bluuebunny/crossref_metadata_2025 huggingface dataset:
Ethnic differences of medicines-taking in older adults: a cross cultural study in New Zealand
Authors: Bassett-Clarke Debbie , Krass Ines , Bajorek Beata
Published: October 2011

Objectives

The literature identifies many barriers to medicines use, including bio-psycho-social issues, but less is known regarding ethno-cultural barriers, which are important in culturally diverse nations. The aim of this study was to explore ethnic differences in attitudes to medicines and medicines-taking, focusing on the main constituents of the New Zealand (NZ) population: NZ European, Māori (the indigenous people of NZ), Pacific and Asian peoples.

Methods

A qualitative study involving a series of focus groups was conducted. Participants (>50 years old) taking medicines were recruited from various community-based groups. The focus group discussions were transcribed verbatim and analysed for key themes via manual inductive coding and constant comparison.

Key findings

Twenty focus groups (n = 100 participants) were conducted. Three key common themes emerged: (1) conception of a medicine; (2) self-management of medication; and (3) seeking further medicines information. In general, NZ European participants had a very narrow view of what a medicine is, were motivated to source medicines information independently and were very proactive in medicines management. At the other end of the spectrum, Pacific peoples expressed a broad view of what constitutes a medicine, were not motivated to source medicines information independently and were not proactive in medicines management, tending to instead rely on healthcare professionals for answers. The findings from the various ethnic groups highlight differences in attitudes to medicines per se and medicines-taking; these influences on medication-taking behaviour need to be considered in the provision of pharmaceutical care.

Conclusion

Ethnic differences in attitudes to medicines and medicines-taking are apparent, although there are some commonalities in terms of needs regarding support and advice around medicines' use. This will help inform the development of resources and communication tools to assist pharmacists in providing pharmaceutical care to diverse patient populations.
Radiation dose reduction to the breast in thoracic CT: Comparison of bismuth shielding, organ‐based tube current modulation, and use of a globally decreased tube current
Authors: Wang Jia , Duan Xinhui , Christner Jodie A. , Leng Shuai , Yu Lifeng , McCollough Cynthia H.
Published: October 2011

Purpose:

The purpose of this work was to evaluate dose performance and image quality in thoracic CT using three techniques to reduce dose to the breast: bismuth shielding, organ‐based tube current modulation (TCM) and global tube current reduction.

Methods:

Semi‐anthropomorphic thorax phantoms of four different sizes (15, 30, 35, and 40 cm lateral width) were used for dose measurement and image quality assessment. Four scans were performed on each phantom using 100 or 120 kV with a clinical CT scanner: (1) reference scan; (2) scan with bismuth breast shield of an appropriate thickness; (3) scan with organ‐based TCM; and (4) scan with a global reduction in tube current chosen to match the dose reduction from bismuth shielding. Dose to the breast was measured with an ion chamber on the surface of the phantom. Image quality was evaluated by measuring the mean and standard deviation of CT numbers within the lung and heart regions.

Results:

Compared to the reference scan, dose to the breast region was decreased by about 21% for the 15‐cm phantom with a pediatric (2‐ply) shield and by about 37% for the 30, 35, and 40‐cm phantoms with adult (4‐ply) shields. Organ‐based TCM decreased the dose by 12% for the 15‐cm phantom, and 34–39% for the 30, 35, and 40‐cm phantoms. Global lowering of the tube current reduced breast dose by 23% for the 15‐cm phantom and 39% for the 30, 35, and 40‐cm phantoms. In phantoms of all four sizes, image noise was increased in both the lung and heart regions with bismuth shielding. No significant increase in noise was observed with organ‐based TCM. Decreasing tube current globally led to similar noise increases as bismuth shielding. Streak and beam hardening artifacts, and a resulting artifactual increase in CT numbers, were observed for scans with bismuth shields, but not for organ‐based TCM or global tube current reduction.

Conclusions:

Organ‐based TCM produces dose reduction to the breast similar to that achieved with bismuth shielding for both pediatric and adult phantoms. However, organ‐based TCM does not affect image noise or CT number accuracy, both of which are adversely affected by bismuth shielding. Alternatively, globally decreasing the tube current can produce the same dose reduction to the breast as bismuth shielding, with a similar noise increase, yet without the streak artifacts and CT number errors caused by the bismuth shields. Moreover, globally decreasing the tube current reduces the dose to all tissues scanned, not simply to the breast.
Impact of leaf motion constraints on IMAT plan quality, deliver accuracy, and efficiency
Authors: Chen Fan , Rao Min , Ye Jin‐song , Shepard David M. , Cao Daliang
Published: October 2011

Purpose:

Intensity modulated arc therapy (IMAT) is a radiation therapy delivery technique that combines the efficiency of arc based delivery with the dose painting capabilities of intensity modulated radiation therapy (IMRT). A key challenge in developing robust inverse planning solutions for IMAT is the need to account for the connectivity of the beam shapes as the gantry rotates from one beam angle to the next. To overcome this challenge, inverse planning solutions typically impose a leaf motion constraint that defines the maximum distance a multileaf collimator (MLC) leaf can travel between adjacent control points. The leaf motion constraint ensures the deliverability of the optimized plan, but it also impacts the plan quality, the delivery accuracy, and the delivery efficiency. In this work, the authors have studied leaf motion constraints in detail and have developed recommendations for optimizing the balance between plan quality and delivery efficiency.

Methods:

Two steps were used to generate optimized IMAT treatment plans. The first was the direct machine parameter optimization (DMPO) inverse planning module in the Pinnacle3 planning system. Then, a home‐grown arc sequencer was applied to convert the optimized intensity maps into deliverable IMAT arcs. IMAT leaf motion constraints were imposed using limits of between 1 and 30 mm/deg. Dose distributions were calculated using the convolution/superposition algorithm in the Pinnacle3 planning system. The IMAT plan dose calculation accuracy was examined using a finer sampling calculation and the quality assurance verification. All plans were delivered on an Elekta Synergy with an 80‐leaf MLC and were verified using an IBA MatriXX 2D ion chamber array inserted in a MultiCube solid water phantom.

Results:

The use of a more restrictive leaf motion constraint (less than 1–2 mm/deg) results in inferior plan quality. A less restrictive leaf motion constraint (greater than 5 mm/deg) results in improved plan quality but can lead to less accurate dose distribution as evidenced by increasing discrepancies between the planned and the delivered doses. For example, the results from our patient‐specific quality assurance measurements demonstrated that the average gamma analysis passing rate decreased from 98% to 80% when the allowable leaf motion increased from 3 to 20 mm/deg. Larger leaf motion constraints also led to longer treatment delivery times (2 to 4 folds) due to the additional MLC leaf motion.

Conclusions:

Leaf motion constraints significantly impact IMAT plans in terms of plan quality, delivery accuracy, and delivery efficiency with the impact magnified for more complex cases. Our studies indicate that a leaf motion constraint of 2 to 3 mm/deg of gantry rotation can provide an optimal balance between plan quality, delivery accuracy, and efficiency.
Wolbachia
Enhance
Drosophila
Stem Cell Proliferation and Target the Germline Stem Cell Niche
Authors: Fast Eva M. , Toomey Michelle E. , Panaram Kanchana , Desjardins Danielle , Kolaczyk Eric D. , Frydman Horacio M.
Published: October 2011

A bacterial endosymbiont up-regulates mitosis of
Drosophila
germline stem cells and blocks programmed cell death.
Acupuncture Might Have Contributed to Improving Amenorrhoea in a Top Athlete
Authors: Donoyama Nozomi , Hotoge Shuko , Ohkoshi Norio
Published: October 2011

A 26-year-old top female athlete (height 157 cm), who took part in competitive sport similar to middle- and long-distance running, became amenorrhoeic in February 2009. In late May 2009, athletic amenorrhoea was diagnosed and a norgestrel–ethinyl estradiol combination (norgestrel 0.5 mg and ethinyl estradiol 0.05 mg three times daily) was prescribed for 2 weeks. She experienced menstrual bleeding on one occasion for 4 days in mid-June before becoming amenorrhoeic again. The athlete visited our centre to try acupuncture treatment. Forty-six acupuncture sessions were given between 1 October 2009 and 2 November 2010. Acupuncture point selection was based on classical acupuncture medicine and included points long used for gynaecological disorders in Japan—namely, CV6, CV12, LR3, LR14, BL17, BL18, BL23, SP6 and SP10. On 7 May 2010, owing to lack of regular normal vaginal bleeding, she again consulted her gynaecologist and was prescribed the same hormone preparation as used previously. She took it for 2 weeks in conjunction with acupuncture treatment. From July, the amount and duration of menstrual flow increased at regular intervals. Throughout July, a biphasic pattern in basal body temperature (BBT) was gradually established. In conclusion, the single hormone replacement therapy in May 2009 without acupuncture treatment was not effective for the amenorrhoea, nor was the single acupuncture treatment between October 2009 and May 2010. However, after hormone replacement therapy was started in May 2010 in conjunction with regular acupuncture treatment, menstrual blood flow restarted and BBT moved close to the biphasic pattern.
Characteristics of fatal abusive head trauma among children in the USA: 2003–2007: an application of the CDC operational case definition to national vital statistics data
Authors: Parks Sharyn E , Kegler Scott R , Annest Joseph L , Mercy James A
Published: October 2011

Objective

In March of 2008, an expert panel was convened at the Centers for Disease Control and Prevention to develop code-based case definitions for abusive head trauma (AHT) in children under 5 years of age based on theInternational Classification of Diseases, 10th Revision(ICD-10) nature and cause of injury codes. This study presents the operational case definition and applies it to US death data.

Methods

National Center for Health Statistics National Vital Statistics System data on multiple cause-of-death from 2003 to 2007 were examined.

Results

Inspection of records with at least oneICD-10injury/disease code and at least oneICD-10cause code from the AHT case definition resulted in the identification of 780 fatal AHT cases, with 699 classified as definite/presumptive AHT and 81 classified as probable AHT. The fatal AHT rate was highest among children age <1 year with a peak in incidence that occurred at 1–2 months of age. Fatal AHT incidence rates were higher for men than women and were higher for non-Hispanic African–Americans compared to other racial/ethnic groups. Fatal AHT incidence was relatively constant across seasons.

Conclusions

This report demonstrates that the definition can help to identify population subgroups at higher risk for AHT defined by year and month of death, age, sex and race/ethnicity. This type of definition may be useful for various epidemiological applications including research and surveillance. These activities can in turn inform further development of prevention activities, including educating parents about the dangers of shaking and strategies for managing infant crying.
DNA testing in companion animals – what is it and why do it?
Authors: Mellersh Cathryn , Sargan David
Published: October 2011

Since the sequencing of the canine genome was completed in 2004, many mutations responsible for inherited disease in dogs have been identified. This, in turn, has led to the development of DNA tests for a wide range of inherited traits in dogs, and tests for genetic diseases in other companion species are also becoming available. With increasing emphasis being placed on improving the health of purebred dogs, DNA testing is likely to be an important tool for breeders to help them make the best breeding selections and, ultimately, eliminate inherited conditions. This article explains the principles of DNA testing and highlights the tests that are currently available commercially. While the article focuses on DNA testing in dogs, and provides an overview of the current situation in cats, the principles discussed are applicable to any species.
Diagnosis and investigation of fluorosis in livestock and horses
Authors: Livesey Chris , Payne Jo
Published: October 2011

Fluorosis (fluoride ion poisoning) can affect all mammals and birds. Acute fluorosis is rare in the UK. Mild dental fluorosis is probably quite common but will not affect production. Severe dental fluorosis and skeletal fluorosis (which requires longer‐term exposure than dental fluorosis) occur close to fluorine‐emitting industries. Fluorosis should be included in the differential diagnosis of dental conditions, lameness and skeletal abnormalities. Background sources of fluorides include soil, feed crops, superphosphate fertilisers and phosphate feed supplements. UK environmental hot spots include natural mineral deposits and areas close to fluorine‐emitting industries. Volcanic ash also contains fluorides and small quantities of volcanic ash grounded in the UK following recent eruptions in Iceland, but monitoring in the UK confirmed that fluoride levels in grass remained within the expected background range. This article describes acute and chronic fluorosis, and discusses how to assess and manage the associated risks.
An age–period–cohort analysis of cannabis use prevalence and frequency in Germany, 1990–2009
Authors: Piontek Daniela , Kraus Ludwig , Pabst Alexander , Legleye Stéphane
Published: October 2011

Background

In order to better understand trends in cannabis use, this study estimates independent and non-confounded age, period and cohort effects on 12-month cannabis use prevalence and frequency.

Methods

Data from seven waves of the German Epidemiological Survey of Substance Abuse (ESA) conducted between 1990 and 2009 were used. The total sample included 29 836 men and 34 877 women aged 18–65 years. Cross-classified random effects models were conducted to estimate fixed effects of age and random effects of periods and birth cohorts. Analyses were stratified by gender.

Results

With regard to 12-month prevalence, substantial age variations were identified with a peak of cannabis use in young adulthood. The overall effects of periods and birth cohorts were not significant. With regard to frequency of use, there were no significant influences of either variable. The results were largely identical for men and women.

Conclusions

This study identified little variation in trend data of current cannabis use. When confounding influences of period and ageing are controlled, the widely reported increases in cannabis consumption in recent birth cohorts cannot be demonstrated.
SOME PERIODIC AND BLOW-UP SOLUTIONS FOR LANDAU–LIFSHITZ EQUATION
Authors: ZHONG PENGHONG , WANG SHU , CHEN SHENGTAO
Published: October 2011

In this paper, we construct the exact solution of two- or three-dimensional spacetime Landau–Lifshitz equation raised in the ferromagnetic materials. Under suitable transformations, some exact solutions are obtained in the radially symmetric coordinates and nonsymmetric coordinates. The type of solutions cover the finite time blow-up solution, vortex solution and periodic solution. In the end, we sketch some solutions and their spatial curvatures.
PRODUCTION OF CHARGED HIGGS BOSON ASSOCIATED WITH A W GAUGE BOSON AT THE LHC
Authors: YUE CHONG-XING , GUO XIAO-JIAO , LI NA
Published: October 2011

Production of charged Higgs boson associated with a W gauge boson at the LHC is mainly induced by the tree-level [Formula: see text] annihilation and the one-loop gg fusion. In the context of the Higgs triplet model (HTM) and the left–right twin Higgs (LRTH) model, we calculate the production cross-section σ of the process pp→H±W∓ and compare our results with those given by supersymmetry (SUSY). We find that, in most of the parameter space of the HTM, the production cross-section σ is smaller than that predicted by the LRTH model or SUSY. The value of σ within the LRTH model is larger or smaller than the SUSY case, which depends on the relevant free parameters.
THE COMPARING OF ACOUSTIC PHONON TRANSPORT ABOUT MONOCHROMATIC MODE AND MIXING MODE THROUGH A DOUBLE T-SHAPED QUANTUM WAVEGUIDE
Authors: YI GUO-JUN , LI KE-MIN , TANG LI-MING , CHEN XIAO-HUA
Published: October 2011

We compare the thermal conductance of SH mode and mixing mode of acoustic phonons in a double T-shaped quantum waveguide at low enough temperatures by using the scattering-matrix method, and analyze the influence from mode conversion. Our results show that the small changes of the geometric parameters can induce different variation on the thermal conductivity, where the effect of the stub height of SH wave is the strongest. Moreover, the mode conversion plays an important role on the thermal conductivity, especially at the higher temperatures, and the coupling effect between two stubs at mixing mode is larger than that at single SH mode.
WRIST DENERVATION IN ISOLATION: A PROSPECTIVE OUTCOME STUDY WITH PATIENT SELECTION BY WRIST BLOCKADE
Authors: Storey P. A. , Lindau T. , Jansen V. , Woodbridge S. , Bainbridge L. C. , Burke F. D.
Published: October 2011

Surgical wrist denervation involves division of the anterior and posterior interosseous nerves and articular branches of the superficial radial nerve. In this outcome study, 37 patients were individually assessed and deemed suitable for denervation surgery due to appreciable symptom resolution following a local anesthetic wrist block. At a mean of 18 months following denervation surgery, median activity pain scores had decreased by 60% (p < 0.001) from initial assessment levels, and more than three quarters (30/37) of patients reported continued improvement in their activity pain (p < 0.001). More than two thirds of patients had a satisfaction VAS of greater than 50, with less postoperative resting pain and a greater reduction in postoperative activity pain as the important predictors of patient satisfaction. Thirty-one out of the 37 patients had not represented to our department for revision wrist surgery by a mean of 10.3 years follow-up. We have found this procedure useful in ameliorating symptoms for some patients who would conventionally have required partial or total wrist fusions with greater residual functional limitation.
ACCURATE RADIOGRAPHIC MEASUREMENT OF THE DISTAL RADIAL TILT
Authors: Rajabi Benjamin , Roed Oyvind , Roed Kristian , Alm-Paulsen Paal Sandoe , Russwurm Harald , Finsen Vilhjalmur
Published: October 2011

Both wrists in 189 patients who had been treated for dorsally displaced distal radius fracture were X-rayed with both right angle and 15° tilted lateral views. Two investigators measured the radial tilt. The mean difference in the angles recorded by the two investigators was 2.5° for the tilted and 3.7° for the right angle projections (p = 4.7 × 10-8). The precision of the method was 2.6° for the tilted and 3.5° for right angle projection. The mean angle measured on the tilted views was 3° more dorsal than on the right angle views for wrists with a volar tilt between 10° and 15°, and 0° to 2° for wrists with less volar tilt or dorsal displacement.

Lateral projections tilted 15° allow more precise measurements than right angle views. Correction is not necessary when comparing to right angle views, as long as there is displacement in a dorsal direction of the distal fragment.
CLINICAL OUTCOMES OF EXCISION ARTHROPLASTY FOR KIENBOCK'S DISEASE
Authors: Matsuhashi Tomoya , Iwasaki Norimasa , Kato Hiroyuki , Minami Michio , Minami Akio
Published: October 2011

We have carried out a replacement of the lunate in 12 patients with advanced Kienböck's disease, with excision of the lunate and insertion of an iliac bone flap wrapped into palmaris longus. The aims of this study were to determine the effect of this procedure for advanced Kienböck's disease. At a mean follow-up period of 45.3 months, the mean clinical score was excellent in all cases. Radiographically, progression of osteoarthritis (OA) in the radiocarpal joint was found in two patients. At follow-up, the X-ray findings indicated a reduced of osseous core in four patients. On the other hand, carpal height ratio showed no significant change at follow-up. Excision arthroplasty using a tendon ball with osseous core for advanced Kienböck's disease leads to OA progression in some cases. However, clinical results were excellent in all cases. Therefore, this current study provides effective therapeutic procedure for advanced Kienböck's disease.
MACROMASTIA: A RISK FACTOR FOR CARPAL TUNNEL SYNDROME?
Authors: Guerra Ana Silva , Correia Carlos Marques , Videira e Castro José Manuel , Almeida Maria Angélica
Published: October 2011

Purpose: To evaluate the prevalence of carpal tunnel syndrome (CTS) in a cohort of women with macromastia and to assess the evolution of the CTS signs and symptoms after breast surgery.

Population: A series of 123 women was evaluated. CTS was defined by co-existence of symptoms, two physical findings and electrophysiological evaluation. One year after reduction mammaplasty, the 22 patients who had been diagnosed CTS were re-evaluated.

Results: CTS group of women had a mean age of 38.8 years, mean body mass index of 28.5 kg/m2and mean breast size of 35.9 cm. Age and nipple-to-sternal notch distance were statistically significantly associated with CTS (p = 0.001 and p = 0.001, respectively). A year after surgery 15 patients were re-assessed: nine patients reported absence or improvement of CTS symptoms while six patients reported symptoms persistence or worsening.

Conclusion: Age, breast size, but not body mass index, have a positive correlation with the CTS.
INTRAMEDULLARY NAILING FOR PATHOLOGICAL FRACTURES OF THE ULNA
Authors: Bennet S. , McCann P. A. , McFadyen I.
Published: October 2011

Pathological lesions of long bones increase the morbidity of many common cancers. The orthopedic management of metastatic skeletal lesions can be challenging. The ultimate aim is to provide patients with a painless, functional limb. We present a report of two cases were a novel minimally invasive long bone nailing technique has been utilized to achieve skeletal stability and alleviation of symptoms.
REMODELING OF DISTAL ULNA AFTER EXCISION ARTHROPLASTY FOR ACUTE COMMINUTED DISTAL ULNAR FRACTURE: A CASE REPORT
Authors: Cheng Chun-Ying
Published: October 2011

Bone adaptation after excision arthroplasty of distal radioulnar joint in an acute traumatic distal ulna fracture has never been reported. A case of irreparable and comminuted distal ulnar head fracture was managed by excising the ulna head and repairing the fovea (deep ligament) attachments of distal radioulnar ligaments, and then an unexpected remodeling of the distal ulna with the shape of pole and seat was noted. The anatomy of deep fibers of distal radioulnar ligament is important not only in biomechanics about the stability of distal radioulnar joint but it is also possible in the morphology about the shape of the distal radioulnar joint.
DOUBLE PLATE FIXATION FOR CORRECTION OF THE MALUNITED DISTAL ULNA FRACTURE: A CASE REPORT
Authors: Bessho Yuki , Okazaki Masato , Nakamura Toshiyasu
Published: October 2011

A 62-year-old woman visited our hospital one year after a motor vehicle accident complaining of ulnar wrist pain and restricted pronation and supination. Radiographs showed a 35° angular deformity at the ulnar neck. Closing wedge osteotomy was performed using two plates for stabilization. Twenty-four months postoperatively, the osteotomy site united without correction loss and the patient gained adequate pronation and supination. To the best of our knowledge, this represents the first report of corrective osteotomy for the treatment of malunited ulnar neck fracture. Although salvage operations such as ulnar head resection and the Sauvé-Kapandji procedure may provide reasonable results, anatomical repair can be considered as an option.
ISOLATED COMPLETE VOLAR DISLOCATION OF THE CAPITATE: A CASE REPORT
Authors: Checcucci Giuseppe , Bigazzi Prospero , Zucchini Maura , Ceruso Massimo
Published: October 2011

Total dislocation of the capitate is an extremely rare event. We report on one such unusual case. The complete expulsion of the capitate from its physiological position is difficult to diagnose. Standard parameters of the antero-posterior and lateral radiological do not head to a definite diagnosis.

In our patient, the only real diagnostic tool was the clinical assessment and the Gilula arches alteration to the standard antero-posterior projection. In the period following trauma, the patient reported a very high level of pain in the wrist. Since this could not be correlated to the lesions that had been diagnosed, we hypothesized the presence of any carpal bones damage. A definite diagnosis was obtained at CT scan, which also revealed the absence of any fractures.
CLOSED TRAUMATIC RUPTURE OF BOTH EXTENSOR TENDONS OF THE INDEX FINGER IN ZONE VI: A CASE REPORT
Authors: Niempoog Sunyarn , Waitayawinyu Thanapong , Angthong Chayanin
Published: October 2011

The patient with closed traumatic rupture of both extensor tendons of the index finger in zone VI was described.
DISTAL PHALANGEAL RECONSTRUCTION FOR RECURRENT INTRAOSSEOUS EPIDERMOID CYST OF THE FINGER — A CASE REPORT
Authors: Kurosawa Kazuya , Kobayashi Ryoichi , Takagishi Kenji
Published: October 2011

Intraosseous epidermoid cyst of the finger phalanx is rare. We report a case of postoperative recurrent intraosseous epidermoid cyst of the distal phalanx of the ring finger. To prevent further recurrence while maintaining morphology and function, the distal half of the distal phalanx that included the epidermoid cyst was resected to completely remove the lesion. The distal phalanx was then reconstructed by grafting corticocancellous bone from the ilium and shaped into a distal phalanx. The operation was performed using a through-the-nail approach, temporarily removing the nail and placing a longitudinal incision in the nail bed to approach the phalanx. Postoperatively, bone fusion was achieved without recurrence and the shape of the distal phalanx was normal. Distal phalangeal hypertrophy and nail plate deformity also normalized and excellent results were obtained.
DIGITAL ARTERY PERFORATOR FLAP FOR RECONSTRUCTION OF FINGERTIP AFTER RESECTION OF MELANOMA IN SITU
Authors: Suzuki Shuji , Koshima Isao
Published: October 2011

A case of 40-year-old female with melanoma in situ on her left index finger is presented. When treating melanoma in situ, it is recommended to have 3 mm margin and to include subcutaneous fat layer for resection of the tumor. To reconstruct the fingertip with the exposed distal phalanx, we used digital artery perforator flap. Since the resection of melanoma in situ in the appropriate manner would result in low risk of recurrence of the tumor, unlike melanoma of more deeply infiltrating types, it is important to use flaps which are easy to raise, functionally superior, and cosmetically excellent, The drawbacks of using digital artery perforator flap is that the operator is not able to tell if the flap includes the perforator until the flap is raised, since there is a risk of damaging the perforator when trying to expose it to visually confirm that it is included in the flap.
PARAMETERIZED FINITE ELEMENT MODELING OF THE SURFACE SYSTEMS WITH COATINGS WHICH CONSIDERS THE CRACKING OF THE COATINGS AND INFLUENCES OF THE CASE-HARDENING OF THE SUBSTRATE
Authors: FENG J. , QIN Y. , ZENG Q. , ALMANDOZ E. , FUENTE G. , DONG H. , RAGHAVAN R. , MICHLER J.
Published: October 2011

Accurately predicting the failure of multilayered surface systems, including coatings on tools or products, is of significance for all of the parties concerned within the chain of design, manufacturing and use of a product. Previous modeling work has, however, been focused largely on the effect of individual parameters rather than on the performance of a multilayered system as a whole. Design and manufacture of multilayered surface systems, currently, still relies largely on experiments and failure tests. A parameterized approach which considers geometrical, material, interfacial and loading variables, processing history, thermal effects, surface-failure modeling, etc. has therefore been developed to address the situation in order to be able to improve the efficiency and accuracy of the analysis and design of multilayered coating-systems. Material property values for the hardened case of the substrate are described with a function of the hardened depth and defined with a field method. Initial residual stresses calculated using a newly developed theoretical model are incorporated into the model as initial stress conditions. Thermo-mechanical coupled modeling is incorporated into the model so as to be able to consider temperature effects. These are associated with a cohesive-element modeling approach, which has been used to predict indentation-induced crack initiation and propagation within the coating layer. The comparison of experimental results with those of numerical modeling affords excellent agreement.

The parameterized modeling method developed allows for the parameters to be changed easily during a series analysis. Combined with the capability of the prediction of cracking of the coatings, the developed method/model provides an efficient way for investigating the effects of these parameters on the behavior of multilayered systems, which is demonstrated by the analysis of three cases of the coated tool steels (H11): (i) a substrate without being pre-heat-treated; and (ii) two substrates with a shallow and a deep hardened-case, respectively, (both are treated by plasma-nitriding). The results showed that the case-hardening of a substrate has a significant influence on the performance of the surface system with coating, especially on its load-bearing capacity and the cracking of the coating.
AUTOMATED CALIBRATION OF A VOID CLOSURE MODEL FOR HIGH-TEMPERATURE DEFORMATION
Authors: AFSHAN S. , BALINT D. , LIN J , FARRUGIA D
Published: October 2011

The so-called Gurson model is a well-established micromechanical model of the ductile fracture of porous materials, where the mechanism is void nucleation, growth and coalescence. Although the Gurson model, and particularly its modified form developed by Tvergaard and Needleman, is widely used, its application to void closure has received relatively little attention. The first objective of the current work is to explore the applicability of the Gurson model to void closure. The fixed parameters characterizing the modified Gurson model are not universal and must be calibrated for a particular material, typically by trial and error fitting of finite element (FE) simulations to experimental data. However, the trial and error approach is expensive and time consuming (one test generally corresponds to only one triaxiality level). A novel approach has been developed in the present work to identify the void closure model parameters using a nongradient based optimization search method (pattern search method). Rather than using experimental data for void closure, a series of finite element analyses, one of a representative volume element (RVE) containing a spherical void, and another with an equivalent cell of Gurson–Tvergaard (GT) material, has been performed. Both models have parametric characterizations, enabling simulations under different triaxialities and initial void volume fractions. The numerical results of the discrete void RVE and the GT cell can then be compared and model parameters identified. The new automated method was applied using material properties obtained from high temperature tensile testing of Telby plus steel at 900°C and 1100°C, temperatures in the range of those experienced during a typical steel rolling process. The effect of strain rate on void closure is also investigated using this approach for Telby plus steel.
RETHINKING THE GROWTH DIAGNOSTICS APPROACH: QUESTIONS FROM THE PRACTITIONERS
Authors: FELIPE JESUS , USUI NORIO , ABDON ARNELYN
Published: October 2011

The growth diagnostics methodology pioneered by Hausmann et al. (2005) is becoming a key component of the toolkit for donor agencies to formulate their operational strategies. This paper aims at clarifying the primary objectives of the approach, and at highlighting some limitations for operational use. The key to benefiting from the full potential that this approach offers lies in a proper understanding of what it does. This requires being forewarned about the indiscriminate application of the approach to any developing country, irrespective of its circumstances, for it can lead to misguided conclusions.
DRIVING A GREEN ECONOMY THROUGH PUBLIC FINANCE AND FISCAL POLICY REFORM
Authors: JONES BENJAMIN
Published: October 2011

Amid a still fragile economic environment, and rising concerns about deteriorating environmental conditions, policy-makers are examining the potential for new sources of environmentally sustainable growth and job creation. A "green economy" has emerged as an important concept linking economic growth and environmental sustainability. This paper emphasises the potentially significant opportunities to enhance welfare from better management of scarce environmental and natural resources, including through the reduction and removal of large distortions arising from environmentally harmful subsidies. It emphasises the centrality of fiscal (and in particular tax based) measures, as part of a portfolio of policies necessary to mobilise the resources, both public and private, for such an economic transformation to be effective and equitable.
Regulation of the gene encoding the intestinal bile acid transporter ASBT by the caudal-type homeobox proteins CDX1 and CDX2
Authors: Ma Li , Jüttner Moritz , Kullak-Ublick Gerd A. , Eloranta Jyrki J.
Published: October 2011

The apical sodium-dependent bile acid transporter (ASBT) is expressed abundantly in the ileum and mediates bile acid absorption across the apical membranes. Caudal-type homeobox proteins CDX1 and CDX2 are transcription factors that regulate genes involved in intestinal epithelial differentiation and proliferation. Aberrant expression of both ASBT and CDXs in Barrett's esophagus (BE) prompted us to study, whether the expression of the ASBT gene is regulated by CDXs. Short interfering RNA-mediated knockdown of CDXs resulted in reduced ASBT mRNA expression in intestinal cells. CDXs strongly induced the activity of the ASBT promoter in reporter assays in esophageal and intestinal cells. Nine CDX binding sites were predicted in silico within the ASBT promoter, and binding of CDXs to six of them was verified in vitro and within living cells by electrophoretic mobility shift assays and chromatin immunoprecipitation assays, respectively. RNAs were extracted from esophageal biopsies from 20 BE patients and analyzed by real-time PCR. Correlation with ASBT expression was found for CDX1, CDX2, and HNF-1α in BE biopsies. In conclusion, the human ASBT promoter is activated transcriptionally by CDX1 and CDX2. Our finding provides a possible explanation for the reported observation that ASBT is aberrantly expressed in esophageal metaplasia that also expresses CDX transcription factors.
Metabolic and morphometric profile of muscle fibers in chronic hemodialysis patients
Authors: Lewis Michael I. , Fournier Mario , Wang Huiyuan , Storer Thomas W. , Casaburi Richard , Cohen Arthur H. , Kopple Joel D.
Published: October 2011

Muscle weakness and effort intolerance are common in maintenance hemodialysis (MHD) patients. This study characterized morphometric, histochemical, and biochemical properties of limb muscle in MHD patients compared with controls (CTL) with similar age, gender, and ethnicity. Vastus lateralis muscle biopsies were obtained from 60 MHD patients, 1 day after dialysis, and from 21 CTL. Muscle fiber types and capillaries were identified immunohistochemically. Individual muscle fiber cross-sectional areas (CSA) were quantified. Individual fiber oxidative capacities were determined (microdensitometric assay) to measure succinate dehydrogenase (SDH) activity. Mean CSAs of type I, IIA, and IIX fibers were 33, 26, and 28% larger in MHD patients compared with CTL. SDH activities for type I, IIA, and IIX fibers were reduced by 29, 40, and 47%, respectively, in MHD. Capillary to fiber ratio was increased by 11% in MHD. The number of capillaries surrounding individual fiber types were also increased (type I: 9%; IIA: 10%; IIX: 23%) in MHD patients. However, capillary density (capillaries per unit muscle fiber area) was reduced by 34% in MHD patients, compared with CTL. Ultrastuctural analysis revealed swollen mitochondria with dense matrix in MHD patients. These results highlight impaired oxidative capacity and capillarity in MHD patients. This would be expected to impair energy production as well as substrate and oxygen delivery and exchange and contribute to exercise intolerance. The enlarged CSA of muscle fibers may, in part, be accounted for by edema. We speculate that these changes contribute to reduce limb strength in MHD patients by reducing specific force.
Chondrolectin Is a Novel Diagnostic Biomarker and a Therapeutic Target for Lung Cancer
Authors: Masuda Ken , Takano Atsushi , Oshita Hideto , Akiyama Hirohiko , Tsuchiya Eiju , Kohno Nobuoki , Nakamura Yusuke , Daigo Yataro
Published: October 2011

Purpose: This study aims to identify molecules that might be useful as diagnostic/prognostic biomarkers and as targets for the development of new molecular therapies for lung cancer.

Experimental Design: We screened for genes that were highly transactivated in a large proportion of 120 lung cancers by means of a cDNA microarray representing 27,648 genes and found chondrolectin (CHODL) as a candidate. Tumor tissue microarray was applied to examine the expression of CHODL protein and its clinicopathologic significance in archival non–small cell lung cancer (NSCLC) tissues from 295 patients. A role of CHODL in cancer cell growth and/or survival was examined by siRNA experiments. Cellular invasive effect of CHODL on mammalian cells was examined by Matrigel assays.

Results: Immunohistochemical staining revealed that strong positivity of CHODL protein was associated with shorter survival of patients with NSCLC (P = 0.0006), and multivariate analysis confirmed it to be an independent prognostic factor. Treatment of lung cancer cells with siRNAs against CHODL suppressed growth of the cancer cells. Furthermore, induction of exogenous expression of CHODL conferred growth and invasive activity of mammalian cells.

Conclusions: CHODL is likely to be a prognostic biomarker in the clinic and targeting CHODL might be a strategy for the development of anticancer drugs. Clin Cancer Res; 17(24); 7712–22. ©2011 AACR.
Clinical Efficacy and Safety in Children with Vesicoureteral Reflux of a Single Injection of Two Different Bulking Agents – Polydimethylsiloxane (Macroplastique) or Dextranomer/Hyaluronic Acid Copolymer (Deflux): A Short-Term Prospective Comparative Study
Authors: Kim Sun-Ouck , Shin Bo Sung , Hwang In Sang , Hwang Eu Chang , Oh Kyung Jin , Jung Seung Il , Kang Taek Won , Kwon Dongdeuk , Park Kwangsung , Ryu Soo Bang
Published: October 2011

Purpose: To compare the clinical efficacy and safety in children with vesicoureteral reflux (VUR) of a single injection of two different bulking agents: polydimethylsiloxane (Macroplastique) or dextranomer/hyaluronic acid copolymer (Deflux). Methods: A total of 73 patients (106 renal units, 41 boys and 32 girls) aged 2–15 years (mean age, 34.5 months) were included. A single subureteral injection of either Macroplastique or Deflux was performed in 37 children (55 ureters) and 36 children (51 ureters), respectively. VUR was grade II in 34 ureterorenal units, grade III in 23, grade IV in 31, and grade V in 18 ureterorenal units. Results: Overall, the reflux was corrected in 84 of the renal units (86%) with one injection. The correction rates, according to the reflux grade, were 91, 91, 83, and 72% for grades II–V, respectively. At the 3-month follow-up visit, reflux was corrected in 48 (87%) of 55 refluxing ureters in the Macroplastique group and in 43 (84%) of 51 refluxing ureters in the Deflux group. Conclusions: A single subureteral injection of either Macroplastique or Deflux is an effective treatment modality for children with VUR. The procedure was well tolerated, safe, and associated with low morbidity.
Feasibility of Tri-Weekly Docetaxel-Based Chemotherapy for Elderly Patients (Age 75 and Older) with Castration-Resistant Prostate Cancer
Authors: Takaha Natsuki , Okihara Koji , Kamoi Kazumi , Hongo Fumiya , Iwata Tsuyoshi , Yano Kimihiro , Ueda Takashi , Takeuchi Ichiro , Yamada Takeshi , Kawauchi Akihiro , Miki Tsuneharu
Published: October 2011

Objectives: To evaluate the efficacy and safety of docetaxel-based chemotherapy for elderly metastatic castration-resistant prostate cancer (CRPC) patients aged 75 or higher. Methods: Twenty CRPC patients aged 75 or higher (older group) and 31 CRPC patients younger than 75 years (younger group) were treated by a regimen of docetaxel (70 mg/m2) once every 3 weeks. Adjustment for docetaxel dosage and period per cycle was subject to investigator’s judgment. Results: The median relative dose intensity of both groups was 0.84, while the median dose intensity and the number of treatment cycles of the younger and older groups were 14.6 versus 12.3 mg/m2/week (p = 0.021), and 9 versus 8 cycles (p = 0.15), respectively. In the older group, PSA response rate was 50%, median time to biochemical progression was 7.5 months, and median survival time was 15.5 months, without any significant difference compared to those of the younger group. No significant difference in the incidence of grade 3–4 adverse events was noted between both groups. All these parameters for efficacy are comparable to those reported for tri-weekly docetaxel regimen. Conclusions: Tri-weekly treatment by docetaxel (70 mg/m2) with proper adjustment might contribute to maintaining efficacy and safety of the treatment for elderly CRPC patients.
Comparison of Two Different Suture Methods in Laparoscopic Dismembered Pyeloplasty
Authors: Shao Pengfei , Qin Chao , Ju Xiaobing , Meng Xiaoxin , Li Jie , Lv Qiang , Zhang Wei , Xu Zhengquan , Yin Changjun
Published: October 2011

Objective: Anastomosis of ureteropelvic junction with a laparoscope for the treatment of ureteropelvic junction obstruction (UPJO) is a time-consuming and technically challenging procedure. We present our experience of laparoscopic dismembered pyeloplasty and compare clinical outcomes of two different suture techniques. Methods: From September 2003 to June 2010, 105 laparoscopic dismembered pyeloplasties were performed in our department. All procedures were done using the retroperitoneal approach. According to the suture methods (interrupted or running), the patients were divided into two groups. An indwelling stent was placed intraoperatively in an antegrade manner. Data on operation time, blood loss and complications were collected. Results: All procedures were completed without open conversion. Mean operation time and anastomotic time were 96 (55–150) and 36 min (15–70), respectively. A significant decrease of operation and anastomosis time was seen when running sutures were applied. Mean blood loss was 54 ml (30–100). The total complication rate was 7.6%. No anastomotic stricture occurred. The average hospitalization stay was 7 days. During 5–85 months of follow-up, hydronephrosis was alleviated in all cases. Conclusions: Laparoscopic dismembered pyeloplasty for the treatment of UPJO can provide satisfactory clinical outcomes. Higher surgical efficiency and lower complication rates can be obtained by using the running suture method.
A Study on Sexual Function of Men with Anterior Urethral Stricture before and after Treatment
Authors: Sharma Varun , Kumar Santosh , Mandal A.K. , Singh S.K.
Published: October 2011

Introduction: Male urethral reconstruction for anterior urethral stricture has become increasingly popular and effective. Little is known about its potential impact on subsequent sexual performance. Patients and Methods: Thirty-four patients of anterior urethral stricture disease were studied from January 2008 to November 2009. The data were collected before surgery and at a follow-up of 3 months after completing the treatment. Evaluation of sexual function was done using O’Leary’s Brief Male Sexual Function Inventory. Results: Patients were divided into two categories: <40 and >40 years of age. Younger patients had more improvement in ejaculatory function and overall satisfaction after surgery than elderly. Elderly males had lower sexual drive scores. Patients with traumatic stricture had significant improvement in ejaculation and overall satisfaction. Patients without history of prior optical internal urethrotomy or dilatations reported a significant improvement in their ejaculatory function and overall satisfaction. Conclusion: Erectile dysfunction is not significant after anterior urethral reconstruction. The improvement is most pronounced in ejaculation and overall satisfaction, which was mostly appreciated by younger men. A successful urethral reconstructive procedure leads to rehabilitation of the patient back into a healthy sexual life. Dorsomedial dissection of bulbar urethra should be limited and cautery use should be minimized in that area.
Mild Cognitive Impairment Is Associated with Impaired Visual-Motor Planning When Visual Stimuli and Actions Are Incongruent
Authors: Salek Yashar , Anderson Nicole D. , Sergio Lauren
Published: October 2011

Background/Aims: This study examined cognitive-motor integration in adults with mild cognitive impairment (MCI). Previously, we showed that the performance of early-stage Alzheimer’s disease patients declined significantly as a visually-guided movement went from having a standard mapping (vision and action spatially aligned) to having a non-standard mapping (vision and action incongruent). The present study extends this line of research by examining the performance of individuals affected by MCI. Methods: The participants made finger movements over a clear touchscreen placed in two separate spatial planes to either constantly present or remembered visual targets. These spatial plane conditions were repeated with the direction of cursor motion rotated 180° from that of hand motion. We also tested an ‘arbitrary’ condition where symbols instructed the participants to move their hand in certain directions. Results: We observe that adults with MCI took significantly longer to plan movements requiring intermediate levels of non-standard mapping, relative to healthy older adults. Conclusions: These data suggest that movements requiring rule integration is affected even in individuals at a very early stage of cognitive decline. Cognitive-motor integration may provide a sensitive means to detect functional difficulty in early cognitive impairment.