bluuebunny/crossref_metadata_2025 huggingface dataset:
The Geneva Conferences and the emergence of the International Network for Person‐centered Medicine
Authors: Mezzich Juan E.
Published: November 2010

The yearly Geneva Conferences on Person‐centered Medicine started in May 2008 as a collaborative effort of global medical and health organizations and committed clinicians and scholars to place the whole person at the centre of medicine and health care. They were informed by the traditions of great ancient civilizations and recent developments in clinical care and public health. The process of the Geneva Conferences led to the development of the International Network for Person‐centered Medicine as a non‐for‐profit institution aimed at organizing future editions of the Geneva Conference and building person‐centred medicine as a paradigmatic repriorizing of the medical and health fields in collaboration inter alia with the World Medical Association, the World Health Organization and the World Organization of Family Doctors.
Outlining the bases of person‐centred integrative diagnosis
Authors: Salloum Ihsan M. , Mezzich Juan E.
Published: November 2010

Rational and aims As diagnosis is a critical first step for clinical care, it was early recognized that an appropriate diagnostic model was necessary as informational basis for person‐centred clinical care.

Methods The design of a person‐centred integrative diagnosis model was based on literature reviews and work meetings in London, Paris, Geneva, Preston, UK and Uppsala, Sweden over the past 2 years.

Results and conclusion The current person‐centred integrative diagnosis model argues for a broader concept of diagnosis and covers both ill health and positive health through the following three levels: Health Status (from illness to recovery/wellness and from disabilities to adaptive functioning), Experience of Health (cultural factors and values concerning ill health and positive health) and Contributory Factors (including internal and external risk and protective factors). Each of these domains will be evaluated with standardized categories and dimensions as well as narratives. Specific attention is paid to evaluators (clinicians, patient, family and other carers) and the interactive evaluation process.
The person in health care policy development
Authors: Wallcraft Janet
Published: November 2010

Objective  The objective of this article is to explore the rationale for involvement of persons in health care policy in western countries, and to examine evidence of the difference public involvement can make.

Methods  The information is drawn from research and reports on changes in health care policy towards greater democratization of decision making.

Conclusions  Strong reasons have been put forward for wider public involvement in health care policy, and some evidence is now available that involvement is popular with stakeholders and can improve services, though it is a complex intervention needing complex strategies of evaluation.
Heart rate response and factors affecting exercise performance during home‐ or class‐based rehabilitation for knee replacement recipients: lessons for clinical practice
Authors: Naylor Justine M. , Ko Victoria
Published: November 2010

Objectives  Patients undergoing total knee replacement (TKR) are typically de‐conditioned and manifest medical co‐morbidities associated with a lack of fitness. Consequently, an argument exists for rehabilitation programmes to target cardiovascular fitness. Doubt exists, however, as to the capacity of TKR recipients to exercise intensely and effectively. This preliminary study aimed to: (1) determine whether patients participating in a home‐ or class‐based exercise programme can exercise in their heart rate (HR) training zone, and (2) identify confounding factors influencing performance.

Methods  A mixed method study nested within a randomized trial was undertaken. Forty‐two people (mean age 70 years; 23 women) randomized to commence a 6‐week group‐based (GRP) or monitored home‐based programme (MHP) 2 weeks post surgery participated. Assessments were undertaken weeks 5 (GRP and MHP) and 8 (GRP only) post surgery. HR and participant perceived exertion (PE, 0–10 point scale) captured exercise intensity. Qualitative description using triangulation of informant sources identified factors influencing exercise performance.

Results  For both programmes, attainment of training HR was almost universal (93% or more), average time spent above the training HR exceeded 30 minutes, and PE indicated moderate exertion (5/10). Individual inconsistency in time spent above the training HR was evident between testing weeks in GRP participants. Therapist skill and focus, and patient co‐morbidity, knee pain and stiffness and willingness were confounders of performance.

Conclusion  TKR recipients participating in exercise programmes can exercise moderately hard indicating a potential for rehabilitation to improve cardiovascular fitness. Whether individual fitness actually improves likely depends in part on therapist recognition of key modifiable factors. It is recommended that therapists use these observations to inform practice so patients extract the most benefit from their rehabilitation.
A multi‐professional evidence‐based practice course improved allied health students' confidence and knowledge
Authors: Bennett Sally , Hoffmann Tammy , Arkins Miranda
Published: November 2010

Purpose  To evaluate the effectiveness of a semester‐long multi‐professional university course teaching evidence‐based practice principles to allied health students in terms of changes in attitudes, confidence, and perceived and actual knowledge regarding evidence‐based practice.

Methods  This was a pre–post study of allied health students who completed a multi‐professional university course that taught evidence‐based practice skills and concepts. The course was run over a 13‐week period (2 hours per week) and utilized didactic lectures, tutorial and workshop formats, and a hands‐on database searching session. Participants completed a questionnaire which assessed their attitudes, confidence, and perceived and actual knowledge regarding evidence‐based practice on the first and last day of the course.

Results  Ninety‐one students participated in the study; however, complete data sets were available for only 59 participants. Attitudes towards evidence‐based practice did not significantly improve; however, attitudes were already positive prior to undertaking the course. There was a statistically significant improvement in confidence with a mean increase of 9.02 [score range 6–30, 95% confidence interval (CI) 8.21, 9.82]. Perceived knowledge improved with a statistically significant mean increase of 14.15 (score range 5–25, 95% CI 12.55, 15.75) and there was a statistically significant mean increase in actual knowledge of 3.56 (score range 0–10, 95% CI 2.83, 4.29).

Conclusions  Teaching evidence‐based practice skills and concepts to allied health students within a multi‐professional university curriculum improved confidence and perceived and actual knowledge regarding evidence‐based practice. Further research is needed to determine if these changes result in long‐term behaviour change once students graduate, and to consider optimal methods for multi‐ and interprofessional delivery of evidence‐based practice training.
The effect of evidence‐based medicine (EBM) training seminars on the knowledge and attitudes of medical students towards EBM
Authors: Khader Yousef S. , Batayha Waleed , Al‐Omari Mousa
Published: November 2010

Background  There is debate about the most effective method for teaching evidence‐based medicine (EBM) in medical schools. This study was conducted to evaluate the effect of integration of EBM training seminars into the curriculum of the community medicine course in changing the knowledge and attitudes of the fourth year medical students towards EBM.

Methods  This is a quasi‐experimental study conducted on the fourth year medical students who joined the community medicine mandatory summer course at Jordan University of Science and Technology in the period between July 1 and August 31, 2008. We measured medical students' self‐reported attitudes about and knowledge of EBM before the integration of EBM seminars into the community medicine course and at the end of course.

Results  A high proportion of students had positive attitude towards EBM before and after the course. After the course, the vast majority (91.8%) became aware of the presence of guidelines and protocols for diseases compared with 59.0% who were aware of that before (P < 0.005). Only small proportion of students reported that they understand and able to explain the common epidemiological concepts that are used in EBM before the training. After the training, a significantly higher proportion of students reported understanding the epidemiological concepts.

Conclusion  Integration of EBM training course into community course for the fourth year students improved their EBM knowledge. Longitudinal studies are needed to evaluate the long‐term effects of EBM curriculum in changing behaviours, practice patterns and patient care outcome.
Molecular and phenotypic characterization ofVibrio aestuarianus, a pathogen of the cultured tongue sole,Cynoglossus semilaevisGünther
Authors: Zhang X‐J , Qin G‐M , Bing X‐W , Yan B‐L , Liang L‐G
Published: December 2010

Studies were conducted to determine the cause of high mortalities of cultured half‐smooth tongue soleCynoglossus semilaevis. Gross signs of disease included loss of appetite, erratic swimming, and haemorrhages on the head, opercula and base of fins, dorsal fin rot, swollen abdomen filled with ascitic fluid and herniation of the intestine. Histological examination of the liver showed focal areas of necrosis and extensive haemorrhages. Virtually pure, dense bacterial cultures were obtained from liver, kidney and spleen tissues, and high pathogenicity of the isolates to tongue sole was confirmed. The phenotypic characteristics of the isolates including morphological, physiological and biochemical characteristics were determined. The 16S rRNA andgyrB genes of the isolates were sequenced, and the phylogenetic trees representing genetic relatedness between the isolate and publicly available 16S rRNA andgyrB gene sequences from GenBank were constructed. The results confirmed that the diseased tongue soles were infected withVibrio aestuarianus. The sequenced 16S rRNA gene of strain TS1 (GenBank Accession No.GQ372983) was 1446bp, thegyrB gene of strain TS1 (GenBank Accession No.GQ372984) was 1200bp and the two genes exhibited high similarity (98∼99%) to those ofV. aestuarianusfrom GenBank. In addition, the activities of extracellular enzymes and haemolysin were also studied; the results showed that the isolates produced beta haemolysis on rabbit blood agar, lecithinase, proteinase, DNase and lipase, but gelatinase was not produced.
Linking irradiance‐induced changes in pit membrane ultrastructure with xylem vulnerability to cavitation
Authors: PLAVCOVÁ LENKA , HACKE UWE G. , SPERRY JOHN S.
Published: December 2010

The effect of shading on xylem hydraulic traits and xylem anatomy was studied in hybrid poplar (Populus trichocarpa × deltoides, clone H11‐11). Hydraulic measurements conducted on stem segments of 3‐month‐old saplings grown in shaded (SH) or control light (C) conditions indicated that shading resulted in more vulnerable and less efficient xylem. Air is thought to enter vessels through pores in inter‐vessel pit membranes, thereby nucleating cavitation. Therefore, we tested if the ultrastructure and/or chemistry of pit membranes differed in SH and C plants. Transmission electron micrographs revealed that pit membranes were thinner in SH, which was paralleled by lower compound middle lamella thickness. Immunolabelling with JIM5 and JIM7 monoclonal antibodies surprisingly indicated that pectic homogalacturonans were not present in the mature pit membrane regardless of the light treatment. Porosity measurements conducted with scanning electron microscopy were significantly affected by the method used for sample dehydration. Drying through a gradual ethanol series seems to be a better alternative to drying directly from a hydrated state for pit membrane observations in poplar. Scanning electron microscopy based estimates of pit membrane porosity probably overestimated real porosity as suggested by the results from the ‘rare pit’ model.
The wheat Mla homologue TmMla1 exhibits an evolutionarily conserved function against powdery mildew in both wheat and barley
Authors: Jordan Tina , Seeholzer Sabine , Schwizer Simon , Töller Armin , Somssich Imre E. , Keller Beat
Published: December 2010

The race‐specific barley powdery mildew (Blumeria graminis f. sp. hordei) resistance gene Mla occurs as an allelic series and encodes CC‐NB‐LRR type resistance proteins. Inter‐generic allele mining resulted in the isolation and characterisation of an Mla homologue from diploid wheat, designated TmMla1, which shares 78% identity with barley HvMLA1 at the protein level. TmMla1 was found to be a functional resistance gene against Blumeria graminis f. sp. tritici in wheat, hereby providing an example of R gene orthologs controlling the same disease in two different species. TmMLA1 exhibits race‐specific resistance activity and its N‐terminal coiled‐coil domain interacts with the barley transcription factor HvWRKY1. Interestingly, TmMLA1 was not functional in barley transient assays. Replacement of the TmMLA1 LRR domain with that of HvMLA1 revealed that this fusion protein conferred resistance against B. graminis f. sp. hordei isolate K1 in barley. Thus, TmMLA1 not only confers resistance in wheat but possibly also in barley against an as yet unknown barley powdery mildew race. The conservation of functional R gene orthologs over at least 12 million years is surprising given the observed rapid breakdown of Mla‐based resistance against barley mildew in agricultural ecosystems. This suggests a high stability of Mla resistance in the natural environment before domestication.
Prevalence of the mutation in cyclophilin B (PPIB), a causal candidate gene for HERDA, among Quarter Horses in France
Authors: White Stephen D. , Bourdeau Patrick
Published: November 2010

Hereditary equine regional dermal asthenia (HERDA) in Quarter Horses is an inherited degenerative skin disease. Initially reported as hyperelastosis cutis, HERDA has a phenotype of hyperextensible, fragile skin, with secondary seromas, haematomas, ulcers and scarring. It primarily affects the dorsal aspect of the body. An autosomal recessive mode of inheritance is considered likely, with affected horses more at risk to produce affected offspring. A mutation in cyclophilin B (PPIB) as a novel, causal candidate gene for HERDA has been described, and verified as segregating with carriers and affected horses. Screening of control Quarter Horses in the USA has indicated a 3.5% carrier frequency. The prevalence of this mutation among Quarter Horses in France was determined to be 1.6%.
Effect of coated and non‐coated fatty acid supplementation on broiler chickens experimentally infected with Campylobacter jejuni
Authors: Molatová Z. , Skřivanová E. , Baré J. , Houf K. , Bruggeman G. , Marounek M.
Published: November 2010

The aim of this study was to examine whether and to what extent the supplementation of feed with a coated or non‐coated mixture of fatty acids (caprylic and capric acid) affects broiler chickens experimentally infected with Campylobacter jejuni. The study was carried out using 48 chickens divided into four experimental groups. Throughout the whole rearing period (1–42 days), the chickens were fed a diet supplemented with 0.25% caprylic and capric acid (1:1), coated or non‐coated. At the age of 14 and 28 days, chickens were orally challenged with C. jejuni. At regular time intervals post‐inoculation, the shedding of C. jejuni was assayed using quantitative real‐time PCR. Both supplements significantly decreased faecal C. jejuni counts by 1.2–4.1 log10 CFU/g 4 days post‐inoculation; after this time period, the effect of medium‐chain fatty acids (MCFA) was less pronounced or absent. Campylobacter jejuni counts in excreta samples were significantly lower in chickens fed coated MCFA than in those fed non‐coated MCFA. No effect of MCFA on feed intake or growth of chickens was observed. In conclusion, (i) MCFA are active against C. jejuni and (ii) the encapsulation enhanced the efficacy of the acids. These results allow the recommendation of using MCFA as feed additives in chickens, preferably 2–3 days before slaughter.
Caecum odd‐numbered and branched‐chain fatty acid composition in response to dietary changes in fattening rabbits
Authors: Papadomichelakis G. , Mountzouris K. C. , Paraskevakis N. , Fegeros K.
Published: November 2010

The study aimed to describe the interactions between nutrition and caecal bacteria abundance using odd‐numbered and branched‐chain fatty acids (OBCFA). Following a 2 × 2 factorial design, 47 rabbits were fed diets with two levels of digestible fibre (DF, 180 vs. 260 g/kg DM) supplemented with soybean oil (SO, 20 g/kg) or not. At 77 days of age, fatty acid (FA) composition was determined in caecal contents. The microbial origin of OBCFA vs. dietary FA in caecal contents was illustrated by clustering of these FA in the loading plots of principal component analysis. The contribution of odd‐numbered FA in the OBCFA pattern was increased (p < 0.05) for high DF diets, whereas that of branched‐chain FA decreased (p < 0.05), indicating potential shifts in the relative abundance of Gram‐negative and Gram‐positive fibrolytic bacteria respectively. Soybean oil reduced the relative importance of OBCFA (p < 0.001) in total microbial FA; however, its effects appeared to depend on the readily available fermentable substrate, as indicated by the DF × SO interactions (p < 0.001). In conclusion, OBCFA may be potentially used as markers of caecum function, but further detailed studies are necessary to validate their use as diagnostic tools in rabbit nutrition.
Pregnancies Following Artificial Insemination with Spermatozoa from Problem Stallion Ejaculates Processed by Single Layer Centrifugation with Androcoll‐E
Authors: Morrell JM , Mari G , Kútvölgyi G , Meurling S , Mislei B , Iacono E , Rodriguez‐Martinez H
Published: November 2010

Contents

Some stallions produce ejaculates of low quality and/or low fertility when used for artificial insemination (AI). The purpose of these five case studies was to use Single Layer Centrifugation (SLC) to select the best spermatozoa from ‘problem’ ejaculates for subsequent use in AI. Sperm quality, in terms of motility, morphology and chromatin integrity, was improved in the SLC‐selected samples compared to the corresponding uncentrifuged samples, with the exception of one stallion thought to have ampullary stasis. In this stallion, neither the incidence of spermatozoa with detached heads nor the proportion of damaged chromatin was decreased by SLC, in contrast to previous results. Pregnancies were obtained after using SLC‐selected spermatozoa from the five stallions for AI, indicating that the spermatozoa were functional after SLC. Overall, the results suggest that SLC may be useful when preparing AI doses from some ‘problem’ ejaculates.
Triggering receptor (TREM‐1) expressed on myeloid cells predicts bacteremia better than clinical variables in community‐acquired pneumonia
Authors: RUIZ‐GONZÁLEZ Agustin , ESQUERDA Aureli , FALGUERA Miquel , ABDULGHANI Nadia , CABEZAS Pamela , BIELSA Silvia , PORCEL José M.
Published: November 2010

Background and objective:  Some clinical variables are associated with bacteremia in patients with community‐acquired pneumonia (CAP). The aim of this study was to analyse the accuracy of the soluble form of triggering receptor expressed on myeloid cells‐1 (sTREM‐1) to predict positive blood cultures in comparison with established clinical prognostic variables.

Methods:  In addition to collecting clinical and laboratory information, a commercially available immunoassay kit was used to measure the serum sTREM‐1 levels on the first day of admit ion in patients with CAP. Receiver operating characteristic (ROC) curves were used to compare the ability of sTREM‐1 and commonly used clinical variables to identify bacteremia.

Results:  Blood cultures yielded a pathogen in 13 (10.4%) out of 124 patient samples. The microorganisms isolated were Streptococcus pneumoniae (11 patients) and Klebsiella pneumoniae (2 patients). The presence of pleuritic chest pain, tachycardia and extreme white cell count (WCC) were associated with bacteremia. However, ROC curve analysis showed an accuracy of sTREM‐1 (area under the receiver operating characteristic curve (AUC) 0.84, 95% CI: 0.72–0.95), which was higher than pleuritic chest pain (AUC 0.71, 95% CI: 0.57–0.84), tachycardia (AUC 0.73, 95% CI: 0.58–0.88) and extreme WCC (AUC 0.70, 95% CI: 0.55–0.85) for predicting positive blood cultures. Low admission sTREM‐1 serum values had a high negative predictive value for excluding bacteremia (sTREM‐1 <120 pg/mL = 98.8%).

Conclusions:  This preliminary study suggests that the determination of sTREM‐1 serum levels on admission may be more accurate than clinical variables for identifying bacteremic patients.
Micropapillary urothelial carcinoma of the urinary bladder: A clinicopathological analysis of 24 cases
Authors: Edgerton Neil , Sirintrapun S Joseph , Munoz Melissa , Chen Zhengjia , Osunkoya Adeboye O
Published: November 2010

Objectives:  To stratify patients with micropapillary urothelial carcinoma of the urinary bladder based on the percentage of micropapillary component and to correlate tumor volume with other clinicopathological features.

Methods:  Cases of micropapillary urothelial carcinoma of the urinary bladder from 2002 to 2009 were identified. Only patients with available follow‐up information were included in the analysis. Tumor volumes were stratified based on the percentage of micropapillary component (<50%, >50% and 100%).

Results:  Overall, 24 cases were analyzed. Mean patient age was 71 years (range 55–86 years), with a male to female ratio of 3:1. Six cases (6/24; 25%) were composed entirely of micropapillary component. A total of 12 cases (12/24; 50%) showed >50% micropapillary component. Six cases (6/24; 25%) showed <50% micropapillary component. A higher percentage of micropapillary urothelial carcinoma component was significantly associated with male sex, regional lymph node metastasis and pathological stage (P‐values = 0.0005, 0.01 and 0.03, respectively). The percentage of the micropapillary component was, however, unrelated to patients' survival.

Conclusions:  The present study confirms that micropapillary urothelial bladder carcinoma is typically aggressive and presents with advanced stage disease in most cases. A quantification of the micropapillary component is to be recommended. An accurate diagnosis of this entity in relatively small biopsies or transurethral resection of bladder tumor specimens is especially critical to define the best treatment plan.
Ecological rebound on Phillip Island, South Pacific
Authors: Coyne Peter
Published: December 2010

Summary  Pigs released on Phillip Island (half‐way between Sydney, Australia and Fiji) in 1793 were followed by goats and rabbits by 1830, quickly destroying the sub‐tropical vegetation and the soil. By 1856, the island was described as mostly bare red ground with little remnant vegetation. The pigs and goats had gone by about 1900 but rabbits prevented most plant establishment. An experimental programme begun in 1979 to investigate the effect of the rabbits and the island’s potential for regeneration quickly provided spectacular evidence. An eradication programme followed, initially using a highly virulent strain of myxoma virus which was very effective but resupply failed. Poisoning with 1080 supplemented by shooting, trapping and gassing finally achieved effective eradication in March 1986, with the removal of the last single rabbit in 1988. Regeneration by native and weed species has been spectacular with consequent faunal changes. Some changes present policy challenges.
The importance of temperate woodland in travelling stock reserves for vertebrate biodiversity conservation
Authors: Lindenmayer David B. , Cunningham Ross B. , Crane Mason , Montague‐Drake Rebecca , Michael Damian
Published: December 2010

Summary  Travelling stock reserves have well recognised and important commercial, cultural and other values in the pastoral and agricultural regions of Australia, but their conservation values remain poorly known. In general, many areas of woodlands within travelling stock reserves have not been subjected to the same high levels of degradation pressure as similar temperate woodlands on private land. In this study, we compared several measures of vertebrate biota in 217 permanent field sites located in travelling stock reserves and woodland remnants located almost exclusively on private land in the Murray Riverina and South West Slopes bioregions in southern New South Wales. We found that in comparison with temperate woodland remnants on private land, temperate woodland in travelling stock reserves tended to support more species of birds, more species of declining birds, and a greater abundance of arboreal marsupials. Temperate woodland in travelling stock reserves was more likely to be occupied by particular individual species of birds of conservation concern. However, such tenure differences were not consistent between bioregions. For example, the Rufous Whistler (Pachycephala rufiventris) and the Red‐capped Robin (Petroica goodenovii ) were significantly more likely to occupy temperate woodland in travelling stock reserves than temperate woodland on private land in the Murray Riverina but such effects were not apparent in the South West Slopes. Similarly, while the Grey‐crowned Babbler (Pomatostomus temporalis) was significantly more likely to occupy temperate woodland in travelling stock reserve sites in the South West Slopes, we found the opposite effect in Murray Riverina. We demonstrated that travelling stock reserves have important conservation values for some taxa and individual species. Because of the paucity of large ecological reserves in the Murray Riverina and South West Slopes bioregions, temperate woodlands located in travelling stock reserves should be considered as an important resource that contributes to a portfolio of vegetation assets in formerly woodland‐dominated, but now extensively cleared, agricultural landscapes.
ENDOSCOPIC SUBMUCOSAL DISSECTION USING A GRASPING‐TYPE SCISSORS FORCEPS FOR EARLY GASTRIC CANCERS AND ADENOMAS
Authors: Akahoshi Kazuya , Honda Kuniomi , Motomura Yasuaki , Kubokawa Masaru , Okamoto Risa , Osoegawa Takashi , Nakama Naotaka , Kashiwabara Yumi , Higuchi Naomi , Tanaka Yoshimasa , Oya Masafumi , Nakamura Kazuhiko
Published: November 2010

Aim:  To reduce the risk of complications related to endoscopic submucosal dissection (ESD) using knives, we developed a new grasping‐type scissors forceps (GSF) that can grasp and incise the target tissue using electrosurgical current. The aim of the present study was to evaluate the efficacy and safety of ESD using GSF for the removal of early gastric cancers and adenomas.

Methods:  ESD using GSF was carried out on 35 consecutive patients with early gastric cancers or adenomas who had preoperative EUS diagnoses of mucosal tumor without lymph node involvement. Therapeutic efficacy and safety were assessed.

Results:  All lesions were treated easily and safely without unexpected incision. The mean size of epithelial tumors and resected specimens was 15.6 mm and 32.7 mm, respectively. Curative en‐bloc resection rates according to tumor size and location were 96% (26/27) in tumors ≤20 mm, 100% (8/8) in tumors >20 mm, 100% (18/18) of tumors in the lower portion, 100% (8/8) of tumors in the middle portion, 89% (8/9) of tumors in the upper portion, and 97% (34/35) overall. The mean operating time according to tumor size and location was 93.4 min in tumors ≤20 mm, 140 min in tumors >20 mm, 77.6 min for tumors in the lower portion, 113.4 min for tumors in the middle portion, 148.6 min for tumors in the upper portion, and 104.1 min overall. No intraoperative complication occurred, and postoperative bleeding was seen in 3% (1/35).

Conclusions:  ESD using GSF allows simple and safe en‐bloc resection of early gastric cancer or adenoma irrespective of tumor size and location.
NEW METHOD OF COVERED WALLSTENTS FOR DISTAL MALIGNANT BILIARY OBSTRUCTION TO REDUCE EARLY STENT‐RELATED COMPLICATIONS BASED ON CHARACTERISTICS
Authors: Nakai Yousuke , Isayama Hiroyuki , Togawa Osamu , Kogure Hirofumi , Tsujino Takeshi , Yagioka Hiroshi , Yashima Yoko , Sasaki Takashi , Ito Yukiko , Matsubara Saburo , Hirano Kenji , Sasahira Naoki , Toda Nobuo , Tada Minoru , Kawabe Takao , Omata Masao , Koike Kazuhiko
Published: November 2010

Aim:  We previously reported a low occlusion rate with covered Wallstents for malignant biliary obstruction, but stent‐related complications other than occlusion posed a problem. A modified covered Wallstent insertion method based on stent characteristics was evaluated to reduce stent‐related complications.

Methods:  A total of 138 patients with distal malignant biliary obstruction received covered Wallstent placement. From October 2001 to October 2003, 69 patients received covered Wallstent placement (Group 1). Thereafter, we modified our stent insertion method and 69 patients received stent placement using this modified method from November 2003 to January 2007 (Group 2). The modified insertion method consists of endoscopic sphincterotomy carried out in patients without pancreatic duct invasion and longer stent placement with the center of the stent located in the center of the biliary stricture to prevent pancreatitis, kinking of the bile duct, and stent dislocation. A comparative analysis was carried out using prospectively collected data in these two cohorts.

Results:  Tumor ingrowth was not observed, and stent occlusion rate was 18.8% in Group 1 and 23.2% in Group 2. The overall rates of stent‐related complications did not differ (39.1% in Group 1 and 30.4% in Group 2), but stent‐related complications within 3 months decreased from 22 episodes in Group 1 to 13 episodes in Group 2. Median event‐free survival was prolonged by modified stent insertion method (125 days in Group 1 and 268 days in Group 2, P = 0.020), although cumulative survival and stent patency were not significantly different.

Conclusions:  Our modified method of covered Wallstent placement showed improved event‐free survival.
Motivational Pursuits in the Context of Human Sexual Relationships
Authors: Cooper M. Lynne , Barber Lindsay L. , Zhaoyang Ruixue , Talley Amelia E.
Published: December 2010

The current article examines how close relationships combine with individual differences in sex motives (Cooper, Shapiro, & Powers, 1998) to shape sexual experience. We first provide an overview of the motivational approach as it relates to sexual behavior and then describe 2 broad mechanisms (1 transactional, the other interactional) by which motives and relational context combine to shape behavior. Drawing on our past research, we review evidence showing that people select relationship contexts based partly on their motives and that these contexts in turn shape future motives and behavior; that partner motives shape sexual experience above and beyond one's own motives; and that both the broader relationship context and partner motives moderate the effects of one's own motives on sexual experience. We conclude that the nature of motivational pursuits cannot be adequately understood in the abstract, but rather we must take into account the relational context in which one's needs are pursued.
Retirement in Australia: A Closer Look at the Financial Incentives
Authors: Warren Diana , Oguzoglu Umut
Published: November 2010

In Australia, labour force participation among older people has been declining. Previous research has found that in many OECD countries, the retirement income system actually provides a financial incentive for older workers to retire early. In this article, we model the retirement behaviour of Australian men and women aged between 55 and 70 years, where individuals retire in the period that the present value of their lifetime retirement income is maximised. Our findings suggest that the Australian retirement system does provide an incentive to retire early. However, men are much more likely than women to respond to these financial incentives.
Transverse Spectral Stability of Small Periodic Traveling Waves for the KP Equation
Authors: Haragus Mariana
Published: November 2010

The Kadomtsev–Petviashvili (KP) equation possesses a four‐parameter family of one‐dimensional periodic traveling waves. We study the spectral stability of the waves with small amplitude with respect to two‐dimensional perturbations which are either periodic in the direction of propagation, with the same period as the one‐dimensional traveling wave, or nonperiodic (localized or bounded). We focus on the so‐called KP‐I equation (positive dispersion case), for which we show that these periodic waves are unstable with respect to both types of perturbations. Finally, we briefly discuss the KP‐II equation, for which we show that these periodic waves are spectrally stable with respect to perturbations that are periodic in the direction of propagation, and have long wavelengths in the transverse direction.
Rotating Nonlinear Vortical Patterns on a Gamma Plane
Authors: Derzho Oleg G. , de Young Brad
Published: November 2010

Nonlinear barotropic vortical patterns on a γ‐plane are investigated analytically. The solutions describe large‐scale Rossby waves rotating anticyclonically with zero circulation. The Rossby waves are predicted to rotate with a specific angular velocity. The stream function–vorticity relation is assumed to be nonlinear, which may lead to a pronounced asymmetry within the pattern. The similarity between the simulated patterns and the Antarctic Circumpolar Wave is highlighted.
TWO KINDS OF INTENTIONALITY IN LOCKE
Authors: SHAPIRO LIONEL
Published: December 2010

Ideas play at least two roles in Locke's theory of the understanding. They are constituents of ‘propositions,’ and some of them ‘represent’ the qualities and sorts of surrounding bodies. I argue that each role involves a distinct kind of intentional directedness. The same idea will in general be an ‘idea of’ two different objects, in different senses of the expression. Identifying Locke's scheme of twofold ‘ofness’ reveals a common structure to his accounts of simple ideas and complex ideas of substances. A consequence is a distinction among substance sorts parallel to one of his distinctions between primary and secondary qualities.
TRANSPARENCY AND SENSORIMOTOR CONTINGENCIES: DO WE SEE THROUGH PHOTOGRAPHS?
Authors: NANAY BENCE
Published: December 2010

It has been claimed that photographs are transparent: we see through them; we literally see the photographed object through the photograph. Whether this claim is true depends on the way we conceive of seeing. There has been a controversy about whether localizing the perceived object in one's egocentric space is a necessary feature of seeing, as if it is, then photographs are unlikely to be transparent. I would like to propose and defend another, much weaker, necessary condition for seeing: I argue that it is necessary for seeing that there is at least one way for me to move such that if I were to move this way, my view of the perceived object would change continuously as I move. Since this condition is not satisfied in the case of seeing objects in photographs, photographs are not transparent.
Labor and the Geographic Reorganization of Container Shipping in the U.S.
Authors: JAFFEE DAVID
Published: December 2010

The globalization of production and the geographic dispersion of economic activity have elevated the importance of the transportation and logistics sectors of the economy. One sector in particular that has experienced significant expansion is maritime transport and container shipping. As the cargo has become increasingly “discretionary” such that it can conceivably be transported through any port that allows intermodal access to the hinterland, the industry has become much more foot‐loose vis‐à‐vis a particular port of entry. The enhanced mobility of the cargo results in more intense port competition. One particular place to observe and study this dynamic is in the port and terminal selection of shippers and shipping lines and the role of port authorities in attempting to attract these carriers to their facilities. In this paper, the focus is on the role of labor and labor relations in such decisions. These issues will be studied in the context of the potential container traffic rerouting from the West to the East Coast of the U.S. and, as an illustrative case study, how these developments have played out for the East Coast port of Jacksonville, Florida.
Cigarette smoking may modify the risk of depression in eczema among adults: a preliminary study using NHANES 2005–2006
Authors: Yang Y.‐W. , Chen Y.‐H. , Huang Y.‐H.
Published: November 2010

Background  Eczema has been shown to be associated with an increased risk of depression. However, the effect of cigarette smoking on the association between eczema and depression remains unclear.

Objectives  In this study, we investigated whether smoking behaviour and tobacco exposure influence the association between eczema and depression.

Methods  This was a population‐based cross‐sectional study. Subjects (287 eczema patients and 40 patients with depression, out of a total of 2974 subjects in the database) were from the National Health and Nutrition Examination Survey 2005–2006, aged between 20 and 59 years. Lifetime presence of eczema was obtained by self‐reporting questionnaires, and depression was assessed by the Patient Health Questionnaire. Smoking status was determined by self‐report and serum cotinine levels. Univariate and multivariate logistic regressions were used to assess the association between eczema and depression with and without adjusting for smoking behaviour. Stratified analysis was also performed according to smoking status.

Results  Eczema was significantly associated with depression (adjusted OR: 2.12; 95% CI: 1.59–2.83). This association persisted after additionally adjusting for smoking status. In stratified analysis, the association between eczema and depression was higher and stronger among current smokers than never smokers, former smokers and passive smokers.

Conclusion  Our findings indicated that cigarette smoking may modify the risk of depression in eczema. We suggested cessation of smoking in eczema patients to decrease the risk of this psychiatric co‐morbidity.
Cloudy and starry milia‐like cysts: how well do they distinguish seborrheic keratoses from malignant melanomas?
Authors: Stricklin S.M. , Stoecker W.V. , Oliviero M.C. , Rabinovitz H.S. , Mahajan S.K.
Published: November 2010

Background  Seborrheic keratoses are the most common skin lesions known to contain small white or yellow structures called milia‐like cysts (MLCs). Varied appearances can sometimes make it difficult to differentiate benign lesions from malignant lesions such as melanoma, the deadliest form of skin cancer found in humans.

Objective  The purpose of this study was to determine the statistical occurrence of MLCs in benign vs. malignant lesions.

Methods  A medical student with 10 months experience in examining approximately 1000 dermoscopy images and a dermoscopy‐naïve observer analysed contact non‐polarized dermoscopy images of 221 malignant melanomas and 175 seborrheic keratoses for presence of MLCs.

Results  The observers found two different types of MLCs present: large ones described as cloudy and smaller ones described as starry. Starry MLCs were found to be prevalent in both seborrheic keratoses and melanomas. Cloudy MLCs, however, were found to have 99.1% specificity for seborrheic keratoses among this group of seborrheic keratoses and melanomas.

Conclusion  Cloudy MLCs can be a useful tool for differentiating between seborrheic keratoses and melanomas.
Southward Pleistocene migration of Douglas‐fir into Mexico: phylogeography, ecological niche modeling, and conservation of ‘rear edge’ populations
Authors: Gugger Paul F. , González‐Rodríguez Antonio , Rodríguez‐Correa Hernando , Sugita Shinya , Cavender‐Bares Jeannine
Published: November 2010

See also the Commentary by Eckert
Alterations in white matter pathways in Angelman syndrome
Authors: PETERS SARIKA U , KAUFMANN WALTER E , BACINO CARLOS A , ANDERSON ADAM W , ADAPA PAVANI , CHU ZILI , YALLAMPALLI RAGINI , TRAIPE ELFRIDES , HUNTER JILL V , WILDE ELISABETH A
Published: December 2010

Aim  Angelman syndrome is a neurogenetic disorder characterized by severe intellectual disability, absent speech, seizures, and outbursts of laughter. The aim of this study was to utilize diffusion tensor imaging (DTI) to examine alterations in white matter pathways in Angelman syndrome, with an emphasis on correlations with clinical severity.

Method  DTI was used to examine the arcuate fasciculus (AF), uncinate fasciculus (UF), inferior longitudinal fasciculus (ILF), inferior fronto‐occipital fasciculus (IFOF), and the corpus callosum (CC). We enrolled 14 children aged 8 to 17 years (mean age 10y 8mo; SD 2y 7mo) with Angelman syndrome (seven male; seven female) and 13 typically developing children, aged 8 to 17 years, for comparison (five male; eight female; mean age 12y; SD 2y 9mo). Individuals with Angelman syndrome were assessed using standardized measures of development, language, and behaviour.

Results  The children with Angelman syndrome exhibited lower fractional anisotropy and increased radial diffusivity values than the comparison group for the AF, UF, ILF, and CC (p<0.006 corrected for multiple comparisons). They also had lower fractional anisotropy values for the IFOF and higher radial diffusivity values for the left IFOF (p<0.006). Additionally, children with Angelman syndrome had significantly higher apparent diffusion coefficient values in the AF, CC, ILF, and the left IFOF (p<0.006). Significant correlations were noted between DTI parameters and some of the clinical assessment outcomes (e.g. language, socialization, cognition) for three of the temporal pathways (AF, UF, ILF; p<0.05).

Interpretation  Changes in DTI parameters in individuals with Angelman syndrome suggest decreased/delayed myelination, decreased axonal density or diameter, or aberrant axonal organization. Our findings suggest a generalized white matter alteration throughout the brain in those with Angelman syndrome; however, only the alterations in temporal white matter pathways were associated with language and cognitive and social functioning.
A Controller for a Miniature Intra‐Aortic Ventricular Assist Device
Authors: Hsu Po‐Lin , Bruch Julius , McMahon Richard
Published: November 2010

Two control algorithms have been developed for a minimally invasive axial‐flow ventricular assist device (VAD) for placement in the descending aorta. The purpose of the device is to offload the left ventricle and to augment lower body perfusion in patients with moderate congestive heart failure. The VAD consists of an intra‐aortic impeller with a built‐in permanent magnet rotor and an extra‐aortic stator. The control algorithms, which use pressure readings upstream and downstream of the VAD to determine the pump status, have been tested in a mock circulatory system under two conditions, namely with or without afterload sensitivity. The results give an insight into controller design for an intra‐aortic blood pump working in series with the heart.
Tax Limits and Housing Markets: Some Evidence at the State Level
Authors: Hoyt William H. , Coomes Paul A. , Biehl Amelia M.
Published: December 2010

Property tax limitations, as well as other tax and expenditure restrictions on state and local governments in the United States, date back to the late 19th century. A surge in property tax limitation legislation occurred in the late 1970s and early 1980s, and its effects on government revenue, school financing and educational quality have been studied extensively. However, there is surprisingly little literature on how property tax limits affect housing markets. For the first time, we examine the impacts of property tax limitations on housing growth, in addition to their impacts on housing prices. Using state‐level data over 23 years, we find that property tax limits increase housing prices (indexes) by approximately 2%. Property tax limits appear to have little impact on the growth in the housing stock, but education spending limits reduce the number of building permits by over 6%. Our indirect evidence suggests that the number of housing units may grow when property tax limits are accompanied by increases in other own‐source revenues to state government.
Electronic Collaboration: Using Technology to Solve Old Problems of Quality Care
Authors: Baumlin Kevin M. , Genes Nicholas , Landman Adam , Shapiro Jason S. , Taylor Todd , Janiak Bruce
Published: December 2010

The participants of the Electronic Collaboration working group of the 2010 Academic Emergency Medicine consensus conference developed recommendations and research questions for improving regional quality of care through the use of electronic collaboration. A writing group devised a working draft prior to the meeting and presented this to the breakout session at the consensus conference for input and approval. The recommendations include: 1) patient health information should be available electronically across the entire health care delivery system from the 9‐1‐1 call to the emergency department (ED) visit through hospitalization and outpatient care, 2) relevant patient health information should be shared electronically across the entire health care delivery system, 3) Web‐based collaborative technologies should be employed to facilitate patient transfer and timely access to specialists, 4) personal health record adoption should be considered as a way to improve patient health, and 5) any comprehensive reform of regionalization in emergency care must include telemedicine. The workgroup emphasized the need for funding increases so that research in this new and exciting area can expand.

ACADEMIC EMERGENCY MEDICINE 2010; 17:1312–1321 © 2010 by the Society for Academic Emergency Medicine
Expression of midkine and endoglin in breast carcinomas with different immunohistochemical profiles
Authors: LI QIN LI , LIAN HUANG HUI , LIANG PING JIN , XU WEI , LI JING , CHENG DAI LI
Published: December 2010

Li LQ, Huang HL, Ping JL, Xu W, Li J, Dai LC. Expression of midkine and endoglin in breast carcinomas with different immunohistochemical profiles, APMIS 2010; 119: 103–110.

The aim of this study was to investigate the midkine and endoglin expression in breast carcinomas with five different immunohistochemical profiles and their relevance to histopathologic and clinicopathologic features. We analyzed 161 archival tissues immunohistologically. The level of midkine expression in breast cancer significantly correlated with lymph node metastasis (p = 0.001) and TNM staging (p = 0.003). High microvessel density (MVD) was associated with higher midkine reactivity group (p = 0.036). Although the basal‐like subtype had higher midkine expression level and MVD, no significant difference with the other breast cancer subtypes was found. In conclusion, midkine was a promising target for tumor prognosis in clinical diagnosis and treatment. This study found no significant differences in tumor angiogenesis in different molecular subtypes of breast cancer.