bluuebunny/crossref_metadata_2025 huggingface dataset:
On Emotion and the Emotions: A Comment to Dixon, Mulligan and Scherer, and Scarantino
Authors: Wassmann Claudia
Published: September 2012

One reason why the debate about “emotion” runs into a dead end is that the second historical source which considered “emotion” as a cognitive function in the late 19th century was forgotten in Anglo-American psychology.
The Cultural Psychology of Natural Kinds and the Deconstruction of the Emotions: A Comment
Authors: Shweder Richard A.
Published: September 2012

Stimulated by these three brilliant target essays this commentary raises a few questions about the universality of the “emotions,” the cultural psychology of “natural kinds,” and the analytic deconstruction of the idea of an emotion.
Registration of Magnetic Resonance Image Series for Knee Articular Cartilage Analysis
Authors: Urish Kenneth L. , Williams Ashley A. , Durkin John R. , Chu Constance R. ,   the OAI Investigators Group
Published: September 2012

Objective:

Although conventional radiography is used to assess osteoarthritis in a clinical setting, it has limitations, including an inability to stage early cartilage degeneration. There is a growing interest in using quantitative magnetic resonance imaging to identify degenerative changes in articular cartilage, including the large multicentered study, the Osteoarthritis Initiative (OAI). There is a demand for suitable image registration and segmentation software to complete this analysis. The objective of this study was to develop and validate the open source software, ImageK, that registers 3 T MRI T2 mapping and double echo steady state (DESS) knee MRI sequences acquired in the OAI protocol.

Methods:

A C++ library, the insight toolkit, was used to develop open source software to register DESS and T2 mapping image MRI sequences using Mattes’s Multimodality Mutual information metric.

Results:

Registration was assessed using three separate methods. A checkerboard layout demonstrated acceptable visual alignment. Fiducial markers placed in cadaveric knees measured a registration error of 0.85 voxels. Measuring the local variation in Mattes’s Mutual Information metric in the local area of the registered solution showed precision within 1 pixel. In this group, the registered solution required a transform of 56 voxels in translation and 1 degree of rotation.

Conclusion:

The software we have developed, ImageK, provides free, open source image analysis software that registers DESS and T2 mapping sequences of knee articular cartilage within 1 voxel accuracy. This image registration software facilitates quantitative MRI analyses of knee articular cartilage.
Molecular Mechanism Underlying the Antidiabetic Effects of a Siddha Polyherbal Preparation in the Liver of Type 2 Diabetic Adult Male Rats
Authors: Balaji Venkataraman , Selvaraj Jayaraman , Sathish Sampath , Mayilvanan Chinnaiyan , Balasubramanian Karundevi
Published: September 2012

A siddha polyherbal preparation consisting of 5 medicinal plants, namely, Asparagus racemosus, Emblica officinalis, Salacia oblonga, Syzygium aromaticum, and Tinospora cordifolia, in equal ratio, was formulated to examine the molecular mechanism by which it exhibits antidiabetic effects in the liver of high-fat and fructose-induced type 2 diabetic rats. The polyherbal preparation treated type 2 diabetic rats showed an increase in insulin receptor, Akt, and glucose transporter2 mRNA levels compared with diabetic rats. Insulin receptor, insulin receptor substrate-2, Akt, phosphorylated Akt substrate of 160kDaThreonine642, α-Actinin-4, β-arrestin-2, and glucose transporter2 proteins were also markedly decreased in diabetic rats, whereas the polyherbal preparation treatment significantly improved the expression of these proteins more than that of metformin-treated diabetic rats. The expression pattern of insulin signaling molecules analyzed in the present study signifies the therapeutic efficacy of the siddha polyherbal preparation.
Sitting in Church
Authors: Sullins D. Paul
Published: September 2012

Giddens’ structuration theory suggests that social zoning or regionalization in worship services may occur on a front-to-back axis. To test this prediction, we observed the seating of individuals ( N = 3,426) at worship services over a 3-year period at 35 churches in three Protestant denominations: Southern Baptist, United Methodist, and Episcopalian. We found that persons seated in congregations are structured into three zones front to rear. Earlier arrivers in church tend to sit in the front region and late arrivers in the back region; this tendency is strongest in large congregations and in small churches. The close fit to the data of a constrained loglinear model ( p = .65) provides evidence that all the hypothesized effects are present. We argue that Giddens’ and Goffman’s categories are validated by and helpful for understanding regions in worship, and that this understudied area of research has value for understanding the sociology of religious congregations as well as structuring worship experiences and worship spaces.
Residual stresses, microstructure and tensile properties in Ti–6Al–4V friction stir welds
Authors: Steuwer A , Hattingh D G , James M N , Singh U , Buslaps T
Published: September 2012

This paper reports the results of a systematic investigation of residual stresses as a function of welding speed in a set of Ti–6Al–4V friction stir welds. The investigation focuses on residual stress but links these data with microstructural information derived from micrographs and hardness measurements as well as mechanical testing results. Residual stresses were determined using energy dispersive synchrotron X-ray diffraction, which allows phase specific stresses to be distinguished. The data presented in this paper demonstrate that welds with high tensile properties can be obtained, which also have relatively low peak tensile residual stress values of ∼30% of the tensile strength. The data also show a clear correlation between heat input and the width of the residual stress profile.
Linear friction welding of aluminium to copper
Authors: Bhamji I , Moat R J , Preuss M , Threadgill P L , Addison A C , Peel M J
Published: September 2012

The joining of dissimilar materials is attaining increasing importance as there is a drive to utilise hybrid structures and reduce the weight or cost of products. The present work therefore studied the linear friction welding of commercially pure grades of aluminium to copper (AA 1050 to C101) for potential power transmission applications. Results showed that welds with very good mechanical and electrical properties can be produced. The weld microstructure was analysed using optical microscopy, backscattered scanning electron microscopy, hardness testing and high energy synchrotron X-ray diffraction. These techniques were used in order to identify any cross-weld grain size variations and possible formation of intermetallic phases close to the weld line.
Genetic polymorphisms in CYP1A1, GSTM1, GSTP1 and GSTT1metabolic genes and risk of lung cancer in Asturias
Authors: López-Cima M Felicitas , Álvarez-Avellón Sara M , Pascual Teresa , Fernández-Somoano Ana , Tardón Adonina
Published: September 2012

Background

Metabolic genes have been associated with the function of metabolizing and detoxifying environmental carcinogens. Polymorphisms present in these genes could lead to changes in their metabolizing and detoxifying ability and thus may contribute to individual susceptibility to different types of cancer. We investigated if the individual and/or combined modifying effects of theCYP1A1 MspIT6235C,GSTM1 present/null,GSTT1 present/nullandGSTP1 Ile105Valpolymorphisms are related to the risk of developing lung cancer in relation to tobacco consumption and occupation in Asturias, Northern Spain.

Methods

A hospital-based case–control study (CAPUA Study) was designed including 789 lung cancer patients and 789 control subjects matched in ethnicity, age, sex, and hospital. Genotypes were determined by PCR or PCR-RFLP. Individual and combination effects were analysed using an unconditional logistic regression adjusting for age, pack-years, family history of any cancer and occupation.

Results

No statistically significant main effects were observed for the carcinogen metabolism genes in relation to lung cancer risk. In addition, the analysis did not reveal any significant gene-gene, gene-tobacco smoking or gene-occupational exposure interactions relative to lung cancer susceptibility. Lastly, no significant gene-gene combination effects were observed.

Conclusions

These results suggest that genetic polymorphisms in theCYP1A1,GSTM1,GSTT1andGSTP1metabolic genes were not significantly associated with lung cancer risk in the current study. The results of the analysis of gene-gene interactions ofCYP1A1 MspI T6235C,GSTM1present/null,GSTT1present/null andGSTP1Ile105Val polymorphisms in lung cancer risk indicate that these genes do not interact in lung cancer development.
Plasma concentrations of soluble cytokine receptors in euthymic bipolar patients with and without subsyndromal symptoms
Authors: Cetin Turan , Guloksuz Sinan , Cetin Esin Aktas , Gazioglu Sema Bilgic , Deniz Gunnur , Oral E Timucin , van Os Jim
Published: September 2012

Background

Current evidence suggests that high concentrations of pro-inflammatory markers are associated with bipolar disorder characterized by severe impairment during inter-episodic periods, reduced treatment response and persistent subsyndromal symptoms. We tested whether persistent subsyndromal symptoms in euthymic bipolar patients were associated with markers of an ongoing chronic pro-inflammatory process.

Methods

Forty-five euthymic bipolar patients (22 with subsyndromal symptoms (BD+) and 23 without subsyndromal symptoms (BD-) and 23 well controls (WC) were recruited for assessment of soluble tumor necrosis factor receptor-1 (sTNF-R1), soluble interleukin-6 receptor (sIL-6R) and soluble interleukin-2 receptor (sIL-2R) concentrations. Soluble cytokine receptor concentrations were assessed using enzyme-linked immunosorbent assay.

Results

In comparison to WC, sTNF-R1 concentration was higher in both BD- and BD+ (age and sex adjusted standardized β, respectively: β = 0.34, p = 0.012 and β = 0.41, p = 0.003). Similarly, compared to WC, sIL-6R concentration was higher in both BD- and BD+ (age and sex adjusted standardized β, respectively: β = 0.44, p = 0.001 and β = 0.37, p = 0.008). There was no difference between BD- and BD+ in the concentration of either sTNF-R1 or sIL-6R; plasma concentration of sIL-2R was not analyzed as 75% percent of the samples were non-detectable.

Conclusions

Although bipolar patients present with a pro-inflammatory shift compared to well controls, subsyndromal symptoms are not associated with additive increasing effects. Longitudinal studies with larger samples are required to clarify the relationship between illness course and inflammatory markers in bipolar disorder.
Seven years of the field epidemiology training programme (FETP) at Chennai, Tamil Nadu, India: an internal evaluation
Authors:   The NIE FETP team (by alphabetical order), Bhatnagar Tarun , Gupte Mohan D , Hutin Yvan J , Kaur Prabhdeep , Kumaraswami Vasanthapuram , Manickam Ponnaiah , Murhekar Manoj , Ramachandran Vidya , Ramakrishnan Ramachandran
Published: September 2012

Background

During 2001–2007, the National Institute of Epidemiology (NIE), Chennai, Tamil Nadu, India admitted 80 trainees in its two-year Field Epidemiology Training Programme (FETP). We evaluated the first seven years of the programme to identify strengths and weaknesses.

Methods

We identified core components of the programme and broke them down into input, process, output and outcome. We developed critical indicators to reflect the logic model. We reviewed documents including fieldwork reports, abstracts listed in proceedings and papers published in Medline-indexed journals. We conducted an anonymous online survey of the graduates to collect information on self-perceived competencies, learning activities, field assignments, supervision, curriculum, relevance to career goals, strengths and weaknesses.

Results

Of the 80 students recruited during 2001–2007, 69 (86%) acquired seven core competencies (epidemiology, surveillance, outbreaks, research, human subjects protection, communication and management) and graduated through completion of at least six field assignments. The faculty-to-student ratio ranged between 0.4 and 0.12 (expected: 0.25). The curriculum was continuously adapted with all resources available on-line. Fieldwork led to the production of 158 scientific communications presented at international meetings and to 29 manuscripts accepted in indexed, peer-reviewed journals. The online survey showed that while most graduates acquired competencies, unmet needs persisted in laboratory sciences, data analysis tools and faculty-to-student ratio.

Conclusions

NIE adapted the international FETP model to India. However, further efforts are required to scale up the programme and to develop career tracks for field epidemiologists in the country.
Trion X+ in vertically coupled type II quantum dots in threading magnetic field
Authors: Horta-Piñeres Sindi , Escorcia-Salas Gene Elizabeth , Mikhailov Ilia D , Sierra-Ortega José
Published: September 2012

We analyze the energy spectrum of a positively charged exciton confined in a semiconductor heterostructure formed by two vertically coupled, axially symmetrical type II quantum dots located close to each other. The electron in the structure is mainly located inside the dots, while the holes generally move in the exterior region close to the symmetry axis. The solutions of the Schrödinger equation are obtained by a variational separation of variables in the adiabatic limit. Numerical results are shown for bonding and anti-bonding lowest-lying of the trion states corresponding to the different quantum dots morphologies, dimensions, separation between them, thicknesses of the wetting layers, and the magnetic field strength.
Heterotrimeric G protein-dependent WNT-5A signaling to ERK1/2 mediates distinct aspects of microglia proinflammatory transformation
Authors: Halleskog Carina , Dijksterhuis Jacomijn Petronella , Kilander Michaela Brita Christina , Becerril-Ortega Javier , Villaescusa Juan Carlos , Lindgren Eva , Arenas Ernest , Schulte Gunnar
Published: September 2012

Background

WNT-5A signaling in the central nervous system is important for morphogenesis, neurogenesis and establishment of functional connectivity; the source of WNT-5A and its importance for cellular communication in the adult brain, however, are mainly unknown. We have previously investigated the inflammatory effects of WNT/β-catenin signaling in microglia in Alzheimer's disease. WNT-5A, however, generally recruits β-catenin-independent signaling. Thus, we aim here to characterize the role of WNT-5A and downstream signaling pathways for the inflammatory transformation of the brain's macrophages, the microglia.

Methods

Mouse brain sections were used for immunohistochemistry. Primary isolated microglia and astrocytes were employed to characterize the WNT-induced inflammatory transformation and underlying intracellular signaling pathways by immunoblotting, quantitative mRNA analysis, proliferation and invasion assays. Further, measurements of G protein activation by [γ-35 S]GTP binding, examination of calcium fluxes and cyclic AMP production were used to define intracellular signaling pathways.

Results

Astrocytes in the adult mouse brain express high levels of WNT-5A, which could serve as a novel astroglia-microglia communication pathway. The WNT-5A-induced proinflammatory microglia response is characterized by increased expression of inducible nitric oxide synthase, cyclooxygenase-2, cytokines, chemokines, enhanced invasive capacity and proliferation. Mapping of intracellular transduction pathways reveals that WNT-5A activates heterotrimeric Gi/o proteins to reduce cyclic AMP levels and to activate a Gi/o protein/phospholipase C/calcium-dependent protein kinase/extracellular signal-regulated kinase 1/2 (ERK1/2) axis. We show further that WNT-5A-induced ERK1/2 signaling is responsible for distinct aspects of the proinflammatory transformation, such as matrix metalloprotease 9/13 expression, invasion and proliferation.

Conclusions

Thus, WNT-5A-induced and G protein-dependent signaling to ERK1/2 is important for the regulation of proinflammatory responses in mouse primary microglia cells. We show for the first time that WNT-5A/G protein signaling mediates physiologically important processes in primary mammalian cells with natural receptor and G protein stochiometry. Consequently, WNT-5A emerges as an important means of astrocyte-microglia communication and we, therefore, suggest WNT-5A as a new player in neuroinflammatory conditions, such as neurodegenerative disease, hypoxia, stroke, injury and infection.
Annotate-it: a Swiss-knife approach to annotation, analysis and interpretation of single nucleotide variation in human disease
Authors: Sifrim Alejandro , Van Houdt Jeroen KJ , Tranchevent Leon-Charles , Nowakowska Beata , Sakai Ryo , Pavlopoulos Georgios A , Devriendt Koen , Vermeesch Joris R , Moreau Yves , Aerts Jan
Published: September 2012

The increasing size and complexity of exome/genome sequencing data requires new tools for clinical geneticists to discover disease-causing variants. Bottlenecks in identifying the causative variation include poor cross-sample querying, constantly changing functional annotation and not considering existing knowledge concerning the phenotype. We describe a methodology that facilitates exploration of patient sequencing data towards identification of causal variants under different genetic hypotheses. Annotate-it facilitates handling, analysis and interpretation of high-throughput single nucleotide variant data. We demonstrate our strategy using three case studies. Annotate-it is freely available and test data are accessible to all users at http://www.annotate-it.org.
Comparison of the low-frequency variations of the vertical and horizontal components of the electric background field at the sea bottom
Authors: Flekkøy Eirik G. , Håland Endre , Måløy Knut Jørgen
Published: September 2012

Natural electric field variations are measured at the sea bottom over long periods of time by means of stationary, vertical, and horizontal galvanic antennas. We compare the power spectra of the vertical and horizontal field components and the extent to which they may be reduced by standard averaging techniques. Although the raw spectra of the vertical and horizontal components do not differ greatly, the difference in the spectra after averaging is significantly greater. Most significantly, in the frequency range between 0.0005 and 0.03 Hz, this averaging scheme suppresses the vertical electric field component more strongly than the horizontal component.
Lithologic imaging using complex conductivity: Lessons learned from the Hanford 300 Area
Authors: Mwakanyamale Kisa , Slater Lee , Binley Andrew , Ntarlagiannis Dimitrios
Published: September 2012

Field-scale lithologic applications of complex conductivity ([Formula: see text]) imaging have been hindered by the challenges of (1) acquiring reliable induced polarization (IP) measurements and (2) obtaining reliable [Formula: see text] images from the measurements. We performed a series of 2D time domain resistivity/IP surveys at the Hanford 300 Area (Richland, Washington) where the challenge was to image the spatial distribution of two lithologic units that control the exchange between groundwater and surface water of the Columbia River. Exploiting the equivalence between time domain and frequency domain measurements of polarization, a 2D [Formula: see text] inversion (real conductivity [Formula: see text], imaginary conductivity [Formula: see text], and phase angle [Formula: see text]) was used to image the spatial distribution of [Formula: see text] across the site. Synthetic studies were carried out to investigate the effects of noise on the resolution of [Formula: see text] images and to add confidence on the interpretation of possible paleochannels observed in the field data sets. The synthetic studies show that, with increasing representative noise levels, degradation of the resolution of lithologic structures in the parameters most controlled by the IP measurements ([Formula: see text] and [Formula: see text]) is significantly greater than degradation of resolution of [Formula: see text] images. However, the acquisition of IP measurements, and the analysis of changes in [Formula: see text] and [Formula: see text] constrains the lithological interpretation of the geoelectrical data set due to the strong dependency of [Formula: see text] on lithological properties. A threshold based on [Formula: see text] measurements from cores at the site was used to estimate the elevation of the contact between the two key units, which is consistent with boreholes at the site. Variation in the elevation of this contact provides evidence of a depression in the Hanford-Ringold contact connecting the aquifer and the Columbia River; this depression likely represents a paleochannel regulating flow and transport at the site.
Discovery of a Novel Glucagon-like Peptide (GCGL) and Its Receptor (GCGLR) in Chickens: Evidence for the Existence of GCGL and GCGLR Genes in Nonmammalian Vertebrates
Authors: Wang Yajun , Meng Fengyan , Zhong Yu , Huang Guian , Li Juan
Published: September 2012

Glucagon (GCG), glucagon-related peptides, and their receptors have been reported to play important roles including the regulation of glucose homeostasis, gastrointestinal activity, and food intake in vertebrates. In this study, we identified genes encoding a novel glucagon-like peptide (named GCGL) and its receptor (GCGLR) from adult chicken brain using RACE and/or RT-PCR. GCGL was predicted to encode a peptide of 29 amino acids (cGCGL1–29), which shares high amino acid sequence identity with mammalian and chicken GCG (62–66%). GCGLR is a receptor of 430 amino acids and shares relatively high amino acid sequence identity (53–55%) with the vertebrate GCG receptor (GCGR). Using a pGL3-CRE-luciferase reporter system, we demonstrated that synthetic cGCGL1–29, but not its structurally related peptides, i.e. exendin-4 and GCG, could potently activate GCGLR (EC50: 0.10 nm) expressed in Chinese hamster ovary cells, indicating that GCGLR can function as a GCGL-specific receptor. RT-PCR assay revealed that GCGL expression is mainly restricted to several tissues including various brain regions, spinal cord, and testes, whereas GCGLR mRNA is widely expressed in adult chicken tissues with abundant expression noted in the pituitary, spinal cord, and various brain regions. Using synteny analysis, GCGL and GCGLR genes were also identified in the genomes of fugu, tetraodon, tilapia, medaka, coelacanth, and Xenopus tropicalis. As a whole, the discovery of GCGL and GCGLR genes in chickens and other nonmammalian vertebrates clearly indicates a previously unidentified role of GCGL-GCGLR in nonmammalian vertebrates and provides important clues to the evolutionary history of GCG and GCGL genes in vertebrates.
Mitochondrial hyperfusion induced by loss of the fission protein Drp1 causes ATM-dependent G2/M arrest and aneuploidy through DNA replication stress
Authors: Qian Wei , Choi Serah , Gibson Gregory A. , Watkins Simon C. , Bakkenist Christopher J. , Van Houten Bennett
Published: September 2012

Mitochondrial fission and fusion cycles are integrated with cell cycle progression. In this paper, we demonstrate that the inhibition of mitochondrial fission protein Drp1 causes an unexpected delay in G2/M cell cycle progression and aneuploidy. In investigating the underlying molecular mechanism, we revealed that inhibiting Drp1 triggers replication stress, which is mediated by a hyperfused mitochondrial structure and unscheduled expression of cyclin E in the G2 phase. This persistent replication stress then induces an ATM-dependent activation of the G2 to M transition cell cycle checkpoint. Knockdown of ATR, an essential kinase in preventing replication stress, significantly enhanced DNA damage and cell death of Drp1-deficienct cells. Persistent mitochondrial hyperfusion also induces centrosomal overamplification and chromosomal instability, which are causes of aneuploidy. Analysis using cells depleted of mitochondrial DNA revealed that these events are not mediated by the defects in mitochondrial ATP production and reactive oxygen species (ROS) generation. Thus dysfunctional mitochondrial fission directly induces genome instability by replication stress, which then initiates the DNA damage response. Our findings provide a novel mechanism that contributes to the cellular dysfunction and diseases associated with altered mitochondrial dynamics.
Measuring What Employers Do about Entry Wages over the Business Cycle: A New Approach
Authors: Martins Pedro S , Solon Gary , Thomas Jonathan P
Published: September 2012

Rigidity in real hiring wages plays a crucial role in some recent macroeconomic models. But are hiring wages really so noncyclical? We propose using employer/employee longitudinal data to track the cyclical variation in the wages paid to workers newly hired into specific entry jobs. Illustrating the methodology with 1982–2008 data from the Portuguese census of employers, we find real entry wages were about 1.8 percent higher when the unemployment rate was 1 percentage point lower. Like most recent evidence on other aspects of wage cyclicality, our results suggest that the cyclical elasticity of wages is similar to that of employment. (JEL E24, E32, J31, J64)
Cut-First Branch-and-Price-Second for the Capacitated Arc-Routing Problem
Authors: Bode Claudia , Irnich Stefan
Published: September 2012

This paper presents the first full-fledged branch-and-price (bap) algorithm for the capacitated arc-routing problem (CARP). Prior exact solution techniques either rely on cutting planes or the transformation of the CARP into a node-routing problem. The drawbacks are either models with inherent symmetry, dense underlying networks, or a formulation where edge flows in a potential solution do not allow the reconstruction of unique CARP tours. The proposed algorithm circumvents all these drawbacks by taking the beneficial ingredients from existing CARP methods and combining them in a new way. The first step is the solution of the one-index formulation of the CARP in order to produce strong cuts and an excellent lower bound. It is known that this bound is typically stronger than relaxations of a pure set-partitioning CARP model. Such a set-partitioning master program results from a Dantzig-Wolfe decomposition. In the second phase, the master program is initialized with the strong cuts, CARP tours are iteratively generated by a pricing procedure, and branching is required to produce integer solutions. This is a cut-first bap-second algorithm and its main function is, in fact, the splitting of edge flows into unique CARP tours.
The outcomes of navigation-assisted bone tumour surgery
Authors: Cho H. S. , Oh J. H. , Han I. , Kim H-S.
Published: September 2012

We evaluated the oncological and functional outcome of 18 patients, whose malignant bone tumours were excised with the assistance of navigation, and who were followed up for more than three years. There were 11 men and seven women, with a mean age of 31.8 years (10 to 57). There were ten operations on the pelvic ring and eight joint-preserving limb salvage procedures. The resection margins were free of tumour in all specimens. The tumours, which were stage IIB in all patients, included osteosarcoma, high-grade chondrosarcoma, Ewing’s sarcoma, malignant fibrous histiocytoma of bone, and adamantinoma. The overall three-year survival rate of the 18 patients was 88.9% (95% confidence interval (CI) 75.4 to 100). The three-year survival rate of the patients with pelvic malignancy was 80.0% (95% CI 55.3 to 100), and of the patients with metaphyseal malignancy was 100%. The event-free survival was 66.7% (95% CI 44.9 to 88.5). Local recurrence occurred in two patients, both of whom had a pelvic malignancy. The mean Musculoskeletal Tumor Society functional score was 26.9 points at a mean follow-up of 48.2 months (22 to 79).

We suggest that navigation can be helpful during surgery for musculoskeletal tumours; it can maximise the accuracy of resection and minimise the unnecessary sacrifice of normal tissue by providing precise intra-operative three-dimensional radiological information.
The clinical and radiological outcome of pulsed electromagnetic field treatment for acute scaphoid fractures
Authors: Hannemann P. F. W. , Göttgens K. W. A. , van Wely B. J. , Kolkman K. A. , Werre A. J. , Poeze M. , Brink P. R. G.
Published: September 2012

The use of pulsed electromagnetic fields (PEMF) to stimulate bone growth has been recommended as an alternative to the surgical treatment of ununited scaphoid fractures, but has never been examined in acute fractures. We hypothesised that the use of PEMF in acute scaphoid fractures would accelerate the time to union by 30% in a randomised, double-blind, placebo-controlled, multicentre trial. A total of 53 patients in three different medical centres with a unilateral undisplaced acute scaphoid fracture were randomly assigned to receive either treatment with PEMF (n = 24) or a placebo (n = 29). The clinical and radiological outcomes were assessed at four, six, nine, 12, 24 and 52 weeks.

A log-rank analysis showed that neither time to clinical and radiological union nor the functional outcome differed significantly between the groups. The clinical assessment of union indicated that at six weeks tenderness in the anatomic snuffbox (p = 0.03) as well as tenderness on longitudinal compression of the scaphoid (p = 0.008) differed significantly in favour of the placebo group.

We conclude that stimulation of bone growth by PEMF has no additional value in the conservative treatment of acute scaphoid fractures.
FRAX and the assessment of the risk of developing a fragility fracture
Authors: Middleton R. G. , Shabani F. , Uzoigwe C. E. , Moqsith M. , Venkatesan M.
Published: September 2012

Osteoporosis is common and the health and financial cost of fragility fractures is considerable. The burden of cardiovascular disease has been reduced dramatically by identifying and targeting those most at risk. A similar approach is potentially possible in the context of fragility fractures. The World Health Organization created and endorsed the use of FRAX, a fracture risk assessment tool, which uses selected risk factors to calculate a quantitative, patient-specific, ten-year risk of sustaining a fragility fracture. Treatment can thus be based on this as well as on measured bone mineral density. It may also be used to determine at-risk individuals, who should undergo bone densitometry. FRAX has been incorporated into the national osteoporosis guidelines of countries in the Americas, Europe, the Far East and Australasia. The United Kingdom National Institute for Health and Clinical Excellence also advocates its use in their guidance on the assessment of the risk of fragility fracture, and it may become an important tool to combat the health challenges posed by fragility fractures.
Proximal interphalangeal joint replacement in patients with arthritis of the hand
Authors: Adams J. , Ryall C. , Pandyan A. , Metcalf C. , Stokes M. , Bradley S. , Warwick D. J.
Published: September 2012

We systematically reviewed all the evidence published in the English language on proximal interphalangeal joint (PIPJ) replacement, to determine its effectiveness on the function of the hand and the associated post-operative complications.

Original studies were selected if they reported clinical outcome with a minimum of one year’s follow-up. Quality was assessed using the Cowley systematic review criteria modified for finger-joint replacements. Of 319 articles identified, only five were adequately reported according to our quality criteria; there were no randomised controlled trials. PIPJ replacements had a substantial effect size on hand pain of -23.2 (95% confidence interval (CI) -27.3 to -19.1) and grip strength 1.2 (95% CI -10.7 to 13.1), and a small effect on range of movement 0.2 (95% CI -0.4 to 0.8). A dorsal approach was most successful. Post-operative loosening occurred in 10% (95% CI 3 to 30) of ceramic and 12.5% (95% CI 7 to 21) of pyrocarbon replacements. Post-operative complications occurred in 27.8% (95% CI 20 to 37).

We conclude that the effectiveness of PIPJ replacement has not been established. Small observational case studies and short-term follow-up, together with insufficient reporting of patient data, functional outcomes and complications, limit the value of current evidence.

We recommend that a defined core set of patients, surgical and outcome data for this intervention be routinely and systematically collected within the framework of a joint registry.
Survey of UK practice for management of breast cancer metastases to the neck
Authors: Bisase B , Kerawala C
Published: September 2012

INTRODUCTION

Cervical metastases from breast carcinoma are rare and their management is controversial. Between 1987 and 2002 the American Joint Committee on Cancer (AJCC) staged patients with supraclavicular fossa nodal disease as M1 but the subsequent demonstration that patients with regional stage IV disease had better outcomes than visceral stage IV disease led to a reclassification of the former to stage IIIC in 2003. The literature remains inconsistent regarding the fate of these patients. Despite the attendant morbidity of treatment and lack of knowledge regarding long-term survival, we hypothesised that current practice varies in the UK and a unified approach does not exist. The aim of this study was therefore to determine current practice and opinion of both head and neck specialists and breast cancer clinicians in the UK.

METHODS

Questionnaires were disseminated to 185 head and neck surgeons, breast surgeons and their oncology counterparts. These outlined a clinical scenario of a patient with a history of T3 primary breast cancer presenting with cervical and supraclavicular nodal metastases, with opinion being sought regarding the significance of this status and the individual’s practical approach to the problem. The extent of any proposed neck dissection was also explored.

RESULTS

Of the 117 respondents, a noticeable variation in opinion was evident. Contrary to the current AJCC staging, 61% of clinicians felt that both level V and III metastases represented stage IV disease. There was a tendency towards aggressive surgical treatment with a third recommending comprehensive neck dissection despite a lack of evidence base. A disparity was noted between adjuvant treatments offered and the final pN stage.

CONCLUSIONS

This study suggests that at present there is widespread inconsistency in the management of breast carcinoma cervical metastases in the UK. There is a need to unify practice with an evidence base in order to improve informed multidisciplinary decision making and, ultimately, patient care. This study goes some way to supporting multicentre collaboration in order to achieve that aim.
Interactions in the aetiology, presentation and management of synchronous and metachronous adenocarcinoma of the prostate and rectum
Authors: Nash GF , Turner KJ , Hickish T , Smith J , Chand M , Moran BJ
Published: September 2012

Adenocarcinoma of the prostate and rectum are common male pelvic cancers and may present synchronously or metachronously and, due to their anatomic proximity. The treatment of rectal or prostate cancer (in particular surgery and/or radiotherapy) may alter the presentation, incidence and management should a metachronous tumour develop. This review focuses on the interaction between prostatic and rectal cancer diagnosis and management. We have restricted the scope of this large topic to general considerations, management of rectal cancer after prostate cancer treatment and vice versa, management of synchronous disease and cancer follow-up issues.
Common bile duct stones: an unusual case of diarrhoea through a mucous fistula
Authors: Davey PT , Epanomeritakis E , Moorehead A
Published: September 2012

We present a very unusual case of diarrhoea in a 77-year-old man. He had a previously complicated surgical history, with a loop ileostomy and a colonic mucous fistula. He developed a sudden onset of diarrhoea from his mucous fistula. A contrast enema suggested a cholecystocolonic fistula and subsequent computed tomography demonstrated a common bile duct stone caused a degree of obstruction. The patient was treated successfully by endoscopic retrograde cholangiopancreatography and stone extraction. This case demonstrated the role that contrast enema may still play in unusual cases of diarrhoea.
Mucinous ovarian tumour presenting as a ruptured incisional hernia
Authors: Toomey D , McNamara D
Published: September 2012

We describe an ovarian borderline tumour that presented as an acute deterioration in an incisional hernia secondary to intraperitoneal mucin accumulation. The differential diagnosis associated with hernial sac contents and options for opportunistic diagnosis are discussed. This case raises awareness of potential serious diagnoses that may be overlooked during emergent hernia repair.
A dermoid cyst fistulating with the transverse colon
Authors: Conway AZ , Hanna T
Published: September 2012

We present a rare case of fistulation of a dermoid cyst with the transverse colon. We illustrate how an infected dermoid cyst can be diagnosed as an appendix abscess although the management of these is quite different. The general surgeon should be aware of this as a differential diagnosis for an appendix abscess.
Difficulties encountered removing locked plates
Authors: Raja S , Imbuldeniya AM , S Garg , Groom G
Published: September 2012

INTRODUCTION

Locked plates are commonly used to obtain fixation in periarticular and comminuted fractures. Their use has also gained popularity in repairing fractures in osteoporotic bone. These plates provide stable fixation and promote biological healing. Over the last 3 years, we have used over 150 locked plates with varying success to fix periarticular fractures involving mainly the knee and ankle. In this study, we report our clinical experience and the difficulties encountered when removing locked plates in adult patients with a variety of indications including implant failure, infection, non-union and a palpable symptomatic implant.

METHODS

A retrospective analysis was performed of patients enrolled prospectively into a database. Included in the study were 36 consecutive adult patients who each underwent the procedure of locked plate removal in a single inner city level 1 trauma centre. Data collected included primary indication for fixation, indication for implant removal, time of the implant in situ, grade of operating surgeon and difficulties encountered during the procedure.

RESULTS

Implant removal was associated with a complication rate of 47%. The major problems encountered were difficulty in removing the locked screws and the implant itself. A total of ten cold welded screws were found in eight cases. Removal was facilitated by high speed metal cutting burrs and screw removal sets in all but one case, where a decision was made to leave the plate in situ.

CONCLUSIONS

The majority of studies investigating implant removal and problems encountered in doing so report a relatively high complication rate. With the advent of locking plates and their growing popularity, difficulties are now being seen intra-operatively when removing them. There is a paucity of data, however, specifically directed at locking plate removal. We recommend that surgeons should be aware of the potential complications while removing locked plates. Fluoroscopic control and all available extra equipment (mainly metal cutting burrs and screw removal sets) should be available in theatre.
Coress feedback
Authors: Smith Frank CT
Published: September 2012

This issue highlights the importance of anatomical orientation, which can sometimes be difficult during bowel anastomosis and stoma formation. The need for good medical communication and an adequate handover, particularly at night and at weekends for patients with medical co-morbidities or following complex surgery, is emphasised in another case.

We are grateful to the clinicians who have provided the material for these reports. The online reporting form is on our website, www.coress.org.uk , which also includes all previous feedback reports. Published contributions will be acknowledged by a ‘Certificate of Contribution’, which may be included in the contributor’s record of continuing professional development.
Maxillofacial Trauma Experience for OMFS Registrars: A Comparison of Surgical Experience and Aetiology in 1980 and 2010
Authors: Nandra BS , Shah KK , Felstead AM , Revington PJ
Published: September 2012

Surgical training has undergone considerable reforms in order to emphasise a structured training programme with supervision in a framework of clinical governance. This was following Sir Kenneth Calman's proposed reforms of the registrar grades in 1993. The European Working Time Regulations (EWTR) became part of British law in 1998 and since August 2009 also includes junior doctors, limiting maximum working times to 48 hours per week with specific rest requirements. This has raised concerns from organisations, such as the British Medical Association and the Royal College of Surgeons, regarding the effect on training and whether changes are needed to prevent a loss in competency and confidence. The 2010 report by Professor Sir John Temple found a lack of conclusive data on the effects of the EWTR on training. However, it recommended that fundamental changes must be made to the way training and service are delivered.
Kinemax Knee Replacement in West on Super-Mare: Putting the Record Straight
Authors: Smith LK , Ahmad R , Langkamer VG
Published: September 2012

In 2002 the government initiated an unprecedented investment in the NHS in England to reduce the waiting time for elective surgery. One of the means of meeting the objective was the development of treatment centres that provided additional capacity. A number of centres were developed across the country managed either within the NHS or in the independent sector. In 2010 the number of primary knee replacement procedures performed in the uK was 76,870, of which 2,456 (3.2%) were completed in NHS treatment centres.
Keys to successful progression directly from CT2 to ST3 in general surgery: a trainee's perspective
Authors: Mishreki AP , Couch DG
Published: September 2012

With a move to national recruitment in general surgery for ST3 places, what characteristics and attitudes are required of the CT2 candidates for successful progression into specialist training? Both authors recently secured a national training number at ST3 level, moving directly from CT2. We describe the factors that we feel helped us to stand out from the crowd and compete successfully with other hopeful trainees. We explain what steps CT1s and CT2s should take to maximise their chances of entering ST3 and what characteristics one should aim to develop to progress in surgery. What is the key to entry into ST3 from CT2? How can candidates shine both at shortlisting and then at interview in the light of the now modernised selection process?
Developing Clinical Care Pathways
Authors: Brunton Paul
Published: September 2012

Clinical care pathways have existed for many years. Their origin is arguably in nursing and many will recall using a nursing care plan. Clinical care pathways are often denounced as 'tick-box' exercises as practitioners wrongly assume that they will result in a loss of clinical freedom. This is not the case; clinical care pathways do not seek to tell practitioners what to do, but to assist and support them in their decisions.
Access all ages: assessing the impact of age on access to surgical treatment
Authors: Ahamat Nona
Published: September 2012

The NHS ban on age discrimination came into force this month. The need for such a policy intervention has been highlighted most recently by studies in the cancer field, which concluded that chronological age as opposed to physiological health has been a barrier to treatment for older people.
Saints and sinner Everard Home
Authors: Tricker John
Published: September 2012

Everard Home was born on 6 May 1756 in Hull, Yorkshire. He had strong medical and military connections: his father was Robert Home, a former army surgeon; his mother, Mary, was the daughter of Colonel Alexander Hutchinson. By 1764 the family had moved to London and were living in Suffolk Street off Pall Mall.
New Evidence on the Relationship Between Economic Freedom and Growth: A Panel Cointegration Analysis for The Case of OECD
Authors: Erdem Ekrem , Tugcu Can Tansel
Published: September 2012

The aim of this paper is to find a new answer to an old question “Is economic freedom good or not for economies?” which was refreshed after the Global Financial Crisis of 2008. For this purpose, the relationship between economic freedom and economic growth, and the relationship between economic freedom and total factor productivity in OECD countries were investigated by using panel data for the period of 1995-2009. Study employed the recently developed cointegration test by Westerlund (2007) and the estimation technique by Bai and Kao (2006) which account for cross-sectional dependence that is an important problem in the panel data studies. Although no significant relationship found between economic freedom and total factor productivity, cointegration analysis revealed that economic freedom matters for economic growth in OECD countries in the long-run, and estimation results showed that direction of the impact is negative.
Regulating Unverifiable Quality by Fixed-Price Contracts
Authors: Cesi Berardino , Iozzi Alberto , Valentini Edilio
Published: September 2012

We apply the idea of relational contracting to a simple problem of regulating a single-product monopoly with unverifiable (then ex ante not contractible) quality. We model the interaction between the regulator and the firm as an infinitely repeated game; we observe that there exist self-enforcing contracts in which the regulator, using her discretionary power on the price (the contractible variable) can induce the firm to produce the required quality level by leaving it a positive rent. When players use grim trigger strategies, the optimal self-enforcing contract implies a distortion from the second best which is greater the more impatient is the firm and the larger is the effect of the price on the deviation profits. Whenever the equilibrium profits of the static game are strictly positive, even if the firm were infinitely patient, the optimal contract would not reach the second-best: it would ensure a quality-adjusted Ramsey condition and, at the same time, leave positive profits to the firm. We extend the model in a few ways: we find that when players use stick-and-carrot strategies, with an infinitely patient firm the second-best outcome is reached even if this implies to punish the deviating firm with negative profits. When instead the regulator is unable to perfectly monitor the firm's quality choice, the price/quality pair giving the highest payoff to the regulator does not directly depend on the firm's discount factor, which instead affects the probability of punishment. Our results suggest that, in fixed price regulatory contracts, the regulatory lag should be shorter the more relevant is the issue of unverifiability, in order to reduce the reward for opportunistic behavior by the firm.