bluuebunny/crossref_metadata_2025 huggingface dataset:
Tratamiento social de las diferencias, teorias infantiles y narrativas
Authors: Maneiro Rosana , Minnicelli Mercedes
Published: June 2013

En este escrito nos ocuparemos del tratamiento social de las diferencias y sus resonancias singulares en tres direcciones: a) la importancia en el devenir de la sexualidad infantil del encuentro con la diferencia entre los cuerpos como percepción clave en la configuración de teorías sexuales infantiles y sus repercusiones cuando las mismas no cuentan con soporte colectivo de tramitación; b) la tendencia a la patologización y medicalización de la infancia ante la falta de escenarios de consideración de dichas teorías; c) alternativas clínico sociales para intentar resistir a la devastación subjetiva de las nuevas generaciones.
O jovem macho e a jovem difícil: governo da sexualidade no currículo
Authors: Sales Shirlei Rezende , Paraíso Marlucy Alves
Published: June 2013

Este artigo analisa o processo de produção de subjetividades juvenis na interface do currículo escolar e do currículo do Orkut (rede social). O argumento desenvolvido é o de que a sexualidade, pautada na heteronormatividade, é acionada e intensamente regulada nos discursos investigados, tendo como efeito o governo da juventude. A regulação se dá por meio da tecnologia da zuação, a qual é composta por várias técnicas como o sarcasmo, a ironia, o deboche, o repúdio, o banimento etc. No caso dos garotos, há nos discursos uma declarada homofobia, demandando o jovem macho. Quanto às garotas, a regulação incide sobre a quantidade de parceiros nas práticas de ficar ou pegar, demandando a jovem difícil.
Políticas educativas, intersetorialidade e desenvolvimento local
Authors: Góes Flávia Temponi , Machado Lucília Regina de Souza
Published: June 2013

O artigo apresenta reflexões sobre potencialidades das relações entre políticas educativas, ações intersetoriais e desenvolvimento local. Recorreu à pesquisa bibliográfica sobre princípios, fundamentos e pressupostos de propostas e programas socioeducacionais, que buscam realizar tais articulações. Concluiu que há, nos discursos dos autores consultados, argumentos fortes e auspiciosos quanto ao potencial de inovações sociais e educacionais nessas relações. Contudo, a realização de tais expectativas depende de condições e possibilidades não isentas de conflitos e contradições, pois pressupõem por em contraposição diferentes pontos de vista e estratégias sociais, nem sempre voltadas para o mesmo horizonte de transformações sociais.
O gauchismo e as escolas: a diversidade cultural em questão
Authors: Brum Ceres Karam
Published: June 2013

Neste texto, desejamos efetuar uma reflexão sobre o gauchismo e o tradicionalismo no Rio Grande do Sul. Partimos da construção mítica da figura do gaúcho e suas utilizações pelo gauchismo, que identifica sua figura como ideal pattern a ser internalizado a partir de múltiplos aprendizados. Como conclusão, desejamos sublinhar algumas dimensões do discurso da diversidade cultural em contextos de culto do gauchismo e do tradicionalismo na atualidade. Isto se dá a partir de análise bibliográfica e de trabalhos de campo, que demonstram o cenário educacional como um campo de disputas perpassado por diferentes formas de violência simbólica, envolvendo ideias, valores e imaginários nos processos de construção das identidades regionais.
A Reappraisal of the Diagnostic and Therapeutic Management of Uncommon Histologies of Primary Ocular Adnexal Lymphoma
Authors: Ponzoni Maurilio , Govi Silvia , Licata Giada , Mappa Silvia , Giordano Resti Antonio , Politi Letterio S. , Spagnuolo Lorenzo , Di Cairano Eliana Sara , Doglioni Claudio , Ferreri Andrés J. M.
Published: June 2013

Lymphoma is the most common malignancy arising in the ocular adnexa, which includes conjunctiva, lachrymal gland, lachrymal sac, eyelids, orbit soft tissue, and extraocular muscles. Ocular adnexal lymphoma (OAL) accounts for 1%–2% of non-Hodgkin lymphoma and 5%–15% of extranodal lymphoma. Histology, stage, and primary localizations are the most important variables influencing the natural history and therapeutic outcome of these malignancies. Among the various lymphoma variants that could arise in the ocular adnexa, marginal zone B-cell lymphoma (OA-MZL) is the most common one. Other types of lymphoma arise much more rarely in these anatomical sites; follicular lymphoma is the second most frequent histology, followed by diffuse large B-cell lymphoma and mantle cell lymphoma. Additional lymphoma entities, like T-cell/natural killer cell lymphomas and Burkitt lymphoma, only occasionally involve orbital structures. Because they are so rare, related literature mostly consists of anecdotal cases included within series focused on OA-MZL and sporadic case reports. This bias hampers a global approach to clinical and molecular properties of these types of lymphoma, with a low level of evidence supporting therapeutic options. This review covers the prevalence, clinical presentation, behavior, and histological and molecular features of uncommon forms of primary OAL and provides practical recommendations for therapeutic management.
Practicing in Partnership With Dr. Google: The Growing Effect of Social Media in Oncology Practice and Research
Authors: West Howard (Jack)
Published: June 2013

A significant proportion of patients and caregivers without formal medical training are turning to Internet-based educational and support resources as they search for relevant and reliable content. Through these efforts, many patients are becoming engaged in learning about their treatment options, including clinical trial opportunities, from outside sources. This editorial discusses the potential beneficial and detrimental effects of the disruptive influence of online information and support on the relationship between patients and physicians.
Health-Related Quality of Life With Adjuvant Docetaxel- and Trastuzumab-Based Regimens in Patients with Node-Positive and High-Risk Node-Negative, HER2-Positive Early Breast Cancer: Results from the BCIRG 006 Study
Authors: Au Heather-Jane , Eiermann Wolfgang , Robert Nicholas J. , Pieńkowski Tadeusz , Crown John , Martin Miguel , Pawlicki Marek , Chan Arlene , Mackey John , Glaspy John , Pintér Tamás , Liu Mei-Ching , Fornander Tommy , Sehdev Sandeep , Ferrero Jean-Marc , Bée Valerie , Santana Maria J. , Miller Dave P. , Lalla Deepa , Slamon Dennis J. ,   on behalf of the Translational Research in Oncology BCIRG 006 trial investigators.
Published: June 2013

Background.

This study aims to describe and compare health-related quality of life (HRQL) in patients with node-positive and high-risk node-negative HER2-positive early breast cancer receiving adjuvant docetaxel and trastuzumab-based or docetaxel-based regimens alone.

Methods.

Eligible patients (n = 3,222) were randomly assigned to either four cycles of adjuvant doxorubicin and cyclophosphamide followed by four cycles of docetaxel (AC→T) or one of two trastuzumab-containing regimens: adjuvant doxorubicin and cyclophosphamide followed by docetaxel plus trastuzumab administered for 1 year (AC→TH) or six cycles of docetaxel plus carboplatin combined with trastuzumab administered for 1 year (TCH). The European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire C30 and BR-23 were administered at baseline, the start of cycle 4 (mid), and the end of chemotherapy (EOC), as well as at 6, 12, and 24 months after chemotherapy.

Results.

Compliance rates for the EORTC questionnaires were acceptable at 72%–93% of eligible patients out to the 12-month assessment. Systemic side effect (SE) change scores were significantly improved for TCH-treated patients compared with AC→TH and AC→T at EOC, suggesting improved tolerability. Physical functioning (PF) was only slightly worse at midpoint for those receiving TCH, compared with patients who were just starting on taxane in an AC→TH regimen, but was otherwise similar between arms. All treatment arms recovered from the deterioration in SE, PF, and Global Health Scale scores by 1 year and median future perspective change scores continued to improve throughout treatment and follow-up.

Conclusion.

HRQL outcomes for adjuvant docetaxel and trastuzumab-based regimens are favorable and support TCH as a more tolerable treatment option.
Novel Targets in Non-Small Cell Lung Cancer: ROS1 and RET Fusions
Authors: Gainor Justin F. , Shaw Alice T.
Published: June 2013

The discovery of chromosomal rearrangements involving the anaplastic lymphoma kinase (ALK) gene in non-small cell lung cancer (NSCLC) has stimulated renewed interest in oncogenic fusions as potential therapeutic targets. Recently, genetic alterations in ROS1 and RET were identified in patients with NSCLC. Like ALK, genetic alterations in ROS1 and RET involve chromosomal rearrangements that result in the formation of chimeric fusion kinases capable of oncogenic transformation. Notably, ROS1 and RET rearrangements are rarely found with other genetic alterations, such as EGFR, KRAS, or ALK. This finding suggests that both ROS1 and RET are independent oncogenic drivers that may be viable therapeutic targets. In initial screening studies, ROS1 and RET rearrangements were identified at similar frequencies (approximately 1%–2%), using a variety of genotyping techniques. Importantly, patients with either ROS1 or RET rearrangements appear to have unique clinical and pathologic features that may facilitate identification and enrichment strategies. These features may in turn expedite enrollment in clinical trials evaluating genotype-directed therapies in these rare patient populations. In this review, we summarize the molecular biology, clinical features, detection, and targeting of ROS1 and RET rearrangements in NSCLC.
Experimental Study on Natural-Gas-Hydrate-Slurry Flow
Authors: Lv X.F.. F. , Gong J.. , Li W.Q.. Q. , Shi B.H.. H. , Yu D.. , Wu H.H.. H.
Published: June 2013

To better understand hydrate-slurry flow, a series of experiments was performed, including water, natural gas, and diesel oil, under 4-MPa system pressure and 1.25-m/s initial linear velocity. The experiments have been conducted in a high-pressure hydrate-flow loop newly constructed at China University of Petroleum (Beijing), and dedicated to flow-assurance studies. A focused-beam reflectance measurement (FBRM) probe is installed in this flow loop, which provides a qualitative chord length distribution (CLD) of the particles/droplets in the system. First, the influence of flow rate on the hydrate-slurry flow was discussed. Then, we studied other influencing factors—such as water cut and additive dosage—on the hydrate induction period and the CLD before/after hydrate formation. Third, a new correlation was fitted between the dimensionless rheological index n′ and water cut as well as additive dosage, according to these experimental data. Finally, a laminar-flow model for the prediction of the pressure drop for the quasisingle-phase hydrate slurry was established, and tested by comparison with the experimental results in this paper.
The Impact of Physical and Psychological Comorbid Conditions on the Quality of Life of Patients with Acute Myocardial Infarction: A Multi-Center, Cross-Sectional Observational Study from Turkey
Authors: Sertoz O. Onen , Aydemir O. , Gulpek D. , Elbi H. , Ozenli Y. , Yilmaz A. , Ozan E. , Atesci F. , Abay E. , Semiz M. , Direk N. , Hocaoglu C. , Elyas Z. , Ozmen M. , Ozen S. , Konuk N.
Published: June 2013

Objective:

Acute myocardial infarction (MI) has significant and detrimental effects on the lifestyles of the patients. It has been shown that quality of life (QoL) in patients with MI is impaired in every aspect. This study aims to evaluate the impact of depression and physical comorbidity on QoL in Turkish patients with acute first MI.

Method:

This multi-center cross-sectional study was carried out in 15 centers with 998 patients hospitalized for acute first MI. For detection of depression, Beck Depression Inventory (BDI) was used. For evaluation of QoL, World Health Organization Quality of Life Questionnaire (WHOQOL) was applied.

Results:

The mean age of the patients was 57.5 ± 10.1 years and 79.2 % ( n = 792) of the patients were men. Patients with comorbid depression (BDI ≤ 10) and comorbid medical conditions, and female patients had significantly lower scores in every domain of WHOQOL. In the regression analysis model, female gender, low education, comorbid medical conditions, especially comorbid hypertension, and BDI score were found to have a significant effect on the domains of WHOQOL.

Conclusions:

Female patients are more prone to impairment in quality of life after myocardial infarction. Both comorbid medical conditions and depression have a significant impact on the impairment of QoL in Turkish patients with acute MI. In order to improve the subjective wellbeing of post MI patients, both psychiatric and physical comorbidities must be detected and managed even in the short term.
Perioperative Psycho-Educational Intervention Can Reduce Postoperative Delirium in Patients after Cardiac Surgery: A Pilot Study
Authors: Lee Jeewon , Jung Joonho , Noh Jai Sung , Yoo Seungmin , Hong You Sun
Published: June 2013

Objective:

Postoperative delirium after cardiac surgery is associated with many consequences such as poorer functional recovery, more frequent postoperative complications, higher mortality, increased length of hospital stay, and higher hospital costs. The aim of this study was to evaluate the efficacy of perioperative psycho-educational intervention in preventing postoperative delirium in post cardiac surgery patients.

Method:

We conducted a comparative retrospective study between 49 patients who had received perioperative psycho-educational intervention and 46 patients who had received standard care. The primary outcome was the incidence of postoperative delirium. Secondary outcomes included length of ICU stay, and severity and duration of postoperative delirium among the patients who had developed delirium.

Results:

The incidence of postoperative delirium was significantly lower in the intervention group than that in the control group (12.24% vs. 34.78%, P = 0.009). Among the patients who had developed postoperative delirium, there was no statistical difference between the two groups regarding secondary outcomes.

Conclusions:

Our results show that the patients who received perioperative psycho-educational intervention were associated with a lower incidence of postoperative delirium after cardiac surgery than those who received standard care. Clinicians would be able to implement this psycho-educational intervention as part of routine practice to reduce delirium.
Forty Days after the Great East Japan Earthquake: Field Research Investigating Community Engagement and Traumatic Stress Screening in a Post-Disaster Community Mental Health Training
Authors: Tuerk Peter W. , Hall Brian , Nagae Nobukazu , McCauley Jenna L. , Yoder Matthew , Rauch Sheila A. M. , Acierno Ron , Dussich John
Published: June 2013

The current article describes the results of posttraumatic stress educational outreach and screening offered to 141 citizens of Japan who attended a public-service mental health training regarding post-disaster coping 40 days after a 6.8 Richter Scale earthquake, local and regional deaths, and an ongoing nuclear radiation threat. Attendees were given access to anonymous questionnaires that were integrated into the training as a tool to help enhance mental health literacy and bridge communication gaps. Questionnaires were turned in by a third of those in attendance. Among respondents, multiple exposures to potentially-traumatic events were common. More than a quarter of respondents met criteria for probable PTSD. Physical health and loss of sense of community were related to PTSD symptoms. Associations and diagnosis rates represented in these data are not generalizable to the population as a whole or intended for epidemiological purposes; rather, they are evidence of a potentially useful approach to post-disaster clinical screening, education, and engagement. Results are presented in the context of previous findings in Japan and ecologically-supportive post-disaster field research is discussed.
Association of Anxiety and Depression with Pulmonary-Specific Symptoms in Chronic Obstructive Pulmonary Disease
Authors: Doyle Todd , Palmer Scott , Johnson Julie , Babyak Michael A. , Smith Patrick , Mabe Stephanie , Welty-Wolf Karen , Martinu Tereza , Blumenthal James A.
Published: June 2013

Objectives:

To examine the association of anxiety and depression with pulmonary-specific symptoms of Chronic Obstructive Pulmonary Disease (COPD), and to determine the extent to which disease severity and functional capacity modify this association.

Method:

Patients ( N = 162) enrolled in the INSPIRE-II study, an ongoing randomized, clinical trial of COPD patients and their caregivers who received either telephone-based coping skills training or education and symptom monitoring. Patients completed a psychosocial test battery including: Brief Fatigue Inventory, St. George's Respiratory Questionnaire, UCSD Shortness of Breath Questionnaire, State-Trait Anxiety Inventory, and Beck Depression Inventory. Measures of disease severity and functional capacity (i.e., FEV1 and six-minute walk test) were also obtained.

Results:

After covariate adjustment, higher anxiety and depression levels were associated with greater fatigue levels ( ps < .001, ΔR2 = 0.16 and 0.29, respectively), shortness of breath ( ps < .001, ΔR2 = 0.12 and 0.10), and frequency of COPD symptoms ( ps < .001, ΔR2 = 0.11 and 0.13). In addition, functional capacity was a moderator of anxiety and pulmonary-specific COPD symptoms. The association between anxiety and shortness of breath ( p = 0.009) and frequency of COPD symptoms ( p = 0.02) was greater among patients with lower functional capacity.

Conclusions:

Anxiety and depression were associated with higher levels of fatigue, shortness of breath, and frequency of COPD symptoms. It is important for clinicians to be aware of the presence of anxiety and depression in COPD patients, which appears to correlate with pulmonary-specific COPD symptoms, especially in patients with lower functional capacity. Prospective design studies are needed to elucidate the causal relationships between anxiety and depression and pulmonary-specific symptoms in COPD patients.
Renal Clearance and Intestinal Generation of p-Cresyl Sulfate and Indoxyl Sulfate in CKD
Authors: Poesen Ruben , Viaene Liesbeth , Verbeke Kristin , Claes Kathleen , Bammens Bert , Sprangers Ben , Naesens Maarten , Vanrenterghem Yves , Kuypers Dirk , Evenepoel Pieter , Meijers Björn
Published: June 2013

Background and objectives

p-Cresyl sulfate and indoxyl sulfate contribute to cardiovascular disease and progression of renal disease. Renal clearance of both solutes mainly depends on tubular secretion, and serum concentrations are widely dispersed for any given stage of CKD. From this information, it is inferred that estimated GFR is not a suitable proxy of the clearance of these solutes. Formal clearance studies have, however, not been performed to date.

Design, setting, participants, & measurements

This study analyzed renal clearances of p-cresyl sulfate and indoxyl sulfate in the Leuven CKD cohort (NCT00441623; inclusion between November of 2005 and September of 2006) and explored their relationship with estimated GFR. Multivariate linear regression models were built to evaluate contributions of estimated GFR, demographics, and generation rates to p-cresyl sulfate and indoxyl sulfate serum concentrations.

Results

Renal clearances were analyzed in 203 patients with CKD stages 1–5. Indoxyl sulfate clearances (median=17.7, interquartile range=9.4–33.2 ml/min) exceeded p-cresyl sulfate clearances (median=6.8, interquartile range=3.4–12.0 ml/min) by about threefold. A linear relationship was observed between estimated GFR and clearances of p-cresyl sulfate (R
2=0.50, P<0.001) and indoxyl sulfate (R
2=0.55, P<0.001). In multivariate regression, p-cresyl sulfate concentrations were associated (R
2=0.75) with estimated GFR and generation rate (both P<0.001). Indoxyl sulfate concentrations were associated (R
2=0.74) with estimated GFR, generation rate (both P<0.001), age (P<0.05), and sex (P<0.05).

Conclusions

Estimated GFR provides an acceptable estimate of renal clearance of p-cresyl sulfate and indoxyl sulfate. Remarkably, clearances of indoxyl sulfate exceed clearances of p-cresyl sulfate by approximately threefold, suggesting substantial differences between tubular transporter affinities and/or involvement of separate transporter systems for p-cresyl sulfate and indoxyl sulfate.
Length Polymorphism in Heme Oxygenase-1 and Cardiovascular Events and Mortality in Hemodialysis Patients
Authors: Chen Yu-Hsin , Hung Szu-Chun , Tarng Der-Cherng
Published: June 2013

Background and objectives

Persistent inflammation and oxidative stress play a pathogenic role in the high cardiovascular morbidity and mortality of hemodialysis patients. Heme oxygenase-1 is considered to have anti-inflammatory and antioxidant properties. This study assessed the association between the length of guanosine thymidine dinucleotide repeats in the heme oxygenase-1 gene microsatellite promoter and cardiovascular events and mortality among hemodialysis patients.

Design, setting, participants, & measurements

Study participants were recruited from October 1, 2006 to December 31, 2006. The allelic frequencies of the length of guanosine thymidine dinucleotide repeats (the S allele represents shorter [<27] repeats, and the L allele represents longer [≥27] repeats) in the heme oxygenase-1 gene promoter were analyzed in 1080 unrelated chronic hemodialysis patients and 365 healthy controls for distribution comparison. Cardiovascular events and mortality were the study outcomes, and the hemodialysis patients were followed until June 30, 2011.

Results

The genotype proportions were 20.6%, 48.8%, and 30.6% for S/S, S/L, and L/L, respectively, in the hemodialysis patients and comparable with those proportions in healthy controls. The patients with the L/L genotype had significantly higher baseline serum high-sensitivity C-reactive protein and malondialdehyde levels than the patients with the S/S or S/L genotypes. During a median follow-up of 50 months, 307 patients died. A Kaplan–Meier survival analysis showed the highest cardiovascular events and all-cause mortality in patients with the L/L genotype. The adjusted hazard ratios (95% confidence intervals) for each L allele in additive model were 1.42 (1.20 to 1.67 [P<0.001]) for cardiovascular events and 1.19 (1.01 to 1.40 [P=0.03]) for all-cause mortality.

Conclusions

Chronic hemodialysis patients with longer lengths of guanosine thymidine dinucleotide repeats in the heme oxygenase-1 gene promoter exhibit higher inflammation and oxidative stress. These patients have higher risk of long-term cardiovascular events and mortality.
Preoperative Venous Intimal Hyperplasia, Postoperative Arteriovenous Fistula Stenosis, and Clinical Fistula Outcomes
Authors: Allon Michael , Robbin Michelle L. , Young Carlton J. , Deierhoi Mark H. , Goodman Jeremy , Hanaway Michael , Lockhart Mark E. , Litovsky Silvio
Published: June 2013

Background and objectives

Arteriovenous fistulas often fail to mature, and nonmaturation has been attributed to postoperative stenosis caused by aggressive neointimal hyperplasia. Preexisting intimal hyperplasia in the native veins of uremic patients may predispose to postoperative arteriovenous fistula stenosis and arteriovenous fistula nonmaturation.

Design, setting, participants, & measurements

This work explored the relationship between preexisting venous intimal hyperplasia, postoperative arteriovenous fistula stenosis, and clinical arteriovenous fistula outcomes in 145 patients. Venous specimens obtained during arteriovenous fistula creation were quantified for maximal intimal thickness (median thickness=22.3 μm). Postoperative ultrasounds at 4–6 weeks were evaluated for arteriovenous fistula stenosis. Arteriovenous fistula maturation within 6 months of creation was determined clinically.

Results

Postoperative arteriovenous fistula stenosis was equally frequent in patients with preexisting venous intimal hyperplasia (thickness>22.3 μm) and patients without hyperplasia (46% versus 53%; P=0.49). Arteriovenous fistula nonmaturation occurred in 30% of patients with postoperative stenosis versus 7% of those patients without stenosis (hazard ratio, 4.33; 95% confidence interval, 1.55 to 12.06; P=0.001). The annual frequency of interventions to maintain arteriovenous fistula patency for dialysis after maturation was higher in patients with postoperative stenosis than patients without stenosis (0.83 [95% confidence interval, 0.58 to 1.14] versus 0.42 [95% confidence interval, 0.28 to 0.62]; P=0.008).

Conclusions

Preexisting venous intimal hyperplasia does not predispose to postoperative arteriovenous fistula stenosis. Postoperative arteriovenous fistula stenosis is associated with a higher arteriovenous fistula nonmaturation rate. Arteriovenous fistulas with hemodynamically significant stenosis frequently mature without an intervention. Postoperative arteriovenous fistula stenosis is associated with an increased frequency of interventions to maintain long-term arteriovenous fistula patency after maturation.
Socioeconomic Measures and CKD in the United States and The Netherlands
Authors: Vart Priya , Gansevoort Ron T. , Coresh Josef , Reijneveld Sijmen A. , Bültmann Ute
Published: June 2013

Background and objectives

According to the cost of health care utilization systems, there may be regional differences in the relative strength of association of income and education-based socioeconomic status measures with CKD. This study investigated the relative strength of the association of income and education with CKD in a United States and a Dutch population.

Design, setting, participants, & measurements

This cross-sectional study examined individuals who participated in the 1999–2002 National Health and Nutritional Examination Survey (NHANES) and in Prevention of Renal and Vascular End-stage Disease (PREVEND 1997–1998), general population-based cohorts in the United States and The Netherlands, respectively. The main outcome was CKD, defined as estimated GFR <60 ml/min per 1.73 m2 (using creatinine) or albuminuria ≥30 mg/24 hours or albumin-to-creatinine ratio ≥30 mg/g.

Results

In NHANES (n=6428), income was strongly associated with CKD (adjusted odds ratio, 2.34 [95% confidence interval (CI), 1.68 to 3.27]; P for trend<0.001) but education was not (adjusted odds ratio, 1.62 [95% CI, 0.87 to 2.25]; P for trend=0.05]. In contrast, in PREVEND (n=7983), low income was weakly associated with CKD whereas low education had a strong association. The fit of the logistic regression model estimating association of income and education with CKD was significantly improved only after income was added in NHANES (P<0.001) and education was added in PREVEND (P=0.01). Sensitivity analyses that used other CKD-defining variables and restricted analyses to participants <65 years of age resulted in similar findings.

Conclusion

In the United States, where access to health care is traditionally income dependent, income appeared more strongly associated with CKD than in The Netherlands, where education showed a stronger association.
Therapeutic efficacy of connective tissue autotransplants with periosteum and platelet rich plasma in the management of gingival recession
Authors: Jovicic Bojan , Lazic Zoran , Nedic Milica , Matijevic Stevo , Gostovic-Spadijer Aleksandra
Published: July 2013

Background/Aim. Gingival recession progression in clinical practaice has
influenced the development of various surgical procedures and techniques for
solving esthetic imperfections and subjective difficulties coused by gingival
recession. The aim of this study was to verify efficacy of surgical
procedures and to compare both of surgical procedures through the keratinized
tissue width. Methods. The study included 20 teeth with gingival recesion,
M?ller class I and II. Ten teeth with gingival recession were treated with
connective tissue autotransplants with periosteum in combination with
coronary guided surgical flap (CTG group). On the contralateral side 10 teeth
with gingival recession were treated with the same surgical procedures but in
combination with platelet-rich plasma (CTGPRP group). We measured the
keratinized tissue width. For statistical significance we used the Student's
t-test. Results. The study reveled a statistical significance in reducing
vertical deepress of recession by both used treatments. Root deepness in CTG
and CTG-PRP group was 90% and 93.5%, respectively. With both surgical
techniques we achieved larger zone of keratinized gingiva but with a wide
zone of keratinized tissue in CTG - the PRP group. Conclusion. The concept
regeneration technique with PRP and with the stimulating influence of platele
activated growth factors results in the regeneration of deep periodontal
tissue as an important prerequisite for the successful treatment of gingival
recession.
Acute meningoencephalitis in a patient with systemic lupus erythematosus
Authors: Peric-Popadic Aleksandra , Bogic Mirjana , Tomic-Spiric Vesna , Djuric Vojislav , Bolpacic Jasna , Milosevic Branko , Spasic Sanja , Raskovic Sanvila
Published: July 2013

Introduction. Infections in patients with systemic lupus erythematosus (SLE)
are a significant factor of morbidity and mortality. Although central nervous
system infections, including septic meningitis, are rare in patients with
SLE, they can be significant causes of mortality inspite of the prompt and
accurate diagnosis and proper management. Case report. We presented a woman
with the diagnosis of SLE and diffuse proliferative lupus nephritis. Because
of disease activity we introduced cytostatic immunosuppressive therapy,
cyclophosphamide and then azathioprine. Meningoencephalitis, staphylococcal
sepsis and abscess of the brain, with resulting seizures developed.
Conclusion. This case alerts to the need of careful examination of patients
with SLE, collection of adequate cultures and evaluation of predisposition
towards ifnections, before the introduction of immunosuppressants due to
potentially fatal infection.
Paravesical haematoma following placement of an isolated anterior mesh for cystocele repair
Authors: Sparic Radmila , Argirovic Rajka , Buzadzic Snezana , Berisavac Milica
Published: July 2013

Introduction. Pelvic organ prolapse is a substantial health problem for women
around the world. Given the limitations of traditional surgery in the
reconstruction of normal vaginal anatomy and function in genitourinary
prolapse, various synthetic implants have been developed for surgical repair.
Mesh procedures are gaining in popularity, encouraged by preliminary data.
Although minimally invasive and relatively safe, serious complications
following these procedures have been described. Case report. We presented a
patient who had underwent an isolated anterior mesh procedure and developed
postoperative haematoma which required surgical intervention. Conclusion.
This report suggests that minimally invasive urogynecological procedures
could result in significant complications. Thus, surgeons should be familiar
with effective interventions in order to manage them.
The Association of Skin Intrinsic Fluorescence With Type 1 Diabetes Complications in the DCCT/EDIC Study
Authors: Orchard Trevor J. , Lyons Timothy J. , Cleary Patricia A. , Braffett Barbara H. , Maynard John , Cowie Catherine , Gubitosi-Klug Rose A. , Way Jeff , Anderson Karen , Barnie Annette , Villavicencio Stephan ,   the DCCT/EDIC Research Group
Published: June 2013

OBJECTIVE

To determine whether skin intrinsic fluorescence (SIF) is associated with long-term complications of type 1 diabetes (T1D) and, if so, whether it is independent of chronic glycemic exposure and previous intensive therapy.

RESEARCH DESIGN AND METHODS

We studied 1,185 (92%) of 1,289 active Diabetes Control and Complications Trial (DCCT)/Epidemiology of Diabetes Interventions and Complications (EDIC) participants from 2010 to 2011. SIF was determined using a fluorescence spectrometer and related cross-sectionally to recently determined measures of retinopathy (stereo fundus photography), cardiac autonomic neuropathy (CAN; R-R interval), confirmed clinical neuropathy, nephropathy (albumin excretion rate [AER]), and coronary artery calcification (CAC).

RESULTS

Overall, moderately strong associations were seen with all complications, before adjustment for mean HbA1c over time, which rendered these associations nonsignificant with the exception of sustained AER >30 mg/24 h and CAC, which were largely unaffected by adjustment. However, when examined within the former DCCT treatment group, associations were generally weaker in the intensive group and nonsignificant after adjustment, while in the conventional group, associations remained significant for CAN, sustained AER >30 mg/24 h, and CAC even after mean HbA1c adjustment.

CONCLUSIONS

SIF is associated with T1D complications in DCCT\EDIC. Much of this association appears to be related to historical glycemic exposure, particularly in the previously intensively treated participants, in whom adjustment for HbA1c eliminates statistical significance.
A Precise and High Speed Charge-Pump PLL Model Based on SystemC/SystemC-AMS
Authors: Ma Kezheng , Van Leuken Rene , Vidojkovic Maja , Romme Jac , Rampu Simonetta , Pflug Hans , Huang Li , Dolmans Guido
Published: July 2013

The Phase Locked Loop (PLL) has become an important part of electrical systems. When designing a PLL, an efficient and reliable simulation platform for system evaluation is needed. However, the closed loop simulation of a PLL is time consuming. To address this problem, in this paper, a new PLL model containing both digital and analog parts based on SystemC/SystemC-AMS (BETA version) is presented. Many imperfections such as Voltage Control Oscillator (VCO) noise or reference jitter are included in this model. By comparing with the Matlab model, the SystemC/SystemC-AMS model can dramatically reduce simulation time. Also, by comparing with Analog Devices ADI SimPLL simulation results, Cadence simulation results and real measurement results, the accuracy of the SystemC/SystemC-AMS model is demonstrated. The paper shows the feasibility of a unified design environment for mixed-signal modelling based on SystemC/SystemC-AMS in order to reduce the cost and design time of electrical systems.
Communication with Environment in Alvis Models
Authors: Szpyrka Marcin , Matyasik Piotr , Mrówka Rafał , Kotulski Leszek
Published: July 2013

Alvis is a modelling language defined for the design and a formal verification of embedded systems. An Alvis model is a system of agents that usually run concurrently, communicate one with another, compete for shared resources etc. Due to the fact that an embedded system usually collects inputs that come from its environment and provides outputs that go to the environment it is necessary to provide a mechanism to describe such a communication. In contrast to another formal languages used to model embedded systems it is not necessary, using Alvis, to design such an environment as a part of a model. The paper deals with the problem of modelling a communication with an embedded system environment with Alvis.
Examination of Transmission Quality in the IP Multi-Protocol Label Switching Corporate Networks
Authors: Strzęciwilk Dariusz
Published: July 2013

The paper presents the examination of quality of transmission designed and built based on IP/MPLS technology as well as BGP and OSPF routing protocols of corporate network. It indicates the factors forming and affecting the service quality in IP network, including QoS support network architecture, particularly the architecture of DiffServ differentiated services. Main problems occurring in these architectures have been discussed. The analysis of data and voice transmission via IP network of Best Effort architecture and in Differentiated Service architecture of differentiated transmission quality have been conducted. It has been presented that the MPLS technology may be effectively applied in building corporate networks requiring network services of highest quality parameters with lossless packet transmission and maximum delay guarantee.
DC Large-Scale Simulation of Nonlinear Circuits on Parallel Processors
Authors: Udave Diego Ernesto Cortés , Ogrodzki Jan , Gutiérrez De Anda Miguel Angel
Published: July 2013

Newton-Raphson DC analysis of large-scale nonlinear circuits may be an extremely time consuming process even if sparse matrix techniques and bypassing of nonlinear models calculation are used. A slight decrease in the time required for this task may be enabled on multi-core, multithread computers if the calculation of the mathematical models for the nonlinear elements as well as the stamp management of the sparse matrix entries is managed through concurrent processes. In this paper it is shown how the numerical complexity of this problem (and thus its solution time) can be further reduced via the circuit decomposition and parallel solution of blocks taking as a departure point the Bordered-Block Diagonal (BBD) matrix structure. This BBD-parallel approach may give a considerable profit though it is strongly dependent on the system topology. This paper presents a theoretical foundation of the algorithm, its implementation, and numerical complexity analysis in virtue of practical measurements of matrix operations.
Accelerator Science and Technology in Europe EuCARD 2012
Authors: Romaniuk Ryszard S.
Published: July 2013

Accelerator science and technology is one of a key enablers of the developments in the particle physics, photon physics, electronics and photonics, also applications in medicine and industry. The paper presents a digest of the research results in accelerators in Europe, shown during the third annual meeting of the EuCARD - European Coordination of Accelerator Research and Development. EuCARD concerns building of research infrastructure, including advanced photonic and electronic systems for servicing large high energy physics experiments. There are debated a few basic groups of such systems like: measurement - control networks of large extent, multichannel systems for metrological data acquisition, precision photonic networks for reference time distribution.
Discriminative Validity of Metabolic and Workload Measurements for Identifying People With Chronic Fatigue Syndrome
Authors: Snell Christopher R. , Stevens Staci R. , Davenport Todd E. , Van Ness J. Mark
Published: June 2013

Background

Reduced functional capacity and postexertion fatigue after physical activity are hallmark symptoms of chronic fatigue syndrome (CFS) and may even qualify for biomarker status. That these symptoms are often delayed may explain the equivocal results for clinical cardiopulmonary exercise testing in people with CFS. Test reproducibility in people who are healthy is well documented. Test reproducibility may not be achievable in people with CFS because of delayed symptoms.

Objective

The objective of this study was to determine the discriminative validity of objective measurements obtained during cardiopulmonary exercise testing to distinguish participants with CFS from participants who did not have a disability but were sedentary.

Design

A prospective cohort study was conducted.

Methods

Gas exchange data, workloads, and related physiological parameters were compared in 51 participants with CFS and 10 control participants, all women, for 2 maximal exercise tests separated by 24 hours.

Results

Multivariate analysis showed no significant differences between control participants and participants with CFS for test 1. However, for test 2, participants with CFS achieved significantly lower values for oxygen consumption and workload at peak exercise and at the ventilatory or anaerobic threshold. Follow-up classification analysis differentiated between groups with an overall accuracy of 95.1%.

Limitations

Only individuals with CFS who were able to undergo exercise testing were included in this study. Individuals who were unable to meet the criteria for maximal effort during both tests, were unable to complete the 2-day protocol, or displayed overt cardiovascular abnormalities were excluded from the analysis.

Conclusions

The lack of any significant differences between groups for the first exercise test would appear to support a deconditioning hypothesis for CFS symptoms. However, the results from the second test indicated the presence of CFS-related postexertion fatigue. It might be concluded that a single exercise test is insufficient to reliably demonstrate functional impairment in people with CFS. A second test might be necessary to document the atypical recovery response and protracted fatigue possibly unique to CFS, which can severely limit productivity in the home and workplace.
Perspectives of Academic Faculty and Clinical Instructors on Entry-Level DPT Preparation for Pediatric Physical Therapist Practice
Authors: Kenyon Lisa K. , Dole Robin L. , Kelly Stephanie P.
Published: June 2013

Background

To prepare students for pediatric practice, the professional (entry-level) curriculum must reflect the essential knowledge, skills, and abilities (KSA) required for pediatric physical therapist practice.

Objectives

The aim of this study was to develop consensus concerning the pediatric-specific KSA that should be expected of doctor of physical therapy (DPT) students at various points in the curriculum: prior to a pediatric clinical education experience, after a pediatric clinical education experience, and at the end of a DPT program.

Design and Methods

The study was conducted using the Delphi method. Purposive and snowball sampling were used to recruit pediatric academic faculty and pediatric clinical instructors. Three Web-based survey rounds were used to achieve consensus, defined as agreement among ≥70% of informants. The first round identified pediatric-specific KSA that were essential for DPT students to demonstrate at the identified points in the curriculum. In the second round, informants indicated their level of agreement with each item identified in the first round. Items that achieved consensus were included in the third round, in which informants rated the level of proficiency that DPT students should demonstrate related to pediatric-specific KSA.

Results

Consensus revealed the informants' perspectives concerning pediatric-specific KSA that a DPT student should be able to demonstrate at the identified curricular points. Consensus was reached on items in the curricular categories of basic science and foundations for practice; common pediatric diagnoses/pathologies, examination, interventions/plan of care/documentation; and general skills and abilities.

Limitations

Limitations included the small sample size and the potential for informants to feel uncomfortable prioritizing KSA.

Conclusions

This study is an initial step toward identifying pediatric-specific KSA that should be demonstrated by DPT students.
Expanding the Scoring System for the Dynamic Gait Index
Authors: Shumway-Cook Anne , Taylor Catherine S. , Matsuda Patricia Noritake , Studer Michael T. , Whetten Brady K.
Published: June 2013

Background

The Dynamic Gait Index (DGI) measures the capacity to adapt gait to complex tasks. The current scoring system combining gait pattern (GP) and level of assistance (LOA) lacks clarity, and the test has a limited range of measurement.

Objective

This study developed a new scoring system based on 3 facets of performance (LOA, GP, and time) and examined the psychometric properties of the modified DGI (mDGI).

Design

A cross-sectional, descriptive study was conducted.

Methods

Nine hundred ninety-five participants (855 patients with neurologic pathology and mobility impairments [MI group] and 140 patients without neurological impairment [control group]) were tested. Interrater reliability was calculated using kappa coefficients. Internal consistency was computed using the Cronbach alpha coefficient. Factor analysis and Rasch analysis investigated unidimensionality and range of difficulty. Internal validity was determined by comparing groups using multiple t tests. Minimal detectable change (MDC) was calculated for total score and 3 facet scores using the reliability estimate for the alpha coefficients.

Results

Interrater agreement was strong, with kappa coefficients ranging from 90% to 98% for time scores, 59% to 88% for GP scores, and 84% to 100% for LOA scores. Test-retest correlations (r) for time, GP, and LOA were .91, .91, and .87, respectively. Three factors (time, LOA, GP) had eigenvalues greater than 1.3 and explained 79% of the variance in scores. All group differences were significant, with moderate to large effect sizes. The 95% minimal detectable change (MDC95) was 4 for the mDGI total score, 2 for the time and GP total scores, and 1 for the LOA total score.

Limitations

The limitations included uneven sample sizes in the 2 groups. The MI group were patients receiving physical therapy; therefore, they may not be representative of this population.

Conclusions

The mDGI, with its expanded scoring system, improves the range, discrimination, and facets of measurement related to walking function. The strength of the psychometric properties of the mDGI warrants its adoption for both clinical and research purposes.
A Rasch-Validated Version of the Upper Extremity Functional Index for Interval-Level Measurement of Upper Extremity Function
Authors: Hamilton Clayon B. , Chesworth Bert M.
Published: June 2013

Background

The original 20-item Upper Extremity Functional Index (UEFI) has not undergone Rasch validation.

Objective

The purpose of this study was to determine whether Rasch analysis supports the UEFI as a measure of a single construct (ie, upper extremity function) and whether a Rasch-validated UEFI has adequate reproducibility for individual-level patient evaluation.

Design

This was a secondary analysis of data from a repeated-measures study designed to evaluate the measurement properties of the UEFI over a 3-week period.

Methods

Patients (n=239) with musculoskeletal upper extremity disorders were recruited from 17 physical therapy clinics across 4 Canadian provinces. Rasch analysis of the UEFI measurement properties was performed. If the UEFI did not fit the Rasch model, misfitting patients were deleted, items with poor response structure were corrected, and misfitting items and redundant items were deleted. The impact of differential item functioning on the ability estimate of patients was investigated.

Results

A 15-item modified UEFI was derived to achieve fit to the Rasch model where the total score was supported as a measure of upper extremity function only. The resultant UEFI-15 interval-level scale (0–100, worst to best state) demonstrated excellent internal consistency (person separation index=0.94) and test-retest reliability (intraclass correlation coefficient [2,1]=.95). The minimal detectable change at the 90% confidence interval was 8.1.

Limitations

Patients who were ambidextrous or bilaterally affected were excluded to allow for the analysis of differential item functioning due to limb involvement and arm dominance.

Conclusion

Rasch analysis did not support the validity of the 20-item UEFI. However, the UEFI-15 was a valid and reliable interval-level measure of a single dimension: upper extremity function. Rasch analysis supports using the UEFI-15 in physical therapist practice to quantify upper extremity function in patients with musculoskeletal disorders of the upper extremity.