bluuebunny/crossref_metadata_2025 huggingface dataset:
Geochemical evidence of aeolian deposits in European soils
Authors: Scheib Andreas J. , Birke Manfred , Dinelli Enrico ,   GEMAS Project Team
Published: June 2013

Hafnium (Hf) and zirconium (Zr) concentrations measured in over 4100 agricultural soil samples from Europe were assessed with the focus on their relationship to the distribution of aeolian deposits, such as loess and coversands. Comparison of extractable (aqua regia; ICP‐MS) and total (XRFS) concentrations shows that only 1.0 to 1.7% of the total Hf and Zr is chemically extractable because of the resistant nature of their host minerals. Resistate minerals, such as zircon, are commonly found in the predominantly silty fraction of loess deposits. In this study a statistical analysis of total Hf and Zr soil data from areas with and without loess was carried out to derive threshold values of 10 mg kg−1 (Hf) and 318 mg kg−1 (Zr). These values were subsequently applied across the project area in an attempt to indicate the presence of aeolian deposits. The spatial distribution of above‐threshold concentrations suggests a more extensive and coherent loess belt across central and eastern Europe, providing additional evidence of loess across Brittany, Aquitaine and near the Vosges mountains in France as well as in the basins of central and northern Spain. Above‐threshold concentrations were also detected in loess regardless of its thickness, emphasising the importance of the abundance of zircon in the upper part of the soil profile rather than the actual thickness of the deposit. Soil data however, failed to indicate various loess facies within most of the Pannonian Basin, suggesting that this approach only works where deposits contain a sufficient amount of zircon. This may also explain why the extensive coversands across northern Germany and Poland were largely undetected. This study demonstrates that continental‐scale soil geochemical data can help identify and map the distribution of zircon‐rich loess and coversand, and subsequently enhance and improve current knowledge of the extent of these deposits.
Management Innovation in Focus: The Role of Knowledge Exchange, Organizational Size, and IT System Development and Utilization
Authors: Černe Matej , Jaklič Marko , Škerlavaj Miha
Published: June 2013

This study aims to examine the correlates of management innovation at the organizational level. We propose that internal knowledge exchange acts as a crucial predictor of management innovation. To fine‐tune the link between knowledge exchange and management innovation, we examine the mediating explanatory mechanism of IT system development and utilization, as well as the moderating boundary role of organizational size. In an attempt to find generalizable patterns across cultures, we test the model using mediated and moderated hierarchical regression analysis on data gathered from 604 firms in three countries: Slovenia, Spain, and South Korea. The results in all three samples indicate that knowledge exchange is an important correlate of management innovation. In addition, our study provides evidence that knowledge exchange results in management innovation through developed and utilized IT systems that enable information and knowledge to flow within an organization. We also find that the relationship between knowledge exchange and management innovation is hindered by firms' size.
Species diversity and community structure of rove beetles (Coleoptera: Staphylinidae) attracted to dung of sika deer in coniferous forests of southwest Japan
Authors: Yamamoto Shuhei , Ikeda Koichi , Kamitani Satoshi
Published: June 2013

Insect communities of mammal dung have been known as excellent model ecosystems for scientific study. Ecological surveys of diversity and seasonal patterns of coprophilous rove beetles in relation to wild mammals have rarely been conducted, although the high potential species diversity and abundance of the rove beetles are known. In order to investigate biodiversity of these beetles, we analyzed species composition, abundance, feeding guild and seasonality of rove beetles that were attracted to sika deer Cervus nippon dung by using dung‐baited pitfall traps for a 1.5‐year study in two plantations (cypress, cedar) and one secondary natural forest (pine) in Fukuoka Prefecture, southwest Japan. Consequently, saprophagous Anotylus sp. (Oxytelinae) was dominant in all forests. Analyses of feeding guild structure showed the number of individuals were dominated by saprophagous beetles, but the number of species were dominated by predatory beetles. Seasonal effects suggested that the species richness and abundance of rove beetles are possibly regulated by scarabaeoid dung beetles. These findings feature one example of a coprophilous rove beetle community.
Hierarchical population structure and genetic diversity of lake trout (Salvelinus namaycush) in a dendritic system in Northern Labrador
Authors: McCracken Gregory R. , Perry Robert , Keefe Donald , Ruzzante Daniel E.
Published: June 2013

Freshwater systems are ideal for landscape genetics studies; they generally exhibit asymmetry in gene flow with populations arranged in a hierarchical, dendritic fashion. Such gene flow asymmetry has the potential to influence the distribution of genetic variation, with downstream populations typically exhibiting higher genetic diversity than headwater populations.

Lake trout (Salvelinus namaycush) are widely distributed throughout temperate North America. We examined the relationship between landscape attributes, molecular genetic diversity and differentiation among lake trout populations inhabiting a hierarchically structured freshwater system in northern Labrador (the Kogaluk River drainage). Lake trout (N = 567) collected from ten lakes in this drainage were examined for polymorphism at 12 microsatellite loci. The lakes differed in connectivity, size, elevation and position within the Kogaluk catchment.

We observed relatively high levels of population structure and little migration among lakes. Waterfalls were identified as a factor contributing to the observed differentiation.

Although a preliminary analysis suggested an isolation‐by‐distance pattern, a subsequent decomposed pairwise regression analysis allowed the identification of outlier lakes. Removal of these outlier lakes and of one other headwater lake, isolated from the rest by several waterfalls, led to the disappearance of the isolation‐by‐distance pattern, suggesting very little or no migration among lakes despite migration being physically possible.

Estimates of effective population size correlated with lake area but did not differ between headwater and downstream populations, nor was there a relationship with elevation, a result consistent with the evidence of very little to zero gene flow among lakes.

Our study is the first to describe patterns of genetic diversity among lake trout populations inhabiting a spatially fragmented system in an ecologically pristine and sensitive area of northern Canada, the barren grounds of northern Labrador.
Long‐wave infrared radiation reflected by compression stockings in the treatment of cellulite: a clinical double‐blind, randomized and controlled study
Authors: Bagatin E. , Miot H. A. , Soares J. L. M. , Sanudo A. , Afonso J. P. J. M. , de Barros Junior N. , Talarico S.
Published: June 2013

Synopsis

Background

Cellulite refers to changes in skin relief on the thighs and buttocks of women, with a prevalence of 80–90%, causing dissatisfaction and search for treatment. Etiopathogenesis is multifactorial, as follows: herniation of the hypodermis towards the dermis, facilitated by perpendicular fibrous septa, changes in the dermal extracellular matrix, decreased adiponectin, genetic polymorphism, microcirculation alterations and inflammatory process. There are numerous therapeutic approaches, with little evidence of effectiveness. The long‐wave infrared (LWIR) radiation interacts with water, improves microcirculation and stimulates metabolic processes. To date, the use of tissues with potential reflection of LWIR radiation has not been systematically investigated as adjuvant treatment for cellulite.

Objective

To investigate the efficacy and safety of the treatment of cellulite through the use of compression stockings made with thread reflecting LWIR radiation.

Patients and methods

Clinical study of therapeutic intervention, controlled and double‐blind, including 30 women, aging from 25 to 40 years, with cellulite of grades II and III on the thighs and buttocks who used compression stockings, “pantyhose” model, made with reflector thread of LWIR radiation, on only one randomized side. Women under other treatments for cellulite and with venous and/or blood insufficiencies were excluded. Evaluation of efficacy by clinical parameters, photographs, Dermatology Life Quality Index (DLQI), cutometry and high frequency ultrasonography and security by observation of adverse events and venous EcoDoppler recordings.

Results

DLQI scores showed significant reduction; the two‐dimensional high‐frequency ultrasonography showed an insignificant increase in dermal echogenicity as well as other efficacy parameters demonstrated no or slight improvement, with no differences between the sides exposed or not to LWIR; and there were no severe adverse events.

Conclusion

Compression stockings, with or without thread reflector of LWIR, showed slight effects in the appearance of cellulite, but the treatment determined a positive impact on women quality of life.
Jonathan Edwards on the Atonement
Authors: Hamilton S. Mark
Published: June 2013

Evidence suggests Jonathan Edwards' adherence to a version of the penal substitution theory of atonement. Evidence also suggests that Edwards' version of the penal substitution theory requires certain metaphysical commitments about the nature of Christ's relationship to the elect, echoing those issued in his Original Sin 4.3, and elsewhere, regarding the relationship of Adam to his posterity. In what follows, I argue that such evidence points to Edwards' adherence to what has more recently been described in the literature of contemporary philosophical theology as an account of realist penal substitution.
The return to hospitality
Authors: CANDEA MATEI , DA COL GIOVANNI
Published: June 2013

Anthropology has been largely absent from the recent explosion of interdisciplinary enthusiasm with hospitality across philosophy, political science, and cultural studies. Yet anthropology's living engagement with hospitality has been far deeper than that of any other discipline. This essay, which introduces the volume, aims to revitalize hospitality as a frontier area of theoretical development in anthropology by highlighting the topic's connections to some of our discipline's most vibrant themes and concerns: ethical reasoning, materiality, temporality and affect, alterity and cosmopolitics, sovereignty and scale.

L'anthropologie a été la grande absente du récent engouement interdisciplinaire pour l'hospitalité qui a fédéré philosophie, politologie et études culturelles. Son engagement concret sur cette question est pourtant beaucoup plus profond que celui de toute autre discipline. Le présent essai, qui préface le volume, vise à raviver l'hospitalité en tant que zone frontière du développement théorique en anthropologie, en mettant en lumière ses liens avec certains des thèmes les plus vivants de notre discipline : raisonnement éthique, matérialité, temporalité et affect, altérité et cosmopolitique, souveraineté et échelle.
Parasitic Chinese, vengeful Russians: ghosts, strangers, and reciprocity in Mongolia
Authors: DELAPLACE GRéGORY
Published: June 2013

This paper considers stories of haunting by ghosts of a foreign origin that have been circulating lately in the capital city of Mongolia, Ulaanbaatar. These narratives, it is argued, depict Chinese and Russian people as very different kinds of strangers, defined by contrastive regimes of relationship with their host. Contrary to Russians, who are still remembered – rightly or not – as great providers, Chinese people are pictured in these stories as some kind of parasites, who constantly take from Mongolian land and never give anything in return.

L'auteur examine ici les histoires de fantômes d'origine étrangère qui circulent depuis quelque temps dans la capitale de la Mongolie, Oulan‐Bator. Ces récits dépeignent les Chinois et les Russes comme des étrangers relevant de deux sortes, différenciées par des modes de relations avec l'hôte différents. À la différence des Russes, dont les Mongols gardent encore, à tort ou à raison, le souvenir d'un peuple qui leur a apporté beaucoup, ces histoires décrivent les Chinois comme des espèces de parasites qui passent leur temps à s'approprier la terre des Mongols sans rien donner en retour.
Multiple Pilomatricomas and Myotonic Dystrophy
Authors: STREET MARCY L. , ROGERS ROY S.
Published: June 2013

Multiple pilomatricomas are rare. However, amongpatients‘with myotonic dystrophy, the occurrence is higher. The authors report a patient, to their knowledge the 11th case of multiple pilomatricomas associated with myotonic dystrophy, to emphasize that these tumors may be associated with the disease.
Use of the Argon‐Pumped Tunable Dye Laser for Port‐wine Stains in Children
Authors: SCHEIBNER ADRIANNA , WHEELAND RONALD G.
Published: June 2013

The authors reported previously a new technique using a low power argon‐pumped tunable dye laser at a wavelength of 577nm (yellow light) to treat port‐wine stains in adults. The authors report their results using this same technique as a form of treatment for 92 children with facial port‐wine stains.
CASE REPORT: Proliferating Trichilemmal Tumor: Report of a Case and Review of the Literature
Authors: LAING VALERIE , KNIPE RONALD C. , FLOWERS FRANKLIN P. , STOER CHARLES B. , RAMOS‐CARO FRANCISCO A.
Published: June 2013

The authors report a case of proliferating trichilemmal tumor and review the related literature. Although considered biologically benign, malignant proliferating trichilemmal tumor have been reported. The authors emphasize the importance of recognizing that the tumors can occur in individuals in their 20s and 30s, and that the tumors should be excised with a margin of normal tissue. Routine follow‐up is recommended.
Tumors of the Nail Unit
Authors: SALASCHE STUART J. , ORENGO IDA F.
Published: June 2013

Tumors of the nail unit are often initially misdiagnosed or diagnosed later in their course than their skin counterparts. This is probably because the nail can obscure the lesion or many nail tumors mimic inflammatory dermatoses of the nail unit. Both benign and malignant tumors of the nail unit are described.
Deoxyribonucleic Acid (DNA) Ploidy and Proliferative Characteristics of Metastatic Squamous Cell Carcinoma Determined by Flow Cytometric Analysis
Authors: PAPPAS ALEX A. , MANERS ANN W. , OWENS REBECCA B. , THOMPSON JENNIFER R. , KING JOHN C. , DINEHART SCOTT M.
Published: June 2013

background
: The deoxyribonucleic acid (DNA) index and the proliferative index (the fraction of cells in the S phase) can be independent prognostic indicators of the biologic aggressiveness of certain malignant neoplasms.

objective
: To determine whether the DNA index or proliferative index could predict metastases in cutaneous squamous cell carcinoma.

methods
: Nineteen different metastases from 15 patients with primary cutaneous squamous cell carcinoma (SCC) were reviewed, graded, and had DNA proliferative indexing performed by fluorescent activated cytometry. A control group of 13 patients with primary cutaneous SCC without metastases were studied in a similar manner.

results
: No significant difference between the metastatic and the nonmetastatic SCC groups for either DNA index or proliferative index (non‐paired t‐test) was observed. No correlative association with histologic grading with DNA index or proliferative index was observed for either group.

conclusion
: We conclude that aneuploidy and S‐phase fraction by fluorescent activated cytometry are not significant predictors of potential metastases in cutaneous squamous cell carcinoma. J Dermatol Surg Oncol 1992;18:957–960.
Microlipoinjection for the Elevation of Depressed Full‐Thickness Skin Grafts on the Nose
Authors: HAMBLEY RICHARD M. , CARRUTHERS J. ALASTAIR
Published: June 2013

background
: Full‐thickness skin grafts on the dorsum of the nose may heal depressed and might benefit from elevation. Microlipoinjection has been used to elevate depressed tissue; however, the long‐term persistence of the augmentation is questioned.

objective
: To determine whether microlipoinjection beneath depressed full‐thickness grafts on the dorsum of the nose can provide effective and persistent graft elevation.

methods
: Microlipoinjection was performed at one to three sessions under depressed full‐thickness skin grafts on the nose of four patients. Their appearance was assessed clinically and photographically for the amount of correction at their last postmicrolipoinjection visit.

results
: All four patients had clinically significant elevation of their full‐thickness skin graft. In the two patients followed for over 3 years, significant augmentation persisted.

conclusion
: Microlipoinjection can provide cosmetically useful soft tissue augmentation under depressed full‐thickness skin grafts; this augmentation can persist. J Dermatol Surg Oncol 1992;18:963–968.
Treatment of Chronic Erosions of Junctional Epidermolysis Bullosa with Human Epidermal Allografts
Authors: HILL JEROME C. , GRIMWOOD RONALD E. , PARSONS DAVID S.
Published: June 2013

We have successfully treated chronic central facial erosions of a patient with junctional epidermolysis bullosa using cultured epidermal allografts. Keratinocytes isolated from a skin biopsy of the patient's biological mother were used to generate the epidermal allografts. Significant re‐epithelialization occurred during the course of four grafting procedures. Cultured epidermal allografts appear to be a promising method for treatment of chronic erosions of junctional epidermolysis bullosa.
An Automatic Computerized Bipolar Coagulator for Dermatologic Surgery
Authors: BERGDAHL BJÖRN , STENQUIST BO
Published: June 2013

BACKGROUND. The problem with all bipolar diathermy equipment is the adherence of the tissue to the prongs of the forceps.

OBJECTIVE and METHODS. We describe a new computerized bipolar coagulator (Coa‐Comp/M) with electronic feedback of the tissue impedance that automatically starts and shuts off coagulation thus preventing overheating, undue tissue damage and sticking of the forceps. The fully automation implies that no footswitch or handcontrol is necessary. The coagulator was tested during 2 years in advanced dermatologic surgery.

RESULTS. A log memory recorded the number of coagulations according to effect and coagulation time. A power setting of 16W was appropriate for effective coagulation of most vessels; 99% of the coagulations were faster than 1.3 seconds necessitating automatic control for preventing sticking and charring.

CONCLUSIONS. The automatic bipolar coagulator saves time and avoids sticking of the forceps. It is a useful tool in dermatologic surgery demanding repeated coagulations for hemostasis.
The Effect of Pre‐Education on Patient Compliance with Full‐Body Examination in a Public Skin Cancer Screening
Authors: LEFFELL DAVID J. , BERWICK MARIANNE , BOLOGNIA JEAN
Published: June 2013

background. Public skin cancer screening has become increasingly common in recent years. However, currently there is no standardized procedure for these screenings. Full body skin examination as opposed to examination of sun‐exposed areas offers several advantages, including the opportunity to diagnose early melanoma in areas normally covered by clothing. Disadvantages of full body skin examination include patient resistance because of inconvenience and concerns about privacy and modesty. The additional time involved in full body skin examination may also be an impediment.

objective. In a randomized double‐armed study, we studied whether patients were more likely to develop a positive attitude towards full body skin examination if they were advised beforehand, in writing, of the logic underlying the need for a complete examination.

methods. Patients presenting to a public skin cancer screening were divided into two groups. Group A (N = 111) received a written explanation of the need for full body skin examination and Group B (N = 175) received no information. Patients were then surveyed, after the screening, about their attitudes towards full body skin examination.

results. Those who received pre‐education were less likely (P < .05) to be concerned about a genital examination. Those who were concerned about a genital exam were compared with those who were not concerned about a genital exam, the former patients were: 1) younger (P < .05); 2) more concerned about privacy (P < .001); and 3) preferred a physician of the same sex (P < .001).

conclusion. Providing patients with information about the need for full body skin examination decreases concern about undergoing a skin genital exam and may minimize resistance to full body skin examination in public skin cancer screenings.
Venous Ulceration
Authors: FALANGA VINCENT
Published: June 2013

background. In the last few years, interest in the pathogenesis and treatment of venous ulceration has been rekindled by novel observations in fibrinolysis and an explosive growth in wound care products, respectively.

objective. The purpose of this work is to summarize the salient clinical features of venous ulceration, its proposed pathogenesis, and conventional as well as future treatment modalities.

RESULT. Venous ulceration is an increasingly common condition. Its pathogenesis is related to failure of the calf muscle pump, and treatment is directed at effective leg compression, avoidance of contact dermatitis, and proper wound care.

conclusion. There is increased interest in both the pathogenic steps involved in venous ulceration and in treatment modalities. We suspect that incremental progress will occur in these areas in the next few years.
Topical Hyperbaric Therapy for Problem Skin Wounds
Authors: HENG MADALENE C.Y.
Published: June 2013

background. Hyperbaric oxygen remains the sole treatment capable of inducing growth of new blood vessels. However, systemic hyperbaric oxygen therapy risks central nervous system and pulmonary toxicity.

objective. To describe topical hyperbaric oxygen therapy for the treatment of recelcitrant open wounds.

methods. Topical and systemic hyperbaric oxygen treatments are described and contrasted from one another. Applications of topical hyperbaric oxygen therapy are described.

conclusion. Topical hyperbaric oxygen therapy is useful only for open wounds. The advantages of topical hyperbaric oxygen therapy include low cost, the lack of systemic oxygen toxicity, and effectiveness, allowing this treatment to be prescribed for many patients early in the course of their disease rather than as a last resort.
Pooled Analysis of the Efficacy of Bacille Calmette‐Guerin (BCG) Immunotherapy in Malignant Melanoma
Authors: TAN JERRY K. L. , HO VINCENT C.
Published: June 2013

BACKGROUND. The trials of bacille Calmette‐Guerin (BCG) as adjuvant therapy in malignant melanoma conducted over the preceding 2 decades have presented conflicting claims of efficacy.

OBJECTIVE. Determination of the role of BCG immunotherapy in malignant melanoma.

METHODS. Critical analysis of randomized clinical trials of stage I and II melanoma and all reported trials of intralesional and oral BCG in stage III melanoma was conducted. A literature search used the Medline data base (1966–1992);bibliographic reviews of relevant texts and pertinent articles.

RESULTS. No significant benefit of BCG as postsurgical adjuvant therapy in stage I malignant melanoma was observed. Although two of seven trials in stage II melanoma demonstrated benefit with the addition of BCG, the trial with the greatest power in this series detected no difference in outcomes. In stage III malignant melanoma, there was no significant benefit with addition of BCG to various chemotherapeutic regimens. Oral BCG monotherapy produced complete responses in 6%, partial responses in 1%, and extended survival in 7% of patients. Objective responses were observed primarily in patients with intracutaneous non‐visceral metastases. Pooled analysis of 15 non‐controlled trials of intralesional BCG injections revealed complete responses in 19%, partial responses in 26%, and extended survival in 13% of patients with stage III melanoma. Objective responses to intralesional BCG were more likely in patients with solely cutaneous metastases, particularly intradermal lesions.

CONCLUSION. Pooled analysis of non‐placebo controlled trials of intralesional BCG for stage III malignant melanoma supports a trend to enhanced survival in patients with cutaneous non‐visceral metastases.
Comparison of Skin Hooks and Foley Catheters for Immediate Tissue Expansion
Authors: AULETTA MICHAEL J. , MATARASSO SETH L. , GLOGAU RICHARD G. , TROMOVITCH THEODORE A.
Published: June 2013

BACKGROUND. Immediate tissue expansion has been reported to expand skin sufficiently to permit primary closure of large facial defects up to 5 cm in diameter.

OBJECTIVE. We wished to evaluate and compare skin hooks with foley catheters in producing tissue expansion.

METHODS. Seven patients with post‐Mohs surgery defects measuring 3.0 to 5.5 cm in diameter and located on scalp, temple, or forehead skin were treated with immediate tissue expansion.

RESULTS. Immediate tissue expansion provided a 16 to 36% increase in the tissue available for closure, over and above what was achieved by undermining alone. In each case, adequate stretching of skin was achieved to permit primary closure relatively easily, which was not possible with undermining alone. Skin hooks were found to be equivalent to foley catheters in their ability to produce tissue expansion. At the one year follow‐up visit, some spreading of the scar was noted, ranging from 1 to 7 mm, which appears in part to be related to the degree to which the skin was expanded.

CONCLUSION. These findings support the concept that immediate tissue expansion is a separate and distinct process from undermining, which provides additional tissue for reconstructive surgery.
Advanced Use of Tissue Adhesive in Hair Transplantation
Authors: ELLIOTT ROBERT M. , THOMAS ROBERT A. , TRUE ROBERT H.
Published: June 2013

BACKGROUND. Cobblestoning is an unsightly result of graft elevation in the recipient site after hair transplantation.

OBJECTIVE. To describe the use of tissue adhesives for the avoidance of cobblestoning.

RESULTS. The long‐term cosmetic appearance of hair transplants may be improved through the use of cyanoacrylate adhesives in the grafting process. The major contribution of the adhesive is the virtual elimination of the common problem of graft elevation or cobblestoning, which produces an unsightly bumpiness in the recipient area. The choice of type of adhesive and the method of application are central to successful use of this technique.

CONCLUSION. The indirect benefits of elimination of the need for postoperative bandages and restrictions in activities couple with the cosmetic results to produce a high degree of patient satisfaction.
Establishing the Physician‐Patient Relationship
Authors: TORRES ABEL , WAGNER RICHARD
Published: June 2013

background.This is the first in a series of articles written to address the many medicolegal issues that impact the practice of dermatology. The topic of establishing the physician‐patient relationship was chosen as the starting point since it is the cornerstone of every medical malpractice action.

methods.A format of an initial discussion of legal concepts followed by hypotheticals and a review of actual cases was chosen to enhance interactive learning. The subject matter is based on a review of medicolegal literature and actual recorded case law.

results.A physician‐patient relationship may be established whether or not there is actual physical contact between the physician and patient, there is gratuitous advice, or there is an academic purpose.

conclusion.The key in determining whether a physician‐patient relationship has been established is whether the patient reasonably relied upon advice given or had an expectation of treatment.
Laser Hair Transplantation
Authors: Unger Walter P. , David Laurence M.
Published: June 2013

background. A new ultrapulse CO2 laser has been investigated for its possible use in hair transplanting. This laser, because of its ultrashort high energy pulses, produces far less thermal damage to adjacent tissues, including hair follicles, than earlier types of CO2 lasers. The potential advantages of using such a laser in minigrafting are reviewed and include less bleeding, greater density, and absence of “compression.”

objective. The purpose of this study was to see if hair survival in grafts placed into laser‐prepared sites would be as good or better than that seen with scalpel slits.

methods. Hair counts were used in 10 patients to compare hair survival in grafts placed into laser‐prepared sites and into scalpel‐prepared sites in a comparable but contralateral location.

results. Average graft hair counts were greater in laser‐prepared sites in four of 10 patients, equal to grafts in scalpel‐prepared sites in five, and fewer in one. Hair growth occurred earlier in laser‐prepared sites in five of the 10 patients.

conclusion. The authors are optimistic that the ultrapulse laser will become an important tool in hair transplanting.
Management of a Hidradenoma with Mohs Micrographic Surgery
Authors: HOUSE NANCY S. , HELM KLAUS F. , MALONEY MARY E.
Published: June 2013

background. Hidradenomas are adnexal tumors that may grow to be very large and frequently recur after excision. Malignant transformation and metastatic spread can occur and histologic distinction of benign from malignant hidradenomas can be very difficult. Some tumors with bland histology have demonstrated aggressive behavior.

objective. To decide the benefits of management with Mohs micrographic surgery of large hidradenomas.

methods. The literature was reviewed, including both the clinical course of the tumor and histologic features. The case of our report was interpreted in light of the review.

results. Three stages of Mohs surgery were required for complete removal of the hidradenoma. The patient remains free of recurrence.

conclusions. This report highlights the difficulties in distinguishing benign from malignant hidradenomas and emphasizes the benefits of Mohs surgery for large or recurrent tumors.
The Treatment of Multiple Angiolipomas by Liposuction Surgery
Authors: KANEKO TAKEHIKO , TOKUSHIGE HIROYUKI , KIMURA NAOHIRO , MORIYA SHUJI , TODA KIYOSHI
Published: June 2013

background. Recently, liposuction surgery has been widely accepted for body contouring or other noncosmetic applications, including lipoma and angiolipomatosis.

objective. We treated a case of multiple angiolipomas at 49 years of age to confirm the Utility of liposuction.

methods. Liposuction under general anesthesia was performed for angiolipomas distributed over the trunk.

results. The patient has been followed for 2 years without recurrence.

conclusion. We believe that liposuction is a safe and easy method of removing multiple angiolipomas.
Spindle Cell Hemangioendothelioma
Authors: ELTORKY MAHMOUD , CHESNEY THOMAS McC. , SEBES JENO , HALL J. CAMERON
Published: June 2013

background. Spindle cell hemangioendothelioma lesions are uncommon, affect a wide age range in both sexes, and show a predilection for skin and subcutaneous tissue of the extremities.

objective. To present three cases of spindle cell hemangioendothelioma and review the literature.

methods. Three cases of spindle cell hemangioendothelioma are presented.

results. Two of our cases first presented very early in life and progressed by local recurrences over many years. None of our cases showed evidence of metastases, but the lesions exhibited local aggressive and invasive behavior. Histologically, the lesions consist of alternating areas of dilated, thin walled cavernous vascular spaces and solid areas composed predominantly of spindle cells and clusters of epithelioid endothelial cells with intracytoplasmic vacuoles. That spindle cell hemangioendothelioma is a non‐neoplastic lesion and not a neoplasm of borderline malignancy is suggested by the following observations from our cases: the repeated presence of organized intravascular thrombi in all cases, the early clinical presentation in two cases, and the presence of some degree of vascular malformation at the periphery of lesions.

conclusion. Both clinicians and pathologists should be aware of the existence of this lesion in order to diagnose and treat an affected patient correctly.
Aquaplast Thermoplastic (Opti‐Mold)
Authors: FISH FREDERICK S. , HILGER PETER A.
Published: June 2013

Aquaplast thermoplastic (Opti‐Mold), a unique moldable “tie‐down” dressing, can be heated, shaped, and sutured in place over full‐thickness skin grafts. It allows for excellent uniform pressure over a skin graft while also allowing for drainage from the graft bed, and is particularly useful for the contoured surfaces of the nose and ears.
The Bipedicle Flap Revisited
Authors: FLINT IVAN D. , SIEGLE RONALD J.
Published: June 2013

background
. There is little written in dermatologic literature on bipedicle advancement flaps.

objective
. In this paper we review the technique, case examples (many of which have not been described in the literature), benefits, and disadvantages of the bipedicle flap.

conclusions
. We believe the bipedicle flap to be a much under‐used flap in superficial soft tissue reconstruction. We suggest that this flap be actively considered as a reconstructive option for a variety of defects on multiple body sites.
Benzyl Alcohol Attenuates the Pain of Lidocaine Injections and Prolongs Anesthesia
Authors: WILLIAMS JOHN M. , HOWE NATHAN R.
Published: June 2013

background. Benzyl alcohol is reported to be painless on injection and to provide limited dermal anesthesia. Benzyl alcohol has also been recommended as an adjuvant to lidocaine to reduce lidocaine's injection pain. There is insufficient data on pain of injection and duration of anesthesia for lidocaine containing benzyl alcohol.

objective. We conducted a randomized, placebo‐controlled, double‐blinded comparison of intradermal 1% lidocaine with 0.86% benzyl alcohol and piain 1% lidocaine for pain of injection and duration of anesthesia.

methods. Twenty subjects received the above two agents plus normal saline with and without 0.9% benzyl alcohol, with all Solutions adjusted to 375 ± 13 mosm/L.

results. Lidocaine containing benzyl alcohol was 27% less painful upon injection and provided anesthesia 29% longer than piain lidocaine.

conclusion. Benzyl alcohol is itself an effective anesthetic and can reduce the pain of injection for lidocaine without adversely affecting its anesthetic properties.
Nonrecurrent Primary Basal Cell Carcinoma of the Lower Extremity with Late Metastasis
Authors: SIEGLE RONALD J. , WOOD THOMAS
Published: June 2013

background. Metastatic basal cell carcinoma (MBCC) is rare, with most cases of head and neck origin and from large multi‐recurrent tumors. MBCC is very rare from lower extremities and even more rare from primary tumors that were small and treated without local recurrence.

objective. This paper presents a case of MBCC in a 78‐year‐old woman who had previously undergone resection without local recurrence of a small lower extremity basal cell carcinoma.

conclusion. MBCC can present atypically with site of origin on lower extremities, initial tumor size small, and nonrecurrence of the primary tumor site. The clinician should be aware of this as well as understand that prompt and aggressive surgical therapy to localized metastases may extend survival
Insurance, Consumer Search, and Equilibrium Price Distributions
Authors: Akın Ş. Nuray , Platt Brennan C.
Published: June 2013

We examine a service market with two frictions: search is required to obtain price quotes, and insurance coverage for the service reduces household search effort. While fewer draws from a price distribution will directly raise a household's average price, the indirect effect of reduced search on price competition has a much greater impact, accounting for at least 89 percent of increased average expenditures. In this environment, a monopolist insurer will exacerbate the moral hazard by offering full insurance. A competitive insurance market typically results in partial insurance and significant price dispersion, yet a second‐best contract would offer even less insurance coverage.
Optimal Design of the Attribution of Pension Fund Performance to Employees
Authors: Müller Heinz , Schiess David
Published: June 2013

The article analyzes risk sharing in a defined contribution pension fund in continuous time. According to a prespecified attribution scheme, the interest rate paid on the employees' accounts is a linear function of the fund's investment performance. For each attribution scheme, the pension fund maximizes the expected utility and the employees derive utility from their savings accounts. It turns out that all Pareto‐optimal attribution schemes are characterized by the same optimal participation rate. We derive the total welfare gain that installs from replacing no participation with optimal participation. This welfare gain can be quantified and is substantial for reasonable parameter values.
Estimating Outstanding Claim Liabilities: The Role of Unobserved Risk Factors
Authors: Spierdijk Laura , Koning Ruud H.
Published: June 2013

This article proposes a new method for estimating claim liabilities. Our approach is based on the observation from contract theory that there is information asymmetry between the insurer and the policyholder about the risks incurred by the latter. We show that unobserved heterogeneity allows for a form of experience learning that can reduce this asymmetry, which makes it easier for the insurer to distinguish between high‐risk and low‐risk claimants. We evaluate our approach in the context of disability insurance for self‐employed and show that it results in more accurate best estimates of outstanding claim liabilities.
Comparison of seminal oxidants and antioxidants in subjects with different levels of physical fitness
Authors: Hajizadeh Maleki B. , Tartibian B. , Eghbali M. , Asri‐Rezaei S.
Published: June 2013

The purpose of this study was to evaluate the seminal 8‐Isoprostane, reactive oxygen species (ROS), malondialdehyde (MDA), superoxide dismutase (SOD), catalase, total antioxidant capacity (TAC) in subjects with different level of physical fitness. A total of 161 semen samples were obtained from three groups of healthy males, including elite athletes (23.8 ± 5.2 years, n = 56) who had regular training (4–5 days per week), recreationally active men (24.2 ± 4.9 years, n = 52) who participated in educational or recreational physical activities for 4–5 h per week and non‐active men (23.9 ± 5.0 years, n = 53) who did not participate in any exercise programmes for at least 6 months prior to the study. The results showed significantly higher levels of SOD, catalase and TAC as well as lower levels of 8‐Isoprostane, ROS and MDA in recreationally active men compared with either elite athletes or non‐active men (p < 0.001). Also, elite athletes revealed significantly higher seminal 8‐Isoprostane, ROS and MDA as well as lower SOD, catalase and TAC levels compared with recreationally active and non‐active men (p < 0.001). In conclusion, the results of the present study indicate that there are differences in seminal oxidants and antioxidants of elite athletes, recreationally active and non‐active men. These differences are more likely related to indices that favour decrement of oxidative stress‐induced peroxidative damage in spermatozoa from recreationally active men. Hence, recreationally active men seem to have a healthier semen production. The physiological significance of this observation is worthy of further investigation.
Growth hormone (GH) activity is associated with increased serum oestradiol and reduced Anti‐Müllerian Hormone in healthy male volunteers treated with GH and a GH antagonist
Authors: Andreassen M. , Frystyk J. , Faber J. , Kristensen L. Ø. , Juul A.
Published: June 2013

Growth hormone (GH) and insulin‐like growth factor I (IGF‐I) receptors are present on pituitary gonadotrophs and on testicular Leydig and Sertoli cells. Thus, the GH/IGF‐I system may modulate the pituitary‐gonadal axis in males. This is a randomized cross‐over study. Eight healthy male volunteers (mean age 35, range 29–46 years) were treated with GH for 3 weeks (1st week 0.01, 2nd week 0.02, 3rd week 0.03 mg/day/kg) or a GH receptor antagonist (Pegvisomant) (1st week 10, last 2 weeks 15 mg/day), separated by 8 weeks of washout. Before and after the two treatment periods, concentrations of luteinizing hormone (LH), follicle‐stimulating hormone, testosterone, oestradiol, sex hormone–binding globulin, inhibin B and Anti‐Müllerian Hormone (AMH) were measured. During GH treatment, IGF‐I increased [(median (IQR)] 166 (162–235) vs. 702 (572–875) μg/L, p < 0.001) together with oestradiol [(mean ± SD) 78 ± 23 vs. 111 ± 30 pm, p = 0.019], and the oestradiol/testosterone ratio (p = 0.003). By contrast, AMH (42 ± 14 vs. 32 ± 7 pm, p = 0.018), Inhibin B (211 (146–226) vs. 176 (129–204) ng/L, p = 0.059) and LH (3.8 ± 1.5 vs. 3.2 ± 1.2 U/L, p = 0.096) decreased. During pegvisomant treatment IGF‐I (204 (160–290) vs. 106 (97–157) μg/L, p = 0.001) and oestradiol (86 ± 28 vs. 79 ± 25 pm, p = 0.060) decreased. No significant changes or trends in the other reproductive hormones occurred during the two treatment regimens. GH/IGF‐I activity was positively associated with serum oestradiol, suggesting that GH/IGF‐I stimulates aromatase activity in vivo. As a novel observation, we found that high GH activity was associated with reduced levels of the Sertoli cell marker AMH. Further studies are needed to evaluate possible effects of GH on Sertoli cell function and/or spermatogenesis.
Europeanization of National Foreign Policy: The Case of Denmark's and Sweden's Relations with China
Authors: Michalski Anna
Published: June 2013

This article examines the link between constructed identity, socialization and interests in the Europeanization of national foreign policy. Theoretically, it contributes to the understanding of the conditions motivating Member States to have recourse to European Union (EU) opportunity structures in order to balance normative foreign policy interest with material interests. Empirically, the article contributes to understanding the influence of Europeanization on the foreign policy of Denmark and Sweden in their relations to China. It discusses perspectives on Europeanization of national foreign policy in the analysis of change in identity, institutions and policy, and explores the misfit thesis in relation to European identity construction and elite socialization, strategic calculation and the influence of alternative sources outside the EU. The research aims, study design and case selection are then presented prior to the analysis of the Europeanization of Denmark's and Sweden's relations with China.
Effect of vitamins, protein level and probiotics on immune response of moulted male broiler breeders
Authors: Khan R. U. , Rahman Z. U. , Javed I. , Muhammad F.
Published: June 2013

This study was planned to investigate the comparative effect of vitamins C (L‐ascorbic acid), E (DL‐α‐tocopherol acetate), probiotics, lower than normal protein level (14%) and combination of these treatments on immune response of male broiler breeders after zinc‐induced moulting. One hundred and eighty birds at the age of 65 weeks were induced to moult by mixing zinc oxide (ZnO) in feed at the rate 3000 IU/kg of feed. Upon completion of moulting, birds were divided into six groups (five replicates per group) in a completely randomized design and were fed vitamin C (500 IU/kg), vitamin E (100 IU/kg), lower protein level, probiotics (50 mg/l), and a combination of these components, while one group was kept as control. After completion of moulting phase (5 weeks), the treatment effects were tested as in vitro macrophages engulfment percentage, nitric oxide (NO) production, serum antibody titres against Newcastle disease (ND) and infectious bronchitis (IB). The results showed that in vitro macrophage engulfment percentage in unopsonized conditions was significantly higher in vitamin E‐supplemented group. In addition, in opsonized condition, the macrophage engulfment percentage was significantly higher in both vitamin E‐ and C‐supplemented groups. The NO (opsonized and unopsonized) production and antibody titre against ND and IB were significantly higher in vitamin E‐supplemented group. It was concluded that vitamin E is a better option for enhanced immune response in broiler breeders after zinc‐induced moulting.
Cerebral oedema is rare in acute‐on‐chronic liver failure patients presenting with high‐grade hepatic encephalopathy
Authors: Joshi Deepak , O'Grady John , Patel Amit , Shawcross Debbie , Connor Steven , Deasy Neil , Willars Chris , Bernal William , Wendon Julia , Auzinger Georg
Published: June 2013

Background & Aims

Acute‐on‐chronic liver failure (ACLF) has a rapidly progressive disease course associated with significant mortality. The prevalence of clinically significant cerebral oedema in ACLF is unknown.

Methods

We aimed to describe the prevalence of cerebral oedema in a cohort of ACLF adult (>18 years). We identified patients admitted to a single, specialist intensive care unit between January 2005 and January 2011 with high‐grade hepatic encephalopathy (≥3) and a clinical picture of either ACLF or chronic liver disease (CLD). Patients who had undergone cranial CT imaging were identified and their imaging reviewed. The ACLF and CLD groups were compared.

Results

One thousand and eight patients with CLD were admitted. One hundred and seventy‐three patients (110 male) underwent neuroimaging. Eighty‐one (48 male) fulfilled criteria for ACLF. Variceal bleeding (30%) and sepsis (31%) were the most frequent precipitants of ACLF. Of those with neuroimaging from the total cohort, 30% of CT scans were normal, 30% demonstrated increased cerebral atrophy for age, 17% small vessel disease and 16% intracranial haemorrhage (ICH). Cerebral oedema was seen in three patients with ACLF only. An increased prevalence of ICH was observed in the ACLF group (23% vs. 9%, P = 0.008).

Conclusion

The prevalence of clinically relevant cerebral oedema was low (4%) but fatal. Death was attributable to tonsillar herniation. An increased prevalence of ICH was seen in ACLF patients and remains an important differential.