bluuebunny/crossref_metadata_2025 huggingface dataset:
El Salvador'sPandilleros Calmados: The Challenges of Contesting Mano Dura through Peer Rehabilitation and Empowerment
Authors: WOLF SONJA
Published: October 2011

In 2003, the Government of El Salvador launchedPlan Mano Durato curb urban violence and homicides, most of which had been attributed to street gangs. Domestic non‐governmental organisations (NGOs) criticised the measure for its repressive nature and the neglect of the wider policies for prevention and rehabilitation, and sought to promote the implementation of alternative gang control. Drawing on ethnographic research in Homies Unidos‐El Salvador – founded and organised bypandilleros calmados(retired gang members) – the article considers how both the socio‐political context and organisational characteristics shaped the agency's advocacy strategy and why its efforts remained largely ineffective.
The deglacial to postglacial marine environments ofSEBarrowStrait,CanadianArcticArchipelago
Authors: Pieńkowski Anna J. , England John H. , Furze Mark F.A. , Marret Fabienne , Eynaud Frédérique , Vilks Gustav , Maclean Brian , Blasco Steve , Scourse James D.
Published: October 2011

Core 86027‐144 (74°15.56′N, 91°14.21′W) represents a rare, continuous record ofLatePleistocene toHolocene sediments fromHighArcticCanada extending from the end of theLastGlaciation. Based on microfossils (dinocysts, non‐pollen palynomorphs, benthic and planktonic foraminifera), foraminiferalδ18Oandδ13C, and sedimentology, seven palaeoenvironmental zones were identified. ZoneI(>10.8 cal. kaBP) records deglaciation, ice‐sheet destabilization, float‐off and subsequent break‐up. ZoneII(c. 10.8–10.4 cal. kaBP) shows ice‐proximal to ice‐distal glaciomarine conditions, interrupted by pervasive land‐fast sea‐ice marked by a hiatus in coarse sediment deposition. Significant biological activity starts in ZoneIII(10.4–9.9 cal. kaBP), where planktonic foraminifera (Neogloboquadrina pachyderma) suggest early oceanic throughflow. Surface waters flowedNW–SE; however, the deep‐water origin remains unclear (potentiallyNWArcticOcean orBaffinBay). Postglacial amelioration (open‐water season greater than present) in ZoneIV(9.9–7.8 cal. kaBP) perhaps corresponds to the regional ‘Holocene Thermal Maximum’ previously proposed. A transitional period (ZoneV; 7.8–6.7 cal. kaBP) of rapid environmental change fluctuating on a scale not observed today is marked by increasing sea‐ice and reduced oceanic influence. This probably signals the exclusion of deeperAtlantic water owing to the glacio‐isostatic shallowing of inter‐island sills, coupled with generally cooling climate. Conditions analogous to those at present, with increased sea‐ice and modern microfossil assemblages, commence atc.6.7 cal. kaBP(zonesVI–VII). Although climate ultimately forces long‐term environmental trends, core 86027‐144 data imply that regional dynamics, especially changes in sea‐level, exert a significant control on marine conditions throughout theCanadianArcticArchipelago.
Full‐Mouth Rehabilitation of a Patient with Severely Worn Dentition and Uneven Occlusal Plane: A Clinical Report
Authors: Moslehifard Elnaz , Nikzad Sakineh , Geraminpanah Farideh , Mahboub Farhang
Published: October 2011

Severe tooth wear is frequently multifactorial and variable. Successful management is a subject of interest in dentistry. A critical aspect is to determine the occlusal vertical dimension (OVD) and a systematic approach that can lead to a predictable and favorable treatment prognosis. Management of patients with worn dentition is complex and difficult. Accurate clinical and radiographic examinations, a diagnostic wax‐up, and determining OVD are crucial. Using mini‐implants as orthodontic anchorage may facilitate orthodontic movement of teeth to improve their position, which is necessary for favorable prosthetic treatment. A 46‐year‐old man was referred for restoration of his worn and missing teeth. After diagnostic work‐up, provisional removable prostheses were fabricated for both jaws, evaluated clinically, and adjusted according to esthetic, phonetic, and vertical dimension criteria. Clinical crown lengthening and free gingival graft procedures were performed in appropriate areas. Drifting of the left posterior mandibular teeth was corrected using mini‐implants as orthodontic anchorage. Two conventional implants were inserted in the right mandibular edentulous area. After endodontic therapy of worn teeth, custom‐cast gold dowels and cores were fabricated, and provisional removable prostheses were replaced with fixed provisional restorations. Metal‐ceramic restorations were fabricated, and a removable partial denture with attachments was fabricated for maxillary edentulous areas. An occlusal splint was used to protect the restorations. Full‐mouth rehabilitation of the patient with severely worn dentition and an uneven occlusal plane was found to be successful after 3 years of follow‐up. This result can encourage clinicians to seek accurate diagnosis and treatment planning to treat such patients.
An Analysis of Prosthodontic Research Productivity: Geographic, Economic, and Collaborative Perspective
Authors: Thornton Kathryn , Lee Damian J. , Yuan Judy Chia‐Chun , Knoernschild Kent L. , Campbell Stephen D. , Sukotjo Cortino
Published: October 2011

Purpose: This study evaluated the quantity of prosthodontic literature produced globally by continent in three prosthodontic journals over a 10‐year period, 1998–2008. Prosthodontic research productivity relative to economic status of countries and collaboration among countries grouped by economic status was assessed.

Materials and Methods: Three peer‐reviewed prosthodontic journals were used for the analysis of articles published in 1998, 2003, and 2008: The Journal of Prosthetic Dentistry, International Journal of Prosthodontics, and Journal of Prosthodontics. The country of every author listed for each included article was recorded. The number of articles published by each continent and each country was reported. Countries were grouped according to the World Bank economic classification system, and the number of articles published by each economic class was found.

Results: The majority of publications over the 10‐year period were produced in Asia (Japan), Europe (Germany), and North America (USA). Productivity declined by 14.4% in high‐income countries while it increased in upper middle‐, lower middle‐, and low‐income countries. The majority of publications written by upper and lower middle‐ and low‐income countries were independent works. Articles resulting from collaboration increased over time for all economic classes of countries.

Conclusions: The origins of prosthodontic literature are becoming more geographically and economically diverse, with increased contributions from Africa, Asia, and South America, and middle‐ and low‐income countries between 1998 and 2008. Collaboration between high‐income countries and the other economic group countries increased over time.
Preparation of commercial quantities of a hyperimmune human intravenous immunoglobulin preparation against an emerging infectious disease: the example of pandemic H1N1 influenza
Authors: Kreil Thomas R. , Mc Vey John K. , Lei Laura Shau‐Ping , Camacho Laureano , Wodal Walter , Kerschbaum Astrid , Segura Edy , Vandamme Etienne , Gavit Patrick , Ehrlich Hartmut J. , Barrett P. Noel , Baker Donald A.
Published: October 2011

BACKGROUND: The recent H1N1 pandemic provided an opportunity to conceptually assess the possibility of rapidly providing a “hyperimmune” human immunoglobulin (H‐IVIG) to an emerging infectious disease, in useful quantities with respect to public health. Commercial‐scale H‐IVIG production from plasma collected from donors convalescent from or vaccinated against pandemic influenza A (H1N1) virus is described.

STUDY DESIGN AND METHODS: A special protocol was implemented for the collection, processing, and shipment of plasma from previously qualified source plasma donors, self‐identifying as convalescent from or vaccinated against H1N1 influenza. A licensed IVIG manufacturing process was utilized for the preparation of two commercial lots of approximately 50 kg 10% human IVIG preparation in total. The H1N1 hemagglutination inhibition and neutralization antibody titers of the resulting H‐IVIG preparations were determined and compared with standard preparations.

RESULTS: Twenty‐six plasma collection centers participated in the protocol. Donor enrollment exceeded 300 donors per week and within 30 days of protocol deployment plasma was being collected at a rate of more than 2000 L/week. Manufacture of both H‐IVIG lots was unremarkable and both lots met the requirements for commercial release and the bulk of the product was distributed in normal commercial channels. Examination of plasma pools and final IVIG product confirmed pandemic H1N1 antibody titers substantially higher than those collected before the emergence of the pandemic H1N1 virus.

CONCLUSIONS: This work demonstrates the feasibility of producing a H‐IVIG preparation at large scale relatively rapidly, with a significant enrichment in antibodies to the H1N1 influenza, achieved by donor self‐identification.
A comparison of volume‐reduced versus standard HLA/HPA–matched apheresis platelets in alloimmunized adult patients
Authors: Honohan Áine , Tomson Bert , van der Bom Johanna , de Vries René , Brand Anneke
Published: October 2011

BACKGROUND: Our blood bank prepares, on indication or request, a volume‐reduced (VR) platelet (PLT) product with greater than 95% reduced plasma content and a 15‐fold higher PLT concentration, potentially minimizing adverse reactions due to plasma, in particular for human leukocyte antigen (HLA)/human PLT antigen (HPA)‐matched PLTs when minor ABO incompatibility cannot be avoided. Here we compared the clinical effectiveness of VR apheresis PLTs (APs) with standard APs.

STUDY DESIGN AND METHODS: We performed a single‐center cohort study among consecutive alloimmunized patients who received either HLA/HPA‐matched standard APs and/or VR‐APs between 1994 and 2008. The endpoints were corrected count increments (CCIs), time to next transfusion, and frequency of adverse reactions. The CCI of VR PLTs was calculated using the PLT dose before volume reduction. Using a random effects model, 851 transfusions to 68 patients were evaluated for CCI and 731 transfusions to 64 patients for time to next transfusion. The frequency of reported adverse reactions was compared between the groups.

RESULTS: The 1‐hour CCI was 23% (95% confidence interval [CI], 9%‐42%; p < 0.001) lower and the 24‐hour CCI was 17% (95% CI, −11% to 59%; p = 0.278) lower after VR‐APs. The mean time to next transfusion was similar: standard APs, 3.1 days (95% CI, 2.7‐3.5); and VR‐APs, 2.8 days (95% CI, 2.5‐3.2). Eight adverse reactions were reported: 4 of 619 in the standard AP group and 4 of 1202 in the VR‐AP group.

CONCLUSION: VR‐APs showed lower 1‐ and 24‐hour CCIs than standard‐APs, which can be largely explained by the lower PLT dose of VR‐APs. The benefits of plasma reduction should seriously be outweighed given these lower increments.
Sex Determination from the Talus of Koreans by Discriminant Function Analysis*
Authors: Lee U‐Young , Han Seung‐Ho , Park Dae‐Kyoon , Kim Yi‐Suk , Kim Deog‐Im , Chung In‐Hyuk , Chun Myung‐Hoon
Published: October 2011

Abstract:  The aims of this study were to investigate the sex discriminating potential of the talus in Koreans and compare this with other analyses in different populations. Statistical analyses were performed using data from nine measurements acquired from 140 tali (70 men, 70 women). The talus of Koreans is dimorphic between sexes in all measurements (p < 0.01). Discriminant function equations were generated by univariate, multivariate, and stepwise methods with a range of accuracy from 67.1 to 87.1%. Stepwise equations of other populations did not discriminate the sex of the Korean sample as accurately as each equation’s own accuracies. The variables with high accuracy in this study are useful for sex determination of Koreans on the basis of confirmation of population specificity.
Primary and Secondary Skeletal Blast Trauma*,†
Authors: Christensen Angi M. , Smith Victoria A. , Ramos Vanessa , Shegogue Candie , Whitworth Mark
Published: October 2011

Abstract:  This study examines primary (resulting from blast wave) and secondary (resulting from disintegrated, penetrating fragments) blast trauma to the skeleton. Eleven pigs were exposed to semi‐controlled blast events of varying explosive type, charge size, and distance, including some cases with shrapnel. Skeletal trauma was found to be extensive, presenting as complex, comminuted fractures with numerous small, displaced bone splinters and fragments. Traumatic amputation of the limbs and cranium was also observed. Fractures were concentrated in areas nearer the blast, but there was generally no identifiable point of impact. Fractures were more random in appearance and widespread than those typically associated with gunshot or blunt force injury events. These patterns appear to be uniquely associated with blast trauma and may therefore assist forensic anthropologists and other forensic examiners in the interpretation of skeletal trauma by enabling them to differentiate between blast trauma and trauma resulting from some other cause.
Differentiated mTOR but not AMPK signaling after strength vs endurance exercise in training‐accustomed individuals
Authors: Vissing K. , McGee S. L. , Farup J. , Kjølhede T. , Vendelbo M. H. , Jessen N.
Published: October 2011

The influence of adenosine mono phosphate (AMP)‐activated protein kinase (AMPK) vs Akt‐mammalian target of rapamycin C1 (mTORC1) protein signaling mechanisms on converting differentiated exercise into training specific adaptations is not well‐established. To investigate this, human subjects were divided into endurance, strength, and non‐exercise control groups. Data were obtained before and during post‐exercise recovery from single‐bout exercise, conducted with an exercise mode to which the exercise subjects were accustomed through 10 weeks of prior training. Blood and muscle samples were analyzed for plasma substrates and hormones and for muscle markers of AMPK and Akt‐mTORC1 protein signaling. Increases in plasma glucose, insulin, growth hormone (GH), and insulin‐like growth factor (IGF)‐1, and in phosphorylated muscle phospho‐Akt substrate (PAS) of 160 kDa, mTOR, 70 kDa ribosomal protein S6 kinase, eukaryotic initiation factor 4E, and glycogen synthase kinase 3α were observed after strength exercise. Increased phosphorylation of AMPK, histone deacetylase5 (HDAC5), cAMP response element‐binding protein, and acetyl‐CoA carboxylase (ACC) was observed after endurance exercise, but not differently from after strength exercise. No changes in protein phosphorylation were observed in non‐exercise controls. Endurance training produced an increase in maximal oxygen uptake and a decrease in submaximal exercise heart rate, while strength training produced increases in muscle cross‐sectional area and strength. No changes in basal levels of signaling proteins were observed in response to training. The results support that in training‐accustomed individuals, mTORC1 signaling is preferentially activated after hypertrophy‐inducing exercise, while AMPK signaling is less specific for differentiated exercise.
Work‐relief ratios and imbalances of load application in sport climbing: Another link to overuse‐induced injuries?
Authors: Donath L. , Roesner K. , Schöffl V. , Gabriel H. H. W.
Published: October 2011

An imbalanced load application of the upper extremity may contribute to overuse‐induced injuries of the fingers. Thus, the present study evaluated load‐application symmetry between the right and the left hand and its work‐relief ratios (WRR) depending on climbing ability and pre‐exhaustion level. Twenty‐eight sport climbers (age: 29 ± 8 years; body mass index: 22 ± 2 kg/m2; years of climbing: 10 ± 6; climbing level: 6+ UIAA to 9 UIAA) were assigned to a group of recreational (≤8–UIAA, n = 14) or a group of ambitious (≥8 UIAA, n = 14) climbers. Blood lactate and perceived exertion level were recorded at the end of the climbing attempt. Load application and WRR were derived from video analysis separately for the left and the right hand. Differences in load‐application time between the left (47 ± 4%) and the right (53 ± 4%) hand (P < 0.001) were observed. Irrespective of side differences, the overall WRR was 5:1. Increasing climbing level leads to a more symmetric load application (r = −0.42, P < 0.03). Differences of lactate concentration and exertion level were found between the pre‐ and the non‐pre‐exhausted group. Depending on climbing ability and exhaustion level, load application for the dominant hand (right) prevails. Further longitudinal studies should focus on imbalanced load application and overuse‐induced climbing injuries.
Alternative treatment of gluteofemoral fistulas using honey: a case report
Authors: Vlcekova Paulina , Krutakova Barbora , Takac Peter , Kozanek Milan , Salus Juraj , Majtan Juraj
Published: October 2011

Perianal fistula is a common disease that affects particular patients with inflammatory bowel disease. Honey has been used as a natural remedy for centuries for the treatment of various disorders. We report a patient with persistent fistulas, in whom conventional medical and surgical therapy failed. In this case, most of fistulas in gluteofemoral region were completely healed and closed after 6 months of treatment with honey. In addition, honey reduced inflammation, pain and induration of affected region. This medical approach positively affected patient's mental condition and also improved his quality of life.
Peyronie’s Disease in Teenagers
Authors: Tal Raanan , Hall Matthew S. , Alex Byron , Choi Judy , Mulhall John P.
Published: October 2011

Introduction

Peyronie’s disease (PD) is commonly seen in middle-aged men, and little is known about this condition in teenagers.

Aim

To investigate the characteristics of PD in teenagers.

Methods

The findings were compared between patients with the disease who were teenagers with those over 40 years of age. Statistical analyses were conducted to define differentiating features between these two groups.

Main Outcome Measures

The demographics, clinical features, and associated comorbidities of patients with PD were reviewed.

Results

Thirty-two teenaged males were evaluated for PD in a single institution over a 10-year period. The median age for our cohort was 18 (15–19) years. Forty-five percent of patients had already been seen by another urologist, and 28% had been told they did not have PD. The mean duration of PD before seeking medical care in our cohort was 3 ± 1 months. Sixteen percent of patients reported antecedent penile trauma, half of which happened during coitus or masturbation, and 18% of patients had hemoglobin (Hb) A1c levels > 5%. Dupuytren’s contracture was not seen in this population. Twenty-two percent of patients presented with penile pain. Subsequent ED was seen in 37% of patients. Multiple noncontiguous plaques were seen in 37% of patients. Twelve percent were previously treated with vitamin E, while another 12% had previous intralesional verapamil. High distress was reported by 94% of patients. Thirty-four percent sought medical attention for anxiety/mood disorder, and 28% had a negative encounter with a sexual partner related to PD. All of the 32 patients had penile curvature with a mean of 32 ± 12 degrees. Seventy-two percent of the patients had dorsal curvature while 22% had an associated deformity. Using duplex Doppler ultrasound, 12% had a calcified plaque, while none of the patients had abnormal hemodynamics. When compared with PD in adults, teenagers had greater than seven times the prevalence of multiple noncontiguous plaques (37% vs. 5%). Also, the prevalence of HbA1c level > 5% was higher in the teenagers as well (18% vs. 5%).

Conclusions

PD does occur in teenagers often causing high distress levels. Compared to older adults, teenagers often present earlier, and more commonly have elevated HbA1c level and increased number of plaques at presentation.
Prevalence and Characteristics of Vibrator Use Among Women Who Have Sex with Women
Authors: Schick Vanessa , Herbenick Debby , Rosenberger Joshua G. , Reece Michael
Published: October 2011

Introduction

Research suggests that vibrator use may be more prevalent among lesbian/bisexual-identified women. However, previous research has been limited by small samples of lesbian- and bisexual-identified women and has not focused specifically on the characteristics of vibrator use between women.

Aims

The present study was designed in order to develop a comprehensive understanding of women’s use of vibrators with their female sexual partners and to understand the extent to which vibrator use is related to their sexual experiences.

Methods

Data were collected via a cross-sectional web-based survey from 2,192 women living in the United States and the United Kingdom. All participants reported engaging in sexual behavior with only women in the previous year.

Main Outcome Measures

Sociodemographic characteristics, vibrator use history, vibrator use perceptions, and the Female Sexual Function Index (FSFI).

Results

Over three-quarters of women in the sample reported a history of vibrator use during solo masturbation/with a female partner and over a quarter of the sample reported use in the previous month. Participants who were older, white, and in a long-term relationship were the most likely to use a vibrator with a female partner in the previous year. Vibrator use lifetime history was unrelated to all FSFI subscales with the exception of pain for lesbian and queer-identified women. In contrast to lifetime use, participants who used a vibrator with a female sexual partner in the previous month scored higher on several of the FSFI domains than women who reported no vibrator use or vibrator use only during solo masturbation in the past month.

Conclusions

Vibrator use was common among this sample of women who have sex with women. Women who reported recent vibrator use with other women had higher mean sexual functioning scores than women who reported no vibrator use or vibrator use only during masturbation. Implications for health-care providers are discussed.
Minimal Clinically Important Differences in the Vaginal Insertion and Successful Intercourse Items of the Sexual Encounter Profile
Authors: Araujo Andre B. , Allen Kerstin R. , Ni Xiao , Rosen Raymond C.
Published: October 2011

Introduction

Despite adoption of the successful vaginal insertion (Q2) and intercourse (Q3) items of the sexual encounter profile (SEP) as end points in clinical trials, there are no objective data on what constitute minimal clinically important differences (MCIDs) in these items.

Aim

The objective was to estimate the MCID for SEP Q2 and Q3.

Methods

Using data from 17 randomized, controlled trials of the phosphodiesterase type 5 inhibitor tadalafil, we estimated MCIDs for the SEP using anchor-based approaches. The 17 studies included 3,345 patients treated for 12 weeks. The anchor for the MCID is the minimal improvement measure calculated using change from baseline to 12 weeks on the following question: “Over the past 4 weeks, when you attempted sexual intercourse how often was it satisfactory for you?” MCIDs were developed using analysis of variance- and receiver operating characteristic (ROC)-based methods in a subset of studies (N = 11) by comparing patients with and without minimal improvement (N = 863). MCIDs were validated in the remaining six studies (N = 377).

Main Outcome Measures

The main outcome measures of this study are SEP Q2 and Q3.

Results

Using the ROC-based approach, the MCID for SEP Q2 was 21.4%, with estimated sensitivity of 0.55 and specificity of 0.73; the MCID for SEP Q3 was 23.0%, with estimated sensitivity of 0.72 and specificity of 0.78. MCIDs for SEP Q2/Q3 varied significantly (P < 0.001) according to baseline erectile dysfunction (ED) severity. MCIDs distinguished between patients in the validation sample classified as no change or minimally improved in each ED etiology, ED duration, and age group, but less well across geographic regions.

Conclusions

The contextualization of treatment-related changes into clinically relevant terms is essential to understanding treatment efficacy, interpreting results across studies, and for effective patient management. Overall, there was a better balance between sensitivity and specificity of the MCIDs using the ROC-based approach for the SEP intercourse success item than for the vaginal insertion item.
Is Roifman syndrome an X‐linked ciliopathy with humoral immunodeficiency? Evidence from 2 new cases
Authors: Gray P. E. A. , Sillence D. , Kakakios A.
Published: October 2011

Roifman syndrome is a rare syndrome of bone dysplasia, growth retardation, retinal dystrophy and humeral immunodeficiency. Six cases have been reported to date, all of whom are male. We report a boy with clinical features of Roifman syndrome, whose older sister has skewed X‐inactivation and a milder phenotype of the same disorder, supporting the hypothesis that this is an X‐linked recessive condition. Both children had previously had a provisional diagnosis of Jeune dysplasia, and the boy had neonatal hip X‐rays which demonstrated ‘acetabular spurs’ which are seen in a number of diseases thought to be caused by dysfunction of nonmotile cilia, including Jeune asphyxiating thoracic dystrophy. This finding in combination with other features such as retinal dystrophy, hepatic and renal disease suggests that the gene which is affected in Roifman syndrome may be involved with the function of nonmotile cilia and that Roifman syndrome may be the first example of a ciliopathy with associated immunodeficiency.
Asthma‐related SNP in FCER2 is associated with increased expression of IL‐4R on human B cells
Authors: Chan M. A. , Gigliotti N. M. , Meng J. , Rosenwasser L. J.
Published: October 2011

A SNP (rs2228137) (R62W) in FCER2 has been linked with severe exacerbations in asthmatics. Transfectants expressing the SNP exhibited increased IL‐4Rα expression after stimulation through CD23 compared with wild‐type. Our data suggest that the SNP may favour increased IgE production through increased responsiveness to IL‐4 in patients possessing this genotype.
Disparities between Prescribing of Secondary Prevention Therapies for Stroke and Coronary Artery Disease in General Practice
Authors: Heeley Emma , Anderson Craig , Patel Anushka , Cass Alan , Peiris David , Weekes Andrew , Chalmers John
Published: October 2011

Background

Extensive evidence exists regarding the effectiveness of secondary prevention measures in patients with cardiovascular disease.

Aim

We aimed to examine the management and risk perceptions of cardiovascular events in people with established cardiovascular disease.

Methods

We analyzed data on 1453 patients, ≥55 year old, with a history of cardiovascular disease, from the Australian Hypertension and Absolute Risk Study.

Results

Compared with those 533 patients with stroke/transient ischemic attack, the 743 patients with coronary artery disease were twice as likely to have been prescribed secondary prevention therapies even after adjustment for potential confounding variables (adjusted relative risks 1·85; 95% confidence interval 1·56–2·19, 42% vs. 73% for use of the combination of blood pressure-lowering, lipid-lowering and antiplatelet therapies) and to have better control of lipid and blood pressure levels. General practitioners estimated that only 27% of patients with stroke/transient ischemic attack – 38% of those with coronary artery disease and 41% of those with both conditions – were at a high risk (≥15%) of a recurrent event. Patients similarly underestimated their risk of recurrent cardiovascular events, with only 8% of stroke/transient ischemic attack, 11% of coronary and 15% of combination disease patients rating themselves at ‘high’ or‘very-high’ risk.

Conclusions

This study reaffirms the large treatment gap in the uptake of secondary prevention for cardiovascular disease in primary care settings, being much greater for patients with cerebral compared with cardiac cardiovascular disease. This appears to be related to differential perceptions of cardiovascular risk across different vascular territories in both patients and doctors.
The Transforming Growth Factor-β Receptor Genes and the Risk of Intracranial Aneurysms
Authors: Ruigrok Ynte M. , Baas Annette F. , Medic Jelena , Wijmenga Cisca , Rinkel Gabriel J.E.
Published: October 2011

Background

Mutations in the receptor genes of the transforming growth factor β pathway, TGFBR1 and TGFBR2, cause syndromes with thoracic aortic aneurysms, while genetic variants in TGFBR1 and TGFBR2 are associated with abdominal aortic aneurysms. The transforming growth factor-β pathway may be involved in aneurysm development in general. Aims To analyze whether genetics variants in TGFBR1 and TGFBR2 are also involved in the pathogenesis of intracranial aneurysms.

Methods

Using tag single nucleotide polymorphisms, we analyzed all common genetic variants in TGFBR1 (five single nucleotide polymorphisms) and TGFBR2 (26 single nucleotide polymorphisms) in a Dutch intracranial aneurysm case-control population approach using a two-stage genotyping approach.

Results

In stage 1, on analyzing 481 patients and 648 controls, two of the five single nucleotide polymorphisms in TGFBR1 were associated with intracranial aneurysm with P<0·10. In an independent cohort of 310 intracranial aneurysm patients and 376 controls, a predominance of the allele of the two single nucleotide polymorphisms found more frequently in patients in stage 1 was also observed in patients of stage 2 but the associations were not statistically significant. On combined analyses of both stages, there was a statistically significant association of both single nucleotide polymorphisms with intracranial aneurysm (single nucleotide polymorphism rs1626340, odds ratio 1·24, 95% confidence intervals 1·05–1·46, P = 0·01; single nucleotide polymorphism rs10819634, odds ratio 1·23, 95% confidence intervals 1·03–1·46, P = 0·02) but these associations did not hold after multiple testing correction (i.e., P<0·0016, 0·05/31). Also, no differences in the single nucleotide polymorphism frequency were observed for TGFBR2 between patients and controls.

Conclusions

We found no evidence for TGFBR1 and TGFBR2 as susceptibility genes for intracranial aneurysm in the Dutch population.
Very Early Poststroke Aphasia Therapy: A Pilot Randomized Controlled Efficacy Trial
Authors: Godecke Erin , Hird Kathryn , Lalor Erin E. , Rai Tapan , Phillips Michael R.
Published: October 2011

Background and purpose

Early stroke rehabilitation has shown benefits over spontaneous recovery. Insufficient evidence exists to determine the benefits of early aphasia intervention. We hypothesized that daily aphasia therapy would show better communication outcomes than usual care (UC) in early poststroke recovery.

Method

This prospective, randomized, single-blinded, controlled trial was conducted in three acute-care hospitals in Perth, Australia, each with over 200 stroke admissions annually. Patients with acute stroke causing moderate to severe aphasia were recruited at a median of three-days (range: 0–10 days) to receive daily aphasia therapy or usual care therapy. Individually tailored, impairment-based intervention was provided for the acute hospital stay or intervention phase (median: 19 days; range: 5–76). Primary outcome measures were the aphasia quotient and functional communication profile at acute hospital discharge or four-weeks poststroke, whichever came first. A random-number generator and sealed envelopes were used to randomize participants. Assessments were completed by a blinded assessor.

Results

Fifty-nine participants were recruited, with six withdrawals (10%) and seven deaths (12%) at six-months. Ninety percent had ischemic strokes, with 56·5% experiencing a total anterior circulation stroke. The group mean (±SD) age was 69·1 (±13·9) years. Six participants (18·75%) in the daily aphasia therapy group did not complete the minimum (150 min) therapy required for this study. The daily aphasia therapy intervention phase mean therapy session time was 45 min (range: 30–80) and the total mean amount of therapy for the daily aphasia therapy participants was 331 min (range: 30–1415). Four (15%) participants in the usual care group received therapy. The collective total therapy provided to these participants was 295 min over seven sessions. Usual care participants received an average of 10·5 min of therapy per week during the intervention phase. At the primary end point, a generalized estimating equations model demonstrated that after controlling for initial aphasia severity, participants receiving daily aphasia therapy scored 15·1 more points ( P = 0·010) on the aphasia quotient and 11·3 more points ( P = 0·004) on the functional communication profile than those receiving usual care therapy.

Conclusions

Daily aphasia therapy in very early stroke recovery improved communication outcomes in people with moderate to severe aphasia.
Co‐oximetry in clinically healthy dogs and effects of time of post sampling on measurements
Authors: Kuleš J. , Mayer I. , Rafaj R. Barić , Matijatko V. , Kiš I. , Kučer N. , Brkljačić M. , Mrljak V.
Published: October 2011

Objectives: Co‐oximetry is a complex and valuable laboratory method that measures haemoglobin species and oxygenation status by multi‐wavelength spectrophotometry. The purpose of this study was to establish reference intervals for clinically healthy dogs and to determine the effect of time of analyses and sex of animals on the accuracy of results.

Methods: Blood was collected from 27 healthy adult dogs of various breeds and sex. Co‐oximetry was performed on a CCX co‐oximeter that measures eight haemoglobin and oxygen transport related parameters: carboxyhaemoglobin (COHb), deoxyhaemoglobin (HHb), oxyhaemoglobin (O2Hb), methaemoglobin (MetHb), total haemoglobin (tHb), oxygen saturation (SO2%), oxygen content (O2Ct) and oxygen capacity (O2Cap).

Results: Results obtained after 2 and 4 hours were not significantly different from those obtained immediately after sampling. But after 48 hours, the results for total haemoglobin, oxygen saturation, oxyhaemoglobin, oxygen content and oxygen capacity were significantly lower, and carboxyhaemoglobin and deoxyhaemoglobin values were significantly higher than determination immediately after sampling. Gender had no significant impact on co‐oximetry values.

Clinical Significance: Co‐oximetry offers several advantages compared with other methods, including ease of use, increased accuracy and greater differentiation among haemoglobin species.
The effectiveness of pelvic floor exercise on urinary incontinence in radical prostatectomy patients
Authors: Lin Yu‐Hua , Yang Mei‐Sang , Chia‐Hsiang Lin Victor , Yu Tsan‐Jung , Chiang Po‐Hui
Published: October 2011

Urinary incontinence (UI) is a major complication among patients after radical prostatectomy (RP). Although previous research supports the efficacy of pelvic floor exercises for male UI, there are both positive and no significant effects. The purpose of this study was to examine the effect of pelvic floor exercises on UI after RP. This was a quasi‐experimental, randomized, mixed‐method study design. All participants were older than 45 years and had undergone an RP. Outcome measurements included a 1‐h pad test, personal demographics, and disease‐related data. After catheter removal, participants were distributed into either an exercise group (n = 39) or a non‐exercise group (n = 28). Patients in the exercise group took part in a pelvic floor exercise during their regular daily activities. The non‐exercise group did not perform the prescribed exercise. We examined urinary function at 1, 3 and 6 months after catheter removal. Following a mixed‐model anova test for differences, the results of the pad test revealed significant differences for the main effect of time (F = 75·30,P < 0·001), indicating that the amount of urine leakage decreased over time regardless of the group. Results for the main effect of group were statistically significant (F = 8·85,p < 0·01), indicating that urine leakage also decreased over time in both groups, but that urinary control in the exercise group was better than in the non‐exercise group. Although improvements in surgical technique have significantly improved the outcome of prostate surgery, we believe that patient education regarding pelvic floor exercises by a nurse prior to and after surgery has a significant impact on the early recovery of urinary continence. We believe these exercises would certainly have a positive impact on our patients undergoing RP by improving the quality of life after major urological surgery.
A concept analysis of health promotion for women with urinary incontinence
Authors: Kang Youngmi
Published: October 2011

Health promotion (HP) is a multi‐dimensional and complex phenomenon. However, the concept has not been well‐defined and researchers used it in different ways. The aims of this concept analysis are to clarify the meaning of an existing concept of HP and to develop a conceptual definition for the research on women with urinary incontinence. The method suggested by Walker and Avant guided this concept analysis. Health promotion is defined as an artistic science whose goal is to enable humans to enhance their health and well‐being through interaction with the environment. Critical attributes of health promotion include enabling and empowering process and activity, multi‐factoral and multi‐dimensional process, health behaviour and healthy lifestyle inseparable with self‐care and concerning disease prevention and health protection. Antecedents include previous decisions and responsibilities on health, beliefs, attitudes, behaviours, and perceptions, change of healthy lifestyle and health challenges. Health‐promoting behaviour, health and well‐being, self‐actualization, equity, change of healthy lifestyle, increased quality of life, self‐awareness, consciousness, balance and stability are the consequences of health promotion. It is recommended that further inquiry in this area should focus on the development of valid measures to accurately evaluate HP in women with urinary incontinence.
Impact of Temporal Resolution of Flow‐Duration Curve on Sediment Load Estimation1
Authors: Chen Li , Schumer Rina , Knust Anna , Forsee William
Published: October 2011

Chen, Li, Rina Schumer, Anna Knust, and William Forsee, 2011. Impact of Temporal Resolution of Flow‐Duration Curve on Sediment Load Estimation. Journal of the American Water Resources Association (JAWRA) 48(1): 145‐155. DOI: 10.1111/j.1752‐1688.2011.00602.x

Abstract:  Estimates of a channel’s annual sediment transport capacity typically incorporate annualized flow‐duration curves. Average daily flow data, commonly used to develop flow‐duration curves, may not adequately describe sediment‐transporting flows in arid and semiarid ephemeral streams. In this study, we examined impacts of varied temporal resolution flow data on annual sediment load estimation. We derived flow‐duration curves for eight sites in the Southwestern United States based on both 15‐min and daily‐averaged flow data. We then estimated sediment loads for both flow‐duration curves using the Sediment Impact Analysis Method, implemented in HEC‐RAS. When average daily flow is used to generate flow‐duration curves, sediment load estimation is lower by up to an order of magnitude. This trend is generally unaffected by uncertainty associated with sediment particle size or hydraulic roughness. The ratio of sediment loads estimated by 15‐min versus daily‐averaged flow‐duration curves is strongly correlated with channel slope, being greater on steep‐slope channels. Sediment loads estimated by the two types of flow‐duration curves are closely correlated, suggesting possible relationships for improving predictions when high‐temporal resolution data are unavailable. Results also suggest that the largest flow contributes significantly to total sediment load, and thus will greatly impact ephemeral stream geomorphology in arid and semiarid regions.
Acromioclavicular Joint Dislocation: Diagnosis and Management
Authors: Yewlett Alun , Dearden Paul M. C. , Ferran Nicholas A. , Evans Richard O. , Kulkani Rohit
Published: October 2011

We present a review of the literature with respect to the anatomy, biomechanics, classification, diagnosis and rationale for contemporary management of both acute and chronic acromioclavicular joint dislocations. Both conservative and surgical management are discussed.
Demonstration of quality of care measurement using the Japanese liver cancer registry
Authors: Higashi Takahiro , Hasegawa Kiyoshi , Kokudo Norihiro , Makuuchi Masatoshi , Izumi Namiki , Ichida Takafumi , Kudo Masatoshi , Ku Yonson , Sakamoto Michiie , Nakashima Osamu , Matsui Osamu , Matsuyama Yutaka , Sobue Tomotaka ,   the Liver Cancer Study Group of Japan
Published: October 2011

Aim:  Despite advances in medical therapy, studies have reported gaps between current evidence and actual practice in many areas of medicine. Process‐of‐care quality indicators (QIs) are tools to measure the evidence–practice gap. This study aims to examine the feasibility of applying QIs for liver cancer care to the national registry database operated by the Liver Cancer Study Group of Japan.

Methods:  Prior research developed a set of process‐of‐care QIs developed on the basis of the Japanese Clinical Practice Guidelines for hepatocellular carcinoma. Each QI describes target patients and care processes indicated for such patients. Among the 25 developed QIs, six appeared scorable using the information contained in the dataset from the 17th Nationwide Survey of Primary Liver Cancer.

Results:  In total, 16 187 patients were eligible for the six QIs for 34 599 times, among which the indicated care was provided 83.9% times. The scores ranged from 64.4% (surgical therapy in patients with HCC 3–5 cm in diameter) to 91.1% (indocyanine green checkup before surgical resection). The information was generally available to determine eligibility (78.3%–100%) and pass/fail (91.9%–99.9%) for the QIs.

Conclusions:  Applying QIs to the liver cancer registry, the quality of hepatocellular carcinoma care can be measured. In future, providing feedback regarding the results to the participating society may improve the quality of liver cancer care nationwide.
Assortment Planning for Vertically Differentiated Products
Authors: Pan Xiajun Amy , Honhon Dorothée
Published: October 2011

We consider the problem of a retailer managing a category of vertically differentiated products. The retailer has to pay a fixed cost for each product included in the assortment and a variable cost per product sold. Quality levels, fixed, and variable costs are exogenously determined. Customers differ in their valuation of quality and choose the product (if any) that maximizes their utility. First, we consider a setting in which the selling prices are also fixed. We find that the optimal set of products to offer depends on the distribution of customer valuations and might include dominated products, that is, products which are less attractive than at least one other product, on every possible dimension. We develop an efficient algorithm to identify an optimal assortment. Second, we consider a setting in which the retailer also determines the selling prices. We show that in this case the optimal assortment does not include any dominated product and does not vary with the distribution of customer valuations when there is no fixed cost. We develop several efficient algorithms to identify an optimal assortment and optimally price the products. We also test the applicability of our methods with realistic data for two product categories.
An Application of Master Schedule Smoothing and Planned Lead Time Control
Authors: Teo Chee‐Chong , Bhatnagar Rohit , Graves Stephen C.
Published: October 2011

Make‐to‐order (MTO) manufacturers must ensure concurrent availability of all parts required for production, as any unavailability may cause a delay in completion time. A major challenge for MTO manufacturers operating under high demand variability is to produce customized parts in time to meet internal production schedules. We present a case study of a producer of MTO offshore oil rigs that highlights the key aspects of the problem. The producer was faced with an increase in both demand and demand variability. Consequently, it had to rely heavily on subcontracting to handle production requirements that were in excess of its capacity. We focused on the manufacture of customized steel panels, which represent the main sub‐assemblies for building an oil rig. We considered two key tactical parameters: the planning window of the master production schedule and the planned lead time of each workstation. Under the constraint of a fixed internal delivery lead time, we determined the optimal planning parameters. This improvement effort reduced the subcontracting cost by implementing several actions: the creation of a master schedule for each sub‐assembly family of the steel panels, the smoothing of the master schedule over its planning window, and the controlling of production at each workstation by its planned lead time. We report our experience in applying the analytical model, the managerial insights gained, and how the application benefits the oil‐rig producer.
Sourcing from Multiple Suppliers for Price‐Dependent Demands
Authors: Feng Qi , Shi Ruixia
Published: October 2011

We analyze a model that integrates demand shaping via dynamic pricing and risk mitigation via supply diversification. The firm under consideration replenishes a certain product from a set of capacitated suppliers for a price‐dependent demand in each period. Under deterministic capacities, we derive a multilevel base stock list price policy and establish the optimality of cost‐based supplier selection, that is, ordering from a cheaper source before more expensive ones. With general random capacities, however, neither result holds. While it is optimal to price low for a high inventory level, the optimal order quantities are not monotone with respect to the inventory level. In general, a near reorder‐point policy should be followed. Specifically, there is a reorder point for each supplier such that no order is issued to him when the inventory level is above this point and a positive order is placed almost everywhere when the inventory level is below this point. Under this policy, it may be profitable to order exclusively from the most expensive source. We characterize conditions under which a strict reorder‐point policy and a cost‐based supplier‐selection criterion become optimal. Moreover, we quantify the benefit from dynamic pricing, as opposed to static pricing, and the benefit from multiple sourcing, as opposed to single sourcing. We show that these two strategies exhibit a substitutable relationship. Dynamic pricing is less effective under multiple sourcing than under single sourcing, and supplier diversification is less valuable with price adjustments than without. Under limited supply, dynamic pricing yields a robust, long‐term profit improvement. The value of supply diversification, in contrast, mainly comes from added capacities and is most significant in the short run.
Impact of Storage Assignment Decisions on a Bucket Brigade Order Picking Line
Authors: Webster Scott , Ruben Robert A. , Yang Kum‐Khiong
Published: October 2011

Bucket brigade order picking is a method for retrieving orders from a storage rack where workers follow a fixed sequence and dynamically adjust to variability in work content along the rack. The method is simple and has been shown to provide superior performance in many applications. In this article, we analyze how the location in which products are stored in the rack affects throughput. We identify conditions where storage decisions have a large impact on throughput (e.g., a 20% increase in productivity) and conditions where the impact is minimal. Conditions associated with high impact are high variation in worker skill, high variation in SKU volume, and a moderate level of walking‐to‐picking work content per pick list.