bluuebunny/crossref_metadata_2025 huggingface dataset:
A Systematic Review of the Psychosocial Outcomes Associated with Erectile Dysfunction: Does the Impact of Erectile Dysfunction Extend Beyond a Man's Inability to Have Sex?
Authors: McCabe Marita P. , Althof Stanley E.
Published: November 2013

Aim

The aim of this study was to report and analyze the published data from randomized controlled trials (RCTs) for (i) the psychosocial outcomes associated with erectile dysfunction (ED) before treatment with a phosphodiesterase type 5 (PDE5) inhibitor; and (ii) the change in psychosocial outcomes after the use of a PDE5 inhibitor in men with ED.

Methods

The method used was a prospectively designed systematic literature review of publications reported in MEDLINE via PubMed, EMBASE, the Cochrane Library, Science Citation Index Expanded, and PsychINFO from January 1, 1995 to May 14, 2012.

Main Outcome Measures

The main outcome measures were scores on psychosocial measures in men who were treated for ED with a PDE5 inhibitor before and after treatment.

Results

A total of 1,714 publications were retrieved; 1,674 publications were excluded because they did not meet the design requirements of the review, and 40 publications (32 RCTs) were retained. Before treatment, men who participated in clinical trials reported relatively good quality of life and overall relationships, but poor sexual relationships and sexual satisfaction, diminished confidence, low self-esteem, and symptoms of depression. After treatment, there were significant improvements from baseline in most of these measures, except for overall life satisfaction and overall relationship satisfaction.

Conclusions

ED and the treatment of ED are associated with substantially broader aspects of a man's life than just erectile functioning. This review demonstrates the importance of evaluating the psychosocial factors associated with ED and its treatment, and the importance of using standardized scales to conduct this evaluation. Further research is needed to better understand the mechanisms underlying the reciprocal relationships among physical and psychological functioning in men with ED.
Intracavernous Delivery of Clonal Mesenchymal Stem Cells Restores Erectile Function in a Mouse Model of Cavernous Nerve Injury
Authors: Ryu Ji-Kan , Kim Da-Ham , Song Kang Moon , Yi TacGhee , Suh Jun-Kyu , Song Sun U.
Published: November 2013

Introduction

Recently, much attention has focused on stem cell therapy; bone marrow-derived stem cells (BMSCs) are one of the most studied mesenchymal stem cells used in the field of erectile dysfunction (ED). However, a major limitation for the clinical application of stem cell therapy is the heterogeneous nature of the isolated cells, which may cause different treatment outcomes.

Aim

We investigated the effectiveness of mouse clonal BMSCs obtained from a single colony by using subfractionation culturing method (SCM) for erectile function in a mouse model of cavernous nerve injury (CNI).

Methods

Twelve-week-old C57BL/6J mice were divided into four groups: sham operation group, bilateral CNI group receiving a single intracavernous (IC) injection of phosphate-buffered saline (20 μL) or clonal BMSCs (3 × 105 cells/20 μL), and receiving a single intraperitoneal (IP) injection of clonal BMSCs (3 × 105 cells/20 μL).

Main Outcome Measures

The clonal BMSC line was analyzed for cell-surface epitopes by using fluorescence-activated cell sorting and for differentiation potential. Two weeks after CNI and treatment, erectile function was measured by electrically stimulating the cavernous nerve. The penis was harvested for histologic examinations and Western blot analysis.

Results

Clonal BMSCs expressed cell surface markers for mesenchymal stem cells and were capable of differentiating into several lineages, including adipogenic, osteogenic, and chondrogenic cells. Both IC and IP injections of clonal BMSCs significantly restored cavernous endothelial and smooth muscle content, and penile nNOS and neurofilament content in CNI mice. IC injection of clonal BMSCs induced significant recovery of erectile function, which reached 90–100% of the sham control values, whereas IP injection of clonal BMSCs partially restored erectile function.

Conclusion

We established a homogeneous population of mouse clonal BMSCs using SCM; clonal BMSCs successfully restored erectile function in CNI mice. The homogeneous nature of clonal mesenchymal stem cells may allow their clinical applications.
The Implications of Temporary Jobs on the Distribution of Wages in Italy: An Unconditional IVQTE Approach
Authors: Bosio Giulio
Published: November 2013

Using Italian data, this paper investigates the wage implications of temporary jobs across the whole pay profile using unconditional quantile regression (UQR) models. Results clearly indicate that the wage penalty associated to temporary jobs is significantly larger at the bottom of wage profile and is almost absent for high‐wage jobs. This is in line with the sticky floors hypothesis, supporting the idea that the wage gap for temporary employees depends on their position in the wage distribution for low‐paid jobs. To recover a causal interpretation, I employ an instrumental variable (IV) strategy. I adopt the unconditional instrumental variable quantile treatment effects (IVQTE) estimator proposed by Frolich and Melly, which corrects for endogenous selection in temporary contracts. The IVQTE estimates yield similar results to standard UQR, even if the wage penalty is larger in size at the bottom of the wage distribution and disappears at the top quantiles. This evidence highlights that policies aimed at increasing flexibility may reinforce the two‐tier nature of the Italian labour market and the relative wage inequality.
Peripheral blood leucocyte subclasses as potential biomarkers of adipose tissue inflammation and obesity subphenotypes in humans
Authors: Pecht T. , Gutman‐Tirosh A. , Bashan N. , Rudich A.
Published: November 2013

While obesity is clearly accepted as a major risk factor for cardio‐metabolic morbidity, it is also apparent that some obese patients largely escape this association, forming a unique obese subphenotype(s). Current approaches to define such subphenotypes include clinical biomarkers that largely reflect already manifested comorbidities, such as markers of dyslipidaemia, hyperglycaemia and impaired regulation of vascular tone, and anthropometric or imaging‐based assessment of adipose tissue distribution. Low‐grade inflammation, evident both systemically and within adipose tissue (particularly intra‐abdominal fat depots), seems to characterize the more cardio‐metabolically morbid forms of obesity. Indeed, several systemic inflammatory markers (C‐reactive protein), adipokines (retinol‐binding protein 4, adiponectin) and cytokines have been shown to correlate in humans with adipose tissue inflammation and with obesity‐associated health risks. Circulating leucocytes constitute a diverse group of cells that form a major arm of the immune system. They are both major sources of cytokines and likely also of infiltrating adipose tissue immune cells in obesity. In the present review, we summarize currently available literature on ‘classical’ blood white cell classes and on more specific leucocyte subclasses present in the circulation in human obesity. We critically raise the possibility that leucocytes may constitute clinically available markers for the more morbidity‐associated obesity subphenotype(s), and when available, for intra‐abdominal adipose tissue inflammation.
Surgical Management of the Multiple‐Ligament Injured Knee: a Case Series from Chongqing, China and Review of Published Reports
Authors: Zhang Yuan , Zhang Xia , Hao Yong , Zhang Yu‐Mei , Wang Min , Zhou Yue
Published: November 2013

Objective

The correct management of multiple‐ligament injured knees (MLIKs) remains controversial. This study aimed to summarize the epidemiological features and short‐term results of patients treated in our department.

Methods

Sixty‐six patients diagnosed with MLIKs from 2009 to 2011 were enrolled. Relevant patient characteristics and clinical variables were analyzed to characterize the epidemiology. A surgical algorithm based on a knee dislocation classification system and postoperative rating scales, including Lysholm and Tegner rating, as well as joint mobility, stability and radiography were collected for functional evaluation at 2.5‐year follow‐up.

Results

The epidemiological profile demonstrated that 30‐ to 50‐year‐old men were at the highest risk. The primary causes were vehicle accidents and falls and most common injury type cruciate combined collateral ligament injuries. Final follow‐up analysis comparing operative versus conservative management and surgically treated mild versus severe MLIKs showed significant differences in Lysholm and Tegner scale scores, as well as knee mobility and stability.

Conclusion

The therapeutic outcome of MLIKs depends on various clinical variables and a surgical algorithm. Satisfactory restoration of function was acquired in the majority of our surgically treated MLIK cases; however, most patients had not achieved their pre‐injury activity levels by the follow‐up endpoint.
Written Pain Neuroscience Education in Fibromyalgia: A Multicenter Randomized Controlled Trial
Authors: van Ittersum Miriam W. , van Wilgen C. Paul , van der Schans Cees P. , Lambrecht Luc , Groothoff Johan W. , Nijs Jo
Published: November 2013

Mounting evidence supports the use of face‐to‐face pain neuroscience education for the treatment of chronic pain patients. This study aimed at examining whether written education about pain neuroscience improves illness perceptions, catastrophizing, and health status in patients with fibromyalgia.

A double‐blind, multicenter randomized controlled clinical trial with 6‐month follow‐up was conducted. Patients with FM (n = 114) that consented to participate were randomly allocated to receive either written pain neuroscience education or written relaxation training. Written pain neuroscience education comprised of a booklet with pain neuroscience education plus a telephone call to clarify any difficulties; the relaxation group received a booklet with relaxation education and a telephone call. The revised illness perception questionnaire, Pain Catastrophizing Scale, and fibromyalgia impact questionnaire were used as outcome measures. Both patients and assessors were blinded. Repeated‐measures analyses with last observation carried forward principle were performed. Cohen's d effect sizes (ES) were calculated for all within‐group changes and between‐group differences.

The results reveal that written pain neuroscience education does not change the impact of FM on daily life, catastrophizing, or perceived symptoms of patients with FM. Compared with written relaxation training, written pain neuroscience education improved beliefs in a chronic timeline of FM (P = 0.03; ES = 0.50), but it does not impact upon other domains of illness perceptions.

Compared with written relaxation training, written pain neuroscience education slightly improved illness perceptions of patients with FM, but it did not impart clinically meaningful effects on pain, catastrophizing, or the impact of FM on daily life. Face‐to‐face sessions of pain neuroscience education are required to change inappropriate cognitions and perceived health in patients with FM.
Raising Local Community Voices: CITES, Livelihoods and Sustainable Use
Authors: Cooney Rosie , Abensperg‐Traun Max
Published: November 2013

Trade in wild resources contributes to the livelihoods of many rural people and communities, particularly the poorer people in developing countries. Livelihoods are central elements of many strategies for conservation based on sustainable use of wildlife. This article surveys CITES' formal engagement on livelihoods, including decisions adopted at the recent sixteenth Conference of the Parties (CoP16). It then draws on examples from debate at CoP16 to illustrate that in practice, livelihood concerns have considerable relevance to CITES parties' decisions on listing species in the Appendices. It goes on to discuss several issues arising from this, and concludes that there are clear arguments for CITES decision making (including listing in particular) to more clearly and consistently address the impact of decisions on rural communities (including through enhanced participation of rural communities themselves), both for their own sake and because these impacts will often influence the eventual conservation success of CITES decisions.
Uncertainty and Markets for Endangered Species under CITES
Authors: Wiersema Annecoos
Published: November 2013

At the next Conference of the Parties in 2016, the parties to the Convention on International Trade in Endangered Species (CITES) will likely be presented with proposals for legal trade in some of the most iconic endangered species covered by the treaty – elephants, rhinoceroses and tigers. This article evaluates the proposals for legal trade and discusses how the parties to CITES should approach the questions raised by these proposals. The projections about trade in elephants, rhinoceroses and tigers reveal deep and multilayered uncertainty. The article concludes by suggesting that conservation principles, sound science and the legal mandate of CITES itself should lead the parties to adopt a cautious approach. Trade bans should be maintained to protect species from extinction due to trade.
White Racism, Social Class, and the Backlash Against Affirmative Action
Authors: Pierce Jennifer L.
Published: November 2013

Among scholars in sociology and history, the backlash against affirmative action has been blamed on White working‐class Americans. What has received far less attention is the individual and collective institutional role(s) played by the White middle and upper middle‐class in backlash politics. Given that individuals in these social classes have far greater institutional power than White working‐class Americans, their beliefs and practices deserve sustained critical attention, and, as the few existing research studies demonstrate, White middle‐class and upper middle‐class Americans have played an influential role in backlash politics. Part of the reason for this gap in the literature is that these groups are more difficult to access as research subjects. Gaining access to this population may require working through many levels of a bureaucratic organization designed to protect their time and privacy. Moreover, when interviewed, these Americans are more likely than their working‐class counterparts to mask racist sentiments through the polite language of “color blindness.” Research methods that complement surveys and in‐depth interviews are recommended as strategies for probing White middle and upper middle‐class Americans' deeply hidden beliefs.
Examples of Mental Mistakes Made by Systems Engineers While Creating Tradeoff Studies
Authors: Bohlman James , Terry Bahill A.
Published: November 2013

Problem statement: Humans often make poor decisions. To help them make better decisions, engineers are taught to create tradeoff studies. However, these engineers are usually unaware of mental mistakes that they make while creating their tradeoff studies. We need to increase awareness of a dozen specific mental mistakes that engineers commonly make while creating tradeoff studies. Aims of the research: To prove that engineers actually do make mental mistakes while creating tradeoff studies. To identify which mental mistakes can be detected in tradeoff study documentation. Methodology: Over the past two decades, teams of students and practicing engineers in Bahill’s Systems Engineering courses wrote the system design documents for an assigned system. On average, each of these document sets took 100 man-hours to create and comprised 75 pages. We used 110 of these projects, two dozen government contractor tradeoff studies and three publicly accessible tradeoff studies. We scoured these document sets looking for examples of 28 specific mental mistakes that might affect a tradeoff study. We found instances of a dozen of these mental mistakes. Results: Often evidence of some of these mistakes cannot be found in the final documentation. To find evidence for such mistakes, the experimenters would have had to be a part of the data collection and decision making process. That is why, in this paper, we present only 12 of the original 28 mental mistakes. We found hundreds of examples of such mistakes. We provide suggestions to help people avoid making these mental mistakes while doing tradeoff studies. Conclusions: This paper shows evidence of a dozen common mental mistakes that are continually being repeated by engineers while creating tradeoff studies. When engineers are taught about these mistakes, they can minimize their occurrence in the future.
Effects of Working Conditions on TEHL Performance of a Helical Gear Pair With Non-Newtonian Fluids
Authors: Liu Mingyong , Zhu Caichao , Liu Huaiju , Ding Huafeng , Sun Zhangdong
Published: November 2013

A thermal elastohydrodynamic lubrication (TEHL) finite line contact model is developed for a helical gear pair lubricated with an Eyring fluid or a power-law fluid in order to investigate the effects of the working conditions. A lubrication analysis within a meshing period shows that the differences between the Eyring and Newtonian solutions mainly lie in the film temperature and the shear stress. For the power-law fluid, the power index n has a significant effect on the film thickness. The effects of load and speed on lubrication performance along the line of action are discussed.
Quantitative Diagnosis of Malignant Pleural Effusions by Single-Cell Mechanophenotyping
Authors: Tse Henry T. K. , Gossett Daniel R. , Moon Yo Sup , Masaeli Mahdokht , Sohsman Marie , Ying Yong , Mislick Kimberly , Adams Ryan P. , Rao Jianyu , Di Carlo Dino
Published: November 2013

Single-cell biophysical properties were used for diagnosing malignant pleural effusions from patients.
Diagnostic accuracy of clinical tests for ankle syndesmosis injury
Authors: Sman Amy D , Hiller Claire E , Rae Katherine , Linklater James , Black Deborah A , Nicholson Leslie L , Burns Joshua , Refshauge Kathryn M
Published: November 2013

Objective

Our aim was to investigate the diagnostic accuracy of the clinical presentation of ankle syndesmosis injury and four common clinical diagnostic tests.

Design

Cross-sectional diagnostic accuracy study.

Setting

9 clinics in two Australian cities.

Participants

87 participants (78% male) with an ankle sprain injury presenting to participating clinics within 2 weeks of injury were enrolled.

Methods

Clinical presentation, dorsiflexion-external rotation stress test, dorsiflexion lunge with compression test, squeeze test and ankle syndesmosis ligament palpation were compared with MRI results (read by a blinded radiologist) as a reference standard. Tests were evaluated using diagnostic accuracy, sensitivity, specificity and likelihood ratios (LRs). A backwards stepwise Cox regression model determined the combined value of the clinical tests.

Results

The clinical presentation of an inability to perform a single leg hop had the highest sensitivity (89%) with a negative LR of 0.37 (95% CI 0.13 to 1.03). Specificity was highest for pain out of proportion to the apparent injury (79%) with a positive LR of 3.05(95% CI 1.68 to 5.55). Of the clinical tests, the squeeze test had the highest specificity (88%) with a positive LR of 2.15 (95% CI 0.86 to 5.39). Syndesmosis ligament tenderness (92%) and the dorsiflexion-external rotation stress test (71%) had the highest sensitivity values and negative LR of 0.28 (95% CI 0.09 to 0.89) and 0.46 (95% CI 0.27 to 0.79), respectively. Syndesmosis injury was four times more likely to be present with positive syndesmosis ligament tenderness (OR 4.04, p=0.048) or a positive dorsiflexion/external rotation stress test (OR 3.9, p=0.004).

Conclusions

Although no single test is sufficiently accurate for diagnosis, we recommend a combination of sensitive and specific signs, symptoms and tests to confirm ankle syndesmosis involvement. An inability to hop, syndesmosis ligament tenderness and the dorsiflexion-external rotation stress test (sensitive) may be combined with pain out of proportion to injury and the squeeze test (specific).
Readiness for cancer rehabilitation in Denmark: protocol for a cross-sectional mixed methods study
Authors: Kristiansen Maria , Adamsen Lis , Hendriksen Carsten
Published: November 2013

Introduction

Rehabilitation is a key element in most cancer care policies in recognition of the often unmet physical, psychological and social needs among the rising numbers of patients with cancer. A systematic assessment of patients’ needs and available rehabilitation services constitute the foundation for timely, comprehensive and coordinated cancer rehabilitation. This study aims to provide insight into the current organisation and practice of cancer rehabilitation in Denmark with special emphasis placed on the assessment of patients’ needs and availability of services across the cancer treatment trajectory.

Methods and analysis

A cross-sectional design using a mixed methods approach will be used in order to analyse the readiness for cancer rehabilitation in different sectors and from differing perspectives. Substudy 1 consists of an electronic survey among the 98 Danish municipalities and focuses on the availability and use of cancer rehabilitation services for patients with all types of cancers. In substudy 2, a survey among the 19 surgical and 12 oncological departments involved in colorectal cancer treatment in Denmark is conducted in order to describe the current clinical practice regarding the assessment of rehabilitation needs and referral to services. Substudy 3 involves a retrospective clinical audit and semistructured interviews at four randomly selected surgical and oncological departments treating colorectal patients with cancer in order to elucidate current needs assessment practices.

Ethics and dissemination

The study was approved by the Danish Data Protection Agency and will be conducted in accordance with the principles of the Helsinki Declaration Representatives from municipalities and clinical practice are engaged in the design and execution of the study in order to ensure the usefulness of survey instruments, reflexive interpretation of data and transfer of implications into practice.

Results

Published in international peer-reviewed scientific journals and presented at conferences, seminars and as short reports.
‘Not yet’ and ‘Just ask’: barriers and facilitators to advance care planning—a qualitative descriptive study of the perspectives of seriously ill, older patients and their families
Authors: Simon Jessica , Porterfield Pat , Bouchal Shelley Raffin , Heyland Daren
Published: November 2013

Objectives

To explore seriously ill, older hospitalised patients’ and their family members’ perspectives on the barriers and facilitators of advance care planning (ACP).

Methods

We used qualitative descriptive study methodology to analyse data from an interviewer administered, questionnaire-based, Canadian multicentre, prospective study of this population.

Results

Three main categories described these barriers and facilitators: (1) person (beliefs, attitudes, experiences, health status), (2) access (to doctors and healthcare providers, information, tools and infrastructure to communicate ACP preferences) and (3) the interaction with the doctor (who and how initiated, location, timing, quality of communication, relationship with doctor).

Conclusions

Based on the findings, we suggest strategies for both healthcare systems and individual healthcare providers to improve the quality and quantity of ACP with this population. These include assessing readiness for participation in ACP and personalising relevance of ACP to each individual, routinely offering scheduled family meetings for exploring a person's own goals and sharing information, ensuring systems and policies are in place to access previous ACP documentation and ensuring doctors’ education includes ACP communication skills.
MONTE CARLO RELIABILITY SIMULATION OF WATER SYSTEM OF LONGWALL SHEARER MACHINE
Authors: HOSEINIE SEYED HADI , GHODRATI BEHZAD , KUMAR UDAY
Published: November 2013

The water system of coal shearer machine consists of three main subsystems namely spray jets, water & hoses, and filters which are connected and working in series configuration. In this paper, the Kamat–Riley Monte Carlo simulation method was used for reliability analysis of the considered system. The studied data was collected from an Iranian longwall coal mine for analysis. The MATLAB software was used for simulation and then reliability plot of water system in shearer machine was determined. The results show that the reliability of shearer machine reduces to almost zero in a period of 300 h. Comparison between the results of analytical method and simulated reliability plot presents that for analyzed data set, in high reliability levels (28% ≤), the simulation approach estimates the higher reliability than analytical method. The maximum difference between the results of analytical and simulation methods is 23%. However, in low reliability levels (≤ 28%) there is no remarkable difference between the methods.
CARBON TAXES VERSUS CAP AND TRADE: A CRITICAL REVIEW
Authors: GOULDER LAWRENCE H. , SCHEIN ANDREW R.
Published: November 2013

We examine the relative attractions of a carbon tax, a "pure" cap-and-trade system, and a "hybrid" option (a cap-and-trade system with a price ceiling and/or price floor). We show that the various options are equivalent along more dimensions than often are recognized. In addition, we bring out important dimensions along which the approaches have very different impacts, including some dimensions that have received little attention in prior literature. Although no option dominates the others, a key finding is that exogenous emissions pricing (whether through a carbon tax or through the hybrid option) has a number of important attractions over pure cap and trade. Beyond helping prevent price volatility and reducing expected policy errors in the face of uncertainties, exogenous pricing helps avoid problematic interactions with other climate policies and helps avoid potential wealth transfers to oil-exporting countries.
A framework for using signal, noise, and variation to determine whether the brain controls movement synergies or single muscles
Authors: Joshua Mati , Lisberger Stephen G.
Published: November 2013

We have used an analysis of signal and variation in motor behavior to elucidate the organization of the cerebellar and brain stem circuits that control smooth pursuit eye movements. We recorded from the abducens nucleus and identified floccular target neurons (FTNs) and other, non-FTN vestibular neurons. First, we assessed neuron-behavior correlations, defined as the trial-by-trial correlation between the variation in neural firing and eye movement, in brain stem neurons. In agreement with prior data from the cerebellum, neuron-behavior correlations during pursuit initiation were large in all neurons. Second, we asked whether movement variation arises upstream from, in parallel to, or downstream from a given site of recording. We developed a model that highlighted two measures: the ratio of the SDs of neural firing rate and eye movement (“ SDratio”) and the neuron-behavior correlation. The relationship between these measures defines possible sources of variation. During pursuit initiation, SDratio was approximately equal to neuron-behavior correlation, meaning that the source of signal and variation is upstream from the brain stem. During steady-state pursuit, neuron-behavior correlation became somewhat smaller than SDratio for FTNs, meaning that some variation may arise downstream in the brain stem. The data contradicted the model's predictions for sources of variation in pathways that run parallel to the site of recording. Because signal and noise are tightly linked in motor control, we take the source of variation as a proxy for the source of signal, leading us to conclude that the brain controls movement synergies rather than single muscles for eye movements.
Kernohan’s Notch: A Forgotten Cause of Hemiplegia—CT Scans Are Useful in This Diagnosis
Authors: Panikkath Ragesh , Panikkath Deepa , Lim Sian Yik , Nugent Kenneth
Published: November 2013

Hemiparesis ipsilateral to a cerebral lesion can be a false localizing sign. This is due to midline shift of the midbrain resulting in compression of the contralateral pyramidal fibers on the tough dural reflection tentorium cerebelli. This may result in partial or complete damage to these fibers. Since these fibers are destined to cross in the medulla and innervate the opposite side of the body, this causes hemiparesis ipsilateral to the site of cerebral lesion. Computed tomography (CT) scans have not been used to support the diagnosis of this entity until now. We report a 68-year-old woman with a subdural hematoma who developed ipsilateral hemiparesis without any other explanation (Kernohan’s notch). The CT of the head showed evidence of compression of the midbrain contralateral to the hematoma and was useful in the diagnosis. The purpose of this report is to increase the awareness of this presentation and to emphasize the utility of CT scans to support the diagnosis.
Role of Stenting for Intracranial Atherosclerosis in the Post-SAMMPRIS Era
Authors: Ding Dale , Starke Robert M. , Crowley R. Webster , Liu Kenneth C.
Published: November 2013

Introduction. The initial promise of endovascular stenting for the treatment of intracranial atherosclerotic disease (ICAD) has been tempered by the results of the SAMMPRIS trial which demonstrated better outcomes with medical management compared to stenting for symptomatic ICAD. We review post-SAMMPRIS ICAD stenting outcomes.Methods. A comprehensive literature search was performed using PubMed to identify all ICAD stenting series published after the SAMMPRIS in September 2011. The type and design of the stent, number of patients and lesions, inclusion criteria, and clinical and angiographic outcomes were noted.Results. From October 2011 to August 2013, 19 ICAD stenting series were identified describing the interventional outcomes for 2,196 patients with 2,314 lesions. Of the 38 different stents used, 87% were balloon-expandable stents (BESs) and 13% were self-expanding stents. The median minimum stenosis was 50%. The median rates of technical success rate, postprocedural ischemic events, and symptomatic in-stent restenosis (ISR) were 98% (range 87–100%), 9.4% (range 0–25%), and 2.7% (range 0–11.1%), respectively. The median follow-up durations were one to 67 months.Conclusions. The management of severe ICAD remains controversial. Future trials are needed to define the optimal patient, lesion, and stent characteristics which will portend the best outcomes with intervention.
A Location Prediction Algorithm for Mobile Communications Using Directional Antennas
Authors: Lu Xiaofeng , Lio Pietro , Hui Pan , Jin Haifei
Published: November 2013

A directional communication scheme, TRAC, is proposed in this paper to deal with issues in mobile directional communications. Directional communication can bring benefits in terms of spatial reuse, power consumption, and security. Using direction antennas implies that the transmitters must know the direction or location of the receiver. It is necessary to predict the receiver's location to keep the transmitter's antenna pointing in the right direction if nodes travel always. TRAC is composed of the location prediction and antenna adjustment. It predicts a possible circular region where the moving receiver may enter into in the near future. The transmitter points its antenna at the predicted circular region and adjusts the beam-width of its directional antenna to cover the predicted region. The authors validated the TRAC algorithm on some vehicles traces. The validation indicated that the algorithm efficiency of TRAC is larger than 96%. TRAC can be employed in mobile communications without nodes' history movement traces.
Control Theory Concepts Applied to Retail Supply Chain: A System Dynamics Modeling Environment Study
Authors: Janamanchi Balaji , Burns James R.
Published: November 2013

Control theory concepts have been long used to successfully manage and optimize complex systems. Using system dynamics (SD) modeling methodology, which is continuous deterministic simulation modeling methodology, we apply control theory concepts to develop a suitable performance functional (or objective function) that optimizes the performance of a retail supply chain. The focus is to develop insights for inventory management to prevent stock-outs and unfilled orders and to fill customer orders at the lowest possible cost to supply chain partners under different scenarios, in a two-player supplier-retailer supply chain. Moderate levels of inventory, defining appropriate performance functional, appear to be crucial in choosing the right policies for managing retail supply chain systems. The study also demonstrated how multiple objectives can be combined in a single performance functional (or objective function) by carefully assigning suitable weights to the components of objectives based on their priority and the existence of possible trade off opportunities.
The Sasang Constitution as an Independent Risk Factor for Metabolic Syndrome: Propensity Matching Analysis
Authors: Jang Eunsu , Baek Younghwa , Park Kihyun , Lee Siwoo
Published: November 2013

The Sasang Constitutional Medicine is a traditional Korean customized medicine that classifies people into four types: Tae-eumin (TE), Soyangin (SY), Soeumin (SE), and Taeyangin. The aim of this study was to show whether the Sasang Constitution (SC) could be an independent risk factor for the metabolic syndrome (MS). Totally, 3,334 subjects from 24 Korean medicine clinics participated in this study. A one-way ANOVA for the continuous variables and a chi-square test for the prevalence of MS were conducted. A logistic regression was conducted to calculate the propensity score and the odds ratios (ORs). The prevalence for MS in TE, SY, and SE was 50.6%, 30.9%, and 17.7% (P<0.001) before matching, and 36.7%, 28.6% and 28.2% (P=0.042) after matching, respectively. The TE was associated with an increased OR for MS compared with the SE and SY in both crude (OR 4.773, 95% CI 3.889–5.859, and OR 2.292, 95% CI 1.942–2.704, resp.) and matched groups (OR 1.476, 95% CI 1.043–2.089, and OR 1.452, 95% CI 1.026–2.053, resp.). This study reveals that the SC, especially the TE type, could be considered as a risk element for MS even in people with otherwise similar physical characteristics.
Ultrasound for the Anesthesiologists: Present and Future
Authors: Terkawi Abdullah S. , Karakitsos Dimitrios , Elbarbary Mahmoud , Blaivas Michael , Durieux Marcel E.
Published: November 2013

Ultrasound is a safe, portable, relatively inexpensive, and easily accessible imaging modality, making it a useful diagnostic and monitoring tool in medicine. Anesthesiologists encounter a variety of emergent situations and may benefit from the application of such a rapid and accurate diagnostic tool in their routine practice. This paper reviews current and potential applications of ultrasound in anesthesiology in order to encourage anesthesiologists to learn and use this useful tool as an adjunct to physical examination. Ultrasound‐guided peripheral nerve blockade and vascular access represent the most popular ultrasound applications in anesthesiology. Ultrasound has recently started to substitute for CT scans and fluoroscopy in many pain treatment procedures. Although the application of airway ultrasound is still limited, it has a promising future. Lung ultrasound is a well‐established field in point‐of‐care medicine, and it could have a great impact if utilized in our ORs, as it may help in rapid and accurate diagnosis in many emergent situations. Optic nerve sheath diameter (ONSD) measurement and transcranial color coded duplex (TCCD) are relatively new neuroimaging modalities, which assess intracranial pressure and cerebral blood flow. Gastric ultrasound can be used for assessment of gastric content and diagnosis of full stomach. Focused transthoracic (TTE) and transesophageal (TEE) echocardiography facilitate the assessment of left and right ventricular function, cardiac valve abnormalities, and volume status as well as guiding cardiac resuscitation. Thus, there are multiple potential areas where ultrasound can play a significant role in guiding otherwise blind and invasive interventions, diagnosing critical conditions, and assessing for possible anatomic variations that may lead to plan modification. We suggest that ultrasound training should be part of any anesthesiology training program curriculum.
Improved Electric Strength and Space Charge Characterization in LDPE Composites with Montmorillonite Fillers
Authors: Liao Ruijin , Bai Ge , Yang Lijun , Cheng Huanchao , Yuan Yuan , Guan Jianxin
Published: November 2013

Space charge distribution and breakdown strength were investigated in composites of low density polyethylene (LDPE) and various contents of montmorillonite (MMT). The disperse performance of MMT in LDPE was observed with scanning electron microscopy (SEM) and X‐ray diffraction. For MMT concentration of 1 wt%, the better intercalation of LDPE into MMT interlayers and the tighter interface structure between polymer‐filler were observed, relative to MMT concentration of 3 and 5 wt%. Space charge profiles were obtained using the pulsed electroacoustic (PEA) method. Less space charge accumulated in the LDPE/MMT with MMT content of 1 wt% than that in pure LDPE, and space charge in the central of LDPE/MMT was much more uniformly. On the other hand, when MMT concentration was up to 3 and 5 wt%, large amounts of heterocharges were accumulated in the sample bulk. In MMT doped samples the dielectric strength increased up to a maximum at 1 wt% loading, and then decreases at 3 and 5 wt%.
Tolvaptan in the Treatment of Acute Hyponatremia Associated with Acute Kidney Injury
Authors: Gopinath Shilpa , Janga Kalyana C. , Greenberg Sheldon , Sharma Shree K.
Published: November 2013

Hyponatremia defined as a plasma sodium concentration of less than 135 mmol/L is a very common disorder, occurring in hospitalized patients. Hyponatremia often results from an increase in circulating arginine vasopressin (AVP) levels and/or increased renal sensitivity to AVP, combined with an increased intake of free water. Hyponatremia is subdivided into three groups, depending on clinical history and volume status: hypovolemic, euvolemic, and hypervolemic. Acute symptomatic hyponatremia is usually treated with hypertonic (3%) saline. Syndrome of inappropriate antidiuretic hormone hypersecretion (SIADH) and hypervolemic hyponatremia caused by heart failure or cirrhosis are treated with vasopressin antagonists (vaptans) since they increase plasma sodium (Na2+) concentration via their aquaretic effects (augmentation of free-water clearance). The role of tolvaptan in the treatment of acute hyponatremia and conversion of oliguric to nonoliguric phase of acute tubular necrosis has not been previously described.
The Effects of Mindfulness-Based Stress Reduction Program on the Mental Health of Family Caregivers: A Randomized Controlled Trial
Authors: Hou Rebecca Jing , Wong Samuel Yeung-Shan , Yip Benjamin Hon-Kei , Hung Anchor T.F. , Lo Herman Hay-Ming , Chan Peter H.S. , Lo Cola S.L. , Kwok Timothy Chi-Yui , Tang Wai Kwong , Mak Winnie W.S. , Mercer Stewart W. , Ma S. Helen
Published: November 2013

Background: Caregivers of people with chronic conditions are more likely than non-caregivers to have depression and emotional problems. Few studies have examined the effectiveness of mindfulness-based stress reduction (MBSR) in improving their mental well-being. Methods: Caregivers of persons with chronic conditions who scored 7 or above in the Caregiver Strain Index were randomly assigned to the 8-week MBSR group (n = 70) or the self-help control group (n = 71). Validated instruments were used to assess the changes in depressive and anxiety symptoms, quality of life, self-efficacy, self-compassion and mindfulness. Assessments were conducted at baseline, post-intervention and at the 3-month follow-up. Results: Compared to the participants in the control group, participants in the MBSR group had a significantly greater decrease in depressive symptoms at post-intervention and at 3 months post-intervention (p < 0.01). The improvement in state anxiety symptoms was significantly greater among participants in the MBSR group than those of the control group at post-intervention (p = 0.007), although this difference was not statistically significant at 3 months post-intervention (p = 0.084). There was also a statistically significant larger increase in self-efficacy (controlling negative thoughts; p = 0.041) and mindfulness (p = 0.001) among participants in the MBSR group at the 3-month follow-up compared to the participants in the control group. No statistically significant group effects (MBSR vs. control) were found in perceived stress, quality of life or self-compassion. Conclusions: MBSR appears to be a feasible and acceptable intervention to improve mental health among family caregivers with significant care burden, although further studies that include an active control group are needed to make the findings more conclusive.
Restoring Vascular Function with Hyperbaric Oxygen Treatment: Recovery Mechanisms
Authors: Drenjancevic Ines , Kibel Aleksandar
Published: November 2013

Treatment with hyperbaric oxygen can be a beneficial adjuvant therapy in various disorders characterized by compromised tissue oxygenation and perfusion. However, the effects of hyperbaric oxygenation cannot be simply explained as a compensation of the oxygen deficit. Hyperbaric oxigenation has a much broader influence and has the ability to alter protein expression, modulate signaling pathways and affect vascular structure and function. We discuss some of the most important uses of hyperbaric oxigenation for clinical conditions that involve abnormal vascular function. We present recent studies and insights into the mechanisms and effects of hyperbaric oxygen in the vasculature.
Instrumental Variable Analysis to Compare Effectiveness of Stents in the Extremely Elderly
Authors: Yeh Robert W. , Vasaiwala Samip , Forman Daniel E. , Silbaugh Treacy S. , Zelevinski Katya , Lovett Ann , Normand Sharon-Lise T. , Mauri Laura
Published: November 2013

Background—

Evaluating novel therapies is challenging in the extremely elderly. Instrumental variable methods identify variables associated with treatment allocation to perform adjusted comparisons that may overcome limitations of more traditional approaches.

Methods and Results—

Among all patients aged ≥85 years undergoing percutaneous coronary intervention in nonfederal hospitals in Massachusetts between 2003 and 2009 (n=2690), we identified quarterly drug-eluting stent (DES) use rates as an instrumental variable. We estimated risk-adjusted differences in outcomes for DES versus bare metal stents using a 2-stage least squares instrumental variable analysis method. Quarterly DES use ranged from 15% to 88%. Unadjusted 1-year mortality rates were 14.5% for DES versus 23.0% for bare metal stents (risk difference, −8.5%;
P
<0.001), an implausible finding compared with randomized trial results. Using instrumental variable analysis, DES were associated with no difference in 1-year mortality (risk difference, −0.8%;
P
=0.76) or bleeding (risk difference, 2.3%;
P
=0.33) and with significant reduction in target vessel revascularization (risk difference, −8.3%;
P
<0.0001).

Conclusions—

Using an instrumental variable analysis, DES were associated with similar mortality and bleeding and a significant reduction in target vessel revascularization compared with bare metal stents in the extremely elderly. Variation in use rates may be useful as an instrumental variable to facilitate comparative effectiveness in groups underrepresented in randomized trials.
Blood pressure normalization post-jugular venous balloon angioplasty
Authors: Sternberg Zohara , Grewal Prabhjot , Cen Steven , DeBarge-Igoe Frances , Yu Jinhee , Arata Michael
Published: November 2013

Objective

This study is the first in a series investigating the relationship between autonomic nervous system dysfunction and chronic cerebrospinal venous insufficiency in multiple sclerosis patients. We screened patients for the combined presence of the narrowing of the internal jugular veins and symptoms of autonomic nervous system dysfunction (fatigue, cognitive dysfunction, sleeping disorders, headache, thermal intolerance, bowel/bladder dysfunction) and determined systolic and diastolic blood pressure responses to balloon angioplasty.

Methods

The criteria for eligibility for balloon angioplasty intervention included ≥50% narrowing in one or both internal jugular veins, as determined by the magnetic resonance venography, and ≥3 clinical symptoms of autonomic nervous system dysfunction. Blood pressure was measured at baseline and post-balloon angioplasty.

Results

Among patients who were screened, 91% were identified as having internal jugular veins narrowing (with obstructing lesions) combined with the presence of three or more symptoms of autonomic nervous system dysfunction. Balloon angioplasty reduced the average systolic and diastolic blood pressure. However, blood pressure categorization showed a biphasic response to balloon angioplasty. The procedure increased blood pressure in multiple sclerosis patients who presented with baseline blood pressure within lower limits of normal ranges (systolic ≤105 mmHg, diastolic ≤70 mmHg) but decreased blood pressure in patients with baseline blood pressure above normal ranges (systolic ≥130 mmHg, diastolic ≥ 80 mmHg). In addition, gender differences in baseline blood pressure subcategories were observed.

Discussion

The coexistence of internal jugular veins narrowing and symptoms of autonomic nervous system dysfunction suggests that the two phenomena may be related. Balloon angioplasty corrects blood pressure deviation in multiple sclerosis patients undergoing internal jugular vein dilation. Further studies should investigate the association between blood pressure deviation and internal jugular veins narrowing, and whether blood pressure normalization affects Patient's clinical outcomes.