bluuebunny/crossref_metadata_2025 huggingface dataset:
An Analytic Vortex Initialization Technique for Idealized Tropical Cyclone Studies in AGCMs
Authors: Reed Kevin A. , Jablonowski Christiane
Published: October 2010

The paper discusses the design of idealized tropical cyclone experiments in atmospheric general circulation models (AGCMs). The evolution of an initially weak, warm-core vortex is investigated over a 10-day period with varying initial conditions that include variations of the maximum wind speed and radius of maximum wind. The initialization of the vortex is built upon prescribed 3D moisture, pressure, temperature, and velocity fields that are embedded into tropical environmental conditions. The initial fields are in exact hydrostatic and gradient-wind balance in an axisymmetric form. The formulation is then generalized to provide analytic initial conditions for an approximately balanced vortex in AGCMs with height-based vertical coordinates. An extension for global models with pressure-based vertical coordinates is presented. The analytic initialization technique can easily be implemented on any AGCM computational grid.

The characteristics of the idealized tropical cyclone experiments are illustrated in high-resolution model simulations with the Community Atmosphere Model version 3.1 (CAM 3.1) developed at the National Center for Atmospheric Research. The finite-volume dynamical core in CAM 3.1 with 26 vertical levels is used, and utilizes an aquaplanet configuration with constant sea surface temperatures of 29°C. The impact of varying initial conditions and horizontal resolutions on the evolution of the tropical cyclone–like vortex is investigated. Identical physical parameterizations with a constant parameter set are used at all horizontal resolutions. The sensitivity studies reveal that the initial wind speed and radius of maximum wind need to lie above a threshold to support the intensification of the analytic initial vortex at horizontal grid spacings of 0.5° and 0.25° (or 55 and 28 km in the equatorial regions). The thresholds lie between 15 and 20 m s−1 with a radius of maximum wind of about 200–250 km. In addition, a convergence study with the grid spacings 1.0°, 0.5°, 0.25°, and 0.125° (or 111, 55, 28, and 14 km) shows that the cyclone gets more intense and compact with increasing horizontal resolution. The 0.5°, 0.25°, and 0.125° simulations exhibit many tropical cyclone–like characteristics such as a warm-core, low-level wind maxima, a slanted eyewall-like vertical structure and a relatively calm eye. The 0.125° simulation even starts to resolve spiral rainbands and reaches maximum wind speeds of about 72–83 m s−1 at low levels. These wind speeds are equivalent to a category-5 tropical cyclone on the Saffir–Simpson hurricane scale. It is suggested that the vortex initialization technique can be used as an idealized tool to study the impact of varying resolutions, physical parameterizations, and numerical schemes on the simulation and representation of tropical cyclone–like vortices in global atmospheric models.
The Effects of the RAW Filter on the Climatology and Forecast Skill of the SPEEDY Model
Authors: Amezcua Javier , Kalnay Eugenia , Williams Paul D.
Published: October 2010

In a recent study, Williams introduced a simple modification to the widely used Robert–Asselin (RA) filter for numerical integration. The main purpose of the Robert–Asselin–Williams (RAW) filter is to avoid the undesired numerical damping of the RA filter and to increase the accuracy. In the present paper, the effects of the modification are comprehensively evaluated in the Simplified Parameterizations, Primitive Equation Dynamics (SPEEDY) atmospheric general circulation model. First, the authors search for significant changes in the monthly climatology due to the introduction of the new filter. After testing both at the local level and at the field level, no significant changes are found, which is advantageous in the sense that the new scheme does not require a retuning of the parameterized model physics. Second, the authors examine whether the new filter improves the skill of short- and medium-term forecasts. January 1982 data from the NCEP–NCAR reanalysis are used to evaluate the forecast skill. Improvements are found in all the model variables (except the relative humidity, which is hardly changed). The improvements increase with lead time and are especially evident in medium-range forecasts (96–144 h). For example, in tropical surface pressure predictions, 5-day forecasts made using the RAW filter have approximately the same skill as 4-day forecasts made using the RA filter. The results of this work are encouraging for the implementation of the RAW filter in other models currently using the RA filter.
A Change in the Climate: New Interpretations and Perceptions of Climate Change through Artistic Interventions and Representations
Authors: Duxbury Lesley
Published: October 2010

The uncertainties concerning climate change debated daily in the media polarize political leaders and the general public alike. While daily weather is something that can be experienced by everyone and changes in the weather can be accounted for within the timeframe of a human lifetime, climate change is more difficult to comprehend or connect with in an appreciable way because of its remoteness in time and unpredictability. General populations can be alienated by the overwhelming proliferation of scientific data and statistics and, in the face of potentially cataclysmic events, feel paralyzed and incapable of action. Scientific evidence alone may not be working to encourage or initiate changes in behaviors with the potential to curtail the perceived changes to life as we know it.

This paper sets out to explicate alternative ways of comprehending and addressing some of the complex problems of climate change through art by focusing on the ways people perceive and sense the changing world around them. It contends that artists have the potential to engage society in emotional and experiential ways to promote behavioral and cognitive change. Drawing on the work of certain artists and art commentators, this paper argues that, far from being a purely imaginative or aesthetic activity, art is integral to meaningful communication between humans and the changing world.
Altered Ion-responsive Gene Expression in Mmp20 Null Mice
Authors: Tye C.E. , Sharma R. , Smith C.E. , Bartlett J.D.
Published: October 2010

During enamel maturation, hydroxyapatite crystallites expand in volume, releasing protons that acidify the developing enamel. This acidity is neutralized by the buffering activity of carbonic anhydrases and ion transporters. Less hydroxyapatite forms in matrix metalloproteinase-20 null ( Mmp20-/-) mouse incisors, because enamel thickness is reduced by approximately 50%. We therefore asked if ion regulation was altered in Mmp20-/- mouse enamel. Staining of wild-type and Mmp20-/- incisors with pH indicators demonstrated that wild-type mice had pronounced changes in enamel pH as development progressed. These pH changes were greatly attenuated in Mmp20-/- mice. Expression of 4 ion-regulatory genes ( Atp2b4, Slc4a2, Car6, Cftr) was significantly decreased in enamel organs from Mmp20-/- mice. Notably, expression of secreted carbonic anhydrase ( Car6) was reduced to almost undetectable levels in the null enamel organ. In contrast, Odam and Klk4 expression was unaffected. We concluded that a feedback mechanism regulates ion-responsive gene expression during enamel development.
Examining Critical Health Policy Issues within and beyond the Clinical Encounter: Patient-Provider Relationships and Help-seeking Behaviors
Authors: Boyer Carol A. , Lutfey Karen E.
Published: October 2010

Among notable issues in health care policy and practice over the past 50 years have been those centered on the changing dynamics in clinical encounters, predominantly the relationship between physicians and patients and access to health care. Patient roles have become more active, diverse, long-term, and risk-based, while patient—provider relationships are multifaceted, less paternalistic, and more pivotal to health outcomes. Extensive literatures on help-seeking show how much social influences affect both undertreatment and inappropriate high utilization of health care. The challenge in trying to contain the growth of health care costs is two-fold: developing better ways of defining need for care and promoting better access for those who could benefit most from health care. Both of these strategies need to be considered in the context of addressing racial, ethnic, socioeconomic, and health status disparities. Rebuilding the primary care sector as a sociologically informed strategy and a key component of health care reform may optimize both health care delivery and patient outcomes.
The Social Construction of Illness: Key Insights and Policy Implications
Authors: Conrad Peter , Barker Kristin K.
Published: October 2010

The social construction of illness is a major research perspective in medical sociology. This article traces the roots of this perspective and presents three overarching constructionist findings. First, some illnesses are particularly embedded with cultural meaning—which is not directly derived from the nature of the condition—that shapes how society responds to those afflicted and influences the experience of that illness. Second, all illnesses are socially constructed at the experiential level, based on how individuals come to understand and live with their illness. Third, medical knowledge about illness and disease is not necessarily given by nature but is constructed and developed by claims-makers and interested parties. We address central policy implications of each of these findings and discuss fruitful directions for policy-relevant research in a social constructionist tradition. Social constructionism provides an important counterpoint to medicine’s largely deterministic approaches to disease and illness, and it can help us broaden policy deliberations and decisions.
Sociology of Health Care Reform: Building on Research and Analysis to Improve Health Care
Authors: Mechanic David , McAlpine Donna D.
Published: October 2010

Health reform efforts in the United States have focused on resolving some of the fundamental irrationalities of the system whereby costs and services utilization are often not linked to improved patient outcomes. Sociologists have contributed to these efforts by documenting the extent of problems and by confronting central questions around issues of accountability, reimbursement, and rationing that must be addressed in order to achieve meaningful reform that controls costs, expands access, and improves quality. Major reform rarely occurs without “paying off ” powerful interests, a particularly difficult challenge in the context of a large and growing deficit. Central to achieving increased coverage and access, high quality, and cost control is change in reimbursement arrangements, increased accountability for both costs and outcomes, and criteria for rationing based on the evidence and accepted as legitimate by all stakeholders. Consensus about health reform requires trust. The traditional trust patients have in physicians provides an important base on which to build.
Social Conditions as Fundamental Causes of Health Inequalities: Theory, Evidence, and Policy Implications
Authors: Phelan Jo C. , Link Bruce G. , Tehranifar Parisa
Published: October 2010

Link and Phelan (1995) developed the theory of fundamental causes to explain why the association between socioeconomic status (SES) and mortality has persisted despite radical changes in the diseases and risk factors that are presumed to explain it. They proposed that the enduring association results because SES embodies an array of resources, such as money, knowledge, prestige, power, and beneficial social connections that protect health no matter what mechanisms are relevant at any given time. In this article, we explicate the theory, review key findings, discuss refinements and limits to the theory, and discuss implications for health policies that might reduce health inequalities. We advocate policies that encourage medical and other health-promoting advances while at the same time breaking or weakening the link between these advances and socioeconomic resources. This can be accomplished either by reducing disparities in socioeconomic resources themselves or by developing interventions that, by their nature, are more equally distributed across SES groups.
The Continued Social Transformation of the Medical Profession
Authors: Timmermans Stefan , Oh Hyeyoung
Published: October 2010

A pressing concern in contemporary health policy is whether the medical profession’s mandate to take care of clients has been undermined by the influx of money into health care. We examine the medical profession’s transformation over the past decades. First, we review how sociologists have viewed the medical profession over the past half-century as one stakeholder among other stakeholders vying for market share and power in the health care field.We then examine three recent challenges to the profession that exemplify the tension between self-interest and collective altruism to act in the best interest of patients: (1) the rise of patient consumerism, (2) the advent of evidence-based medicine, and (3) the increasing power of the pharmaceutical industry. We show the resilience of the medical profession as it adapts and transforms in response to these challenges. We conclude with implications to help inform policy makers’ assessments of how the medical profession will react to policy initiatives.
Thoughts on the Visual Aspect of the Neoliberal Order and the Piquetero Movement in Argentina
Authors: Abal Medina Paula
Published: October 2010

The Argentine piquetero movement of the 1990s, in which unemployed workers blockaded the roads to protest the neoliberal order, has been described as the emergence of a “visibility” that achieved political centrality. Visibility is a technology of power. The neoliberal order depends on the visual metaphor of “exclusion” or “obscurity” for the maintenance and reproduction of relations of domination. The subjects of this exclusion become living beings when they begin to struggle for visibility, exposing the relations of exploitation that characterize neoliberal capitalism. Such a struggle was launched by the piqueteros, and their blockades put an end to the darkness imposed upon them. In response, neoliberalism was forced to invent new ways of guaranteeing the reproduction of the social order, among them extortion (through the provision of temporary assistance) and repression (through the criminalization of protest), but the piqueteros’ efforts weakened the efficacy of these instruments of power. The subsequent reconfiguration of areas of social inclusion (first in the neighborhoods and then, especially since 2005, in the workplace) is largely the result of the emerging politicization that began with their struggles.
Participatory Democracy in Action
Authors: Starr Amory , Martínez-Torres María Elena , Rosset Peter
Published: October 2010

Participatory democracy has been studied as an auxiliary to state processes and as an institutional and cultural part of social movements. Studies of the use of participatory democracy by the Zapatistas of Mexico and the Movimento Sem Terra (Landless Movement—MST) of Brazil show a shared concern with autonomy, in particular avoidance of demobilization through the clientelism and paternalism induced by government programs and political parties. Both movements stress training in democracy (the experience of “being government”) and the obligation to participate. Detailed examination of their governance practices may be helpful to communities building democratic movements in other places.
The Bridge Called Zapatismo
Authors: Zugman Dellacioppa Kara
Published: October 2010

Study of a social movement in Los Angeles called Casa del Pueblo reveals the limitations of current theory on transnational social movements and advocacy networks. Whereas current theory tends to view the diffusion of political culture as a one-way process whereby Western ideas diffuse from the wealthier North to the Third World, Casa del Pueblo was born out of a transnational activist network created by the Ejército Zapatista de Liberación Nacional (Zapatista National Liberation Army—EZLN) in Mexico, a trailblazer of the global justice movement. Casa del Pueblo is a multiracial, largely Latino community group that organizes undocumented immigrants in Echo Park on a variety of issues. It borrows from the Zapatistas an expressive politics focused on consensus building and the active participation of all members and shares with them an emphasis on cultural and political autonomy. The record of Casa del Pueblo and similar transcultural movements in the United States and elsewhere suggests the need for a more interdisciplinary and multicultural approach to the study of transnational movements and advocacy networks.
Performance Improvement in Behavioral Health Care: Collateral Effects of Planned Treatment Integrity Observations as an Applied Example of Schedule-Induced Responding
Authors: Reed Derek D. , Fienup Daniel M. , Luiselli James K. , Pace Gary M.
Published: October 2010

With rising interest in the role of treatment integrity on student outcomes, research has primarily focused on isolating the techniques and procedures necessary to improve staff’s acquisition and maintenance of adequate levels of integrity. Despite increasing numbers of publications on this topic, there has been little discussion of the variables surrounding the collection of integrity data. Using an archived database of logged integrity observations at a residential school for children with brain injury, the authors sought to examine the degree to which integrity data collection conformed to best practices of behavioral assessment with respect to temporal sequencing. Moreover, due to the agency’s goal of collecting integrity on each student per month, the authors sought to examine whether the sequencing of integrity observations scalloped similarly to responding on conjunctive fixedinterval—fixed-ratio schedules. Results indicated that a majority of the staff exhibited some form of scalloping in their collection of integrity data. This article discusses possible sources of stimulus control and the potential for reactivity on the part of the teachers being observed when integrity observations are conducted in scalloped patterns. The authors conclude with a discussion on possible procedures to support the distributed collection of integrity data in applied setting.
Behavioral Systems Analysis in Health and Human Services
Authors: McGee Heather M. , Diener Lori H.
Published: October 2010

This article provides a behavioral systems approach to improve operational performance in health and human service organizations. This article provides six performance truths that are relevant to any organization and a case study from a community mental health network of agencies. A comprehensive analysis, as described here, will help health and human service leaders identify the critical areas in which to focus improvement efforts to better achieve their organizational mission.
Writing for Publication: A Performance Enhancement Guide for the Human Services Professional
Authors: Luiselli James K.
Published: October 2010

More human services professionals need to write for publication in peer-reviewed journals. This article discusses some of the perceived obstacles to writing for publication and how to overcome them by implementing a performance enhancement plan. By following a few basic guidelines, practitioners can write productively, publish their work successfully, and contribute meaningful findings, opinions, and recommendations to the professional community.
Carl Schmitt’s two concepts of humanity
Authors: Lievens Matthias
Published: October 2010

A dominant interpretation of Carl Schmitt’s work depicts him as a theologically inspired and anti-humanist thinker. This article argues, however, that his concept of the political, founded on a plea for relative instead of absolute enmity, takes Schmitt away from theology onto a profane level, where enemies recognize each other as human beings. Although Schmitt states that whoever invokes the concept of humanity wants to deceive, one can trace in his work a distinction between two concepts of humanity, which gives a philosophical foundation for the distinction between relative and absolute enmity, and, thus, for the political. It is at the basis of a minimally normative understanding of the political which can be of great interest for contemporary debates on the contemporary world order.
Arts, language and hermeneutical aesthetics: Interview with Paul Ricoeur (1913-2005)
Authors: Sweeney R.D.
Published: October 2010

Responding to the interlocutors, Ricoeur, utilizing Kantian aesthetic theory, addresses the nature of the work of art, its universality and communicability, and explores its temporality — its ‘transhistoricity’ — by utilizing concepts derived from medieval philosophy, including ‘sempiternality’ and ‘monstration’. He expands on hermeneutics, defends it against charges of relativism, expatiates on the danger of aestheticism, and explains the value of mimesis in art. He explores the different art forms, focusing with Merleau-Ponty on Cézanne as a model of the ‘ipseity’ of the artist; and he dwells particularly on the singularity of music and its ‘pathic’ moods. A discussion of literature culminates in an emphasis on the special importance of Holocaust texts.
Changes in Grandchildren’s Adult Role Statuses and Their Relationships With Grandparents
Authors: Monserud Maria A.
Published: October 2010

This study examines the associations between grandchildren’s ( N = 1,170) adult role transitions and their contact with, and closeness to, grandparents, by drawing on data from Waves 2 and 3 of the National Survey of Families and Households. Findings indicate that this relationship is frequently contingent on the nature of the adult role in question, a specific dimension of intergenerational solidarity (i.e., contact vs. closeness), lineage, and grandparent’s gender. The effect of grandchildren’s adult roles on grandparent—grandchild ties may also differ for grandsons and granddaughters. The explanations suggested by relevant theoretical perspectives—the saliency of different roles, the similarity of life experiences between generations, and evaluations of adult role transitions—only partially account for the patterns of these associations. Future research should take into consideration the mediating role of parents, the geographic proximity, social opportunities and constraints related to grandchildren’s adult roles, and grandparents’ assistance for grandchildren.
The outcomes of palliative care day services: A systematic review
Authors: Stevens Elaine , Martin Colin R , White Craig A
Published: October 2010

This systematic review evaluates the evidence underpinning the provision of palliative day care services (PDS) to determine whether such services have a measurable effect on attendees’ wellbeing. The majority of studies reviewed were qualitative and elicited individual perceptions of the benefits PDS. Although it was difficult to determine the quality of many studies, it would appear that attendance at PDS had a positive impact on attendees’ quality of life. Fewer studies utilized validated outcome measures to determine the effect of PDS on attendees’ wellbeing and small sample sizes combined with high attrition rates influenced the significance of some the results. However little quantitative evidence was offered to prove that PDS had an impact on attendees’ quality of life or wellbeing. The review concludes that dying people find attending PDS a valuable experience that allows them to engage with others and to be supported in a restorative environment. However, further well-powered empirical studies are required to provide quality evidence to determine whether or not attendance at PDS does indeed have a positive impact on the wellbeing of attendees.
Direct Inoculation of Mycobacteriumavium Subspecies Paratuberculosis Into Ileocecal Peyer’s Patches Results in Colonization of the Intestine in a Calf Model
Authors: Plattner B. L. , Chiang Y.-W. , Roth J. A. , Platt R. , Huffman E. , Zylstra J. , Hostetter J. M.
Published: October 2010

The objective of this study was to develop an intestinal model of Mycobacterium avium subspecies paratuberculosis ( Map) infection in the calf for evaluation of mucosal pathology and local and systemic immunologic responses. Map was inoculated into Peyer’s patches of young calves using a right flank surgical approach in standing calves to exteriorize the ileocecal junction. Inoculum doses ranging from 103 to 109 colony-forming units of strain K10 Map were injected through the serosal surface into Peyer’s patches of the distal ileum near the ileocecal valve. Fecal samples were collected for culture from each calf weekly until termination of the study. Calves were necropsied at 7, 30, 60, and 90 days after infection, when inoculation sites, lymph nodes, spleen, and peripheral blood were collected for evaluation. Ileocecal lymph nodes were consistently colonized by Map in the 105 to 109 groups. The ileocecal valve was also colonized in 107 and 109 groups. This correlated with fecal culture results as infected calves intermittently shed Map in their feces throughout the study. Granulomatous lesions with giant cells and acid-fast bacilli at the ileocecal junction, ileocecal lymph nodes, and lamina propria of high-dose animals (107 and 109) were identified from each time point. Flow cytometry was used to detect antigen-specific production of interferon-γ and interleukin-4 locally (ileocecal lymph node) and systemically (peripheral blood mononuclear cells), which defined distinct immunologic profiles in low-dose and high-dose calves. This study demonstrates intestinal Map infection via Peyer’s patch inoculation, a novel model with many shared features of natural Map infection.
T-Lymphocyte Predominance in Lesions of Canine Coccidioidomycosis
Authors: Shubitz L. F. , Dial S. M. , Galgiani J. N.
Published: October 2010

Coccidioidomycosis is a systemic fungal infection endemic to the southwestern United States. Although cell-mediated immunity is considered critical in control of the infection, little is known of the cellular population in naturally occurring lesions. To characterize the lymphocytic infiltration, archived formalin-fixed, paraffin-embedded tissues (subcutis, pericardium/heart, lung, bone, and synovium) from 18 dogs with coccidioidomycosis were studied with immunohistochemistry for CD3 and CD79a. In nearly all lesions, T lymphocytes were more numerous than B lymphocytes and were distributed throughout the lesion with concentration in the periphery of granulomas, whereas B lymphocytes were mostly confined to the periphery of granulomas. The predominance of T lymphocytes in lesions of canine coccidioidomycosis was independent of the tissue evaluated, the number of intralesional organisms, and the nature or severity of the inflammatory response.
Histopathologic Changes of the Ear in Canine Models of Mucopolysaccharidosis Types I and VII
Authors: Hordeaux J. , Deniaud J. , Bemelmans I. , Bertrand L. , Moreau S. , Amiaud J. , Wyers M. , Cherel Y. , Colle M.-A.
Published: October 2010

Mucopolysaccharidosis (MPS) types I and VII are inborn errors of metabolism caused by mutation of enzymes involved in glycosaminoglycan catabolism, which leads to intralysosomal accumulation of glycosaminoglycans. In children, severe forms of MPS I and VII are characterized by somatic and neurologic manifestations, including a poorly understood hearing loss. The purpose of this study is to describe the age-related histopathologic changes of the ear in spontaneous canine models of MPS I and VII. Pathologic changes in the ear were assessed in MPS I and VII dogs ranging from 1.6 to 9.3 months of age. Paraffin-embedded sections of the whole ear and Epon-embedded semithin sections of the cochlea were examined. The following lesions were blindly scored in the middle and inner ear: inflammation, cells vacuolization, thickening of osseous and membranous structures, perivascular vacuolated macrophages infiltration, and bone resorption. All dogs had lysosomal storage within cells of tympanic membrane, ossicles, tympanic bone and mucosa, cochlear bone, spiral ligament, limbus, and stria vascularis. The MPS I dogs mainly had progressive cochlear lesions. The MPS VII dogs had severe and early middle ear lesions, including chronic otitis media and bone resorption. The MPS I dog only partially recapitulates the pathology seen in humans; specifically, the dog model lacks inflammatory middle ear disease. In contrast, the MPS VII dog has severe inflammatory middle ear disease similar to that reported in the human. In conclusion, the canine MPS VII model appears to be a good model to study MPS VII–related deafness.
The Clinical Presentation and Histopathologic–Immunohistochemical Classification of Histiocytic Sarcomas in the Flat Coated Retriever
Authors: Constantino-Casas F. , Mayhew D. , Hoather T. M. , Dobson J. M.
Published: October 2010

The Flat Coated Retriever is a breed at risk of development of histiocytic sarcoma (HS), but in contrast to the disseminated form of disease recognized in the Bernese Mountain Dog, most reports of HS in Flat Coated Retrievers describe a localized lesion affecting the musculature or fascia of limbs. The purpose of this study was to review data and material received though an ongoing Flat Coated Retriever tumor survey to better define the presentation of HS in the breed and to determine the utility of subclassification of tumors arising at different sites by histology and immunohistologic phenotyping. Data on 180 dogs bearing HS-like tumors were available for review, which showed that although the majority (101 lesions, 57%) were primary limb lesions, 47 dogs (26%) had visceral, mainly splenic lesions with no peripheral primary tumor. A detailed histologic and immunohistologic review of 20 limb tumors and 20 splenic tumors showed that 2 distinct phenotypic subtypes could be identified: a histiocytic subtype, most prevalent in the splenic tumors, and a histiocytic–spindle–pleomorphic subtype, mainly seen in the limb tumors. Despite their variable morphology, all tumors expressed major histocompatibility complex class II and the leukocyte antigen CD18, but only those tumors in the spleen consistently expressed CD11d. The majority of tumors also contained a mild to moderate infiltrate of T lymphocytes.
Outcome of Ulnar Collateral Ligament Reconstruction of the Elbow in 1281 Athletes
Authors: Cain E. Lyle , Andrews James R. , Dugas Jeffrey R. , Wilk Kevin E. , McMichael Christopher S. , Walter James C. , Riley Renee S. , Arthur Scott T.
Published: October 2010

Background

The anterior bundle of the ulnar collateral ligament (UCL) is the primary anatomical structure providing elbow stability in overhead sports, particularly baseball. Injury to the UCL in overhead athletes often leads to symptomatic valgus instability that requires surgical treatment.

Hypothesis

Ulnar collateral ligament reconstruction with a free tendon graft, known as Tommy John surgery, will allow return to the same competitive level of sports participation in the majority of athletes.

Study Design

Case series; Level of evidence, 4.

Methods

Ulnar collateral reconstruction (1266) or repair (15) was performed in 1281 patients over a 19-year period (1988—2006) using a modification of the Jobe technique. Data were collected prospectively and patients were surveyed retrospectively with a telephone questionnaire to determine outcomes and return to performance at a minimum of 2 years after surgery.

Results

Nine hundred forty-two patients were available for a minimum 2-year follow-up (average, 38.4 months; range, 24-130 months). Seven hundred forty-three patients (79%) were contacted for follow-up evaluation and/or completed a questionnaire at an average of 37 months postoperatively. Six hundred seventeen patients (83%) returned to the previous level of competition or higher, including 610 (83%) after reconstruction. The average time from surgery to the initiation of throwing was 4.4 months (range, 2.8-12 months) and the average time to full competition was 11.6 months (range, 3-72 months) after reconstruction. Complications occurred in 148 patients (20%), including 16% considered minor and 4% considered major.

Conclusion

Ulnar collateral ligament reconstruction with subcutaneous ulnar nerve transposition was found to be effective in correcting valgus elbow instability in the overhead athlete and allowed most athletes (83%) to return to previous or higher level of competition in less than 1 year.
Anterior Laxity, Slippage, and Recovery of Function in the First Year After Tibialis Allograft Anterior Cruciate Ligament Reconstruction
Authors: Smith Conrad K. , Howell Stephen M. , Hull Maury L.
Published: October 2010

Background: The increase in anterior laxity and slippage is greater with metal interference screw fixation of a hamstring anterior cruciate ligament (ACL) graft than a bone-patellar tendon-bone graft.

Hypothesis: When slippage-resistant fixation is used with a soft tissue graft, early recovery of function does not result in a clinically important increase in anterior laxity and slippage

Study Design: Case series; Level of evidence, 4.

Methods: Nineteen subjects were treated with a single-tunnel, single-looped, tibialis allograft with slippage-resistant, cortical fixation. An examiner, different from the treating surgeon, used stereophotogrammetric analysis to compute the increase in anterior laxity at a 150 N anterior force and slippage between the day of surgery and each monthly follow-up interval, and determined recovery of function and motion.

Results: Anterior laxity did not increase between the day of surgery and 1 year ( P = .23). Total slippage plateaued after 1 month, but increased 1.5 mm between the day of surgery and 1 month ( P < .05). Extension and flexion plateaued after 2 months ( P < .0001 and P < .02, respectively); activity level (Tegner score) plateaued after 3 months ( P < .05), function (Lysholm score) plateaued after 4 months ( P < .002), and subjective satisfaction (International Knee Documentation Committee score) plateaued after 6 months ( P < .02).

Conclusion: Early recovery of function after ACL reconstruction with a soft tissue allograft did not result in a clinically important increase in anterior laxity and slippage at 1 year. We believe the avoidance of an increase in anterior laxity was related to the use of a transtibial technique designed to place the femoral and tibial tunnels without roof and posterior cruciate ligament impingement, the use of cortical fixation devices designed to resist slippage, the use of an aseptically harvested fresh-frozen tibialis allograft that was not irradiated or chemically processed, and the use of a self-administered rehabilitation program designed to encourage an early return of motion and function.
In Vivo Positioning Analysis of Medial Patellofemoral Ligament Reconstruction
Authors: Servien Elvire , Fritsch Brett , Lustig Sébastien , Demey Guillaume , Debarge Romain , Lapra Carole , Neyret Philippe
Published: October 2010

Background: Several techniques have been described for reconstruction of the medial patellofemoral ligament (MPFL). The anatomical insertion of the MPFL has been defined; however, there are no reports describing the accuracy of femoral graft positioning assessed postoperatively.

Purpose: To analyze our femoral tunnel positioning for MPFL reconstruction in correlation with our clinical results.

Study Design: Case series; Level of evidence, 4.

Methods: The authors reported a prospective series of 29 MPFL reconstructions with a minimum follow-up of 24 months. The tunnel positioning analysis was performed using plain radiographs and magnetic resonance imaging at 1-year follow-up.

Results: Twenty-nine femoral tunnels were analyzed; 20 femoral tunnels (69%) were considered to be in good position on plain radiographs. On magnetic resonance imaging, the authors found 19 femoral tunnels (65%) in a proper location, 5 (17.5%) in a high position, and 5 in an anterior and/or high position.

Conclusion: The study highlights the difficulty of reproducible MPFL reconstruction. The surgical procedure continues to be improved and finding a reliable technique to anatomically place the graft remains challenging. Verifying femoral tunnel placement radiographically may be recommended during surgery.
Characteristics of General Education Reading Interventions Implemented in Elementary Schools for Students With Reading Difficulties
Authors: Wanzek Jeanne , Cavanaugh Christie
Published: October 2010

The implementation of response to intervention requires that interventions for struggling students be provided through general education prior to referral for special education. The authors surveyed elementary teachers (K–3) in one state to examine the characteristics of the supplemental reading interventions that their students receive through general education. Findings reveal differences among grade levels in the amount of time interventions are provided to students, the providers of the intervention, and the materials selected for the interventions. No differences among grade levels were noted in the frequency of intervention or instructional group sizes. Three fourths of the teachers reported providing the supplemental interventions to students in their class. The findings provide insight into the resources utilized by schools to implement supplemental interventions.
Botulinum Toxin A Injections to the Upper Limbs in Children With Cerebral Palsy: Duration of Effect
Authors: Fattal-Valevski Aviva , Sagi Liora , Domenievitz Dafna
Published: October 2010

We report our experience on the duration of effectiveness of botulinum toxin A injections to the upper extremities of children with cerebral palsy. A retrospective chart review was conducted on 30 consecutive patients (mean age, 9.9 ± 5.0 years) with spastic hemiparesis and quadriparesis. They received 1 to 5 treatments, totaling 56 treatments for the entire cohort. The injected muscles were the pronator teres (50/56), flexor carpi radialis (39/56), biceps (38/56), flexor carpi ulnaris (35/56), opponens (21/56), and adductor pollicis (17/56). Children were assessed for muscle tone and classified according to the Manual Ability Classification System before and after treatment. Functional improvement was apparent after 42 of 56 treatments, and muscle tone decreased significantly (P < .001). The mean duration of the effect was 7.0 ± 3.0 months. We conclude that the effect of botulinum toxin A to the upper limbs is retained for longer periods of time than those reported for lower limbs.
Protective effect of Cassia fistula fruit extract against bromobenzene-induced liver injury in mice
Authors: Kalantari Heibatullah , Jalali Mohammadtaha , Jalali Amir , Mahdavinia Masood , Salimi Abobakr , Juhasz Bela , Tosaki Arpad , Gesztelyi Rudolf
Published: October 2010

In the present study, hepatoprotective effect of Cassia fistula fruit extract was investigated in mice. Animals were divided into six groups receiving normal saline (1), bromobenzene (460 mg/kg) alone (2) and together with increasing doses (200, 400, 600, 800 mg/kg) of a crude hydro-alcoholic extract of Cassia fistula fruit (3-6, respectively). All administrations were carried out orally, daily, for 10 days. On the 11th day, animals were sacrificed. Serum activities of aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP) and gamma glutamyl transpeptidase (γGT) were determined; serum levels of direct and total bilirubin were measured; furthermore, livers were prepared for histological examination. Our results showed that bromobenzene treatment alone elicited a significant increase in activities of AST, ALT, ALP (but not γGT), and it significantly elevated the levels of direct and total bilirubin. Co-treatment with Cassia fistula fruit extract, however, significantly and dose-dependently decreased the above-mentioned enzyme activities (with exception of γGT) and bilirubin levels, producing a recovery to the naive state. The protective effect of Cassia fistula fruit extract against liver injury evoked by bromobenzene was confirmed by histological examination as well. In conclusion, the Cassia fistula fruit extract has significant hepatoprotective effect in our murine model.
2-(3-Methoxyphenyl)-6, 7-methylenedioxoquinolin-4-one, a novel synthetic compound, inhibited migration and invasion in TSGH8301 human bladder cancer cells
Authors: Lai Kuang-Chi , Hsu Shu-Chun , Yang Jai-Sing , Kuo Chao-Lin , Ip Siu-Wan , Lai Tung-Yuan , Lin Shuw-Yuan , Huang Ching-Che , Kuo Sheng-Chu , Gibson Wood W. , Chung Jing-Gung
Published: October 2010

Matrix metalloproteinases (MMPs) play an important role in the invasion, metastasis and angiogenesis of cancer cells. Many agents have been shown to inhibit the cancer cell migration and invasion by suppression of MMPs. 2-(3-Methoxyphenyl)-6,7-methylenedioxoquinolin-4-one (MMEQ) is a derivative compound synthesized from quinolin and the purpose of this study is to determine whether or not cell migration would be reduced in human bladder cancer TSGH8301 cells after MMEQ treatment. Wound healing assay and boyden chamber assay were used in cell migration and invasion determinations. Cell migration and invasion inhibited by MMEQ exerted an inhibitory effect on the sevenless homolog-1 (SOS-1), protein kinase c (PKC), extracellular signal-regulated kinase (ERK) and Rho A for causing the inhibitions of MMP-2 and -9, and then followed by the inhibitions of invasion and migration. MMEQ also affected FAK, PI3K or inhibited growth factor receptor-bound protein 2 (GRB2), nuclear factor kappaB (NF-κB), inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2) for cell proliferation inhibition. Therefore, MMEQ may serve as a drug in the prevention of tumor metastasis of bladder cancer in the future.
Access and Quality of Primary Care for People With Disabilities: A Comparison of Practice Factors
Authors: McColl Mary Ann H. , Shortt Sam , Hunter Duncan , Dorland John , Godwin Marshall , Rosser Walter , Shaw Ralph
Published: October 2010

This study shows how practice factors, particularly payment type, affect quality and accessibility of primary care for adults with disabilities. The study consisted of: (a) a survey of practice characteristics, including accessibility, accommodations for disabled patients, and payment type; and, (b) a retrospective chart audit for quality of care indicators. The sample consisted of 513 patients within 73 doctors within 47 practices. The study show that there are significant differences between payment types on location, number of physicians and other health professionals, caseloads and patient contacts. Salaried practices scored significantly higher on accessibility and willingness to make accommodations for patients with disabilities. Salary practices scored significantly higher than FFS or capitation for the treatment of diabetes, hypertension and urinary tract infections. Capitation practices scored significantly lower than the other two payment types on preventive care. These findings raise questions regarding the mix of salary to other models of practice, and incentives for ensuring that those with the greatest need receive the best possible primary care.
Structure and stability reconsidered
Authors: Roth Ariel Ilan
Published: October 2010

The argument that multipolar international systems are less stable because certain states have an incentive to externalize the costs of defense to other states has been built on interpretations of the behavior of France, Russia, and especially Great Britain between the two World Wars. This article addresses flaws in both the use of the French and Russian cases, but is most tightly focused on the British case, which was the strongest, prima facie, of the three. This article demonstrates how the British scheme for defense against Germany was not a policy of attempted externalization on either the political or military level. Consequently, the long debate over the relationship between systemic structure and systemic stability, which has been heavily influenced by the belief in the existence of an incentive to externalize defense costs under multipolarity, must be re-examined, with new tests run and new conclusions explored.
The Role of Identity in Adjustment among Survivors of Oesophageal Cancer
Authors: Clarke Ceara , Mccorry Noleen K. , Dempster Martin
Published: October 2010

The study sought to contextualize the physical, social and emotional adjustments that are faced by oesophageal cancer patients following surgery. Semi-structured interviews were conducted with five survivors, guided by the principles of Interpretative Phenomenological Analysis (IPA). Participants’ accounts encompassed descriptions of personal, social and medical relationships, illness and treatment experiences, eating behaviours, and spiritual and religious perspectives, representing myriad challenges to the self-concept. Surviving patients may have a role in addressing patient expectations about eating. The importance of attempts to nurture and maintain a sense of self should be recognized by those providing care.
Personality Pathology Comorbidity in Adult Females with Eating Disorders
Authors: De Bolle Marleen , De Clercq Barbara , Pham-Scottez Alexandra , Mels Saskia , Rolland Jean-Pierre , Guelfi Julien Daniel , Braet Caroline , De Fruyt Filip
Published: October 2010

Personality pathology is examined in 100 female in-patients diagnosed with eating disorders. The Eating Disorder Inventory-II and the NEO-PI-R were self-administered and personality pathology was assessed using a structured interview. Clinicians additionally evaluated patients’ global functioning. The results indicated sizeable personality disorder comorbidity, and two dimensions of personality pathology, for example, an internalizing and an externalizing factor, could be identified. Patients’ global functioning was primarily associated with dimensions of personality pathology, but not with eating disorder symptoms. Assessment and therapeutic interventions should focus on this co-occurring pathology in order to improve patients’ functioning.
Using Mixed Methods to Design a Web-based Behavioural Intervention to Reduce Transmission of Colds and Flu
Authors: Yardley L. , Miller S. , Teasdale E. , Little P.
Published: October 2010

This mixed methods study informed the development of our web-based intervention to reduce the risk of transmission of respiratory infections. Two qualitative studies examined 28 users’ responses to website materials, and elicited additional beliefs. A questionnaire study ( N = 129) tested key intervention assumptions: that hand-washing is considered the most feasible preventive behaviour; behavioural determinants were related to behavioural intentions; beliefs related to hand-washing intentions and behaviour. Thematic analysis of the qualitative data revealed important issues, such as the belief that catching minor infections is beneficial to the immune system. The questionnaire results confirmed our assumptions, including hand-washing as the appropriate target behaviour.
Better to bend than to break: Coping strategies utilized by substance-abusing homeless youth
Authors: Dashora Pushpanjali , Erdem Gizem , Slesnick Natasha
Published: October 2010

This study investigated the relationship between coping styles and problem behaviors among a sample of substance-abusing homeless youth. Homeless youth (n = 268) were recruited through the only drop-in center in Albuquerque, New Mexico. Results revealed that youth with higher task-oriented coping reported less delinquent behaviors while those with higher emotion-oriented coping reported higher levels of anxiety/ depression and higher delinquency. Contrary to expectations, youth utilizing higher avoidance-oriented coping skills showed fewer HIV risk behaviors, fewer anxiety/depressive symptoms, and less frequent alcohol use. Findings emphasize the need to examine coping strategies in the context that individuals are situated.