bluuebunny/crossref_metadata_2025 huggingface dataset:
The Headache Management Trial: A Randomized Study of Coordinated Care
Authors: Matchar David B. , Harpole Linda , Samsa Gregory P. , Jurgelski Annette , Lipton Richard B. , Silberstein Stephen D. , Young William , Kori Shashidhar , Blumenfeld Andrew
Published: June 2008

Context.— Headache is a common, disabling disorder that is frequently not well managed in general clinical practice.

Objective.— To determine if patients cared for in a coordinated headache management program would achieve reduced headache disability compared with patients in usual care.

Design.— A randomized controlled trial of headache management vs usual care.

Setting.— Three distinctly different practice sites: an academic internal medicine practice located in a major east coast city, a staff‐model managed care organization located in a major west coast city, and a community practice in a medium‐sized city in the southeast.

Patients.— Individuals 21 years of age or older with chronic tension‐type, migraine, or mixed etiology headache and a Migraine Disability Assessment (MIDAS) score greater than 5, not receiving treatment from a neurologist or headache clinic currently or within the previous 6 months and with an intention to continue general medical care at their current location and to continue their present health insurance coverage for the next 12 months.

Interventions.— Active intervention is a headache management program consisting of: (1) a class specifically designed to inform patients about headache types, triggers, and treatment options; (2) diagnosis and treatment by a professional especially trained in headache care (based on US Headache Consortium guidelines); and (3) proactive follow‐up by a case manager. Participation lasted 6 months. Control patients received usual care from their primary care providers.

Main Outcome Measures.— The primary efficacy measure reported in this article is a comparison of MIDAS scores of headache disability between the intervention group and the control group at 6 months. Secondary measures were response at 12 months, general health and quality of life, and satisfaction with headache care.

Results.— The intervention improved (ie, decreased) MIDAS scores by 7.0 points (95% confidence interval 2.9 to 11.1) more than the control (P = .008) at 6 months. The difference was not affected by site (P = .59 for clinic by intervention interaction), and a trend toward persistent benefit at 12 months (mean difference in improvement 6.8 points, 95% confidence interval −.3 to 13.9, P = .06) was observed. Quality of life and satisfaction with headache treatment were similarly improved.

Conclusions.— Coordinated headache management significantly improved outcomes for patients who, despite contact with the healthcare system for headache, had substantial unmet needs. The intervention in this trial can be implemented practically in a wide range of settings with the expectation that meaningful improvements will accrue.
Traumatic Subarachnoid Hemorrhage Associated With Acupuncture
Authors: Tsukazaki Yuji , Inagaki Takayuki , Yamanouchi Yasuo , Kawamoto Keiji , Oka Nubuyuki
Published: June 2008

Subarachnoid hemorrhage as a complication of acupuncture has been reported in only a few cases. We report another case and discuss the implications of subarachnoid hemorrhage following acupuncture. Although acupuncture has traditionally been thought to be relatively safe, physicians should be aware that it may be a cause of intracranial hemorrhage.
Subcutaneous Sumatriptan Relieved Migraine‐Like Headache in Two Adolescents With Aseptic Meningitis
Authors: Prokhorov Sergey , Khanna Shefali , Alapati Deepthy , Pallimalli Sai Lakshmi
Published: June 2008

Sumatriptan was developed as an agent for the treatment of acute migraine. However, sumatriptan may alleviate not only migraine headache, but also headache of subarachnoid hemorrhage and meningitis. We report 2 patients whose migraine‐like headache on presentation was relieved by subcutaneous sumatriptan. Later, both patients were diagnosed with aseptic meningitis.
Low Leptin Levels in Migraine: A Case Control Study
Authors: Guldiken Baburhan , Guldiken Sibel , Demir Muzaffer , Turgut Nilda , Tugrul Armagan
Published: June 2008

Background.— Obesity has been shown to be a risk factor for transformation of episodic migraine to chronic form, and adipocytokines have been implicated to modulate some of the cytokins such as interleukin‐6 and tumor necrosis factor, which also act in the neurogenic inflammation in migraine. The aim of the study was to assess leptin levels, one of the adipocytokines, in headache‐free period of migraine patients and investigate its relation to vascular risk factors.

Material and Methods.— Sixty‐one patients with episodic migraine headaches and 64 control subjects were enrolled in the study. Demographic data and anthropometric measurements were obtained from all participants; body mass index and fat mass values were calculated. Glucose and lipid parameters were measured by oxidase technique and cholesterol esterase enzymatic assays, and leptin levels were measured by ELISA in serum samples obtained after an overnight fasting.

Results.— Leptin levels were found significantly lower in migraineurs than controls (40.1 ± 21.2 ng/mL, 48.5 ± 24.5 ng/mL; P < .05). Although body mass index did not differ between 2 groups, fat mass, and fat percentages were significantly lower in migraine patients (19.4 ± 8.8 kg, 26.0 ± 8.7 kg; P < .001 and 28 ± 9%, 34 ± 5%; P < .001, respectively).

Conclusion.— Migraine patients have low leptin levels and fat mass which may be related to the pathogenesis of migraine. The importance and impact of our findings on the prevalence, characteristics, and treatment of migraine needs to be investigated in further detailed studies.
Raising Adult Vaccination Rates over 4 Years Among Racially Diverse Patients at Inner‐City Health Centers
Authors: Nowalk Mary Patricia , Zimmerman Richard K. , Lin Chyongchiou Jeng , Raymund Mahlon , Tabbarah Melissa , Wilson Stephen A. , McGaffey Ann , Wahrenberger J. Todd , Block Bruce , Hall David G. , Fox Dwight E. , Ricci Edmund M.
Published: June 2008

OBJECTIVES: To increase adult immunizations at inner‐city health centers serving primarily minority patients.

DESIGN: A before–after trial with a concurrent control.

SETTING: Five inner‐city health centers.

PARTICIPANTS: All adult patients at the health centers eligible for influenza and pneumococcal vaccines.

INTERVENTION: Four intervention sites chose from a menu of culturally appropriate interventions based on the unique features of their respective health centers.

MEASUREMENTS: Immunization and demographic data from medical records of a random sample of 568 patients aged 50 and older who had been patients at their health centers since 2000.

RESULTS: The preintervention influenza vaccination rate of 27.1% increased to 48.9% (P<.001) in intervention sites in Year 4, whereas the concurrent control rate remained low (19.7%). The pneumococcal polysaccharide vaccine (PPV) rate in subjects aged 65 and older increased from 48.3% to 81.3% (P<.001) in intervention sites in Year 4. Increase in PPV in the concurrent control was not significant. In logistic regression analysis, the likelihood of influenza vaccination was significantly associated with the intervention (odds ratio (OR)=2.07, 95% confidence interval (CI)=1.77–2.41) and with age of 65 and older (OR=2.0, 95% CI=1.62–2.48) but not with race. Likelihood of receiving the pneumococcal vaccination was also associated with older age and, to a lesser degree, with intervention.

CONCLUSION: Culturally appropriate, evidence‐based interventions selected by intervention sites resulted in increased adult vaccinations in disadvantaged, racially diverse, inner‐city populations over 2 to 4 years.
A Comparison of the Retention of Three Endodontic Dowel Systems Following Different Surface Treatments
Authors: Kelsey William P. , Latta Mark A. , Kelsey Matthew R.
Published: June 2008

Purpose: Practitioners have several options during the selection of a dowel for core restoration, including metal and glass fiber materials. Retention of the cemented dowel is critical for the success of this type of restoration. The purpose of this in vitro study was to evaluate the effect of two surface treatments on the retention of three types of dowels placed into prepared canals with a resin cement.

Materials and Methods: Following the removal of the clinical crown, gutta percha was used to restore canals prepared to size 40 in 90 extracted human anterior teeth. The access openings were then sealed, and the teeth stored in water for 3 weeks at 37°C. Post preparations were made to a depth of 9 mm, and parallel ParaPost, FibreKleer, and FibreKor dowels were each used to restore 30 teeth. Ten dowels in each group received no surface roughening treatment, 10 were air abraded with 50 μ aluminum oxide, and 10 were air abraded with CoJet. The specimens were stored in water for 24 hours at 37°C following dowel placement and prior to debonding with an Instron Testing Machine.

Results: The forces (N) required in tensile load to dislodge the dowels for each group were: ParaPost/CoJet 214.04 ± 91.72, FibreKleer/AlOxide 196.07 ± 57.69, ParaPost/AlOxide 184.46 ± 35.05, FibreKleer/CoJet 176.36 ± 42.43, FibreKor/AlOxide 174.32 ± 53.64, ParaPost/Unroughened 174.14 ± 40.74, FibreKor/CoJet 167.16 ± 35.94, FibreKor/Unroughened 116.69 ± 37.01, and FibreKleer/Unroughened 96.88 ± 33.45. Post hoc analysis demonstrated that the unroughened FibreKor and FibreKleer dowels had significantly less retention than all other test groups (p≤ 0.05).

Conclusion: Surface roughening with air abrasion increases retention in dowels cemented with a resin cement. Both the aluminum oxide and CoJet systems were equally effective in this regard.
Osseointegrated Implants and Auricular Defects: A Case Series Study
Authors: Wright Robert F. , Zemnick Candice , Wazen Jack J. , Asher Eric
Published: June 2008

Purpose: The objective of this study was to report on the survival rate of 16 patients treated with extraoral implants in the auricular region, analyze treatment outcomes, and discuss important clinical variables encountered during treatment.

Materials and Methods: Sixteen patients who received extraoral dental implants to retain auricular prostheses between 1987 and 2003 were followed retrospectively. The variables recorded were gender, initial diagnosis, number and size of implants, implant placement date, age at implant placement, history of radiation to the treated field, abutment size, design of initial prosthesis, age of initial prosthesis (when a remake was indicated), date of prosthesis delivery, soft tissue response, grafting procedure, date of last follow‐up, and complications. All patients were thoroughly evaluated presurgically by the reconstruction team, which consisted of prosthodontists, a facial prosthetist, and an otolaryngologist. Surgical templates were used for all patients. The criteria for success of the prostheses included marginal accuracy, overall stability and function, symmetry/position, texture, color stability, and patient acceptance.

Results: Thirty‐nine implants were placed in 16 patients. All 16 patients were completely satisfied with their reconstructions. No surgical complications, implant failures, or prosthetic failures were encountered. Therefore, the survival rate was 100%. Three patients (18.75%) had grade 0, seven (43.75%) had grade 1, five (31.25%) had grade 2, and one (6.25%) had grade 3 soft tissue inflammation. The inflammation completely resolved in 7 of the 13 patients (54%) with hygiene reinforcement or soft tissue reduction.

Conclusions: The survival rate for bone‐anchored titanium implants and prostheses was 100%. Bone‐anchored titanium implants provided the 16 patients in this study with a safe, reliable, adhesive‐free method to anchor auricular prostheses with recovery of normal appearance. Under the guidance of an appropriate implant team, proper positioning of implants was optimized to allow prosthodontic rehabilitation using implant‐retained prostheses.
An Alternative Technique for Fabrication of an Occlusal Device
Authors: Choi Mijin , Holden Jason , Tung Francis
Published: June 2008

Several methods have been described for fabrication of occlusal devices, but many require complex and time‐consuming laboratory procedures. In this article, an alternative fabrication method for a hard occlusal device while maintaining the articulation of the cast is described.
Fabrication of a Caliper Device for Interalveolar Dimension Measurement in the Complete Denture Patient
Authors: Pitigoi‐Aron Gabriela , LaBarre Eugene , Giusti Lola , Leknius Casimir
Published: June 2008

A method is presented for measuring interalveolar dimension (IAD) of existing dentures using a caliper. Directions for construction of an IAD gauge are included. This device is easy to construct and “zeroes out” in the closed position. The measurement is useful for determining occlusal vertical dimension (OVD) in new dentures and for monitoring changes over time. Its dimension is entered in the patient record for future reference.
Effect of Core Material and Restoration Design on Strength of Endodontically Treated Bovine Teeth: A Laboratory Study
Authors: Hinckfuss Simon , Wilson Peter R.
Published: June 2008

Purpose: The purpose of this study was to evaluate the fracture resistance of bovine teeth restored with one‐piece cast core/crowns and no ferrule, compared to teeth restored with amalgam cores and full coverage crowns, with and without a dentine ferrule.

Materials and Method: Thirty bovine incisors were selected and modified to ensure all teeth had axial dentine walls of similar size. The teeth were then randomly allocated to one of the three groups: control group restored with amalgam core and cast crown without ferrule; ferrule group restored with amalgam core and cast crown with a 2‐mm dentine ferrule; one‐piece group restored with one‐piece cast core/crown without ferrule. Each tooth was loaded to the point of fracture.

Results: The mean load resisted by the control group, the ferrule group, and the one‐piece group were 1092.5, 1843.5, and 1463.1 N, respectively. The mean load resisted by the ferrule group was significantly greater than the control group (p < 0.001) and the one‐piece cast core/crown group (p= 0.04). The mean load resisted by the one‐piece cast core/crown group was significantly greater than the control group (p= 0.04).

Conclusions: The maximum load resistance was significantly enhanced by a 2‐mm ferrule compared with teeth with no ferrule and teeth restored with one‐piece cast core/crowns. Teeth restored with one‐piece cast core/crowns were significantly more resistant to loading than teeth restored with amalgam cores and crowns without a ferrule.
Effect of Surface Preparation Using Ethyl Acetate on the Shear Bond Strength of Repair Resin to Denture Base Resin
Authors: Shimizu Hiroshi , Kakigi Masayoshi , Fujii Junko , Tsue Fumitake , Takahashi Yutaka
Published: June 2008

Purpose: This study evaluated the effect of using ethyl acetate as a surface preparation agent on the shear bond strength of repair resin to denture base resin.

Materials and Methods: The flat surfaces of a heat‐processed denture base resin were prepared with one of the following: (1) without preparation, (2) 60‐second application of ethyl acetate, (3) 120‐second application of ethyl acetate, (4) 180‐second application of ethyl acetate, and (5) 5‐second application of dichloromethane. An autopolymerizing repair resin was applied. The specimens were then immersed in 37°C distilled water for 24 hours. The specimens in groups 1, 3, and 5 were thermocycled up to 10,000 times in water between 5 and 55°C with a 1‐minute dwell time at each temperature. The shear bond strengths were determined at a crosshead speed of 1.0 mm/min (n = 10). The morphological changes in the repair surfaces after preparation were observed with a scanning electron microscope.

Results: The shear bond strengths of groups 3 and 5 were significantly higher than the other groups before thermocycling (p < 0.05). The shear bond strengths of group 3 were significantly lower than those of group 5 after thermocycling (p < 0.05). The scanning electron microscope (SEM) views showed that the dissolution progressed deeper with the preparation duration.

Conclusions: The 120‐second surface application of ethyl acetate enhanced the shear bond strength between the repair resin and the denture base resin, although the bond durability was inferior to that of the conventional surface preparation.
Autogenous Osteochondral Grafting for Treatment of Stifle Osteochondrosis in Dogs
Authors: COOK JAMES L. , HUDSON CALEB C. , KUROKI KEIICHI
Published: June 2008

Objective— To develop and assess clinical outcomes for osteochondral autografting for treatment of stifle osteochondrosis (OC) in dogs.

Study Design— Retrospective case series.

Animals— Dogs with stifle OC (n=10).

Methods— Osteochondral autografting was developed and optimized in canine cadavers and purpose‐bred research dogs using the Osteochondral Autograft Transfer System (OATS). Dogs with stifle OC (n=10 dogs, 12 stifles) were then treated using the OATS system. Outcomes were assessed by radiography (n=12), magnetic resonance imaging (1), second‐look arthroscopy (9), lameness scoring (12), and telephone survey of owners (10 clients, 12 stifles) 6–15 months after surgery.

Results— Complications were documented in 4 of the 12 stifles treated and included peri‐incisional seromas (3) and marked stifle effusion (1). Subjective assessment of follow‐up radiographs revealed evidence of integration of the grafts with maintenance of subchondral bone surface architecture. Subjective assessment of follow‐up MRI in 1 stifle revealed evidence for incorporation of grafts with restoration of articular surface contour. Second‐look arthroscopy 6–30 weeks after surgery revealed maintenance of articular cartilage at the graft site. Dogs were significantly (P<.001) less lame at follow‐up compared with preoperative scores. Based on follow‐up owner surveys, only 2 dogs had no pain or lameness; the other dogs were judged to have mild pain and/or lameness. All owners noticed improvement in the dogs' quality of life after surgery.

Conclusion— Osteochondral autografting deserves consideration and further evaluation as a primary treatment option for stifle OC in dogs.

Clinical Relevance— Osteochondral autografting for treatment of lateral femoral condylar OC lesions in dogs using OATS instrumentation is safe and results in improved function and quality of life based on owners' perception 6–15 months after treatment.
Desmitis of the Distal Digital Annular Ligament in Seven Horses: MRI Diagnosis and Surgical Treatment
Authors: COHEN JENNIFER M. , SCHNEIDER ROBERT K. , ZUBROD CHAD J. , SAMPSON SARAH N. , TUCKER RUSSELL L.
Published: June 2008

Objective— (1) To describe the clinical signs and abnormalities observed on magnetic resonance imaging (MRI) in 7 horses with desmitis of the distal digital annular ligament (DDAL); (2) to describe the normal magnetic resonance (MR) appearance and thickness of the DDAL in health; and (3) to describe a tenoscopic surgical technique for treating horses with desmitis of the DDAL.

Study Design— Retrospective study.

Animals— Horses (n=7) with desmitis of the DDAL.

Methods— MR examinations of 20 sound horses were reviewed to determine the normal appearance of the DDAL. Dimensions obtained from these images were compared with MR findings from 7 horses with DDAL desmitis. Desmitis of the DDAL was treated by tenoscopic surgery and outcome assessed.

Results— Horses with DDAL desmitis had lameness (grade 2–3 out of 5) that improved after a palmar digital nerve block. The affected DDAL was enlarged and had an abnormal signal on MR images of the feet. After tenoscopy and DDAL transection, 5 horses returned to athletic performance, including 2 horses that failed to respond to medical treatment and rest before surgery.

Conclusion— Primary desmitis of the DDAL is a cause of lameness in horses. Transection of the DDAL allowed 5 horses with this injury to return to athletic performance.

Clinical Relevance— DDAL desmitis should be included in the differential diagnoses of horses with lameness that improves after a palmar digital nerve block but have no abnormalities observed on radiographs of the feet. Tenoscopic surgical transection of the DDAL is an effective treatment for some horses.
Surgical Technique to Repair Grade IV Rectal Tears in Post‐Parturient Mares
Authors: KAY ALASTAIR T. , SPIRITO MICHAEL A. , RODGERSON DWAYNE H. , BROWN STUART E.
Published: June 2008

Objective—To describe a surgical technique for repair of grade IV rectal tears after parturition in mares and to report outcome.

Study Design—Clinical report.

Animals—Horses (n=6) with grade IV rectal tears.

Methods—Mares were sedated and restrained in standing stocks. After caudal anesthesia and evacuation of feces from the rectum, the perineal region was aseptically prepared. Four stay sutures were placed through the external anal sphincter before vertical transection (12 o'clock). Caudal retraction of the tear was performed using Allis tissue forceps (5 mares) or stay sutures before accurate apposition of the tear margins with steel staples below the tissue forceps. The mucosal edges were then sharply dissected leaving ∼5 mm edges which were apposed in a single layer (2‐0 poliglecaprone 25) before stapler release. In 1 mare, the rectal tear was identified and apposed using a 2‐layer hand‐sutured closure. Systemic antibiotics and anti‐inflammatory agents were administered postoperatively (5 mares) and standing abdominal lavage performed (3 mares).

Results—Four mares survived long term and subsequently became pregnant. Immediately after surgical repair, 1 mare was anesthetized for exploratory celiotomy and abdominal lavage but fractured her pelvis during recovery from anesthesia and was euthanatized. A 2nd mare was euthanatized after 72 h because of severe diffuse peritonitis; however, the repair was still intact.

Conclusion—In standing mares, rectal tears can be exteriorized by prolapse through the anal sphincter after sphincterotomy and repaired in 2 layers with staples oversewn with a continuous suture pattern.

Clinical Relevance—Rectal tears occurring as a result of parturition can potentially be repaired efficiently using an oversewn stapled primary closure technique.
Arthroscopic Surgical Approach and Intra‐Articular Anatomy of the Equine Suprapatellar Pouch
Authors: VINARDELL TATIANA , DAVID FLORENT , MORISSET SOPHIE
Published: June 2008

Objective— To describe a direct arthroscopic approach to the suprapatellar pouch (SPP), its intra‐articular anatomy, and report our clinical experience with SPP arthroscopy.

Study Design— (1) Experimental study and (2) retrospective clinical study.

Animals— (1) Cadaveric equine hind limbs (n=24; 14 horses) and (2) 5 horses.

Methods— Four femoropatellar joints (FPJ) were dissected or injected with latex to document surface landmarks and topographic anatomy. (1) Arthroscopic exploration of 20 SPP (10 equine cadavers) was performed and described, followed by dissection. (2) Medical records of horses that had FPJ arthroscopy were reviewed for cases where SPP portals were required.

Results— (1) The optimal arthroscopic portal was located ∼10 cm lateral to the longitudinal patellar axis and 2 cm proximal to the patellar base in the intermuscular septum between the biceps femoris and vastus lateralis muscles. This approach allowed arthroscopic observation of the proximal aspect of the lateral and medial femoral trochlear ridges, the intertrochlear groove, the patellar base, and the synovial recess of the SPP. (2) Additional arthroscopic and instrument suprapatellar portals were used in 5 of 25 horses to complete lavage/debridement in osteochondritis dissecans (OCD) and septic arthritis.

Conclusion— Suprapatellar arthroscopy improved arthroscopic observation of structures located proximally in the FPJ and facilitated surgical access to the SPP.

Clinical Relevance— SPP arthroscopy is a safe and complementary approach to traditional distal FPJ arthroscopy that could be helpful for inspection and removal of free fragments/debris/fibrin located in the SPP, for OCD lesions extending proximally, and fracture(s) involving the proximal aspect of the patella.
Comparison of Locking and Conventional Screws for Maintenance of Tibial Plateau Positioning and Biomechanical Stability After Locking Tibial Plateau Leveling Osteotomy Plate Fixation
Authors: LEITNER MICHAEL , PEARCE SIMON G. , WINDOLF MARKUS , SCHWIEGER KARSTEN , ZEITER STEPHAN , SCHAWALDER PETER , JOHNSON KENNETH A.
Published: June 2008

Objective—To compare locking screws with conventional screws inserted in the tibial plateau fragment for reduction and stability of the construct after tibial plateau leveling osteotomy (TPLO), using a locking TPLO plate.

Study Design—Experimental biomechanical study.

Animals—Cadaveric canine pelvic limbs (n=8 pairs).

Methods—TPLO was stabilized with either conventional cortical screws or locking screws in a compressed osteotomy model. Titanium pins inserted into the tibial plateau and proximal metaphysis were used to track bone fragment location by computed tomography (CT) imaging. CT imaging was performed after osteotomy reduction, after plate stabilization, and after 30,000 cycles of axial compression testing. After 30,000 cycles, cyclic loading was continued with monotonically increasing peak‐load until failure.

Results—The magnitude of rotation about the sawing axis was significantly greater for the conventional screw group because of plate application (P=.009). Translational movement of the tibial plateau fragment toward the plate was significantly greater for the conventional screw group (P=.006). There were no significant differences between groups in stiffness or number of cycles to failure.

Conclusion—Maintenance of tibial plateau position was significantly superior for the locking screw group during plate application; however, screw type had no effect on fixation stability under cyclic loading.

Clinical Relevance—These results suggest that conventional screws and careful contouring of the TPLO plate can provide comparable mechanical stability to fixation with locking screws in the tibial plateau under load‐sharing conditions, but potentially at the expense of osteotomy reduction.
Influence of Intervertebral Disc Fenestration at the Herniation Site in Association with Hemilaminectomy on Recurrence in Chondrodystrophic Dogs with Thoracolumbar Disc Disease: A Prospective MRI Study
Authors: FORTERRE FRANCK , KONAR MARTIN , SPRENG DAVID , JAGGY ANDRE , LANG JOHANN
Published: June 2008

Objective— To describe the influence of fenestration at the disc herniation site on recurrence in thoracolumbar disc disease of chondrodystrophoid dogs.

Study Design— Prospective clinical study.

Animals— Chondrodystrophic dogs (n=19).

Methods— Dogs were divided into 2 groups: group 1 (9 dogs) had thoracolumbar disc extrusion (Hansen type I) treated by hemilaminectomy and concomitant fenestration of the affected intervertebral disc and group 2 (10 dogs) had hemilaminectomy without fenestration. All dogs had 3 magnetic resonance imaging (MRI) examinations: preoperatively, immediately postoperatively to assess removal of herniated disc material, and again 6 weeks after surgery.

Results— There were 13 male and 6 female dogs; mean age, 7.1 years. Thoracolumbar disc herniation was confirmed with MRI. Immediate post surgical MRI revealed that the herniated disc removal was complete in all but 1 dog and that fenestration did not lead to complete removal of nucleus pulposus within the intervertebral disc space. On the 3rd MRI examination, none of the group 1 dogs had further disc material herniation at the fenestrated site. Six of the 10 group 2 dogs had a recurrence of herniation leading to clinical signs in 3 dogs (pain in 2 dogs, paresis in 1 dog).

Conclusion— In thoracolumbar disc herniation, fenestration of the affected intervertebral disc space prevents further extrusion of disc material.

Clinical Relevance— Fenestration reduces the risk of early recurrence of disc herniation and associated postoperative complications.
Getting Ready for Day One: Taking Advantage of the Opportunities and Minimizing the Hazards of a Presidential Transition
Authors: Kumar Martha Joynt
Published: June 2008

Presidential transitions make a difference to the quality of the start a chief executive has coming into office. With formal presidential transitions a reality since 1952, we have sufficient experience to identify some of the elements of an effective transition. This article focuses on how a president‐elect can minimize the hazards and take advantage of the opportunities transitions offer. Opportunities and hazards can be found in the actions and commitments candidates take during their presidential campaigns, the information they gather on past transitions and on the actions of the incumbent president, the coordination they do with those in the Washington community, and their capacity to identify and take advantage of the early goodwill that exists when a new president comes into office.
Preparing to Be President on Day One
Authors: Wellford Harrison
Published: June 2008

Nearly 50 years ago, John F. Kennedy asked Clark Clifford to handle his transition planning; the day after the election, Clifford handed Kennedy a single memorandum. Transition for today’s president‐elect is much more complex. Managing the shift from campaigning to governing is the president‐elect’s greatest challenge and biggest opportunity. According to Martha Joynt Kumar in her foregoing essay, the newly elected would do well to learn from the successes and failures of their predecessors. In short, the risks rooted in the inexperience and hubris of new presidents may be mitigated or avoided by knowledge gained from analysis of transition precedents. In this essay, the author provides a practitioner’s checklist of dos and don’ts drawn from his experience as a manager and advisor in presidential transitions.
Ethics in Government: No Matter How Long and Dark the Night
Authors: Bowman James S. , Knox Claire Connolly
Published: June 2008

This work examines attitudes about ethics in American government during the turbulent time from the end of the past century to the beginning of the new. Using data from a national survey, the authors explore views toward ethics in society and integrity in public agencies, with an emphasis on the code of ethics of the American Society for Public Administration. The results not only reveal considerable continuity over the years but also suggest that individual managers are increasingly empowered, that agencies are affecting positive change, and that the ASPA code may be influencing management practices. The implications of the findings for ASPA ethics initiatives are considered.
Portraying the Nature of Corruption Using an Explorative Case Study Design
Authors: De Graaf Gjalt , Huberts L. W. J. C.
Published: June 2008

What is the nature of corruption in Western democracies? To answer this research question, the authors study 10 Dutch corruption cases in depth, looking at confidential criminal files. The cases allow them to sketch a general profile of a corruption case. The authors offer nine propositions to portray the nature of corruption. They conclude that corruption usually takes place within enduring relationships, that the process of becoming corrupt can be characterized as a slippery slope, and that important motives for corruption, aside from material gain, include friendship or love, status, and the desire to impress others. The explorative multiple case study methodology helps to expand our understanding of the way in which officials become corrupt.
Black or Blue: Racial Profiling and Representative Bureaucracy
Authors: Wilkins Vicky M. , Williams Brian N.
Published: June 2008

Are there conditions under which minority bureaucrats are less likely to provide active representation? The authors address this question by testing the link between passive and active representation for race in a police department and in the particular instance of racial profiling. Literature from three areas—racial profiling, representative bureaucracy, and police socialization—is brought together. The findings support the hypothesis that organizational socialization can hinder the link between passive and active representation. Furthermore, the authors find that the presence of black police officers is related to an increase in racial profiling in the division. This finding was unexpected and raises several important questions regarding active representation and race.
Wisdom in Public Administration: Looking for a Sociology of Wise Practice
Authors: Rooney David , McKenna Bernard
Published: June 2008

This article explores a sociological account of practical wisdom in public administrations. Very little research on contemporary applications of wisdom exists, and what research there is has a cognitive bias, largely ignoring sociology. For public organizations to create the conditions for wise practice within themselves and within individual administrators, an understanding of the social relational structures and processes that build and sustain practical wisdom is crucial. Furthermore, given that there is an aesthetic dimension to practical wisdom, an aesthetics‐based approach to sociology of organizational wisdom provides a useful starting point in this sociological project. Aesthetics raises important issues of communicative action and discourse that address social relations and their structures and processes. Finally, a research agenda that explores these structural and processual issues in public administration is canvassed.
Mayors and Urban Governance: Developing a Facilitative Leadership Style
Authors: Greasley Stephen , Stoker Gerry
Published: June 2008

Modern urban governance, because of its demanding and complex environment, requires a facilitative style of local political leadership that is visible, outward looking, open, and less partisan than more established forms. This article examines the impact of new constitutional expressions of local political leadership in England since the introduction of executive forms of governance for larger municipalities in 2002. The mayoral form, though established in only a handful of municipalities, is showing signs of supporting a more facilitative leadership style compared to the more widespread council leader model. This finding may be explained by the decision‐making resources of mayors and their relationship to followers, which are, in turn, created by the institutional framing of their role by new constitutional arrangements. Political leadership is not simply a product of personality, capabilities, or contingency—although all of these factors play a part. Crucially, from the perspective of reformers, institutional design does make a difference and can encourage leadership practices of a particular style and form.
Preventing Local Government Fiscal Crises: Emerging Best Practices
Authors: Coe Charles K.
Published: June 2008

What type of oversight should states exercise over local units in order to prevent fiscal crises? This article discusses a sequence of three best practices that some states use to prevent fiscal emergencies. They first monitor local government finances to predict fiscal distress. After detecting signs of fiscal distress, states actively assist local units in ameliorating the problem. Finally, assistance notwithstanding, if a situation becomes grave, states require local units to take strong remedial measures, including increasing taxes and reducing expenditures.
Living it on the skin: Italian states, working illness
Authors: MOLÉ NOELLE J.
Published: June 2008

In this article, I examine the codification of an Italian work‐related illness caused by mobbing, a type of psychological harassment that emerged at the moment neoliberal policies transformed Italy's historically protectionist labor market. I trace how the medicalization of mobbing has expanded workers’ access to compensation, resources, and discursive tools for criticizing neoliberal labor conditions, even as it has produced new structures of surveillance. I unravel the neoliberal politics of a state that protects workers’ health yet governs worker–citizens through an apparatus of medical experts. I find that workers’ labor problems are experienced and managed as bodily problems in ways important to remaking Italian citizenship. [neoliberalism, state, labor, biopolitics, citizenship, bodies, Italy]
Skills and selves in the new workplace
Authors: URCIUOLI BONNIE
Published: June 2008

In the neoliberal imaginary of contemporary capitalism, workers' employment value depends on their skills. Skills terms, especially communication, team, and leadership, formulate aspects of personhood and modes of sociality as productive labor. The key semiotic properties of skills terms are strategic indexicality (expressing alignment with corporate values) and denotational indeterminacy (knowledge and practices referred to as skills are quite disparate). Yet all skills are assumed to be commensurable and readily available for inculcation into workers. Drawing from Internet sites marketing skills‐related services, I explore the semiotic properties of discourses that facilitate skills' commensurability and commodification. [neoliberalism, discourse analysis, corporate culture, labor history, communication, commodification]
Rhythms of the secular: The politics of modernizing Arab poetic forms
Authors: FURANI KHALED
Published: June 2008

In this article, I ethnographically trace how Arab, mainly Palestinian, poets have modernized their literary tradition during the last seven decades. Shortly after the 1948 Israeli occupation of Palestine, the reign of the classical Arabic ode collapsed, and the modern forms of free verse and, later, the prose poem became dominant. Aiming to contribute to the ethnography of modernity, I examine how poets have adopted and abandoned poetic forms by analyzing their narratives on rhythm. I explore the political salience of rhythmical transformations and argue that the secular has been a vital and complex force in the modern abandonment of metrical discipline. The secular affects how poets seek to modernize their rhythm, vocabulary, and relation to public. It also affects, I conclude, the ways in which anthropologists can and do write about modernity. [poetic form, modernity and secularism, Palestine–Israel]
Prelude to violence: Show trials and state power in 1930s Mongolia
Authors: KAPLONSKI CHRISTOPHER
Published: June 2008

In this article, I examine the role of show trials in 1930s socialist Mongolia as a precursor to state violence. I argue that the show trial I focus on here, held in October 1937, paved the way for imminent state violence by portraying a threat against the state from an extensive conspiracy of high‐ranking Buddhist figures and former government leaders. The trial not only served to justify the violence that was to come but also sought to turn people against the Buddhist hierarchy, which posed a threat to the socialist state's sovereignty. Through an examination of the narrative of the conspiracy it presented at the trial, I highlight the ways in which the state attempted to shift allegiances and convince people to accept the coming violence as necessary. Given the contested and precarious position of the socialist government in the 1930s, this study also highlights the role of the show trial in state formation. [state formation, violence, Mongolia, show trials, Buddhism, socialism, political theater]
Micronucleus‐Specific Bacterium Holospora elegans Irreversibly Enhances Stress Gene Expression of the Host Paramecium caudatum
Authors: HORI MANABU , FUJII KIMIKO , FUJISHIMA MASAHIRO
Published: June 2008

ABSTRACT. The bacterium Holospora is an endonuclear symbiont of the ciliate Paramecium. Previously, we reported that paramecia bearing the macronuclear‐specific symbiont Holospora obtusa survived better than symbiont‐free paramecia, even under high temperatures unsuitable for growth. The paramecia with symbionts expressed high levels of hsp70 mRNAs even at 25 °C, a usual growth temperature. We report herein that paramecia bearing the micronuclear‐specific symbiont Holospora elegans also acquire the heat‐shock resistance. Even after the removal of the bacteria from the hosts by treatment with penicillin, the resulting aposymbiotic paramecia nevertheless maintained their heat shock‐resistant nature for over 1 yr. Like symbiotic paramecia, these aposymbiotic paramecia also expressed high levels of both hsp60 and hsp70 mRNAs even at 25 °C. Moreover, analysis by fluorescent in situ hybridization with a probe specific for Holospora 16S rRNA revealed that the 16S rRNA of H. elegans was expressed around the nucleoli of the macronucleus in the aposymbiotic cells. This result suggests the possible transfer of Holospora genomic DNA from the micronucleus into the macronucleus in symbiotic paramecia. Perhaps this exogenous DNA could trigger the aposymbiotic paramecia to induce a stress response, inducing higher expression of Hsp60 and Hsp70, and thus conferring heat‐shock resistance.
Impact of Disaster Drills on Patient Flow in a Pediatric Emergency Department
Authors: Timm Nathan , Kennebeck Stephanie
Published: June 2008

Objectives:  Joint Commission on Accreditation of Healthcare Organizations (JCAHO)‐accredited hospitals must conduct disaster drills twice a year, with one incorporating a mass casualty incident to the emergency department (ED). The authors found no studies describing the potential negative impact on the quality of care real patients in the ED receive during these drills. The objective was to determine the impact that mass casualty drills have on the timeliness of care for nondisaster patients in a pediatric ED.

Methods:  Since 2001, nine disaster drills involving mass casualties to the ED were conducted at the authors’ institution. The authors studied 5‐, 10‐, and 24‐hour blocks of time surrounding these events and defined quality measures as the timeliness of care in terms of length of stay (LOS) in ED, time‐to‐triage, and time‐to‐physician. Drill dates were compared with control dates (the same weekday on the following week). Paired t‐tests were used to compare outcomes of interest between drill and control days.

Results:  Nine drill days and nine control days were studied. There was no statistically significant difference between drill dates and control dates in average time‐to‐triage and time‐to‐emergency physician and average ED LOS. Admitted patients spent less time in the ED during drill dates.

Conclusions:  Disaster drills at this institution do not appear to significantly affect the timeliness of care to nondisaster drill ED patients. Attention should be paid to the quality of care “real” patients receive to ensure that their care is not jeopardized during an artificial stress to the system during a disaster drill.
Disaster Victim Identification: New Applications for Postmortem Computed Tomography
Authors: Blau Soren , Robertson Shelley , Johnstone Marnie
Published: June 2008

Abstract: Mass fatalities can present the forensic anthropologist and forensic pathologist with a different set of challenges to those presented by a single fatality. To date radiography has played an important role in the disaster victim identification (DVI) process. The aim of this paper is to highlight the benefits of applying computed tomography (CT) technology to the DVI process. The paper begins by reviewing the extent to which sophisticated imaging techniques, specifically CT, have been increasingly used to assist in the analysis of deceased individuals. A small scale case study is then presented which describes aspects of the DVI process following a recent Australian aviation disaster involving two individuals. Having grided the scene of the disaster, a total of 41 bags of heavily disrupted human remains were collected. A postmortem examination was subsequently undertaken. Analysis of the CT images of all body parts (n = 162) made it possible not only to identify and side differentially preserved skeletal elements which were anatomically unrecognizable in the heavily disrupted body masses, but also to observe and record useful identifying features such as surgical implants. In this case the role of the forensic anthropologist and CT technology were paramount in facilitating a quick identification, and subsequently, an effective and timely reconciliation, of body parts. Although this case study is small scale, it illustrates the enormous potential for CT imaging to complement the existing DVI process.
A Calculation of the Theoretical Significance of Matched Bullets
Authors: Howitt David , Tulleners Fred , Cebra Karen , Chen Shiahn
Published: June 2008

Abstract:  The comparison and identification of bullets from the striations that appear on their surfaces, after they have been fired from a gun, have been practiced since the 1920s. Although the significance of the correspondences of these impression marks has been empirically justified, there is a conspicuous absence of any theoretical foundation for the likelihood. What is presented here is the derivation of the formulae for calculating the probability for the correspondence of the impression marks on a subject bullet to a random distribution of a similar number of impression marks on a suspect bullet of the same type. The approach to the calculation entails subdividing the impression marks into a series of individual lines having widths equal to the separation distance at which a misalignment of striations between the two bullets cannot be distinguished. This distance depends upon the resolution limit imposed by the microscope as well as by the visual acuity of the examiner. A calculation of the probabilities for finding pairs and triplets of consecutively matching lines on nonmatching bullets, by an examiner with normal perception using a microscope at 40× magnification, produces values that agree well with the empirical probabilities determined by Biasotti in the 1950s and when determined for larger consecutive sequences suggest that they are extremely unlikely to occur. The formulae can be used to determine the probabilities for the random occurrence of any sequence of striae and provide a straightforward way to quantitatively justify the significance of a specific match between any two bullets.
Recent Human Sexual Dimorphism Study Using Cephalometric Plots on Lateral Teleradiography and Discriminant Function Analysis
Authors: Veyre‐Goulet Sophie A. , Mercier Catherine , Robin Olivier , Guérin Claude
Published: June 2008

Abstract:  The examination of skull sexual dimorphism has been the subject of numerous morphologic and craniometric studies, but the disadvantage of these studies is that they are dependent on the experience of the operator and involve subjectivity. In 1996, a team from Taiwan refined the methods enabling the sex of an individual to be determined using cephalometric plots made from lateral teleradiography. To validate their work using a European population, 114 dry skulls (59 men and 55 women) were examined. Cephalometric plots were made on lateral teleradiography with an orthodontic software and 18 cephalometric variables were analyzed. Sex was determined with 95.6% accuracy using the 18 variables discriminant function. A subset of eight variables was selected and could predict sex with the same accuracy. In conclusion, it can be said that skull‐sexing methods using lateral teleradiography seem always suitable but the most indicative variables could differ relative to the ethnic population concerned.