bluuebunny/crossref_metadata_2025 huggingface dataset:
The contribution of diffusion tensor imaging and magnetic resonance spectroscopy for the differentiation of breast lesions at 3T
Authors: Tsougos Ioannis , Svolos Patricia , Kousi Evanthia , Athanassiou Evangelos , Theodorou Kiriaki , Arvanitis Dimitrios , Fezoulidis Ioannis , Vassiou Katerina
Published: July 2013

Background

Conventional breast magnetic resonance imaging (MRI), including dynamic contrast-enhanced MR mammography (DCE-MRM), may lead to ambiguous diagnosis and unnecessary biopsies.

Purpose

To investigate the contribution of proton MR spectroscopy (1H-MRS) combined with diffusion tensor imaging (DTI) metrics in the discrimination between benign and malignant breast lesions.

Material and Methods

Fifty-one women with known breast abnormalities from conventional imaging were examined on a 3T MR scanner. DTI was performed during breast MRI, and fractional anisotropy (FA) and apparent diffusion coefficient (ADC) were measured in the breast lesions and the contralateral normal breast. FA and ADC were compared between malignant lesions, benign lesions, and normal tissue. 1H-MRS was performed after gadolinium administration and choline peak was qualitatively evaluated.

Results

In our study 1H-MRS showed a sensitivity of 93.5%, specificity 80%, and accuracy 88.2%. FA was significantly higher in breast carcinomas compared to benign lesions. However, no significant difference was observed in ADC between benign and malignant lesions. The combination of Cho presence and FA achieved higher levels of accuracy and specificity in discriminating malignant from benign lesions over Cho presence or FA alone.

Conclusion

In conclusion, applying DTI and 1H-MRS together, adds incremental diagnostic value in the characterization of breast lesions and may sufficiently improve the low specificity of conventional breast MRI.
Correlation between anatomic landmarks and fMRI in detection of the sensorimotor cortex in patients with structural lesions
Authors: Hingwala Divyata , Thomas Bejoy , Radhakrishnan Ashalatha , Nair N Suresh , Kesavadas C
Published: July 2013

Background

Structural lesions in/near the sensorimotor cortex may cause distortion/obscuration of the anatomic landmarks.

Purpose

To compare the localization of the sensorimotor cortex using anatomical landmarks and fMRI in the clinical setting in patients with structural lesions in/near the central sulcus.

Material and Methods

We analyzed the anatomic and fMRI data of 68 consecutive patients (42 tumors, 15 gliotic lesions, 11 focal cortical dysplasias [FCD]) who underwent MRI to assess the relationship of these lesions to the sensorimotor cortex. Anatomical data was analyzed on conventional two- and three-dimensional sequences. BOLD fMRI was performed with block design hand/leg or lip movement paradigm and general linear model was used for detecting the activated cortex. fMRI was considered as a valid method for identifying the sensorimotor cortex based on previously reported literature.

Results

The sensorimotor cortex could not be identified with anatomical landmarks in 9/68 (13.2%) patients. fMRI detected activation in areas different from that predicted by anatomical landmarks in 11/68 (16.2%) cases. This occurred in 5/42 (11.9%) tumors, 6/15 (40%) gliotic lesions, and 0/11 (0%) FCDs. The kappa value for concordance between fMRI and anatomic landmarks was 0.883 overall, 1.0 for tumors, 0.721 for gliotic lesions, and in none of the patients with focal cortical dysplasias.

Conclusion

In patients with lesions that obscure normal cerebral landmarks, fMRI supplies the information that is not available from the anatomic images. In patients with landmarks that can be recognized, the location of the rolandic cortex may be misjudged in some cases if functional imaging is not used. Anatomic landmarks may not correlate with the area of functional activation in gliotic lesions and tumors. Determining the risk of a postoperative neurologic defect from surgery is likely to be more reliable with functional imaging than with conventional anatomic imaging.
Investigating the influence of musical training on cross-modal correspondences and sensorimotor skills in a real-time drawing paradigm
Authors: Küssner Mats B. , Leech-Wilkinson Daniel
Published: July 2013

Previous research comparing musically trained and untrained individuals has yielded valuable insights into music cognition and behaviour. Here, we explore two aspects of musical engagement previously studied separately, auditory-visual correspondences and sensorimotor skills, in a novel real-time drawing paradigm. To that end, musically trained and untrained participants were presented with 18 short sequences of pure tones varying in pitch, loudness and tempo, as well as two short musical excerpts. Using an electronic graphics tablet, participants were asked to represent the sound stimuli visually by drawing along with them while they were played. Results revealed that the majority of participants represented pitch with height (higher on the tablet referring to higher pitches), and loudness with the thickness of the line (thicker line for louder sounds). However, musically untrained participants showed a greater diversity of representation strategies and tended to neglect pitch information if unchanged over time. Investigating the performance accuracy in a subgroup of participants revealed that, while pitch-height correspondences were generally represented more accurately than loudness–thickness correspondences, musically trained participants’ representations of pitch and loudness were more accurate. Results are discussed in terms of cross-modal correspondences, the perception of time, and sensorimotor skills.
Tempo and intensity of pre-task music modulate neural activity during reactive task performance
Authors: Bishop Daniel T. , Wright Michael J. , Karageorghis Costas I.
Published: July 2013

Research has shown that not only do young athletes purposively use music to manage their emotional state (Bishop, Karageorghis, & Loizou, 2007), but also that brief periods of music listening may facilitate their subsequent reactive performance (Bishop, Karageorghis, & Kinrade, 2009). We report an fMRI study in which young athletes lay in an MRI scanner and listened to a popular music track immediately prior to performance of a three-choice reaction time task; intensity and tempo were modified such that six excerpts (2 intensities × 3 tempi) were created. Neural activity was measured throughout. Faster tempi and higher intensity collectively yielded activation in structures integral to visual perception (inferior temporal gyrus), allocation of attention (cuneus, inferior parietal lobule, supramarginal gyrus), and motor control (putamen), during reactive performance. The implications for music listening as a pre-competition strategy in sport are discussed.
When the spread of disease becomes a global event: The classification of pandemics
Authors: Abeysinghe Sudeepa
Published: July 2013

The classification of novel disease events is central to public health action surrounding them. Drawing upon the sociology of scientific classification, this article examines the role and contestation of the World Health Organization’s Pandemic Alert Phases, as applied to the spread of 2009/10 H1N1 Influenza. The analysis of World Health Organization texts, including policy documents, public statements and epidemiological documents, has been utilized to examine the Organization’s actions and public narratives around the event of H1N1. Analytically, the functional role of such classificatory schemes and the social construction of scientific classifications are examined. It is argued that in understanding the World Health Organization’s 2009/10 application of the Pandemic Alert Phases, the critical limitation of the functions served by the classificatory scheme led to the breakdown of its construction. This case study highlights the importance of classification for the successful production of scientific ‘facts’, the constructed nature of classificatory systems and the potential for contestation that arises when such classifications do not adequately fulfil their functional roles.
An Exploration of the Latent Constructs of the STATIC-99
Authors: Allen Bradley P. , Pflugradt Dawn M.
Published: July 2013

Although actuarial instruments are ubiquitously used in the field of sex offender recidivism risk assessment, there is limited empirical information about the underlying constructs from which they are derived. The following study utilized a nonparametric item response theory procedure, a Mokken analysis, and nonlinear factor analysis (Normal Ogive Harmonic Analysis Robust Method) to explore the underlying constructs of the STATIC-99 scores obtained for male sexual offenders ( N = 451) referred for an evaluation to determine if they met criteria for civil commitment under a state’s Sexually Violent Persons Law. The results from the analyses indicated that the STATIC-99 comprises the two previously identified constructs associated with sexual deviancy and antisocial behaviors as well as a third, additional construct, associated with the items pertaining to age and past marital-type relationships. These findings support Hanson and Thornton’s assertion that sexual offender recidivism risk is multifactorial and not the result of a single underlying trait. Implications for future research are discussed.
An Empirical Assessment of the Overlap Between Sexual Victimization and Sex Offending
Authors: Jennings Wesley G. , Zgoba Kristen M. , Maschi Tina , Reingle Jennifer M.
Published: July 2013

There has been a recent proliferation in the number of studies that are investigating the phenomenon that has been coined the victim–offender overlap. There has been noticeably less attention toward examining the sexual victimization and sex offending overlap. Acknowledging this gap in the literature, the present study provides an assessment of this overlap among a large sample of male prisoners with a focus on the cycle of violence hypothesis. Bivariate results reveal a considerable degree of overlap between sexual victimization and sex offending, and multivariate results estimated from a series of bivariate probit models simultaneously assessing both outcomes suggest that experiencing emotional abuse early on in the life-course is a robust risk factor for experiencing sexual victimization and demonstrating sex offending behavior. Furthermore, being physically neglected and witnessing family violence also emerged as significant risk factors for sexual victimization. Study limitations and policy implications are also discussed.
Trends in Meniscus Repair and Meniscectomy in the United States, 2005-2011
Authors: Abrams Geoffrey D. , Frank Rachel M. , Gupta Anil K. , Harris Joshua D. , McCormick Frank M. , Cole Brian J.
Published: July 2013

Background:

Meniscus deficiency may lead to degenerative arthritis in the knee. There is a significant emphasis on meniscus preservation, particularly in the young patient, to reduce the risk of arthritis.

Purpose:

To report on the incidence of meniscus repair and meniscectomy, with and without concomitant anterior cruciate ligament (ACL) reconstruction, in the United States (US) over the past 7 years.

Study Design:

Descriptive epidemiology study.

Methods:

Patients who underwent arthroscopic meniscectomy ( Current Procedural Terminology [ CPT] codes 29880 and 29881), meniscus repair ( CPT codes 29882 and 29883), and ACL reconstruction ( CPT code 29888) for the years 2005 through 2011 were identified using the PearlDiver Patient Record Database. Age group and sex were collected for each patient. Patient groups included meniscectomy alone, meniscus repair alone, meniscus repair followed by meniscectomy, ACL reconstruction with concomitant meniscus repair, and ACL reconstruction with concomitant meniscus repair followed by meniscectomy. Linear regression and Student t tests were utilized for comparisons, with an α value of .05 set as significant.

Results:

The database represented approximately 9% of the US population under 65 years of age. There was no significant change in the number of patients in the covered population during the study time frame ( P = .138). From 2005 to 2011, there were a total of 387,833 meniscectomies, 23,640 meniscus repairs, and 84,927 ACL reconstructions. There was a significant increase in the total number of isolated meniscus repairs performed ( P = .001) and a doubling of the incidence of repairs from 2005 to 2011. There was no significant increase in the total number of meniscectomies performed ( P = .712), while the incidence of meniscectomies increased only 14% from 2005 to 2011. There was no significant change in the number of meniscus repairs performed at the same time as ACL reconstruction during the study time frame. The total number and incidence of meniscectomies after repair with and without ACL reconstruction significantly decreased.

Conclusion:

There has been an increased number of isolated meniscus repairs being performed in the US over the past 7 years without a concomitant increase in meniscectomies over the same time frame. These data suggest that meniscus repairs are preferentially being performed over meniscectomies.
Uncommon Leber “Plus” Disease Associated With Mitochondrial Mutation m.11778G>A in a Premature Child
Authors: Paquay Stéphanie , Benoit Valérie , Wetzburger Catherine , Cordonnier Monique , Meire Françoise , Charon Anne , Roland Dominique , Coster Rudy Van , Nassogne Marie-Cécile , Maystadt Isabelle
Published: July 2013

Leber hereditary optic neuropathy is a well-known mitochondrial disorder that leads to bilateral subacute visual failure. Although visual impairment is often the sole clinical feature, additional and severe neurologic abnormalities also have been documented for this disease. We report on a 13-year-old boy who has presented with severe visual failure since early childhood in a context of prematurity. In the first years of his life, clinical features included delayed psychomotor development and ataxia. The clinical presentation, which was initially attributed to prematurity, worsened thereafter, and the child developed acute neurologic degradation with the typical radiological findings of Leigh syndrome. The mitochondrial DNA point mutation 11778G>A was identified in the ND4 gene. The probable influence of environmental background on clinical expression of Leber optic neuropathy, particularly those of prematurity and oxygen therapy, is discussed in our manuscript.
Obstetric Brachial Plexus Palsy Following Routine Versus Difficult Deliveries
Authors: El-Sayed Amel A. F.
Published: July 2013

Previous bio-engineering studies showed that intrapartum peak forces applied by the clinician were lower in routine deliveries than difficult deliveries. A total of 751 cases of obstetric brachial plexus palsy were included and divided into two groups: group I (248 patients) were born following routine deliveries and group II (503 patients) were born following difficult deliveries. Both groups were compared regarding the type of palsy and the rate of good/poor spontaneous motor recovery from the palsy. Group I subjects were more likely to have upper Erb palsy whereas those in group II were more likely to develop total palsy ( P < .0001). The percentage of newborns with poor functional recovery was significantly higher ( P < .05) in group II with regards to shoulder, wrist, and hand function. It was concluded that higher peak forces applied by the clinician in difficult deliveries affect the type of obstetric brachial plexus palsy.
Hemisphere Differences in Speech-Sound Event-Related Potentials in Intensive Care Neonates
Authors: Maitre Nathalie L. , Slaughter James C. , Aschner Judy L. , Key Alexandra P.
Published: July 2013

Neurodevelopmental delays in intensive care neonates are common but difficult to predict. In children, hemisphere differences in cortical processing of speech are predictive of cognitive performance. We hypothesized that hemisphere differences in auditory event-related potentials in intensive care neonates are predictive of neurodevelopment in infancy, even in those born preterm. Event-related potentials to speech sounds were prospectively recorded in 57 infants (gestational age 24-40 weeks) prior to discharge. The Developmental Assessment of Young Children was performed at 6 and 12 months. Hemisphere differences in mean amplitudes increased with postnatal age ( P < .01) but not with gestational age. Greater hemisphere differences were associated with improved communication and cognitive scores at 6 and 12 months, but decreased in significance at 12 months after adjusting for socioeconomic and clinical factors. Auditory cortical responses can be used in intensive care neonates to help identify infants at higher risk for delays in infancy.
Blindness From Late Presenting Undiagnosed Pancraniosynostosis Mimicking Pseudotumor Cerebri
Authors: Bonfield Christopher M. , Tamber Mandeep S. , Losee Jospeh E.
Published: July 2013

We report the unique case of late-onset pancraniosynostosis presenting with rapid visual deterioration, without other symptoms of increased intracranial pressure. A 10-year-old girl had episodes of blurry vision for 1 month. Magnetic resonance imaging (MRI) demonstrated a borderline Chiari I malformation. Ophthalmologic exam confirmed papilledema and decreased visual acuity. Opening pressure on lumbar puncture was 55 mmH2O. The patient was diagnosed with pseudotumor cerebri and prescribed Diamox. Four days later, she re-presented with worsening vision and increased papilledema and was taken for emergent ventriculo-peritoneal shunt placement. A postoperative computed tomographic scan showed the absence of all cranial sutures. Vision had not improved. A cranial vault expansion and optic nerve fenestration was performed. Pancraniosynostosis must be considered in a child with rapid visual deterioration and increased intracranial pressure, or with the presumptive diagnosis of pseudotumor cerebri. Assurance of normal cranial suture anatomy by computed tomographic scan is imperative in patients with an atypical presentation of pseudotumor cerebri.
The Stress Response to Surgery and Postoperative Delirium
Authors: Cerejeira Joaquim , Batista Pedro , Nogueira Vasco , Vaz-Serra Adriano , Mukaetova-Ladinska Elizabeta B.
Published: July 2013

Introduction:

The aim of this study is to determine whether postoperative delirium is associated with dysregulation of hypothalamic–pituitary–adrenal and growth hormone/insulin-like growth factor 1 (GH/IGF-1) responses following acute systemic inflammation.

Methods:

Plasma levels of cortisol, IGF-1, C-reactive protein, interleukin (IL)-6, IL-8, and IL-10 were measured before and after surgery in 101 patients ≥60 years without dementia undergoing elective hip arthroplasty. Participants were assessed with confusion assessment method and Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition, Text Revision; DSM-IV-TR) postoperatively and 37 patients fulfilled the DSM-IV-TR criteria for delirium.

Results:

Preoperative plasma cortisol levels were similar in delirium and nondelirium groups (405.37 ± 189.04 vs 461.83 ± 219.39; P = .22). Participants with delirium had higher postoperative cortisol levels (821.67 ± 367.17 vs 599.58 ± 214.94; P = .002) with enhanced postoperative elevation in relation to baseline (1.9- vs 1.5-fold; P = .004). The plasma levels of IGF1 did not differ in delirium and nondelirium groups before (18.12 ± 7.58 vs 16.8 ± 7.86; P = .477) and following surgery (13.39 ± 5.94 vs 11.12 ± 6.2; P = .639), but the levels increased in relation to baseline more frequently in patients who developed delirium (24.3% vs 7.8%; P = .034). The magnitude of postoperative cortisol elevation correlated with ΔIL-6 ( P = .485; P = .002), ΔIL-8 ( P = .429; P = .008), and ΔIL-10 ( P = .544; P < .001) only in patients with delirium.

Conclusions:

Hypothalamic–pituitary–adrenal axis hyperresponsiveness and a less frequent suppression of the GH/IGF-1 axis in response to acute stress are possibly involved in delirium pathophysiology.
The Most Trusted Advisor and the Subtle Advice Process in Family Firms
Authors: Strike Vanessa M.
Published: July 2013

The literature on advising family firms has primarily focused on providing practical advice through offering explicit intervention phases and advising models to family firm advisors. Yet the underlying implicit processes behind advising are not well understood. This study examines nine most trusted advisors in six family firms to develop a grounded theory model of how advisors capture attention, how they become attuned to family firm members to influence attention, and how they aid family members to collaboratively interrelate and mindfully govern the firm in order to facilitate an environment of collective attention.
The Evaluation of Mindfulness-Based Stress Reduction for Veterans With Mental Health Conditions
Authors: Kluepfel Lisa , Ward Terry , Yehuda Rachel , Dimoulas Eleni , Smith Ann , Daly Kelly
Published: July 2013

Purpose: To assess the feasibility of mindfulness-based stress reduction (MBSR) for veterans with mental health conditions and to evaluate its efficacy on psychological well-being and stress reduction. Design: Single-group, pretest–posttest design. Method: 30 veterans within a mental health clinic of a VA (Veterans Administration) medical center were enrolled in an 8-week standard MBSR program. Perceived stress, sleep, mindfulness, and depression were measured via self-reports at baseline and study end. Feasibility was measured by compliance and satisfaction with the course. Findings: Scores on the Perceived Stress Scale ( p =.002) and Beck Depression Inventory–II ( p = .005) were significantly reduced ( p = .002). The global measure for sleep from the Pittsburgh Sleep Quality Index improved significantly ( p = .035). Satisfaction and compliance were high. Conclusion: MBSR is a feasible intervention that has potential efficacy for veterans with mental health conditions. Future controlled trials are needed in this area.
Healing the Healer
Authors: Gershon J. Casey
Published: July 2013

Health care workers have the most challenging of professions. They are expected to work long hours while demonstrating compassion and care for the patients that they serve. Although health care practitioners are among the most disciplined of working professionals, they are often some of the unhealthiest of individuals, facing enormous amounts of stress in their lives. Healing the Healer: One Step at a Time is a 6-week health fitness program. It explores the unique challenges faced in the field of health care and teaches techniques to address those challenges head on. Healing the Healer uses Nordic walking as the exercise portion of the class. The case study examines the structure, purpose, and design of this 6-week course. Special attention is given to four basic sections: balance, pacing, joy, and discipline. The arguments presented in this article are theory based and supported by case study evidence.
The Cognitive Benefits of Movement Reduction
Authors: Warburton Edward C. , Wilson Margaret , Lynch Molly , Cuykendall Shannon
Published: July 2013

In a number of domains, humans adopt a strategy of systematically reducing and minimizing a codified system of movement. One particularly interesting case is “marking” in dance, wherein the dancer performs an attenuated version of the choreography during rehearsal. This is ostensibly to save the dancer’s physical energy, but a number of considerations suggest that it may serve a cognitive function as well. In this study, we tested this embodied-cognitive-load hypothesis by manipulating whether dancers rehearsed by marking or by dancing “full out” and found that performance was superior in the dancers who had marked. This finding indicates that marking confers cognitive benefits during the rehearsal process, and it raises questions regarding the cognitive functions of other movement-reduction systems, such as whispering, gesturing, and subvocalizing. In addition, it has implications for a variety of topics in cognitive science, including embodied cognition and the nascent fields of dance and music cognition.
Rituals Enhance Consumption
Authors: Vohs Kathleen D. , Wang Yajin , Gino Francesca , Norton Michael I.
Published: July 2013

Four experiments tested the novel hypothesis that ritualistic behavior potentiates and enhances ensuing consumption—an effect found for chocolates, lemonade, and even carrots. Experiment 1 showed that participants who engaged in ritualized behavior, compared with those who did not, evaluated chocolate as more flavorful, valuable, and deserving of behavioral savoring. Experiment 2 demonstrated that random gestures do not boost consumption as much as ritualistic gestures do. It further showed that a delay between a ritual and the opportunity to consume heightens enjoyment, which attests to the idea that ritual behavior stimulates goal-directed action (to consume). Experiment 3 found that performing a ritual oneself enhances consumption more than watching someone else perform the same ritual, suggesting that personal involvement is crucial for the benefits of rituals to emerge. Finally, Experiment 4 provided direct evidence of the underlying process: Rituals enhance the enjoyment of consumption because of the greater involvement in the experience that they prompt.
Spatial Attention Interacts With Serial-Order Retrieval From Verbal Working Memory
Authors: van Dijck Jean-Philippe , Abrahamse Elger L. , Majerus Steve , Fias Wim
Published: July 2013

The ability to maintain the serial order of events is recognized as a major function of working memory. Although general models of working memory postulate a close link between working memory and attention, such a link has so far not been proposed specifically for serial-order working memory. The present study provided the first empirical demonstration of a direct link between serial order in verbal working memory and spatial selective attention. We show that the retrieval of later items of a sequence stored in working memory—compared with that of earlier items—produces covert attentional shifts toward the right. This observation suggests the conceptually surprising notion that serial-order working memory, even for nonspatially defined verbal items, draws on spatial attention.
Heart failure in a woman with SLE, anti-phospholipid syndrome and Fabry’s disease
Authors: Nandagudi A , Jury EC , Alonzi D , Butters TD , Hughes S , Isenberg DA
Published: July 2013

We describe a female patient with systemic lupus erythematosus (SLE) also diagnosed with Fabry’s disease and anti-phospholipid antibody syndrome (APS). SLE and Fabry’s disease are both systemic diseases with variable clinical presentations. Recent studies have shown a relatively high incidence of late onset Fabry’s disease in female heterozygous individuals, suggesting that this condition could be under-diagnosed. We discuss a possible association between SLE and Fabry’s disease and consider the role of lipid abnormalities in the pathogenesis of SLE.
The comparability of quantitative surveys on sport participation in France (1967–2010)
Authors: Aubel Olivier , Lefèvre Brice
Published: July 2013

Results from quantitative surveys enable historians, sociologists and demographers to describe and analyse the evolution of sport participation in France from 1967 to 2010. However, most of these social scientists use the results of these surveys to create very different methodologies without having studied the surveys’ empirical data or databases. In this article, we demonstrate how we have attempted to establish a basis for comparability of the surveys by analysing these databases. As a result of our work, certain affirmations on which the history of sport participation in France has long been based may be called into question or even changed. This comparison raises the question of the distinction between the work of statisticians on the one hand, and that of historians, sociologists and demographers on the other.
Proximal Oblique Sliding Closing Wedge Osteotomy for Hallux Valgus
Authors: Wagner Emilio , Ortiz Cristián , Gould John S. , Naranje Sameer , Wagner Pablo , Mococain Pablo , Keller Andrés , Valderrama Juan José , Espinosa Maximiliano
Published: July 2013

Background:

The proximal oblique sliding closing wedge osteotomy (POSCOW) technique was developed to address moderate to severe hallux valgus deformity. We present a retrospective multicenter study to analyze the midterm radiological and clinical outcomes of patients treated with this type of proximal osteotomy fixed with plates.

Materials and Methods:

One hundred and forty-four patients (187 feet) were operated on between May 2005 and June 2010 in 2 separate centers. Inclusion criteria were symptomatic moderate to severe incongruent hallux valgus deformity, no significant restriction in the first metatarsophalangeal joint movement, none to minimal degenerative changes in the first metatarsophalangeal or the tarsometatarsal joints, and no hypermobility. The median age was 60 years. The preoperative hallux valgus angle (HV) was 35.6 degrees, intermetatarsal angle (IM) was 15.3 degrees, AOFAS score was 53 points. The median follow-up was 35 months (range, 12-73). A POSCOW osteotomy was performed in all patients and fixed with plates. We recorded the satisfaction rate, postoperative clinical and radiological results, and complications.

Results:

The patient satisfaction rate was 87%. The mean postoperative HV angle was 12.3 degrees, IM angle 4.8 degrees, AOFAS score 89 points. The mean decrease in the first metatarsal length was 2.2 mm (range, 0-8). Twelve feet (6.4%) with recurrence of the deformity required revision surgeries. Removal of complete or partial hardware was needed in 23 feet (12.3%) for symptomatic hardware. Five feet (2.6%) developed hallux varus but only 2 required surgery. Transfer metatarsalgia was noted in 9 feet (4.8%).

Conclusions:

The POSCOW osteotomy was an effective and reliable method for relieving pain and improving function. A learning curve was present, as most of the complications happened in the initial cases. To our knowledge, this is the largest reported series of proximal closing wedge osteotomy for hallux valgus deformities.

Level of Evidence:

Level IV, case series.
FPGA – realization of digital PWM controller using Q-format-based signal processing
Authors: Pongiannan RK , Sathiyanathan M , Vinothkumar U , Junaid KA Mohammed , Prakash A , Yadaiah N
Published: July 2013

This paper first presents a review of very large scale integration signal processing applications using Q-format data representation, through field programmable gate arrays. Also, this paper presents a comprehensive review of Q-format-based applications, which include arithmetic computations in signal processing, linear time-invariant systems, finite impulse response filter, 3-D graphics system, personal digital assistant, and neural networks and power electronic converter control are discussed. Finally, a Q-format-based arithmetic logic unit (QALU) has been designed and developed using very high speed integrated circuit hardware description language. The QALU is used to develop the space vector pulse width modulation control, and the simulation and experimental results are presented.
A novel application of Lucy–Richardson deconvolution: bearing fault diagnosis
Authors: Raj A Santhana , N Murali
Published: July 2013

The main hindrance in easy detection of bearing faults from vibration data is that the signal is noise ridden, and only an efficient method for noise reduction will effectively bring out the fault characteristics. This paper proposes a novel method for such noise reduction using Lucy–Richardson deconvolution, which is an iterative technique for deblurring images. Its application in signal processing more specially in bearing fault diagnosis is being studied in this paper. The characteristics of this deconvolution with different shapes of point spread function and their effectiveness are also shown.
Optimization of damped dynamic vibration absorber to control chatter in metal cutting process
Authors: Saravanamurugan Sundaram , Alwarsamy Thirunarayanaswamy , Devarajan Kaliyannan
Published: July 2013

This paper deals with finding the optimum parameters of a damped dynamic vibration absorber (DVA) to control chatter in metal cutting systems. The performance of conventional damped DVA is compared with the proposed skyhook damper in which the damper of the absorber system is connected between the absorber mass and an inertial reference in the sky, referred to as a skyhook damper. The damped DVA is optimized by reducing the magnitude in the positive side and increasing it in the negative side of the real part of the frequency response function of the main system. The optimum frequency ratio and the damping ratio of the damped DVA for the undamped and damped main system are obtained using analytical solutions and a numerical optimisation technique, viz genetic algorithm, respectively. The performance of the proposed skyhook damper is marginally better than the conventional type of damped DVA in controlling the vibration of the main system. This is verified by analyzing both the proposed and conventional models using finite element method-based commercial software ANSYS.
The Role of Patient Activation in Improving Blood Pressure Outcomes in Black Patients Receiving Home Care
Authors: Ryvicker Miriam , Feldman Penny Hollander , Chiu Ya-Lin , Gerber Linda M.
Published: July 2013

Variations in patients’ self-management knowledge, skills, and confidence as measured by the Patient Activation Measure (PAM) have been linked to variations in health behavior and outcomes. In a randomized trial, we tested two blood pressure (BP) control interventions, one grounded in activation principles. Study participants were Black home care patients ( N = 587) with uncontrolled hypertension. This article examines intervention impacts on 12-month PAM score change, other predictors of PAM change, and associations between PAM change and BP outcomes. In multivariate models, the interventions did not significantly affect PAM change. Baseline characteristics associated with increased PAM were lower PAM score, higher income, higher health literacy, younger age, lower systolic BP, diabetes, and fewer medications. PAM increase was associated with a modest reduction in diastolic BP but not with improved systolic BP or BP control. Although studies suggest that increasing activation may lead to improved patient outcomes, this study did not find it to be so.
Calcium Channel Blockers as Initial Therapeutic Agents in Hypertension
Authors: Shields Denise L.
Published: July 2013

Blood pressure (BP) control is central to health promotion and maintenance across the health care continuum. Optimal control has been associated with improved microvascular end organ outcomes, reduced morbidity and mortality, and improved quality of life. Calcium channel blockers (CCBs) are a frequently utilized first-line antihypertensive agent, either as a monotherapy or in combination, as advocated by the 2003 Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC VII). However, despite their ability to achieve BP parameters comparable to alternative agents, CCBs may be inducing heart failure (HF) pathology by a mechanism other than the well-known negative inotropic effects of nondihydropyridine CCBs and thus may be responsible for more incident HF than was previously thought. Review of current literature indicates that there is a strong association between all types of CCBs and incident HF, that this association is found in persons with and without preexisting myocardial dysfunction, that BP measurement alone is an insufficient measure of end organ preservation with CCB use, and that CCB-induced HF is more problematic with comorbid coronary disease, renal disease, and diabetes mellitus. Furthermore, current research suggests that these outcomes are a result of CCB-induced neurohormonal sympathetic activation, sustained CCB-generated nitric oxide production leading to inflammation and tissue destruction, and/or increased systemic calcification secondary to concurrent calcium supplementation. These findings suggest the pressing need for reevaluation of CCBs as first-line agents in treating hypertension and for possible revision of JNC VII hypertension guidelines.
Identification of Fatigue Biomarkers in Treated and Treatment-Naive HIV Patients
Authors: Jensen Kelly , Goo Young Ah , Yahiaoui Anella , Bajwa Sundeep , Goodlett Dave , Russo Jim , Voss Joachim
Published: July 2013

Objective assessment in human immunodeficiency virus (HIV)-related fatigue has been elusive because the biological mechanisms are not well characterized. We tried to identify low-abundance plasma proteins that correlate with self-reported fatigue intensity in people living with HIV. We used plasma samples from 32 patients with HIV with varying degrees of fatigue who were either treated with nucleoside reverse transcriptase inhibitors or treatment naïve. The plasma samples were enriched for low-abundance proteins and trypsinized. The peptides were analyzed using shotgun proteomics. Five targets correlated with severity of fatigue: apolipoprotein A-1 (ApoA1), apolipoprotein B (ApoB), histine-rich glycoprotein, alpha-1 B glycoprotein, and orosomucoid 2. These targets were selected based on total abundance and spectral count differences, and ApoA1 and ApoB were analyzed via Western blots to verify the mass spectrometry results. ApoA1 levels were higher in untreated patients, while ApoB results suggested a possible positive trend in treated patients. Further analysis is needed to identify additional low-abundance proteins and confirm already-identified proteins as potential fatigue biomarkers.
Antenatal screening for Down syndrome: A quantitative demonstration of the improvements over the past 20 years
Authors: Renshaw Richard , Ellis Katrina , Jacobs Patricia , Morris Joan
Published: July 2013

Objectives

Pregnant women who receive a high screening risk result for Down, Edwards or Patau syndrome are offered diagnostic tests that carry a procedure-related risk of miscarriage. This study quantifies the improvement in the screening tests by calculating the number of women who had such tests per syndrome diagnosis from 1991 to 2010.

Methods

Routinely stored data on prenatal chorionic villus sampling (CVS) and amniocentesis samples performed from 1991 to 2010 from the Wessex Regional Genetics Laboratory in England were extracted from the laboratory database. The numbers of diagnostic tests performed per Down, Edwards or Patau syndrome diagnosis were calculated according to the type of diagnostic test, and were adjusted for maternal age and gestational age at diagnosis.

Results

A total of 32,345 CVSs and amniocenteses identified 872 diagnoses of Down syndrome and 328 of Edwards and Patau syndrome. In 1991, there were 46 (95%CI: 16–111) CVSs per syndrome diagnosis compared with five (95%CI: 4–7) in 2010. For amniocenteses, the number fell from 53 (37–78) to 15 (11–22).

Conclusion

This analysis demonstrates the improvements in antenatal screening for Down syndrome that have been made over the past 20 years, resulting in a reduction in the number of women tested and thus in the number of foetal deaths attributable to the testing procedure.
Affect mediates the association between mental adjustment styles and quality of life among Chinese cancer survivors
Authors: Yeung Nelson CY , Lu Qian
Published: July 2013

This study examined the association between mental adjustment styles and quality of life, and affect as a mediator among 238 Chinese cancer survivors. Regression analysis showed that quality of life was positively associated with fighting spirit and negatively associated with fatalism. Path analysis showed that greater fighting spirit was associated with more positive affect, which in turn was associated with higher quality of life. Greater fatalism was associated with less positive affect and more negative affect, which in turn was associated with lower quality of life. Findings suggest that positive affect and negative affect are important in understanding mental adjustment styles and its health implications.
Clinician styles of care: Transforming patient care at the intersection of leadership and medicine
Authors: Huynh Ho P , Sweeny Kate
Published: July 2013

A key role of clinicians is to motivate their patients to initiate and maintain beneficial health behaviors. This article integrates research on transformational leadership, clinician–patient communication, and health behavior to introduce a novel approach to understanding and improving clinicians’ effectiveness as motivators. We describe three dominant clinician styles or patterned approaches to patient care that derive from leadership theory (in order of least to most effective): laissez-faire, transactional, and transformational. Additionally, we suggest potential mediators and effects of the transformational style of care. Finally, we discuss future research directions for the study of clinician styles of care.
Developing and testing theory-based and evidence-based interventions to promote switching to arsenic-safe wells in Bangladesh
Authors: Inauen Jennifer , Mosler Hans-Joachim
Published: July 2013

Millions of people in Bangladesh drink arsenic-contaminated water despite increased awareness of consequences to health. Theory-based and evidence-based interventions are likely to have greater impact on people switching to existing arsenic-safe wells than providing information alone. To test this assumption, we first developed interventions based on an empirical test of the Risk, Attitudes, Norms, Abilities and Self-regulation (RANAS) model of behaviour change. In the second part of this study, a cluster-randomised controlled trial revealed that in accordance with our hypotheses, information alone showed smaller increases in switching to arsenic-safe wells than information with reminders or information with reminders and implementation intentions.
Difficult encounters with a hemophilic patient: The inner perspective of physicians
Authors: Vegni Elena , Leone Daniela , Biasoli Chiara , Moja Egidio A
Published: July 2013

This study aimed at exploring the hematologists’ internal representation of a difficult encounter with a hemophilic patient, using a written open format. Narrations were analyzed with Interpretative Phenomenological Analysis. Three main issues were identified, each with sub-issues: (1) Inside the relationship: to tell or not to tell, the balance between a normal life and a deviant medical condition, the guilt; (2) The borders of the professional role: professional values, the “do-it-all” doctor; and (3) The existential confrontation. This study reveals the deep involvement of physicians with their patients, at a professional level and, strongly, at a personal level. The experience of being so deeply involved should be considered in the continuing medical programs for physicians dealing with hemophilia.
When do next-of-kin opt-in? Anticipated regret, affective attitudes and donating deceased family member’s organs
Authors: Shepherd Lee , O’Carroll Ronan E
Published: July 2013

This research assessed whether affective factors promote and prevent family members from donating their loved one’s organs. Participants ( N = 191) imagined that a family member had died and that they had to decide whether or not to donate their organs and body parts for transplantation purposes. The least organs and body parts were donated when the deceased opposed donation. Moreover, participants who were not registered organ donors donated fewer organs than registered donors. This effect was mediated by anticipated regret, disgust and the perceived benefits of donation. Organ donation campaigns should target such factors to increase donor rates.
Liquid modernity and choice of university degree programmes: Malaysian university students’ perception
Authors: Kok Jin Kuan , Ang Siew Mun
Published: July 2013

Education has become increasingly driven by economic forces and it is now seen as a way to advance economic growth and prosperity. This article starts by describing the traditional educational vision and Bauman’s liquid modernity. Later, the higher education scenario in Malaysia will be presented. The objective of this research is to investigate the factors influencing Malaysian students’ university degree choice, and their perspectives on basic science as well as basic social science degree courses in universities. Our findings show the primacy of economic considerations when students make a choice about their education. An examination of the relevance of Bauman’s liquid modernity is also applied here. Moreover, the discrepancies in the research results will be discussed. The article concludes that while liquid modernity promises opportunities and advancement, awareness of the current dynamics in the education sector is also needed.
Social democracy and social policy in neoliberal times
Authors: Deeming Christopher
Published: July 2013

This article considers the path of social policy and democracy in Australia and the latest set of welfare reforms under Labor. The reforms can be seen to mark a reaction to the excesses of neoliberal government on the one hand, but they also represent continuity in neoliberal thought and policy on the other. As we shall see, engrained ideas about individualist wage-earning welfare, that were established during the formative years of the 20th century, continue to shape, if not constrain collectivist solutions to some of the inherent social risks faced by Australian citizens today. In this light, efforts to create a welfare state geared towards meeting the needs of ‘hard-working’ Australian families appear much sharper.
The impact of co-morbid conditions and insurance status on trauma patient outcomes
Authors: Dua Anahita , Desai Sapan , Dua Arshish , Charlton-Ouw Kristofer , Dongerkery Sahana Pai , Patel Bhavin , Kuy SreyRam , McMaster Jason , Darlow Melissa , Shapiro Mark L
Published: July 2013

Introduction

This study aimed to determine the correlation between trauma patient co-morbidities, insurance status and final disposition.

Methods

We evaluated the impact of co-morbid conditions and insurance status on trauma patient outcomes utilising the National Trauma Data Bank. Paired T-tests were used to determine significance ( P < 0.05).

Results

Patients who were discharged to home had the highest rate of private insurance (27%, P < 0.01), while those sent to a facility had the highest rate of public insurance such as Medicare or Medicaid (50%, P < 0.01) and the lowest rate of no insurance (5%, P < 0.01). Patients who died had the lowest rate of private insurance (17%, P < 0.01) and 15% had no insurance ( P < 0.01). Complications and co-morbidities were significantly more common in patients who died compared to those sent to another facility or home.

Conclusion

Improving access to private insurance is associated with improved trauma-related morbidity and mortality.
Management of a Patient With Turner Syndrome Presenting With an Isolated Left Subclavian Artery Aneurysm
Authors: Columbo Jesse , Simons Jessica P. , Baril Donald T. , Schanzer Andres
Published: July 2013

We describe a case of a 52-year-old female with Turner syndrome found to have an isolated 3.5-cm left subclavian artery aneurysm. Surgical intervention was performed to decrease the risk of compressive symptoms, distal embolization, and rupture. This entailed exclusion of the aneurysm proximally using thoracic stent graft, carotid–subclavian bypass, and ligation of the subclavian artery distal to the aneurysm. One-year follow-up demonstrated exclusion of the aneurysm with a 5-mm reduction in maximum aneurysm sac diameter. This case represents the management of a rare isolated left subclavian artery aneurysm, in the setting of Turner syndrome, treated with a successful endovascular approach.