bluuebunny/crossref_metadata_2025 huggingface dataset:
The Evolution of the Locoregional Therapy of Breast Cancer
Authors: Ho Alice , Morrow Monica
Published: September 2011

Learning Objectives

After completing this course, the reader will be able to: Describe the influence of tumor biology when selecting options for local treatment of breast cancer.Identify key areas of controversy relating to localized treatment of breast cancer.

CME This article is available for continuing medical education credit at CME.TheOncologist.com

Breast-conserving therapy (BCT) and mastectomy have equal survival outcomes. Rates of local recurrence after BCT have declined steadily, largely as a result of the widespread use of systemic therapy. Sentinel node biopsy has replaced axillary dissection for staging the axilla, and in women undergoing BCT with whole-breast irradiation (WBI), axillary dissection is not needed for local control or survival in those with fewer than three involved sentinel nodes. Alternatives to 6 weeks of WBI have been shown to be safe and effective for subsets of breast cancer patients, and the use of preoperative chemotherapy allows BCT in some women who require mastectomy if surgery is the initial step in treatment. The combination of the smaller cancers detected with screening and the routine use of multimodality therapy has resulted in a decrease in the morbidity of local therapy and improved cancer treatment outcomes.
Risk analysis of rich–poor rainfall encounter in inter-basin water transfer projects based on Bayesian networks
Authors: Ling Kang , Xiaocong He
Published: September 2011

An inter-basin water transfer project is one of the effective ways to resolve the problem of an uneven distribution of water resources. Temporal and spatial variations in rainfall in different basins greatly affect water supply and demand in inter-basin water transfer projects, leading to risks to the operation of the water transfer projects. This paper applies a Bayesian network model to analyze this risk and studies the rich–poor rainfall encounter risk between a water source area and water receiving areas in the middle route of the South-to-North Water Transfer Project in China. Real time scenario simulations with the input of new observations were also studied. The results show that the rich–poor rainfall encounter risk is high for the Tangbai River receiving area in the fourth quarter, for the Huai River and South of Hai River receiving area in the second quarter, and for the North of the Hai River receiving area in the fourth and first quarters. The scenario simulations reflect risk change in the operation of water transfer projects, providing scientific decision support for the management of the water resource distribution in the inter-basin water transfer projects.
Novel Batch Reactor for the Dilute Acid Pretreatment of Lignocellulosic Feedstocks with Improved Heating and Cooling Kinetics
Authors: Degenstein John C. , Kamireddy Srinivas , Tucker Melvin P. , Ji Yun
Published: September 2011

The pretreatment of lignocellulosic biomass is an important part of the process of utilizing a renewable and abundant feedstock. This paper aims to provide a novel lab-scale batch pretreatment reactor that significantly improves heating and cooling kinetics over typical batch pretreatment reactors, yet made from readily available parts. The heating and cooling kinetics of a batch pretreatment reactor are important for emulating the behavior of a large scale continuous reactor system. The heat transfer performance has been quantified and presented here as a tool for aiding the design of a similar reactor system. One important lignocellulosic feedstock is corn stover, which was used in this study to validate the reactor performance. The pretreatment method that was used in this study is the dilute acid pretreatment. The pretreatment runs were enzymatically saccharified to evaluate the pretreatment effectiveness. The results from this enzymatic saccharification were compared with several literature sources to validate the reactor performance. The pretreatment conditions that were used are 0.5 wt% sulfuric acid, 10 minute pretreatment time, and 10 wt% solids loading. The enzymatic digestibility of the cellulose in the pretreated solids was 53.3% at 150°C and 72.1% at 160°C.
The Effects of Consumer-Directed Health Plans on Episodes of Health Care
Authors: Haviland Amelia M. , Sood Neeraj , McDevitt Roland D. , Marquis M. Susan
Published: September 2011

Past research has shown that high deductible and consumer-directed health plans (HD/CDHPs) can significantly reduce health care costs. In this paper we investigate how these cost savings are realized. We use panel data from many large employers and difference in difference models to examine how HD/CDHPs affect the number of health care episodes and the cost per episode. Our results show that about two-thirds of the cost savings from HD/CDHP enrollment are from reductions in number of episodes and the remaining one-third of the savings are from reductions in costs per episode. The presence of a Health Reimbursement Arrangement (HRA) or Health Savings Account (HSA) does not temper the effects of high deductibles on number of episodes. However, enrollees in plans with generous employer contributions to HSAs have more episodes of care than enrollees in plans where employers make smaller account contributions. The reductions in costs per episode and in visits to specialists, inpatient care, and use of non-generic pharmaceuticals suggest that higher deductibles are effective at making patients more cost conscious even after care is initiated.
Racial Disparities in Credit Constraints in the Great Recession: Evidence from the UK
Authors: Gathergood John
Published: September 2011

This paper investigates racial disparities in household credit constraints using UK survey data. We find a widening disparity in the proportion of racial minority households reporting they face credit constraints compared with non-minority households over the period 2006-2009. By 2009 three times as many racial minority households faced credit constraints compared with non-minority households. The difference in credit constraints across racial minority and non-minority households is not explained by a broad set of covariates. While cross-section variation in reported credit constraints might most likely reflect unobservables, we argue this time series variation is very unlikely to arise due to unobservables and is evidence of growing perceived disparity in credit access between racial groups over the period.
Country at a Crossroads: An Insight into How an Economic Crisis Led to Dramatic Policy Change
Authors: Hogan John W. , Hara Ana
Published: September 2011

In this paper, we try to understand the nature of the changes to Mexican macroeconomic policy in the early 1980s using a critical juncture framework. The framework argues that three elements—crisis, ideational change, and radical policy change—must be identified in order for us to be able to declare, with some certainty, whether an event constitutes a critical juncture. Utilizing this framework, we will ascertain whether the changes to Mexican macroeconomic policy constituted a clean break with the past or were a continuation of previously established policy pathways.
Resilience, Entropy, and Efficiency in Crisis Management: The January 12, 2010, Haiti Earthquake
Authors: Comfort Louise K. , Siciliano Michael D. , Okada Aya
Published: September 2011

The transition from disaster to recovery represents a major challenge to decision makers who seek to build a stronger, sustainable future while they cope with losses and destruction from an extreme event. Decision makers encounter a dynamic environment in which they must balance the tensions between entropy and efficiency in their search for resilience as they seek to maintain sustainable operations in a region exposed to recurring risk. In communities that have experienced disaster, the initial response is a strong mobilization of resources and personnel focused on clear goals of saving lives, protecting property, and meeting immediate needs. The urgency of danger directs the priorities for action, and organizations and individuals voluntarily act cooperatively to meet immediate needs, representing a first step toward resilience. Yet, the resources and energy committed to a shared effort to meet immediate needs generated by the extreme event slowly give way to entropy, or the dissipation of attention, energy, and resources that leads to a consequent loss of efficiency in risk reduction. The deteriorating situation leads to new calls for efficiency to regain resilience. The evolving process represents a dynamic among resilience, entropy, and efficiency that shapes the community's capacity to manage risk from exposure to recurring hazards. It is largely driven by interactions among organizations participating in disaster operations, their exchange of timely, valid information, and their capacity for learning and adaptation, as well as gaps in cognition and action. We explore the tensions among resilience, entropy, and efficiency in an analysis of interactions among local, regional, national, and international organizations operating in response to the January 12, 2010, Haiti Earthquake. Three types of data are used to analyze patterns of interaction among the organizations: 1) content analysis of newspapers; 2) documentary reports by professional organizations; and 3) semistructured interviews with policy makers operating in Haiti. In analyzing the networks of organizations operating in disaster operations, we document the response system that emerged during the first three weeks following the earthquake, January 12‐February 3, 2010. We conclude that timely intervention in information flow can be used to minimize entropy, increase efficiency, and strengthen resilience in a disaster‐stricken society's transition from response to recovery.
Effectiveness and Safety of Warfarin Initiation in Older Hemodialysis Patients with Incident Atrial Fibrillation
Authors: Winkelmayer Wolfgang C. , Liu Jun , Setoguchi Soko , Choudhry Niteesh K.
Published: September 2011

Background and objectives

Although generally recommended in atrial fibrillation (AF) patients, the effectiveness and safety of oral anticoagulation in dialysis patients with AF is unknown.

Design, setting, participants, & measurements

We assembled a cohort of older hemodialysis patients who initiated dialysis without prior record of AF and who had prescription drug benefits through three state-administered programs. The index event was a first hospitalization with diagnosed AF; patients with any recorded prior warfarin use were excluded. Eligible patients survived ≥30 days from discharge, and new warfarin use was recorded from prescription records during that 30-day window. Propensity-matched warfarin users and nonusers were compared using Cox regression. Outcomes included ischemic stroke, hemorrhagic stroke, and mortality.

Results

Among 2313 patients with new AF who survived 30 days from discharge, 249 (10.8%) filled a prescription for warfarin. Comparing 237 warfarin users and 948 propensity-matched nonusers over 2287 person-years of follow-up, the occurrence of ischemic stroke was similar (HR = 0.92; 95% CI, 0.61 to 1.37), whereas warfarin users experienced twice the risk of hemorrhagic stroke (HR = 2.38; 95% CI, 1.15 to 4.96). The risks of stroke, gastrointestinal hemorrhage, and mortality did not differ between groups. As-treated analyses yielded similar findings, as did analyses restricted to patients with CHADS2 scores ≥2.

Conclusions

Although we confirmed association between warfarin use and hemorrhagic stroke in dialysis patients with AF, we found no association between warfarin use and ischemic stroke. Adequately powered randomized trials are required to conclusively determine the risks and benefits of the studied warfarin indication in hemodialysis patients.
Abdominal wall paresis as a complication of minimally invasive lateral transpsoas interbody fusion
Authors: Dakwar Elias , Le Tien V. , Baaj Ali A. , Le Anh X. , Smith William D. , Akbarnia Behrooz A. , Uribe Juan S.
Published: September 2011

Object

The minimally invasive lateral transpsoas approach for interbody fusion has been increasingly employed to treat various spinal pathological entities. Gaining access to the retroperitoneal space and traversing the abdominal wall poses a risk of injury to the major nervous structures. Nerve injury of the abdominal wall can potentially lead to paresis of the abdominal musculature and bulging of the abdominal wall. Abdominal wall nerve injury resulting from the minimally invasive lateral retroperitoneal transpsoas approach has not been previously reported. The authors describe a case series of patients presenting with paresis and bulging of the abdominal wall after undergoing a minimally invasive lateral retroperitoneal approach.

Methods

The authors retrospectively reviewed all patients who underwent a minimally invasive lateral transpsoas approach for interbody fusion and in whom development of abdominal paresis developed; the patients were treated at 4 institutions between 2006 and 2010. All data were recorded including demographics, diagnosis, operative procedure, positioning, hospital course, follow-up, and complications. The onset, as well as resolution of the abdominal paresis, was reviewed.

Results

The authors identified 10 consecutive patients in whom abdominal paresis developed after minimally invasive lateral transpsoas spine surgery out of a total of 568 patients. Twenty-nine interbody levels were fused (range 1–4 levels/patient). There were 4 men and 6 women whose mean age was 54.1 years (range 37–66 years). All patients presented with abdominal paresis 2–6 weeks postoperatively. In 8 of the 10 patients, abdominal wall paresis had resolved by the 6-month follow-up visit. Two patients only had 1 and 4 months of follow-up. No long-term sequelae were identified.

Conclusions

Abdominal wall paresis is a rare but known potential complication of abdominal surgery. The authors report the first case series associated with the minimally invasive lateral transpsoas approach.
Intracerebral malignant peripheral nerve sheath tumor in a child with neurofibromatosis Type 1 and middle cerebral artery aneurysm treated with endovascular coil embolization
Authors: Ellis Michael J. , Cheshier Samuel , Sharma Sunjay , Armstrong Derek , Hawkins Cynthia , Bouffet Eric , Rutka James T. , Taylor Michael D.
Published: September 2011

Among the neoplastic conditions that affect patients with neurofibromatosis Type 1 (NF1) are malignant peripheral nerve sheath tumors (MPNSTs), which typically arise from peripheral nerves of the limbs, trunk, and lumbar and brachial plexuses. Ionizing radiation is an established risk factor for MPNST development, especially in susceptible patients such as those with NF1. Patients with NF1 are also at risk for intracranial aneurysms, which are increasingly being successfully managed with endovascular therapies. The authors describe the case of a 9-year-old, previously healthy girl who presented in extremis with a right frontal intracerebral hemorrhage resulting from a ruptured right middle cerebral artery (MCA) trifurcation aneurysm. Following urgent decompressive craniectomy, the patient underwent endovascular coil embolization of the MCA aneurysm without complication. Given her mother's history of NF1, the child underwent genetic testing, which disclosed signs positive for NF1. The patient recovered well, but follow-up MR imaging and MR angiography performed at 14 months demonstrated a large frontotemporal mass encasing the right MCA trifurcation. The patient underwent frontotemporal craniotomy and subtotal resection of the mass, which was histologically found to be an intracranial MPNST. The patient received chemotherapy and focal radiation therapy and remains alive at 6 months postresection. To the authors' knowledge, this represents the only known case of intracranial neoplasm arising in the region of an intracranial aneurysm repaired by endovascular coil embolization. While patients with NF1 represent a population with genetic susceptibility to radiation-induced tumors, the pathogenesis of intracerebral MPNSTs remains poorly understood.
Technique for insertion of intraventricular baclofen catheters
Authors: Albright A. Leland
Published: September 2011

Intraventricular baclofen (IVB) infusion has been used recently to treat secondary dystonia. Techniques of catheter implantation have not been thoroughly described. The object of this study was to describe a technique developed in the past 6 years to implant intraventricular catheters for baclofen infusion. Thirty-one patients underwent endoscopic placement of intraventricular catheters for IVB, primarily patients whose anatomy made implantation of intrathecal catheters difficult or inappropriate. Using the technique described, catheters were successfully inserted into the desired ventricular location in each patient. Catheters remained in the desired location in 29 of 31 cases. Catheters can be inserted into the cerebral ventricles for infusion of baclofen. The technique described herein has been associated with few complications.
Cervical juxtafacet cyst after anterior cervical discectomy and fusion
Authors: Sivakumar Walavan , Elder J. Bradley , Bilsky Mark H.
Published: September 2011

Anterior cervical discectomy and fusion (ACDF) is a common neurosurgical procedure, and the benefits, long-term outcomes, and complications are well described in the literature. The development of a juxtafacet joint cyst resulting in radiculopathy is a rare outcome after ACDF and merits further description. The authors describe a patient in whom a juxtafacet joint cyst developed after ACDF procedures, resulting in surgical intervention. When a juxtafacet joint cyst develops after ACDF, symptoms can include radiculopathy, neck pain, and neurological symptoms such as paresthesias and motor weakness. The presence of a juxtafacet joint cyst implies instability in that region of the spine. Patients with this pathological entity may require decompression of neural elements and fusion across the segment involved with the cyst.
Cerebral cavernous malformations: from genes to proteins to disease
Authors: Cavalcanti Daniel D. , Kalani M. Yashar S. , Martirosyan Nikolay L. , Eales Justin , Spetzler Robert F. , Preul Mark C.
Published: September 2011

Over the past half century molecular biology has led to great advances in our understanding of angio- and vasculogenesis and in the treatment of malformations resulting from these processes gone awry. Given their sporadic and familial distribution, their developmental and pathological link to capillary telangiectasias, and their observed chromosomal abnormalities, cerebral cavernous malformations (CCMs) are regarded as akin to cancerous growths. Although the exact pathological mechanisms involved in the formation of CCMs are still not well understood, the identification of 3 genetic loci has begun to shed light on key developmental pathways involved in CCM pathogenesis. Cavernous malformations can occur sporadically or in an autosomal dominant fashion. Familial forms of CCMs have been attributed to mutations at 3 different loci implicated in regulating important processes such as proliferation and differentiation of angiogenic precursors and members of the apoptotic machinery. These processes are important for the generation, maintenance, and pruning of every vessel in the body. In this review the authors highlight the latest discoveries pertaining to the molecular genetics of CCMs, highlighting potential new therapeutic targets for the treatment of these lesions.
Density-Dependent Effects of Amphibian Prey on the Growth and Survival of an Endangered Giant Water Bug
Authors: Ohba Shin-ya
Published: September 2011

Amphibian predator–insect prey relationships are common in terrestrial habitats, but amphibian larvae are preyed upon by a variety of aquatic hemipterans in aquatic habitats. This paper suggests that the survival of the nymphs of the endangered aquatic hemipteran Kirkaldyia (=Lethocerus) deyrolli (Belostomatidae: Heteroptera) is directly and indirectly affected by the abundance of their amphibian larval prey (tadpoles). Young nymphs of K. deyrolli mainly feed on tadpoles, regardless of differences in prey availability. Nymphs provided with tadpoles grow faster than nymphs provided with invertebrate prey. Therefore, tadpole consumption seems to be required to allow the nymphs to complete their larval development. In addition, the survival of K. deyrolli nymphs was greater during the period of highest tadpole density (June) than during a period of low tadpole density (July). Higher tadpole density moderates predation pressure from the water scorpion Laccotrephes japonensis (Nepidae: Heteroptera) on K. deyrolli nymphs; i.e., it has a density-mediated indirect effect. These results suggest that an abundance of tadpoles in June provides food for K. deyrolli nymphs (a direct bottom-up effect) and moderates the predation pressure from L. japonensis (an indirect bottom-up effect). An abundance of amphibian prey is indispensable for the conservation of this endangered giant water bug species.
Synthesis, Photophysical and Electrochemical Properties of a Mixed Bipyridyl-Phenanthrolyl Ligand Ru(II) Heteroleptic Complex Having trans-2-Methyl-2-butenoic Acid Functionalities
Authors: Adeloye Adewale O.
Published: September 2011

In this work, two ligands: 4-(trans-2-Methyl-2-butenoic acid)-2,2'-bipyridine) (L1) and 5-(trans-2-methyl-2-butenoic acid)-1,10-phenanthroline (L2), with the corresponding mixed-ligand heteroleptic Ru(II) complex were synthesized and characterized by FT-IR, 1H-, 13C-NMR spectroscopy and elemental analysis. The influence of the mixed functionalized polypyridyl ruthenium(II) complex on the photophysical and electrochemical properties were investigated and compared to individual single-ligand homoleptic complexes. Interestingly, the mixed-ligand complex formulated as [RuL1L2(NCS)2] exhibits broad and intense metal-to-ligand charge transfer (MLCT) absorption with a high molar extinction coefficient (λmax = 514 nm, ε = 69,700 M−1 cm−1), better than those of individual single-ligand complexes, [Ru(L1)2(NCS)2] and [Ru(L2)2(NCS)2], and a strong photoluminescence intensity ratio in the red region at λem = 686 nm. The electrochemical properties of the complex indicated that the redox processes are ligand-based.
Inserting Ecological Detail into Economic Analysis: Agricultural Nutrient Loading of an Estuary Fishery
Authors: Finnoff David , Tschirhart John
Published: September 2011

Linked general equilibrium economic and ecological models are connected through agricultural runoff and the fisheries. They are applied to a North Carolina estuary in which agricultural runoff alters phytoplankton densities and the resulting hypoxia leads to diminished fisheries. The effects of hypoxia on multiple species across space are analyzed and the joint economic and ecosystem wide response to a policy of reduced runoff is quantified. The approach provides an assessment of changes in ecological welfare (in terms of species populations) and economic welfare (in terms of equivalent variations) following reductions in runoff.
Does polyembryony reduce seed germination and seedling development in Eriotheca pubescens (Malvaceae: Bombacoideae)?
Authors: Mendes‐Rodrigues Clesnan , Ranal Marli A. , Oliveira Paulo E.
Published: September 2011

• Premise of the Study: Competition between siblings affect their growth and survival ability. An extreme situation is polyembryony, whereby siblings are exposed to competition from the beginning of their development. But its effect on plant reproduction is seldom tested. Eriotheca pubescens is a tree in the Cerrado, the Neotropical Savannas in Brazil, with apomictic/polyembryonic and sexual/monoembryonic populations. We tested the effect of polyembryony on germination, emergence, and growth in E. pubescens. This may have ecological consequences within the Cerrado, where seedling establishment is critical for species persistency and distribution.

• Methods: We tested the effect of embryonic origin on germinability‐ and time‐related parameters using seeds from different populations. We measured cultivated seedling growth continuously for 70 d and exhumed them after 9 mo to measure seedling biometry traits such as shoot, root, and seedling mass. We compared these traits with the number of seedlings emerged per seed and fitted data to a linear regression model.

• Key Results: Polyembryony reduced germinability and seedlings’ initial growth in E. pubescens. Seedling traits and biomass decreased with the number of seedlings arising per seed. But the effect of polyembryony was mostly on initial seedling size and not on seedling growth rate.

• Conclusions: Polyembryony and apomixis affected germination and led to smaller seedlings compared with monoembryonic sexual counterparts. Although smaller, these extra seedlings may enhance per‐seed survival chances in the Cerrado conditions of seasonal drought and frequent fires and explain the predominance of polyembryonic populations.
Hybridization among dominant tree species correlates positively with understory plant diversity
Authors: Adams Rachel I. , Goldberry Shaunna , Whitham Thomas G. , Zinkgraf Matthew S. , Dirzo Rodolfo
Published: September 2011

• Premise of the study: Elucidating the factors that determine the abundance and distribution of species remains a central goal of ecology. It is well recognized that genetic differences among individual species can affect the distribution and species interactions of dependent taxa, but the ecological effects of genetic differences on taxa of the same trophic level remain much less understood. Our goal was to test the hypothesis that differences between related overstory tree species and their hybrids can influence the understory plant community in wild settings.

• Methods: We conducted vegetation surveys in a riparian community with the overstory dominated by Populus fremontii, P. angustifolia, and their natural hybrids (referred to as cross types) along the Weber River in north central Utah, USA. Understory diversity and community composition, as well as edaphic properties, were compared under individual trees.

• Key results: Diversity metrics differ under the three different tree cross types such that a greater species richness, diversity, and cover of understory plants exist under the hybrids compared with either of the parental taxa (30–54%, 40–48%, and 35–74% greater, respectively). The community composition of the understory also varied by cross type, whereby additional understory plant species cluster with hybrids, not with parental species.

• Conclusions: Genetic composition dictated by hybridization in the overstory can play a role in structuring the associated understory plants in natural communities—where a hybridized overstory correlates with a species‐rich understory—and thus can have cascading effects on community members of the same trophic level. The underlying mechanism requires further investigation.
Les voyages organisés par ordre du roi à Versailles
Authors: Vandersmissen Jan
Published: September 2011

Cette conférence étudiera les voyages financés par l’État français aux xviie et xviiie siècles en vue d’une acquisition de nouvelles connaissances sur le monde en dehors de l’Europe. Cette période fut témoin d’un changement radical de l’exploration scientifique outre-mer. Pendant le règne du Roi-Soleil, et sous l’impulsion de Colbert, les voyageurs académiques partant de la France, ainsi que certains Français résidant dans les territoires d’outre-mer, recevaient des instructions pour mieux orienter leurs observations et améliorer la collecte de données, et ceci afin de recueillir des connaissances qui seraient utiles à l’État. Les projets à petite échelle prévalaient. Grâce au soutien d’institutions royales comme l’Académie royale des sciences ou le Jardin du roi, des individus comme Charles Plumier, Joseph Pitton de Tournefort et Louis Éconches Feuillée ramenaient des échantillons et descriptions de « plantes utiles ». D’autres, comme Jean Richer, faisaient des observations astronomiques dans l’hémisphère Sud, améliorant ainsi non seulement la connaissance géographique, mais aussi les techniques cartographiques et les compétences dans le domaine de la navigation. Sous Louis XV vint une amplification des entreprises. La rivalité avec l’Angleterre conduisait les Français vers le Pacifique. Science, exploration et géopolitique se confondaient. De vastes équipes de chercheurs montaient à bord de navires militaires. Les expéditions enrichirent les collections scientifiques de Versailles et des institutions royales à Paris. Sous Louis XVI, ce processus culmina dans l’expédition de La Pérouse. Trois aspects de la politique scientifique française dans le domaine de l’exploration seront analysés ici en détail : les mécanismes de patronage et de protection, les mécanismes d’approbation scientifique et la mise à profit des connaissances rassemblées par les voyageurs.
Where went the dung-breeding insects of the American bison?
Authors: Tiberg K. , Floate K.D.
Published: September 2011

The demise of the American bison, Bison bison (L.), following European settlement has given rise to two hypotheses regarding the fate of their dung-associated insects. The “extant” hypothesis proposes that all of these taxa now persist in the dung of cattle, Bos taurus L. The “extinction” hypothesis proposes that a subset of these taxa were unable to make this transition and have gone extinct. We examined these hypotheses by comparing the response of coprophilous insects to dung of bison versus cattle on similar diets and versus dung of cattle on different diets. Results showed insects to be more responsive to changes in diet than to changes in host species and, therefore, were supportive of the extant hypothesis. To our knowledge, these data provide the first experimental comparisons of bison dung versus cattle dung as habitat for coprophilous insects.
Short-term Use of Tranexamic Acid to Reduce Blood Loss in Endoscopic Nasal Surgeries
Authors: Chhapola Sunita , Matta Inita
Published: September 2011

Objective

To evaluate the effect of tranexamic acid, an antifibrinolytic agent, in reduction of surgical hemorrhage during endoscopic nasal surgery.

Design

Comparative analysis of the use of tranexamic acid in 200 patients undergoing endoscopic nasal surgery and its demonstrable reduction of hemorrhage and improvement of visibility of operative field.

Subjects

Around 200 patients with varied indications underwent endoscopic nasal surgery; 100 were given tranexamic acid perioperatively and 100 did not receive tranexamic acid and were used as a control. Selection of patients was done on random basis. We used the following parameters to measure intraoperative blood loss: Visibility of field of surgery, weight of blood swabs postoperatively and amount of blood from suction machine.

Result

Patient who received tranexamic acid showed reduction of blood loss amounting to 72.48% (p < 0.05). This reduction was compared with results published by other authors using various kinds of anesthesia.

Conclusions

Tranexamic acid is an antifibrinolytic agent which inhibits the action of plasmin. There is also reduction in blood level of D-dimer. It is seen to significantly reduce intraoperative blood loss during endoscopic nasal surgery. Additionally, there seems to be no alteration of coagulation parameters or untoward systemic effects. The consequent improvement in surgical field visibility is of great benefit which is encouraging and should prompt further trials.
The Accuracy of a Forecast Targeting Central Bank
Authors: Falch Nina Skrove , Nymoen Ragnar
Published: September 2011

This paper evaluates inflation forecasts made by Norges Bank which is a successful forecast targeting central bank. It is expected that Norges Bank produces inflation forecasts that are on average better than other forecasts, both ’naive’ forecasts, and forecasts from econometric models outside the central bank. We find that the superiority of the bank’s forecast cannot be asserted, when compared with genuineex-antereal time forecasts from an independent econometric model. The 1-step Monetary Policy Report forecasts are preferable to the 1-step forecasts from the outside model, but for the policy relevant horizons (e.g., 4 quarters ahead), the forecasts from the outsider model are preferred with a wider margin. An explanation in terms of too high speed of adjustment to the inflation target is supported by the evidence. Norges Bank’s forecasts are better than the ‘naive’ forecasts. Norwegian inflation appears to be predictable, despite the reduction in inflation persistence that has taken place over the last two decades.
Classic Measures of Hip Dysplasia Do Not Correlate with Three-Dimensional Computer Tomographic Measures and Indices
Authors: Stubbs Allston J. , Anz Adam W. , Frino John , Lang Jason E. , Weaver Ashley A. , Stitzel Joel D.
Published: September 2011

Acetabular dysplasia is a precursor to osteoarthritis of the hip, and it causes acute and degenerative injuries of soft tissue stabilisers. Traditional radiographic assessments of dysplasia are useful in moderate and severe dysplasia, but they have questionable reliability in mild dysplasia. Computed tomography (CT) reconstruction provides a method for calculation of acetabular geometry and analysis of existing radiographic methods.

We performed a retrospective radiographic review of anteroposterior pelvic films and their corresponding pelvic CT scans. Using 30 skeletally mature patients, we analyzed the following five measurements for 60 hips: lateral centre edge angle of Wiberg (LCE), Tönnis angle, Sharp angle, a modified Sharp angle, and the depth to width acetabular index. We also estimated hip surface areas, volumes, and ratios from 3-D reconstructions of a CT scan taken within 60 days of the plain radiograph. The Pearson Correlation Coefficient was used to evaluate the relationship between the plain film measurements and the computed hip indices.

No moderate or strong correlation was found between the measured plain film indices and the calculated hip indices. Traditional 2-D measurements used to define acetabular dysplasia have little to no ability to quantify hip volumes and surface areas. CT reconstruction provides a better screening tool in the identification of subtle acetabular hip dysplasia in adults. Level of Evidence: Level III
Craniofacial morphology in patients with hypophosphatemic rickets: A cephalometric study focusing on differences between bone of cartilaginous and intramembranous origin
Authors: Gjørup Hans , Kjær Inger , Sonnesen Liselotte , Haubek Dorte , Beck‐Nielsen Signe Sparre , Hintze Hanne , Poulsen Sven
Published: September 2011

Hypophosphatemic rickets (HR) are diseases characterized by deficient mineralization of bone due to abnormal renal wasting of phosphate. Deformation of bony structures of cartilaginous origin has been described as a major characteristic in patients with HR, but little is known about the impact on bony structures of intramembranous origin. The aim of the present study was to describe the osseous morphology of the craniofacial structures in patients with HR compared to healthy controls, and to investigate the impact of different bone origin on the osseous morphology. Fifty‐three patients with HR (17 males, 36 females), aged 3–74 yrs, were included. Fifty HR patients had dominant X‐linked disease, and in three patients no mutations were identified. A total of 79 healthy individuals (37 males, 42 females), aged 6–79 yrs, with normal occlusion served as controls. Significant cephalometric differences were found between HR patients and controls. In HR patients, the cranial base was flattened and the depth of the posterior cranial fossa was decreased. The anterior height of the cranium, the angle nasion‐sella‐frontale, and the thickness of theca were increased. The length of the nasal bone and the height of the maxilla were reduced. In contrast, the vertical as well as the sagittal relation between the jaws were unaffected in HR patients compared to controls. In conclusion, we found that the cranial structures of cartilaginous origin as well as the structures of intramembraneous origin were affected in patients with HR. © 2011 Wiley Periodicals, Inc.
Compound heterozygous deletion ofNRXN1causing severe developmental delay with early onset epilepsy in two sisters
Authors: Harrison Victoria , Connell Lyndsey , Hayesmoore Jesse , McParland Joanna , Pike Michael G. , Blair Edward
Published: September 2011

Neurexin 1 (NRXN1) is a cell adhesion protein, the normal function of which is critical for effective neurotransmission. It forms a trans‐synaptic complex in the central nervous system with neuroligin. There has been one case in the literature of a patient with a heterozygous deletion inNRXN1on one allele and a nonsense mutation on the other allele, reported to have a Pitt Hopkins‐like phenotype. We report on two daughters of healthy, nonconsanguineous, Caucasian parents with biallelicNRXN1deletions identified by array CGH. The children presented with severe early onset epilepsy, profound developmental delay, gastroesophageal reflux disease, constipation, and early onset puberty. Our report confirms that biallelicNRXN1mutations result in a severe recessive mental retardation syndrome and broadens the range of phenotypes associated with this gene. © 2011 Wiley‐Periodicals, Inc.
Progressive leukoencephalopathy with intracranial calcification, congenital deafness, and developmental deterioration
Authors: Kuki Ichiro , Kawawaki Hisashi , Okazaki Shin , Kimura‐Ohba Shihoko , Nakano Tomoaki , Fukushima Hiroko , Inoue Takeshi , Tomiwa Kiyotaka , Itoh Masayuki
Published: September 2011

We report on a 12‐year‐old male with a unique cerebral white matter disease. His initial symptoms were congenital hearing loss and multiple intracranial calcifications on head CT. He developed severe intellectual disability and epilepsy. MRI showed signal abnormalities in the posterior limbs of the internal capsules, thalami, and cerebral white matter. The abnormalities were progressive over time. The neuropathology revealed diffuse and severe disruption of myelin and axons of the cerebral white matter and cerebrospinal tracts. We performed various metabolic examinations, detailed pathological investigations and genetic analyses, but could not identify the cause. To our knowledge his clinical course has not been described in the literature. © 2011 Wiley Periodicals, Inc.
Severe osteogenesis imperfecta caused by a small in‐frame deletion in CRTAP
Authors: Amor I.M. Ben , Rauch F. , Gruenwald K. , Weis M. , Eyre D.R. , Roughley P. , Glorieux F.H. , Morello R.
Published: September 2011

Mutations of proteins involved in posttranslational modification of collagen type I can cause osteogenesis imperfecta (OI) inherited in a recessive pattern. The cartilage‐associated protein (CRTAP) is part of a heterotrimeric complex (together with prolyl‐3‐hydroxylase‐1 [P3H1] and cyclophilin B) that 3‐hydroxylates the alpha 1 chain of collagen type I at proline residue 986 and plays a collagen chaperon role. CRTAP mutations usually cause severe OI. We report on a patient with OI and a homozygous in‐frame deletion in CRTAP and a severe form of OI. The girl was born with markedly deformed long bones. Despite intravenous bisphosphonate treatment, she developed multiple vertebral compression fractures and severe scoliosis and at 4 years of age was able to sit only with support. Although CRTAP transcript levels were normal in the patient's fibroblasts, protein levels of both CRTAP and P3H1 were severely reduced. The degree of 3‐hydroxylation at proline residue 986 was also decreased. This report characterizes a patient with a CRTAP small in‐frame deletion. We are unaware of prior reports of this finding. We suggest that this deletion affects crucial amino acids that are important for the interaction and/or stabilization of CRTAP and P3H1. © 2011 Wiley Periodicals, Inc.
Histologic estimation of age at death using the anterior cortex of the femur
Authors: Ericksen M.F.
Published: September 2011

This report describes a new histologic method for determination of age at death, the latest in a series of studies that began with Kerley's pioneer presentation in 1965. The study population was collected from 328 documented individuals from an anatomy dissecting room in the United States, from two modern cemeteries in the Dominican Republic, and from autopsies performed in a Chilean hospital. Undecalcified thin sections 1.0 cm wide were made from specimens taken from the femoral midshaft directly opposite the linea aspera. Five 0.886 mm2 fields were located at the periosteal edge and photographed, mainly for purposes of defining the fields and providing a permanent record. Secondary osteons, type II osteons, osteon fragments, resorption spaces, and non‐Haversian canals were recorded as number/mm2, and a 100‐space grid was used to measure average percent of unremodeled, osteonal, and fragmental bone. Stepwise regression analysis of the measurements produced a series of regression equations for age estimation for females, males, and sexes combined. Most equations have a standard error of estimate of about 10 years, but the coefficients of determination (r2) range from 0.48 to 0.72. In practice, sex‐specific equations gave better results than opposite‐sex or nonspecific equations, mainly because males and females differed in the pattern of relations between osteons and osteon fragments with advancing age.
Sexual dimorphism in the baboon facial skeleton
Authors: Leigh Steven R. , Cheverud James M.
Published: September 2011

Baboons exhibit marked sexual dimorphism in many aspects of their morphology. Dimorphism is especially pronounced in the face. We use finite‐element analysis to investigate the ontogeny of sexual dimorphism in a cross‐sectional sample of baboon (Papio sp.) faces. This method provides detailed quantitative information about size and shape changes at anatomical landmarks in the face during growth. Allometric results suggest that sexual dimorphism in facial size and shape is produced by ontogenetic scaling: males and females share a common ontogenetic trajectory. Analyses of growth in time, which complement allometric analyses, show that female growth slows much earlier than male growth, accounting for the differences between sexes. Local size and local shape follow similar patterns of growth, but changes in these variables are slower in females. Local and global facial size are much more dimorphic than local and global facial shape.
Use of active surveillance methodologies to examine over‐reporting of stillbirths on fetal death certificates
Authors: Makelarski Jennifer A. , Romitti Paul A. , Caspers Kristin M. , Puzhankara Soman , McDowell Bradley D. , Piper Kimberly N.
Published: September 2011

BACKGROUND: Data from Iowa fetal death certificates (FDCs) suggest that reportable stillbirths (unintended fetal deaths ≥20 weeks gestation and/or weighing ≥350 grams) occur in about 1 in 200 deliveries. In 2005, the Iowa Department of Public Health and the Iowa Registry for Congenital and Inherited Disorders (IRCID) collaborated with other state stakeholders to establish the Iowa Stillbirth Surveillance Project. The goal of this project was to use population‐based, active surveillance methodologies to identify reportable stillbirths delivered by Iowa residents since January 1, 2000. METHODS: To conduct stillbirth surveillance, the IRCID expanded its existing public health authority and electronic abstract application for birth defects surveillance. The expanded application was piloted using a random sample (n = 250 of 989) of FDCs reported from January 2000 through December 2004. RESULTS: IRCID procedures for active case finding and medical record abstraction verified 192 (76.8%) as reportable stillbirths. Stillbirths not verified as reportable were due to findings of elective terminations (n = 30), live births (n = 3), induced deliveries (n = 2), and FDC entries for gestational age and/or delivery weight that were either inaccurately recorded (n = 13) or accurately recorded but did not meet Iowa FDC reporting criteria (n = 9); medical records for one FDC were unavailable. Infant malformations were more common among unverified stillbirths, whereas the cause of death due to maternal‐related conditions was higher among verified stillbirths. CONCLUSIONS:These results suggest that over‐reporting limits the use of FDCs as a primary ascertainment source for stillbirth surveillance in Iowa. Continued expansion of the IRCID active surveillance methodologies to monitor stillbirths in Iowa is recommended. Birth Defects Research (Part A), 2011. © 2011 Wiley Periodicals, Inc.
Twenty‐Five–Year survival of children with birth defects in New York State: A population‐based study
Authors: Wang Ying , Hu Jiaqi , Druschel Charlotte M. , Kirby Russell S.
Published: September 2011

BACKGROUND: Few studies have been conducted on long‐term survival of children with major birth defects because of a lack of longitudinal birth defects surveillance data. The objective of this study was to conduct a 25‐year survival analysis among children in New York born with major defects by survival age, birth defect category, and other possible contributing factors. METHODS: A cohort was constructed containing children born in 1983 to 2006 with selected major birth defects. Deaths among the study cohort were identified by matching the children to their death certificates. The survival probability was estimated by Kaplan‐Meier methods. Cox proportional hazards regression was used to examine the effect of the risk factors on survival. RESULTS: A total of 9112 deaths were identified among 57,002 live births with selected birth defects between 1983 and 2006. The overall 25‐year survival probability of the study cohort was 82.51% (95% confidence interval, 82.11–82.89%). The estimated survival probability was comparable to that reported from previous studies regarding individual defects including spina bifida, encephalocele, atrioventricular septal defects, tracheoesophageal fistula and esophageal atresia or stenosis, renal agenesis or dysgenesis, lower limb reduction, diaphragmatic hernia, abdominal wall defects, and Down syndrome. Sex, low birth weight for gestational age, existence of multiple birth defects (nonisolated), and maternal age and nativity were identified as risk factors. CONCLUSION: Using the statewide, population‐based birth defects surveillance data in New York State, the survival experience of the study cohort was examined across all survival time periods by individual birth defect of interest. Several risk factors that affect survival were identified. Birth Defects Research (Part A), 2011. © 2011 Wiley Periodicals, Inc.