bluuebunny/crossref_metadata_2025 huggingface dataset:
Door‐to‐door screening as a strategy for the detection of congenital Chagas disease in rural Bolivia
Authors: Romero Mario , Postigo Jorge , Schneider Dominique , Chippaux Jean‐Philippe , Santalla José Antonio , Brutus Laurent
Published: February 2011

Objective  To demonstrate the feasibility of a house‐to‐house screening system used for congenital Chagas disease in rural areas based on an active search for pregnant women and newborns in their homes in addition to passive case detection in health facilities.

Methods  Exploratory phase conducted by the research team followed by an operational period coordinated by municipal health service. A blood sample was taken for serological and parasitological tests of Trypanosoma cruzi from pregnant women who were searching antenatal care or visited at home by field investigators. Infants born to T. cruzi‐infected women were examined for infection at birth and again at 1 and 7 months of age.

Results  64.5% of the pregnant women were infected. Congenital infection was diagnosed at birth in 4.0% (12/299) of the children born to seroreactive mothers. Twelve additional cases of infection (4%) were diagnosed in children between 1 and 7 months of age. Finally, 37% of the children were lost to follow‐up in the exploratory phase and 53% during the operational phase (P = 0.002), significantly fewer than in most passive case detection studies.

Conclusion  Despite poorer outcomes after door‐to‐door screening activities have been transferred to the health system, a combined strategy based on active and passive case detection appeared to be efficient for identifying rural cases of congenital Chagas disease.
Five‐year experience using sirolimus‐based, calcineurin inhibitor‐free immunosuppression in pediatric renal transplantation
Authors: Hymes Leonard C. , Warshaw Barry L.
Published: February 2011

Hymes LC, Warshaw BL. Five‐year experience using sirolimus‐based, calcineurin inhibitor‐free immunosuppression in pediatric renal transplantation. Pediatr Transplantation 2011: 15: 437–441. © 2011 John Wiley & Sons A/S.

Abstract:  From December 2003 to December 2008, we employed a protocol for withdrawing TAC and converting to SRL in a cohort of low‐risk renal pediatric transplant recipients. We report our experience in these children with respect to graft survival, AR episodes, renal function, and adverse events. All patients received basiliximab induction and TAC, MMF, and prednisone. Criteria for conversion to SRL included first transplants without histologic evidence for AR on three‐month surveillance biopsies. Patient exclusion criteria included AR prior to or before surveillance biopsies, polyoma (BK) virus nephropathy, a history of nephrotic syndrome, or multiple organ transplants. Fifty‐one of 137 patients who received transplants from December 2003 to December 2008 met criteria for withdrawal of TAC and were converted to SRL. SRL was discontinued in 11 children because of adverse events within 12 months after conversion. Among the remaining 40 patients, actuarial graft survival was 91% at five yr. AR occurred in 13% of patients within one yr after conversion. Complications from SRL included aphthous ulcers (30%); viremia with BK virus (20%), EBV (13%), and CMV (3%); proteinuria (7%); elevated cholesterol (7%); diabetes mellitus (2%); thrombocytopenia (2%); erectile dysfunction (2%); and lymph edema (2%). SRL was discontinued in 20%, predominantly for aphthous ulcers. Our experience with SRL‐based immunosuppression demonstrates that a CNI‐free regimen can be successful in lower‐risk patients meeting our selection criteria. Aphthous ulcers and BK virus viremia were the most prevalent adverse events.
Preemptive plasmapheresis and recurrence of focal segmental glomerulosclerosis in pediatric renal transplantation
Authors: Gonzalez Elsa , Ettenger Robert , Rianthavorn Pornpimol , Tsai Eileen , Malekzadeh Mohammed
Published: February 2011

Gonzalez E, Ettenger R, Rianthavorn P, Tsai E, Malekzadeh M. Preemptive plasmapheresis and recurrence of focal segmental glomerulosclerosis in pediatric renal transplantation.  Pediatr Transplantation 2011: 15: 495–501. © 2011 John Wiley & Sons A/S.

Abstract:  FSGS has a high recurrence rate after renal transplantation. To examine the effects of the use of preemptive and post‐transplant PP on recurrence and graft outcome, we conducted a retrospective study on 34 pediatric patients (mean age 13 ± 5 yr) with biopsy‐proven pretransplant FSGS and who underwent a renal transplantation between 1996 and 2007. Recurrence was defined as a serum albumin level of <3.0 g/L in the presence of nephrotic‐range proteinuria (>40 mg/m2/h). Total response to PP therapy was defined as the resolution of the nephrotic‐range proteinuria and partial response as persistent proteinuria despite PP but not in the nephrotic range. Fifteen patients received a LD renal transplantation and 19 patients received a DD renal transplantation. Nineteen patients received CsA and 14 patients received tacrolimus. Nineteen patients (56%) had FSGS recurrence. There was no difference in the recurrence rate between patients receiving CsA vs. tacrolimus. Among the 15 LD patients, 13 received preemptive PP (1–10 sessions) and seven patients (47%) had subsequent FSGS recurrence. Among the 19 DD patients, four received preemptive PP and 12 (63%) had FSGS recurrence. The number of preemptive PP did not affect the recurrence rate. In a group of patients with a previous graft loss secondary to recurrence, the rate of recurrence was lower than expected (40%) and two of the three patients who did not recur had three or more sessions of preemptive PP. Of the 19 patients with recurrence, 17 were treated with PP therapy and 88% of the patients fully or partially responded. Only five patients had graft loss at three yr post‐transplant: two from FSGS recurrence and three from non‐compliance. These results suggest that preemptive PP does not decrease the rate of recurrence after transplantation but might be beneficial in treating high‐risk patients with documented recurrence. Patients with FSGS recurrence post‐transplant can achieve good graft survival with both LD and DD transplantation.
Granulomatous amebic encephalitis: an under‐recognized cause of infectious mortality after hematopoietic stem cell transplantation
Authors: Akpek G. , Uslu A. , Huebner T. , Taner A. , Rapoport A.P. , Gojo I. , Akpolat Y.T. , Ioffe O. , Kleinberg M. , Baer M.R.
Published: February 2011

G. Akpek, A. Uslu, T. Huebner, A. Taner, A.P. Rapoport, I. Gojo, Y.T. Akpolat, O. Ioffe, M. Kleinberg, M.R. Baer. Granulomatous amebic encephalitis: an under‐recognized cause of infectious mortality after hematopoietic stem cell transplantation. Transpl Infect Dis 2011: 13: 366–373. All rights reserved

Abstract: Granulomatous amebic encephalitis (GAE) is a rare, nearly always fatal form of encephalitis that occurs mostly in the setting of immune compromise or chronic disease. The prevalence and clinical characteristics of this Acanthamoeba infection in hematopoietic stem cell transplant (HSCT) recipients are not well described. We present an HSCT patient in whom the diagnosis of GAE was made at autopsy. A systematic review of previously reported cases is provided to highlight the clinical presentation and early diagnostic features of GAE in HSCT recipients. Amebic infection usually initially involves the skin or lungs over a period of months, and becomes rapidly fatal once it crosses the blood–brain barrier. GAE is usually discovered postmortem owing to lack of awareness of this deadly infection and delay in diagnosis. Subacute presentation of multiple recurrent panniculitis‐like subcutaneous nodules associated with eosinophilia and a history of chronic rhinitis or sinusitis warrant investigation for a possible amebic infection. Prolonged corticosteroid use and a recent exposure to unhygienic water are potential risk factors for GAE. Successful outcomes may be achieved with early intensive treatment using a combination of effective drugs.
Intravenous guanethidine in patients with reflex sympathetic dystrophy
Authors: Kaplan R. , Claudio M. , Kepes E. , Gu X. F.
Published: February 2011

Background: Intravenous regional guanethidine Bier block (IVRGBB) has been used predominantly in Europe for treating reflex sympathetic dystrophy (RSD). Our experience in the United States, where its use has been limited, is reported. Methods: Fifty‐five patients received IVRGBB for RSD. Upper extremities received 20 mg (10 mg/ml) of guanethidine in 30–50 ml of 0.5% lidocaine; lower extremities received 40 mg in 40–75 ml of lidocaine (volume adjusted for size, weight, or prior adverse effect). Pain severity (mild, moderate, severe, excruciating) was obtained pretreatment. Pain severity and a global clinical assessment (GCA) (resolved, improved, no change, worse) were obtained following each treatment. The final GCA was analyzed vs: pretreatment score; age; sex; pain duration; number of treatments; and precipitating event. Adverse effects were documented.

Results: Of 55 enrolled patients, 2 were lost to follow‐up, and 2 returned 1 and 4 years later for repeat treatment. Therefore, 53 patients were evaluated for 55 treatments. Age: 38.2 − 14.8 (SD) (range 10–77) years. Sex: 11 males, 44 females. Average pain duration: 2.0 − 1.7 years (3 days ‐ 7 years). Final assessment occurred at 3.88 − 5.21 months (6 days ‐ 2 2/3 years). Effect on pain: resolution‐9.1%; improved‐14.5%; no change‐61.8%; worsening‐14.5%. No significant relationship was found between GCA and the factors evaluated. There was a significant positive linear association between pretreatment pain and post treatment GCA (P = 0.032). Fifty‐six adverse effects occurred in 19 (34.5%) patients (nausea, vomiting, orthostatic hypotension, dizziness, diarrhea, weakness).

Conclusions: IVRGBB does not provide long‐term pain relief and is associated with adverse effects in over 1 / 3 of patients.
Continuous end‐tidal carbon dioxide monitoring during normofrequent jet‐ventilation
Authors: Bach L. F. , Wanner‐Olsen H. , Andersen B. N. , Madsen I. K. , Kruse S.
Published: February 2011

Background: Continuous end‐tidal carbon dioxide (ETCO2) monitoring during normofrequent jet‐ventilation (NFJV) has not previously been successful and no correspondence between ETCO2 and arterial carbon dioxide (PaCO2) demonstrated.

Methods: During NFJV jet‐ventilation in 19 healthy volunteers, continuous ETCO2 was measured and compared to PaCO2 values. The original ETCO2 sampling line from our Datex CO2 measuring equipment was placed longitudinally against a suction catheter and both were wrapped with aluminium foil. They were placed 4–5 cm above the carina and the position was verified with a fiberoptic bronchoscope.

Results: The correlation between methods gave a Pearson's product moment correlation (r value) of 0.836, significant at the P < 0.001 level, indicating a close correlation between methods. A difference against mean scatter diagram confirmed that ETCO2 and PaCO2 measurements are of equal value in monitoring healthy patients during NFJV.

Conclusion: A valuable method of continuous ETCO2monitoring during NFJV is presented.
Anaesthesia and gastric content — new methods and new trends
Authors: Søreide E.
Published: February 2011

Abstract: In the present investigation, factors that might influence gastric content and the risk of perioperative aspiration pneumonitis have been studied. Compared to fibre‐optic gastroscopy and electronic pH meter, a standardised blind orogastric aspiration and pH indicator paper technique was found to be simpler, less expensive and to produce gastric fluid volume and pH estimates with sufficient accuracy.

In fasting, elective patients, neither benzodiazepine premedication nor level of anxiety influenced gastric fluid volume and acidity. Intramuscular morphine‐scopolamine premedication significantly reduced gastric acidity. No difference in gastric content could be detected between outpatients and inpatients or between patients taking an oral benzodiazepine premedication 1–2 h before anaesthesia with 20, 150 or 300–450 ml of water. Intake of 150 ml water was associated with the lowest anxiety scores. In a meta‐analysis of 12 randomised studies of the impact of oral fluid intake on gastric content, statistical and technical flaws rendered the conclusion of two studies invalid. This, however, did not change the main conclusion that intake of clear fluids up to 2 h preoperatively is safe as fluid intake either decreased or had no effect on gastric fluid volume.

Use of sugarless gum was associated with a 50% increase in gastric fluid volume, but did not affect gastric fluid acidity or improve patients' well‐being. In smokers, nicotine gum improved the feeling of well‐being and did not increase gastric fluid volume or acidity. Using gastric ultrasonography in healthy female volunteers, it was shown that up to 4 hours is needed before a light breakfast meal is completely emptied. In order to provide some safety limits, a 6‐hour fasting period for solids was recommended.

In a survey of Norwegian Departments of Anaesthesiology (100% response rate), the respondents showed considerable variation in use and attitudes towards preoperative fasting and aspiration pneumonitis prophylaxis in OB/GYN patients. In an audit of perioperative aspiration pneumonitis we identified 11 cases, giving an incidence of 1, 5 and 11 per 10000 anaesthesia in gynaecological in‐ and outpatients and caesarean section patients, respectively. Preventable factors were identified in all cases. Eight patients needed ICU treatment, but none died. At discharge all had symptoms of bronchial hyper‐reactivity, but during the follow‐up period they all experienced improvement in their condition. There appears to be a need for consensus discussions on the topic of preoperative fasting and aspiration pneumonitis prophylaxis.
Topical wound anesthesia for postoperative pain relief
Authors: Sinclair R.
Published: February 2011

Abstract: Pain from uncomplicated surgical wounds is most pronounced during the first postoperative days. Effective pain relief with a minimum of sedation, motor paralysis or disturbance of protective reflex functions is a prerequisite for early mobilization of the patient in day‐case surgery as well as for reducing the risk of postoperative pulmonary and thromboembolic complications in connection with in‐hospital procedures. The aim of this thesis was to evaluate topical lidocaine aerosol in the surgical wound as a method of suppressing postoperative pain, and to study some of the mechanisms of amide local anesthetics on the pain‐inducing inflammatory responses of the wound area.

Postoperative pain (VAS) and opioid analgesic consumption were measured after a single dose of lidocaine aerosol in the wound of minor and major surgical procedures. The accumulation, viability and metabolic responsiveness of leukocytes harvested from titanium chambers implanted in an experimental surgical wound of rats in vivo after treatment with lidocaine aerosol were studied. To investigate the dose‐response effects of lidocaine and bupivacaine on the metabolic response and release of leukotrienes and interleukins, human leukocytes were studied in vitro.

Topical lidocaine aerosol administered as a single dose at wound closure was found to offer significant pain relief and reduced consumption of opioid analgesics during the first 24 postoperative hours. Combination with NSAID administered pre‐ and postoperatively did not add to the analgesic effect of lidocaine or NSAID alone. Lidocaine aerosol reduced the number and metabolic responsiveness of leukocytes harvested from rat experimental wounds without affecting the viability of the cells.

In vitro, amide local anesthetics were shown to reduce in a dose‐dependent manner the metabolic response of human leukocytes as well as their release of leukotriene B4 and the release of interleukin‐lalpha from human monocytes.

Results showed that a single dose of lidocaine aerosol in the surgical wound of extra‐ and intraabdominal procedures induced a long‐lasting analgesic effect. The duration and potency are suggested to be secondary to slow‐release and reduced washout of lidocaine from the aerosol solution and, apart from the nerve‐blocking effect, due to the anti‐inflammatory properties of amide local anesthetics.
Ketamine anesthesia in children with acute burns and scalds
Authors: Maldini B.
Published: February 2011

The purpose of the study was to assess the value and the safety of ketamine as a single anesthetic in burned children in a war area. The material consists of 547 children admitted to the hospital in a 4‐year period. The parameters studied were blood pressure, heart rate, pulseoxymetry, pre‐ and postoperative blood gases. Clinical observations were performed during anesthesia and recovery. The children were questioned about bad dreams.
Atropine premedication attenuates heart rate variability during high thoracic epidural anesthesia
Authors: Kawamoto M. , Matsumoto C. , Yuge O.
Published: February 2011

Background: Atropine premedication is used as it possesses an anticholinergic effect on the cardiac autonomic nervous system (CANS). The aim of this study was to investigate the effect of atropine premedication on the CANS during thoracic epidural anesthesia (TEA) by assessing power spectral analysis of heart rate (HR) variability.

Method: Female patients (n=28) undergoing elective mammary biopsy were randomly allocated into two groups; one received intramuscular premedication of 0.01 mg/kg of atropine 30 min before the procedure (group A: n=14), and the other did not (group N: n=14). Each electrocardiogram was digitally recorded before and during TEA, and played back off‐line to detect R‐R intervals. As a power spectrum required R‐R intervals of 256 s, this was analysed before TEA and repeated thereafter for 25 min. The spectra were quantified by determining the peak areas of the spectral density by integrating low frequency (Lo: 0.04‐0.15 Hz) and high frequency (Hi: 0.15‐0.40 Hz) bands as they showed sympathetic and parasympathetic nervous activity in the CANS. The neural balance was assessed by calculating Hi:Lo ratio.

Results: Decreases in Lo and increases in Hi:Lo ratio were observed, suggesting sympathectomy and vagotonia with TEA in both groups. For 10 min after commencement, TEA maintained Hi:Lo ratios lower in group A than in group N, suggesting a vagolytic effect of premedication with atropine. With TEA, cardiac slowing was observed, which was dependent on the level of dermal analgesia.

Conclusion: Power spectral analysis revealed that TEA had the effect of making CANS relatively vagotonic, and that atropine premedication would attenuate the effect of TEA.
Liver transplantation is associated with increased met‐enkephalin levels in the pig
Authors: Donovan K. L. , Janicki P. K. , Franks W. T. , Striepe V. I. , Pinson C. W.
Published: February 2011

Background: It has been reported that less postoperative morphine is required following liver transplantation than is required following open cholecystectomy. This may be attributable to endogenous factors rather than to altered morphine pharmacokinetics. We measured the plasma concentrations of two endogenous neuropeptides associated with pain modulation, substance P (SP) and met‐enkephalin (ME), in pigs undergoing liver transplantation and in control pigs undergoing laparotomy.

Methods: With the approval of the institutional Animal Care Committee, pigs were anesthetized with ketamine (30 mg/kg, IM), atropine (0.05 mg/kg, IM) and acetylpromazine (0.1 mg/kg, IM). Anesthesia was maintained with isoflurane in oxygen. Pigs in the transplantation group (n=10) underwent liver transplantation and control pigs (n=10) underwent laparotomy. Blood samples for SP and ME measurement were collected pre‐incision (Pre‐In), pre‐emergence (Pre‐Em) from anesthesia, 6–12 hours, 18 hours, and 24 hours after surgery. SP and ME levels were determined by radioimmunoassay. Results are expressed as mean±SEM (in pg/ml of plasma for both peptides) and were compared by the non‐parametric Mann‐Whitney U test. Statistical significance was inferred if P<0.05.

Results: Plasma ME levels were significantly increased in the transplanted pigs at Pre‐Em, 6–12 hours and 18 hours after surgery. No statistically significant difference was observed for plasma SP level between the control and transplant pigs.

Conclusions: Liver transplantation in the pig model is associated with increased concentrations of endogenous ME (but not SP) in plasma for at least 18 hours after surgery as compared to animals undergoing laparotomy.
No reversion to single mating in a socially parasitic ant
Authors: THURIN N. , ARON S.
Published: February 2011

Social Hymenoptera are ideal biological models for the study of the selective forces affecting the evolution of multiple mating (polyandry), because sister species can evolve different lifestyles and mating strategies. Single mating is predicted in workerless social parasites, because the key benefit of multiple mating in social insects, that is, the increase in genetic diversity among worker offspring, does not hold for workerless species. We compared the queen mating frequency between the ant Plagiolepis pygmaea and its derived social parasite P. xene. Previous studies showed that queens of the host P. pygmaea are obligately polyandrous. Here, pedigree analyses of mother–offspring combinations indicate that queens of the parasite P. xene did not revert to single mating; more than 50% of queens mated multiply, with 2–4 males. This result shows that reversal from multiple to single mating may be not selected in polyandrous social insect workerless parasites. We propose that such reversion does not occur when multiple mating is virtually cost free.
Identification and gene mapping of a soybean chlorophyll‐deficient mutant
Authors: Zhang H. , Zhang D. , Han S. , Zhang X. , Yu D.
Published: February 2011

With 5 figures and 2 tables

Chlorophyll variation mutants are important materials for studying chlorophyll metabolism, photosynthesis, chloroplast biogenesis and related physiological processes. In this study, a chlorophyll‐deficient soybean mutant (cd1) was isolated by screening M2 progenies of cultivar ‘Nannong 86‐4’ treated with 0.4% ethyl methanesulfonate. cd1 displayed yellow‐green leaves from seedling stage V1 to fully flowering stage R2, abnormal chloroplasts, lower total chlorophyll content (30–66% reduction), lower plant height and lower seed yield compared to its wild‐type control. Genetic analysis demonstrated that the visible yellow‐green trait was controlled by a single recessive nuclear gene. Subsequently, the cd1‐mutant gene was mapped at a 6.9‐cM interval on chromosome 10, flanked by two simple sequence repeat markers Satt633 and Sat_291. These results provide us with the opportunity to study a novel gene regulating chlorophyll synthesis.
Two new species of Oxycanus Walker (Lepidoptera: Hepialidae) from Kosciuszko National Park, one with a sub‐brachypterous female
Authors: Edwards Edward D , Green Ken
Published: February 2011

Oxycanus oreades sp.n. and Oxycanus oressigenes sp.n. (Lepidoptera: Hepialidae) are described from the subalpine and alpine zones above 1600 m in Kosciuszko National Park, New South Wales. The females of O. oreades are sub‐brachypterous and flightless. These species are compared to similar species of Oxycanus and to other Oxycanus found in the Mt Kosciuszko area. Sub‐brachypterous Hepialidae in New Zealand and Europe are discussed. Aspects of the biology of the new species are described and the suitability of O. oreades for assessing climatic change is evaluated.
Linking Genetics and Political Attitudes: Reconceptualizing Political Ideology
Authors: Smith Kevin B. , Oxley Douglas R. , Hibbing Matthew V. , Alford John R. , Hibbing John R.
Published: February 2011

In this paper, we trace the route by which genetics could ultimately connect to issue attitudes and suggest that central to this connection are chronic dispositional preferences for mass‐scale social rules, order, and conduct—what we label political ideology. The need to resolve bedrock social dilemmas concerning such matters as leadership style, protection from outgroups, and the degree to which norms of conduct are malleable, is present in any large‐scale social unit at any time. This universality is important in that it leaves open the possibility that genetics could influence stances on issues of the day. Here, we measure orientation to these bedrock principles in two ways—a survey of conscious, self‐reported positions and an implicit association test (IAT) of latent orientations toward fixed or flexible rules of social conduct. In an initial test, both measures were predictive of stances on issues of the day as well as of ideological self‐labeling, thereby suggesting that the heritability of specific issue attitudes could be the result of the heritability of general orientations toward bedrock principles of mass‐scale group life.
From interpersonal networks to inter‐organizational alliances for university–industry collaborations in Japan: the case of the Tokyo Institute of Technology
Authors: Lee Kyoung‐Joo
Published: February 2011

Successful collaborations between university and industry (U–I) promise numerous mutual benefits. In order to realize these benefits, both parties need effective governance mechanisms to overcome organizational and cultural barriers. Until 2004 in Japan, national universities were government organizations, and as such, they were prevented from actively pursuing collaborations with industry. Under this restriction, U–I collaborations were established through informal interpersonal networks. Joint R&D projects were inherently small and seldom likely to generate concrete results for industry. After a series of institutional and organizational reforms by the Japanese government, universities and industries adopted a new strategic approach in the early 2000s to form inter‐organizational alliances. Based on the case of the Tokyo Institute of Technology, this paper analyzes how the inter‐organizational alliances are managed and investigates their impact on joint R&D projects, in comparison with the traditional interpersonal networks. Additional research indicates that most national and private universities adopt management schemes similar to those presented in the case study. The findings suggest that inter‐organizational U–I alliances, being equipped with contractual arrangements, organizational commitments, specialized coordination, and formal evaluation procedures, enable alliance partners to initiate more explorative research, to organize interdisciplinary projects with faculties in different research fields, and to establish larger‐scale R&D projects.
Knowledge communication, exploitation and endogenous innovation: the moderating effects of internal controls in SMEs
Authors: Li Yuan , Li Xiyao , Liu Yi , Barnes Bradley R.
Published: February 2011

This research develops a theoretical framework for leveraging internal knowledge effectively to achieve endogenous innovation goals in small and medium‐sized enterprises (SMEs). The manuscript reports the findings based on a sample of 213 SMEs, suggesting that knowledge exploitation has a mediating effect on knowledge communication for enhancing endogenous innovation. The research reveals that strategic controls moderate the relationship between knowledge exploitation and innovation positively, whereas financial controls appear to moderate the same relationship negatively. Our findings advocate that entrepreneurs in SMEs should focus on communication and the exploitation of knowledge as well as carefully consider their choice of efficient control mechanisms.
The evolution of technology licensing management: identifying five strategic approaches
Authors: Lichtenthaler Ulrich
Published: February 2011

Besides applying technology in new products inside the organization, industrial firms may actively license technology to external partners. There is anecdotal evidence that firms have increasingly licensed technology in recent years in order to achieve monetary and non‐monetary benefits. However, prior research into the evolution of licensing activities and into the management of these activities is relatively limited. Therefore, we rely on an exploratory research design and collect unique data by means of 57 interviews in 25 industrial firms over a 5‐year period. On this basis, we identify five different strategic approaches to licensing management. In addition, we examine the relationship between the firms' licensing management and licensing activity. Finally, we analyze the development of the firms' licensing management over the 5‐year period. The results considerably deepen our understanding of licensing management, and they provide new insights into interfirm differences in the success of active licensing programs. The findings have major implications for research into technology licensing, knowledge exploitation, open innovation, and markets for technology.
Rawls's Political Liberalism. A Reassessment
Authors: NUSSBAUM MARTHA
Published: February 2011

Since Rawls's Political Liberalism is by now the subject of a wide and deep philosophical literature, much of it excellent in quality, it would be foolhardy to attempt to say something about each of the major issues of the work, or to sort through debates that can easily be located elsewhere. I have therefore decided to focus on a small number of issues where there is at least some chance that a fresh approach may yield some new understanding of the text: Rawls's distinction between “reasonable” and “unreasonable” comprehensive doctrines; the psychological underpinnings of political liberalism; and the possibility that political liberalism might be extended beyond the small group of modern Western societies that Rawls's historical remarks suggest as its primary focus. I also include a discussion of the much‐debated issue of civility and public reason, which could hardly be avoided given its prominence in the book's reception. This paper should therefore be read not as a comprehensive account of the work but as one person's attempt to grapple, very incompletely and imperfectly, with a book that is as great as any philosophy has seen on this topic of great human urgency.
Habermas, Feminism, and Law: Beyond Equality and Difference?*
Authors: SORIAL SARAH
Published: February 2011

In this paper, I argue that Habermas' proceduralist model of law can be put to feminist ends in at least two significant ways. First, in presenting an alternative to the liberal and welfare models of laws, the proceduralist model offers feminism a way out of the equality/difference dilemma. Both these attempts to secure women's equality by emphasising women's sameness to men or their difference from men have placed the onus on women to either find a way of integrating themselves into existing institutions or to confront the so‐called question of women's difference. The proceduralist model renders this dilemma irrelevant. Instead, it proceeds from the fact of sexual difference; a fact that produces competing and conflicting needs and interests that require interpretation by both men and women. This, I argue, marks a change in the very way we conceptualise the so‐called problem of women's difference, insofar as the question is no longer framed in these terms. Second, I argue that this deliberative process over the interpretation of conflicting interests affects a fundamental shift in the nature of legal institutions themselves, insofar as law is no longer a vehicle for promoting male interests.
Constitutional Conflicts, Moral Dilemmas, and Legal Solutions
Authors: ALVAREZ SILVINA
Published: February 2011

The article focuses on the definition of constitutional conflicts as moral dilemmas. It discusses the conception of tragic conflicts by which “loss” is a distinctive feature that identifies both moral and constitutional dilemmas. It also asserts the peculiarity of constitutional conflicts vis‐à‐vis moral dilemmas, as well as the possibility of legal solutions to constitutional conflicts.
Responding to Trust
Authors: HARDING MATTHEW
Published: February 2011

The essay considers what respect demands and what trust demands when one person trusts another. What respect requires in responding to trust is substantial but limited, ranging from the sharply proscriptive to the mildly prescriptive. What trust requires is, in a sense, unlimited, its content depending on the extent to which the person who trusts, and more importantly the person who is trusted, seek to build a relationship characterised by trust and trustworthiness.
Directives in EU Legal Systems: Whose Norms Are They Anyway?
Authors: Dickson Julie
Published: February 2011

This article is concerned with whether the concept of a legal system—long a centrepiece of state‐based legal theories—is a useful conceptual tool in theorising the contemporary EU and its legal relations with its Member States. The focus lies particularly with EU directives, and with what the character and operation of this distinctive type of EU norm can tell us as regards the existence of and relations between legal systems in the EU. I argue for the view that the EU is comprised of distinct but interacting legal systems at EU and national level, and claim that the character and operation of directives supports this view. Throughout the discussion I try to bring the conceptual tools of analytical legal philosophy to bear on puzzles generated by EU law and its relations with national law, in order to show that a sound analysis of aspects of the EU can benefit from abstract legal philosophical reflection, and vice versa.
EU Enlargement and the Emboldening of Institutional Integrity in Central and Eastern Europe: The ‘Tough Test’ of Public Procurement
Authors: Engelbrekt Kjell
Published: February 2011

EU enlargement and the incorporation of the acquis communautaire are widely seen as successful and emboldening the integrity of political, administrative and legal institutions in Central and Eastern Europe (CEE). The analysis reported here describes the specific problems associated with affirming institutional integrity in the field of public procurement, which constitutes a ‘tough test’. Public procurement is namely an area where the acquis swiftly gained pre‐eminence in accession states, but whose complex regulations depend on a well‐functioning judiciary, effective administrative supervision and limited corruption. The experience in Poland and Bulgaria, countries that represent different stages of institution building in this area, is compared. The results suggest that an EU‐compatible public procurement regime is being consolidated throughout the CEE region. At the same time, that regime may only work well when boundaries between institutional subjects, as well as between the spheres of law, politics and economics, are upheld in post‐communist countries.
The Value of ‘Integration’ in European Law—The Implications of the Förster Case on Legal Assessment of Integration Conditions for Third‐Country Nationals
Authors: Jesse Moritz
Published: February 2011

The European Court of Justice's Förster judgment can lead to a reduction of legal uncertainty caused by integration requirements for third‐country nationals. The judgment has created a strong ‘assumption of integration’ after five years of legal residence because it equalised integration requirements for European students to access the welfare system of host Member States with a requirement of five years legal residence. Almost all pieces of European legal migration law also contain five‐year residence requirements after which the status of third‐country nationals improves. However, these improvements are mostly subjected to the fulfilment of additional integration requirements. To keep coherence with European law, courts will not be able to disregard the Förster‘assumption of integration’ when assessing the legality of integration conditions for third‐country nationals put in place in addition to residence requirements.
Contribution of glucocerebrosidase mutation in a large cohort of sporadic Parkinson’s disease in Taiwan
Authors: Huang C.‐L. , Wu‐Chou Y.‐H. , Lai S.‐C. , Chang H.‐C. , Yeh T.‐H. , Weng Y.‐H. , Chen R.‐S. , Huang Y.‐Z. , Lu C.‐S.
Published: February 2011

Background and purpose:  The association between glucocerebrosidase (GBA) mutations and Parkinson’s disease (PD) is attracting increased attention worldwide. In patients of Chinese ethnicity, other than the common L444P mutation, a few mutations have been reported. However, the contribution of GBA to PD can be answered only by a thorough investigation of its mutations in a unique large population.

Methods:  We enrolled 1747 participants: 967 PD patients and 780 healthy individuals. We screened entire GBA coding regions and exon–intron boundaries in 30 randomly chosen PD patients, followed by testing five variants (L444P, D409H, R120W, L174P, and Q497R) in all participants. The G2385R and R1628P in LRRK2 had been previously studied in almost all participants.

Results:  In total, 36 patients (3.72%) carried a heterozygous mutant GBA allele (27 L444P, 7 RecNciI, and 2 D409H). Only two controls (0.26%) carried heterozygous GBA mutation (1 L444P and 1 RecNciI). In PD group, the mean age at onset in carriers was younger than in non‐carriers. The difference in percentage of mutation frequencies between patients and controls was highly significant for the L444P mutation (P < 0.0001). One L444P carrier was also associated with LRRK2 G2385R variant, but no atypical Parkinsonism was observed.

Conclusions:  The present study ascertains that L444P mutation in GBA gene may contribute to an earlier onset of development of PD in Han/Chinese population. Following LRRK2 variants, GBA is the second most frequent mutations indicated for sporadic PD development in the Han/Chinese population. These GBA carriers are associated with an earlier onset of Parkinsonism.
Patient care encounters with the MCHL: a questionnaire study
Authors: Ström Mayvor , Baigi Amir , Hildingh Cathrine , Mattsson Bengt , Marklund Bertil
Published: February 2011

Scand J Caring Sci; 2011; 25; 517–524
 
Patient care encounters with the MCHL: a questionnaire study

Background:  Both internationally and nationally, the medical care help line (MCHL) is a growing operation within the healthcare field. In Sweden, approximately 5 million calls per year are processed. The service is managed by specially trained nurses.

Aim:  To describe how patients’ sex, age, education level and care level influenced their perceptions of care encounters with the MCHL.

Methodological design and instrument:  A questionnaire was designed through the operationalisation of terms based on a previous interview study with MCHL callers. It was distributed to 858 callers in a region of southwest Sweden. The questionnaire was comprised of 14 visual analogue scales (VAS). Validity and reliability were determined to be acceptable by a pilot study and factor analyses.

Results:  Response frequency n = 517 (60.4 %). Three factors, interaction, service and product, emerged to describe high satisfaction with the MCHL from different perspectives. The items ‘friendliness’, ‘respect’, ‘confirmation’, ‘accessibility’ and ‘simplicity’ scored highest, whereas the ‘joint decision‐making’, ‘composure’ and ‘time’ items had the lowest values.

Conclusions and relevance to clinical nursing:  A new questionnaire with acceptable validity and reliability was created on the basis of an interview study examining patient encounters with the MCHL. The new questionnaire may provide useful support in the education of MCHL nurses and other nurses in telephone triage. It can also be used for quality development and as a basis for further research on telephone nursing.
THE MICRO‐DYNAMICS OF CATCH‐UP IN INDONESIAN PAPER MANUFACTURING
Authors: Van Dijk Michiel , Szirmai Adam
Published: February 2011

In this study we analyze the micro‐dynamics of catch‐up in Indonesian paper manufacturing, using a two‐country plant‐level dataset for the period 1975–97. We apply data envelopment analysis (DEA) to measure to what extent Indonesian paper mills are catching up with Finnish mills in terms of technical efficiency. Three questions are addressed: What is the distribution of Indonesian plant technical efficiency vis‐à‐vis the technological frontier? What is the role of entry, exit, and survival in Indonesia for catch‐up in the paper industry as a whole? In what ways do catching‐up plants in Indonesia differ from non‐catching‐up plants? We find that on average the Indonesian paper industry moved closer to the technological frontier during the 1990s. However, catch‐up has been a highly localized process in which only a few large establishments have achieved near best‐practice performance, while most other plants have stayed behind.
The Importance of Prognosis in Cancer Screening in Patients with Chronic Kidney Disease
Authors: Holley Jean L.
Published: February 2011

The high mortality of end‐stage renal disease (ESRD) suggests that general cancer screening in this population is costly and of little value. Patients with ESRD awaiting transplantation and those who have been successfully transplanted require cancer screening because of their higher expected survival and increased cancer risk. If shared decision‐making is to guide cancer screening protocols that are individualized based on cancer risk, transplantation status, and expected survival, it is incumbent upon nephrologists to discuss overall expected survival with their patients with ESRD. Most nephrologists are poorly trained in the communication skills needed to address these issues and feel uncomfortable engaging in such discussions. The revised clinical practice guideline, “Shared Decision‐Making in the Appropriate Initiation of and Withdrawal from Dialysis,” is a useful resource which nephrologists may consult when facing such situations.
Vascular Access for HD: Aligning Payment with Quality
Authors: Amedia Chester A. , Bolton W. Kline , Cordray Trelles , Hakim Ray , Howard Randy , Jackson Jerry , Kulawik Deuzimar , Lyon Maryam , Mahoney David , Messana Anthony , Nissenson Allen , Oviatt Lauren , Parlato David , Roddy Sean , Solid Craig
Published: February 2011

The Fistula First Breakthrough Initiative (FFBI) has improved the awareness of the value of fistula creation in patients with end‐stage renal disease (ESRD). The FFBI Health Policy Workgroup has been charged with reviewing the relationship of policy and economic issues to this project. This article reviews the efforts and successes of renal community clinical activities and reemphasizes the economic impact of fistula creation and catheter reduction on the health care system. Major obstacles are discussed, and existing tools and efforts designed to address them are outlined. The FFBI Health Policy Workgroup then identifies less frequently recognized barriers to the achievement of the FFBI goals and suggests solutions to them. It concludes that nephrologists need to assume the leadership role and drive fistula creation and central venous catheter reduction to achieve programmatic success.
Distinct expression of perforin and granzyme B in lip and oral cavity squamous cell carcinoma
Authors: Costa Nádia Lago , Gonçalves Andréia Souza , Souza‐Lima Nathália Caroline , Jaime‐Paiva Luís Gustavo , Junqueira‐Kipnis Ana Paula , Silva Tarcília Aparecida , Mendonça Elismauro Francisco , Batista Aline Carvalho
Published: February 2011

J Oral Pathol Med (2011) 40: 380–384

Background:  Perforin and granzyme B (GB) are the main constituents of cytotoxic T‐lymphocyte granules, and they have important roles in preventing the initiation and progression of cancer.

Methods:  The aim of this study was to compare the expression of CD8+/perforin+ double‐staining and GB+ cells, by immunohistochemistry, in primary oral cavity squamous cell carcinoma (OCSCC), lip squamous cell carcinoma (LSCC), non‐dysplastic leukoplakia (LK), dysplastic LK, actinic cheilitis (AC), oral lichen planus (LP) and normal oral mucosa.

Results:  Our results showed a higher expression of CD8+/perforin+ and GB+ cells in LSCC when compared with the samples of OCSCC, non‐dysplastic and dysplastic LK, AC, oral LP and normal oral mucosa. In addition, increased CD8+/perforin+ and GB+ cell numbers were observed in all pre‐malignant lesions (non‐dysplastic LK, dysplastic LK, AC) when compared with the control.

Conclusions:  Perforin and GB proteins may contribute to antitumoural immunity, leading to the direct killing of tumour cells; however, it seems to occur more effectively in LSCC than OCSCC.
Skin texture parameters of the dorsal hand in evaluating skin aging in China
Authors: Gao Qian , Hu Li‐Wen , Wang Yang , Xu Wen‐Ying , Ouyang Nan‐Ning , Dong Guo‐Qing , Shi Song‐Tian , Liu Yang
Published: February 2011

Background/purpose: There are various non‐invasive methods in skin morphology for assessing skin aging. The use of digital photography will make it easier and more convenient. In this study, we explored some skin texture parameters for evaluating skin aging using digital image processing.

Methods: Two hundred and twenty‐eight subjects who lived in Sanya, China, were involved. Individual sun exposure history and other factors influencing skin aging were collected by a questionnaire. Meanwhile, we took photos of their dorsal hands. Skin images were graded according to the Beagley–Gibson system. These skin images were also processed using image analysis software. Five skin texture parameters, Angle Num., Angle Max., Angle Diff., Distance and Grids, were produced in reference to the Beagley–Gibson system.

Results: All texture parameters were significantly associated with the Beagley–Gibson score. Among the parameters, the distance between primary lines (Distance) and the value of angle formed by intersection textures (Angle Max., Angle Diff.) were positively associated with the Beagley–Gibson score. However, there was a negative correlation between the number of grids (Grids), the number of angle (Angle Num.) and the Beagley–Gibson score. These texture parameters were also correlated with factors influencing skin aging such as sun exposure, age, smoking, drinking and body mass index. In multivariate analysis, Grids and Distance were mainly affected by age. But Angle Max. and Angle Diff. were mainly affected by sun exposure.

Conclusion: It seemed that the skin surface morphologic parameters presented in our study reflect skin aging changes to some extent and could be used to describe skin aging using digital image processing.
A novel method to measure conspicuous facial pores using computer analysis of digital‐camera‐captured images: the effect of glycolic acid chemical peeling
Authors: Kakudo Natsuko , Kushida Satoshi , Tanaka Nobuko , Minakata Tatsuya , Suzuki Kenji , Kusumoto Kenji
Published: February 2011

Background/purpose: Chemical peeling is becoming increasingly popular for skin rejuvenation in dermatological esthetic surgery. Conspicuous facial pores are one of the most frequently encountered skin problems in women of all ages. This study was performed to analyze the effectiveness of reducing conspicuous facial pores using glycolic acid chemical peeling (GACP) based on a novel computer analysis of digital‐camera‐captured images.

Methods: GACP was performed a total of five times at 2‐week intervals in 22 healthy women. Computerized image analysis of conspicuous, open, and darkened facial pores was performed using the Robo Skin Analyzer CS 50.

Results: The number of conspicuous facial pores decreased significantly in 19 (86%) of the 22 subjects, with a mean improvement rate of 34.6%. The number of open pores decreased significantly in 16 (72%) of the subjects, with a mean improvement rate of 11.0%. The number of darkened pores decreased significantly in 18 (81%) of the subjects, with a mean improvement rate of 34.3%.

Conclusion: GACP significantly reduces the number of conspicuous facial pores. The Robo Skin Analyzer CS 50 is useful for the quantification and analysis of ‘pore enlargement’, a subtle finding in dermatological esthetic surgery.