bluuebunny/crossref_metadata_2025 huggingface dataset:
A Case of Isolated Elevated Copper Levels during Pregnancy
Authors: Walker LaToya R. , Rattigan Meghan , Canterino Joseph
Published: July 2011

Introduction. Outside of Wilson's Disease, abnormal copper metabolism is a rare condition. In pregnancy, excess copper levels can be associated with intrauterine growth restriction, preeclampsia and neurological disease.Case Report. A 32 year old Gravida 4 para 2012 with an obstetrical history complicated by elevated copper levels presented for routine prenatal care. Her children had elevated copper levels at birth, with her firstborn child being diagnosed with autism and suffering three myocardial infarctions and being treated for elevated copper levels. During her prior pregnancies, she declined treatment for her elevated copper levels. During this pregnancy, she had declined chelation therapy and instead choose zinc therapy. She delivered a healthy infant with normal copper levels.Conclusion. Alterations in copper metabolism are rare, the consequences in pregnancy can be devastating. While isolated elevations of copper in pregnancy is exceedingly rare, it is treated the same as Wilson's disease. The goal is to prevent fetal growth restricting and neurological sequelae in the newborn and preeclampsia in the mother. Counseling, along with treatment options and timely delivery can greatly improve neonatal and maternal outcome.
A Wiener‐Laguerre Model of VIV Forces Given Recent Cylinder Velocities
Authors: Mainçon Philippe
Published: July 2011

Slender structures immersed in a cross flow can experience
vibrations induced by vortex shedding (VIV), which
cause fatigue damage and other problems. VIV models
that are used in structural design today tend to assume
harmonic oscillations in some way or other. A time domain
model would allow to capture the chaotic nature of
VIV and to model interactions with other loads and nonlinearities.
Such a model was developed in the present
work: for each cross section, recent velocity history is
compressed using Laguerre polynomials. The compressed
information is used to enter an interpolation function to
predict the instantaneous force, allowing to step the dynamic
analysis. An offshore riser was modeled in this way:
some analyses provided an unusually fine level of realism,
while in other analyses, the riser fell into an unphysical
pattern of vibration. It is concluded that the concept is
promising, yet that more work is needed to understand
orbit stability and related issues, in order to produce an
engineering tool.
ISD: A New Methodological Approach for Measuring the Sustainability of the German Energy System
Authors: Schlör Holger , Fischer Wolfgang , Hake Jürgen-Friedrich
Published: July 2011

The research community has developed three main concepts and indicator systems to measure sustainability: the capital concept, the ecological concept and the multidimensional concept. Whereas a lot of research has been dedicated to the pros and cons of the three/four‐pillar sustainability concept, to the shaping of the pillars and their indicators, research on standardized methods to aggregate the indicators to one index is lacking. However, a useful model exists—the GDP—which summarizes the different economic activities of various social actors in one index. An overall sustainability index has the advantage that the sustainability of a system can be expressed in one index. This allows the sustainability status of a system to be better communicated both to the public and to politicians. Against this background, we developed the Index of Sustainable Development (ISD) to measure the sustainability of systems described by multidimensional sustainability concepts. We demonstrate that it is possible to aggregate sustainability indicators of the multidimensional sustainability concepts to one index. We have chosen exemplarily the German sustainability strategy and selected the energy indicators within it because of the importance of the energy sector and due to the good statistical database in this sector.
Association between Six Environmental Chemicals and Lung Cancer Incidence in the United States
Authors: Luo Juhua , Hendryx Michael , Ducatman Alan
Published: July 2011

Background.An increased risk of lung cancer has been observed at exposure to certain industrial chemicals in occupational settings; however, less is known about their carcinogenic potential to the general population when those agents are released into the environment.Methods.We used the Toxics Release Inventory (TRI) database and Surveillance, Epidemiology, and End Results (SEER) data to conduct an ecological study at the county level. We used multiple linear regression to assess the association of age-adjusted lung cancer incidence with the quantities of on-site air and water releases of six selected industrial chemicals including arsenic, 1,3 butadiene, cadmium, chromium, formaldehyde, and nickel after controlling for other risk variables.Results.Overall, we observed a significantly increased risk of lung cancer incidence associated with releases of chromium, formaldehyde, and nickel. The links were present for both males and females. Significant effects were present in nonmetropolitan but not metropolitan counties. Releases of arsenic, 1,3 butadiene, and cadmium were reported by small numbers of facilities, and no relationships to lung cancer incidence were detected.Conclusions.Our results suggest that environmental exposure to chromium, formaldehyde, and nickel from TRI sites may increase population risk of lung cancer. These findings need to be confirmed in individual-level studies, but in congruence with the precautionary principle in environmental science, support prudent efforts to limit release of these agents into the environment.
Optimizing Anterior En Masse Retraction with Miniscrew Anchorage
Authors: Vibhute Pavankumar Janardan
Published: July 2011

In severely protrusive patients, skeletal anchorage from miniscrew is often used to avoid anchorage loss with preferred miniscrew location near centre of resistance (Cres) of posterior teeth. Biomechanical requirement for directing retraction force towards Cres of posterior teeth demands the insertion of miniscrew in loose mucosa, where risk of infection and failure increases. In addition, undesirable biomechanical side effects on anterior and posterior segments may be possible in all three planes, when continuous arch sliding mechanics are installed with miniscrew anchorage. This paper describes technique of molar-stabilizing power arm (MSPA) for simultaneous intrusion and retraction of anteriors with miniscrew placement at attached gingiva between 1st molar and 2nd premolar. Advantages of this technique include (i) the need of miniscrews placement in loose mucosa apically near the Cres of the posterior teeth is eliminated, (ii) the risk of infection and miniscrew failure is lowered since the miniscrew is placed in attached gingiva rather than the loose mucosa, and (iii) by adjusting vertical length or replacing MSPA, alteration of the retraction force vector is possible in all three planes; thus, need of removal and repositioning of the miniscrew (e.g., in correction of occlusal cant) can be eliminated.
Management of Worsening Aortic Dilation and Insufficiency in a 20-Week Pregnant Woman: A Case Report
Authors: Shah Amy , Schwarzenberger Johanna , Gui Dorina , Hong Richard , Chen Angela
Published: July 2011

Preexisting aortic disease can worsen during pregnancy as physiologic hemodynamic changes evolve. At a large academic institution, a patient with a remote history of vasculitis presented with a second trimester pregnancy with increasing aortic dilatation and aortic insufficiency. Extensive obstetric discussions encompassed maternal cardiac risks from continuing the pregnancy and fetal risks from maternal cardiac intervention. This patient desired termination of pregnancy to avoid further complications and to expedite surgical aortic repair.
Electrooxidation of Hydrogen on Ni-Organic Metal Complex Catalysts in Acidic Media for PEMFCs
Authors: Lin Rui , Qiao Jinli , Zhang Haiyan , Cao Chunhui , Fu Jing , Ma Jianxin
Published: July 2011

Novel organic metal complexes with N2O2coordination structure which showed high hydrogen oxidation reaction were synthesized. The catalytic activity was found to strongly depend on the heat-treatment temperature and the structural properties.
Multifaceted Assessment of Chronic Gastritis: A Study of Correlations between Serological, Endoscopic, and Histological Diagnostics
Authors: Takao Toshitatsu , Ishikawa Takeshi , Ando Takashi , Takao Madoka , Matsumoto Tsuguhiro , Isozaki Yutaka , Okita Mika , Nagao Yasuyuki , Oyamada Hirokazu , Yokoyama Keiichi , Tatebe Atsushi , Uchiyama Kazuhiko , Handa Osamu , Takagi Tomohisa , Yagi Nobuaki , Kokura Satoshi , Naito Yuji , Yoshikawa Toshikazu
Published: July 2011

Aim. Chronic gastritis was assessed serologically, endoscopically and histologically to identify correlations between these methods.Methods. Subjects comprised 319 patients who had provided informed consent. Serological assessment of chronic gastritis was based on the pepsinogen test method. Endoscopic gastritis and histological gastritis were assessed and scored according to the Kimura-Takemoto classification system and the updated Sydney classification system respectively, and correlations between these three methods were studied.Results. Pepsinogen I/II ratio showed a significant correlation to the extent of mononuclear cell infiltration of the gastric corpus. When histological gastritis was divided, on the basis of the distribution of mononuclear cell infiltration, into gastritis limited to the antrum and corpus gastritis, these types were distinguished with high accuracy using a pepsinogen I/II ratio of 3 as the cutoff. A good correlation was also seen between pepsinogen I/II ratio and development of atrophy in endoscopic gastritis, where groups with and without advanced atrophy were also distinguished with high accuracy using a cutoff value of 3.Conclusion. Significant correlations exist between serum pepsinogen levels, endoscopic gastritis, and histological gastritis. Pepsinogen I/II ratio allows prediction of the existence of endoscopic gastritis and histological gastritis, or the extent of their development, with high accuracy.
A Defect‐Correction Method for Time‐Dependent Viscoelastic Fluid Flow Based on SUPG Formulation
Authors: Zhang Yunzhang , Hou Yanren , Yang Ganshan
Published: July 2011

A defect‐correction mixed finite element method for solving the time‐dependent
Johnson‐Segalman viscoelastic equations in two dimensions is given. In
the defect step, the constitutive equation is computed with the artificially
reduced Weissenberg parameter for stability, and the resulting residual is
corrected in the correction step on the same grid. A streamline upwind
Petrov‐Galerkin (SUPG) approximation is used to stabilize the hyperbolic
character of the constitutive equation for the stress. We establish a priori
error estimates for the defect step and the first correction step of the defect
correction method. The derived theoretical results are supported by
numerical tests.
Study of Thermodynamically Inspired Quantities for Both Thermal and External Colored Non-Gaussian Noises Driven Dynamical System
Authors: Sen Monoj Kumar , Baura Alendu , Bag Bidhan Chandra
Published: July 2011

We have studied dynamics of both internal and external noises-driven dynamical system in terms of information entropy at both nonstationary and stationary states. Here a unified description of entropy flux and entropy production is considered. Based on the Fokker-Planck description of stochastic processes and the entropy balance equation we have calculated time dependence of the information entropy production and entropy flux in presence and absence of nonequilibrium constraint (NEC). In the presence of NEC we have observed extremum behavior in the variation of entropy production as function of damping strength, noise correlation, and non-Gaussian parameter (which determine the deviation of external noise behavior from Gaussian characteristic), respectively. Thus the properties of noise process are important for entropy production.
Using Spectral-Domain Optical Coherence Tomography to Follow Outer Retinal Structure Changes in a Patient with Recurrent Punctate Inner Choroidopathy
Authors: Stepien Kimberly E. , Carroll Joseph
Published: July 2011

Punctate inner choroidopathy (PIC) is a rare idiopathic inflammatory disorder of the retina and choroid usually affecting healthy, young, myopic females and presenting with photopsia, paracentral scotomata, and blurred vision. It is characterized by yellow-white chorioretinal lesions concentrated in the posterior pole, no vitritis, relapsing inflammatory activity of the retina and choroid, and frequent development of choroidal neovascular membranes. Here we describe a case in which spectral-domain optical coherence tomography (SD-OCT) imaging was used to monitor outer retinal structure changes associated with recurrent PIC over time. SD-OCT, which is both quantative and objective, provides an efficient, non-invasive way to follow recurrent inflammatory chorioretinal lesion activity, choroidal neovascular membrane development, and treatment response in patients with recurrent PIC.
The Role of Lymphadenectomy in Surgical Staging of Endometrial Cancer
Authors: Neubauer Nikki L. , Lurain John R.
Published: July 2011

Surgical staging, including lymph node sampling, for endometrial cancer was adopted by the International Federation of Gynecology and Obstetrics (FIGO) in 1988 based on reports demonstrating diagnostic and therapeutic advantages. This review focuses on the incidence of lymph node metastasis, risk factors for lymph node involvement, the effect of lymph node metastasis on prognosis, the therapeutic effect and diagnostic usefulness of lymphadenectomy, risks of lymph node dissection, and future directions in surgical staging of endometrial cancer. Surgical staging identifies most patients with extrauterine disease as well as uterine risk factors for recurrence, thereby allowing for a more informed approach to postoperative adjuvant therapy. Lymphadenectomy as a part of surgical staging is not required in patients assessed intraoperatively to be at low risk for lymph node metastasis (<2 cm grade 1 tumors with superficial myometrial invasion), however, a systematic lymph node dissection should be performed in most other patients with endometrial cancer. In the future, molecular markers may be useful to predict preoperatively tumor aggressiveness and lymph node metastasis. It is hoped that an approach of surgical staging with selective lymph node dissection will improve survival and spare patients additional surgical complications or unnecessary postoperative exposure to radiation and/or chemotherapy.
Optimal Sliding Mode Controllers for Attitude Stabilization of Flexible Spacecraft
Authors: Pukdeboon Chutiphon
Published: July 2011

The robust optimal attitude control problem for a flexible spacecraft is considered. Two optimal sliding mode control laws that ensure the exponential convergence of the attitude control system are developed. Integral sliding mode control (ISMC) is applied to combine the first‐order sliding mode with optimal control and is used to control quaternion‐based spacecraft attitude manoeuvres with external disturbances and an uncertainty inertia matrix. For the optimal control part the state‐dependent Riccati equation (SDRE) and optimal Lyapunov techniques are employed to solve the infinite‐time nonlinear optimal control problem. The second method of Lyapunov is used to guarantee the stability of the attitude control system under the action of the proposed control laws. An example of multiaxial attitude manoeuvres is presented and simulation results are included to verify the usefulness of the developed controllers.
Postoperative Bowel Perforation due to Heterotopic Ossification (Myositis Ossificans Traumatica): A Case Report and Review of the Literature
Authors: Lao Victoria Valinluck , Lao Oliver B. , Figueredo Edgar
Published: July 2011

Heterotopic ossification (HO) is the ectopic development of normal bone within soft tissue that can occur after traumatic injury. It is uncommon and may be missed or misdiagnosed, which can lead to complications. We report the case of an 84-year-old male with a previous history of a laparotomy who underwent resection of an intra-abdominal tumor through a midline incision. On postoperative day six, the patient was taken to the operating room, as succus was draining from the incision. Upon re-exploration, sharp bone-like material was found in the wound directly adjacent to an enterotomy. Pathology confirmed mature lamellar bone and the diagnosis of HO. This is the first report of postoperative intestinal perforation secondary to HO in a midline wound. We report this case to encourage accurate reporting of HO and its morbidity and complications for the benefit of appropriate surgical planning and epidemiologic tracking of outcomes.
Anti-Glutamic Acid Decarboxylase Antibody-Associated Ataxia as an Extrahepatic Autoimmune Manifestation of Hepatitis C Infection: A Case Report
Authors: Awad Amer , Stüve Olaf , Mayo Marlyn , Alkawadri Rafeed , Estephan Bachir
Published: July 2011

Extrahepatic immunological manifestations of hepatitis C virus (HCV) are well described. In addition, antiglutamic acid decarboxylase (GAD) antibody-associated cerebellar ataxia is well-established entity. However, there have been no reports in the literature of anti-GAD antibody-associated ataxia as an extrahepatic manifestation of HCV infection. We report the case of a young woman with chronic hepatitis C virus and multiple extrahepatic autoimmune diseases including Sjögren syndrome and pernicious anemia who presented with subacute midline cerebellar syndrome and was found to have positive antiglutamic acid decarboxylase (GAD) antibody in the serum and cerebrospinal fluid. An extensive diagnostic workup to rule out neoplastic growths was negative, suggesting the diagnosis of nonparaneoplastic antiglutamic acid decarboxylase antibody-associated cerebellar ataxia as an additional extrahepatic manifestation of hepatitis C virus infection. The patient failed to respond to high-dose steroids and intravenous immunoglobulin. Treatment with the monoclonal antibody rituximab stabilized the disease. We postulate that anti-GAD associated ataxia could be an extrahepatic manifestation of HCV infection.
Stereotactic Body Radiosurgery for Spinal Metastatic Disease: An Evidence-Based Review
Authors: Hall William A. , Stapleford Liza J. , Hadjipanayis Costas G. , Curran Walter J. , Crocker Ian , Shu Hui-Kuo G.
Published: July 2011

Spinal metastasis is a problem that afflicts many cancer patients. Traditionally, conventional fractionated radiation therapy and/or surgery have been the most common approaches for managing such patients. Through technical advances in radiotherapy, high dose radiation with extremely steep drop off can now be delivered to a limited target volume along the spine under image-guidance with very high precision. This procedure, known as stereotactic body radiosurgery, provides a technique to rapidly treat selected spinal metastasis patients with single- or limited-fraction treatments that have similar to superior efficacies compared with more established approaches. This review describes current treatment systems in use to deliver stereotactic body radiosurgery as well as results of some of the larger case series from a number of institutions that report outcomes of patients treated for spinal metastatic disease. These series include nearly 1400 patients and report a cumulative local control rate of 90% with myelopathy risk that is significantly less than 1%. Based on this comprehensive review of the literature, we believe that stereotactic body radiosurgery is an established treatment modality for patients with spinal metastatic disease that is both safe and highly effective.
Successful Pregnancy after Simultaneous Pancreas-Kidney Transplantation
Authors: Smyth A. , Gaffney G. , Hickey D. , Lappin D. , Reddan D. , Dunne F.
Published: July 2011

The effect of pregnancy on simultaneous pancreas-kidney transplant recipients has previously been described, but experience is limited. We describe the case of a thirty-five-year-old female who previously underwent simultaneous pancreas-kidney transplant for type 1 diabetes mellitus-complicated nephropathy. An integrated multidisciplinary team including the transplant team, nephrologist, endocrinologist, and obstetrician closely followed progress during pregnancy. Blood glucose levels and HbA1c remained within normal limits, and she did not require insulin treatment at any point. She experienced deterioration in renal indices and underwent an uncomplicated, elective Caesarean section at thirty-week gestation. She delivered a male infant of 1.18 kg, appropriate for gestational age, who had hypothermia and respiratory distress, which required intubation and ventilation and an eleven-week stay in the special care baby unit. At eighteen-month followup the infant shows normal development, and there has been no deterioration in either grafts' function.
p53-Dependent BRCA1 Nuclear Export Controls Cellular Susceptibility to DNA Damage
Authors: Jiang Juhong , Yang Eddy S. , Jiang Guochun , Nowsheen Somaira , Wang Hong , Wang Tong , Wang Yihan , Billheimer Dean , Chakravarthy A. Bapsi , Brown Melissa , Haffty Bruce , Xia Fen
Published: July 2011

Subcellular localization regulates BRCA1 function, and BRCA1 is exported to the cytoplasm following DNA damage in a p53-dependent manner. Because more than 50% of solid tumors harbor p53 mutations, it is possible that genetically wild-type (wt) BRCA1 is functionally abnormal through compromised nuclear-cytoplasmic shuttling in sporadic breast cancer patients with dysfunctional p53. In this study, we have investigated the mechanisms of p53-dependent BRCA1 subcellular distribution and DNA damage-induced nuclear export, as well as the impact on the resulting cytotoxic response to therapy in human breast cancer. We first show that p53 mediates BRCA1 nuclear export via protein–protein binding, rather than by modulation of its transcription. Furthermore, it is the C-terminal (BRCT) region of BRCA1 that is critical for its interaction with p53, and p53 may promote BRCA1 nuclear export by interrupting the association of BRCA1 with BARD1. In sporadic breast cancer specimens, dysfunctional p53 strongly correlates with nuclear retention of sequence-verified wt BRCA1. This p53-dependent BRCA1 shuttling determines cellular susceptibility to DNA damage as augmentation of cytosolic BRCA1 significantly enhances cancer cell susceptibility to ionizing radiation. Taken together, our data suggest that p53 dysfunction compromises nuclear export of wt BRCA1 as a mechanism to increase cellular resistance to DNA damage in sporadic breast cancer. We propose that targeting nuclear BRCA1 to the cytoplasm may offer a unique strategy to sensitize p53-deficient sporadic breast cancers to DNA damage–based therapy. Cancer Res; 71(16); 5546–57. ©2011 AACR.
IL-12 Release by Engineered T Cells Expressing Chimeric Antigen Receptors Can Effectively Muster an Antigen-Independent Macrophage Response on Tumor Cells That Have Shut Down Tumor Antigen Expression
Authors: Chmielewski Markus , Kopecky Caroline , Hombach Andreas A. , Abken Hinrich
Published: July 2011

During malignant progression cancer cells tend to lose cell surface expression of MHC and other immune antigens, making them invisible to cytotoxic T cells and therefore inaccessible to tumor antigen-directed immunotherapy. Moreover, cancer cell variants that have lost antigen expression frequently contribute to deadly tumor relapses that occur following treatments that had been initially effective. In an effort to destroy antigen-loss cancer cells in tumors, we created a strategy that combines a chimeric antigen receptor (CAR)-redirected T-cell attack with an engineered local release of the cytokine interleukin 12 (IL-12), which recruits and reinforces macrophage function. Cytotoxic T cells were engineered to release inducible IL-12 upon CAR engagement in the tumor lesion, resulting in destruction of antigen-loss cancer cells that would normally escape. Importantly, elimination of the antigen-loss cancer cells was accompanied by an accumulation of activated macrophages that was critical to the antitumor response, because removing the macrophages abolished the response and restoring them reengaged it. Neutralizing TNF-α also abrogated the elimination of antigen-loss cancer cells, implying this proinflammatory factor in the process. Taken together, our results show how IL-12 supplementation by CAR T cells can target otherwise inaccessible tumor lesions, in a manner associated with reduced systemic toxicity, by recruiting and activating innate immune cells for a proinflammatory response. Cancer Res; 71(17); 5697–706. ©2011 AACR.
A Gene Expression Signature from Peripheral Whole Blood for Stage I Lung Adenocarcinoma
Authors: Rotunno Melissa , Hu Nan , Su Hua , Wang Chaoyu , Goldstein Alisa M. , Bergen Andrew W. , Consonni Dario , Pesatori Angela C. , Bertazzi Pier Alberto , Wacholder Sholom , Shih Joanna , Caporaso Neil E. , Taylor Phil R. , Landi Maria Teresa
Published: July 2011

Affordable early screening in subjects with high risk of lung cancer has great potential to improve survival from this deadly disease. We measured gene expression from lung tissue and peripheral whole blood (PWB) from adenocarcinoma cases and controls to identify dysregulated lung cancer genes that could be tested in blood to improve identification of at-risk patients in the future. Genome-wide mRNA expression analysis was conducted in 153 subjects (73 adenocarcinoma cases, 80 controls) from the Environment And Genetics in Lung cancer Etiology study using PWB and paired snap-frozen tumor and noninvolved lung tissue samples. Analyses were conducted using unpaired t tests, linear mixed effects, and ANOVA models. The area under the receiver operating characteristic curve (AUC) was computed to assess the predictive accuracy of the identified biomarkers. We identified 50 dysregulated genes in stage I adenocarcinoma versus control PWB samples (false discovery rate ≤0.1, fold change ≥1.5 or ≤0.66). Among them, eight (TGFBR3, RUNX3, TRGC2, TRGV9, TARP, ACP1, VCAN, and TSTA3) differentiated paired tumor versus noninvolved lung tissue samples in stage I cases, suggesting a similar pattern of lung cancer–related changes in PWB and lung tissue. These results were confirmed in two independent gene expression analyses in a blood-based case–control study (n = 212) and a tumor–nontumor paired tissue study (n = 54). The eight genes discriminated patients with lung cancer from healthy controls with high accuracy (AUC = 0.81, 95% CI = 0.74–0.87). Our finding suggests the use of gene expression from PWB for the identification of early detection markers of lung cancer in the future. Cancer Prev Res; 4(10); 1599–608. ©2011 AACR.
Reaction to the Major Contribution: Training for Skills Competency in Counseling Psychology
Authors: Nutt Roberta L.
Published: July 2011

The authors of the Major Contribution have developed a complex and elegant three-level training model on which they suggest advanced microskills may be built. Prior to the description of their model, they have built a case that current microskills training has proved foundationally important but insufficient to training needs. They then invite colleagues to evaluate their model for viability and utility.

This reaction suggests that the model could be enriched by incorporating survey data regarding how doctoral programs are currently teaching advanced psychotherapy/counseling skills, outcome data from common factors and master therapists’ research, and the APA Competency Benchmarks work. In addition, the contribution contains a detailed, very useful teaching application, and some similarly detailed research suggestions would be helpful to encourage research on the model.
Therapeutic Change
Authors: Mollen Debra , Kelly Shannon M. , Ridley Charles R.
Published: July 2011

In this rejoinder, the authors respond to the comments, feedback, and suggestions offered by Hatcher, Miville, and Nutt. The authors clarify a possible point of confusion, reaffirm their contention that the crux of sound psychology practice rests on therapists’ ability to facilitate change with their clients, and acknowledge both the progressive development that characterizes the process of becoming a competent counselor and the problem of assuming advanced training alone can compensate for the limitations inherent in the microskills-only approach to training. Next, the authors address the issue of complexity, including their intention to balance the need to provide a coherent, accessible model that does not fall prey to oversimplification. Finally, the authors note key similarities to and differences from the competency benchmarks and invite their colleagues to join them in the rigorous testing needed to validate their model of counseling competence.
Challenges to Party Development and Democratic Consolidation: Perspectives on Reforming Ghana’s Institutional Framework
Authors: Fobih Nick
Published: July 2011

The second half of the twentieth century witnessed the emergence of the party system and democracy in African countries, for example Ghana, in the period preceding the postcolonial era. This article looks at some of the challenges facing Ghana’s democratic consolidation and party development, and some of the institutional benchmarks required to help to promote effectively an accountable, participatory and democratic party system in the country in order to consolidate further its democracy. The study concludes with the view that regardless of their apparent weaknesses, political parties in Ghana are generally important institutions that grease the wheels of the country’s democratic governance in the post-transition era.
Civil War Diffusion and Regional Motivations for Intervention
Authors: Kathman Jacob D.
Published: July 2011

Third-party states consider the regional destabilization consequences of civil wars when deciding to intervene. However, previous work implicitly assumes that potential interveners base their intervention decisions solely on their links to the civil war country. This approach is unlikely to reflect the regional concerns of interested parties. When a civil war is increasingly likely to infect its surrounding region, potential interveners with strong interests in those states neighboring the conflict will be more likely to intervene to contain the violence. Thus, relationships outside the civil war state—intervener dyad are causally associated with intervention. To test these arguments, the author accounts for the contagious properties of civil wars and the regional interests of third parties, constructing dynamic measures to represent the contagion threat posed to third party regional interests. Analyses of these measures support the argument that third parties are increasingly likely to intervene as the risk of diffusion increasingly threatens their regional interests.
Gene Regulation in S. mutans
Authors: Smith E.G. , Spatafora G.A.
Published: July 2011

Dental caries is a chronic infectious disease of multifactorial etiology that derives from the interplay among cariogenic bacteria on the dentition, the host diet, and other environmental exposures. Streptococcus mutans proliferates as a biofilm on the tooth surface, where it obtains nutrients and metabolizes fermentable dietary carbohydrates. The accumulation of lactic acid as a by-product of fermentation results in acidification of the plaque biofilm and demineralization of tooth enamel, marking the onset of decay. The ability of S. mutans to respond to environmental stresses presented by salivary flow, acid pH, oxidative stress, and changes in carbohydrate source and availability is essential for its survival and predominance in caries lesions. Importantly, S. mutans has evolved a network of regulators to integrate its cellular response to environmental change. Herein we describe the latest insights into global gene regulation in S. mutans, including mechanisms of signal transduction, carbon catabolite repression, and quorum-sensing. An improved understanding of these regulatory networks can provide a basis for novel therapeutic applications aimed at treating and/or preventing caries.
The development of articles in children’s early Spanish: Prosodic interactions between lexical and grammatical form
Authors: Demuth Katherine , Patrolia Meghan , Song Jae Yung , Masapollo Matthew
Published: July 2011

Studies of English and French show that children’s first articles are more likely to appear when they can be prosodified as part of a disyllabic foot (cf. Gerken, 1996; Demuth & Tremblay, 2008). However, preliminary studies of Spanish suggest that children’s first articles appear in larger prosodic structures, possibly due to the higher frequency of longer words. To assess this issue, this study examined longitudinal data from two Spanish 1- to 2-year-olds. As expected, both produced their early articles with monosyllabic and disyllabic nouns, rapidly expanding article use to trisyllabic nouns as well. The results suggest that the prosodic complexity of the lexicon plays an important role in the development of prosodic structure, providing the context for early prosodic licensing of grammatical morphemes.
Expressive vocabulary and early grammar of 16- to 30-month-old children acquiring Quebec French
Authors: Trudeau Natacha , Sutton Ann
Published: July 2011

This article reports on data obtained through the Quebec-French adaptation of the MacArthur–Bates Communicative Development Inventories – Words and Sentences ( N = 826). Results from parent questionnaires show a steady increase in expressive vocabulary and the use of morphology and syntax with age, as well as links between the three components. Strong correlations between parent reports and sample analysis confirm the concurrent validity of the parental reports.
Social Support and Dietary Quality in Older African American Public Housing Residents
Authors: Ralston Penny A. , Cohen Nancy L. , Wickrama Kandauda (K. A. S.) , Kwag Kyunghwa
Published: July 2011

This study examined the role of social support in influencing dietary quality in older African American public housing residents, specifically investigating individual (age, education, gender, marital status, and living arrangement), social support (help with meals, social network size, frequency of contact, and proximity or distance from network), and dietary factors (number of meals consumed daily, dietary quality). A random sample ( n = 80) of public housing residents age 55+ living in a Northeastern community was interviewed. Data were analyzed using Pearson correlation coefficients, multiple regression analyses, and structural equation modeling (SEM). Given the limited sample size, a SEM path model was developed based on observed associations in correlation and regression analyses. Results show that number of meals, frequency of contact, and proximity significantly influenced dietary quality. However, dietary quality was indirectly influenced by education, marital status, having a housemate, and help with meals, highlighting influence of both individual and social factors.
Mitigating the limited scalability of bootstrapping through strategic alliances to enhance new venture growth
Authors: Patel Pankaj C. , Fiet James O. , Sohl Jeffrey E.
Published: July 2011

Although the benefits of bootstrapping are widely known, decreasing returns to venture growth from this strategy are less understood; falls in returns. Decreasing returns may result from limited scalability and increased costs resulting from reduced legitimacy among stakeholders. Using a sample of high-technology firms, this article tests the non-linear relationship between bootstrapping and venture growth and the moderating effects of alliances on this non-linear relationship. We find that bootstrapping has an inverted-U relationship with venture growth; however, alliance diversity enhances the positive effects of bootstrapping while mitigating its negative effects on venture growth.
Exploring the potential impact of colonialism on national patterns of entrepreneurial networking
Authors: Georgiou Catherine , Dodd Sarah Drakopoulou , Andriopoulos Constantine , Gotsi Manto
Published: July 2011

This study emphasizes the concept of variform universality and considers whether colonialism may be one of the cultural drivers of such divergence. We use a well-established methodology to explore the personal entrepreneurial networks of Cypriots with those of their Greek and English counterparts. We suggest that entrepreneurial networking exhibits variform universality, whereby patterns evident across nations are moderated by culture. We conclude by relating these tentative findings to other work suggesting that power-related phenomena may be important in shaping variform universality in entrepreneurial networks. We recommend post-colonial theory as a promising path to explore these in-between social spaces where the entrepreneurship of the dominated is enacted.
The effect of a cardiopulmonary bypass system with biocompatible coating on fibrinogen levels determined by the TEG – functional fibrinogen method: preliminary results
Authors: Fluger I , Maderová K , Šimek M , Hájek R , Zapletalová J , Lonský V
Published: July 2011

When cardiopulmonary bypass (CPB) is used, the blood comes into contact with foreign surfaces. To diminish this impact, various types of biocompatibly coated surfaces have been developed. The study assessed the effects of heparin-coated CPB systems on the level and function of fibrinogen as measured by thromboelastography (TEG), as compared with non-coated systems. No statistically significant differences between both groups were revealed by comparing paired data. In our study, heparin-coated CPB circuits had no significant effect on either fibrinogen level or its function.
Intracranial Dissection Mimicking Transient Cerebral Arteriopathy in Childhood Arterial Ischemic Stroke
Authors: Dlamini Nomazulu , Freeman Jeremy L. , Mackay Mark T. , Hawkins Cynthia , Shroff Manohar , Fullerton Heather J. , deVeber Gabrielle A.
Published: July 2011

Transient cerebral arteriopathy is a frequent cause of childhood arterial ischemic stroke. Differentiating this condition from intracranial carotid artery dissection is challenging but important for initial treatment. We describe 4 cases from the International Pediatric Stroke Study of intracranial carotid artery dissection, initially misdiagnosed as transient cerebral arteriopathy. Presentations were abrupt, with focal neurological deficits in 4, preceding headache in 3, and minor trauma in 1. Infarcts involved the anterior circulation, and magnetic resonance angiography showed unilateral arterial stenosis/occlusion. None had evidence of dissection. All received anticoagulation or thrombolysis. Three died from refractory intracranial hypertension. Intracranial carotid artery dissection was confirmed postmortem (n = 3) and on dedicated MR wall imaging showing intramural hematoma (n = 1). In differentiating transient cerebral arteriopathy from intracranial carotid artery dissection, routine magnetic resonance angiography is unreliable and adjunctive conventional angiography, gadolinium magnetic resonance angiography, or dedicated MRI wall imaging should be considered.
Dielectric, mechanical, and thermal characterization of high-density polyethylene composites with ground tire rubber
Authors: Mujal-Rosas R , Marin-Genesca M , Orrit-Prat J , Rahhali Ahmed , Colom-Fajula X
Published: July 2011

The mass manufacture of tires and the difficulty in storing or disposing them constitute a serious environmental problem. At present, various recycling methods for tires are used, such as grinding, which separates the steel and fibers from the vulcanized rubber, then using the rubber in numerous industrial applications such as pavements, insulators, footwear, etc. The aim of this article focuses on finding a new application for the ground tire rubber (GTR). This would allow including GTR in industrial applications of recycled high-density polythene (HDPE). Tire dust and HDPE thermoplastic have been mixed, and the maximum accepted values of GTR concentration that can be admitted while keeping dielectric, mechanical, and thermal properties within acceptable values, as well as initial polymer microstructure, have been checked. In addition, the suitability of the compounds for antistatic applications is studied. The recycled tire dust which results from the industrial milling processes has been divided by sieve in three different categories according to the size of the particles (<200, 200–500, and >500 µm). This has then been mixed with HDPE in different GTR concentrations (0%, 5%, 10%, 20%, 40%, 50%, and 70%) in order to establish its conduct through electrical, mechanical, thermal, and microstructure tests, which will be held in a temperature range 30–120°C, and with a frequency range 1 × 10−2 and 3 × 106 Hz. The thermal tests determined the enthalpies and fusion temperatures which allow for the observation of changes in crystalline and microstructure of the matrix, and finally, the fracture surfaces of the compound samples have been evaluated using scanning electron microscopy.
Coexistence of Renal Epithelioid Angiomyolipoma and Clear Cell Carcinoma in Patients Without Tuberous Sclerosis
Authors: Cao Qing-hua , Liu Fang , Xiao Ping , Tian Xiao-ying , Li Bin , Li Zhi
Published: July 2011

Renal epithelioid angiomyolipoma (EAML) is a rare but distinct variant of angiomyolipoma, closely simulating renal cell carcinoma or sarcoma both clinically and histopathologically. This report presents an unusual case of unilateral simultaneous renal EAML and renal clear cell carcinoma. A 52-year-old man without any sign of tuberous sclerosis had a complaint of 6-month history of pain in left renal area and had macroscopic hematuria twice within the recent 1 month. Computed tomography showed the presence of 2 masses in the upper and lower portion of the left kidney. The patient underwent left radical nephrectomy. Histological examination revealed the upper mass was composed of medium to large epithelioid cells with clear or eosinophilic cytoplasm and numerous giant multinucleated cells. Adult-appearing adipose tissue and coagulative necrosis could also be observed focally in the mass. Immunohistochemically, the tumor cells in the upper mass showed positive reactions to actin, HMB-45, Melan-A, and CD68 but negative reactions to pan-cytokeratin (pan-CK), epithelial membrane antigen, and CD10. However, the lower mass was composed of diffusely monomorphic clear cells with strongly immunoreactive for pan-CK, vimentin, and CD10, whereas without expression for HMB-45 and actin. The patient showed no evidence of recurrence or metastasis during 1-year postoperative following-up period. To the authors’ knowledge, this is the first report of coincidental renal EAML and clear cell carcinoma in the same kidney. Unlike classic triphasic angiomyolipoma, adjuvant therapy after resection should be considered for renal EAML because of its malignant potential, more aggressive behavior and poor prognosis.
Reversible pulmonary toxicity due to lenalidomide
Authors: Coates Stephanie , Barker Alan , Spurgeon Stephen
Published: July 2011

Lenalidomide is a derivative of thalidomide and is FDA-approved for the treatment of myelodysplastic syndrome and, in combination with dexamethasone, for the treatment of relapsed multiple myeloma. Pulmonary toxicity with thalidomide is a recognized potential complication; however, there have only been two case reports in the literature of lenalidomide-associated pulmonary toxicity. In this case, we describe a patient who developed profound dyspnea, decreased exercisetolerance, and new ground-glass opacities with reticulation, consistent with a nonspecific interstitial pneumonia pattern. Clinical suspicion for pulmonary drug toxicity was high and lenalidomide was discontinued. Within 2 weeks of stopping lenalidomide, the patient had significant improvement in dyspnea and interstitial changes on CT were resolving. After 8 weeks, there was complete resolution of symptoms. Lenalidomide-induced pulmonary toxicity is significantly debilitating but, to date, it appears to be reversible with discontinuation of the medication.
Health Literacy and Women’s Health-Related Behaviors in Taiwan
Authors: Lee Shoou-Yih D. , Tsai Tzu-I , Tsai Yi-Wen , Kuo Ken N.
Published: July 2011

Extant health literacy research is unclear about the contribution of health literacy to health behaviors and is limited regarding women’s health issues. The primary purpose of this study is to investigate the association between health literacy and five health behaviors (Pap smear screening, annual physical checkup, smoking, checking food expiration dates, and monitoring physical changes) in women and to test whether the association is mediated by health knowledge. A national sample of 1,754 female adults in Taiwan was included in the study. Result showed that health literacy was positively and independently related to checking food expiration dates and monitoring physical changes, and that health literacy was not related to physical checkup and Pap smear screening. Interestingly, women with high health literacy were more likely to be a current smoker. Study findings suggest that efforts to improve health promotion behaviors in women should consider health literacy as an important factor and that the effect of health literacy on health prevention behaviors may vary by women’s access to care.
Perception of Thermal Comfort in the Enclosed Transitional Space of Tropical Buildings
Authors: Jie Kwong Qi , Adam Nor Mariah
Published: July 2011

The enclosed lift lobby distinguishes itself as a unique form of region categorised under building transitional spaces. This paper reports on an evaluation of thermal comfort conditions in a prominent transitional space in buildings which is the enclosed lift lobby of an educational institution in Malaysia, using field survey which included objective measurement and subjective assessment. The temperature set-point of air conditioner was increased and maintained at 26°C to investigate the human thermal perceptions in the enclosed region. Comparison was made on the percentage of thermal sensation, preference, acceptability and general comfort votes obtained from field survey. The outcomes clearly indicated that the human thermal perception in the enclosed lift lobby would be directly proportional to the level of human occupancy, and any sudden temperature change could lead to thermal discomfort of occupants. The respondents generally preferred to have cooler environment, rather than warmer one. Also, comfortable temperature can be obtained even with higher air conditioner thermostat settings. These findings may serve as a guide for building operators in the tropics to control the energy consumption of cooling equipment attached to the enclosed transitional spaces.
Perirectal NOTES Access
Authors: Zorron Ricardo , Phillips Henrique Neubarth , Coelho Djalma , Flach Luciana , Lemos Fabiano Batista , Vassallo Ricardo Cortez
Published: July 2011

Objectives. Clinical natural orifice surgery has been applied for abdominal surgery in recent years, mostly by vaginal and oral access. The study describes preliminary successful human applications of transcolonic natural orifice transluminal endoscopic surgery (NOTES), using a new transrectal total mesorectal excision procedure for rectal cancer. Methods. Institutional review board approval was obtained for the study. In 2 patients with rectal adenocarcinoma, total mesorectal resection and rectosigmoidectomy with lymphadenectomy was performed using a low NOTES transcolonic access. “Down-to-up” mesorectal dissection was achieved either using a flexible scope or a transrectal single port device. The specimens were extracted transanally, and transorificial low anastomosis was performed. Results. Operative time was 350 and 360 minutes, respectively; no complications occurred and patients were discharged after 6 days. Conclusion. Successful human reports on transcolonic NOTES suggest potential applications. The treatment of colorectal diseases through transorificial single port or flexible perirectal NOTES access are promising new approaches besides current methods to improve patient care.