bluuebunny/crossref_metadata_2025 huggingface dataset:
Vitamin D deficiency in psychiatric in-patients and treatment with daily supplements of calcium and ergocalciferol
Authors: Tiangga Eleanor , Gowda Asha , Dent John A.
Published: September 2008

Aims and Method

This study examines the prevalence of vitamin D deficiency in a group of male psychiatric in-patients and follows 16 of them prospectively during treatment with calcium and ergocalciferol tablets.

Results

Of 17 male patients, 15 had vitamin D deficiency and two had borderline deficiency. Vitamin D deficiency was associated with Black and minority ethnic background. Improvement in vitamin D status was observed following replacement therapy.

Clinical Implications

Vitamin D deficiency may be widespread in the psychiatric population particularly in Black and minority ethnic but also in White European in-patients. Vitamin D level should be routinely monitored in psychiatric in-patients. for those with vitamin D deficiency, replacement therapy can be commenced with calcium and ergocalciferol tablets (containing 10 μg of ergocalciferol), which is safe and well tolerated. All psychiatric in-patients should have adequate exposure to sunlight and attention to diet to ensure that they receive their recommended daily allowance of vitamins and minerals.
The results of the titanium-coated RM acetabular component at 20 years
Authors: Ihle M. , Mai S. , Pfluger D. , Siebert W.
Published: September 2008

In a prospective study, 93 unselected consecutive uncemented hip arthroplasties were performed in 80 patients using the titanium-coated RM acetabular component and the CLS femoral component. The mean age of the patients at operation was 52 years (28 to 81). None were lost to follow-up. In the 23 patients who had died (26 hips) only one acetabular component had been revised. In the 57 living patients (67 hips), 13 such revisions had been performed. Of the 14 revisions, seven were for osteolysis, five for loosening and two for infection.

Survival analysis of this implant showed a total probability of survival of 83% (95% confidence interval 73 to 90), with all revisions as the endpoint, and a probability of 94% (95% confidence interval 87 to 98) with revision for aseptic loosening as the endpoint, indicating reliable long-term fixation of the titanium-coated RM acetabular component.
The NexGen LPS-flex to the knee prosthesis at a minimum of three years
Authors: Kim T.-H. , Lee D.-H. , Bin S.-I.
Published: September 2008

We carried out a prospective study to assess the clinical outcome, complications and survival of the NexGen Legacy posterior-stabilised-Flex total knee replacement (TKR) in a consecutive series of 278 knees between May 2003 and February 2005. Mean follow-up for 259 TKRs (98.2%) was 3.8 years (3.0 to 4.8). Annual follow-up showed improvement in the Knee Society scores (paired t-test, p < 0.05). At the last follow-up, the mean maximum flexion was 135° (110° to 150°). Two knees showed radiolucent lines, but revision was not required because the patients were asymptomatic. Revision was required in one case because of infection, but there were no prosthesis-related revisions. There were no other complications. The estimated survival rate at four years with revision for any reason and prosthesis-related problems was 99.6% and 100%, respectively.

This relatively large study indicates that the legacy posterior stabilised-Flex design provides excellent short-term outcome but warrants ongoing evaluation to confirm the long-term durability and functioning of the implant.
A history of limb amputation
Authors: Birch R.
Published: September 2008

John Kirkup, the distinguished orthopaedic surgeon and archivist recently published a book describing the history of amputation. This annotation highlights the importance of this work and the particular relevance of many of its themes to current orthopaedic and trauma practice.
Erzählte Emotionen, vermittelte Gegenwart. Zeichen und Präsenz in der literaturwissenschaftlichen Emotionstheorie
Authors: Philipowski Katharina
Published: September 2008

The author discusses some recent developments in literary theory concerning the notion of emotions, ›presence‹ and body. Taking a review of two monographs on the narrative function of emotions in medieval narrative texts as a starting point, the text focuses on the concept of ›performance‹ (Performanz) and ‹performativity‹ (Performativität) and argues, that the immediate can be represented by literature only in terms of intermediation, because literature itself is intermediation.
Gli indirizzi e l'attività principale della «Zeitschrift für romanische Philologie» nei suoi primi decenni
Authors: Holtus Günter
Published: September 2008

Riassunto

Il processo della costituzione della romanistica è accompagnato e promosso dalla fondazione di riviste specializzate. Si illustrerà, in sintesi, in che misura la ZrP ha contribuito a indirizzare gli studi di romanistica nei decenni fondativi della disciplina, indicandone i metodi e mettendo a fuoco temi essenziali di ricerca per gli anni successivi. Con ciò si mostra che la ZrP, nei primi decenni della sua esistenza, non si è occupata solamente degli ambiti tradizionali della filologia (romanza), ma ha rappresentato anche un forum per temi nuovi e innovativi della ricerca, promuovendo così, fin dall'inizio, gli scambi scientifici della romanistica in Germania e all'estero.
Der Atlante linguistico ed etnografico del Piemonte occidentale – ALEPO
Authors: Pfister Max
Published: September 2008

Den beiden verantwortlichen Herausgebern Sabina Canobbio und Tullio Telmon kann man gratulieren zu diesem viel versprechenden Publikationsbeginn des ALEPO: Die Bände Presentazione e guida alla lettura des ALEPO und I rilevamenti sociovariazionali. Linee progettuali (Palermo, Centro di Studi Filologici e Linguistici Siciliani, 2005) von Mari D'Agostino und Giovanni Ruffino sind die beiden besten und methodologisch wegweisenden Publikationen für soziovariationale Spracherhebungen in der Italoromania. Für Sprachaufnahmen und Ethnotext haben die im ALEPO angewandte Aufnahmemethode («sociolinguistica areale») und die kartographische Darstellung (Farbfotos, Verbreitungskarten der Pflanzen) Modellcharakter. Als Anregung für die weiteren ALEPO-Bände sollte die Lesbarkeit der Sprachkarten verbessert werden. Man kann vom Benutzer nicht erwarten, dass er den gedruckten Text mit der Lupe lesen muss. Die Interpretation der lexikalischen Typisierungen sollte nicht allein den zwar kompetenten und versierten Artikelbearbeitern überlassen werden. Ähnlich wie dies Pierre Gardette und Paulette Durdilly im Kommentarband des Atlas Linguistique du Lyonnais praktiziert haben, darf für jeden Worttypus ein Verweis auf von Wartburgs FEW nicht fehlen.

In einer Zeit der knappen finanziellen Mittel ist es entscheidend, die folgenden ALEPO-Bände in regelmäßigem Rhythmus zu publizieren und das wertvolle Kartenmaterial angemessen zu interpretieren und möglichst rasch einem interessierten Publikum zugänglich zu machen.
Changing Use of Surfactant Over 6 Years and Its Relationship to Chronic Lung Disease
Authors: Chong Euming , Greenspan Jay , Kirkby Sharon , Culhane Jennifer , Dysart Kevin
Published: September 2008

OBJECTIVES. Our goals were to identify the trend of surfactant use over a 6-year period and to determine whether a relationship exists between the incidence of chronic lung disease in infants born weighing <1000 g who receive surfactant and those who do not.

METHODOLOGY. Data regarding surfactant use, incidence of chronic lung disease, nasal continuous positive airway pressure use and duration, and demographic data were collected from the Alere (formerly ParadigmHealth) database from 2001 to 2006 (n = 3086). Groups were compared by using χ2 test, analysis of variance, or Student's t test.

RESULTS. Use of surfactant has decreased over time from 67% in 2001 to 59.9% in 2006. Infants who received surfactant were more likely to develop chronic lung disease. Those who received >1 dose of surfactant were more likely to develop chronic lung disease when compared with infants treated with only 1 dose. Chronic lung disease rates have risen over time from 47.8% in 2001 to 57.8% in 2006. There was no difference in survival between groups.

CONCLUSIONS. Despite the findings that surfactant use decreased during the study period and the rate of chronic lung disease increased, the data do not support a connection. Infants who receive surfactant are more likely to develop chronic lung disease, and chronic lung disease rates are stable in those infants not treated with surfactant. It is concerning, however, that 60% of infants not receiving surfactant developed chronic lung disease.
Pitfalls in the Diagnosis and Management of Obstructive Uterovaginal Duplication: A Series of 32 Cases
Authors: Capito Carmen , Echaieb Anis , Lortat-Jacob Stephen , Thibaud Elisabeth , Sarnacki Sabine , Nihoul-Fékété Claire
Published: September 2008

OBJECTIVES. Obstructive uterovaginal duplication is rare and frequently misdiagnosed. The aims of this study were to review all the patients managed for this malformation in our institution, evaluate their long-term outcomes, and discuss the embryologic origin of this malformation.

METHODS. From 1984 to 2007, we treated 32 patients for obstructive uterovaginal duplication in our institution. We separated them in 2 groups (prepubertal [n = 8] and pubertal [n = 24]) and analyzed their clinical and radiologic presentations and their treatments. Patients >18 years of age (n = 22) were recontacted.

RESULTS. For the prepubertal group, the median age at diagnosis was 6 months. Postnatal ultrasound showed an absent ipsilateral kidney in 6 case subjects, although 4 patients had a prenatal diagnosis of ipsilateral multicystic dysplastic kidney. This renal anomaly was associated with a pelvic sonolucent mass in 3 case subjects, allowing us to prenatally suspect the diagnosis. All of the patients were cured by vaginal approach. For the pubertal group, the median delay of diagnosis after menarche was 9 months. Among patients managed in an emergency setting (n = 11), there were 9 misdiagnoses with inappropriate abdominal surgeries, including 3 hysterectomies of the obstructed hemiuterus. Concerning long-term results, 5 patients were attempting to have children, with successful pregnancies for 4 of them. One patient suffered from infertility attributable to contralateral isthmic stenosis after a hysterectomy of the obstructed hemiuterus.

CONCLUSIONS. Obstructive uterovaginal duplication is a benign pathology when properly managed. Therefore, management of abdominal pain in peripubertal girls should include systematic abdominal and gynecologic examinations completed by radiologic pelvic and renal evaluation. Surgical treatment should be performed by vaginal approach to avoid infertility. Concerning the origin of the malformation, the high association of prenatal dysplastic kidneys and postnatal absent kidneys suggests anomalies of both wolffian and müllerian duct development, contrasting with the classic definition of this malformation.
Laser deposition of a Cu-based metallic glass powder on a Zr-based glass substrate
Authors: Sun H. , Flores K.M.
Published: September 2008

Laser Engineered Net Shaping (LENS™) is a laser-assisted manufacturing process that offers the possibility of producing metallic coatings and components with highly nonequilibrium microstructures. In this work, the microstructure developed by LENS deposition of Cu47Ti33Zr11Ni8Si1 powder on a bulk metallic glass substrate, with nominal composition Zr58.5Nb2.8Cu15.6Ni12.8Al10.3, is investigated. Single-layer deposition results in the formation of an inhomogeneous but partially amorphous layer above a crystalline heat-affected zone. Elemental analysis of the deposited layer indicates incomplete mixing of the powder with the melt pool. The as-deposited alloy exhibits a single glass transition event and its primary crystallization event is consistent with the first crystallization temperature of the Cu-based powder. Subsequent remelting of this layer results in a still partially amorphous deposit with a uniform composition of (Zr + Nb)51.8Cu24.7Ti3.4Ni16.4Al3.7. The remelted layer exhibits a structural rearrangement immediately prior to the primary crystallization event, possibly associated with the formation of a quasicrystalline phase.
Structural, optical, and magnetic properties of Fe-doped In2O3 nanocubes
Authors: Chu Dewei , Zeng Yu-Ping , Jiang Dongliang , Ren Zhongming , Ren Weili , Wang Junhu , Zhang Tao
Published: September 2008

Fe-doped In2O3 nanocubes were synthesized by a solvothermal method. The lattice constant a decreases linearly as Fe doping concentration increases, and Raman scattering measurement proves the incorporation of Fe ions into the In2O3 crystal lattice. Mössbauer spectra show the presence of mixed valence of Fe ions instead of Fe3O4, while the sample is superparamagnetic. The products with an average diameter of 80 nm have a single-crystalline phase and appear as a square shape. Magnetic measurements confirm the superparamagnetic properties of the nanocubes, and electron paramagnetic resonance studies indicate Fe ions occupy different sites in the In2O3 matrix.
Esgotamento profissional e transtornos mentais comuns em agentes comunitários de saúde
Authors: Silva Andréa Tenório Correia da , Menezes Paulo Rossi
Published: September 2008

OBJETIVO: Estimar a prevalência da síndrome do esgotamento profissional e de transtornos mentais comuns em agentes comunitários de saúde, identificando fatores associados. MÉTODOS: Estudo transversal realizado com 141 agentes comunitários atuantes há pelo menos seis meses em unidades básicas de saúde do município de São Paulo (SP), em 2006. Os participantes responderam a três questionários: um sobre características sociodemográficas, socioeconômicas, da saúde e do trabalho; o Self Reporting Questionnaire; e o Maslach Burnout Inventory, que permite medir três dimensões da síndrome do esgotamento profissional: exaustão emocional, despersonalização e decepção. A regressão logística multivariada foi usada para verificar associações entre variáveis. RESULTADOS: No total, 24,1% dos entrevistados apresentaram síndrome do esgotamento profissional. Níveis moderados ou altos de esgotamento profissional foram observados em 70,9% dos participantes para exaustão emocional, em 34% para despersonalização e em 47,5% para decepção. A prevalência de transtornos mentais comuns foi 43,3%. Foram observadas associações positivas entre as dimensões de esgotamento profissional. Presença de transtorno mental comum associou-se independentemente com maiores níveis de exaustão emocional e decepção. CONCLUSÕES: A alta freqüência de níveis intensos de esgotamento profissional e a elevada ocorrência de transtornos mentais comuns encontradas entre os agentes comunitários de saúde suscitam a necessidade de estratégias de intervenção no cotidiano desses indivíduos e de novas investigações sobre a dimensão e determinantes do esgotamento profissional.
Factores de riesgo de caídas en ancianos: revisión sistemática
Authors: Gama Zenewton André da Silva , Gómez-Conesa Antonia
Published: September 2008

OBJETIVO: Sistematizar los hallazgos de los estudios de cohorte prospectivos sobre los múltiples factores de riesgo de caídas en ancianos y valorar la calidad metodológica de los mismos. MÉTODOS: Revisión sistemática de estudios epidemiológicos en las bases de datos Medline, SciELO y Lilacs. Fueron incluidos estudios con número de sujetos >100, con edad >64 años, de ambos sexos, residentes en la comunidad o en instituciones para ancianos. RESULTADOS: De 726 publicaciones encontradas, 15 estudios cumplieron con los criterios de inclusión, habiendo sido publicados entre 1988 y 2005. Los estudios presentaron heterogeneidad metodológica. Los principales factores asociados a un aumento del riesgo de caída son: antecedente de caída, alteración de la marcha, incapacidad funcional, deterioro cognitivo, consumo de medicación psicotrópica y exceso de actividad física. A pesar de hallazgos contradictorios, ser del sexo femenino y tener edad avanzada, también pueden ser predictores de caída. CONCLUSIONES: Se identifican algunas carencias metodológicas de los estudios de cohorte prospectivo sobre caídas: carencia de estudios sobre determinantes extrínsecos, necesidad de enmascaramiento del evaluador durante el seguimiento y de un mejor control del seguimiento con menores intervalos entres las recogidas de datos.
Aumento da prematuridade no Brasil: revisão de estudos de base populacional
Authors: Silveira Mariângela F , Santos Iná S , Barros Aluísio J D , Matijasevich Alicia , Barros Fernando C , Victora Cesar G
Published: September 2008

OBJETIVO: A maior causa de mortalidade infantil no Brasil são condições perinatais, associadas em sua maioria à prematuridade. O objetivo do estudo foi avaliar a evolução das taxas de prematuridade no Brasil. MÉTODOS: Foi realizada revisão nas bases de dados Medline e Lilacs, incluindo estudos publicados em periódicos, teses e dissertações, desde 1950. Os critérios de exclusão foram: estudos que se referiam a temas clínicos, com complicações da prematuridade e gestação, bem como cuidados com prematuros. Os critérios de inclusão foram: estudos de base populacional sobre prevalência de prematuridade com dados do Brasil, com amostra representativa do local do estudo e com dados primários. De 71 estudos encontrados, a análise foi realizada com 12. RESULTADOS: A prevalência de prematuridade variou de 3,4% a 15,0% nas regiões Sul e Sudeste, entre 1978 e 2004, sugerindo tendência crescente a partir da década de 1990. Estudos na região Nordeste, entre 1984 e 1998, encontraram prevalências de prematuridade de 3,8% a 10,2%, também com tendência a aumentar. CONCLUSÕES: Dados do Sistema de Informações de Nascidos Vivos não corroboram este aumento, pois mostram diferenças entre as taxas de prematuridade informadas por esse Sistema e as taxas medidas nos estudos incluídos nesta revisão. Devido ao importante papel da prematuridade na mortalidade infantil no Brasil é importante identificar as causas deste aumento e planejar intervenções que diminuam sua ocorrência.
Evaluation of STD/HIV/AIDS peer-education and danger: a local perspective
Authors: Laperrière Hélène
Published: September 2008

An evaluation of peer-education projects with sex workers, men who have sex with men and marginalized adolescents, was introduced in a remote region of Brazil. The context of varied limits of predictability made it difficult to conduct inquiry. To go beyond available epidemiological surveys and questionnaires on sexual behavior, a self-evaluation aimed at increasing pragmatic knowledge about prevention in a challenging socio-political context. During five-months, a participatory-action research explored participant observation; individual and collective exchanges with users, peer-educators, coordinators, administrators, politicians and regional health professionals. Collective understanding of peer-education in prostitution zones underlines the reality of unforeseen social repercussions and confluence/divergence of multiple actors' perspectives. It identifies meaningful dimensions at a community-level, such as the collective history and dangerous working conditions. Nurses face complex struggles and negotiations over multiple actors in their practice. This study suggests that nurses have a role to play in the conceptualization of participatory evaluation. It also underlines the threats to their physical and social safety, which they might share with peer-educators.
Transformações da "aids aguda" para a "aids crônica": percepção corporal e intervenções cirúrgicas entre pessoas vivendo com HIV e aids
Authors: Alencar Tatianna Meireles Dantas de , Nemes Maria Ines Battistella , Velloso Marco Aurélio
Published: September 2008

Após dez anos de uso da terapia anti-retroviral de alta potência, um novo problema surge: a síndrome lipodistrófica do HIV, uma distribuição irregular de gordura no corpo, decorrente do uso das medicações anti-retrovirais. Se no início da epidemia, a aids era caracterizada, sobretudo, pela magreza, hoje - tempos de "aids crônica"- estamos, uma vez mais, diante do estigma sobre o corpo, só que, paradoxalmente, com sinal trocado - o acúmulo "desordenado" de gordura no corpo. Este artigo apresenta e compara as mudanças corporais percebidas por pessoas que vivem com HIV e aids, ocorridas nos últimos anos da epidemia, com a utilização dos anti-retrovirais. Foram analisadas 32 entrevistas qualitativas com pessoas vivendo com HIV e aids, realizadas nos anos de 1999 e 2005. Ao nos depararmos com as novas questões emergentes e analisarmos sua interação com a crescente disponibilidade e utilização de tecnologias, fica a forte sensação de ressurgimento, sob nova forma, dos mesmos paradoxos previamente existentes nos tempos da aids aguda: o impacto dos sinais e um certo tipo de ressurgimento da desesperança quanto ao futuro de vida dessas pessoas.
Influência da escolaridade e do trabalho maternos no aleitamento materno exclusivo
Authors: Damião Jorginete de Jesus
Published: September 2008

O presente artigo tem por objetivo analisar a associação entre a prática do aleitamento materno exclusivo (AME) e características maternas (idade, escolaridade, paridade e trabalho), peso ao nascer e alimentação no primeiro dia após alta da maternidade, em crianças menores de quatro meses de idade. Para tal, foram utilizados dados de dois inquéritos realizados no município do Rio de Janeiro, em 1998 e 2000. Nesses inquéritos foram realizadas entrevistas com acompanhantes de menores de um ano de idade, selecionados por meio de amostragem probabilística da população de menores de um ano vacinada nos Dias Nacionais de Vacinação (que possuem cobertura universal para esta faixa etária neste município) (n=2.459). A prática do AME foi descrita segundo cada uma das variáveis de exposição e, em seguida, procedeu-se a análise multivariada por regressão logística. A prevalência de AME foi de 22,7% entre os menores de quatro meses, variando de 39,6% no primeiro dia a 12,4% aos 120 dias de vida. Apresentaram maiores prevalências de AME os filhos de mulheres de maior escolaridade, filhos de mulheres que não trabalhavam fora e crianças que estavam em AME no primeiro dia em casa depois da alta da maternidade. Os resultados da análise multivariada indicam associação positiva de AME com escolaridade materna (OR: 1,93 para 3º grau completo) e negativa com trabalho materno (OR: 0,59). A escolaridade e trabalho maternos e alimentação da criança no primeiro dia em casa após alta da maternidade tiveram associação com o AME entre menores de quatro meses de idade.
Relationship between Transit's Usual and Actual Mode Shares
Authors: Chu Xuehao , Polzin Steven E.
Published: September 2008

One major source of transit mode share at the national level is the journey-to-work data from the U.S. Census Bureau's Decennial Census surveys conducted since 1960. These data can be used to determine transit's usual mode share, that is, the share of workers who state that they usually use transit for commuting. The relation of transit's usual mode share to its actual mode share, that is, the share of work trips made by transit as revealed by respondents to daily travel surveys, was studied. Theoretically, a simple aggregate model of workers who commute to work by transit or by nontransit means is built to establish a theoretical relationship between transit's usual and actual mode shares. This model establishes a necessary and sufficient condition for transit's usual share to be greater than its actual share. Empirically, the FHWA's 2001 National Household Travel Survey is used to measure transit's usual and actual mode shares for 34 transit market segments defined by 14 personal, household, and geographical characteristics. For each of the 34 transit market segments, the empirical results show that the necessary and sufficient condition is met and that transit's usual mode share is greater than its actual mode share. Furthermore, the degree to which transit's usual mode share is greater than its actual share is significant, ranging from 14.7% to 87.3%. Differences of such magnitude are too large to be ignored.
Toward Understanding and Reducing Errors in Real-Time Estimation of Travel Times
Authors: Kothuri Sirisha M. , Tufte Kristin A. , Fayed Enas , Bertini Robert L.
Published: September 2008

In recent years, the increased deployment of the infrastructure of intelligent transportation systems has enabled the provision of real-time traveler information to the public. Many states as well as private contractors are providing real-time travel-time estimates to commuters to help improve the quality and efficiency of their trips. Accuracy of travel-time estimates is important: inaccurate estimates can be detrimental to travelers, particularly when such estimates are less accurate than a person's ability to predict traffic on the basis of experience. Improving the accuracy of real-time estimates involves identifying and understanding the sources of error. The errors found during the evaluation of real-time travel-time estimates in Portland, Oregon, were explored and solutions are provided for reducing estimation error. The midpoint algorithm used by the Oregon Department of Transportation was used to estimate travel times from speeds obtained from loop detectors. The estimates were assessed for accuracy by comparisons with ground truth probe vehicle runs. The findings from the study indicate that 85% of the travel-time runs had errors less than 20% and, further, that accuracy varied widely between segments. The evaluation of high-error runs revealed the main causes of errors as transition traffic conditions, failure of detectors, and detector spacing. Potential solutions were identified for each source of error. In addition, a method was tested for evaluating the benefits of additional detectors by simulation of virtual detectors. The results indicated that additional detection helps in reducing the mean average percentage error in most cases, but the location of detectors is critical to error reduction.
Prototype Information System for Estimating Average Vehicle Occupancies from Traffic Accident Records
Authors: Gan Albert , Liu Kaiyu , Shen L. David , Jung Rax
Published: September 2008

Vehicle occupancy data are increasingly being used to assess and monitor congestion management strategies. They are traditionally collected in the field with the roadside windshield method and the carousel method. Although these traditional methods have the benefit of collecting up-to-date data and can be tailored to specific application needs, they are also much more costly to conduct, especially when repeated data collection is needed for monitoring purposes. An alternative to these traditional methods is to estimate average vehicle occupancies (AVOs) from vehicle occupancy information recorded in existing traffic accident records. This method is cost-effective because it involves no new data collection, and it can provide better spatial and temporal coverage. However, this method is also known to be affected by potential biases resulting from under-and overinvolvement of certain population sectors in traffic accidents. Also, for corridor studies, the number of accident records available may not meet the minimum required sample size for the desired accuracy. An effort was made to develop a prototype information system that can make use of vehicle occupancy information in accident data to estimate AVOs. The system was designed to account for driver's age and driver's gender biases. The system also includes a number of variables that can be used for spatial and temporal AVO monitoring, including district, county, hour, week, month, year, vehicle type, facility type, area type, and crash severity. A reasonableness check of the results from the system shows AVO estimates that are highly consistent with expectations.
Development of Regional Traffic Data for the Mechanistic–Empirical Pavement Design Guide
Authors: Swan D. J. , Tardif Robert , Hajek Jerry J. , Hein David K.
Published: September 2008

To obtain full benefits from the new Guide for Mechanistic–Empirical Design of New and Rehabilitated Pavement Structures (MEPDG), it is necessary to characterize pavement traffic loads using detailed traffic data, including axle load spectra. Preferably, the detailed traffic data should be site specific. In the absence of site-specific traffic data, default input data need to be used. Truck traffic data, collected as part of a periodic commercial traffic survey, were used to obtain the best possible default values for traffic input parameters required for the MEPDG. Default traffic input parameters were developed for two Ontario, Canada, regions. The sensitivity of the predicted pavement performance to changes in traffic input parameters was explored. There are several notable differences between the default traffic data inputs included in the MEPDG software and the regional traffic data inputs developed for Ontario, particularly in terms of axle load spectra. Axle load spectra for Ontario have a smaller number of heavily overloaded axles, and the peaks between loaded and unloaded axles are more pronounced. There are also notable differences between axle load spectra for northern and southern Ontario. Compared with southern Ontario, northern Ontario axle load spectra are heavier and have a large proportion of fully loaded axles. The number and type of trucks, followed by the axle load spectra, have the predominant influence on the predicted pavement performance. The MEPDG contains several input parameters that do not have any significant influence on the predicted pavement performance, namely, hourly traffic volume adjustment factors and axle spacing.
Travel Time Prediction
Authors: Wang Jianwei , Zou Nan , Chang Gang-Len
Published: September 2008

As reported in the literature for the applications of intelligent transportation systems with traffic detectors, various missing data patterns are frequently observed in such systems and may dramatically degrade their performance. This study presents two imputation approaches for contending with the missing data issues in travel time prediction. The first model is based on the concept of multiple imputation technique to predict directly the travel times under various missing data patterns. The second model that serves as the supplemental component is to estimate the missing detector values using neighboring detector data and historical traffic patterns. Both models have been incorporated with reliability indicators so as to assess the quality of imputed data and its applicability for use in prediction. The numerical example based on 10 roadside detectors on I-70 in Maryland has demonstrated that both developed models outperformed existing methods and offer the potential for field implementation.
Managed-Lanes Stated Preference Survey in Atlanta, Georgia
Authors: Hess Stephane , Smith Colin , Falzarano Stacey , Stubits Jevan
Published: September 2008

With the vast majority of choice modeling studies making use of data collected using stated preference (SP) surveys, there is considerable interest in the benefit of advanced survey techniques, such as efficient designs. Although there is a growing body of statistical evidence of the advantages of such advanced methods, there is still relatively little evidence from actual real-world studies. The findings of a large study in Atlanta, Georgia, making use of SP surveys in the context of road tolling initiatives are presented. The study has a rather special characteristic in that the data collection used survey questionnaires with various different experimental design approaches. This allowed direct comparison of the stated choice behavior across designs. Significant differences could be observed in a number of crucial indicators, such as the value of time and elasticities with respect to income and trip distance, depending on the design used. The analysis further showed that superior performance was obtained when use was made of an efficient design, while highlighting the disadvantages of random blocking approaches.
Disaggregating Freight Analysis Framework Version 2 Data for Florida
Authors: Viswanathan Krishnan , Beagan Daniel , Mysore Vidya , Srinivasan Nanda
Published: September 2008

Economic expansion and global trade over the past several decades have driven growth in demand for freight transportation in the United States. However, freight transportation capacity is expanding too slowly to keep up with demand, and freight productivity improvements gained through investment in the Interstate highway system and economic deregulation of the freight transportation industry in the 1980s are showing diminishing returns. In Florida, this problem is especially acute, because the population and employment in the state between 2001 and 2030 are expected to grow dramatically. For Florida to maintain its competitiveness in the face of this growth, a good understanding of freight and its impacts on the transportation network is needed. The Freight Analysis Framework Version 2.2 (FAF2) provides a wealth of information to understand and evaluate the impact of freight on the transportation network. To make FAF2 more applicable to state departments of transportation and metropolitan planning organizations (MPOs), it is necessary to disaggregate the FAF2 regional origin–destination (O-D) database to smaller geographies. Two potential audiences will find a disaggregated FAF2 O-D database useful. The first audience consists of MPO and state department of transportation modelers who want equations for inclusion in travel demand models that would estimate freight, and ultimately truck shipments, on the basis of population and employment. The second audience consists of planners who want the FAF2 tonnage information by detailed commodities at the county level of geography. The existence of the two groups suggests different methods. A methodology that satisfies both audiences was developed.
Somatosensory, motor, and reaching/grasping responses to direct electrical stimulation of the human cingulate motor areas
Authors: Chassagnon Serge , Minotti Lorella , Kremer Stéphane , Hoffmann Dominique , Kahane Philippe
Published: September 2008

Object

Surgery for frontal lobe drug-resistant epilepsies is often limited by the apparent widespread distribution of the epileptogenic zone. Recent advances in the parcellation of the medial premotor cortex give the opportunity to reconsider “seizures of the supplementary motor area” (SMA), and to assess the contribution of cingulate motor areas (CMAs), SMA proper (SMAp), and pre-SMA to the symptomatology of premotor seizures.

Methods

The authors reviewed the results of extraoperative electrical stimulation (ES) applied in 52 candidates for epilepsy surgery who underwent stereotactic intracerebral electroencephalographic recordings, focusing on ES of the different medial premotor fields; that is, the anterior and posterior CMA, the SMAp, and the pre-SMA. The ES sites were localized by superposition of the postoperative lateral skull x-ray and the preoperative sagittal MR imaging studies.

Results

Among 94 electrodes reaching the medial premotor wall, 57 responses were obtained from the anterior CMA (13 cases), the posterior CMA (11), the pre-SMA (18), and the SMAp (15). The ES of the pre-SMA and SMAp gave rise most often to a combination of motor (31 cases), speech-related (22), or somatosensory (3) elementary symptoms. The ES of the CMA yielded simple (17 of 24) more often than complex responses (7 of 24), among which sensory symptoms (7) were overrepresented. Irrepressible exploratory reaching/grasping movements were elicited at the vicinity of the cingulate sulcus, from the anterior CMA (3 cases) or the pre-SMA (1). Clinical responses to ES were not predictive of the postoperative neurological outcome.

Conclusions

These findings might be helpful in epilepsy surgery candidates, to better target investigation of the CMA, pre-SMA, and SMAp, and therefore to provide a better understanding of premotor seizures.
Deep brain stimulation in the treatment of obesity
Authors: Halpern Casey H. , Wolf John A. , Bale Tracy L. , Stunkard Albert J. , Danish Shabbar F. , Grossman Murray , Jaggi Jurg L. , Grady M. Sean , Baltuch Gordon H.
Published: September 2008

Obesity is a growing global health problem frequently intractable to current treatment options. Recent evidence suggests that deep brain stimulation (DBS) may be effective and safe in the management of various, refractory neuropsychiatric disorders, including obesity. The authors review the literature implicating various neural regions in the pathophysiology of obesity, as well as the evidence supporting these regions as targets for DBS, in order to explore the therapeutic promise of DBS in obesity.

The lateral hypothalamus and ventromedial hypothalamus are the appetite and satiety centers in the brain, respectively. Substantial data support targeting these regions with DBS for the purpose of appetite suppression and weight loss. However, reward sensation associated with highly caloric food has been implicated in overconsumption as well as obesity, and may in part explain the failure rates of conservative management and bariatric surgery. Thus, regions of the brain's reward circuitry, such as the nucleus accumbens, are promising alternatives for DBS in obesity control.

The authors conclude that deep brain stimulation should be strongly considered as a promising therapeutic option for patients suffering from refractory obesity.
Deep brain stimulation as an effective treatment option for post–midbrain infarction-related tremor as it presents with Benedikt syndrome
Authors: Bandt S. Kathleen , Anderson Douglas , Biller Jose
Published: September 2008

Benedikt syndrome is a rare but debilitating constellation of symptoms that manifests from infarction of the red nucleus, cerebral peduncle, oculomotor fascicles, and lower oculomotor nucleus. Clinically, it presents as ipsilateral cranial nerve III palsy, contralateral hemiataxia with intention tremor, contralateral hemiparesis, and hyperactive tendon reflexes. Commonly, the tremor upon purposeful movement proves to be the most debilitating manifestation of the infarction with significant impact on the patient's ability to perform activities of daily living and, therefore, quality of life. The authors report the successful management of this debilitating post–midbrain infarction tremor with the insertion of a deep brain stimulator with targets in the contralateral lenticular fasciculus.
Factors involved in long-term efficacy of deep brain stimulation of the thalamus for essential tremor
Authors: Pilitsis Julie G. , Metman Leo Verhagen , Toleikis John R. , Hughes Lindsay E. , Sani Sepehr B. , Bakay Roy A. E.
Published: September 2008

Object

Although nucleus ventralis intermedius stimulation has been shown to be safe and efficacious in the treatment of essential tremor, there is a subset of patients who eventually lose benefit from their stimulation. Proposed causes for this phenomenon include tolerance, disease progression, and suboptimal location. The goal of this study was to assess the factors that may lead to both stimulation failure, defined as loss of meaningful tremor relief, and less satisfactory outcomes, defined as leads requiring voltages > 3.6 V for effective tremor control.

Methods

The authors present their clinical outcomes from 31 leads in 27 patients who had effective tremor control for > 1 year following nucleus ventralis intermedius stimulation. All patients postoperatively had a mean decrease in both the writing and drawing subscales of the Fahn-Tolosa-Marin Tremor Rating Scale (p < 0.001).

Results

After a mean follow-up of 40 months, 22 patients continued to have tremor control with stimulation. Four patients eventually lost efficacy of their stimulation at a mean of 39 months. There was no difference in age, duration of disease, or disease severity between the groups. Examination of perioperative factors revealed that suboptimal anteroposterior positioning as evidenced on intraoperative fluoroscopy occurred significantly more frequently in patients with stimulation failure (p = 0.018). In patients with less satisfactory outcomes, no difference was seen between group demographics. Fluoroscopy again revealed suboptimal positioning more frequently in these patients (p = 0.005).

Conclusions

This study provides further evidence that suboptimal lead position in combination with disease progression or tolerance may result in less satisfactory long-term outcomes.
Relationship of “dose” of intracranial hypertension to outcome in severe traumatic brain injury
Authors: Vik Anne , Nag Torbjørn , Fredriksli Oddrun Anita , Skandsen Toril , Moen Kent Gøran , Schirmer-Mikalsen Kari , Manley Geoffrey T.
Published: September 2008

Object

It has recently been suggested that the degree of intracranial pressure (ICP) above the treatment goal can be estimated by the area under the curve (AUC) of ICP versus time in patients with severe traumatic brain injury (TBI). The objective of this study was to determine whether the calculated “ICP dose”—the ICP AUC—is related to mortality rate, outcome, and Marshall CT classification.

Methods

Of 135 patients (age range 1–82 years) with severe TBI treated during a 5-year period at the authors' institution, 113 patients underwent ICP monitoring (84%). Ninety-three patients with a monitoring time > 24 hours were included for analysis of ICP AUC calculated using the trapezoidal method. Computed tomography scans were assessed according to the Marshall TBI classification. Patients with Glasgow Outcome Scale scores at 6 months and > 3 years were separated into 2 groups based on outcome.

Results

Sixty patients (65%) had ICP values > 20 mm Hg, and 12 (13%) developed severe intracranial hypertension and died secondary to herniation. A multiple regression analysis adjusting for Glasgow Coma Scale score, age, pupillary abnormalities and Injury Severity Scale score demonstrated that the ICP AUC was a significant predictor of poor outcome at 6 months (p = 0.034) and of death (p = 0.035). However, it did not predict long-term outcome (p = 0.157). The ICP AUC was significantly higher in patients with Marshall head injury Categories 3 and 4 (24 patients) than in those with Category 2 (23 patients, p = 0.025) and Category 5 (46 patients, p = 0.021) TBIs using the worst CT scan obtained.

Conclusions

The authors found a significant relationship between the dose of ICP, the worst Marshall CT score, and patient outcome, suggesting that the AUC method may be useful in refining and improving the treatment of ICP in patients with TBI.
Brain biopsy in patients with suspected Creutzfeldt–Jakob disease
Authors: Heinemann Uta , Krasnianski Anna , Meissner Bettina , Kallenberg Kai , Kretzschmar Hans A. , Schulz-Schaeffer Walter , Zerr Inga
Published: September 2008

Object

Creutzfeldt–Jakob disease (CJD) is a rare neurodegenerative disorder with diagnostic criteria defined as a combination of clinical symptoms, electroencephalography findings, cerebrospinal fluid (CSF) analysis, and MR imaging results. Special subtypes are known to present with an atypical course and test findings that can complicate the clinical diagnosis. In such patients a brain biopsy can support the clinical approach.

Methods

The authors studied the records on 26 brain biopsies conducted in patients with suspected CJD who had been referred to the CJD Surveillance Unit in Germany between 1993 and 2005.

Results

Of the 26 included patients, 11 suffered from neuropathologically confirmed CJD, which in 5 cases had been deemed clinically “probable” and in 2 had been deemed “possible.” The disease in the remaining 4 patients had been categorized as “other” prior to neuropathological confirmation of CJD. The results of 15 brain biopsies showed no features of prion disease. None of these 15 patients had received a probable diagnosis of CJD, 4 had a possible diagnosis, and 11 had received a diagnosis of “other.” Three of the cases classified as other and none of those with CJD presented with pleocytosis in the CSF. In 73% of the other cases, biopsy sampling did not reveal any results characteristic of CJD but did not provide specific findings on which to base a differential diagnosis. Autopsy confirmed the biopsy diagnosis of CJD in all cases, and additionally confirmed that CJD was not present in 3 patients who had nondiagnostic biopsy results.

Conclusions

Biopsy sampling may be helpful in the diagnostic approach to rare cases of dementia for which a reliable diagnosis cannot be established on the basis of clinical symptoms, CSF parameters, electroencephalography, and MR imaging results.
Management of Cushing's disease: outcome in patients with microadenoma detected on pituitary magnetic resonance imaging
Authors: Prevedello Daniel M. , Pouratian Nader , Sherman Jonathan , Jane John A. , Vance Mary Lee , Lopes M. Beatriz , Laws Edward R.
Published: September 2008

Object

Outcomes of therapy for Cushing's disease (CD) vary depending on different aspects of presentation and diagnostic studies. The authors designed this study to verify the remission rate and outcomes after transsphenoidal surgery (TSS) for patients with CD who had positive findings on MR imaging.

Methods

Patients who had presented with CD at the University of Virginia for initial treatment between July 1992 and December 2005 were retrospectively reviewed. The patients included in the study were considered to be optimal surgical candidates, defined as an adult (> 18 years of age) with classic clinical features of CD, laboratory studies confirming a central (pituitary/hypothalamic) adrenocorticotropic hormone–dependent source of disease, and an MR imaging study revealing a microadenoma in the sella turcica.

Results

A total of 167 patients fulfilled the criteria. Thirty were men (18%) and 137 were women (82%). The mean age was 42.3 years (range 18.2–77 years). All patients underwent TSS. Surgical remission was achieved in 148 patients (88.6%), which was correlated with the surgeon's intraoperative identification of an adenoma (p = 0.03). Histopathological confirmation of an adrenocorticotropic hormone–secreting adenoma strongly correlated with remission (p = 0.0001). Three patients (1.8%) had postoperative cerebrospinal fluid leaks, and 1 patient had meningitis. Transient diabetes insipidus was diagnosed and treated in 10 patients (6%), whereas permanent diabetes insipidus occurred in 8 patients (4.8%). Panhypopituitarism followed the surgery in 14 patients (8.3%), 13 of whom underwent total hypophysectomy (9 initially and 4 with early reoperations), and in 1 of 10 patients who underwent subtotal hypophysectomy. Nineteen patients (12.8%) who were initially in remission developed recurrent CD after an average of 50 months. The mean follow-up for the 167 patients was 39 months (range 6–157 months). Gamma Knife surgery was the most common modality of radiotherapy used to treat 31 patients (18.5%) who did not achieve remission or later presented with recurrent disease. Bilateral adrenalectomies were performed in 10 patients in the series (6%), 2 of whom developed Nelson's syndrome. The overall posttreatment remission rate was 95.8%.

Conclusions

Even in patients with ideal diagnostic criteria of CD, there remain a significant number of cases in which TSS alone is not adequate to assure long-lasting remission. A multidisciplinary approach is essential to the achievement of satisfactory overall remission rates.