bluuebunny/crossref_metadata_2025 huggingface dataset:
A Large-Scale Evaluation of Risk Matrix 2000 in Scotland
Authors: Grubin Don
Published: October 2011

Risk Matrix 2000 is a statistically derived risk-assessment instrument for use with convicted male sex offenders. It is a core element of the sex offender risk assessments carried out in England, Wales, and Scotland. This study examines its validity in a large cohort of sex offenders released from Scottish prisons. It compares 5-year outcomes with findings from the original Risk Matrix validity sample (a 1979 cohort of sex offenders in England and Wales). The instrument had moderate predictive validity and performed in a similar manner in the two studies in spite of different underlying base rates of reconviction.
On the dynamic response of a half-space subjected to a moving mass
Authors: Dehestani M , Vafai A , Mofid M , Ahmadi G
Published: October 2011

The dynamic response of a homogeneous, isotropic elastic half-space under a moving time-varying inertial load with subsonic speed is investigated. The surface of the half-space, which is under the action of the moving load, is a thin frictionless layer. In order to study the influences of the inertia of loads, the problem was first solved for a moving load and, then, the procedure was extended to include the inertial effects. The Navier equations of motion for the two-dimensional half-space were transformed to a system of wave-type partial differential equations using the Stokes–Helmholtz resolution. A new moving coordinate system was used and a modified system of equation was derived. The solutions of the modified system are obtained by utilizing a concurrent two-sided and one-sided Laplace transformation. The transformed dynamic responses and stresses were inverted by the Cagniard–de Hoop method. The effects of the inertia of the moving load were included using a numerical procedure to obtain the vertical surface displacement. Numerical examples for a landing traversing object on a half-space are presented to illustrate the methodology for finding the dynamic stresses and displacements in the half-space for moving load and mass cases. The final results revealed the influences of the inertia of moving loads on the dynamic stresses and displacements in the half-space. A parametric study was carried out to clarify the effects of the magnitude of the load, the Poisson ratio, density and shear moduli of the half-space on the results.
Road Signs on the Border
Authors: Rodney Lee
Published: October 2011

This article considers the political impact of a series of billboards that appeared at the Windsor–Detroit border and the Tijuana–San Ysidro border between 1991 and 2007. While there is a significant asymmetry between the political tensions on the northern and southern borders of the United States, there are remarkable parallels and relays between events that have taken place in major cities on these borders that indicate that generalized border anxiety has spread far beyond the localized territory of the southern borderlands. In this heightened climate of border insecurity, artists and community groups have seized on the geopolitical confusion that has emerged in mainstream American media where issues such as terrorism and illegal migration have often been folded into the same discourse. While border regions are tightly controlled spaces, these projects have served to highlight contradictory narratives of globalization and security, unmasking national insecurities that have been submerged through the bureaucratic discourses of the North American Free Trade Agreement and the more recent Smart Border agreements.
Liminal Spaces
Authors: Sacramento Octávio
Published: October 2011

Based on ethnographic fieldwork on female prostitution in the border areas between Portugal and Spain, this article focuses on the analysis of physical space as a dimension of substantial influence over the organization and social dynamics of the cross-border demand for sexual services. The basic aim is to understand the strategies underpinning the localization of “clubs,” and to interpret the processes whereby their clients incorporate specific geographies of desire/eroticism and cartographies of male (in)fidelity into their everyday lives. In order to do this, special analytical attention was paid to the diacritical markers that men use to delineate the specific social spheres in which they are permanent or temporary actors, and that indicate the changes taking place in the frames that guide their definition of the distinct situations in which they find themselves. By constructing a multidimensional concept of the border/frontier, the article also explores and interprets men’s experiences in the “ecology” of commercial sex, and their subjective perceptions and attempts to legitimate extramarital sexual pursuits in the context of their most typical daily social roles, in particular those related to the family.
Making Sense of the Weather
Authors: Vannini Phillip , Waskul Dennis , Gottschalk Simon , Ellis-Newstead Toby
Published: October 2011

Drawing on ethnographic data collected throughout British Columbia’s coastal regions, in this article, the authors examine people’s experiences of ordinary weather. Data show how people experience weather multisensorially and how the weather plays a central role in the way individuals and collectives define sense of place. Experiences of weather, the authors argue, are a reflexive and active form of dwelling. A focus on skillful embodied practices and dwelling highlights how weathering is a process through which people make and remake places and shape their sense of self. The authors conceptualize the practice of weathering as a form of somatic work and explain how through somatic work places and weather emerge within a performative ecology of movements.
Telemedicine for multiple sclerosis patients: assessment using Health Value Compass
Authors: Zissman Keren , Lejbkowicz Izabella , Miller Ariel
Published: October 2011

Background: Telemedicine carries the potential of improving accessibility to health services, especially for disabled people.

Objective: To assess the health-related outcomes of short-term implementation of telemedicine (telemed) for MS patients.

Methods: A prospective study of 40 MS patients divided into a control group and a telemed group was conducted, in two stages: A. Six months’ follow-up for measurement of baseline health-related variables; B. Implementation stage, adding home telecare to the telemed group. A Health Value Compass was applied to assess the outcomes of home telecare implementation. Clinical status, cost data, patients’ self-assessment of Health Related Quality of Life (HRQoL) and satisfaction with telecare were studied.

Results: Patients in the telemed group demonstrated improved clinical outcome measured by symptoms severity. There was a decrease of at least 35% in the medical costs for 67% of the telemed group patients. Satisfaction with telecare was high and most patients would recommend this service to others.

Conclusions: The present pilot study, applying Health Value Compass-based analysis, suggests that telecare is a powerful tool for monitoring MS patients at home, carries the potential to improve health care while reducing costs, and should be considered for implementation as part of the management of chronic neurological diseases.
Molecular evidence of transient therapeutic effectiveness of natalizumab despite high-titre neutralizing antibodies
Authors: Pilz G , Harrer A , Oppermann K , Wipfler P , Golaszewski S , Afazel S , Haschke-Becher E , Trinka E , Kraus J
Published: October 2011

Natalizumab is a humanized monoclonal antibody directed against the alpha-4 integrin subunit of very late activation antigen-4 (VLA-4). Natalizumab neutralizing antibodies (NAB) have been found to significantly reduce beneficial effects of natalizumab treatment in multiple sclerosis. We investigated interactions of NAB with natalizumab by serial measurements of alpha-4 integrin levels on peripheral blood mononuclear cells using flow cytometry. In addition, serum concentrations of soluble vascular cell adhesion molecule-1 (sVCAM-1), the endothelial ligand of VLA-4, and serum NAB were serially determined. Natalizumab infusion led to a transient reduction in alpha-4 integrin levels on immune cells and serum sVCAM-1 levels along with serum negativity of NAB lasting for a few days post-infusion. Apparently, the high-dose effect of freshly infused natalizumab resulted in a transient neutralization of NAB possibly involving a transient therapeutic effectiveness.
Altered effective connectivity during performance of an information processing speed task in multiple sclerosis
Authors: Leavitt Victoria M , Wylie Glenn , Genova Helen M , Chiaravalloti Nancy D , DeLuca John
Published: October 2011

Background: Functional magnetic resonance imaging (fMRI) studies of persons with multiple sclerosis (MS) reveal distinct patterns of activation during task performance. We were interested in determining whether distinct patterns of effective connectivity would be revealed with Granger causality analysis (GCA).

Objective: To characterize directed neural connections in persons with MS during a processing speed task between brain regions known to be activated in healthy controls.

Methods: fMRI and GCA were used to examine effective connectivity underlying performance of a processing speed task in persons with MS. In total, 16 individuals with MS and 17 healthy controls (HC) performed a modified version of the Symbol Digit Modality Task (mSDMT) in the MRI scanner. Eight seed regions were selected on the basis of a priori data showing areas involved in mSDMT performance of HC.

Results: Behaviorally, the MS group attained a level of accuracy equivalent to the HC group, although they were significantly slower. While there was a great deal of overlap in the connections relied upon by both groups, the MS group showed significant differences in connectivity between critical brain regions. Specifically, the MS group had more connections from multiple regions to frontal cortices bilaterally relative to HCs.

Conclusions: Greater neural recruitment by the MS group relative to HC is consistent with the neural efficiency hypothesis, and lends further support to the notion that more connections must be recruited to maintain performance in the presence of brain pathology.
Change in disability profile and quality of life in multiple sclerosis patients: a five-year longitudinal study using the Multiple Sclerosis Impact Profile (MSIP)
Authors: Wynia K , van Wijlen AT , Middel B , Reijneveld SA , Meilof JF
Published: October 2011

Background: Evidence on the progress of disease severity in Multiple Sclerosis (MS) is generally limited in scope.

Objectives: To examine the course of a broad spectrum of MS-related disabilities and quality of life (QOL) in relation to disease severity, and responsiveness of the Multiple Sclerosis Impact Profile (MSIP).

Methods: The mortality rate was calculated after checking the national population register for vital status of the initial cohort. We performed a longitudinal study among 245 patients with MS attending the Groningen MS Center in the Netherlands. We assessed these patients in 2004 and 2009 using a postal survey including the MSIP to evaluate disabilities, the World Health Organization Quality of Life-Abbreviation version (WHOQOL-BREF) to evaluate QOL, and the ambulation question of the Expanded Disability Status Scale (EDSS) to evaluate disease severity. Responsiveness of the MSIP was estimated using standardized response mean (SRM).

Results: Increase of disability in the MSIP disability domains and loss of QOL were most prevalent and pronounced in patients with EDSS 0 to < 4.5 in 2004. MSIP and QOL scores were remarkably stable in the higher disease severity groups. Mortality rates were highest (24%) in patients with EDSS ≥ 7 to < 10 in 2004. SRM indices for the MSIP ranged between 0.26 and 0.56.

Conclusions: Prominent increases in multiple aspects of disability and loss of QOL occur especially in the early stages in MS. Health care interventions may lead to health and QOL gains, in particular when offered to patients in the first stage of the MS process. Responsiveness was sufficient for nine of the 11 MSIP domains.
Cortical dysfunction underlies disability in multiple sclerosis
Authors: Vucic Steve , Burke Therese , Lenton Kerry , Ramanathan Sudarshini , Gomes Lavier , Yannikas Con , Kiernan Matthew C
Published: October 2011

Background: Gray matter atrophy has been implicated in the development of secondary progressive multiple sclerosis (SPMS). Cortical function may be assessed by transcranial magnetic stimulation (TMS). Determining whether cortical dysfunction was a feature of SPMS could be of pathophysiological significance.

Objectives: Consequently, novel paired-pulse threshold tracking TMS techniques were used to assess whether cortical dysfunction was a feature of SPMS.

Methods: Cortical excitability studies were undertaken in 15 SPMS, 25 relapsing–remitting MS patients (RRMS) and 66 controls.

Results: Short interval intracortical inhibition (SPMS 3.0 ± 2.1%; RRMS 12.8 ± 1.7%, p < 0.01; controls 10.5 ± 0.7%, p < 0.01) and motor evoked potential (MEP) amplitude (SPMS 11.5 ± 2.2%; RRMS 26.3 ± 3.6%, p <0.05; controls 24.7 ± 1.8%, p < 0.01) were reduced in SPMS, while intracortical facilitation (SPMS -5.2 ± 1.9%; RRMS -2.0 ± 1.4, p < 0.05; controls -0.9 ± 0.7, p < 0.01) and resting motor threshold were increased (SPMS 67.5 ± 4.5%; RRMS 56.0 ± 1.5%, p < 0.01; controls 59.0 ± 1.1%, p < 0.001). Further, central motor conduction time was prolonged in SPMS (9.1 ± 1.2 ms, p < 0.001) and RRMS (7.0 ± 0.9 ms, p < 0.05) patients compared with controls (5.5 ± 0.2 ms). The observed changes in cortical function correlated with the Expanded Disability Status Scale.

Conclusion: Together, these findings suggest that cortical dysfunction is associated with disability in MS, and documentation of such cortical dysfunction may serve to quantify disease severity in MS.
Cost of multiple sclerosis in the Czech Republic: The COMS study
Authors: Blahova Dusankova J , Kalincik T , Dolezal T , Kobelt G , Havrdova E
Published: October 2011

Background: Information about cost of multiple sclerosis (MS) is available from a number of European countries, but no data from the Czech Republic have been published so far.

Objective: The objective of this study was to establish the cost of MS in the Czech Republic, overall and by level of disease severity.

Methods: Data on demographics, disease history, resource consumption and production losses were collected from 909 patients recruited in 7 MS centres in the Czech Republic. Annual costs were estimated in the societal perspective, using 2007 unit costs. To evaluate the relationship between disability and costs, patients were stratified into those with mild (67%), moderate (27%) and severe (10%) disability using the Expanded Disability Status Scale.

Results: Mean total annual costs per patient were €12,272, of which 51% were direct medical costs, 4% direct non-medical costs and 45% indirect costs. The average annual costs in patients with mild, moderate and severe disability amounted to €9905, €14,064 and €22,880, respectively.

Conclusion: The total costs of MS in the Czech Republic are estimated at €208.6 million per year. Consistent with other studies, the costs increase significantly with the severity of MS.
Intrathecal synthesis of IgM measured after a first demyelinating event suggestive of multiple sclerosis is associated with subsequent MRI brain lesion accrual
Authors: Durante Laurence , Zaaraoui Wafaa , Rico Audrey , Crespy Lydie , Wybrecht Delphine , Faivre Anthony , Reuter Françoise , Malikova Irina , Pommier Gilbert , Confort-Gouny Sylviane , Cozzone Patrick J , Ranjeva Jean-Philippe , Pelletier Jean , Boucraut Jose , Audoin Bertrand
Published: October 2011

Background: Previous studies have demonstrated that intrathecal synthesis of IgM is observed in multiple sclerosis (MS) and correlates with a worse disease course. These results suggest that IgM participates in the formation of MS lesions.

Objective: The aim of the present study was to assess the potential association between the level of intrathecal synthesis of IgM measured after a clinically isolated syndrome (CIS) and the subsequent formation of brain lesions.

Methods: Fifty seven patients with a CIS and a high risk developing MS were enrolled in a longitudinal study. Examination of cerebrospinal fluid was performed after the CIS and included measures of intrathecal IgM and IgG synthesis. Patients were assessed with the same 1.5 Tesla magnetic resonance imaging (MRI) system at baseline and after a mean follow-up period of 49 months (range 36–60). Spearman Rank correlation was used to assess the potential correlations between levels of intrathecal immunoglobulin synthesis and MRI data.

Results: The level of intrathecal IgM synthesis was correlated with the number of gadolinium-enhancing lesions at baseline ( p = 0.01) and with accrual of brain lesions during the follow-up period ( p = 0.02). By taking into account brain sub-regions, we demonstrated that the level of intrathecal IgM synthesis was only correlated with the increased number of lesions in the periventricular regions ( p = 0.004). The level of intrathecal IgG synthesis was not correlated with any MRI data.

Conclusion: The present longitudinal study demonstrates that the level of intrathecal IgM synthesis measured after a CIS is associated with subsequent lesion accrual during the first years of MS. This result emphasizes the involvement of IgM in plaque formation.
Quantitative measurement of anti-aquaporin-4 antibodies by enzyme-linked immunosorbent assay using purified recombinant human aquaporin-4
Authors: Kim Woojun , Lee Ji-Eun , Li Xue Feng , Kim Su-Hyun , Han Byeong-Gu , Lee Byung Il , Kim Jong Kuk , Choi Kyungho , Kim Ho Jin
Published: October 2011

Background: Antibodies to aquaporin-4 (AQP4-Ab), known as NMO-IgG, are a sensitive and specific marker for neuromyelitis optica (NMO).

Methods: To develop an enzyme-linked immunosorbent assay (ELISA) for AQP4-Ab, we expressed M23 isoform of human AQP4 in a baculovirus system, and used it as an antigen. We measured AQP4-Ab in the sera of 300 individuals: 64 with definite NMO, 31 with high-risk NMO, 105 with multiple sclerosis (MS), 57 with other neurological diseases (ONDs), and 43 healthy controls. We also performed longitudinal measurements of AQP4–Ab in 787 samples collected from 51 patients with definite or high-risk NMO.

Results: AQP4-Abs were positive in 72% with definite NMO, 55% with high-risk NMO, and 4% with MS, but none of the OND patients and the healthy individuals. The longitudinal measurement showed AQP4-Ab levels correlating with disease activity. Out of 38 initially seropositive patients, 21 became seronegative under effective immunosuppressive therapy. During most relapses, the serum AQP4-Ab levels were either high or rising compared with the previous value, although rising AQP4-Ab levels did not always lead to acute exacerbation. Two of the 13 initially seronegative patients converted to seropositive following acute exacerbations.

Conclusions: We established an AQP4-Ab ELISA, which could be a potential monitoring tool of disease activity.
Cytokine mapping in cerebrospinal fluid and blood in multiple sclerosis patients without oligoclonal bands
Authors: Vrethem M , Kvarnström M , Stenstam J , Cassel P , Gustafsson M , Landtblom AM , Ernerudh J
Published: October 2011

Objective: Since there are clinical and genetic differences between MS patients with intrathecal oligoclonal bands (OCB+) in the cerebrospinal fluid (CSF) compared with those without (OCB−), the aim was to find out if OCB− patients showed a different pattern of cytokine immune activation compared with OCB+ patients.

Methods: The study included 25 MS patients (10 OCB− and 15 OCB+) and 13 controls. A panel of cytokines was measured; IL-1β, IL-6, IL-8/CXCL8, IL-10, TNF and GM-CSF in serum, CSF and in supernatants from polyclonally stimulated blood mononuclear cells, where also levels of IL-12p40, IL-13, IL-15, IL-17 and IFN-γ were measured. The concentrations of soluble (s) VCAM-1 and sCD14 were measured in serum and CSF.

Results: In general, there were no extensive differences in cytokine concentrations between the OCB− and OCB+ groups.

Conclusion: OCB− MS patients do not seem to constitute a separate entity concerning inflammatory parameters measured as cytokine concentrations in CSF and blood.
Exploring the Feasibility of Alternative STD-Testing Venues and Results Delivery Channels for a National Screening Campaign
Authors: Friedman Allison L. , Bloodgood Bonny
Published: October 2011

Annual chlamydia screening is recommended for sexually active women aged 25 years and younger, though less than half of eligible women are screened each year. If acceptable to young women, nontraditional testing venues and new communication technologies could promote efficiencies in sexually transmitted disease (STD) screening and facilitate screening by overcoming barriers at systems and patient levels. Objective. This study sought to explore young women’s technology use, preferences for STD-testing venues, attitudes toward nontraditional venues, and acceptability of test results delivery options. Method. A total of 80 ethnographic one-on-one telephone interviews were conducted with African American, Caucasian, and Latina women, aged 15 to 25 years, in 10 metropolitan areas of the United States. Interviews were recorded, transcribed, and analyzed using NVivo2. Results. Alternative STD-testing venues and results delivery channels are valued by young women for their convenience and accessibility, but they must also offer privacy, confidentiality, and emotional/informational support to be acceptable. Assuring provider (or self) competence and valid/accurate test results is also important. Conclusions. Although new technologies have been embraced by young women for personal and social uses, they may not be as readily embraced for the provision of STD-related services. Additional social marketing efforts may be needed to promote acceptance of nontraditional STD-testing settings and results delivery methods.
Using Mixed Methods to Measure the Perception of Community Capacity in an Academic–Community Partnership for a Walking Intervention
Authors: Anderson-Lewis Charkarra , Cuy-Castellanos Diana , Byrd Arnecca , Zynda Karen , Sample Alicia , Blakely Reed Vickie , Beard Mary , Minor Latessa , Yadrick Kathleen
Published: October 2011

H.U.B. City Steps is a 5-year community-based participatory research walking intervention designed to help lower blood pressure in a majority African American population in southern Mississippi via community collaboration and capacity building, increased walking, culturally tailored health education sessions, and motivational interviewing. Building community capacity for physical activity is a key component of this intervention. Qualitative and quantitative methods have been used to assess how project stakeholders perceive the community capacity-building efforts of the project. This article illustrates the baseline results of this mixed methods approach from the perspective of three groups of stakeholders: project researchers and staff, community advisory board, and intervention walking coaches. Eight constructs were examined, including leadership, resources, external networking, visibility and recognition, personnel sustainability, ability and commitment to organize, communication with community members, and relationships with influential others. Quantitative results indicated significant differences among stakeholder groups for project leadership and personnel sustainability. Qualitative perspectives provided an opportunity to examine possible reasons for these differences. Overall findings provide direction related to improving intervention outcomes and sustainability.
The Death Rattle of the American Mind
Authors: McLaren Peter
Published: October 2011

This article surveys the recent political scene in the United States, paying particular attention to contradictions embedded in foreign policy and domestic initiatives. Also addressed are educational issues within the context of the struggle for both educational justice and economic justice. The author recounts, as well, some of his recent experiences in Michoacan, Mexico, and outlines an approach for social justice education through revolutionary critical pedagogy.
The Pretender
Authors: Sughrua William
Published: October 2011

Following “reflexive ethnography” and using a “layered narrative” of autobiography, academic argument, exposition, and fictionalization set within the “story” of the author as “I” and a group of childhood friends on a summer night, this text challenges the apparent hegemony of mainstream academic writing of applied linguistics and poses alternative forms of writing. This theme is “performed” rather than “explained.” Consequently, the text engages in what Denzin and Lincoln describe as the sixth moment of qualitative research, which calls for performative narratives blurring or eliminating the divisions between data and analysis through means of “creative writing” (e.g., scene, characterization). The following text, therefore, expounds on neither its theme, reflexive ethnographic approach, nor methodological positioning (above); rather, the text “dramatizes” its theme, approach, and methodology, with this present abstract signposting such intentions.1
Narratives of Sport Pedagogies
Authors: Keyes Megan S. , Gearity Brian T.
Published: October 2011

The following article is a messy, performative text that combines the voices of student and professor to tell and show critical (auto)ethnographies. Using multiple biographical, poetic narratives, the student’s voice inscribes sport and its intersections with race, class, and gender. The professor’s theoretical-literary voice precedes the individual narratives, and provides testimony to the pedagogical value of creative analytic practices.
The Role of Religion and Spirituality in Psychological Distress Prior to Surgery for Urologic Cancer
Authors: Biegler Kelly , Cohen Lorenzo , Scott Shellie , Hitzhusen Katherine , Parker Patricia , Gilts Chelsea D. , Canada Andrea , Pisters Louis
Published: October 2011

The present study examined the associations between religion and spirituality (R/S), presurgical distress, and other psychosocial factors such as engagement coping, avoidant coping, and social support. Participants were 115 men scheduled for surgery for urologic cancer. Before surgery, participants completed scales measuring intrinsic religiosity, organized religious activity, and nonorganized religious activity (IR, ORA, NORA); social support (Medical Outcomes Study Social Support Survey); and distress (Impact of Event Scale [IES], Perceived Stress Scale [PSS], Brief Symptom Inventory-18 [BSI-18], and Profile of Mood States [POMS]). R/S was positively associated with engagement coping. Social support was positively associated with engagement coping and inversely associated with POMS and PSS scores. Engagement coping was positively associated with IES and BSI scores, and avoidant coping was positively associated with all distress measures. R/S moderated the association between engagement coping and IES scores, such that the association between engagement coping and IES was not significant for men with high R/S scores (greater religious belief). R/S moderated the association between social support and distress; the inverse association between social support and PSS and POMS scores was only significant for men who scored high on R/S. This study replicated findings from previous studies suggesting that engagement and avoidant types of coping can lead to increased distress prior to surgery. Although R/S was associated with engagement coping, it was not associated with any of the distress measures. The finding that R/S moderated the associations between engagement coping and distress and social support and distress suggests that the association between R/S, coping style, social support, and adjustment to stressful life situations is not simplistic, and indirect associations should be explored.
Racism, Union Busting, or Just Plain Cultural Conflict?
Authors: Stryker Don , Bergerson Amy Aldous
Published: October 2011

This case describes the struggle of a small school employee association located in a right-to-work state as it attempts to continue exercising influence after a political turmoil caused the composition of the school board to change. This case presents many elements that foster discussion of basic employee rights such as freedom of association, free speech, and due process. As such, this case is designed for usage in educational leadership programs and is particularly pertinent to provoke discussions regarding school politics, employee association authority, preferences in hiring practices, and employee dismissal procedures. Students of educational leadership enrolled in school law, human resources, and/or multicultural education courses can engage in discussion of multiple aspects of course content.
Trabecular microstructure of the human lunate in Kienböck’s disease
Authors: Han K.-J. , Kim J. Y. , Chung N.-S. , Lee H. R. , Lee Y. S.
Published: October 2011

The trabecular microstructure of normal lunates and lunates with Kienböck’s disease was investigated using micro-computed tomography (micro-CT). Five lunates with advanced Kienböck’s disease were obtained during lunate excision and scaphocapitate fusion, and five control lunates were from embalmed cadavers. Microstructural morphometric parameters were measured using micro-CT images. Trabeculations of lunates with Kienböck’s disease were 2.67 times denser and 1.84 times thicker than those of normal lunates. Furthermore, bone surface areas were 1.43 times greater and bone volume 2.67 times greater, and structural model indices were significantly lower in lunates with Kienböck’s disease. The study estimated that high mechanical stress would be applied to lunates with Kienböck’s disease, and suggests that new bone formation and collapse may play important roles in the microstructural changes in the lunate with advanced Kienböck’s disease.
Nonoperative treatment of PIPJ flexion contractures associated with Dupuytren’s disease
Authors: Larocerie-Salgado J. , Davidson J.
Published: October 2011

Post-surgical outcomes in patients with Dupuytren’s disease causing flexion contractures of the proximal interphalangeal joint can be inconsistent and are often associated with protracted rehabilitation, reduced flexion, recurrence of the contracture, and patient dissatisfaction. An alternative treatment option, comprised of splinting and soft tissue mobilization techniques, was introduced to stabilize early contractures of the proximal interphalangeal joint in the hopes of delaying or obviating surgery. Over the course of approximately 12.6 months (±7.8), thirteen patients were followed at the hand clinic at Hotel Dieu Hospital in Kingston. One patient was unable to complete the course of therapy. Of the remaining patients, analysis showed significant improvement in active proximal interphalangeal joint extension of approximately 14.6° (SD: ±5.1°; range: 5–25°) over the course of the treatment ( p < .05). Nighttime static extension splinting and soft tissue mobilization techniques appear to delay and possibly prevent the need for surgery in individuals with flexion contractures of the proximal interphalangeal joint due to Dupuytren’s disease.
Design optimization of a sport shoe sole structure by evolutionary computation and finite element method analysis
Authors: Shimoyama K , Seo K , Nishiwaki T , Jeong S , Obayashi S
Published: October 2011

This paper describes the design optimization of a sport shoe sole structure by evolutionary computation coupled with eigenmode analysis based on the finite element method. A genetic algorithm assisted by the Kriging response surface model was used for global and efficient optimization. The present study implemented two optimization cases based on equivalent design problem formulations: the single-objective constrained problem and multi-objective non-constrained problem. The optimization described here provided a midsole structure with optimal material properties, in which the elastic modulus should be reduced in rearfoot→midfoot→forefoot-centre domains sequentially as the midsole weight becomes lighter. In addition, a comparison of the results between the two cases yielded insight into constraint handling for faster convergence in midsole design optimization by evolutionary computation.
The aerodynamic performance of a range of FIFA-approved footballs
Authors: Passmore M , Rogers D , Tuplin S , Harland A , Lucas T , Holmes C
Published: October 2011

Much discussion surrounds the flight of a football, especially that which is perceived as irregular, and is typically done so with little understanding of the aerodynamic effects or substantive evidence of the path taken. This work establishes that for a range of FIFA-approved balls there is a significant variation in aerodynamic performance.

This paper describes the methods used for mounting stationary and spinning footballs in a wind tunnel enabling accurate force data to be obtained, and the analysis techniques used. The approach has been to investigate a number of scenarios: the non-spinning Reynolds sweep, unsteady loads, orientation sensitivity (yaw sweep), and the spinning Reynolds sweep. The techniques are applied to a number of footballs with differing constructions and the results reported. To put the aerodynamic data into context, the results are applied in a flight model to predict the potential differences in the behaviour of each ball in the air.

This paper concludes that, although the drag characteristics are different for each different ball tested, the simulation suggests that this has only a limited effect on the flight of the ball. It is also shown that the unsteadiness of the aerodynamic loads is unlikely to be responsible for unpredictable behaviour. However, it is also shown that there are significant differences in the lateral aerodynamic forces for a range of FIFA-approved match balls, and that these aerodynamic differences have a significant effect on the flight path for both spinning and slowly rotating balls.
Challenges and controversies in the medical management of primary and antithrombotic-related intracerebral hemorrhage
Authors: Moussouttas Michael
Published: October 2011

Intracerebral hemorrhage (ICH) represents 10–15% of all cerebrovascular events, and is associated with substantial morbidity and mortality. In contrast to ischemic cerebrovascular disease in which acute therapies have proven beneficial, ICH remains a more elusive condition to treat, and no surgical procedure has proven to be beneficial. Aspects pertinent to medical ICH management include cessation or minimization of hematoma enlargement, prevention of intraventricular extension, and treatment of edema and mass effect. Therapies focusing on these aspects include prothrombotic (hemostatic) agents, antihypertensive strategies, and antiedema therapies. Therapies directed towards the reversal of antithrombosis caused by antiplatelet and anticoagulant agents are frequently based on limited data, allowing for diverse opinions and practice styles. Several newer anticoagulants that act by direct thrombin or factor Xa inhibition have no natural antidote, and are being increasingly used for various prophylactic and therapeutic indications. As such, these new anticoagulants will inevitably pose major challenges in the treatment of patients with ICH. Ongoing issues in the management of patients with ICH include the need for effective treatments that not only limit hematoma expansion but also result in improved clinical outcomes, the identification of patients at greatest risk for continued hemorrhage who may most benefit from treatment, and the initiation of therapies during the hyperacute period of most active hemorrhage. Defining hematoma volume increases at various anatomical locations that translate into clinically meaningful outcomes will also aid in directing future trials for this disease. The focus of this review is to underline and discuss the various controversies and challenges involved in the medical management of patients with primary and antithrombotic-related ICH.
Medical therapy for premature ejaculation
Authors: Mohee Amar , Eardley Ian
Published: October 2011

Premature ejaculation (PE) is a common male sexual dysfunction. Advances in PE research have been hampered owing to a nonstandardized definition of PE, until the definition by the International Society of Sexual Medicine (ISSM) in 2009. Once the diagnosis of PE is established through a thorough history, a variety of medical therapies is available, including tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRIs), centrally acting opiates, phosphodiesterase 5 inhibitors and topical desensitizing creams. Most of these treatments increase the intravaginal ejaculation latency time (IELT) and patient satisfaction scores, with the most convincing evidence for SSRIs and topical creams. Daily SSRIs such as paroxetine, although efficacious, do have a substantial and prolonged side effect profile. Dapoxetine, which is a on-demand SSRI, is the only licensed drug for the treatment of PE, increasing IELT by a factor of 2.5 to 3 with limited and tolerable side effects. In the near future, the topical aerosol PSD502 is due to be licensed for the treatment of PE, increasing IELT by up to a factor of 6 but having minimal local and negligible systemic side effects.
Efficacy of vitamin E in knee osteoarthritis management of North Indian geriatric population
Authors: Bhattacharya Ijen , Saxena Rahul , Gupta Veena
Published: October 2011

Background: Osteoarthritis (OA) is the most common cause of chronic pain and disability in the elderly. It involves progressive destruction of articular cartilage as a consequence of various factors including augmented oxidative stress with advancing age which has not yet been controlled. It is conceivable that exogenous vitamin E supplementation ameliorates the modifiable indexes via regulation of free radical production and the consumption of antioxidant reserve. The objectives of the present study were to investigate the therapeutic effect of vitamin E supplementation in ameliorating the altered activity of antioxidant enzymes (superoxide dismutase, ceruloplasmin, glutathione peroxidase and catalase), erythrocyte malondialdehyde level (MDA, i.e. marker of lipid peroxidation) and markers of systemic inflammation (plasma C-reactive protein [CRP] and synovial fluid interleukin 6 [IL-6]) in osteoarthritic elderly.

Methods: Antioxidant enzymes status, MDA, IL-6 and CRP levels were estimated by using standard methods in 40 healthy individuals (control group) and in 40 osteoarthritic patients aged 50–70 years before and after 3 months of vitamin E supplementation, i.e. group I (nonsupplemented) and group II (200 mg/day vitamin E supplemented). The obtained values were compared statistically by using Student’s t-test.

Results: Marked alteration in antioxidant enzymes, MDA and inflammatory markers were observed in group I ( p < 0.05) as compared with controls. These levels were ameliorated significantly after vitamin E supplementation ( p < 0.05) in group II. However, elevated levels of serum CRP and synovial fluid IL-6 ( r = 0.034; p < 0.05) were decreased insignificantly ( p < 0.1) after vitamin E supplementation in knee OA patients.

Conclusions: These findings confirm the protective role of vitamin E supplementation against oxidative stress mediated biomolecular deterioration in OA. However, the anti-inflammatory role of vitamin E remains to be explored.
A Case Report of Fibular Aplasia, Tibial Campomelia, and Oligosyndactyly (FATCO) Syndrome Associated With Klinefelter Syndrome and Review of the Literature
Authors: Ekbote Alka V. , Danda Sumita
Published: October 2011

Limb development is a complex regulated development phenomenon involving multiple genes. Fibular Aplasia, Tibial Campomelia and Oligosyndactyly (FATCO) syndrome (MIM#246570) is a syndrome of unknown genetic basis and inheritance with variable expressivity and penetrance. Its counterpart, Fuhrmann syndrome or Femoral-Fibularaplasia-Campomelia and Oligosyndactyly are a result of defect in the WNT7a gene located on the 3p25. Former is proposed to be a development dysplasia of defective dorso-ventral polarity assignment and distal limb development. Ectrodactyly and fibular a/hypoplasia (EFA, MIM# 113310) share the full phenotypic spectrum of FATCO syndrome, whether they are allelic disorders or represent two variable presentations in the spectrum of the same disorder is not an established fact. We report here one Indian patient with findings of FATCO syndrome with associated Klinefelter syndrome. This is the first such report which is likely to be a co-incidental finding and has implications for genetic counseling.

Levels of Evidence: Therapeutic, Level IV
Osteoarthritis of the Ankle and Foot Complex in Former Greek Soccer Players
Authors: Armenis Elias , Pefanis Nikolaos , Tsiganos Georgios , Karagounis Panagiotis , Baltopoulos Panagiotis
Published: October 2011

Sports activities cause increased loads in elite athletes’ joints. Current scientific knowledge highlights the importance of applied mechanical loads on the physiology and pathophysiology of the articular cartilage. Thus, it is possible that sporting activity has a role in the development of osteoarthritis (OA), a painful and damaging joint disease. The aim of the present study was to investigate and record osteoarthritic alterations in the ankle and foot complex in former Greek soccer players and also compare them with those in the general population. The study sample consisted of 170 male, former elite soccer players, aged between 42 and 55 years (mean = 49.8 years, standard deviation [SD] = 7.4). A control group of 132 men, aged between 42 and 55 years (mean, 50.7 years, SD = 9.9), with no regular athletic activity were examined. The development of osteoarthritic alterations was recorded through a questionnaire and clinical and radiological examination. Radiographic analysis of the images in former athletes group showed not only more signs of cartilage degeneration in comparison with the control group (P < .05) but also similar clinical manifestations (pain and impaired mobility; P > .05). Osteophyte formation is a frequent disease among former soccer players—with variations on radiographic images—but it does not appear in their clinical picture. However, it is likely that both spurs and subchondral sclerosis (main findings) are preclinical manifestations of OA.

Levels of Evidence: Prognostic, Level II
Efficacy of Intravenous Tissue Plasminogen Activator in Frostbite Patients and Presentation of a Treatment Protocol for Frostbite Patients
Authors: Johnson Adam R. , Jensen Heather L. , Peltier George , DelaCruz Eugene
Published: October 2011

Frostbite can be a devastating and even debilitating injury. Early identification and proper treatment of frostbite is critical in saving digits and limbs. Tissue plasminogen activator (tPA) has been shown to be effective in reducing the number of digits amputated after severe frostbite injury. Nothing has been presented in the podiatric literature regarding the use of tPA in treating frostbite patients for preserving toes and feet. Intravenous tPA and IV heparin were used to treat severe frostbite injuries that did not show improvement after rapid rewarming, had absent Doppler pulses in the distal limb or digits, showed limited or no perfusion by Tc-99 3-phase bone scan, and had no contraindications to use of tPA. All 11 patients included in this study were treated at Hennepin County Medical Center between 2008 and 2010. A total of 73 digits (upper and lower extremity) were considered at risk for amputation after evaluation with Tc-99 bone scan. Of those digits that were affected, 43 were amputated. Intravenous tPA is a safe and effective treatment to reduce the number of digital amputations after severe frostbite injury. The authors’ protocol for treating severe frostbite includes the use of tPA.

Levels of Evidence: Therapeutic, Level IV
A Method Used to Access the Functional Outcome of Tibial Posterior Tendon Transfer for Foot Drop in Leprosy
Authors: Reis Felipe J. J. , Knackfuss Irocy , Verçosa Nubia , de Menezes Sara Lúcia , Gomes Maria Kátia
Published: October 2011

Objectives. The aim of this study was to access the postoperative functional results of posterior tibial tendon transfer for foot drop as a consequence of nerve palsy in leprosy. Material and Methods. Thirteen patients (9 males and 4 females) with ages ranging from 9 to 69 years were submitted to posterior tibial tendon transfer by the circumtibial route to correct foot drop in leprosy. The length of postoperative follow-up ranged from 1 to 5 years. The Stanmore system was used as a method for evaluating the functional results of postoperative posterior tibial tendon transfer. This system is made up of 7 different categories and the total score is 100. Results. According to the Stanmore system, the results were poor in 1 patient (7.6%), moderate in 2 feet (15.3%), good in 5 feet (38.4%), and excellent in 5 feet (38.4%). All the patients were satisfied with the final outcome. Conclusion. The posterior tibial tendon transfer for foot drop in leprosy was efficient in restoring normal function of the foot and gait without changing foot posture. In the absence of a standardized method for assessing the results of posterior tibial tendon transfer, the Stanmore system seems to be a good tool for an objective evaluation.

Levels of Evidence: Therapeutic, Level IV
Retigabine (ezogabine) as add-on therapy for partial-onset seizures: an update for clinicians
Authors: Harris Jacklyn A. , Murphy Julie A.
Published: October 2011

Objective: The present study reviewed the pharmacology, pharmacokinetics, efficacy, and safety of retigabine (ezogabine), a potential agent for use as adjunctive treatment in refractory partial-onset seizures.

Methods: A MEDLINE search (1966–May 2011) was conducted using the key words retigabine, ezogabine, D-23129, epilepsy, and anticonvulsant. Bibliographies of all articles retrieved were also reviewed. All studies including humans and published in English with data describing retigabine for the adjunctive treatment of partial-onset seizures were reviewed.

Results: Retigabine has been shown to interact with the KCNQ2/KCNQ3 subunits of the potassium channels, GABAA receptors, and weakly block sodium and calcium channels. Retigabine is 50–60% bioavailable, metabolized by N-glucuronidation and N-acetylation, 80% protein bound, and has few drug–drug interactions. Recent data suggest that retigabine may have a role as adjunctive treatment for refractory partial-onset seizures. Placebo-controlled trials demonstrated a 23.4–44.3% reduction in seizure frequency with 50% responder rates ranging from 23.2% to 47.0% with varying doses of retigabine. The most common adverse effects, occurring in greater than 10% of subjects in the clinical trials, include abnormal gait, confusion, dizziness, fatigue, headache, nausea, somnolence, speech disorder, tremor, urinary tract infection, and blurred vision.

Conclusions: Retigabine is a promising agent for adjunctive treatment of refractory partial-onset seizures.
New anticoagulants in atrial fibrillation: an update for clinicians
Authors: Bhusri Satjit , Ansell Jack
Published: October 2011

Anticoagulation is vital for stroke and systemic embolism prevention in patients with atrial fibrillation. Current therapy with the vitamin K inhibitor warfarin has many inherent limitations in clinical practice. With the potential of broadening anticoagulation therapy to a larger population, new classes of anticoagulants have recently emerged with the potential for improved efficacy, safety and convenience. Direct thrombin inhibitor and Factor Xa inhibitor classes are showing promise for both patients and clinicians.