends that World Bank involvement affected the nature, reach and depth of these initiatives. The influence of the Bank can be traced through three dimensions that have characterized its approach to institutional reform: donor‐driven designs for project reform; reliance on technical approaches; and restricted forms of decision making in project initiatives. Such an approach to institutional change conditioned domestic reform in Argentina and contributed to piecemeal and inadequate initiatives. The author also argues that the Bank's approach in Argentina can be traced to wider strategies that derive from embedded institutional practices and ideological foundations within the institution that throw into question the Bank's capacities to promote such reforms.
‘Social Development’ as Neoliberal Trojan Horse: The World Bank and the Kecamatan Development Program in Indonesia
Authors: Carroll Toby
Published: August 2009

This article seeks to reconceptualize the post‐Washington consensus (PWC) by focusing not simply upon the institutional structures and ideology promoted by it, but the manner in which these are promoted on the ground. The aim is to reveal a central distinction between the Washington consensus and the PWC that has been somewhat neglected: their diverging approaches to implementation. The author focuses on the World Bank‐funded Kecamatan Development Program (KDP) in Indonesia, a project that is viewed by some as being somewhat unorthodox. He argues that in addition to its promotion of the latest round of institutional reforms, what is really different about KDP, compared with older approaches to market‐led development typical of the Washington consensus, is the manner in which it delivers its mix of neoliberalism. What is radical about a programme like KDP is that it constitutes a new Trojan horse for embedding market‐centred norms and practices.1 In general, this is demonstrative of a key difference between the Washington consensus and the PWC that has been undervalued in many analyses of the dominant development paradigm: the methods used to embed and sustain liberal markets.
Notes from a recession
Authors: Scott Andrew
Published: August 2009

While the current recession is at the forefront of everyone's mind, Andrew Scott suggests we take a moment to examine what we've really learned.
Default lines
Authors: Goldstein Daniel G.
Published: August 2009

Most consumers don't think about the potential range of choices in a sales transaction; thus, they often accept the pre‐selected “default” choice. Companies can benefit immensely from well‐designed defaults, though, and Daniel Goldstein tells us how.
Diagnosis of advanced fibrosis in HIV and hepatitis C virus‐coinfected patients via a new noninvasive index: the HGM‐3 index
Authors: Resino S , Micheloud D , Miralles P , Bellón JM , Vargas A , Catalán P , Álvarez E , Cosín J , Lorente R , López JC , Muñoz‐Fernández MA , Berenguer J
Published: August 2009

Background

Noninvasive tests are increasingly being used for the assessment of liver fibrosis. We aimed to develop a serum index for the identification of advanced fibrosis (F≥3) in HIV/hepatitis C virus (HCV)‐coinfected patients.

Methods

We carried out a cross‐sectional study on a group of 195 patients comprised of an estimation group (EG; n=127) and a validation group (VG; n=68) who all underwent liver biopsy and had not received previous interferon therapy. Liver fibrosis was estimated using the METAVIR score. We developed a new serum index (HGM‐3) dependent on levels of platelets, alkaline phosphatase, hepatic growth factor, tissue inhibitor of metalloproteinase‐1 and hyaluronic acid.

Results

In the EG, the area under the receiver operating characteristic curve (AUC‐ROC) of HGM‐3 for identification of F≥3 was 0.939 [95% confidence interval (CI) 0.899, 0.979] which was significantly higher than the AUC‐ROC of the HGM‐2, FIB‐4, aspartate aminotransferase to platelet ratio (APRI) and Forns' indexes. With HGM‐3 <0.135 for F<3, 57 patients were correctly identified and two patients were misclassified. We found the presence of F<3 with 96.6% certainty. The negative likelihood ratio (LR) was <0.1 and the diagnostic odds ratio (DOR) was >40. With HGM‐3 >0.570 in the EG for F≥3, 31 patients were correctly identified, and five patients were misclassified. We found the presence of F≥3 with 86.1% certainty. The positive LR was >12 and the DOR was >40. For the VG, the diagnostic accuracy values were similar to the values for the EG.

Conclusions

HGM‐3 appears to be an accurate noninvasive method for the diagnosis of bridging fibrosis and cirrhosis in HIV/HCV‐coinfected patients.
Running From a Bear: How Poor Stock Market Performance Affects the Determinants of Mutual Fund Flows
Authors: Shrider David G.
Published: August 2009

Abstract:  Using a proprietary data set to study how past performance affects the determinants of mutual fund flows for a sample of load fund investors, I provide evidence that the determinants of fund flow depend on market conditions for both redemptions and purchases. Specifically, I show that, for redemptions, relative performance and risk adjusted performance are important determinants during a period of record flows into mutual funds. Conversely, during a period of poor performance, absolute performance becomes much more important and relative performance and risk adjusted performance become less important. For purchases, absolute performance, risk adjusted performance, and most relative performance measures become more important during the bear market.
Dollar Dominance, Euro Aspirations: Recipe for Discord?
Authors: COHEN BENJAMIN J.
Published: August 2009

After nearly a century of dominance of the international monetary system, has the US dollar finally met its match in the euro? When Europe's economic and monetary union (EMU) came into existence in 1999, many observers predicted that the euro would soon join America's greenback at the peak of global finance. Achievements, however, have fallen short of aspiration. After an initial spurt of enthusiasm, international use of the euro actually appears now to be levelling off, even stalling, and so far seems confined largely to a limited range of market sectors and regions. The euro has successfully attained a place second only to the greenback – but it remains, and is likely to remain, a quite distant second without a determined effort by EMU authorities to promote their money's global role. The temptation will surely be great. In practical terms, it is difficult to imagine that EMU authorities will refrain entirely from trying to promote a greater role for the euro. But that, in turn, could turn out to be a recipe for discord with the United States, which has never made any secret of its commitment to preserving the greenback's worldwide dominance. A struggle for monetary leadership could become a source of sustained tensions in US–European relations. Fortunately, however, there seems relatively little risk of a destabilizing escalation into outright geopolitical conflict.
Does Bilateralism Foster Co‐operation in Europe? An Experimental Approach of Comparative Merits of Bilateralism and Multilateralism*
Authors: MY KENE BOUN , VERCHERE ALBAN , BERTRAND STEPHANE
Published: August 2009

Europe is oscillating between increased integration and permanent risk of dissolution. In this framework, one often debates the role of bilateral relations, with the following question: does bilateralism foster or delay overall co‐operation? We address this question in an experimental framework where we study the behaviour of agents who are confronted with a multiplicity of prisoners' dilemma games, either in abilateralor amultilateralway. We surprisingly observe that the co‐operationbetween allis significantly higher when interactions are bilateral and that the difference between these two institutional contexts is growing in time in favour of bilateralism.
The role of interspecific interference competition in character displacement and the evolution of competitor recognition
Authors: Grether Gregory F. , Losin Neil , Anderson Christopher N. , Okamoto Kenichi
Published: August 2009

The extent to which interspecific interference competition has contributed to character evolution is one of the most neglected problems in evolutionary biology. When formerly allopatric species come into secondary contact, aggressive interactions between the species can cause selection on traits that affect interspecific encounter rates (e.g. habitat preferences, activity schedules), competitor recognition (e.g. colouration, song), and fighting ability (e.g. weaponry, body size). We define agonistic character displacement (ACD) as the process of phenotypic evolution in a population caused by interference competition with one or more sympatric species and which results in shifts in traits that affect the rate, intensity or outcome of interspecific aggression. After clarifying the relationships between ACD and other evolutionary processes that may occur when species come into secondary contact, we develop an individual‐based, quantitative genetic model to examine how traits involved in competitor recognition would be expected to evolve under different secondary contact scenarios. Our simulation results show that both divergence and convergence are possible outcomes, depending on the intensity of interspecific exploitative competition, the costs associated with mutualversusunilateral recognition, and the extent of phenotypic differences prior to secondary contact. We then devise a set of eight criteria for evaluating putative examples of ACD and review the empirical literature to assess the strength of existing evidence and to identify promising avenues for future research. Our literature search revealed 33 putative examples of ACD across insects, fishes, bats, birds, lizards, and amphibians (15 divergence examples; 18 convergence examples). Only one example satisfies all eight criteria for demonstrating ACD, but most case studies satisfy four or more criteria. The current state of the evidence for ACD is similar to the state of the evidence for ecological character displacement just 10 years ago. We conclude by offering suggestions for further theoretical and empirical research on ACD.
A proof‐of‐principle gel‐free proteomics strategy for the identification of predictive biomarkers for the onset of pre‐eclampsia
Authors: Blankley RT , Gaskell SJ , Whetton AD , Dive C , Baker PN , Myers JE
Published: August 2009

Objective  Progress in the prevention and treatment of women at risk of pre‐eclampsia (PE) still remains hindered by the lack of clinical screening tools that can accurately predict which mothers are at risk. The identification and validation of predictive biomarkers is therefore seen as a critical milestone towards improved healthcare provision and the clinical testing of new therapeutic strategies. Gel‐free proteomic technologies offer the capability of analysing hundreds of plasma proteins simultaneously, but as yet these methods have not been applied to pregnancy complications. To assess the feasibility of such an approach to plasma biomarker research in pregnancy we have applied the technique to samples from women with PE to gestation‐matched controls.

Sample  Pooled plasma samples taken at time of disease from women with PE (n = 23) and gestation‐matched controls (n = 23).

Methods  Proteomics strategy for relative quantification of proteins using mass spectrometry.

Results  We identified several differences, including elevated levels of endoglin, PAPP‐A and PSG1 in PE plasma. Increased levels of endoglin were validated using immunoassay analysis of individual plasma samples.

Conclusions  Although at a relatively early stage, this mass spectrometry‐based approach shows promise as a tool to identify global protein changes in plasma. The application of these methods to pre‐disease samples is the next step in the identification of clinically useful biomarkers.
The more you introduce the more you get: the role of colonization pressure and propagule pressure in invasion ecology
Authors: Lockwood Julie L. , Cassey Phillip , Blackburn Tim M.
Published: August 2009

Aim We argue that ‘propagule pressure’, a key term in invasion biology, has been attributed at least three distinct definitions (with usage of a related term causing additional confusion). All of the definitions refer to fundamental concepts within the invasion process, with the result that the distinct importance of these different concepts has been at best diluted, and at worst lost.

Location Global.

Methods We reviewed pertinent literature on propagule pressure to resolve confusion about different uses of the term ‘propagule pressure’ and we introduced a new term for one variant, colonization pressure. We conducted a computer simulation whereby the introduction of species is represented as a simple sampling process to elucidate the relationship between propagule and colonization pressure.

Results We defined colonization pressure as the number of species introduced or released to a single location, some of which will go on to establish a self‐sustaining population and some of which will not. We subsequently argued that colonization pressure should serve as a null hypothesis for understanding temporal or spatial differences in exotic species richness, as the more species that are introduced, the more we should expect to establish. Finally, using a simple simulation, we showed that propagule pressure is related to colonization pressure, but in a non‐linear manner.

Main conclusion We suggest that the nature of the relationship between propagule pressure and colonization pressure, as well as the efficacy of various proxy measures of each, require more detailed exploration if invasion ecology is to continue to develop into a more predictive science.
The effectiveness of questionnaires in the determination of Contact Lens Induced Dry Eye
Authors: Michel M. , Sickenberger W. , Pult H.
Published: August 2009

Purpose:  This study investigates how well the recently introduced Ocular Comfort Index (OCI) and the more established McMonnies Dry Eye Index are able to detect contact lens induced dry eye (CLIDE).

Methods:  Seventy volunteer contact lens wearers (mean age = 28.7 ± 8.0; 52 female, 18 male) were grouped as CLIDE positive or CLIDE negative depending on three sets of criteria: Method I: objective (tear meniscus height, lid parallel conjunctival folds, phenol red thread test and tear break‐up time); Method II: objective and/or subjective [contact lens dry eye questionnaire (CLDEQ)] (i.e. being positive by Method I and/or Method III); Method III: subjective (CLDEQ). Symptoms were measured using the McMonnies Dry Eye Index and the OCI. Discrimination was analysed by the receiver operating characteristic (ROC) curves; positive predictive values (PPV) and cut‐off values were calculated.

Results:  ROC results for Methods I and II were statistically significant only for the McMonnies (p = 0.008; p < 0.001; respectively). In Method III ROC results were statistically significant for both the McMonnies (p = 0.001) and OCI (p = 0.005). The McMonnies showed the best prediction of Method I [0.646/10.5 (PPV/cut‐off value)], while the OCI gave the best predictability in Method III only (0.518/30.6).

Conclusion:  A McMonnies scoring of ≥10.5 or an OCI scoring of ≥30.6 indicates CLIDE. The McMonnies performs better in prediction of CLIDE than the OCI.
Glial cell factors and the outer blood retinal barrier
Authors: Constable Paul A. , Lawrenson John G.
Published: August 2009

The retinal pigment epithelium is an important barrier to drug transport as well as contributing to the normal functioning of the photoreceptors. The contributions of glial cells in the retina to the maintenance and development of this barrier is important. There is evidence that retinal secreted factors play a role in the induction and maintenance of the outer blood retinal barrier. One possible source of such factors are the retinal glial cells, astrocytes and Müller cells, which may influence tight junction formation and maturation. The aim of this study was to examine the changes in the trans‐epithelial resistance (TER), as a measure of barrier integrity, on cell lines of epithelial origin (ECV304 and ARPE‐19) following co‐culture with glial cell lines (C6 and MIO‐M1) or with the addition of medium conditioned by these cells. One cell line, ECV304, showed a significant increase in the TER in response to glial secreted factors whilst ARPE‐19 did not. This finding suggests that ECV304 responds well to glial factors and may be useful for further studies of the factors that affect tight junction formation through glial cell induction in vitro.
A versatile optoelectronic aid for low vision patients
Authors: Peláez‐Coca María Dolores , Vargas‐Martín Fernando , Mota Sonia , Díaz Javier , Ros‐Vidal Eduardo
Published: August 2009

The purpose of this work is to describe a versatile optoelectronic aid for low vision rehabilitation based on reconfigurable hardware. This aid is easily adaptable to diverse pathologies (with different associated processing tasks) and to the progression of the visual impairment. This platform has a mobile configuration that uses a see‐through head‐mounted display (Nomad). We have implemented different types of vision enhancement on this versatile platform, and briefly summarize here their computational costs (in terms of hardware resource requirements). We have evaluated two representative capabilities of this aid (Augmented View and digital zoom) with measurements of visual acuity, contrast sensitivity and visual field. We have tested the Nomad head‐mounted display and the Augmented View modality, in eight subjects with retinitis pigmentosa: the digital zoom was tested in six low vision subjects and nine normally‐sighted subjects. We show that the Nomad display with Augmented View configuration does not impair the residual vision; and that there is an increase in visual acuity (VA) with the digital zoom configuration. The major advantage of this platform is that it can easily embed different image processing tasks and since it is based on a FPGA device, it can be specifically configured to tasks requiring real‐time processing.
The importance of grating orientation in contrast sensitivity following refractive surgery
Authors: Tahir Humza J. , Parry Neil R. A. , Brahma Arun , Ikram Khalid , Murray Ian J
Published: August 2009

Higher‐order aberrations degrade visual performance when the pupil is large, particularly in eyes that have abnormally high amounts of aberrations, such as those that have undergone refractive surgery. Geometrical optics predicts that asymmetrical aberrations such as coma can produce orientation selective effects, much like uncorrected astigmatism. Coma is also one of the main aberrations to increase following refractive surgery. Orientation may therefore be an important parameter when testing grating based contrast sensitivity, particularly in refractive surgery patients. Contrast sensitivity to four orientations of a 12 cycles deg−1 sine wave grating was measured in normals (n = 34) and refractive surgery patients (n = 12). In over a third of normal subjects the higher‐order aberrations produced a significant orientation‐specific change in contrast sensitivity (13 out of 34 eyes, p < 0.05). No significant differences existed in the aberrations between those that displayed orientation‐selective changes and those that did not. In subjects who underwent refractive surgery those that displayed orientation selective changes had significantly higher amounts of overall aberrations and also higher amounts of primary coma than those that did not. These results indicate that grating orientation is an important factor when assessing the effects of higher‐order aberrations on contrast sensitivity.
THE CHALLENGE OF ‘TECHNOLOGICAL CHOICES’FOR MATERIALS SCIENCE APPROACHES IN ARCHAEOLOGY*
Authors: SILLAR B. , TITE M. S.
Published: August 2009

Recently several anthropological and sociological studies have interpreted technologies as cultural choices that are determined as much by local perceptions and the social context fly any material constraints or purely functional criteria. Using the example of ceramic technology we consider how materials science studies can contribute to and benefit from this understanding of technology as a social construct. Although we acknowledge some potential difficulties, it is our contention that both materials scientists and archaeologists have gained much and have much to gain by cooperating together to study ancient technologies, and that the concept of ‘technological choices’can facilitate a wider consideration of the factors shaping technological developments.
Lifting the Siege of Liberalism
Authors: Fabbrini Sergio
Published: August 2009

Starr, P. (2007) Freedom's Power: The True Force of Liberalism. New York: Basic Books.
Role of glaciohydraulic supercooling in the formation of stratified facies basal ice: Svínafellsjökull and Skaftafellsjökull, southeast Iceland
Authors: COOK SIMON J. , ROBINSON ZOE P. , FAIRCHILD IAN J. , KNIGHT PETER G. , WALLER RICHARD I. , BOOMER IAN
Published: August 2009

Cook, S. J., Robinson, Z. P., Fairchild, I. J., Knight, P. G., Waller, R. I. & Boomer, I. 2009: Role of glaciohydraulic supercooling in the formation of stratified facies basal ice: Svínafellsjökull and Skaftafellsjökull, southeast Iceland. Boreas, 10.1111/j.1502‐3885.2009.00112.x. ISSN 0300‐9483.

There is need for a quantitative assessment of the importance of glaciohydraulic supercooling for basal ice formation and glacial sediment transfer. We assess the contribution of supercooling to stratified facies basal ice formation at Svínafellsjökull and Skaftafellsjökull, southeast Iceland, both of which experience supercooling. Five stratified basal ice subfacies have previously been identified at Svínafellsjökull, but their precise origins have not been determined. Analysis of stratified basal ice stable isotope compositions (δ18O and δD), spatial distribution and physical characteristics demonstrates that two subfacies present at both glaciers are consistent with supercooling. These ‘supercool’ subfacies account for 42% of stratified facies exposed at Svínafellsjökull, although estimates at Skaftafellsjökull are precluded by limited basal ice exposure. Owing to their high debris contents, supercooling‐related facies contribute a debris flux of 4.8 to 9.6 m3 m−1 a−1 at Svínafellsjökull (83% of the stratified facies debris flux). Other stratified subfacies, formed by non‐supercooling processes, account for 58% of the stratified basal ice at Svínafellsjökull, but only contribute a debris flux of 1.0 to 2.0 m3 m−1 a−1 (17% of the stratified facies debris flux). We conclude that supercooling has a significant role in glacial sediment transfer, although in stratified basal ice formation its role is less significant at these locations than has been reported elsewhere.
PHACE Syndrome: Current Knowledge, Future Directions
Authors: Metry Denise W. , Garzon Maria C. , Drolet Beth A. , Frommelt Peter , Haggstrom Anita , Hall Judith , Hess Christopher P. , Heyer Geoffrey L. , Siegel Dawn , Baselga Eulalia , Katowitz William , Levy Moise L. , Mancini Anthony , Maronn Mandi L. , Phung Thuy , Pope Elena , Sun Grace , Frieden Ilona J.
Published: August 2009

Abstract:  On November 7–8, 2008, physicians gathered in Houston Texas for the first‐ever workshop on PHACE syndrome, an important and recently described neurocutaneous syndrome. This article represents a summary of the discussions held at that workshop, which was attended by a broad range of medical specialists.
Ichthyosis Follicularis, Alopecia, and Photophobia (IFAP) Syndrome Due to Mutation of the Gene MBTPS2 in a Large Australian Kindred
Authors: Ming Andrew , Happle Rudolf , Grzeschik Karl‐Heinz , Fischer Gayle
Published: August 2009

Abstract:  Ichthyosis follicularis, alopecia and photophobia (IFAP) is a rare genodermatosis. Most patients have been men without significant family history. We present the largest kindred of IFAP reported to date in the medical literature clearly demonstrating X‐linked inheritance. The gene defect has recently been mapped to Xp22.11‐p22.13. Missense mutations of the gene, MBTPS2, which codes for an intramembrane zinc metalloprotease essential for cholesterol homeostasis and endoplasmic reticulum stress response, are associated with the IFAP phenotype in this kindred. We describe the clinical features and discuss the differential diagnosis of IFAP. Our proband has benefited from treatment with acitretin.
Faun Tail Nevus with Aplasia Cutis Congenita
Authors: CHANDER RAM , JAIN ARPITA , JAYKAR KRANTI , GARG TARU , ANAND RAMA
Published: August 2009

Abstract:  Faun tail nevus describes abnormal lumbar hypertrichosis, which may overlie on occult spinal abnormality and be a marker of asymptomatic underlying spinal dysraphism. We report a case of faun tail nevus, with dermal pits along with aplasia cutis congenita and asymptomatic spina bifida occulta, tethered conus, and diastematomyelia, a constellation of findings which to our knowledge has not been previously reported.
Development and Pilot Testing of Computerized Order Entry Algorithms for Geriatric Problems in Nursing Homes
Authors: Colón‐Emeric Cathleen S. , Schmader Kenneth E. , Twersky Jack , Kuchibhatla Maragantha , Kellum Sally , Weinberger Morris
Published: August 2009

OBJECTIVES: To develop order entry algorithms for five common nursing home problems and to test their acceptance, use, and preliminary effect on nine quality indicators and resource utilization.

DESIGN: Pre–post, quasi‐experimental study.

SETTING: Two Department of Veterans Affairs nursing homes.

PARTICIPANTS: Randomly selected residents (N=265) with one or more target conditions and 42 nursing home providers.

INTERVENTION: Expert panels developed computerized order entry algorithms based on clinical practice guidelines. Each was displayed on a single screen and included an array of diagnostic and treatment options and means to communicate with the interdisciplinary team.

MEASUREMENTS: Medical records were abstracted for the 6 months before and after deployment for quality indicators and resource utilization.

RESULTS: Despite positive provider attitudes toward the computerized order entry algorithms, their use was infrequent and varied according to condition: falls (73.0%), fever (9.0%), pneumonia (8.0%), urinary tract infection (7.0%), and osteoporosis (3.0%). In subjects with falls, trends for improvements in quality measures were observed for six of the nine measures: measuring orthostatic blood pressure (17.5–30.0%, P=.29), reducing neuroleptics (53.8–75.0%, P=.27), reducing sedative‐hypnotics (16.7–50.0%, P=.50), prescription of calcium (22.5–32.5%, P=.45), vitamin D (20.0–35.0%, P=.21), and external hip protectors (25.0–47.5%, P=.06). Little improvement was observed in the other conditions (documentation of vital signs, physical therapy referrals, or reduction of benzodiazepines or antidepressants). There was no change in resource utilization.

CONCLUSION: Computerized order entry algorithms were used infrequently, except for falls. Further study may determine whether their use leads to improved care.
Pain, Functional Limitations, and Aging
Authors: Covinsky Kenneth E. , Lindquist Karla , Dunlop Dorothy D. , Yelin Edward
Published: August 2009

OBJECTIVES: To examine the relationship between functional limitations and pain across a spectrum of age, ranging from mid life to advanced old age.

DESIGN: Cross‐sectional study.

SETTING: The 2004 Health and Retirement Study (HRS), a nationally representative study of community‐living persons aged 50 and older.

PARTICIPANTS: Eighteen thousand five hundred thirty‐one participants in the 2004 HRS.

MEASUREMENTS: Participants who reported that they were often troubled by pain that was moderate or severe most of the time were defined as having significant pain. For each of four functional domains, subjects were classified according to their degree of functional limitation: mobility (able to jog 1 mile, able to walk several blocks, able to walk one block, unable to walk one block), stair climbing (able to climb several flights, able to climb one flight, not able to climb a flight), upper extremity tasks (able to do 3, 2, 1, or 0), and activity of daily living (ADL) function (able to do without difficulty, had difficulty but able to do without help, need help).

RESULTS: Twenty‐four percent of participants had significant pain. Across all four domains, participants with pain had much higher rates of functional limitations than subjects without pain. Participants with pain were similar in terms of their degree of functional limitation to participants 2 to 3 decades older. For example, for mobility, of subjects aged 50 to 59 without pain, 37% were able to jog 1 mile, 91% were able to walk several blocks, and 96% were able to walk one block without difficulty. In contrast, of subjects aged 50 to 59 with pain, 9% were able to jog 1 mile, 50% were able to walk several blocks, and 69% were able to walk one block without difficulty. Subjects aged 50 to 59 with pain were similar in terms of mobility limitations to subjects aged 80 to 89 without pain, of whom 4% were able to jog 1 mile, 55% were able to walk several blocks, and 72% were able to walk one block without difficulty. After adjustment for demographic characteristics, socioeconomic status, comorbid conditions, depression, obesity, and health habits, across all four measures, participants with significant pain were at much higher risk for having functional limitations (adjusted odds ratio (AOR)=2.85, 95% confidence interval (CI)=2.20–3.69, for mobility; AOR=2.84, 95% CI=2.48–3.26, for stair climbing; AOR=3.96, 95% CI=3.43–4.58, for upper extremity tasks; and AOR=4.33; 95% CI=3.71–5.06, for ADL function).

CONCLUSION: Subjects with pain develop the functional limitations classically associated with aging at much earlier ages.
Comparison of the Marginal Fit of Pressable Ceramic to Metal Ceramic Restorations
Authors: Holden Jason E. , Goldstein Gary R. , Hittelman Eugene L. , Clark Elizabeth A.
Published: August 2009

Purpose: The aim of this in vitro study was to compare the marginal adaptation of a pressed ceramic material, when used with and without a metal substructure, to a traditional feldspathic porcelain‐fused‐to‐metal restoration with a porcelain butt margin.

Materials and Methods: A maxillary central incisor typodont tooth was prepared with a 1.5 mm 360° shoulder with rounded internal line angle, and 30 polyether impressions were made. Dies were poured in type IV dental stone, and 30 restorations were fabricated: 10 metal ceramic restorations (MCR) with porcelain butt joints, 10 pressed to metal restorations (PTM), and 10 all‐ceramic restorations (PCR). All restorations were evaluated on their respective dies at 45× magnification using an Olympus SZX‐12, measurements of the marginal openings were made, and ANOVA and Scheffé post hoc tests were used to evaluate the data.

Results: The mean marginal opening was 72.2 ± 5.9 μm for MCR, 49.0 ± 5.9 μm for PTM, and 55.8 ± 5.9 μm for PCR. The post hoc tests showed that there was a statistical difference between the marginal adaptation of the PTM and MCR groups (p < 0.05). There was no significant difference in marginal adaptation between the PTM and the PCR groups, or the PCR and the MCR groups.

Conclusions: The PTM group demonstrated a smaller mean marginal opening than the MCR group. The mean marginal openings of all three groups were within a clinically acceptable range.
Aftercare of the Complete Denture Patient
Authors: Shigli Kamal
Published: August 2009

Complete denture treatment does not end with the insertion of the finished prosthesis. Regular denture maintenance by the patient and periodic consultation with the prosthodontist are essential for the long‐term success of treatment. This article attempts to focus on the points to be considered in the aftercare of the complete denture patient.
A novel rapid and effective donor arm disinfection method
Authors: McDonald Carl , McGuane Siobhan , Thomas Julia , Hartley Stephen , Robbins Steve , Roy Anjana , Verlander Neville , Barbara John
Published: August 2009

BACKGROUND: The aim of the study was to derive a donor arm disinfection technique that was rapid, but with a disinfection efficacy equivalent to a previous “best‐practice” technique. This method consisted of a two‐stage procedure with an initial application of 70% isopropyl alcohol and then 2% tincture of iodine (IATI). The total time for the IATI method was 2 minutes in duration. A rapid technique (1 min in duration) was needed to obviate potential problems due to increased donor waiting time, had the IATI method been implemented at blood donation sessions.

STUDY DESIGN AND METHODS: A direct swabbing and plating technique was used to enumerate bacteria present before and after disinfection. In total, seven methods were evaluated.

RESULTS: The chlorhexidine/alcohol applicator (CAA) disinfection device containing 1.5 mL of 2% chlorhexidine gluconate and 70% isopropyl alcohol (99.91% reduction; confidence limits, 99.55%, 99.98%) was shown to have equivalent disinfection efficacy as the IATI method (99.89% reduction; confidence limits, 99.36%, 99.98%; p = 0.86). Procedural time for the 1.5‐mL CAA method was 1 minute thereby avoiding potential problems of increased donor waiting time, inherent in the IATI 2‐minute procedure at blood donation sessions.

CONCLUSIONS: The 1.5‐mL CAA disinfection method offers blood services a rapid and effective donor arm disinfection procedure. In 2006, the 1.5‐mL CAA procedure was implemented throughout the entire English blood service for all donations.
The Intensive Medical Care of Sick, Impaired, and Preterm Newborns in Israel and the Production of Vulnerable Neonatal Subjectivities
Authors: Weiner Noga
Published: August 2009

Following reduction in mortality rates of term and preterm babies hospitalized in NICUs, neonataology refocused its concerns on the survivors’ elevated risks of long‐term health and developmental problems, thus turning the “intact survival” of hospitalized newborns into an equivalently desired moral and professional goal as their “survival.” Based on ethnographic observations in an Israeli NICU (“pagia”), I suggest that the new moral practice has bearings on the construction of neonatal subjectivities. According to Jewish and Israeli laws, personhood is conferred on at birth. However, my findings indicate that in practice the question of “quality of life” often appears to be a stronger consideration than legal personhood when withdrawal of intensive therapies is discussed in the nursery. Consequently, the significance of the moment of birth to the construction of subjectivity is obscured. The construction of subjectivity as a progressively developed and irreversible category is challenged, and it becomes vulnerable.
Effect of Cr3C2 on Valence‐Electron Structure and Plasticity of Rim Phase in Ti(C,N)‐Based Cermets
Authors: Zheng Yong , You Min , Xiong Weihao , Liu Wenjun , Wang Shengxiang
Published: August 2009

Based on the empirical electron theory of solids and molecules, the valence‐electron structure (VES) of the rim phase in Ti(C,N)‐based cermets was calculated, and the relationship between the VES and plasticity was determined. The results indicated that the plasticity of the rim phase in a Ti(C,N)‐based cermet could be defined using the sum of the na values for the covalent bonds, and that chromium dissolution in the rim phase improved the plasticity of the rim phase. Moreover, a series of experiments showed that adding Cr2C3 to a typical Ti(C,N)‐based cermet strengthened the interface. Based on those results, a Ti(C,N)‐based cermet with added Cr3C2 was manufactured; the new cermet had more than twice the transverse rupture strength of a typical cermet.
Oxidation Behavior of a Fully Dense Polymer‐Derived Amorphous Silicon Carbonitride Ceramic
Authors: Bharadwaj Lavanya , Fan Yi , Zhang Ligong , Jiang Dapeng , An Linan
Published: August 2009

The oxidation behavior of a polymer‐derived amorphous silicon carbonitride (SiCN) ceramic was studied at temperature range of 900°–1200°C using fully dense samples, which were obtained using a novel pressure‐assisted pyrolysis technique. The oxidation kinetics was investigated by measuring the thickness of oxide layers. The data were found to fit a typical parabolic kinetics. The measured oxidation rate constant and activation energy of the SiCN are close to those of CVD and single‐crystal SiC. The results suggest that the oxidation mechanism of the SiCN is the same as that of SiC: oxygen diffusion through a silica layer.
Preparation of an Organic‐Inorganic Hybrid Ionic Conductive Material with Thermal and Chemical Stability
Authors: Kikukawa Takashi , Kuraoka Koji , Kawabe Kazuhiro , Yasuda Kazuaki , Hirao Kazuyuki , Yazawa Tetsuo
Published: August 2009

An organic–inorganic hybrid ionic conductive material was prepared through oxidation of thiol groups in a surface‐modified porous glass. Surface‐modified pores in the hybrid materials acted as permeation paths for protons. Proton conductivity of the hybrid material was 4.2 × 10−2 S/cm at 120°C under 100% relative humidity. This hybrid material was thermally stable at high temperature (above 100°C) due to the temperature‐tolerant inorganic frameworks.
Phase Transition and Physical Characteristics of Nanograined BaTiO3 Ceramics Synthesized from Surface‐Coated Nanopowders
Authors: Park Myung‐Beom , Cho Nam‐Hee , Kim Chung‐Don , Lee Sang‐Kyun
Published: August 2009

Nanograined BaTiO3 ceramics prepared from 40‐nm‐size BaTiO3 nanopowders exhibited the cubic as well as the tetragonal phase, while nanograined BaTiO3 ceramics prepared from BaTiO3 nanopowders coated with Mn had only the tetragonal phase. The dielectric constant of the latter was 10 times larger than that of the former; the latter exhibited PTCR behavior with a resistivity jump ratio of about 5.0 × 104. These physical properties of the BaTiO3 ceramics appeared to be significantly affected by the strain near grain boundaries; such strain resulted in a phase transition from the cubic to the tetragonal phase in the nanograined BaTiO3 ceramics, even though the grain size was about 40 nm.
Fracture Mirrors in Nanoscale 3Y‐TZP
Authors: Quinn George D. , Eichler Jens , Eisele Ulrich , Rödel Jürgen
Published: August 2009

The strengths of fine‐microstructural scale yttria‐stabilized tetragonal zirconia polycrystal rectangular bars and circular disks were measured by four‐point flexure and flat ball (piston) on three‐ball methods. Fracture mirror sizes were measured and correlated to the strengths. Although it was difficult to precisely judge the mirror boundary location in this material, consistent readings could be obtained once simple guidelines were followed.
Electromechanical Imaging and Spectroscopy of Ferroelectric and Piezoelectric Materials: State of the Art and Prospects for the Future
Authors: Balke Nina , Bdikin Igor , Kalinin Sergei V. , Kholkin Andrei L.
Published: August 2009

Piezoresponse force microscopy (PFM) has emerged as a powerful and versatile tool for probing nanoscale phenomena in ferroelectric materials on the nanometer and micrometer scales. In this review, we summarize the fundamentals and recent advances in PFM, and describe the nanoscale electromechanical properties of several important ferroelectric ceramic materials widely used in memory and microelectromechanical systems applications. Probing static and dynamic polarization behavior of individual grains in PZT films and ceramics is discussed. Switching spectroscopy PFM is introduced as a useful tool for studying defects and interfaces in ceramic materials. The results on local switching and domain pinning behavior, as well as nanoscale fatigue and imprint mapping are presented. Probing domain structures and polarization dynamics in polycrystalline relaxors (PMN‐PT, PLZT, doped BaTiO3) are briefly outlined. Finally, applications of PFM to dimensionally confined ferroelectrics are demonstrated. The potential of PFM for studying local electromechanical phenomena in polycrystalline ferroelectrics where defects and other inhomogeneities are essential for the interpretation of their macroscopic properties is illustrated.
Some Examples of Applications of a Microthermal Desorption Device in the Forensic Laboratory
Authors: Andrasko Jan
Published: August 2009

Abstract:  Several applications of a microthermal desorption device for analysis of small forensic samples are presented. The method uses a solid phase microextraction holder with the fiber removed. In addition to samples of inks on paper, this device was successfully used for analysis of toners, various stains on bank notes, and lipstick stains on paper. Other small items encountered in a forensic science laboratory were also analyzed: particles of smokeless powder, particles of coffee, and automotive clear topcoat layer. The desorbed compounds were analyzed by gas chromatography with a flame ionization detector or by gas chromatography–mass spectrometry. This device can be used in connection with any kind of gas chromatograph. By selection of different injector temperatures, fractionated thermal desorption of samples is achieved. The procedure was demonstrated on samples of ballpoint pen ink of various age.
The U.S. Health System and Immigration: An Institutional Interpretation1
Authors: Portes Alejandro , Light Donald , Fernández‐Kelly Patricia
Published: August 2009

We examine the institutions that comprise the U.S. health system and their relationship to a surging immigrant population. The clash between the system and this human flow originates in the large number of immigrants who are unauthorized, poor, and uninsured and, hence, unable to access a system largely based on ability to pay. Basic concepts from sociological theory are brought to bear on the analysis of this clash and its consequences. Data from a recently completed study of health institutions in three areas of the United States are used as an empirical basis to illustrate various aspects of this complex relation. Implications of our results for theory and future health policy are discussed.