bluuebunny/crossref_metadata_2025 huggingface dataset:
Detection of Premature Ventricular Contractions on a Ventricular Electrocardiogram for Patients With Left Ventricular Assist Devices
Authors: Park Sung Min , Lee Jin Hong , Choi Seong Wook
Published: April 2014

The ventricular electrocardiogram (v‐ECG) was developed for long‐term monitoring of heartbeats in patients with a left ventricular assist device (LVAD) and does not normally have the functionality necessary to detect additional heart irregularities that can progress to critical arrhythmias. Although the v‐ECG has the benefits of physiological optimization and counterpulsation control, when abnormal heartbeats occur, the v‐ECG does not show the distinct abnormal waveform that enables easy detection of an abnormal heartbeat among normal heartbeats on the conventional ECG. In this study, the v‐ECGs of normal and abnormal heartbeats are compared with each other with respect to peak‐to‐peak voltage, area, and maximal slopes, and a new method to detect abnormal heartbeats is suggested. In a series of animal experiments with three porcine models (Yorkshire pigs weighing 30–40 kg), a v‐ECG and conventional ECG were taken simultaneously during LVAD perfusion. Clinical experts found 104 abnormal heartbeats from the saved conventional ECG data and confirmed that the other 3159 heartbeats were normal. Almost all of the abnormal heartbeats were premature ventricular contractions (PVCs), and there was short‐term tachycardia for 3 s. A personal computer was used to automatically detect abnormal heartbeats with the v‐ECG according to the new method, and its results were compared with the clinicians' results. The new method found abnormal heartbeats with 90% accuracy, and less than 15% of the total PVCs were missed.
Biases in the Perception of Barack Obama's Skin Tone
Authors: Kemmelmeier Markus , Chavez H. Lyssette
Published: April 2014

White Americans higher in prejudice were less likely to vote for Barack Obama than other Americans. Recent research also demonstrated that supporters and opponents of Mr. Obama engaged in skin tone biases, i.e., they perceive Mr. Obama's skin tone as lighter or darker in line with more positive or negative views of him. Across two studies we hypothesized that skin tone biases occur as a function of two independent sources: racial prejudice, which is always related to skin tone bias, and political partisanship, which is related to skin tone bias primarily during elections. Study 1 assessed perceptions of Mr. Obama's skin tone shortly before and after the 2008 Presidential election, and shortly after the first inauguration. Study 2 assessed perceptions in the middle of his first term, immediately prior to the 2012 Presidential election, and 1 year into his second term in office. Consistent with our hypothesis, we found that partisan skin tone bias was limited to the election period, whereas prejudice‐based skin tone biases occurred independent from any election.
A pseudo‐penalized quasi‐likelihood approach to the spatial misalignment problem with non‐normal data
Authors: Lopiano Kenneth K. , Young Linda J. , Gotway Carol A.
Published: April 2014

Spatially referenced datasets arising from multiple sources are routinely combined to assess relationships among various outcomes and covariates. The geographical units associated with the data, such as the geographical coordinates or areal‐level administrative units, are often spatially misaligned, that is, observed at different locations or aggregated over different geographical units. As a result, the covariate is often predicted at the locations where the response is observed. The method used to align disparate datasets must be accounted for when subsequently modeling the aligned data. Here we consider the case where kriging is used to align datasets in point‐to‐point and point‐to‐areal misalignment problems when the response variable is non‐normally distributed. If the relationship is modeled using generalized linear models, the additional uncertainty induced from using the kriging mean as a covariate introduces a Berkson error structure. In this article, we develop a pseudo‐penalized quasi‐likelihood algorithm to account for the additional uncertainty when estimating regression parameters and associated measures of uncertainty. The method is applied to a point‐to‐point example assessing the relationship between low‐birth weights and PM2.5 levels after the onset of the largest wildfire in Florida history, the Bugaboo scrub fire. A point‐to‐areal misalignment problem is presented where the relationship between asthma events in Florida's counties and PM2.5 levels after the onset of the fire is assessed. Finally, the method is evaluated using a simulation study. Our results indicate the method performs well in terms of coverage for 95% confidence intervals and naive methods that ignore the additional uncertainty tend to underestimate the variability associated with parameter estimates. The underestimation is most profound in Poisson regression models.
Semiparametric transformation models for semicompeting survival data
Authors: Lin Huazhen , Zhou Ling , Li Chunhong , Li Yi
Published: April 2014

Semicompeting risk outcome data (e.g., time to disease progression and time to death) are commonly collected in clinical trials. However, analysis of these data is often hampered by a scarcity of available statistical tools. As such, we propose a novel semiparametric transformation model that improves the existing models in the following two ways. First, it estimates regression coefficients and association parameters simultaneously. Second, the measure of surrogacy, for example, the proportion of the treatment effect that is mediated by the surrogate and the ratio of the overall treatment effect on the true endpoint over that on the surrogate endpoint, can be directly obtained. We propose an estimation procedure for inference and show that the proposed estimator is consistent and asymptotically normal. Extensive simulations demonstrate the valid usage of our method. We apply the method to a multiple myeloma trial to study the impact of several biomarkers on patients' semicompeting outcomes—namely, time to progression and time to death.
Robotic management of genitourinary injuries from obstetric and gynaecological operations: a multi‐institutional report of outcomes
Authors: Gellhaus Paul T. , Bhandari Akshay , Monn M. Francesca , Gardner Thomas A. , Kanagarajah Prashanth , Reilly Christopher E. , Llukani Elton , Lee Ziho , Eun Daniel D. , Rashid Hani , Joseph Jean V. , Ghazi Ahmed E. , Wu Guan , Boris Ronald S.
Published: April 2014

Objective

To evaluate the utility of robotic repair of injuries to the ureter or bladder from obstetrical and gynaecological (OBGYN) surgery

Patients and Methods

A retrospective review of all patients from four different high‐volume institutions between 2002 and 2013 that had a robot‐assisted (RA) repair by a urologist after an OBGYN genitourinary injury.

Results

Of the 43 OBGYN operations, 34 were hysterectomies: 10 open, 10 RA, nine vaginally, and five pure laparoscopic. Nine patients had alternative OBGYN operations: three caesarean sections, three oophorectomies (one open, two laparoscopic), one RA colpopexy, one open pelvic cervical cerclage with mesh and one RA removal of an invasive endometrioma. In all, 49 genitourinary (GU) injuries were sustained: ureteric ligation (26), ureterovaginal fistula (10), ureterocutaneous fistula (one), vesicovaginal fistula (VVF; 10) and cystotomy alone (two). In all, 10 patients (23.3%) underwent immediate urological repair at the time of their OBGYN RA surgery. The mean (range) time between OBGYN injury and definitive delayed repair was 23.5 (1–297) months. Four patients had undergone prior failed repair: two open VVF repairs and two balloon ureteric dilatations with stent placement. In all, 22 ureteric re‐implants (11 with ipsilateral psoas hitch) and 15 uretero‐ureterostomies were performed. Stents were placed in all ureteric cases for a mean (range) of 32 (1–63) days. In all, 10 VVF repairs and two primary cystotomy closures were performed. Drains were placed in 28 cases (57.1%) for a mean (range) of 4.1 (1–26) days. No case required open conversion. Two patients (4.1%) developed ureteric obstruction after RA repair requiring dilatation and stenting. The mean (range) follow‐up of the entire cohort was 16.6 (1–63) months.

Conclusions

RA repair of GU injuries during OBGYN surgery is associated with good outcomes, appears safe and feasible, and can be used successfully immediately after injury recognition or as a salvage procedure after prior attempted repair. RA techniques may improve convalescence in a patient population where quick recovery is paramount.
MACROECONOMIC VOLATILITY AND INTERNATIONAL INTEGRATION
Authors: Arespa Marta
Published: April 2014

This paper explores the effects that varying degrees of international openness have on macroeconomic volatility. The analysis is conducted for a two‐symmetric‐country world under three levels of international integration: that of a closed economy, a financial autarky, and full financial integration. Different degrees of trade openness are considered in the form of home biases, while the economy is left vulnerable to total factor productivity and innovation shocks. Full financial integration is found to reduce firm‐size volatility and volatility in the mass of operative firms following a productivity shock and to increase them after an innovation shock. Moreover, the interaction between international sharing of profits and terms of trade transmissions determines the non‐linear behaviour of consumption‐to‐output ratio volatility found in empirical studies.
RAC1 inhibition as a therapeutic target for gefitinib‐resistant non‐small‐cell lung cancer
Authors: Kaneto Naoki , Yokoyama Satoru , Hayakawa Yoshihiro , Kato Shinichiro , Sakurai Hiroaki , Saiki Ikuo
Published: April 2014

Although epidermal growth factor receptor (EGFR)‐tyrosine kinase inhibitors (EGFR‐TKI), including gefitinib, provide a significant clinical benefit in non‐small‐cell lung cancer (NSCLC) patients, the acquisition of drug resistance has been known to limit the efficacy of EGFR‐TKI therapy. In this study, we demonstrated the involvement of EGF‐EGFR signaling in NSCLC cell migration and the requirement of RAC1 in EGFR‐mediated progression of NSCLC. We showed the significant role of RAC1 pathway in the cell migration or lamellipodia formation by using gene silencing of RAC1 or induction of constitutive active RAC1 in EGFR‐mutant NSCLC cells. Importantly, the RAC1 inhibition suppressed EGFR‐mutant NSCLC cell migration and growth in vitro, and growth in vivo even in the gefitinib‐resistant cells. In addition, these suppressions by RAC1 inhibition were mediated through MEK or PI3K independent mechanisms. Collectively, these results open up a new opportunity to control the cancer progression by targeting the RAC1 pathway to overcome the resistance to EGFR‐TKI in NSCLC patients.
Risk indicators for root caries in institutionalized elders
Authors: Tan Hai Ping , Lo Edward C. M.
Published: April 2014

Objective

To investigate the risk indicators for root caries in institutionalized elders.

Methods

Nonfrail elders living in 21 residential elderly homes who had at least 5 teeth with exposed roots were examined in this cross‐sectional study. The dental examinations were conducted by one trained dentist in the elderly homes using a portable clinic light, mouth mirror, and dental explorer. Two‐level logistic regression analyses, one using the presence of decay and the other using decay/filling in the root surface as the dependent variable, were conducted to study the relationship between root caries and a number of selected subject‐level and site‐level factors.

Results

A total of 306 elders with a mean age of 78.8 years were examined. Their mean DS‐root and DFS‐root scores were 1.3 and 2.1, respectively. Their mean root caries index score was 3.92. Results from the regression analyses revealed a positive correlation between the caries status of the root surfaces in the same subject (ICC1=0.37, ICC2=0.29, P < 0.001). Root surfaces with visual plaque, with denture contact, with more gingival recession, and in the upper anterior region were found to have a higher chance of being affected by root caries.

Conclusion

Presence of plaque, proximity to denture, and gingival recession are important site‐level risk indicators for root caries in institutionalized elders. More attention should be paid to plaque control on exposed root surfaces and avoiding placement of denture components close to roots so as to lower the risk of root caries in elders.
The proportion of cancellous bone as predictive factor for early marginal bone loss around implants in the posterior part of the mandible
Authors: Simons Willem‐Frederik , De Smit Menke , Duyck Joke , Coucke Wim , Quirynen Marc
Published: April 2014

Aim

This study envisaged to explain early marginal bone loss (first years of function) around implants in the posterior area of the mandible by the local bone quality (ratio cortical vs. cancellous bone).

Material and methods

Four hundred and twenty‐three Brånemark MKIII® implants inserted in the posterior region of the mandible were examined, retrospectively, on intra‐oral radiographs taken at abutment connection, and 1 and 3–4 years after loading. The quality of the bone was assessed on cone beam or multi‐slice CTs. The bone quality was determined by the relative proportions of cortical and trabecular bone at the insertion site. Cortical bone was defined as a clearly white structure without a trabecular pattern. Trabecular bone was defined as the structure between the two cortical plates. The width of both structures was measured at 1, 3, 5, and 7 mm away from the crest of the alveolar bone and converted in to relative proportions. Other parameters (smoking, history of periodontitis, dehiscence, pre‐tapping, submerged healing, etc.) were retrieved from the patients record.

Results

At abutment connection, the mesial and distal marginal bone level was located 0.7 (±0.7) and 0.8 (±0.7) mm apically to the implant–abutment junction. At 1 year and 3–4 years of loading implants placed in a mandible consisting of <30% of cancellous bone had lost 1.49 and 1.83 mm, respectively. Implants placed in jawbone consisting of more than 60% of cancellous bone lost 0.74 and 0.91 mm after 1 year and 3–4 years of loading. The bone‐level changes (both first year as well as after 3–4 years) were significantly less when the implant was placed in sites with a higher proportion of cancellous bone. Other parameters were significantly less important.

Conclusions

Very cortical bone could jeopardize the long‐term stability of the marginal bone surrounding implants placed in the posterior region of the mandible. A correlation between marginal bone loss and the proportion of cortical bone was demonstrated around Brånemark® implants. At present, no comparable studies are available, and therefore, it cannot be excluded that similar events take place around other implant systems.
P2X7 Receptor Inhibition Interrupts the Progression of Seizures in Immature Rats and Reduces Hippocampal Damage
Authors: Mesuret Guillaume , Engel Tobias , Hessel Ellen V. , Sanz‐Rodriguez Amaya , Jimenez‐Pacheco Alba , Miras‐Portugal M. Teresa , Diaz‐Hernandez Miguel , Henshall David C.
Published: April 2014

Aims

Early‐life seizures, particularly when prolonged, may be harmful to the brain. Current pharmacotherapy is often ineffective; therefore, novel neuro‐ and/or glio‐transmitter systems should be explored for targeting. The P2X7 receptor is a cation‐permeable channel with trophic and excitability effects on neurons and glia which is activated by high amounts of ATP that may be released in the setting of injury after severe seizures. Here, we tested the effects of A‐438079, a potent and selective P2X7 receptor antagonist in a lesional model of early‐life status epilepticus.

Methods

Seizures were induced by intra‐amygdala kainic acid in 10‐day‐old rat pups. Electrographic seizure severity, changes to P2X7 receptor expression, inflammatory responses and histological effects were evaluated.

Results

Seizures induced by intra‐amygdala kainic acid increased levels of P2X7 receptor protein and interleukin‐1β and caused significant cell death within the ipsilateral hippocampus. A‐438079 rapidly reached the brain following systemic injection in P10 rats. Intraperitoneal injection of A‐438079 (5 and 15 mg/kg) 60 min after triggering seizures reduced seizure severity and neuronal death within the hippocampus. A‐438079 had superior neuroprotective effects compared with an equally seizure‐suppressive dose of phenobarbital (25 mg/kg).

Conclusions

These results suggest P2X7 receptor antagonists may be suitable as frontline or adjunctive treatments of pediatric status epilepticus or other early‐life seizures, particularly when associated with brain damage.
Analyzing the Semantics of Point Spaces through the Topological Weighted Centroid and Other Mathematical Quantities: The Hidden Geometry of the Global Economic Order
Authors: Buscema M. , Sacco P. L. , Ferilli G. , Breda M. , Grossi E.
Published: April 2014

For many spatial processes, there is a natural need to find out the point of origin on the basis of the available scatter of observations; think, for instance, of finding out the home base of a criminal given the actual distribution of crime scenes, or the outbreak source of an epidemics. In this article, we build on the topological weighted centroid (TWC) methodology that has been applied in previous research to the reconstruction of space syntax problems, for example, of problems where all relevant entities are of spatial nature so that the relationships between them are inherently spatial and need to be properly reconstructed. In this article, we take this methodology to a new standard by tackling the new and challenging task of analyzing space semantics problems, where entities are characterized by properties of a nonspatial nature and must therefore be properly spatialized. We apply the space semantics version of the TWC methodology to a particularly hard problem: the reconstruction of global political and economic relationships on the basis of a small‐dimensional qualitative dataset. The combination of a small set of spatial and nonspatial sources of information allows us to elucidate some intriguing and counterintuitive properties of the inherent global economic order and, in particular, to highlight its long‐term structural features, which interestingly point toward the idea of longue durée developed by the distinguished French historian Fernand Braudel.
Heterogeneity of rectus femoris muscle architectural adaptations after two different 14‐week resistance training programmes
Authors: Matta Thiago T. , Nascimento Francisco X. M. B. , Fernandes Igor A. , Oliveira Liliam F.
Published: April 2014

Purpose

This study aimed to determine the architectural changes of rectus femoris muscle at distinctive sites of the thigh length after two different 14‐week resistance training programmes.

Methods

Thirty‐five untrained men were randomly allocated into three different groups: conventional resistance training (n = 12), isokinetic training (n = 12) and control (n = 11). Rectus femoris cross‐sectional area, thickness and fascicle angle at two specific thigh sites (30% and 50% of the length) were assessed before and after 14 weeks of unilateral knee extension exercise or control. The isometric peak torque of the knee extensors was estimated as a muscle strength index.

Results

Conventional (30% = 47·4% versus 50% = 14·4%) and isokinetic (30% = 31·8% versus 50% = 11·4%) training induced significant increases on thickness at both rectus femoris sites. While conventional training resulted in substantial increments on cross‐sectional area (30% = 62·1%, 50% = 19·5%), isokinetic training provoked a significant increase only at the distal site (50% = 64·7%). The isometric peak torque increased (22·4 and 29·6%, for conventional and isokinetic groups, respectively) after training independently of the training mode, although no significant changes were observed for any dependent variable in the control group.

Conclusions

In general, the training modes resulted in similar changes on rectus femoris architecture, whereas their magnitude depended on the thigh site.
Combination of racial/ethnic and etiology/disease‐specific factors is associated with lower survival following liver transplantation in African Americans: an analysis from UNOS/OPTN database
Authors: Wong Robert J. , Ahmed Aijaz
Published: April 2014

Higher rates of hepatitis C virus (HCV) recurrence and lower response to HCV antiviral therapy contribute to the lower post‐liver transplantation (LT) survival among African Americans with HCV. The current study aims to evaluate race/ethnicity‐specific and etiology‐specific factors contributing to lower post‐LT survival among African Americans in the USA. The 2002–2012 United Network for Organ Sharing registry was utilized to evaluate race/ethnicity‐specific post‐LT survival among patients with HCV, hepatocellular carcinoma (HCC), alcoholic liver disease (ALD), non‐alcoholic steatohepatitis, and cryptogenic cirrhosis. From 2002 to 2012, HCV was the leading indication for LT. While African Americans accounted for 9.5% of all LT during this period, they had the lowest overall and etiology‐specific five‐yr post‐LT survival. On multivariate Cox proportional hazards modeling, African Americans had significantly lower post‐LT survival compared with non‐Hispanic whites among patients with HCV (HR, 1.30; 95% CI, 1.19–1.41), HCC (HR, 1.49; 95% CI, 1.25–1.79), and ALD (HR, 1.52; 95% CI, 1.19–1.94). In conclusion, African Americans had the lowest post‐LT survival among patients with HCV, HCC, and ALD. Race/ethnicity and the etiology of chronic liver disease were observed to have a combined detrimental effect leading to lower survival following LT in African Americans.
Systemic Antioxidants and Lung Function in Asthmatics during High Ozone Season: A Closer Look at Albumin, Glutathione, and Associations with Lung Function
Authors: Khatri Sumita B. , Peabody Jeannie , Burwell Leandrea , Harris Frank , Brown LouAnnE S.
Published: April 2014

Background

Asthma is a chronic airway inflammatory disease with episodic symptoms of wheezing, chest tightness, cough, and shortness of breath. High ambient ozone levels have been associated with increased airway inflammation and asthma morbidity in prior studies. Mechanisms underlying individual susceptibility to asthma exacerbations from poor air quality are not fully understood.

Objective

As part of a panel observational study, we hypothesized that systemic antioxidant ability and antioxidant status may be associated with more stable asthma during high ozone season. Methods: A cross sectional study was performed to evaluate the antioxidant profile in systemic circulation and its associations with clinical parameters in asthmatics and healthy controls during three summers in Atlanta, Georgia.

Results

In this panel of individuals with and without asthma, we found that although systemic glutathione levels were not different between the groups, serum albumin was significantly lower in the asthmatic group. Albumin also significantly correlated with lung function (%FEV1) and asthma quality of life scores. In a subgroup tested, plasma reduced glutathione (GSH) levels were associated with worse airways obstruction.

Conclusion

Antioxidants GSH and albumin may have a role in maintaining lung function and asthma stability during times of poor ambient air quality. Clin Trans Sci 2014; Volume #: 1–5
Performing Repatriation? The Role of Refugee Aid in Shaping New Beginnings in Mauritania
Authors: Fresia Marion
Published: April 2014

Academic work on transitional justice has tended to focus on the most obvious and institutionalized sites where ideas about justice and transition are discussed or contested, such as truth commissions or international tribunals. Yet, there are many other sites where such ideas are framed, circulated or challenged, including sites outside transitional countries. Drawing on the case of Mauritania, where the repatriation of refugees has played a highly symbolic role during the latest ‘democratic’ transition, this article explores the specific roles played by refugee aid and past experiences of refugee life in shaping the terms of new beginnings in this country. As places of intense politicization of memory and appropriation of transnational discourses on human rights violations and transitional justice, refugee camps enhance the construction of new imagined communities based on a feeling of victimhood and abnormality and the construction of hegemonic narratives over the ‘just order’ to be aspired to for the future. The article outlines how such hegemonic ideas on justice and transition are shaped by humanitarian actors and the refugee elite, while at the same time being contested by subaltern groups through the production of alternative accounts of past injustices and through mundane practices.
Conflicting Logics of Exceptionality: New Beginnings and the Problem of Police Violence in Post‐Apartheid South Africa
Authors: Jensen Steffen
Published: April 2014

This article explores the uneasy co‐existence between two different pressing needs in post‐apartheid South Africa: the urgency to reform the South African Police and the urgency to address the crime wave. Both imply a logic of exceptionality in that both are perceived to require extraordinary measures in exceptional times. On an abstract and ideal level, each of these logics of exceptionality envisages a new beginning, namely a democratic, prosperous and safe South Africa. On the level of everyday practices, however, they oppose each other radically. Indeed, they seem to conflict to the extent that the fulfilment of one is premised on the disavowal of the other. Through an exploration of how transitional justice through institutional reform fared in relation to the imperative to deal with crime, the police emerge as a central player — as the problem in relation to the first logic of exceptionality and the solution in addressing the second. The notions of conflicting logics of exceptionality and diverging new beginnings offer a useful framework for analysing and understanding the complexities at play. Empirically, the article explores police reform from 1994 until the present through ethnographic material in rural and urban South Africa as well as a media archive of police violence.
Justice without Peace? International Justice and Conflict Resolution in Northern Uganda
Authors: Armstrong Kimberley
Published: April 2014

This article examines the heated debate that resulted from the decision of the International Criminal Court to investigate the events surrounding the conflict between the Government of Uganda and the Lord's Resistance Army. The Court's decision to intervene in Uganda was heavily criticized by political, traditional and religious leaders from the region, and by officials from a number of international humanitarian organizations on the basis of its perceived threat to peaceful outcomes to the conflict. The analysis demonstrates how particular discursive constructs of ‘peace’ and ‘justice’ became central to the debate as opponents and supporters of the ICC intervention struggled to impose distinct frameworks for evaluating and addressing the situation. Though the struggle appeared to be about abstract concepts, the ability to control these constructs had tangible consequences on the ground, as such concepts were linked with particular strategies of conflict resolution. The article concludes that the unequal relations of power which existed from the outset gave supporters of the ICC intervention an advantage over those opposing the intervention, allowing agendas for justice to overtake agendas for peace.
Making Good Citizens from Bad Life in Post‐Genocide Rwanda
Authors: Turner Simon
Published: April 2014

This contribution explores the attempts by international humanitarian agencies and the post‐genocide Rwandan state respectively to deal with exceptionality created by the genocide and return to normality. It does so by comparing two kinds of camps that deal with exceptional life: the refugee camps for Hutu who fled after the genocide and the Rwandan government's ingando re‐education camps. While there are resemblances between the exceptional space of refugee camps and the ingando camps, there are also subtle differences. While the international community is attempting to create universal citizens out of ‘bare life’, the Rwandan state is attempting to create good citizens by exorcizing a concrete historical moment of violence; the Hutu who enter the ingando are perceived as what I term ‘bad life’. In this sense, the Rwandan state's concept of a new beginning differs from universalist claims to transitional justice in that it is specific, political and at times violent. Creating a new Rwanda is a political project which involves casting the country in a specific image.
The Violence of Peace: Ethnojustice in Northern Uganda
Authors: Branch Adam
Published: April 2014

Traditional justice, or what this article refers to as ‘ethnojustice’, claims to promote social reconstruction, peace and justice after episodes of war by rebuilding traditional order. Ethnojustice has become an increasingly prominent mode of transitional justice in northern Uganda. As such interventions multiply throughout Africa, it is essential to probe their political and practical consequences. This article situates ethnojustice theoretically within the broader discourse, practice and institutions of transitional justice, and historically within the reaction against orthodox liberal transitional justice from within the industry. Through an engagement with ethnojustice texts and interventions in the Acholi region of northern Uganda, the article argues that ethnojustice can end up extending forms of unaccountable, patriarchal power within Acholi society, funded and supported by the Ugandan state and international donors. In addition to underpinning this project of social discipline, ethnojustice also benefits the Ugandan state in its effort to avoid accountability for its violence during the war.
Role of Random Capacity Risk and the Retailer in Decentralized Supply Chains with Competing Suppliers
Authors: Qin Fei , Rao Uday S. , Gurnani Haresh , Bollapragada Ramesh
Published: April 2014

This research considers a supply chain under the following conditions: (i) two heterogeneous suppliers are in competition, (ii) supply capacity is random and pricing is endogenous, (iii) consumer demand, with and without an intermediate retailer, is price dependent. Specifically, we examine how uncertainty in supply capacity affects optimal ordering and pricing decisions, supplier and retailer profits, and the incentives to reduce such uncertainty. When two suppliers sell through a monopolistic retailer, supply uncertainty not only affects the retailer's diversification strategy for replenishment, but also changes the suppliers’ wholesale price competition and the incentive for reducing capacity uncertainty. In this dual‐sourcing model, we show that the benefit of reducing capacity uncertainty depends on the cost heterogeneity between the suppliers. In addition, we show that a supplier does not necessarily benefit from capacity variability reduction. We contrast this incentive misalignment with findings from the single‐supplier case and a supplier‐duopoly case where both suppliers sell directly to market without the monopolistic retailer. In the latter single‐supplier and duopoly cases, we prove that the unreliable supplier always benefits from reducing capacity variability. These results highlight the role of the retailer's diversification strategy in distorting a supplier's incentive for reducing capacity uncertainty under supplier price competition.
Sourcing Decisions with Competitive Suppliers and Imperfect Information
Authors: Jin Yue , Ryan Jennifer K. , Yund Walter
Published: April 2014

Manufacturers often must choose between outsourcing and producing internally. This choice is complex and influenced by a variety of factors, including the costs and capabilities of the potential suppliers. In addition, if the manufacturer outsources, he must design the sourcing process. We study the manufacturer's outsourcing decision, with a focus on the impact of the sourcing process on that decision. We consider a setting in which the manufacturer has imperfect information regarding the suppliers' costs and capabilities, and we assume that the manufacturer uses a two‐stage sourcing process. The first stage is the qualification stage, in which the manufacturer seeks to reduce the uncertainty regarding the suppliers' capabilities. The second stage is the supplier selection stage, in which the manufacturer selects among the qualified suppliers on the basis of price. We first characterize the optimal design of the two‐stage process, and then consider the outsourcing decision. We demonstrate several trade‐offs. Vertical integration enables the manufacturer to reduce uncertainty and extract all of the profits of production. However, outsourcing enables the manufacturer to take advantage of the (potentially) lower costs and higher capabilities of the suppliers, particularly if competition between suppliers can be encouraged. We find that the manufacturer is more likely to vertically integrate when the warranty cost and the cost of exerting effort during qualification are large, and when there is significant uncertainty regarding the suppliers' capabilities. The manufacturer is more likely to outsource when the suppliers' costs (capabilities) are low (high), and when the number of suppliers is large.
Evaluation of the effectiveness of color intensity analysis using a second‐generation autofluorescence imaging system for diminutive colorectal polyp differentiation
Authors: Tamai Naoto , Saito Syoichi , Aihara Hiroyuki , Kato Tomohiro , Tajiri Hisao
Published: April 2014

Background and Aim

We previously reported the effectiveness of color tone intensity analysis using autofluorescence imaging (AFI) for distinguishing between colorectal neoplastic and non‐neoplastic lesions. Moreover, a second‐generation AFI system has become commercially available in Japan. In the present study, we assessed the effectiveness of color tone intensity analysis using a second‐generation AFI system for evaluating diminutive colorectal lesions.

Methods

We retrospectively reviewed the cases of 35 consecutive patients with 101 diminutive colorectal lesions that were examined using a second‐generation AFI system and resected at the Jikei University Hospital. We estimated the mean green‐to‐red (G/R) ratio – obtained by dividing the green color tone intensity by the red color tone intensity – of the lesions and compared the values of the neoplastic and non‐neoplastic lesions. We also assessed the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the AFI system for neoplastic lesion identification.

Results

The mean G/R ratios of the non‐neoplastic and neoplastic lesions were 1.06 and 0.87, respectively; the mean G/R ratio significantly differed between the neoplastic and non‐neoplastic lesions. Using the second‐generation AFI system, neoplastic lesions were identified with a sensitivity, specificity, PPV, and NPV of 94.2%, 91.8%, 92.5%, and 93.8%, respectively.

Conclusion

Color intensity analysis of diminutive colorectal polyps using the second generation AFI system could effectively distinguish between neoplastic and non‐neoplastic lesions.
Post‐endoscopic retrograde cholangiopancreatography pancreatitis caused by papillary large‐balloon dilation of incidental intrapapillary fistula in Roux‐en‐Y patients: Lesson from a case
Authors: Ishii Kentaro , Itoi Takao , Itokawa Fumihide , Tsuchiya Takayoshi , Sofuni Atsushi
Published: April 2014

Endoscopic papillary large‐balloon dilation (EPLBD) has been popular worldwide for difficult stones. At the primary stage, EPLBD is done immediately after endoscopic sphincterotomy (ES) or after previous ES. Recently, several endoscopists have reported the feasibility and safety of EPLBD without ES and post‐endoscopic retrograde cholangiopancreatography pancreatitis (PEP) as adverse events. Herein, we encountered a case of PEP in which EPLBD was carried out through a spontaneous fistula in the papillary roof, although there was no manipulation of the pancreatic duct. We learned a lesson from the present case in which possible PEP might occur during the procedure of EPLBD without ES.
Natural history of diminutive colorectal polyps: Long‐term prospective observation by colonoscopy
Authors: Mizuno Ken‐ichi , Suzuki Yutaka , Takeuchi Manabu , Kobayashi Masaaki , Aoyagi Yutaka
Published: April 2014

Background and Aim

Endoscopic removal of colorectal adenomatous polyps effectively prevents cancer. However, the treatment strategy for diminutive polyps (diameter ≤5 mm) remains controversial. Understanding the natural history of diminutive polyps is a prerequisite to their effective management. We prospectively examined the natural history of diminutive polyps by long‐term surveillance colonoscopy.

Methods

A total of 207 polyps detected in 112 patients from December 1991 through March 2002 were studied. To avoid potential effects on size and morphological characteristics, all polyps were selected randomly and were followed without biopsy. Polyp size was estimated by comparing the lesion with the diameter of a biopsy forceps.

Results

Mean follow up was 7.8 years (SD, 4.8; range, 1.0–18.6; median, 7.5; interquartile range 3.4–11.2). Twenty‐four polyps were resected endoscopically, and the histopathological diagnosis was mucosal high‐grade neoplasia (Category 4) for one polyp, and mucosal low‐grade neoplasia (Category 3) for 23 polyps. Mean linear size of the polyps was 3.2 mm (SD, 1.0; range, 1.3–5.0) at initial colonoscopy and 3.8 mm (SD 1.6; range 1.3–10.0) at final colonoscopy (P < 0.01). Left‐sided polyps showed a higher growth rate than right‐sided polyps, and a type IIIL2 pit pattern was associated with a lower growth rate than a type IIIL1 pattern.

Conclusion

We clarified the natural history of diminutive polyps by long‐term follow‐up colonoscopy. The benign course of diminutive polyps should be considered in the design of treatment strategies.
Endoscopic bile duct and/or pancreatic duct cannulation technique for patients with surgically altered gastrointestinal anatomy
Authors: Okabe Yoshinobu , Ishida Yusuke , Kuraoka Kei , Ushijima Tomoyuki , Tsuruta Osamu
Published: April 2014

There are two major hurdles to carrying out endoscopic retrograde cholangiopancreatography (ERCP) in patients with altered gastrointestinal anatomy (Billroth II gastrectomy [B‐II], Roux‐en‐Y anastomosis [R‐Y] etc.), post‐pancreatoduodenectomy or post‐choledochojejunostomy. These are: (i) the endoscopic approach to the afferent loop, blind end, and the site of bilio‐pancreatic anastomosis; and (ii) bile duct and/or pancreatic duct cannulation. Balloon‐assisted enteroscopy (BAE) became available in recent years and is now being actively used to overcome the first hurdle and, at least, the success rate has improved. However, room for improvement still remains in regards to the second hurdle (i.e. the success rate of cannulation of the bile duct and/or pancreatic duct), and there has been a desire for the development of dedicated devices (ERCP catheters, hoods etc.) and for improvement in the functionality of the enteroscopes etc. In the present review, we explain the basic procedure for bile duct and/or pancreatic duct cannulation with conventional endoscopes and BAE, and modifications of the basic procedure.
Current status and future perspectives of endoscopic diagnosis and treatment of diminutive colorectal polyps
Authors: Matsuda Takahisa , Kawano Hiroshi , Hisabe Takashi , Ikematsu Hiroaki , Kobayashi Nozomu , Mizuno Kenichi , Oka Shiro , Takeuchi Yoji , Tamai Naoto , Uraoka Toshio , Hewett David , Chiu Han‐Mo
Published: April 2014

During colonoscopy, small and diminutive colorectal polyps are commonly encountered. It is estimated that at least one adenomatous polyp is detected in almost half of all patients undergoing screening colonoscopy. In contrast, the ‘predict, resect, and discard’ strategy for diminutive and small colorectal polyps is a current topic especially in Western countries. ‘Is this an acceptable policy in Japan?’ Herein, we report the results of a questionnaire survey with regard to the management of diminutive colorectal polyps, including the thoughts of Japanese endoscopists regarding the ‘predict, resect, and discard’ strategy. At the moment, we propose that this strategy should be used by skilled endoscopists only.
Ethical Implications of Case‐Based Payment in China: A Systematic Analysis
Authors: Jin Pingyue , Biller‐Andorno Nikola , Wild Verina
Published: April 2014

How health care providers are paid affects how medicine is practiced. It is thus important to assess provider payment models not only from the economic perspective but also from the ethical perspective. China recently started to reform the provider payment model in the health care system from fee‐for‐service to case‐based payment. This paper aims to examine this transition from an ethical perspective.

We collected empirical studies on the impact of case‐based payment in the Chinese health care system and applied a systematic ethical matrix that integrates clinical ethics and public health ethics to analyze the empirical findings. We identified eleven prominent ethical issues related to case‐based payment. Some ethical problems of case‐based payment in China are comparable to ethical problems of managed care and diagnosis related groups in high‐income countries. However, in this paper we discuss in greater detail four specific ethical issues in the Chinese context: professionalism, the patient‐physician relationship, access to care and patient autonomy. Based on the analysis, we cautiously infer that case‐based payment is currently more ethically acceptable than fee‐for‐service in the context of China, mainly because it seems to lower financial barriers to access care. Nonetheless, it will be difficult to justify the implementation of case‐based payment if no additional measures are taken to monitor and minimize its existing negative ethical implications.
Uricaemia and ejection fraction in elderly heart failure outpatients
Authors: Borghi Claudio , Cosentino Eugenio R. , Rinaldi Elisa R. , Cicero Arrigo F.G.
Published: April 2014

Background

Preliminary data suggest that serum uric acid (SUA) could be involved in the prognosis of chronic heart failure (HF). The aim of our study was to test the relationship betweenSUAand left ventricular ejection fraction (EF%) in a cohort of elderly hypertensive outpatients with chronicHF.

Design

We consecutively enrolled 487 elderly outpatients (M = 59·8%;F = 40·2%; mean age: 72 ± 11 years old) affected by mild‐to‐moderate hypertensive and/or ischaemicHF, evaluating the relationship betweenSUAandEF%.

Results

In an univariate analysis,SUAwas inversely related withEF%:B = −4·392, 95% CI −5·427 to −3·357,P < 0·001. After adjustment for a large number of variables in a multivariate analysis, the value ofEF% was best predicted bySUA(B = −3·005, 95% CI −4·386 to −1·623,P < 0·001), log brain natriuretic peptide (BNP:B = −2·341, 95% CI −3·137 to −1·248,P < 0·001) and mean arterial pressure (MAP:B = 0·241, 95% CI 0·047 to 0·435,P = 0·015). A separate analysis by estimated glomerular filtration rate (eGFR) levels confirmed the inverse relationship betweenSUAandEF% in patients with normal renal function. A separate analysis by sex confirmed thatSUAand logBNPwere significant strong predictors ofEF% in men, but not in women where the best predictors were logBNP,MAPand body mass index. The predicting role ofSUAwas apparently independent of eGFRand use of diuretics.

Conclusion

Serum uric acid seems to be inversely related toEF% in male elderly patients withHFafter adjustment for the several confounding factors. This observation supports a primary negative effect ofSUAon left ventricular function that warrants further investigations.
Philadelphia chromosome‐positive mixed phenotype acute leukemia in the imatinib era
Authors: Shimizu Hiroaki , Yokohama Akihiko , Hatsumi Nahoko , Takada Satoru , Handa Hiroshi , Sakura Toru , Nojima Yoshihisa
Published: April 2014

Although the introduction of imatinib dramatically improved the outcomes for patients with Philadelphia chromosome‐positive B‐cell precursor acute lymphoblastic leukemia (Ph+BCP‐ALL), the survival benefit of imatinib has not been assessed in the context of Ph+ mixed phenotype acute leukemia (Ph+MPAL). To clarify this important issue, we studied 42 Ph+ acute leukemia (Ph+AL) patients who received intensive chemotherapy and concurrent administration of imatinib. Of the 42 Ph+AL patients, 13 (31%) patients were categorized as Ph+MPAL (positive for both myeloid and B‐cell lineage), 27 (64%) were categorized as Ph+BCP‐ALL, and two (5%) were categorized as Ph+ acute myeloid leukemia. The complete remission rates after the initial induction therapy were not significantly different when comparing Ph+MPAL and Ph+BCP‐ALL patients (100% vs. 85%, respectively, P = 0.14). Likewise, there were no significant differences in the 5‐yr overall survival (OS) or disease‐free survival (DFS) rates when comparing the MPAL and BCP‐ALL groups (OS: 55% vs. 53%, respectively, P = 0.87, DFS: 46% vs. 42%, respectively, P = 0.94). These findings suggest that concurrent imatinib administration with chemotherapy improved the outcomes of Ph+MPAL patients to the level seen in Ph+BCP‐ALL patients and should, therefore, be considered as the standard therapy for these patients.
Clinical and microbiological impact of discontinuation of fluoroquinolone prophylaxis in patients with prolonged profound neutropenia
Authors: Verlinden Anke , Jansens Hilde , Goossens Herman , van de Velde Ann L. , Schroyens Wilfried A. , Berneman Zwi N. , Gadisseur Alain P.
Published: April 2014

Background

Infections remain a leading cause of morbidity and mortality in patients with reduced immunity caused by haematological disease and chemotherapy‐induced neutropenia. We evaluated the clinical and microbiological impact of discontinuing fluoroquinolone prophylaxis in these patients.

Methods

We analysed 154 admissions in three sequential periods of 8 months: long‐standing use, discontinuation of prophylaxis and reintroduction of prophylaxis. Clinical endpoints were occurrence of febrile neutropenia, bacteraemia, severe sepsis, septic shock, response to antibiotic therapy, total antibiotic consumption and duration of hospital stay. Microbiological analysis included bacterial isolates from stool and blood cultures and their resistance pattern.

Results

No significant increase in serious infectious complications was seen with the discontinuation of prophylaxis. The overall incidence of bacteraemia did not change, but a higher proportion of bacterial isolates were Gram‐negative (22.2% vs. 5.9% & 8.6%; P = 0.030), more often multisusceptible (50% vs. 0%) and less fluoroquinolone resistant (10% vs. 100%). Screening of stools showed a higher prevalence of organisms in the discontinuation period (86.7% vs. 37.3% & 55.2%; P ≤ 0.001), but they were more frequently multisusceptible (53.8% vs. 10.5% & 6.3%; P ≤ 0.001). After discontinuation of prophylaxis, fluoroquinolone resistance decreased rapidly from 73.7 to 7.7%, in association with a significant decrease in extended spectrum beta‐lactamase (ESBL)‐producing isolates from 42.1 to 10.3%. Resistance figures immediately returned to prediscontinuation values after reinstitution of prophylaxis.

Conclusions

No clinically relevant short‐term drawbacks were observed with the discontinuation of fluoroquinolone prophylaxis in patients with chemotherapy‐induced prolonged profound neutropenia, which led to a significant decrease in fluoroquinolone resistance as well as occurrence of ESBL‐producing isolates.