bluuebunny/crossref_metadata_2025 huggingface dataset:
A Model for Emergency Department End‐of‐life Communications After Acute Devastating Events—Part I: Decision‐making Capacity, Surrogates, and Advance Directives*
Authors: Limehouse Walter E. , Ramana Feeser V. , Bookman Kelly J. , Derse Arthur
Published: September 2012

ACADEMIC EMERGENCY MEDICINE 2012; 19: 1068–1072; © 2012 by the Society for Academic Emergency Medicine

Making decisions for a patient affected by sudden devastating illness or injury traumatizes a patient’s family and loved ones. Even in the absence of an emergency, surrogates making end‐of‐life treatment decisions may experience negative emotional effects. Helping surrogates with these end‐of‐life decisions under emergent conditions requires the emergency physician (EP) to be clear, making medical recommendations with sensitivity. This model for emergency department (ED) end‐of‐life communications after acute devastating events comprises the following steps: 1) determine the patient’s decision‐making capacity; 2) identify the legal surrogate; 3) elicit patient values as expressed in completed advance directives; 4) determine patient/surrogate understanding of the life‐limiting event and expectant treatment goals; 5) convey physician understanding of the event, including prognosis, treatment options, and recommendation; 6) share decisions regarding withdrawing or withholding of resuscitative efforts, using available resources and considering options for organ donation; and 7) revise treatment goals as needed.

Emergency physicians should break bad news compassionately, yet sufficiently, so that surrogate and family understand both the gravity of the situation and the lack of long‐term benefit of continued life‐sustaining interventions. EPs should also help the surrogate and family understand that palliative care addresses comfort needs of the patient including adequate treatment for pain, dyspnea, or anxiety. Part I of this communications model reviews determination of decision‐making capacity, surrogacy laws, and advance directives, including legal definitions and application of these steps; Part II (which will appear in a future issue of AEM) covers communication moving from resuscitative to end‐of‐life and palliative treatment. EPs should recognize acute devastating illness or injuries, when appropriate, as opportunities to initiate end‐of‐life discussions and to implement shared decisions.
Emergency Cricothyroidotomy: A Randomized Crossover Trial Comparing Percutaneous Techniques: Classic Needle First Versus “Incision First”
Authors: Kanji Hussein , Thirsk Warren , Dong Sandy , Szava‐Kovats Michael , Villa‐Roel Cristina , Singh Mira , Rowe Brian H.
Published: September 2012

ACADEMIC EMERGENCY MEDICINE 2012; 19:1061–1067 © 2012 by the Society for Academic Emergency Medicine

Objectives:  Emergency cricothyroidotomy is potentially lifesaving in patients with airway compromise who cannot be intubated or ventilated by conventional means. The literature remains divided on the best insertion technique, namely, the open/surgical and percutaneous methods. The two are not mutually exclusive, and the study hypothesis was that an “incision‐first” modification (IF) may improve the traditional needle‐first (NF) percutaneous approach. This study assessed the IF technique compared to the NF method.

Methods:  A randomized controlled crossover design with concealed allocation was completed for 180 simulated tracheal models. Attending and resident emergency physicians were enrolled. The primary outcome was time to successful cannulation; secondary outcomes included needle insertion(s), incision, and dilatation attempts. Finally, proportions of intratracheal insertion on the first attempt and subjective ease of insertion were compared.

Results:  The IF technique was significantly faster than the standard NF technique (median = 53 seconds, interquartile range [IQR] = 45.0 to 86.4 seconds vs. median = 90 seconds, IQR = 55.2 to 108.6 seconds; p < 0.001). The median number of needle insertions was significantly higher for the NF technique (p = 0.018); there was no significant difference in dilation or incision attempts. Intratracheal insertion on the first attempt was documented in 90 and 93% of the NF and IF techniques, respectively (p = 0.317). All the study participants found the IF hybrid approach easier.

Conclusions:  The IF modification allows faster access, fewer complications, and more favorable clinician endorsement than the classic NF percutaneous technique in a validated model of cricothyroidotomy. We suggest therefore that the IF technique be considered as an improved method for insertion of an emergency cricothyroidotomy.
The Evacuation of Cairns Hospitals Due to Severe Tropical Cyclone Yasi
Authors: Little Mark , Stone Theona , Stone Richard , Burns Jan , Reeves Jim , Cullen Paul , Humble Ian , Finn Emmeline , Aitken Peter , Elcock Mark , Gillard Noel
Published: September 2012

ACADEMIC EMERGENCY MEDICINE 2012; 19:1088–1098 © 2012 by the Society for Academic Emergency Medicine

On February 2, 2011, Tropical Cyclone Yasi, the largest cyclone to cross the Australian coast and a system the size of Hurricane Katrina, threatened the city of Cairns. As a result, the Cairns Base Hospital (CBH) and Cairns Private Hospital (CPH) were both evacuated, the hospitals were closed, and an alternate emergency medical center was established in a sports stadium 15 km from the Cairns central business district.

This article describes the events around the evacuation of 356 patients, staff, and relatives to Brisbane (approximately 1,700 km away by road), closure of the hospitals, and the provision of a temporary emergency medical center for 28 hours during the height of the cyclone.

Our experience highlights the need for adequate and exercised hospital evacuation plans; the need for clear command and control with identified decision‐makers; early decision‐making on when to evacuate; having good communication systems with redundancy; ensuring that patients are adequately identified and tracked and have their medications and notes; ensuring adequate staff, medications, and oxygen for holding patients; and planning in detail the alternate medical facility safety and its role, function, and equipment.
FKBP5 and emotional neglect interact to predict individual differences in amygdala reactivity
Authors: White M. G. , Bogdan R. , Fisher P. M. , Muñoz K. E. , Williamson D. E. , Hariri A. R.
Published: September 2012

Individual variation in physiological responsiveness to stress mediates risk for mental illness and is influenced by both experiential and genetic factors. Common polymorphisms in the human gene for FK506 binding protein 5 (FKBP5), which is involved in transcriptional regulation of the hypothalamic–pituitary–adrenal (HPA) axis, have been shown to interact with childhood abuse and trauma to predict stress‐related psychopathology. In the current study, we examined if such gene–environment interaction effects may be related to variability in the threat‐related reactivity of the amygdala, which plays a critical role in mediating physiological and behavioral adaptations to stress including modulation of the HPA axis. To this end, 139 healthy Caucasian youth completed a blood oxygen level‐dependent functional magnetic resonance imaging probe of amygdala reactivity and self‐report assessments of emotional neglect (EN) and other forms of maltreatment. These individuals were genotyped for 6 FKBP5 polymorphisms (rs7748266, rs1360780, rs9296158, rs3800373, rs9470080 and rs9394309) previously associated with psychopathology and/or HPA axis function. Interactions between each SNP and EN emerged such that risk alleles predicted relatively increased dorsal amygdala reactivity in the context of higher EN, even after correcting for multiple testing. Two different haplotype analyses confirmed this relationship as haplotypes with risk alleles also exhibited increased amygdala reactivity in the context of higher EN. Our results suggest that increased threat‐related amygdala reactivity may represent a mechanism linking psychopathology to interactions between common genetic variants affecting HPA axis function and childhood trauma.
Giant squamous cell carcinoma as a complication of a chronic enterocutaneous fistula: complex parietal reconstruction
Authors: Rebibo Lionel , Deguines Jean‐Baptiste , Prevot Flavien , Pérignon David , Sinna Raphaël , Verhaeghe Pierre , Regimbeau Jean‐Marc
Published: September 2012

Treatment of an enterocutaneous fistula is complex and may require multidisciplinary management, especially when associated with a neoplastic process. Here, we describe the case of a 59‐year‐old patient with a squamous cell carcinoma that had invaded the abdominal wall through a chronic enterocutaneous fistula identified 30 years ago. We combined parietectomy with small intestine and colon resection and inguinal lymphadenectomy in order to obtain clear surgical margins. At the same time, plastic surgery involved the implementation of a large bioprosthesis and coverage with a vastus lateralis muscle free flap.
Influence of comorbidity in cancer surgery on treatment decisions, postoperative course and oncological outcome
Authors: Chaudhary Rahul K , Bhaduri Debanshu , Bhatia Manish , Hatti Sharanabasappa , Ba Roshan , Meva Jignesh
Published: September 2012

Aim

Comorbidity in cancer patients may influence treatment decisions, postoperative morbidity and ultimately, survival. The TNM staging system does not take comorbidity into account. This study investigates the burden of comorbidity in cancer patients, its effect on resection rate, postoperative morbidity, adjuvant therapy, recurrence and survival.

Methods

 This prospective cohort study included 358 patients with potentially operable cancer. Pretreatment comorbidity was assessed using a modified Kaplan–Feinstein index (adult comorbidity evaluation‐27) and its influence on resection rate and postoperative adjuvant therapy was assessed. The comorbidity grade was consolidated with TNM stage into four distinct groups that were compared for differences in the incidence of postoperative complications, duration of hospital stay, 30‐day mortality, recurrence and survival.

Results

Cardiovascular diseases including hypertension (27%) and diabetes mellitus (12%) were the most common comorbidities. Comorbidity did not influence the resection rate, but affected adjuvant treatment (P < 0.01). There was a greater incidence of postoperative local and systemic complications and duration of hospital stay in patients with comorbidity. Recurrence rates were unaffected. Mortality in patients with comorbidity was greater, especially postoperative 30‐day mortality, but this was statistically insignificant.

Conclusion

Comorbidity increases postoperative morbidity and affects adjuvant therapy, although the resection rate is not influenced. The greater percentage of deaths in patients with comorbidity warrants further studies. Recurrence rates remain unaffected. However, a longer period of follow up is needed for a clearer picture.
Interpretation of Water Level Changes in the High Plains Aquifer in Western Kansas
Authors: Butler J.J. , Stotler R.L. , Whittemore D.O. , Reboulet E.C.
Published: September 2012

Water level changes in wells provide a direct measure of the impact of groundwater development at a scale of relevance for management activities. Important information about aquifer dynamics and an aquifer's future is thus often embedded in hydrographs from continuously monitored wells. Interpretation of those hydrographs using methods developed for pumping‐test analyses can provide insights that are difficult to obtain via other means. These insights are demonstrated at two sites in the High Plains aquifer in western Kansas. One site has thin unconfined and confined intervals separated by a thick aquitard. Pumping‐induced responses in the unconfined interval indicate a closed (surrounded by units of relatively low permeability) system that is vulnerable to rapid depletion with continued development. Responses in the confined interval indicate that withdrawals are largely supported by leakage. Given the potential for rapid depletion of the unconfined interval, the probable source of that leakage, it is likely that large‐scale irrigation withdrawals will not be sustainable in the confined interval beyond a decade. A second site has a relatively thick unconfined aquifer with responses that again indicate a closed system. However, unlike the first site, previously unrecognized vertical inflow can be discerned in data from the recovery periods. In years of relatively low withdrawals, this inflow can produce year‐on‐year increases in water levels, an unexpected occurrence in western Kansas. The prevalence of bounded‐aquifer responses at both sites has important ramifications for modeling studies; transmissivity values from pumping tests, for example, must be used cautiously in regional models of such systems.
Inpatient Stroke Care Quality for Veterans: Are There Differences between Veterans Affairs Medical Centers in the Stroke Belt and other Areas?
Authors: Jia Huanguang , Phipps Michael , Bravata Dawn , Castro Jaime , Li Xinli , Ordin Diana , Myers Jennifer , Vogel W. Bruce , Williams Linda , Chumbler Neale
Published: September 2012

Background

Stroke mortality has been found to be much higher among residents in the stroke belt region than in the rest of United States, but it is not known whether differences exist in the quality of stroke care provided in Department of Veterans Affairs medical centers in states inside and outside this region.

Objective

We compared mortality and inpatient stroke care quality between Veterans Affairs medical centers inside and outside the stroke belt region.

Methods

Study patients were veterans hospitalized for ischemic stroke at 129 Veterans Affairs medical centers. Inpatient stroke care quality was assessed by 14 quality indicators. Multivariable logistic regression models were fit to examine differences in quality between facilities inside and outside the stroke belt, adjusting for patient characteristics and Veterans Affairs medical centers clustering effect.

Results

Among the 3909 patients, 28·1% received inpatient ischemic stroke care in 28 stroke belt Veterans Affairs medical centers, and 71·9% obtained care in 101 non-stroke belt Veterans Affairs medical centers. Patients cared for in stroke belt Veterans Affairs medical centers were more likely to be younger, Black, married, have a higher stroke severity, and less likely to be ambulatory pre-stroke. We found no statistically significant differences in short- and long-term post-admission mortality and inpatient care quality indicators between the patients cared for in stroke belt and non-stroke belt Veterans Affairs medical centers after risk adjustment.

Conclusions

These data suggest that a stroke belt does not exist within the Veterans Affairs health care system in terms of either post-admission mortality or inpatient care quality.
A Systematic Review of Perceived Barriers and Motivators to Physical Activity after Stroke
Authors: Nicholson Sarah , Sniehotta Falko F. , van Wijck Frederike , Greig Carolyn A. , Johnston Marie , McMurdo Marion E. T. , Dennis Martin , Mead Gillian E
Published: September 2012

Background and purpose

Physical fitness is impaired after stroke, may contribute to disability, yet is amenable to improvement through regular physical activity. To facilitate uptake and maintenance of physical activity, it is essential to understand stroke survivors' perceived barriers and motivators. Therefore, we undertook a systematic review of perceived barriers and motivators to physical activity after stroke.

Methods

Electronic searches of EMBASE, Medline, CINAHL, and PsychInfo were performed. We included peer-reviewed journal articles, in English, between 1 January 1966 and 30 August 2010 reporting stroke survivors' perceived barriers and motivators to physical activity.

Results

Searches identified 73 807 citations of which 57 full articles were retrieved. Six articles were included, providing data on 174 stroke survivors (range 10 to 83 per article). Two reported barriers and motivators, two reported only motivators, and two reported only barriers. Five were qualitative articles and one was quantitative. The most commonly reported barriers were lack of motivation, environmental factors (e.g. transport), health concerns, and stroke impairments. The most commonly reported motivators were social support and the need to be able to perform daily tasks.

Conclusion

This review has furthered our understanding of the perceived barriers and motivators to physical activity after a stroke. This review will enable the development of tailored interventions to target barriers, while building upon perceived motivators to increase and maintain stroke survivors' physical activity.
A Longitudinal Cohort Study on Quality of Life in Stroke Patients and Their Partners: Restore4Stroke Cohort
Authors: van Mierlo Maria L. , van Heugten Caroline M. , Post Marcel W. M. , Lindeman Eline , de Kort Paul L. M. , Visser-Meily Johanna M.A.
Published: September 2012

Background

Stroke is a major cause of disability in the Western world. Its long-term consequences have a negative impact on the quality of life of both the patients and their partners.

Aim

The aim of the Restore4Stroke Cohort study is to investigate the changes in quality of life of stroke patients and their partners over time, and to determine factors predicting quality of life in several domains, especially personal and environmental factors.

Method

Multicentre prospective longitudinal cohort study. Inclusion and the first assessment take place during hospital stay in the first week post-stroke. Follow-up assessments take place at two months, six months, one year, and two years post-stroke. Recruitment of 500 patients from stroke units in six participation hospitals is foreseen. If the patient has a partner, he or she is also asked to participate in the study.

Outcomes

The main outcome is quality of life, considered from a health-related quality of life and domain-specific quality of life perspective. Factors predicting long-term quality of life will be determined by taking into account the health condition (pre-stroke health condition and stroke-related health condition), personal factors (e.g. coping and illness cognitions), and environmental factors (e.g. caregiver burden and social support).

Discussion

This study is expected to provide information about the changes in quality of life of stroke patients and their partners over time. Furthermore, the identification of factors predicting quality of life can be used to improve rehabilitation care and develop new interventions for stroke patients and their partners.
Burden of Stroke in Bangladesh
Authors: Islam Md. Nazmul , Moniruzzaman Mohammed , Khalil Md. Ibrahim , Basri Rehana , Alam Mohammad Khursheed , Loo Keat Wei , Gan Siew Hua
Published: September 2012

Stroke is the third leading cause of death in Bangladesh. The World Health Organization ranks Bangladesh's mortality rate due to stroke as number 84 in the world. The reported prevalence of stroke in Bangladesh is 0·3%, although no data on stroke incidence have been recorded. Hospital-based studies conducted in past decades have indicated that hypertension is the main cause of ischaemic and haemorrhagic stroke in Bangladesh. The high number of disability-adjusted life-years lost due to stroke (485 per 10 000 people) show that stroke severely impacts Bangladesh's economy. Although two non-governmental organizations, BRAC and the Centre for the Rehabilitation of the Paralysed, are actively involved in primary stroke prevention strategies, the Bangladeshi government needs to emphasize healthcare development to cope with the increasing population density and to reduce stroke occurrence.
Demographics, Socio-Economic Characteristics, and Risk Factor Prevalence in Patients with Non-Cardioembolic Ischaemic Stroke in Low- and Middle-Income Countries: The OPTIC Registry
Authors: Abboud Halim , Labreuche Julien , Arauz Antonio , Bryer Alan , Lavados Pablo G , Massaro Ayrton , Collazos Mario Munoz , Steg Philippe Gabriel , Yamout Bassem I , Vicaut Eric , Amarenco Pierre ,   for the OPTIC Registry Investigators
Published: September 2012

Background

There is a paucity of data on patients with stroke/transient ischaemic attack in low- and middle-income countries. We sought to describe the characteristics and management of patients with an ischaemic stroke and recent transient ischaemic attack or minor ischaemic strokes in low- or middle-income countries.

Methods

The Outcomes in Patients with TIA and Cerebrovascular disease registry is an international, prospective study. Patients ≥45 years who required secondary prevention of stroke (either following an acute transient ischaemic attack or minor ischaemic strokes (National Institutes of Health Stroke Scale <4) of <24 h duration, or recent (<6 months), stable, first-ever, non-disabling ischaemic stroke) were enrolled in 17 countries in Latin America, the Middle East, and Africa. The main measures of interest were risk factors, comorbidities, and socio-economic variables.

Results

Between January 2007 and December 2008, 3635 patients were enrolled in Latin America ( n =1543), the Middle East ( n =1041), North Africa ( n = 834), and South Africa ( n = 217). Of these, 63% had a stable, first-ever ischaemic stroke (median delay from symptom onset to inclusion, 25 days interquartile range, 7–77); 37% had an acute transient ischaemic attack or minor ischaemic stroke (median delay, two-days; interquartile range, 0–6). Prevalence of diabetes was 46% in the Middle East, 29% in Latin America, 35% in South Africa, and 38% in North Africa; 72% had abdominal obesity (range, 65–78%; adjusted P < 0·001); prevalence of metabolic syndrome was 78% (range, 72–84%, P < 0·001). Abnormal ankle brachial index (<0·9) was present in 22%, peripheral artery disease in 7·6%, and coronary artery disease in 13%. Overall, 24% of patients had no health insurance and 27% had a low educational level.

Interpretation

In this study, patients in low- and middle-income countries had a high burden of modifiable risk factors. High rates of low educational level and lack of health insurance in certain regions are potential obstacles to risk factor control.

Funding

The Outcomes in Patients with TIA and Cerebrovascular disease registry is supported by Sanofi-Aventis, Paris, France.
Using a video assisted teaching program to reduce the severity of urinary incontinence symptoms in women
Authors: Seshan Vidya , Muliira Joshua K , Krishnamurthy Rajalakshmi , Sivaram Vidhya
Published: September 2012

Urinary incontinence (UI) is still a common chronic health problem affecting physical, psychological and social well‐being of women in developing countries. UI is a challenge to women's health because of the number affected and lack of access to affordable care that can cure or relieve associated symptoms especially in resource limited settings. This study explored the prevalence of UI and assessed effectiveness of a Video Assisted Teaching Program for Kegel's Exercises (VATPKE) in reducing severity of UI symptoms among community dwelling women. A survey was used to obtain data from a sample of 598 community dwelling Indian women in Coimbatore district in Tamilnadu State. A pre–posttest design was then used to assess effectiveness of the VATPKE in reducing UI symptom severity in affected women. Data were analysed using a paired samples t‐test. Of the 598 women, 202 (34%) reported having some level of UI and most participants affected were married (78%), less educated (56%), had high BMI (52%) and lower socio‐economic status. Affected women mostly reported the severity level of UI symptoms at pre‐intervention as moderate (78%) or mild (22%).The mean post‐intervention UI symptoms severity score (M = 21·72, SD = 3·99) was lower than pre‐ intervention (M = 29·91, SD = 5·12) and paired t‐test results showed that the difference was highly statistically significant (p < 0·00). The VATPKE used in this study was effective in reducing the severity of self‐reported UI symptoms in community dwelling Indian women.
Suppressed Expression of Autophagosomal Protein LC3 in Cortical Tubers of Tuberous Sclerosis Complex
Authors: Miyahara Hiroaki , Natsumeda Manabu , Shiga Atsushi , Aoki Hiroshi , Toyoshima Yasuko , Zheng Yingjun , Takeuchi Ryoko , Murakami Hiroatsu , Masuda Hiroshi , Kameyama Shigeki , Izumi Tatsuro , Fujii Yukihiko , Takahashi Hitoshi , Kakita Akiyoshi
Published: September 2012

Tuberous sclerosis complex (TSC) is characterized by benign tumors and hamartomas, including cortical tubers. Hamartin and tuberin, encoded by the TSC 1 and 2 genes, respectively, constitute a functional complex that negatively regulates the mammalian target of rapamycin (mTOR) signaling pathway, eventually promoting the induction of autophagy. In the present study, we assessed the induction of autophagy in cortical tubers surgically removed from seven patients with TSC in comparison with five controls of cortical tissue taken from non‐TSC patients with epilepsy. Immunoblotting demonstrated a marked reduction of LC3B‐I and LC3B‐II in tubers relative to the controls. In tubers, strong, diffuse and dot‐like immunoreactivity (IR) for LC3B was observed in dysmorphic neurons and balloon cells, but LC3B‐IR in other neurons with normal morphology was significantly weaker than that in neurons in the controls. Immunoelectron microscopy revealed diffuse distribution of LC3B‐IR within the cytoplasm of balloon cells. The dot‐like pattern may correspond to abnormal aggregation bodies involving LC3. In an autopsy patient with TSC, we observed that LC3B‐IR in neurons located outside of the tubers was preserved. Thus, autophagy is suppressed in tubers presumably through the mTOR pathway, and possibly a pathological autophagy reaction occurs in the dysmorphic neurons and balloon cells.
Modification of Fatty Acid, Essential Oil and Phenolic Contents of Salt‐Treated Sweet Marjoram (Origanum majorana L.) According to Developmental Stage
Authors: Baâtour O. , Kaddour R. , Tarchoun I. , Nasri N. , Mahmoudi H. , Zaghdoudi M. , Ghaith H. , Marzouk B. , Nasri‐Ayachi Mouhiba Ben , Lachaâl M.
Published: September 2012

Abstract:  Variation in the composition of Origanum majorana L. essential oil (EO) and fatty acids were studied under salt treatment. Plant material has been harvested at 2 phenological stages: early vegetative stage (EVS) and late vegetative stage (LVS) or prefloral. Our results showed that the application of 75 mM NaCl increased total lipid contents in marjoram shoots and caused great qualitative changes in the fatty acids profiles. NaCl treatment reduced and stimulated the EO yields, respectively, at EVS and LVS and induced quantitative changes in the chemical EO composition in shoots. Phenolic contents were higher during the LVS than EVS in the absence and the presence of salt. Under control conditions, RP‐HPLC analysis of the methanolic extract of marjoram dried shoots showed a predominance of flavonoid during the EVS whereas phenolic acids predominated during the LVS. However, under 75 mM NaCl, we noted a predominance of flavonoid at LVS and constant levels of phenolic and flavonoid classes at the EVS. For control treatment and at both EVS and LVS, the main components identified were respectively rosmarinic acid gallic as phenolic acids and amentoflavone as flavonoid. In the presence of salt and at the EVS, we observed a significant increase in trans‐2 hydrocinnamic, gallic acid and quercetin‐3‐galactoside contents. However, for the LVS, salt induced a stimulation of gallic acid, apigenin, and amentoflavone. Our results showed that LVS had the highest contents of bioactive compounds, and could be considered as the best stage for harvesting marjoram plants.

Practical Application:  In this study, the fatty acid composition, essential oil, and phenolic content of Origanum majorana were investigated. This is important for potential application of marjoram as functional food at the late vegetative stage. The richness of O. majorana in volatile and phenolic active compounds known for their antioxidant, antimicrobial, and insecticidal activities could support the utilization of this plant in a large field of application including cosmetic, pharmaceutical, agro alimentary, and biological defense.
Sociological Research on Feminism and the Women’s Movement: Ideology, Identity, and Practice
Authors: Harnois Catherine E.
Published: September 2012

This article provides an overview of sociological research on three aspects of feminism: feminism as an ideology; feminism as an identity; and feminism as a practice. I summarize the main contributions of sociological research in each of these areas, and highlight the overarching contributions for understanding contemporary feminism. Three contributions are key. First, sociological research highlights the existence multiple varieties of feminism –“feminisms” as opposed to a singular “feminism.” Second, this research reveals that feminist ideologies, identities, and movements are each dynamic – they have changed historically, and continue to change in response to shifting socio‐political, economic, and technological landscapes. Third, sociological research demonstrates that feminism is alive and well, and in many senses thriving, in the contemporary United States. Though some aspects of feminism are more widespread than others, sociological research challenges the notion that feminism, on the whole, has declined. As an ideology, an identity, and a practice, feminism remains strong in the contemporary United States.
Latin American Identity Politics: Redefining Citizenship
Authors: Warren Sarah D.
Published: September 2012

Identity‐based social movements and politics have played an important role in Latin America since the 1970s and continue to do so today. In this essay, I argue that this form of politics – as it has taken shape across Latin America – has been defined by its intersectionality. I trace the ways in which neoliberalism has facilitated a certain kind of identity politics while limiting more radical political claims. I argue that identity politics have contributed to the current “pink tide” sweeping across the continent and are in continual dialogue with these new leftist governments as they redefine what it means to be citizen and what the relationship between state and citizen should be.
Women’s Cultures and Social Movements in Global Contexts
Authors: Hurwitz Heather McKee , Taylor Verta
Published: September 2012

This article examines the role that women’s cultures and communities have played in political protest and social change. We argue that women’s cultures, which form around the reproductive roles, labor, and emotional expectations placed on women, have been used to express femininity and as cultural resources or “toolkits” to transform male‐dominated spheres of society. We begin by defining women’s cultures, emphasizing that there is no universal women’s culture because the structural arrangements and cultural meanings of gender vary by race, ethnicity, class, nationality, and political context. We then review research that demonstrates the significance of women’s cultures for the collective identities and tactics deployed in social movements and protest, demonstrating how the study of women’s cultures and gender processes in social movements has contributed empirically and theoretically to understanding social movements. We examine women’s cultures and collective identities in communities as wide ranging as self‐help groups, lesbian communities, feminist organizations, and anti‐feminist groups. We then draw on prevailing theories of cultural change in globalization studies (cultural differentialism, cultural convergence, and cultural hybridization) to understand how women’s cultures have contributed to social change. We conclude by identifying future directions for the study of women’s cultures and social movements.
FDI and Domestic Firms’ Export Behaviour: Evidence from Vietnam*
Authors: Nguyen Dao Thi Hong , Sun Sizhong
Published: September 2012

This study investigates firms’ export behaviour in the manufacturing sector in Vietnam, using a Heckman sample selection model estimated over firm‐level data in 2003 and 2004. Empirical results indicate that (i) firm‐specific characteristics have significant impacts on firm export behaviour; (ii) there exist significant export spillovers from foreign direct investment (FDI) to domestic firms; and (iii) spillovers are heterogeneous and depend on firm characteristics. Firm age, private ownership, average wage and import intensity are found to have positive and significant impacts on the spillover magnitude, whereas firm size and domestic competition exert negative and significant impacts.
Insuring for a Crisis: Deposit Insurance and the GFC, the Australian and New Zealand Experience*
Authors: Jain Ameeta , Keneley Monica , Thomson Di
Published: September 2012

Deposit insurance schemes were an important element in policy responses to the global financial crisis (GFC). There has been considerable debate about the nature and efficacy of such policy measures in alleviating the fallout from financial crises. The GFC highlighted problems associated with deposit insurance schemes including moral hazard, coverage limits, co‐insurance, cross border issues and market distortions. Despite these shortcomings, deposit insurance schemes were able to ameliorate the financial panic experienced and reduce contagion. This paper evaluates the Australian and New Zealand experience with deposit insurance introduced in response to the GFC, and compares this to the OECD experience. It reflects on the performance of deposit insurance schemes considered against the attributes of good policy design, and evaluates the specific problems and strengths encountered during the GFC.
Finite element analysis to compare stress distribution of gold alloy, lithium‐disilicate reinforced glass ceramic and zirconia based fixed partial denture
Authors: Zheng Zhiqiang , Lin Jie , Shinya Akikazu , Matinlinna Jukka P. , Botelho Michael G. , Shinya Akiyoshi
Published: September 2012

Aim

Clinical data indicate that veneer chipping of zirconia core is more likely than with ceramic‐fused‐to‐metal structures. The purposes of this simulation study were to: (a) use two‐dimensional finite element modeling to simulate stresses at the interface of three‐unit posterior fixed partial dentures (FPDs) made with three different core materials; and (b) to investigate the influence of three different veneer thicknesses on the stress distribution within the veneer–core complex.

Methods

A mesio‐distal cross‐section of a three‐unit FPD was digitized and used to create two‐dimensional models of the teeth, supporting bone, different core materials (gold alloy, zirconia and lithia‐disilicate reinforced glass ceramic), and different pontic preparation configurations (occlusal veneer thickness 1.0, 1.5, and 2.0 mm). A simulated 100 N vertical occlusal load was applied to the standardized pontic element. Compression stress and tensile stress values were calculated by finite element analysis along the veneer–core interface and compared.

Results

The veneer–core interfacial stress of zirconia‐based FPD is greater than that of gold alloy and lithium‐disilicate reinforced glass ceramic core. The veneer–core interface stress value decreased with increasing occlusal veneer thickness.

Conclusions

Finite element modeling revealed differences in tensile and compressive stresses between different pontic preparation configurations and core materials. In general, gold alloy and lithium‐disilicate reinforced glass ceramic core provided more even stress distribution at the connector and pontic of fixed partial denture than a zirconia framework.
Effects of a self‐care promoting problem‐based learning programme in people with rheumatic diseases: a randomized controlled study
Authors: Arvidsson Susann , Bergman Stefan , Arvidsson Barbro , Fridlund Bengt , Tingström Pia
Published: September 2012

Aim

To evaluate the effects of a self‐care promoting problem‐based learning programme for people with rheumatic diseases in terms of health‐related quality of life, empowerment, and self‐care ability.

Background

Individuals with rheumatoid arthritis express a great need for education and support in adapting to the disease, but the average qualities of studies about patient education interventions are not high. There is no evidence of long‐term benefits of patient education.

Design

Randomized controlled trial.

Methods

A randomized controlled design was selected with test at baseline, 1‐week and 6‐month post‐interventions after completed the 1‐year programme. The tests consisted of validity and reliability tested instruments. The participants were randomly assigned in spring 2009 to either the experimental group (n = 54) or the control group (n = 148). The programme was running alongside the standard care the participants received at a rheumatology unit. Parametric and non‐parametric tests were used in the analyses.

Results

The participants in the experimental group had statistically significant stronger empowerment after participation in the self‐care promoting problem‐based learning programme compared with the control group, at the 6‐month post‐intervention. Approximately, two‐thirds of the participants in the experimental group stated that they had implemented lifestyle changes due to the programme.

Conclusion

The self‐care promoting problem‐based learning programme enabled people with rheumatic diseases to improve their empowerment compared with the control group. It is important to continue to develop problem‐based learning in patient education to find the very best way to use this pedagogical method in rheumatology care.
Transient elastography: a meta‐analysis of diagnostic accuracy in evaluation of portal hypertension in chronic liver disease
Authors: Shi Ke‐Qing , Fan Yu‐Chen , Pan Zhen‐Zhen , Lin Xian‐Feng , Liu Wen‐Yue , Chen Yong‐Ping , Zheng Ming‐Hua
Published: September 2012

Objectives

Transient elastography (TE), as a non‐invasive method, has been studied for evaluation of portal hypertension in patients with chronic liver diseases (CLD) with variable results. We studied the performance of TE for detection of significant portal hypertension, oesophageal varices and large oesophageal varices using meta‐analysis.

Methods

PubMed, the Cochrane Library, EMBASE and ISI web of Knowledge were searched. The studies published in English relating to the diagnostic value of TE for significant portal hypertension, oesophageal varices and large oesophageal varices in patients with CLD were collected.

Results

A total of 18 studies, which included 3644 patients were analysed. Summary sensitivity and specificity were 0.90 (95% confidence interval (CI), 0.81–0.95) and 0.79 (95% CI, 0.58–0.91) for significant portal hypertension, and 0.87 (95% CI, 0.80–0.92) and 0.53 (95% CI, 0.36–0.69) for oesophageal varices and 0.86 (95% CI, 0.71–0.94) and 0.59 (95% CI, 0.45–0.72) for large oesophageal varices respectively. The HSROCs were 0.93 for significant portal hypertension, 0.84 for oesophageal varices and 0.78 for large oesophageal varices respectively. TE was very informative with 81% probability of correctly detection significant portal hypertension following a ‘positive’ measurement (over the threshold value) and lowering the probability of disease to as low as 11% when ‘negative’ measurement (below the threshold value) when pre‐test probability was 50% whereas, for oesophageal varices or large oesophageal varices, the probability of a correct diagnosis following a ‘positive’ measurement did not exceeded 70%.

Conclusions

TE could be used as a good screening tool for significant portal hypertension, but only moderate diagnostic utility for the prediction of oesophageal varices or large oesophageal varices.
Rise and fall of a wolf population: genetic diversity and structure during recovery, rapid expansion and drastic decline
Authors: Jansson E. , Ruokonen M. , Kojola I. , Aspi J.
Published: September 2012

The grey wolves (Canis lupus) of Finland have had a varied history, with a period of rapid population expansion after the mid‐1990s followed by a decline with a current census size of about 140 wolves. Here, we investigate the impact of unstable population size and connectivity on genetic diversity and structure in a long‐term genetic study of 298 Finnish wolves born in 1995–2009 and genotyped for 17 microsatellite loci. During the initial recovery and prior to population expansion, genetic diversity was high (1995–1997: LD‐Ne = 67.2; Ho = 0.749; He = 0.709) despite a small census size and low number of breeders (Nc < 100; Nb < 10) likely reflecting the status of the Russian source population. Surprisingly, observed heterozygosity decreased significantly during the study period (t = −2.643, P = 0.021) despite population expansion, likely a result of an increase in inbreeding (FIS = 0.108 in 2007–2009) owing to a low degree of connectivity with adjacent Russian wolf population (m = 0.016–0.090; FST = 0.086, P < 0.001) and population crash after 2006. However, population growth had a temporary positive impact on Ne and number of family lines. This study shows that even strong population growth alone might not be adequate to retain genetic diversity, especially when accompanied with low amount of subsequent gene flow and population decline.
The fate of duplicated genes in a polyploid plant genome
Authors: Roulin Anne , Auer Paul L. , Libault Marc , Schlueter Jessica , Farmer Andrew , May Greg , Stacey Gary , Doerge Rebecca W. , Jackson Scott A.
Published: September 2012

Polyploidy is generally not tolerated in animals, but is widespread in plant genomes and may result in extensive genetic redundancy. The fate of duplicated genes is poorly understood, both functionally and evolutionarily. Soybean (Glycine max L.) has undergone two separate polyploidy events (13 and 59 million years ago) that have resulted in 75% of its genes being present in multiple copies. It therefore constitutes a good model to study the impact of whole‐genome duplication on gene expression. Using RNA‐seq, we tested the functional fate of a set of approximately 18 000 duplicated genes. Across seven tissues tested, approximately 50% of paralogs were differentially expressed and thus had undergone expression sub‐functionalization. Based on gene ontology and expression data, our analysis also revealed that only a small proportion of the duplicated genes have been neo‐functionalized or non‐functionalized. In addition, duplicated genes were often found in collinear blocks, and several blocks of duplicated genes were co‐regulated, suggesting some type of epigenetic or positional regulation. We also found that transcription factors and ribosomal protein genes were differentially expressed in many tissues, suggesting that the main consequence of polyploidy in soybean may be at the regulatory level.
Observer-Based H∞ Feedback Control for Arbitrarily Time-Varying Discrete-Time Systems With Intermittent Measurements and Input Constraints
Authors: Zhang Hui , Shi Yang
Published: September 2012

In this paper, we investigate the observer-based H∞ feedback control problem for discrete-time systems subject intermittent measurements and constrained control inputs. To characterize the practical scenario of the intermittent measurement phenomenon, we model it using a stochastic Bernoulli approach. We assume that the control action is constrained to be below a prescribed level. Sufficient conditions are obtained for the observer-based H∞ feedback control problem. The estimator and the controller are derived by solving a linear matrix inequality (LMI)-based optimization problem. Moreover, the proposed method is extended to systems with arbitrarily time-varying parameters within a polytope with unknown vertices. Three examples are given to illustrate the effectiveness and efficacy of the proposed method.
Microstructure and electrical properties of LaNiO3 thin films by RF sputtering for the growth of (Pb,La)(Zr,Ti)O3 films on silicon and nickel substrates
Authors: Liu Shanshan , Ma Beihai , Narayanan Manoj , Tong Sheng , Koritala Rachel , Balachandran Uthamalingam
Published: September 2012

Conductive LaNiO3 (LNO) thin films were deposited on Si substrates by RF sputtering at room temperature to 600 °C. X-ray diffraction of the LNO films showed that preferred orientation varied from (100) below 500 °C to (110) at 600 °C at deposition temperature of 200–600 °C. The room temperature resistivity was 2250–3400 μΩ-cm at the range of 200 °C ∼500 °C. The LNO films, deposited at room temperature, were postannealed in air from 500 to 800 °C, and the resistivity value was 280 μΩ-cm at a postannealing temperature of 600 °C. Subsequently, sol–gel derived (Pb,La)(Zr,Ti)O3 thin films were deposited on LNO-buffered nickel substrates and characterized, the results were compared to those of the same films on silicon substrates. The comparison demonstrated that the performance characteristics of the LNO-buffered nickel foils are similar to those of LNO-buffered silicon substrates. Thus, LNO films prepared by the sputtering method can act as an effective barrier layer on nickel substrates for embedded microelectronic devices.
Metagenome Mining Reveals Polytheonamides as Posttranslationally Modified Ribosomal Peptides
Authors: Freeman Michael F. , Gurgui Cristian , Helf Maximilian J. , Morinaka Brandon I. , Uria Agustinus R. , Oldham Neil J. , Sahl Hans-Georg , Matsunaga Shigeki , Piel Jörn
Published: September 2012

Made and Modified

The polytheonamides are 48-residue toxins derived from marine sponges that include 18
D
-amino acids, as well as many other unusual amino acid modifications. Given the complexity, one might guess that these peptides are the product of nonribosomal, peptide synthetase (NRPS). However,

Freeman
et al.

(p.
387
, published online 13 September now show that polytheonamides are produced by a bacterial symbiont using a ribosomal pathway. Six candidate enzymes for the 48 posttranslational modifications were identified and three were functionally validated. Such ribosomal systems could be useful in bioengineering.
Cross-Site Soil Microbial Communities under Tillage Regimes: Fungistasis and Microbial Biomarkers
Authors: Sipilä Timo P. , Yrjälä Kim , Alakukku Laura , Palojärvi Ansa
Published: September 2012

The exploitation of soil ecosystem services by agricultural management strategies requires knowledge of microbial communities in different management regimes. Crop cover by no-till management protects the soil surface, reducing the risk of erosion and nutrient leaching, but might increase straw residue-borne and soilborne plant-pathogenic fungi. A cross-site study of soil microbial communities and
Fusarium
fungistasis was conducted on six long-term agricultural fields with no-till and moldboard-plowed treatments. Microbial communities were studied at the topsoil surface (0 to 5 cm) and bottom (10 to 20 cm) by general bacterial and actinobacterial terminal restriction fragment length polymorphism (T-RFLP) and phospholipid fatty acid (PLFA) analyses.
Fusarium culmorum
soil fungistasis describing soil receptivity to plant-pathogenic fungi was explored by using the surface layer method. Soil depth had a significant impact on general bacterial as well as actinobacterial communities and PLFA profiles in no-till treatment, with a clear spatial distinction of communities (
P
< 0.05), whereas the depth-related separation of microbial communities was not observed in plowed fields. The fungal biomass was higher in no-till surface soil than in plowed soil (
P
< 0.07). Soil total microbial biomass and fungal biomass correlated with fungistasis (
P
< 0.02 for the sum of PLFAs;
P
< 0.001 for PLFA 18:2ω6). Our cross-site study demonstrated that agricultural management strategies can have a major impact on soil microbial community structures, indicating that it is possible to influence the soil processes with management decisions. The interactions between plant-pathogenic fungi and soil microbial communities are multifaceted, and a high level of fungistasis could be linked to the high microbial biomass in soil but not to the specific management strategy.