bluuebunny/crossref_metadata_2025 huggingface dataset:
Peripheral Dentinogenic Ghost Cell Tumor
Authors: Bello Ibrahim O. , Qannam Ahmed , Al-Zahrani Ahmed , AlDosari Abdullah
Published: December 2011

Peripheral dentinogenic ghost cell tumor is a rare tumor with only 24 cases previously described in the English literature. The majority of cases have been reported to occur in the anterior part of the jaws. A case occurring in posterior (molar region) of the mandible in a 75-year-old edentulous woman is reported. The patient presented with a nodular swelling in the left mandible that showed erosion (saucerization) of the underlying bone radiographically. On microscopy, the tumor showed mainly solid epithelial islands resembling ameloblastoma in fibrous connective tissue. The islands were associated with ghost cells and dysplastic dentin. This report includes the clinical, radiographic, and microscopic features of the patient, in addition to the review of the English literature on the tumor.
Selected Unusual Tumors of the Stomach
Authors: Wang Lai Mun , Chetty Runjan
Published: December 2011

Several unusual stomach tumors have been recently described. In addition, some tumors that are often encountered in other sites may rarely occur as primary gastric tumors. The diagnostic surgical pathologist needs to be aware of some of these lesions to prevent misdiagnosis. This overview discusses the key clinical features, pathology, immunohistochemistry, and relevant molecular findings of multiple minute gastrointestinal stromal tumors and interstitial cell of Cajal hyperplasia, nerve sheath tumors (schwannoma and perineurioma), gastroblastoma, granular cell tumor, glomus tumor, plexiform angiomyxoid myofibroblastic tumor, and primary clear cell sarcoma of the gastrointestinal tract that occur as primary gastric neoplasms.
Participatory Decision Making for Sanitation Improvements in Unplanned Urban Settlements in East Africa
Authors: Hendriksen Astrid , Tukahirwa Judith , Oosterveer Peter J. M. , Mol Arthur P. J.
Published: December 2011

Solving the problem of inadequate access to sanitation in unplanned settlements in East Africa needs to combine social and technical dimensions in such a manner that they fit the local context. The modernized mixtures approach offers an analytical framework for identifying such solutions, but this approach requires effective methods for participatory decision making. This article intends to contribute to filling this gap by identifying and further elaborating an appropriate multicriteria decision-making tool. The multicriteria decision analysis methodology, Proact 2.0, offers an adequate solution as it creates the possibility to connect knowledge, experiences, and preferences from scientists, experts, and policy makers with those of the end users. We show in particular that users not always prefer the most optimal sanitation system, defined from an “expert” point of view. This article concludes that using Proact 2.0 can lead to substantial improvements in decision making in the field of sanitation in unplanned settlements in East Africa.
Apixaban and Rivaroxaban Safety After Hip and Knee Arthroplasty
Authors: Alves Carlos , Batel-Marques Francisco , Macedo Ana Filipa
Published: December 2011

Direct experimental safety comparisons of Xa coagulation factor direct inhibitors, apixaban and rivaroxaban, on their approved therapeutic indications have not been identified. Due to recently raised safety concerns, a meta-analysis was carried out pooling data from studies identified on a Medline and Cochrane Library search in order to better evaluate the safety profile of both drugs. Abstracts from scientific meetings were also searched from 2003 to 2011. Primary and secondary outcome measures were major bleeding and total bleeding, respectively. Relative risks (RRs) were estimated using random effects models and statistical heterogeneity was estimated with I2 statistics. Of the 160 screened publications, 12 clinical trials were included in which enoxaparin was the active control. For knee arthroplasty, apixaban was associated with significantly fewer major bleeding events (6496 patients, RR 0.56, 95% confidence interval [CI] 0.32-0.96) and fewer total bleeding events (6496 patients, RR 0.81, 95% CI 0.67-0.97). There were no significant differences in the incidence of major bleeding events (5699 patients, RR 1.40, 95% CI 0.56-3.52) or in the incidence of total bleeding events for rivaroxaban (5699 patients, RR 1.09, 95% CI 0.91-1.30). No differences were found when thromboprophylaxis after hip replacement was the case. Apixaban seems to be associated with a lower risk of the incidence of hemorrhagic events after total knee arthroplasty. For hip arthroplasty, no differences were found between the studied drugs.
Reframing Regional Governance for Research and Practice
Authors: Foster Kathryn A. , Barnes William R.
Published: December 2011

The article proposes a framework to clarify and specify regional governance, a concept widely used but as yet inadequately formulated for research and practice. Using capacity and purpose rather than governance or governmental forms as a foundation, the framework identifies five dimensions—actor group, agenda, internal capacity, external capacity, and implementation experience—that together describe regional governance for a time, place, and policy goal.
DSM-IV ADHD Symptoms Self-Ratings by Adolescents
Authors: Gomez Rapson
Published: December 2011

Objective: Measurement invariance deals with whether the expected scores on a measure are the same or different across different groups when the groups have the same level of the underlying latent trait scores. The study used multiple-group confirmatory factor analysis (CFA) to examine measurement invariance across male and female adolescent self-ratings of the ADHD symptoms (recoded as binary scores). Method: To accomplish this, 178 male and 185 female adolescents, between 12 and 17 years of age, completed an ADHD rating scale. Results: For the measurement model, the results support the invariance for the configural model (same factor structure and the same items associated with the latent factors), metric invariance (same strength of the associations of items with the factors) for the factor loadings of 17 of the 18 symptoms, and all the error variances. For the construct model, there was invariance for the inattention (IA) and hyperactivity/impulsivity (HI) latent factor variances, covariances, and mean scores. Thus, there was good support for gender equivalency for the ADHD symptoms. Conclusion: These findings extend existing gender invariance data for the ADHD symptoms. The theoretical and clinical implications of the findings as well as the revision implications for Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-V) are discussed.
Affective Infrastructure
Authors: Street Alice
Published: December 2011

Hospitals are designed as spaces of improvement. Yet an accumulation of infrastructural projects can lead over time to the emergence of a layered landscape made up of multiple incongruous planned spaces. This article focuses on Madang General Hospital in Papua New Guinea as one example of such a landscape. Here, deteriorating colonial buildings jostle against new gleaming constructions built with donor funds. The layered effect of the postcolonial landscape draws attention to enduring racial and class inequalities; the colonial past is rendered present in the buildings of the future. Drawing on recent work on affect in anthropology and cultural geography, the author argues that this landscape impresses affects of hope and disappointment on the people who inhabit it and shapes ambivalent attachments to national and state futures. This double movement of improvement and decay is analyzed as a process of ruination that is intrinsic to modern spaces of improvement.
Moving in With Care
Authors: Mesman Jessica
Published: December 2011

This article argues that patient safety is also a spatial achievement. To demonstrate this, the author aims to accomplish a spatial analysis with a focus on the coordinating and problem-solving role of the (material) environment and a focus on the way spatial order is produced by safety activities. To gain insight into the spatiality of patient safety, the author follows doctors and nurses while they deal with an unplanned admission of a newborn baby to the neonatal intensive care unit. The analysis especially focuses on the crucial role of the collaborative work of the doctors and nurses in the preservation of patient safety. As the point of departure for the analysis, the author considers space as integral to social action and as something created in the turbulence of social action. This enables the author to go beyond a mere description of how the spatial arrangement of the ward is a part of safety measures. The mobility work that is involved in a safe and smooth collaboration will also be taken into account. The analysis of their mobility patterns on different levels of scale displays the intertwinement between layers of safety and the spatial layers of the neonatology ward.
Culture and unethical conduct: Understanding the impact of individualism and collectivism on actual plagiarism
Authors: Martin Daniel E
Published: December 2011

This criterion study examined the impact of the cultural dimensions of individualism and collectivism on actual plagiarism in working business students. Given globalization of business and recent business scandals, furthering our understanding of international ethics remains critical. Business students are the potential employees, managers and leaders of organizations in the future. In this study we focus on one form of unethical conduct by business students, i.e. actual plagiarism, and seek to determine the link between this behavior and cultural values of individualism/collectivism and associated stereotypes of Asian/Caucasian students. Our findings suggest that individualists plagiarize more than collectivists, and that no significant differences in plagiarism exist between Asian and Caucasian students, contrary to popular beliefs. The implications of these findings for scholars and managers are discussed.
Glocalizing Nonaka’s knowledge creation model: Issues and challenges
Authors: Hong Jacky F.L.
Published: December 2011

The main objective of this article is to explore the challenges for globalizing knowledge management theories. Adopting a practice-based view of knowledge and engaging critically with Nonaka’s SECI (socialization, externalization, combination and internalization) model, the hidden behavioral assumptions and cultural values and meanings embedded within the model are revealed so as to provide a thought experiment to explain the organizational and inter-cultural dynamics that may disrupt its translation in overseas contexts. It is argued that a successful implementation of Nonaka’s SECI model requires a ‘glocalized’ approach, which involves trade-offs between core underlying values and objectives during the process of local translation. This article contributes to current theories of knowledge management by revealing the underlying sources of cultural embeddedness and the implications for their global diffusion.
An exploration of young women’s experiences of living with excess weight
Authors: Holland Sarah , Dallos Rudi , Olver Lynn
Published: December 2011

The experiences of eight young women with excess weight were explored using a semi structured interview consisting of open ended questions and also the Child Attachment Interview (CAI). Interpretative Phenomenological Analysis indicated four group themes around participants’ experience of having excess weight; emotional regulation, focus on family relationships, lack of control and sense of self. The CAIs indicated that many of the young women had adopted a caring role in their families, which were often characterized by conflict within family relationships. Dismissing their own vulnerability and emotional needs in preference for self reliance was the dominant attachment strategy adopted by participants. It is suggested that obesity is a complex condition and one that requires an understanding of each individual’s experiences and relationship with food, in order to offer treatment that is most likely to be effective.
Using whole-word production measures to determine the influence of phonotactic probability and neighborhood density on bilingual speech production
Authors: Freedman Skott E. , Barlow Jessica A.
Published: December 2011

Numerous lexical and sublexical factors have been reported to influence speech production in monolinguals (Storkel, 2001; Vitevitch, 2002); however, whole-word production analyses have rarely been used to measure such influences. The present study investigated the effects of phonotactic probability and neighborhood density on bilingual speech production using whole-word production measures (Ingram, 2002). Five typically developing English–Spanish bilingual children were administered a picture-naming task in English and Spanish in which stimuli varied in sublexical and lexical parameters. Their English and Spanish productions were compared with those of five age-matched monolingual English- and Spanish-speaking children, respectively. No differences were found between bilinguals and monolinguals in the respective languages; however, bilinguals evidenced greater phonological complexity in Spanish than English on words with low phonotactic probability and low neighborhood density. Whole-word approximation remained similar between languages. Findings are interpreted in the context of crosslinguistic influences of sublexical and lexical factors on speech production.
Positive and negative transfer in the phonological systems of bilingual speakers
Authors: Goldstein Brian A. , Bunta Ferenc
Published: December 2011

The present study examines the phonological skills of bilingual children, taking language use and proficiency into consideration, and compares their skills to monolingual peers. The main research question is whether bilingual children who have parent-reported language use and proficiency measures commensurate with those of their monolingual peers have phonological skills comparable to their monolingual peers. METHOD. Thirty typically developing Spanish- and English-speaking children participated in this study who were matched on age and language use and proficiency (10 monolingual English, mean age: 5;10; 10 monolingual Spanish, mean age: 5;10, and 10 bilingual, mean age: 6;0). The independent variable was language status (bilingual versus monolingual), and the dependent measures included phonological whole-word measures, segmental accuracy measures, and phonological patterns. RESULTS. Bilingual children did not differ from their monolingual peers on any of the Spanish measures, except on accuracy for stops, on which the monolinguals outperformed their bilingual peers. However, bilingual children outperformed their monolingual English-speaking peers on Proximity, PVC, PCC-R, and PCC for nasals. Moreover, bilingual children displayed lower frequencies-of-occurrence on phonological patterns than their English-speaking monolingual peers: weak syllable deletion, spirantization, and fronting. DISCUSSION. The findings of our study indicate that bilingual children may have an advantage over their monolingual peers when it comes to select phonological skills when language use and proficiency are controlled for.
Egyptian hotel marketing managers’ perceptions of the Internet’s impact on marketing
Authors: Essawy Mohamed
Published: December 2011

While the Internet is having a profound effect on the economies of the developed world, there is less evidence of its impact on developing economies. There is a lack of empirical evidence in terms of what the managers of independent Egyptian hotels are actually thinking and more importantly doing in response of the diffusion of the Internet. This study examines managers’ perceptions of the impact of the Internet on key marketing activities: changes in the conceptualisation of the marketing activity, changes in market definition and value creation. Findings suggest that the impact of the Internet will urge hotels to redefine markets, improve marketing activities and value creation. Although these changes are more dramatic with large hotels, the majority of hotels still use the Internet for informational purposes but they are optimistic regarding the way in which hotels will be marketed via the Internet in the future.
Comparing local strategies and practices: recollections from two qualitative cross-national research projects
Authors: Gómez Maria Victoria , Kuronen Marjo
Published: December 2011

The article is based on methodological reflections and recollections from two qualitative cross-national research projects, one of them comparing Finland and Scotland, and the other one Scotland and Spain. One of them was a case-oriented study of local regeneration strategies in two cities, while the other one used an ethnographic approach for the study of local practices on maternity and child healthcare services. The article is based on the authors’ dialogue and it contributes to the discussion about the value of a qualitative approach in cross-national comparisons and its place in the field of comparative research. It points at its advantages in enabling the analysis of societies and their specific features from inside to recognize cultural and social contexts, but it also draws attention to some specific problems and challenges concerning qualitative cross-national research by providing concrete examples from the two pieces of research.
From rapport to collaboration . . . and beyond? Revisiting field relationships in an ethnography of Ecuadorian migrants
Authors: Boccagni Paolo
Published: December 2011

The article revisits my personal relationships with fieldwork members in an ethnography on transnational migration between Ecuador and Italy. As this focused on the social relationships and practices that may connect emigrants with their motherland, the import of my interpersonal relationships was a crucial one. In reflecting on their development and impingements, I draw on three interpretive categories: respect, in terms of reciprocal recognition and legitimation with the members of the social group I had selected for my fieldwork; opportunities, i.e. the influence of structural factors, along with contingencies, on my ethnographic involvement; and interests, that is the motivations and objectives underlying my participant observation, along with the expectations emerging in those I met and stayed with. The implications and dilemmas of my field relationships are also sketched out, with respect both to the knowledge generated through my fieldwork, and to my own positioning within it. I finally reflect on the scope for collaboration, and for fair and ‘balanced’ relationships with the interlocutors of my research.
Creating socially networked knowledge through interdisciplinary collaboration
Authors: Chuk Eric , Hoetzlein Rama , Kim David , Panko Julia
Published: December 2011

We report on the experience of creating a socially networked system, the Research-oriented Social Environment (RoSE), for representing knowledge in the form of relationships between people, documents, and groups. Developed as an intercampus, interdisciplinary project of the University of California, this work reflects on a collaboration between scholars in the humanities, software engineering, and information studies by providing an opportunity not only to synthesize different disciplinary perspectives, but also to interrogate and challenge the assumptions each brings to team-based design projects in the digital humanities. This work examines socially networked knowledge as both content and methodology for collaboration, calling for further critique and future investigation of epistemological questions in models of social networks.
The digital humanities as a humanities project
Authors: Svensson Patrik
Published: December 2011

This article argues that the digital humanities can be seen as a humanities project in a time of significant change in the academy. The background is a number of scholarly, educational and technical challenges, the multiple epistemic traditions linked to the digital humanities, the potential reach of the field across and outside the humanities, and the ‘digital’ as a boundary object. In the article, four case studies are used to exemplify the digital humanities as a humanities project, and it is suggested that the field can be seen as a trading zone and meeting place rather than a strained ‘big tent’. In this way, the digital humanities can accept scholarly and technological challenges in relation to the digital as well as being an important place for thinking about, experimenting with and rethinking the humanities.
Consumers, creators or commentators?
Authors: Prescott Andrew
Published: December 2011

A 2008 article by Patrick Juola describes the digital humanities community as marginal to mainstream academic discussions and suggests that its work has little scholarly impact. At the same time, mainstream humanities scholars are using digital resources more and more, but these resources are chiefly produced by libraries and commercial organizations rather than digital humanities specialists. How can the digital humanities achieve its promise and transform humanities scholarship? It is suggested that the digital humanities community is too inward-looking and needs to reach out to wider constituencies. In particular, digital humanities specialists should urgently engage with the wider theoretical concerns that characterize humanities scholarship. Projects such as the Proceedings of the Old Bailey, 1674–1913 engage new audiences because they are grounded in a strong research vision.
Colloquium: Digital technologies
Authors: Barker Elton , Bissell Chris , Hardwick Lorna , Jones Allan , Ridge Mia , Wolffe John
Published: December 2011

This article offers reflections arising from a recent colloquium at the Open University on the implications of the development of digital humanities for research in arts disciplines, and also for their interactions with computing and technology. Particular issues explored include the ways in which the digital turn in humanities research is also a spatial/visual one; the tension between analysis based on the extensive ‘hard’ data generated by digital methodologies and the more subtle evaluations of traditional humanities research; the advantages and disadvantages of online resources that distance the researcher from the actual archive, book, artefact or archaeological site under investigation; and the unrealized potential for applying to the humanities software tools designed for science and technology. Constructive responses to such challenges and opportunities require the full rigour of the critical thinking that is the essence of arts and humanities research.
Human rights and the use of force: Assertive liberalism and just war
Authors: Sutch Peter
Published: December 2011

This paper critically explores the growing assertiveness with which liberalism has approached questions of the just use of force since 9/11. The liberal position rests upon broad claims about the centrality of human rights concerns to considerations of the justice of war. The claim is that a liberal-cosmopolitan respect for human rights forces us to reconsider the conservative, generally prohibitive, position on the use of force defended by traditional just war theory and enshrined in international law. This argument is has been most fully developed by Allen Buchanan in several important books and papers and it is Buchanan’s position that forms the basis for the critique of the assertive cosmopolitan attitude to the use of force that is offered in this article. The paper shows that both the just war tradition and those who theorize the ethics of the law of armed conflict have taken the moral and political reality of human rights seriously (in a manner that directly addresses Buchanan’s core argument) but that there remain compelling reasons to defend a conservative approach to the use of force.
Glocalized Telenovelas and National Identities
Authors: Adriaens Fien , Biltereyst Daniel
Published: December 2011

This article examines the globalization of the telenovela format in relation to issues of adaptation, proximities, and national identities. As a case study of glocalized telenovelas, it deals with the domestic adaptation of one of the most popular Latin American telenovelas, Yo soy Betty, la fea (1999-2001), into the “telenovelle” Sara (2007-2008), which takes place in a Belgian (more specifically Flemish) context. Therefore, this article specifically asks how Flemish identities are represented through the production process of Sara. While examining the international flow of telenovelas and the cross-cultural adaptation of the telenovela format, this case study considers an additional geopolitical and cultural context, as well as confronts and combines thematic textual analysis with expert interviews. Considering the successful export of “canned” telenovelas and the adaptation of this format within the framework of national identity and identification, this article deals with the emergence of the telenovelle as a local genre that is inspired by, and modifies, the original Latin American format.
Authentic Ways of Knowing, Authentic Ways of Being
Authors: Dencev Hilary , Collister Rupert
Published: December 2011

All teaching and learning experiences exist within a complexity of contexts which impact those experiences in a myriad of observable and unobservable ways. This article discusses how an example of a specific contemplative pedagogy appears to have nurtured an emergent community of learning and praxis in the context of a Master of Education (MEd) classroom. Specifically this pedagogy encouraged the members of the classroom community to explore whom they are, how they exist in the world, and the effects of their beliefs, attitudes, and behaviors on the relationships and contexts within which they are situated. This exploration occurred within an emergent holistic frame of reference, which overtly acknowledged and appreciated the complexity inherent in human existence. Pedagogical practices including the experiential teaching of contemplation, deep and authentic presence and engagement (both within the community itself and with a range of traditional, modern, and pioneer texts1), and dialogue were used on a regular basis. This article describes, both, the design of the course and the contemplative pedagogy used in the classroom. It also describes how this design and pedagogy not only appeared to affect a profound change for some within the classroom community, but also how this change subsequently influenced the epistemological and ontological understandings of these students.
Robotic-Assisted Step Training (Lokomat) Not Superior to Equal Intensity of Over-Ground Rehabilitation in Patients With Multiple Sclerosis
Authors: Vaney Claude , Gattlen Brigitte , Lugon-Moulin Véronique , Meichtry André , Hausammann Rita , Foinant Denise , Anchisi-Bellwald Anne-Marie , Palaci Cécilia , Hilfiker Roger
Published: December 2011

Background. Robot-assisted gait training (RAGT) has been suggested as an intervention to improve walking capacity in patients with multiple sclerosis (MS). Objective. This study aimed to evaluate whether RAGT (Lokomat) is superior to over-ground walking training in terms of quality of life, activity level, and gait. Methods. A total of 67 patients with MS with the Expanded Disability Status Scale (EDSS) 3.0 to 6.5 were randomized to walking or RAGT, in addition to multimodal rehabilitation. Primary outcomes were walking speed, activity level (estimated metabolic equivalent, metabolic equivalents [METs], using an accelerometer), and quality of life (Well-Being Visual Analogue Scale (VAS) and EQ-5D European VAS. Results. In all, 49 patients finished the interventions. Mean age was 56 years (range 36-74 years), mean EDSS was 5.8 (3.0-6.5), and the preferred walking speed at baseline was 0.56 m/s (0.06-1.43 m/s). Before rehabilitation, participants spent on average 68 min/d at an MET ≥3. The walking group improved gait speed nonsignificantly more than the RAGT; the upper bound of the confidence interval (CI) did not exclude a clinically relevant benefit (defined as a difference of 0.05 m/s) in favor of the walking group; the lower bound of the CI did exclude a clinically important benefit in favor of the Lokomat. Quality of life improved in both groups, with a nonsignificant between-group difference in favor of the walking group. Both groups had reduced their activity by 8 weeks after the rehabilitation. Conclusion. It is unlikely that RAGT is better than over-ground walking training in patients with an EDSS between 3.0 and 6.5.
Physical Activity and Breast Cancer Survivorship
Authors: Brunet Jennifer , Sabiston Catherine M. , Meterissian Sarkis
Published: December 2011

The completion of primary treatment for breast cancer has been referred to as a “teachable moment” for health behavior change, suggesting that women are receptive to receiving physical activity counseling. However, the majority of breast cancer survivors are not sufficiently active. Health care providers may play a pivotal role in increasing patients’ physical activity behavior, yet physician counseling for physical activity is not done regularly. One reason for this failure may relate to the limited guidelines put forward to assist health care providers in how best to optimize the benefits of physical activity among breast cancer survivors. To help provide guidelines for physical activity counseling with breast cancer survivors, the authors synthesized evidence-based recommendations based on a review of 30 intervention studies. The evidence on (1) type, (2) intensity, and (3) frequency and duration of physical activity for this population was examined. On the basis of the reviewed studies, the authors find that physical activity programs for breast cancer survivors should include aerobic training at least 3 times/wk for 30 minutes, resistance training 2 to 3 times/wk (6-12 exercises), and flexibility training 3 times/wk for 50 to 60 minutes to obtain health benefits. The provision of these recommendations may facilitate effective and consistent delivery of physical activity counseling to breast cancer survivors.
The prevalence of pharmaceutical shortages in the United States
Authors: Le Paul , Seoane-Vazquez Enrique , Rodriguez-Monguio Rosa , Fox Erin R , Szeinbach Sheryl L , Dunehew Allen R , Montagne Michael
Published: December 2011

Shortages of drugs, vaccines, and other biologics are a perennial problem of the U.S. health care system. The objectives of this study were to assess the prevalence of these shortages of drugs, vaccines, and other biologics, and to characterize the products in short supply as reported in the United States by several public agencies and private organizations on June 1, 2011. Reported shortages of pharmaceuticals were obtained from the FDA, the CDC, the American Society of Health-System Pharmacists (ASHP), and the Brigham and Women’s Hospital (BWH). A list of approved drugs and licensed vaccines and other biologic products were obtained from the FDA. The units of analyses were the active ingredient(s) and the route of administration. The study included descriptive analyses of the characteristics of products experiencing shortages and an estimation of the prevalence of shortages as the proportion of non-discontinued FDA-approved products that were listed by the FDA in June 1, 2011. The most frequent characteristics of shortages included: reported by ASHP, referred to a drug approved under the NDA/ANDA system, contained only one active ingredient, was a drug administered by injection, required a prescription, was part of one of six main therapeutic classes, and was marketed by three or less companies. The overall prevalence of drug shortages was estimated at 11.0% of all the FDA-approved and marketed drugs, vaccines, and other biologics. Vaccines had the highest prevalence of shortage. The prevalence varied from 9.9% reported by the ASHP to 4.0% reported by public agencies and to 2.0% reported by BWH. Differences in the reporting of shortages can be attributed to variations in defining shortages and how they were characterized within each reporting organization. The highest prevalence rate was found among active ingredients with injection routes of administration (23.1%). Shortages are prevalent in the U.S. health care system. Several definitions of shortage are currently in use in the United States. Additional research is needed to develop a standard definition for a pharmaceutical shortage and to standardize the criteria used to characterize a pharmaceutical shortage.
The Japanese drug master file
Authors: Chokshi Nirav
Published: December 2011

Pharmaceutical market in Japan is the largest in Asia by value. ICH comprises three developed regions namely USA, Europe, and Japan. Though majority of regulations are harmonized, Japan’s regulations are yet less explored compared to USA and Europe perhaps due to language barriers. Sharing of vital technological information to the drug product manufacturer remains a cause of concern to the manufacturers of ingredients and packaging components. Master files are voluntary vehicles for conveying product and manufacturing information from suppliers and contractors directly to regulators to support new drug and biologic product review, and may have open and closed sections. The latter contains confidential information for regulator’s reference. Japan has master file systems that accommodate a broader range of drug and components like packaging materials. Japan added a master file system similar to the US model by updating its regulatory process under the 2005 Pharmaceutical Affairs Law. The accreditation of manufacturing facility is one of the very unique features of master file system as unlike US and Europe, for Japan facility approval process starts well before the submission of the actual drug master file. The stability requirements involve more sample analysis compared to the other international regulatory compliance requirements. Point has to be noted that data equivalent to module 2 of common technical document and application form are required to be translated in Japanese language. However, the quality section (module 3) can be submitted in English language. Understanding of master file system is important for companies entering into the Japanese market. The master file system of Japan is discussed in this article.
The expanding world market of generic pharmaceuticals
Authors: Brems Yannik , Seville Jonathan , Baeyens Jan
Published: December 2011

The advantages of generic pharmaceuticals are acknowledged by policy makers worldwide, provided efficient national policies are in place, generics are available at reduced prices, drive competition and innovation, enhance access to essential medicines, ensure supply continuity, stimulate economic development, and generate savings for healthcare systems.

This paper reviews the world market of generic pharmaceuticals, with special emphasis on the current situation and expected future development. Besides providing a global picture, different regions are separately examined by both assessing recent market analyses data, and by including recent literature on generics and their role in enhancing access to essential medicines. In view of the challenges in developing countries, the Republic of South Africa is dealt with in more detail. The analysis stresses the importance of this highly dynamic and competitive market, expected to continue to grow in the future, thus remaining an attractive business for new entrants, for mergers and for acquisitions.
Monte Carlo simulation of railway track geometry deterioration and restoration
Authors: Quiroga L M , Schnieder E
Published: December 2011

Travelling safely and comfortably on high-speed railway lines requires excellent conditions of the whole railway infrastructure in general and of the railway track geometry in particular. The maintenance process required to achieve such excellent conditions is complex and expensive, demanding a large amount of both human and technical resources. In this framework, choosing the right maintenance strategy becomes a critical issue. A reliable simulation of the railway geometry ageing process would offer a great advantage for the optimization of planning and scheduling of maintenance activities. A fundamental requirement for such simulation is a statistical model describing the behaviour of the railway track geometry deterioration as well as the effects of maintenance activities. The French railway operator SNCF has been periodically measuring the geometrical characteristics of its high-speed network since its commissioning (i.e. for more than 20 years now). These records are an excellent data source to achieve a sound statistical description of the process.

In this paper a new system identification method to obtain such simulations is presented. The proposed method uses a grey-box model: a model structure and its constraints are specified basing on previous knowledge of the process to be identified, and then the set of parameter values which best fits the signal measurements is searched. As previous knowledge indicates that the process is non-linear, parameter values are searched by means of the Levenberg–Marquardt algorithm, an iterative technique that finds a local minimum of a function that is expressed as the sum of squares of non-linear functions. Furthermore, the presented model is extended in order to analyse the effect of the variation of factors influencing the ageing process (e.g. operational speed). Finally, the method is applied and validated with real data of a French high-speed TGV line.
Secondary causes of nonalcoholic fatty liver disease
Authors: Kneeman Jacob M. , Misdraji Joseph , Corey Kathleen E.
Published: December 2011

Nonalcoholic fatty liver disease (NAFLD) is becoming the most common cause of chronic liver disease in the developing world, found in 17-30% of the population in Western countries and 2-4% worldwide. Defined as the accumulation of fatty acid content greater than 5% of liver weight, NAFLD is a spectrum of disease ranging from simple steatosis to nonalcoholic steatohepatitis. The pathophysiology of NAFLD involves increased de novo synthesis of fatty acids in hepatocytes, the retention of lipids due to impaired hepatocyte apolipoprotein secretion or beta-oxidation. The well-known primary causes of NAFLD are obesity, type II diabetes, dyslipidemia, and insulin resistance. However, other less common conditions can cause a similar clinical and histologic picture, and should be considered in patients who present with NAFLD but do not have traditional risk factors. In this review, we discuss uncommon but important causes of NAFLD, including inborn errors of metabolism, iatrogenic causes, viral hepatitis, and nutritional disorders to provide practicing clinicians with an understanding of the less well recognized causes of NAFLD.
Recent advances in the surgical treatment of benign prostatic hyperplasia
Authors: Rocco Bernardo , Albo Giancarlo , Ferreira Rafael Coelho , Spinelli Matteo , Cozzi Gabriele , Dell’Orto Paolo , Patel Vipul , Rocco Francesco
Published: December 2011

TURP for many years has been considered the gold standard for surgical treatment of BPH. Symptoms relief, improvement in Maximum flow rate and reduction of post void residual urine have been reported in several experiences. Notwithstanding a satisfactory efficacy, concerns have been reported in terms of safety outcomes:intracapsular perforation, TUR syndrome, bleeding with a higher risk of transfusion particularly in larger prostates have been extensivelyreported in the literature.

In the recent years the use of new forms of energy and devices suchas bipolar resector, Ho: YAG and potassium-titanyl-phosphate laserare challenging the role of traditional TURP for BPH surgical treatment.

In 1999 TURP represented the 81% of surgical treatment for BPHversus 39% of 2005. Is this a marketing driven change or is there areal advantage in new technologies?

We analyzed guidelines and higher evidence studies to evaluate therole of the most relevant new surgical approaches compared to TURPfor the treatment of BPH.

In case of prostates of very large size the challenge is ongoing, withminimally invasive laparoscopic approach and most recently roboticapproach. We will evaluate the most recent literature on thisemerging field.
Closed Total Talar Extrusion After Ankle Sprain
Authors: Turhan Yalcin , Cift Hakan , Ozkan Korhan , Ozkut Afsar , Eren Abdullah
Published: December 2011

Closed total talus dislocation from tibiotalar, subtalar, and talonavicular joints is a very rare injury. A 25-year-old young man, who had severe ankle distortion while walking down a flight of stairs, was brought to the emergency room complaining of a deformity and pain in his ankle joint. Roentgenographies revealed total talar body extrusion. The patient was treated urgently with open reduction in the authors’ clinic. Tibialis posterior tendon might prevent closed reduction so open reduction with retraction of the tendon may be necessary.

Level of Evidence: Therapeutic Level IV
Long-Term Results of Neurectomy in the Treatment of Morton’s Neuroma
Authors: Lee Kyung Tai , Kim Jun Beom , Young Ki Won , Park Young Uk , Kim Jin Su , Jegal Hyuk
Published: December 2011

Purpose. The objective of this retrospective study was to evaluate the long-term follow-up results of neurectomy clinical outcomes and complications in the treatment of Morton’s neuroma. Materials and methods. A total of 19 patients (19 different feet) were treated for Morton’s neuroma by excision of the interdigital nerve at our institute between May 1997 and May 1999. Thirteen (13 feet) of them were followed up. The 13 patients were female and had an average age of 43 years (range 34-54 years) at the time of the operation. The patients were followed-up for a mean of 10.5 years (range 10.0-12.2 years) and scored using the American Orthopaedic Foot & Ankle Society (AOFAS) forefoot scoring system and Visual Analogue Scale (VAS) score. Subjective satisfaction was evaluated at the final follow-up. Results. Eight patients scored more than 90 on the AOFAS forefoot scoring system. The VAS score was improved in all patients. The mean preoperative VAS score was 8.6 ± 0.8 cm (7-10) and the mean follow-up VAS score was 2.4 ± 1.8cm (0-6), which indicated no significant difference (P > .05). The final follow-up satisfaction results indicated that 4 patients were completely satisfied with the operation, 4 were satisfied with minor reservations, 5 were satisfied with major reservations, and no patient was unsatisfied. Neurectomy to treat Morton’s neuroma had a good satisfaction rate (61%). Eleven of the patients complained of numbness on the plantar aspect of the foot adjacent to the interspace, and 2 of these 11 patients complained of disability induced by severe numbness. There was a complaint of residual pain by 1 patient. There were no skin problems on the operation lesions. Conclusion. The long-term results of neurectomy clinical outcomes in Morton’s neuroma are slightly worse than the short- and mid-term results.

Levels of Evidence: Therapeutic, Level IV, Retrospective case series
A Randomized Trial of Micropreemies Receiving Higher Amounts of Intravenous Fat Emulsion During the First Week of Life
Authors: Drenckpohl Douglas , Niehaus Matthew , Schneider Catherine , McConnell Connie , Wang Huaping , Macwan Kamlesh
Published: December 2011

Objective. The goal of this study was to determine if micropreemies could tolerate higher infusion rates of intravenous fat emulsions (IVFEs) during the first week of life by maintaining their serum triglyceride levels at <200 mg/dL. Methods. This was a randomized controlled trial of 19 infants who were classified as appropriate for gestational age and had birth weights between 500 and 750 g. The primary clinical outcome was serum triglyceride levels; secondary outcomes also were monitored. Results. A total of 19 micropreemies completed the study (experimental group: n = 10; control group: n = 9). Of the infants in the experimental group, 100% had developed hypertriglyceridemia (>201 g/dL) during the first week of life compared with only 44.4% of the infants in the control group. The experimental group experienced a lower weight loss of 8.6% ± 3.10% as compared with 16.22% ± 8.04% in the control group during the first week of life. Initially, the experimental group was given significantly higher infusion rates of IVFEs, but at the end of the week, the control group was receiving significantly higher infusion rates of IVFEs. Calorie intake was significantly better initially for the experimental group, but because of the incidences of hypertriglyceridemia and a reduction of IVFEs, the control group had significantly better calorie intake at the end of the study period. Conclusions. Micropreemies do not tolerate initial higher infusion rates of IVFEs during the first week of life because of their potential risk for developing hypertriglyceridemia.
Splitting of the Mind
Authors: Zell Ethan , Warriner Amy Beth , Albarracín Dolores
Published: December 2011

Self-talk has fascinated scholars for decades but has received little systematic research attention. Three studies examined the conditions under which people talk to themselves as if they are another person, indicating a splitting or fragmentation of the self. Fragmented self-talk, defined by the use of the second person, You, and the imperative, was specifically expected to arise in contexts requiring explicit self-control. Results showed that fragmented self-talk was most prevalent in response to situations requiring direct behavior regulation, such as negative events (Study 1), experiences of autonomy (Study 2), and action as opposed to behavior preparation or behavior evaluation (Study 3). Therefore, people refer to themselves as You and command themselves as if they are another person in situations requiring conscious self-guidance. The implications of these findings for behavior change are discussed.
Expansion of CD8+ T cells lacking Sema4D/CD100 during HIV-1 infection identifies a subset of T cells with decreased functional capacity
Authors: Eriksson Emily M. , Milush Jeffrey M. , Ho Emily L. , Batista Mariana D. , Holditch Sara J. , Keh Chris E. , Norris Philip J. , Keating Sheila M. , Deeks Steven G. , Hunt Peter W. , Martin Jeffrey N. , Rosenberg Michael G. , Hecht Frederick M. , Nixon Douglas F.
Published: December 2011

Sema4D, also known as CD100, is a constitutively expressed immune semaphorin on T cells and NK cells. CD100 has important immune regulatory functions that improve antigen-specific priming by antigen-presenting cells, and can also act as a costimulatory molecule on T cells. We investigated the consequence of HIV-1 infection on CD100 expression by T cells, and whether CD100 expression signifies functionally competent effector cells. CD100 expression on T cells from healthy individuals was compared with HIV-1–infected subjects including elite controllers, noncontrollers, and patients receiving antiretroviral therapy. The frequency and fluorescence intensity of CD100 on CD8+ and CD4+ T cells were decreased during HIV-1 infection. Furthermore, the absolute number of CD100-expressing CD8+ T cells was positively associated with the magnitude of HIV-1–specific T-cell responses. CD8+ T cells lacking CD100 expression were functionally impaired and present in increased numbers in HIV-1–infected individuals. The number of CD100−CD8+ T cells positively correlated with T-cell immunosenescence, immune activation, and viral load. Loss of CD100 expression appears to result from direct antigen stimulation, as in vitro cytokine exposure and viral replication did not significantly impact CD100 expression. These data suggest that loss of CD100 expression probably plays an important role in dysfunctional immunity in HIV-1 infection.