bluuebunny/crossref_metadata_2025 huggingface dataset:
Book Review: Yoichi Mine, Frances Stewart, Sakiko Fukuda-Parr and Thandika Mkandawire (Eds), Preventing Violent Conflicts in Africa: Inequality, Perceptions and Institutions
Authors: Moosa J.M.
Published: January 2015

Yoichi Mine, Frances Stewart, Sakiko Fukuda-Parr and Thandika Mkandawire (Eds), Preventing Violent Conflicts in Africa: Inequality, Perceptions and Institutions, Palgrave Macmillan, Houndsmill, 2013, pp. xi + 298, $100.
Home-based training to improve manual dexterity in patients with multiple sclerosis: A randomized controlled trial
Authors: Kamm Christian P , Mattle Heinrich P , Müri René M , Heldner Mirjam R , Blatter Verena , Bartlome Sandrine , Lüthy Judith , Imboden Debora , Pedrazzini Giovanna , Bohlhalter Stephan , Hilfiker Roger , Vanbellingen Tim
Published: January 2015

Background:

Impaired manual dexterity is frequent and disabling in patients with multiple sclerosis (MS), affecting activities of daily living (ADL) and quality of life.

Objective:

We aimed to evaluate the effectiveness of a standardized, home-based training program to improve manual dexterity and dexterity-related ADL in MS patients.

Methods:

This was a randomized, rater-blinded controlled trial. Thirty-nine MS patients acknowledging impaired manual dexterity and having a pathological Coin Rotation Task (CRT), Nine Hole Peg Test (9HPT) or both were randomized 1:1 into two standardized training programs, the dexterity training program and the theraband training program. Patients trained five days per week in both programs over a period of 4 weeks. Primary outcome measures performed at baseline and after 4 weeks were the CRT, 9HPT and a dexterous-related ADL questionnaire. Secondary outcome measures were the Chedoke Arm and Hand Activity Inventory (CAHAI-8) and the JAMAR test.

Results:

The dexterity training program resulted in significant improvements in almost all outcome measures at study end compared with baseline. The theraband training program resulted in mostly non-significant improvements.

Conclusion:

The home-based dexterity training program significantly improved manual dexterity and dexterity-related ADL in moderately disabled MS patients. Trial Registration NCT01507636.
Cell-specific effects in different immune subsets associated with SOCS1 genotypes in multiple sclerosis
Authors: Lopez de Lapuente Aitzkoa , Pinto-Medel María Jesús , Astobiza Ianire , Alloza Iraide , Comabella Manuel , Malhotra Sunny , Montalban Xavier , Zettl Uwe K , Rodríguez-Antigüedad Alfredo , Fernández Oscar , Vandenbroeck Koen
Published: January 2015

Background:

Single nucleotide polymorphisms (SNPs) near SOCS1 are associated with multiple sclerosis (MS), but the most important SNPs in the area and mechanisms by which they influence the disease are unknown.

Methods:

A haplotype-tagging association study was performed covering 60.5kbp around SOCS1, and the index SNP was validated in a total of 2292 individuals. mRNA expression of SOCS1 and nearby genes was measured in MS patients with different disease courses and healthy controls. SOCS1 protein expression was studied by flow cytometry in a separate cohort of patients and controls. Differentiation and maturation of monocyte-derived dendritic cells (moDCs) were also studied.

Results:

One SNP, rs423674, reached genome-wide significance. No genotype-specific mRNA expression differences were seen, but, by flow cytometry, significant interactions were observed between genotypes for rs423674 and disease activity (relapse or remission) in B cells and regulatory T cells. Furthermore, homozygotes for the risk allele (GG) showed higher levels of CD1a and CD86 than carriers of the protective allele (GT) in immature moDCs and a greater increase of HLA-DR+ cell percentage than GT heterozygotes upon maturation.

Conclusions:

rs423674, or its genetic proxies, may influence MS risk by modulating SOCS1 expression in a cell-specific manner and by influencing dendritic cell function.
Promoting remyelination in multiple sclerosis: Current drugs and future prospects
Authors: Kremer David , Küry Patrick , Dutta Ranjan
Published: January 2015

Myelin destruction due to inflammatory oligodendrocyte cell damage or death in conjunction with axonal degeneration are among the major histopathological hallmarks of multiple sclerosis (MS). The majority of available immunomodulatory medications for MS are approved for relapsing–remitting (RR) MS, for which they reduce relapse rate, MRI measures of inflammation, and the accumulation of disability. These medications are, however, of little benefit during progressive MS where axonal degeneration following demyelination outweighs inflammation. This has sparked great interest in the development of new remyelination therapies aimed at reversing the neurodegenerative damage observed in this disease. Remyelination as a result of oligodendrocyte production from oligodendrocyte precursor cells (OPCs) is considered a promising potential target for the treatment of all stages of MS. In this review we present an overview of a) approved medications (some of them FDA-and EMA-approved for other diseases) with a proposed role in regeneration, b) regenerative treatments under investigation in clinical trials, and c) promising future therapeutic approaches aiming specifically at facilitating endogenous repair.
Optimal time for manipulation of frozen shoulder may be between 6 and 9 months
Authors: Vastamäki H. , Varjonen L. , Vastamäki M.
Published: January 2015

Background and Aims:

Idiopathic frozen shoulder can be successfully treated conservatively. Manipulation under anesthesia, in randomized controlled studies, has proven to bring no additional benefit to other treatments. However, manipulation under anesthesia still is a used method mainly among patients with unbearable pain or too longstanding restriction of shoulder motion. Manipulation under anesthesia may lead to significant improvement in shoulder motion and function. However, the best timing for manipulation under anesthesia is still unclear. We therefore investigated whether timing of manipulation under anesthesia has influence on the results of manipulation under anesthesia, concerning range of motion, pain, and function.

Material and Methods:

We followed 57 patients (65 shoulders; 31 in women) at 2–14 years after manipulation under anesthesia evaluating range of motion, pain, and function. Their mean age at manipulation under anesthesia was 54.0 years. A total of 10 patients had diabetes. The time between the onset of symptoms and manipulation averaged 8.8 months. We formed two groups, those mobilized between 6 and 9 months after the onset of symptoms (Group A, 25 shoulders), and the others (Group B, 40 shoulders). We recorded visual analog scale pain, range of motion, Simple Shoulder Test, and Constant–Murley scores.

Results:

Patients manipulated between 6 and 9 months after the onset of symptoms had significantly better abduction and external rotation, less pain at rest and at night, and better Simple Shoulder Test than the others.

Conclusions:

It seems that timing has statistically significant influence on results of manipulation of the idiopathic frozen shoulder. The best time for manipulation under anesthesia, if non-operative treatment has failed to alleviate pain or limitation of shoulder motion is too cumbersome, might be between 6 and 9 months from the onset of the symptoms. However, the clinical importance of results can be questioned.
Comparison of venous and HePTFE tibial and peroneal bypasses in critical limb ischemia patients unsuitable for endovascular revascularization
Authors: Uhl Christian , Hock Carolin , Betz Thomas , Greindl Markus , Töpel Ingolf , Steinbauer Markus
Published: January 2015

Background

We examined short- and long-term outcomes of tibial and peroneal venous and heparin-bonded expanded polytetrafluoroethylene bypasses in patients with critical limb ischemia who were unsuitable for endovascular revascularization.

Methods

A retrospective analysis was done for all patients who underwent tibial and peroneal bypass surgery in our department between October 2007 and October 2012. Vein was the preferred graft material and used whenever possible.

Results

One hundred and ninety-eight crural grafts were included. Indications for the surgery were rest pain (30.3%) or ulcer or gangrene (69.7%). Autologous veins were used in 109 cases (vein group) and heparin-bonded expanded polytetrafluoroethylene grafts were used in 89 cases (heparin-bonded expanded polytetrafluoroethylene group). At three years, primary patency for the vein group was 68.2% versus 34.1% for the heparin-bonded expanded polytetrafluoroethylene group ( P = .000) and secondary patency was 69.8% versus 35.5% ( P = .001). Limb salvage was 81.8% for the vein group versus 56.5% for the heparin-bonded expanded polytetrafluoroethylene group ( P = .000) and survival was 62.8% versus 46.7% ( P = .019).

Conclusions

The results of our study show that autologous vein grafts are still first choice for tibial and peroneal bypasses in patients with critical limb ischemia. If no adequate vein is available, heparin-bonded expanded polytetrafluoroethylene bypasses are an acceptable alternative to an otherwise impending major amputation.
The psychological and neurocognitive consequences of critical illness. A pragmatic review of current evidence
Authors: Clancy Olivia , Edginton Trudi , Casarin Annalisa , Vizcaychipi Marcela P
Published: January 2015

Mortality rates alone are no longer a sufficient guide to quality of care. Due to medical advances, patients are surviving for longer following critical illness and major surgery; therefore, functional outcomes and long-term quality of life are of increasing consequence. Post-operative cognitive dysfunction has been acknowledged as a complication following anaesthesia for many years, and interest in persistent cognitive dysfunction following a critical illness is growing. Psychological and neurocognitive sequelae following discharge from intensive care are acknowledged to occur with sufficient significance to have recently coined the term ‘the post-intensive care syndrome’. Rehabilitation following critical illness has been highlighted as an important goal in recently published national UK guidelines, including the need to focus on both physical and non-physical recovery. Neuropsychological and cognitive consequences following anaesthesia and critical illness are significant. The exact pathophysiological mechanisms linking delirium, cognitive dysfunction and neuropsychological symptoms following critical illness are not fully elucidated but have been studied elsewhere and are outside the scope of this article. There is limited evidence as yet for specific peri-operative preventative strategies, but early management and rehabilitation strategies following intensive care discharge are now emerging. This article aims to summarise the issues and appraise current options for management, including both neuroprotective and neurorehabilitative strategies in intensive care.
The Scythian tombs: Construction and geographical orientation
Authors: Ochir-Goryaeva Maria
Published: January 2015

This paper details a new approach to the study of the Scythian burial mounds—the ‘planigraphy’ (or spatial analysis) of the mound and its burials, which follows two lines of enquiry that have so far been largely overlooked. Firstly, the statistics concerning the depth of all types of graves, such as primary and secondary burials, servants’ and horse graves, have been closely examined and compared because this parameter is an important mark of the social status and hierarchy of the deceased and their burials in Scythian funeral ceremonies. Secondly, grave locations within the mounds have been analysed with regard to their arrangement in relation to the ideal latitudinal and meridian axis of the Scythian mound. This analysis has led to the discovery of new facts concerning the planigraphy of the Scythian burial mound, which contribute to a more detailed understanding of the spatial representation of kinship and family hierarchy in Scythian society. The new evidence also sheds light on their system of geographical orientation in terms of cardinal points.
Effect of specimen size in determining ductile to brittle transition temperature
Authors: Moitra A. , Krishnan S. A. , Sasikala G. , Bhaduri A. K. , Jayakumar T.
Published: January 2015

Ductile to brittle transition temperature (DBTT) for 9Cr–1Mo steel has been determined from Charpy impact testing for full size and subsized specimens. DBTT was obtained at various percentage of upper shelf energy (USE). Assuming that most of the energy is spent in crack initiation, notch root volumes of subsized specimens ( VNS) were normalised with full size specimen ( VNF), and a power law relationship between DBTT and notch root volume has been established. From finite element method, it is observed that the sum of von Mises stress (σeq) and hydrostatic stress (σh) reaches ∼2400 MPa (fracture stress, σf*) as the specimen dimension decreases at a temperature corresponding to 33 USE. This corresponds to ∼68 J of full size specimen used in the determination of nil ductility transition temperature.
Metal solidification–nucleation–rate model under coupling effects of shearing flow and vibration
Authors: Wang X. , Guan R.G. , Guo N. , Zhao Z.Y. , Zhang Y. , Su N.
Published: January 2015

This paper proposes the influence factors of coupling effects of shearing flow and vibration on diffusion coefficient and critical nucleation energy during metal solidification. Based on this proposal, a metal solidification–nucleation–rate model under coupling effects of shearing flow and vibration is established. Verification experiment using Al–7Si alloy is carried out. When vibration frequency and melt flow velocity are zero, the results calculated by the above model agree with that calculated by Turnbull's theory. The results calculated by the above model under coupling effects of shearing flow and vibration agree with the experimental results, with the error within 0·2–14·3. So the established model can calculate and explain the nucleation rate of melt under coupling effects of shearing flow and vibration.
Properties of Cd doped PbS thin films: doping concentration effect
Authors: Rajashree C. , Balu A. R. , Nagarethinam V. S.
Published: January 2015

Highly crystalline cadmium doped lead sulphide (PbS:Cd) thin films with different Cd doping concentrations (0, 2, 4, 6 and 8 at-%) were fabricated on glass substrates using spray pyrolysis technique. The X-ray diffraction (XRD) studies revealed that all the films exhibit face centred cubic structure with a preferential orientation along the (2 0 0) plane irrespective of Cd doping concentration. Optical studies showed that the band gap of doped films vary between 1·96 and 2·12 eV with increasing Cd content and the film coated with 6 at-% Cd dopant has a maximum transmittance of nearly equal to 77%. Electrical studies revealed that the film coated with 6 at-%Cd dopant has a maximum conductivity of 12·67×10−1 Ω cm−1. The obtained results infer that the PbS:Cd film coated with 6 at-%Cd dopant has better structural, morphological, optical and electrical properties.
Both platelet- and endothelial cell–derived ERp5 support thrombus formation in a laser-induced mouse model of thrombosis
Authors: Passam Freda H. , Lin Lin , Gopal Srila , Stopa Jack D. , Bellido-Martin Lola , Huang Mingdong , Furie Barbara C. , Furie Bruce
Published: January 2015

Key Points

ERp5, like its family members PDI and ERp57, accumulates at sites of vessel wall injury. Both platelets and endothelium secrete ERp5 on activation and contribute ERp5 necessary for thrombus formation in vivo.
An international consortium proposal of uniform response criteria for myelodysplastic/myeloproliferative neoplasms (MDS/MPN) in adults
Authors: Savona Michael R. , Malcovati Luca , Komrokji Rami , Tiu Ramon V. , Mughal Tariq I. , Orazi Attilio , Kiladjian Jean-Jacques , Padron Eric , Solary Eric , Tibes Raoul , Itzykson Raphael , Cazzola Mario , Mesa Ruben , Maciejewski Jaroslaw , Fenaux Pierre , Garcia-Manero Guillermo , Gerds Aaron , Sanz Guillermo , Niemeyer Charlotte M. , Cervantes Francisco , Germing Ulrich , Cross Nicholas C. P. , List Alan F.
Published: January 2015

Myelodysplastic syndromes (MDS) and myeloproliferative neoplasms (MPN) are hematologically diverse stem cell malignancies sharing phenotypic features of both myelodysplastic syndromes and myeloproliferative neoplasms. There are currently no standard treatment recommendations for most adult patients with MDS/MPN. To optimize efforts to improve the management and disease outcomes, it is essential to identify meaningful clinical and biologic end points and standardized response criteria for clinical trials. The dual dysplastic and proliferative features in these stem cell malignancies define their uniqueness and challenges. We propose response assessment guidelines to harmonize future clinical trials with the principal objective of establishing suitable treatment algorithms. An international panel comprising laboratory and clinical experts in MDS/MPN was established involving 3 independent academic MDS/MPN workshops (March 2013, December 2013, and June 2014). These recommendations are the result of this collaborative project sponsored by the MDS Foundation.
NH3-treated WO3 as low-cost and efficient counter electrode for dye-sensitized solar cells
Authors: Song Dandan , Chen Zhao , Cui Peng , Li Meicheng , Zhao Xing , Li Yaoyao , Chu Lihua
Published: January 2015

A novel low-cost and efficient counter electrode (CE) was obtained by treating catalytic inert tungsten trioxide (WO3) nanomaterial in NH3 atmosphere at elevated temperatures. The formation of tungsten oxynitride from WO3 after NH3 treatment, as evidenced by X-ray photoelectron spectroscopy and X-ray diffraction, increases the catalytic activity of the CE. Correspondingly, the power conversion efficiency (PCE) of the DSC is significantly increased from 0.9% for pristine WO3 CE to 5.9% for NH3-treated WO3 CE. The photovoltaic performance of DSC using NH3-treated WO3 CE is comparable to that of DSC using standard Pt CE (with a PCE of 6.0%). In addition, it is also shown that NH3 treatment is more efficient than H2 or N2 treatment in enhancing the catalytic performance of WO3 CE. This work highlights the potential of NH3-treated WO3 for the application in DSCs and provides a facile method to get highly efficient and low-cost CEs from catalytic inert metal oxides.
Nanosphere-in-a-nanoegg: damping the high-order modes induced by symmetry breaking
Authors: Qian Jun , Sun Yi-Ding , Li Yu-Dong , Xu Jing-Jun , Sun Qian
Published: January 2015

We study the optical properties of the nanosphere-in-a-nanoegg structure (NSNE) by the three-dimensional finite difference time domain method. We demonstrate the suppression of the high-order plasmon modes in NSNE, which is induced by the plasmon interaction between the inner nanosphere and the outer nanoegg shell. A two-layer plasmon hybridization model is presented to explain this mechanism. The results we showed for plasmon mode suppression would be important to the design of the metal plasmonic devices. In addition, due to high tunable plasmon resonances in the near-infrared region (700 to 1,300 nm) with sub-100-nm size, NSNE can serve as a good substitute for the Au-silica-Au multilayer nanoshells in biological applications. Furthermore, compared with the Au-silica-Au nanoshells, NSNE has the advantage that the strong field enhancement can be achieved at the outer surface of the Au shell.
Axially connected nanowire core-shell p-n junctions: a composite structure for high-efficiency solar cells
Authors: Wang Sijia , Yan Xin , Zhang Xia , Li Junshuai , Ren Xiaomin
Published: January 2015

A composite nanostructure for high-efficiency solar cells that axially connects nanowire core-shell p-n junctions is proposed. By axially connecting the p-n junctions in one nanowire, the solar spectrum is separated and absorbed in the top and bottom cells with respect to the wavelength. The unique structure of nanowire p-n junctions enables substantial light absorption along the nanowire and efficient radial carrier separation and collection. A coupled three-dimensional optoelectronic simulation is used to evaluate the performance of the structure. With an excellent current matching, a promising efficiency of 19.9% can be achieved at a low filling ratio of 0.283 (the density of the nanowire array), which is much higher than the tandem axial p-n junctions.
Variant interpretation through Bayesian fusion of frequency and genomic knowledge
Authors: Shaw Chad A , Campbell Ian M
Published: January 2015

Variant interpretation is a central challenge in genomic medicine. A recent study demonstrates the power of Bayesian statistical approaches to improve interpretation of variants in the context of specific genes and syndromes. Such Bayesian approaches combine frequency (in the form of observed genetic variation in cases and controls) with biological annotations to determine a probability of pathogenicity. These Bayesian approaches complement other efforts to catalog human variation.

See related Research; http://dx.doi.org/10.1186/s13073-014-0120-4
Occupational risk factors for hip osteoarthritis are associated with early hip structural abnormalities: a 3.0 T magnetic resonance imaging study of community-based adults
Authors: Teichtahl Andrew J , Smith Sam , Wang Yuanyuan , Wluka Anita E , O’Sullivan Richard , Giles Graham G , Cicuttini Flavia M
Published: January 2015

Introduction

Occupational exposure to heavy lifting and stair climbing are associated with radiographic hip osteoarthritis (OA). This study examined whether these activities are associated with early structural hip joint changes in a community-based population.

Methods

In total, 198 community-based people with no history of hip disease, including OA, had 3.0 T-magnetic resonance imaging (MRI) to assess hip cartilage volume, defects and bone marrow lesions (BMLs). Recall of occupational exposure to heavy lifting and stair climbing aged 18 to 30 years and in the previous 10 years were collected. A persistence score was defined as exposure at neither time point (0), at one time point (1) or at both time points (2).

Results

Exposure to heavy lifting when aged 18 to 30 years was associated with BMLs of the central superolateral femoroacetabular region (odds ratio (OR) 3.9, 95% confidence interval (CI) 1.6 to 9.8, P <0.01), with persistence score associated with cartilage defects in the central superolateral region of the femoral head (OR 1.6, 95% CI 1.0 to 2.5, P = 0.04). Exposure to stair climbing aged 18 to 30 years and persistence score were associated with an increased risk of cartilage defects in the central superolateral femoral head and BMLs in the central superolateral and posterior femoroacetabular regions (OR range 2.1 to 3.2, all P ≤0.03).

Conclusions

Occupational exposure to heavy lifting and stair climbing are associated with hip structural abnormalities. If confirmed by longitudinal data, such associations may explain how occupational activities affect the hip joint and may identify new targets for the prevention of hip OA.
Energy-efficient stable routing using QoS monitoring agents in MANET
Authors: Palaniappan Senthilnathan , Chellan Kalaiarasan
Published: January 2015

In mobile ad hoc network (MANET), the most important issue is to provide a stable and reliable route for the uninterrupted communication. In order to overcome these issues, in this paper, we propose a stable and energy-efficient routing technique. In the proposed method, quality of service (QoS) monitoring agents collect and calculate the link reliability metrics such as link expiration time (LET), probabilistic link reliable time (PLRT), link packet error rate (LPER) and link received signal strength (LRSS). In addition, residual battery power (RBP) is implemented to maintain the energy efficiency in the network. Finally, route selection probability (RSP) is calculated based on these estimated parameters using fuzzy logic. Simulation results show that the proposed routing technique improves the packet delivery ratio and reduces the energy consumption.
Class I odorant receptors, TAS1R and TAS2R taste receptors, are markers for subpopulations of circulating leukocytes
Authors: Malki Agne , Fiedler Julia , Fricke Kristina , Ballweg Ines , Pfaffl Michael W , Krautwurst Dietmar
Published: January 2015

Our cellular immune system has to cope constantly with foodborne substances that enter the bloodstream postprandially. Here, they may activate leukocytes via specific but yet mostly unknown receptors. Ectopic RNA expression out of gene families of chemosensory receptors, i.e., the ∼400 ORs, ∼25 TAS2R bitter-taste receptors, and the TAS1R umami- and sweet-taste receptor dimers by which we typically detect foodborne substances, has been reported in a variety of peripheral tissues unrelated to olfaction or taste. In the present study, we have now discovered, by gene-specific RT-PCR experiments, the mRNA expression of most of the Class I ORs (TAS1R) and TAS2R in 5 different types of blood leukocytes. Surprisingly, we did not detect Class II OR mRNA. By RT-qPCR, we show the mRNA expression of human chemosensory receptors and their cow orthologs in PMN, thus suggesting an evolutionary concept. By immunocytochemistry, we demonstrate that some olfactory and taste receptors are expressed, on average, in 40–60% of PMN and T or B cells and largely coexpress in the same subpopulation of PMN. The mRNA expression and the size of subpopulations expressing certain chemosensory receptors varied largely among individual blood samples, suggesting a regulated expression of olfactory and taste receptors in these cells. Moreover, we show mRNA expression of their downstream signaling molecules and demonstrate that PTX abolishes saccharin- or 2-PEA-induced PMN chemotactic migration, indicating a role for Gi-type proteins. In summary, our data suggest “chemosensory”-type subpopulations of circulating leukocytes.
MERTK as negative regulator of human T cell activation
Authors: Cabezo´n Raquel , Carrera-Silva E Antonio , Flo´rez-Grau Georgina , Errasti Andrea E , Caldero´n-Go´mez Elisabeth , Lozano Juan Jose´ , Espan~a Carolina , Ricart Elena , Pane´s Julia´n , Rothlin Carla Vanina , Beni´tez-Ribas Daniel
Published: January 2015

The aim of this study was to test the hypothesis whether MERTK, which is up-regulated in human DCs treated with immunosuppressive agents, is directly involved in modulating T cell activation. MERTK is a member of the TAM family and contributes to regulating innate immune response to ACs by inhibiting DC activation in animal models. However, whether MERTK interacts directly with T cells has not been addressed. Here, we show that MERTK is highly expressed on dex-induced human tol-DCs and participates in their tolerogenic effect. Neutralization of MERTK in allogenic MLR, as well as autologous DC–T cell cultures, leads to increased T cell proliferation and IFN-γ production. Additionally, we identify a previously unrecognized noncell-autonomous regulatory function of MERTK expressed on DCs. Mer-Fc protein, used to mimic MERTK on DCs, suppresses nai¨ve and antigen-specific memory T cell activation. This mechanism is mediated by the neutralization of the MERTK ligand PROS1. We find that MERTK and PROS1 are expressed in human T cells upon TCR activation and drive an autocrine proproliferative mechanism. Collectively, these results suggest that MERTK on DCs controls T cell activation and expansion through the competition for PROS1 interaction with MERTK in the T cells. In conclusion, this report identified MERTK as a potent suppressor of T cell response.
Making Cuts to Medicare: The Views of Patients, Physicians, and the Public
Authors: Gogineni Keerthi , Shuman Katherine , Chinn Derek , Weber Anita , Cosenza Carol , Colten Mary Ellen , Emanuel Ezekiel J.
Published: January 2015

Purpose

Cancer-related expenditures are increasing health care costs. Determining how patients with cancer, oncologists, and the general public view Medicare spending and whether they would support cost-containment measures is important to identifying acceptable approaches to reducing health care expenditures.

Methods

Patients with cancer treated at an academic medical center, a random national sample of oncologists, and the general public were surveyed between July 2012 and March 2013 about causes of high health care costs and proposed cost-control measures.

Results

Three hundred twenty-six patients (response rate, 72%), 250 oncologists (response rate, 55%), and 891 members of the general public (response rate, 50%) completed surveys. The majority thought Medicare spending was a moderate or big problem (75.8% of patients; 97.2% of oncologists; 75.3% of the general public) and thought Medicare could spend less without causing harm (65.6% of patients; 74.0% of oncologists; 69.7% of the general public). There was broad consensus that drug and insurance companies' profits added to costs, although physicians, hospitals, and patients were also perceived as sharing responsibility. More than 75% of respondents supported enabling Medicare to refuse reimbursement for more expensive treatment if less costly, equally effective treatment was available. Respondents generally favored means testing Medicare cost sharing but, except for oncologists, resisted the idea of an independent oversight panel. All groups opposed annual ceilings on Medicare spending per patient.

Conclusion

The majority of respondents view Medicare costs as a substantial problem and that all players in the system, including providers, contribute to high costs. Most thought Medicare could spend less without causing harm. Overall, respondents strongly favored not paying for more expensive treatments when cheaper ones are equally effective.
How Do Integrated Health Care Systems Address Racial and Ethnic Disparities in Colon Cancer?
Authors: Rhoads Kim F. , Patel Manali I. , Ma Yifei , Schmidt Laura A.
Published: January 2015

Purpose

Colorectal cancer (CRC) disparities have persisted over the last two decades. CRC is a complex disease requiring multidisciplinary care from specialists who may be geographically separated. Few studies have assessed the association between integrated health care system (IHS) CRC care quality, survival, and disparities. The purpose of this study was to determine if exposure to an IHS positively affects quality of care, risk of mortality, and disparities.

Patients and Methods

This retrospective secondary-data analysis study, using the California Cancer Registry linked to state discharge abstracts of patients treated for colon cancer (2001 to 2006), compared the rates of National Comprehensive Cancer Network (NCCN) guideline–based care, the hazard of mortality, and racial/ethnic disparities in an IHS versus other settings.

Results

More than 30,000 patient records were evaluated. The IHS had overall higher rates of adherence to NCCN guidelines. Propensity score–matched Cox models showed an independent and protective association between care in the IHS and survival (hazard ratio [HR], 0.87; 95% CI, 0.85 to 0.90). This advantage persisted across stage groups. Black race was associated with increased hazard of mortality in all other settings (HR, 1.15; 95% CI, 1.04 to 1.27); however, there was no disparity within the IHS for any minority group (P > .11 for all groups) when compared with white race.

Conclusion

The IHS delivered higher rates of evidence-based care and was associated with lower 5-year mortality. Racial/ethnic disparities in survival were absent in the IHS. Integrated systems may serve as the cornerstone for developing accountable care organizations poised to improve cancer outcomes and eliminate disparities under health care reform.
On the Visceral 2
Authors: Tompkins Kyla Wazana
Published: January 2015

This introduction discusses major themes in the eight essays that make up the double issue titled On the Visceral. Focusing on the tensions between viscerality and abstraction, and tracing the connections between gut feeling, alimentary affects, and political sentiment, the essays in this issue by Sianne Ngai, Bethany Schneider, Ewa Macura-Nnamdi, and Ramzi Fawaz treat the gut as a center of queer feeling.
“I Cherish My Bile Duct as Much as Any Other Organ”
Authors: Fawaz Ramzi
Published: January 2015

This essay explores the use of viscerally charged language around digestive dysfunction in AIDS cultural productions of the late 1980s and early 1990s. I coin the phrase “the digestive politics and poetics of AIDS” to describe the use of metaphors that linked the digestive dysfunctions associated with HIV/AIDS to a political aversion, or disgust, for the state of American politics at the height of the AIDS epidemic. Specifically, I develop a close reading of Tony Kushner's Angels in America that examines how the play's linguistic and performative engagement with alimentary processes (ingestion, defecation, and excretion) worked to rearticulate public culture's disgust with the bodies of people with AIDS to a disgust with government neglect. I argue that the play's affective investment in the gut as a site for intuiting one's response to American political life resonated with an array of contemporaneous queer artistic responses to the AIDS crisis, including works by David Wojnarowicz, Gary Fisher, and Chuck Nanney, ultimately helping forge a powerful discursive formation intended to have political results.
Visceral Abstractions
Authors: Ngai Sianne
Published: January 2015

This essay reads a series of social or capitalist abstractions: the iconic smiley face; Karl Marx's notoriously tricky concept of abstract, value-constituting labor; and the “soldier's body” qua allegory of value in contemporary American poet Rob Halpern's book Music for Porn (2012). It argues that both Marx and Halpern rely on catachresis, a trope of “necessary and forced usage,” to represent the material, synthetic effects of social abstractions while counteracting a tendency, increasingly popular with the rise of the “new materialisms,” to uncover a thingly substance as every abstraction's hidden truth.
The Alimentary Life of Power
Authors: Macura-Nnamdi Ewa
Published: January 2015

Examining Dambudzo Marechera's “House of Hunger,” this article follows the visceral fate of what Frantz Fanon has called the “racialization of thought.” Evoking the alimentary tract, especially the gut but also the various processes that take place within it, Marechera posits the visceral as a site of ambivalence that registers the collusive and resistant attitudes of bodies under colonialism and postcolonialism. While firmly linked to materiality, the visceral is also an index to mental conditions that it both conveys and reveals. Marechera's visceral is what foregrounds the body as the primary site of (post)colonial intervention, understood as both a replication and a critique of colonial violence. Placing the visceral so firmly within the alimentary tract allows Marechera to bring out the literal and metaphorical properties of consuming that, on the one hand, foreground the power inflections of eating and, on the other, intimate what can tentatively be called the homoerotics of colonialism.
Total Synthesis of Stylissatin A, A Cyclic Peptide That Inhibits Nitric Oxide Production
Authors: Akindele Tito , Gise Baro , Sunaba Taiki , Kita Masaki , Kigoshi Hideo
Published: January 2015

Stylissatin A is a proline-rich cyclic heptapeptide isolated from the Papua New Guinean marine sponge Stylissa massa. The first synthesis of stylissatin A was achieved by a combination of solid-phase and solution-phase peptide synthesis. The natural and synthetic samples of stylissatin A showed comparable inhibitory effects on nitric oxide production with negligible cytotoxicity in lipopolysaccharide (LPS)-stimulated murine macrophage RAW264.7 cells (EC50 = 73 µM for synthetic sample). Furthermore, while the d-allo-Ile5 epimer was less potent, a tert-butyl ether analog of stylissatin A was approximately six times more potent than the natural product (EC50 = 12 µM).
An Integer Programming Approach for Fault-Tolerant Connected Dominating Sets
Authors: Buchanan Austin , Sung Je Sang , Butenko Sergiy , Pasiliao Eduardo L.
Published: January 2015

This paper considers the minimum k-connected d-dominating set problem, which is a fault-tolerant generalization of the minimum connected dominating set (MCDS) problem. Three integer programming formulations based on vertex cuts are proposed (depending on whether d < k, d = k, or d > k) and their integer hulls are studied. The separation problem for the vertex-cut inequalities is a weighted vertex-connectivity problem and is polytime solvable, meaning that the LP relaxation can be solved in polytime despite having exponentially many constraints. A new class of valid inequalities—r-robust vertex-cut inequalities—is introduced and is shown to induce exponentially many facets. Finally, a lazy-constraint approach is shown to compare favorably with existing approaches for the MCDS problem (the case k = d = 1), and is in fact the fastest in literature for standard test instances. A key subroutine is an algorithm for finding an inclusion-wise minimal vertex cut in linear time. Computational results for (k, d) = (2,1), (2,2), (3,3), (4,4) are provided as well.
The Value of Markov Chain Games with Incomplete Information on Both Sides
Authors: Gensbittel Fabien , Renault Jérôme
Published: January 2015

We consider zero-sum repeated games with incomplete information on both sides, where the states privately observed by each player follow independent Markov chains. It generalizes the model, introduced by Aumann and Maschler in the sixties and solved by Mertens and Zamir in the seventies, where the private states of the players were fixed. It also includes the model introduced in Renault [19] [Renault J (2006) The value of Markov chain games with lack of information on one side. Math. Oper. Res. 31(3):490–512.], of Markov chain repeated games with lack of information on one side, where only one player privately observes the sequence of states. We prove here that the limit value exists, and we obtain a characterization via the Mertens-Zamir system, where the “nonrevealing value function” plugged in the system is now defined as the limit value of an auxiliary “nonrevealing” dynamic game. This nonrevealing game is defined by restricting the players not to reveal any information on the limit behavior of their own Markov chain, as in Renault [19]. There are two key technical difficulties in the proof: (1) proving regularity, in the sense of equicontinuity, of the T-stage nonrevealing value functions and (2) constructing strategies by blocks in order to link the values of the nonrevealing games with the original values.
Understanding the Memory Effects in Pulsing Advertising
Authors: Aravindakshan Ashwin , Naik Prasad A.
Published: January 2015

Extant models assume that awareness decline commences instantly. In contrast, we incorporate the possibility that awareness declines with a delay due to the memory for advertisements. To this end, we use delay differential equations to understand the evolution of awareness in the presence of ad memorability. This extended model generates optimal advertising policies that include the even spending policy, blitz policy, and various cyclic pulsing policies, depending on whether ad memorability exceeds a critical threshold. The extended model not only unifies the various patterns of advertising spending over time, but also augments the prior research by furnishing the optimality of pulsing advertising. Thus ad memorability could drive pulsing. We discuss the implications for practicing managers and identify avenues for future researchers.
Zonal fixation in revision total knee arthroplasty
Authors: Morgan-Jones R. , Oussedik S. I. S. , Graichen H. , Haddad F. S.
Published: January 2015

Revision knee arthroplasty presents a number of challenges, not least of which is obtaining solid primary fixation of implants into host bone. Three anatomical zones exist within both femur and tibia which can be used to support revision implants. These consist of the joint surface or epiphysis, the metaphysis and the diaphysis. The methods by which fixation in each zone can be obtained are discussed. The authors suggest that solid fixation should be obtained in at least two of the three zones and emphasise the importance of pre-operative planning and implant selection.

Cite this article: Bone Joint J 2015;97-B:147–9.
Major trauma patients with spinal fractures have more complex injuries than non-major trauma patients
Authors: Prime M. , Al-Obaidi B. , Safarfashandi Z. , Lok Y. , Mobasheri R. , Akmal M.
Published: January 2015

This study examined spinal fractures in patients admitted to a Major Trauma Centre via two independent pathways, a major trauma (MT) pathway and a standard unscheduled non-major trauma (NMT) pathway. A total of 134 patients were admitted with a spinal fracture over a period of two years; 50% of patients were MT and the remainder NMT. MT patients were predominantly male, had a mean age of 48.8 years (13 to 95), commonly underwent surgery (62.7%), characteristically had fractures in the cervico-thoracic and thoracic regions and 50% had fractures of more than one vertebrae, which were radiologically unstable in 70%. By contrast, NMT patients showed an equal gender distribution, were older (mean 58.1 years; 12 to 94), required fewer operations (56.7%), characteristically had fractures in the lumbar region and had fewer multiple and unstable fractures. This level of complexity was reflected in the length of stay in hospital; MT patients receiving surgery were in hospital for a mean of three to four days longer than NMT patients. These results show that MT patients differ from their NMT counterparts and have an increasing complexity of spinal injury.

Cite this article: Bone Joint J 2015;97-B:235–9.
A comparison of proximal and distal Chevron osteotomy, both with lateral soft-tissue release, for moderate to severe hallux valgus in patients undergoing simultaneous bilateral correction
Authors: Lee K. B. , Cho N. Y. , Park H. W. , Seon J. K. , Lee S. H.
Published: January 2015

Moderate to severe hallux valgus is conventionally treated by proximal metatarsal osteotomy. Several recent studies have shown that the indications for distal metatarsal osteotomy with a distal soft-tissue procedure could be extended to include moderate to severe hallux valgus.

The purpose of this prospective randomised controlled trial was to compare the outcome of proximal and distal Chevron osteotomy in patients undergoing simultaneous bilateral correction of moderate to severe hallux valgus.

The original study cohort consisted of 50 female patients (100 feet). Of these, four (8 feet) were excluded for lack of adequate follow-up, leaving 46 female patients (92 feet) in the study. The mean age of the patients was 53.8 years (30.1 to 62.1) and the mean duration of follow-up 40.2 months (24.1 to 80.5). After randomisation, patients underwent a proximal Chevron osteotomy on one foot and a distal Chevron osteotomy on the other.

At follow-up, the American Orthopedic Foot and Ankle Society (AOFAS) hallux metatarsophalangeal interphalangeal (MTP-IP) score, patient satisfaction, post-operative complications, hallux valgus angle, first-second intermetatarsal angle, and tibial sesamoid position were similar in each group. Both procedures gave similar good clinical and radiological outcomes.

This study suggests that distal Chevron osteotomy with a distal soft-tissue procedure is as effective and reliable a means of correcting moderate to severe hallux valgus as proximal Chevron osteotomy with a distal soft-tissue procedure.

Cite this article: Bone Joint J 2015;97-B:202–7.
Reconstruction of defects involving the Achilles tendon and local soft tissues
Authors: Soons J. , Rakhorst H. A. , Ruettermann M. , Luijsterburg A. J. M. , Bos P. K. , Zöphel O. T.
Published: January 2015

A total of seven patients (six men and one woman) with a defect in the Achilles tendon and overlying soft tissue underwent reconstruction using either a composite radial forearm flap (n = 3) or an anterolateral thigh flap (n = 4). The Achilles tendons were reconstructed using chimeric palmaris longus (n = 2) or tensor fascia lata (n = 2) flaps or transfer of the flexor hallucis longus tendon (n = 3). Surgical parameters such as the rate of complications and the time between the initial repair and flap surgery were analysed. Function was measured objectively by recording the circumference of the calf, the isometric strength of the plantar flexors and the range of movement of the ankle. The Achilles tendon Total Rupture Score (ATRS) questionnaire was used as a patient-reported outcome measure. Most patients had undergone several previous operations to the Achilles tendon prior to flap surgery. The mean time to flap surgery was 14.3 months (2.1 to 40.7).

At a mean follow-up of 32.3 months (12.1 to 59.6) the circumference of the calf on the operated lower limb was reduced by a mean of 1.9 cm (sd 0.74) compared with the contralateral limb (p = 0.042). The mean strength of the plantar flexors on the operated lower limb was reduced to 88.9% of that of the contralateral limb (p = 0.043). There was no significant difference in the range of movement between the two sides (p = 0.317). The mean ATRS score was 72 points (sd 20.0). One patient who had an initial successful reconstruction developed a skin defect of the composite flap 12 months after free flap surgery and this resulted in recurrent infections, culminating in transtibial amputation 44 months after reconstruction.

These otherwise indicate that reconstruction of the Achilles tendon combined with flap cover results in a successful and functional reconstruction.

Cite this article: Bone Joint J 2015;97-B:215–20.
The Exeter technique can lead to a lower incidence of leg-length discrepancy after total hip arthroplasty
Authors: Halai M. , Gupta S. , Gilmour A. , Bharadwaj R. , Khan A. , Holt G.
Published: January 2015

We evaluated an operative technique, described by the Exeter Hip Unit, to assist accurate introduction of the femoral component. We assessed whether it led to a reduction in the rate of leg-length discrepancy after total hip arthroplasty (THA).

A total of 100 patients undergoing THA were studied retrospectively; 50 were undertaken using the test method and 50 using conventional methods as a control group. The groups were matched with respect to patient demographics and the grade of surgeon. Three observers measured the depth of placement of the femoral component on post-operative radiographs and measured the length of the legs.

There was a strong correlation between the depth of insertion of the femoral component and the templated depth in the test group (R = 0.92), suggesting accuracy of the technique. The mean leg-length discrepancy was 5.1 mm (0.6 to 21.4) pre-operatively and 1.3 mm (0.2 to 9.3) post-operatively. There was no difference between Consultants and Registrars as primary surgeons. Agreement between the templated and post-operative depth of insertion was associated with reduced post-operative leg-length discrepancy. The intra-class coefficient was R ≥ 0.88 for all measurements, indicating high observer agreement. The post-operative leg-length discrepancy was significantly lower in the test group (1.3 mm) compared with the control group (6.3 mm, p < 0.001).

The Exeter technique is reproducible and leads to a lower incidence of leg-length discrepancy after THA.

Cite this article: Bone Joint J 2015;97-B:154–9.