bluuebunny/crossref_metadata_2025 huggingface dataset:
Adaptive and innovative Radiation Treatment FOR improving Cancer treatment outcomE (ARTFORCE); a randomized controlled phase II trial for individualized treatment of head and neck cancer
Authors: Heukelom Jolien , Hamming Olga , Bartelink Harry , Hoebers Frank , Giralt Jordi , Herlestam Teresa , Verheij Marcel , Brekel Michiel van den , Vogel Wouter , Slevin Nick , Deutsch Eric , Sonke Jan-Jakob , Lambin Philippe , Rasch Coen
Published: February 2013

Background

Failure of locoregional control is the main cause of recurrence in advanced head and neck cancer. This multi-center trial aims to improve outcome in two ways. Firstly, by redistribution of the radiation dose to the metabolically most FDG-PET avid part of the tumour. Hereby, a biologically more effective dose distribution might be achieved while simultaneously sparing normal tissues. Secondly, by improving patient selection. Both cisplatin and Epidermal Growth Factor Receptor (EGFR) antibodies like Cetuximab in combination with Radiotherapy (RT) are effective in enhancing tumour response. However, it is unknown which patients will benefit from either agent in combination with irradiation. We will analyze the predictive value of biological markers and 89Zr-Cetuximab uptake for treatment outcome of chemoradiation with Cetuximab or cisplatin to improve patient selection.

Methods

ARTFORCE is a randomized phase II trial for 268 patients with a factorial 2 by 2 design: cisplatin versus Cetuximab and standard RT versus redistributed RT. Cisplatin is dosed weekly 40 mg/m2 for 6 weeks. Cetuximab is dosed 250mg/m2 weekly (loading dose 400 mg/m2) for 6 weeks. The standard RT regimen consists of elective RT up to 54.25 Gy with a simultaneous integrated boost (SIB) to 70 Gy in 35 fractions in 6 weeks. Redistributed adaptive RT consists of elective RT up to 54.25 Gy with a SIB between 64-80 Gy in 35 fractions in 6 weeks with redistributed dose to the gross tumour volume (GTV) and clinical target volume (CTV), and adaptation of treatment for anatomical changes in the third week of treatment.

Patients with locally advanced, biopsy confirmed squamous cell carcinoma of the oropharynx, oral cavity or hypopharynx are eligible.

Primary endpoints are: locoregional recurrence free survival at 2 years, correlation of the median 89Zr-cetuximab uptake and biological markers with treatment specific outcome, and toxicity. Secondary endpoints are quality of life, swallowing function preservation, progression free and overall survival.

Discussion

The objective of the ARTFORCE Head and Neck trial is to determine the predictive value of biological markers and 89Zr-Cetuximab uptake, as it is unknown how to select patients for the appropriate concurrent agent. Also we will determine if adaptive RT and dose redistribution improve locoregional control without increasing toxicity.

ClinicalTrials.gov Identifier: NCT01504815
The effectiveness and cost-effectiveness of spinal cord stimulation for refractory angina (RASCAL study): study protocol for a pilot randomized controlled trial
Authors: Eldabe Sam , Raphael John , Thomson Simon , Manca Andrea , de Belder Mark , Aggarwal Rajesh , Banks Matthew , Brookes Morag , Merotra Susan , Adeniba Rashidat , Davies Ed , Taylor Rod S
Published: February 2013

Background

The RASCAL (R efractory A ngina S pinal C ord stimulation and usuAL care) pilot study seeks to assess the feasibility of a definitive trial to assess if addition of spinal cord stimulation (SCS) to usual care is clinically superior and more cost-effective than usual care alone in patients with refractory angina.

Methods/design

This is an external pilot, patient-randomized controlled trial.

The study will take place at three centers in the United Kingdom - South Tees Hospitals NHS Foundation Trust (The James Cook University Hospital), Dudley Group of Hospitals NHS Foundation Trust, and Basildon and Thurrock University Hospitals NHS Foundation Trust.

The subjects will be 45 adults with refractory angina, that is, limiting angina despite optimal anti-angina therapy, Canadian Cardiovascular Society Functional Classification Class III and IV, angiographically documented coronary artery disease not suitable for revascularization, satisfactory multidisciplinary assessment and demonstrable ischemia on functional testing.

The study will be stratified by center, age and Canadian Cardiovascular Society Functional Classification.

Interventions will involve spinal cord stimulation plus usual care (‘SCS group’) or usual care alone (‘UC group’). Usual care received by both groups will include consideration of an education session with a pain consultant, trial of a transcutaneous electrical neurostimulation, serial thoracic sympathectomy and oral/systemic analgesics.

Expected outcomes will be recruitment and retention rates; reasons for agreeing/declining participation; variability in primary and secondary outcomes (to inform power calculations for a definitive trial); and completion rates of outcome measures. Trial patient-related outcomes include disease-specific and generic health-related quality of life, angina exercise capacity, intake of angina medications, frequency of angina attacks, complications and adverse events, and satisfaction.

Discussion

The RASCAL pilot trial seeks to determine the feasibility and design of a definitive randomized controlled trial comparing the addition of spinal cord stimulation to usual care versus usual care alone for patients with refractory angina.

Fifteen patients have been recruited since recruitment opened in October 2011. The trial was originally scheduled to end in April 2013 but due to slow recruitment may have to be extended to late 2013.

Trial registration

ISRCTN65254102
Determination of Degradation Products of Plant Origin Pigments in the Bottom Sediments of Lakes / Oznaczanie Zawartości Produktów Degradacji Barwników Pochodzenia Roślinnego W Osadach Dennych Jezior
Authors: Cieślewicz Joanna
Published: February 2013

The objective of this exercise was to introduce students to one of the methods used for determination of the content of pigments’ degradation products in lake bottom sediments characterised by heterogeneous physical and chemical properties. The research revealed that the studied bottom sediments were characterised by diverse content of products produced during degradation of pigments of plant origin, whereas higher concentrations of these compounds were found in sediments containing inorganic carbon (carbonates). The obtained results also indicate that it is important to have the results properly presented, particularly in the case of samples containing the carbonates.
Tristram Shandy – The Playful Art of Seduction
Authors: Băniceru Ana Cristina
Published: February 2013

The main concern of a skilled storyteller is not to report a sequence of events, but to tell a ‘tellable’ story and to ward off the question ‘so what?’ coming from the listener. However, what happens when the story has little to recommend it as ‘tellable’? This is the case of Tristram Shandy who uses sexuality as elaborate rhetorical strategy to constantly tease and arouse his narratees’ imagination.
Analysis of displacement of excavation based on inclinometer measurements
Authors: Gorska Karolina , Wyjadłowski Marek
Published: February 2013

The article presents back analysis to estimate geotechnical parameters of fill layer. The agreement between field measurements and theoretical calculations was examined. Displacements of a cantilever CFA bored pile wall were monitored. The inclinometric measurements were taken directly after pile construction and according to excavation process. Over 200 calculation series were performed, with changing fill parameters. The calculations employed the actual geometric and material parameters of the pile wall, as well as geotechnical parameters of layered soil. The parameters estimated through back analysis were the angle of internal friction and Young’s modulus of fill layer. In the case discussed, pile wall cap displacement was the response of the system, and soil medium parameters were the input data. The agreement between theoretical calculations and inclinometer measurements was assessed in accordance with two functions. The measured horizontal displacements of excavation support structure assumed different values at the two inclinometer sites analysed. Back analysis results for these sites are approximately convergent for a final excavation depth.
Relationship Between Postpartum Disorders And Pregnancy Losses and Subsequent Fertility of Dairy Cows
Authors: Zbylut Janusz , Gehrke Marek , Malinowski Edward
Published: February 2013

The aim of the study was to find the relationship between some postpartum disorders and pregnancy losses (PL), and the influence of PL on further fertility of Holstein-Friesian dairy cows. The 1,056 pregnancies and 906 calving intervals (CI) of 378 cows during the nine-year observation period were analysed. The average milk yield during this period increased from 7,500 to 10,500 kg/305 d of lactation. All cows up to 4 weeks after calving were gynecologically examined and cases of genital tract disorders were recorded and treated. Artificial inseminations (AI) were made using commercial frozen/thawed semen. In cows with silent ovulation, oestrus was induced by injection of PGF2α or programmes using PGF2α and GnRH, or hCG were applied. Pregnancy was diagnosed with the use of ultrasonography or foetal membrane slip only from 30 and 42 d after service, respectively, and re-diagnosed between 70 and 90 d after AI. The cases of „early foetal loss” up to 90 d and „mid-to-late PL” between 91 and 260 d after AI were recorded. Endometritis was noted in 31.8%, ovarian cysts in 8.5%, whereas ovarian inactivity in 4.6% of cows. Early PL was observed in 5.2%, whereas mid-to-late PL in 6.8% of cows (total 12%). From all analysed factors, the influence of delayed or periodical lack of ovarian activity was significant with regard to early PL (P=0.029). The probability of early PL increased when besides the diagnosis of ovarian inactivity, AI was made following an induced oestrus (P=0.003). CI for cows, which did not lost pregnancy amounted 442.9 d. The early, mid-to-late and multiple PL extended the CI to 579.6, 661.1 and 657.7 d, respectively (P<0.05). Concurrently, CI for cows with “early foetal loss” was significantly shorter comparing to cows with “mid-to-late foetal loss” (579.6 d vs.661.1 d; P<0.05). On average 2.6 inseminations for one pregnancy were needed, and each PL increased the AI index. Significant differences were stated after early and multiple foetal losses (5.2 and 5.1 vs. 2.6; P<0.05).
Tinea Capitis in Belgrade 1998-2002 / Tinea Capitis u Beogradu 1998-2002. Godine
Authors: Nikolić Miloš M. , Stamenović Zoran , Gajić-Veljić Mirjana , Vukićević Jelica
Published: February 2013

Tinea capitis (TC) is a worldwide health problem and a specific therapeutic challenge. The objective of this study was to establish the causative agents and clinical types and to present management options for TC. From 1993 to 2002, we treated 354 children (61% were boys) with TC. The data for the period 1998-2002, were analyzed in detail. After clinical and Wood's light examination, specimens were directly microscopically analyzed and cultivated. Superficial TC was diagnozed in 230 (65%), and kerion in 124 patients (35%), respectively. Of 51 kerion patients, 3 children (6%) had erythema nodosum. Griseofulvin was given at a dose of 15 to 25 mg/kg (average: 18 mg/kg). A 100% cure rate was achieved. In the period 1998-2002, M. audouinii was predominantly found in superficial TC. Oral griseofulvin therapy should be accompanied by shaving the hair from the scalp and topical imidazole creams, which provides 100% cure rate of superficial TC (in 6.5 weeks) and of kerion (in 5.4 weeks).
History of dermatology and venereology in Serbia - part III/1: Dermatovenereology in Serbia from 1881 - 1918
Authors: Lalević-Vasić Bosiljka M.
Published: February 2013

This paper deals with the period from 1881 to 1918, when the following Sanitary Laws were passed: Law on the Organization of the Sanitary Profession and Public Health Care (1881), which implemented measures for protection from venereal diseases, as well as restriction of prostitution; Public Sanitary Fund (1881), with independent budget for health care; Announcement on Free of Charge Treatment of Syphilis (1887). Dermatovenereological Departments were also founded: in the General Public Hospital in Belgrade (1881), and in the General Military Hospital (1909). The Hospital in Knjaževac for Syphilis was reopened (1881), as well as mobile and temporary hospitals for syphilis, and a network of County and Municipality hospitals. The first Serbian dermatovenereologist was Dr. Jevrem Žujović (1860 - 1944), and then Dr. Milorad Savićević (1877 - 1915). Skin and venereal diseases were treated by general practitioners, surgeons, internists and neurologists. Although Dr. Laza Lazarević (1851 - 1890) was not a dermatologist, but a physician and a writer, he published three papers on dermatovenereology, whereas Dr. Milorad Godjevac (1860 - 1933) wrote an important study on endemic syphilis. From 1885 to 1912, organization of dermatovenereology service has significantly improved. Considering the fact that archive documents are often missing, only approximate structure of diseases is specified: in certain monthly reports in Zaječar, out of all the diseased persons, 45% had skin or venereal diseases, while in Užice the number was 10.5%, which points to different distribution of these diseases. High percentage of dermatovenereology diseases was caused by high frequency of venereal diseases and syphilis. During the war: 1912 - 1918, the military medical service dominated, and in 1917 Prince Alexander Serbian Reserve Hospital was founded in Thessaloniki with a Department for Skin and Venereal Diseases. During this period, work of the Civilian Health Care Service was interrupted, consequently leading to a considerable aggravation of public health.
Cutaneous Blastomycosis – a case report
Authors: Ninković Baroš Đuka , Balaban Jagoda , Tomašević Pavlović Svetlana , Salapura Dugonjić Aleksandra , Popović Gorana , Brđanin Dušanka
Published: February 2013

We present a 46-year-old non-atopic HIV-negative woman from Doboj, Republic of Srpska, Bosnia and Herzegovina, who was referred to the Department of Dermatovenereology, Clinical Center Banja Luka, Republic of Srpska, Bosnia and Herzegovina, with a 3-month long history of an erythematous, large indurated infl amed area on the upper arm. The condition was asymptomatic, immediately following surgical excision of a small tumor. After exlusion of pulmonary blastomycosis and other organ involvement, the diagnosis of primary inoculation cutaneous blastomycosis was made based on clinical presentation and histopathological fi ndings. Histopathology revealed thick-walled, rounded, budding yeasts with broad-based buds that stained pink with periodic acid-schiff (PAS) staining. Itraconazole therapy was initiated at a dose of 2x100 mg/day. After three months of therapy, the dose of itraconazole was increased to 2x200 mg/day during the next three months, and then the dose was reduced to 2x100 mg. Blastomycosis is an uncommon, chronic granulomatous and suppurative mycosis caused by Blastomyces dermatitidis, which belongs to the group of main endemic systemic mycoses and in the great majority of cases represents a primary pulmonary disease. Few sporadic cases have been reported in Europe. There are three forms of blastomycosis: primary cutaneous, pulmonary and disseminated. B. dermatitidis has rarely been isolated from the environment. Wood debris or land close to rivers or subject to fl ooding are considered to be the natural substrate. The fungus can grow in sterile soil in the laboratory, and it is believed that humans get infected by inhaling spores from a saprophytic source. Primary cutaneous blastomycosis is very rare and it is found in farmers and laboratory workers. Human to human transmission does not normally occur. The diagnosis of the skin lesions is made by direct microscopy of skin samples (e.g., pus, scrapings) with 10% potassium hydroxide mount and confi rmed by culture or biopsy. Histopathological analysis provides identifi cation of all the dimorphic fungi. However, this can be complicated by the fact that in some cases they can be morphologically atypical or sterile. In the tissues, B. dermatitidis produces characteristic thick-walled, rounded, refractile, and spherical budding yeasts with broad-based buds. Of the available antimycotic drugs, itraconazole 200 mg/day is probably the most effective, but at least 400 mg/day is redommended initially.
Determination of Dynamic Loads of Sprocket Drum Teeth and Seats by Means of a Mathematical Model of the Longwall Conveyor / Wyznaczenie Obciążeń Dynamicznych Zębów I Gniazd Bębna Łańcuchowego Za Pomocą Modelu Matematycznego Przenośnika Ścianowego
Authors: Dolipski Marian , Remiorz Eryk , Sobota Piotr
Published: February 2013

Scraper conveyors are one of the key machines forming part of mechanised longwall systems. They are currently the only means of transporting the mined rock from longwalls in hard coal mines. The hauling force caused by the drive is transmitted onto a link chain through drive wheels with their external shape corresponding to a geometric polygon. The number of teeth (seats) in such wheels ranges between 5 and 8. The horizontal links running on the drum are arranged in the drive wheel seats and are meshing with the teeth segments. The geometric relationships between the sprocket drum and the links are decisive for the position of the chain links in the seats. The abrasive wear of the chain parts and of the drive drum parts occurring due to conveyor operation is increasing the chain pitch and decreasing the wheel pitch. The position of a link in the seats changes as a result along with the load on the sprocket drum teeth and seats. Sprocket drums are the weakest element in longwall conveyors. It is, therefore, urgently necessary to determine the dynamic loads of such drums’ teeth and seats. The article presents a physical model and a mathematical model of a longwall conveyor created for the purpose of determination of dynamic loads of the sprocket drum teeth and seats. The results of computer simulations are also presented (dynamic loads: in chains, dynamic loads of sprocket drums and dynamic loads of sprocket drums’ teeth and seats) carried out using the created mathematical model for a 350 m long face conveyor.
Carex disperma – not yet extinct species in old-growth swampy forests of Lithuania
Authors: Uselis Vytautas , Uselienė Asta
Published: February 2013

Uselis V., Uselienė A., 2012: Carex disperma - not yet extinct species in old-growth swampy forests of Lithuania [Carex disperma - dar neišnykusi pelkinių sengirių rūšis Lietuvoje]. - Bot. Lith., 18(1): 13-18. The paper describes the locality of Carex disperma reaffirmed after a century; the locality is situated in the present territory of the Viešvilė State Strict Nature Reserve. Plants were found in an old swampy spruce forest, which, according to the geobotanical description, corresponds to the Sphagno girgensohnii-Piceetum Polak. 1962 association. The stand is rich in indicator species of an old-growth forest. Twelve Carex disperma individuals, growing in the area of 3 m2, were recorded in 2009. One more locality has recently been found in Utena region, but it has not been published in scientific references yet. Information on other localities of this species in Lithuania is either very old (mid-19th century) or not confirmed by the herbarium specimens.
Methods for Cyanotoxins detection
Authors: Koreivienė Judita , Belous Olga
Published: February 2013

Koreivienė J., Belous O., 2012: Methods for cyanotoxins detection [Cianotoksinų nustatymo metodai]. - Bot. Lith., 18(1): 58-65. Global occurrence and concern about microcystin contamination, the potential consequences of exposure to cyanobacterial toxins in recreational and drinking waters promoted the development of numerous methods to detect the toxin and their producers as well as identification and quantification of toxins. In current study we overview numerous methods that have been developed for the cyanotoxin analysis. We discuss advantages and shortages of their applications to solve different questions.
Long delay cerebral metastases
Authors: Danaila Leon , Radoi Mugurel , Popa Roxana , Stefanescu Florin
Published: February 2013

In adults, cerebral metastases are the most common intracranial tumors, and their incidence has been rising in the last decades. The median interval between the diagnosis of the primary cancer and the detection of brain metastasis is relatively short, generally around one or two years.

This study made a selection of six cases with a more than five years delay until the diagnosis of a cerebral metastases, from over 246 patients with brain metastases, admitted in our department, between 2006- 2010. All six patients underwent surgery for their primary neoplasm, prior to neurosurgical diagnosis and treatment.

We found 6 patients, having renal, breast or lung cancer, in which the delay between diagnosis of the primary tumor and that of the brain metastases started from 5 years and reached even 18 years.

In all cases, this delay was longer than the median interval found in the most neurosurgical series. Very probably the immune system plays a major role in controlling recurrences and new metastases in the nervous system
Benefiting from External Knowledge in Open Innovation Processes
Authors: Kruse Paul , Geißler Peter
Published: February 2013

The importance of knowledge management for organizations has been widely discussed in recent years. Today, only few firms can sustain their competitiveness and innovativeness by focusing exclusively on internal knowledge sources. Managing highly specific knowledge from customers, technologies, markets, etc. is now a key to innovation. However, integrating external knowledge to foster innovation faces companies with a number of challenges. This study examines the role of external knowledge in the field of open innovation. By carrying out a systematic literature review the author develops eight categories with 19 sub-categories of potential external knowledge sources. A systematization of the identified sources investigates assets and drawbacks that can be associated with the integration of such knowledge. Thereby, the article shows that research on open innovation is highly concerned about the role of external knowledge, but mainly focuses on just a few categories and tends to neglect positive and/or negative influences on competitiveness and innovativeness.
Distributed Web Service Architecture towards Robotic Speech Communication: A Vietnamese Case Study
Authors: Pham Nhut M. , Dau Duong N.H. , Vu Quan H.
Published: February 2013

Robotics is emerging as one of the most prominent research areas in the world and is recently attracting the Vietnamese research community. For the purpose of determining an entrance for a Vietnamese human interacting robotics system, this paper is aimed at proposing a service-oriented architecture for location assistance robotic systems made out of loosely-coupled and distributed web services. The proposed platform consists of two major components: a Speech Processing System (SPS) and a Service Manipulating System (SMS). This architecture allows our robot to meet three critical human interaction robotic systems requirements: flexibility, scalability and reliability.
Using Body-Conducted Acoustic Sensors for Human-Robot Communication in Noisy Environments
Authors: Heracleous Panikos , Ishi Carlos T. , Miyashita Takahiro , Ishiguro Hiroshi , Hagita Norihiro
Published: February 2013

In this study, the use of alternative acoustic sensors in human-robot communication is investigated. In particular, a Non-Audible Murmur (NAM) microphone was applied in tele-operating the Geminoid HI-1 robot in noisy environments. The current study introduces the methodology and the results of speech intelligibility subjective tests when a NAM microphone was used in comparison with using a standard microphone. The results show the advantage of using a NAM microphone when the operation takes place in adverse environmental conditions. In addition, the effect of Geminoid's lip movements on speech intelligibility is also investigated. Subjective speech intelligibility tests show that the operator's speech can be perceived with higher intelligibility scores when the operator's audio speech is perceived along with the lip movements of robots.
Exploring Success Factors of Social Infrastructure Projects in Malaysia
Authors: Wai S.H. , Yusof Aminah Md , Ismail Syuhaida , Ng C.A.
Published: February 2013

In the context of construction management, Social Infrastructure Projects (SIPs) have long been overlooked. However, SIPs are one of the main criteria for enhancing economic productivity. This paper analyses the results of a survey aiming to develop a framework for SIP success factors to enhance the likelihood of success in the provision of SIPs in Malaysia. The principal component analysis reduces a set of 41 project success factors to six dimensions based on the idea of the project life cycle, i.e., the preconstruction factor, the construction factor and post-construction factor, and three internal factors: the organizational factor, the information management factor, and the change management factor. Understanding these success factors could be crucial in managing SIPs, since it will allow project stakeholders to take precautionary steps to identify foreseeable problems and areas for improvement. This will increase the success rate of the project and could even help avoid problems completely.
Por que uma ética do futuro precisa de uma fundamentação ontológica segundo Hans Jonas
Authors: Roberto de Oliveira Jelson
Published: February 2013

O objetivo deste artigo é investigar quais são as bases ontológicas da ética do futuro, tendo como leitmotiv o conceito de reciprocidade ou, sendo mais preciso, justamente a sua prescindibilidade no âmbito ético, a qual repercute como necessidade ontológica de fundamentação. Partiremos de uma análise do próprio conceito de “ética do futuro” para, explicitar, na sequência, por que, com Jonas, o futuro se torna objeto ético e como ele exige a prescindibilidade da reciprocidade. A partir daí, pretendemos mostrar que a fundamentação ontológica da ética é o caminho de solução para o problema da ausência de reciprocidade e de que modo ela se constitui como crítica àquilo que Jonas chama de dois dogmas da filosofia: “nenhuma verdade metafísica” e “nenhum caminho do é para o deve” (PR, p. 95). Por isso, finalmente, tentaremos mostrar que é contra esses dogmas que se ergue a proposta jonasiana, fundamentada numa metafísica racional que nada mais é do que uma ontologia biológica.
Desrealización y diferencia: conceptos fundamentales de la estética de Ortega y Gasset
Authors: Gutiérrez Pozo Antonio
Published: February 2013

En este artículo pensamos críticamente la estética de Ortega y Gasset. Esa estética consiste básicamente en una filosofía del arte, cuyo tema principal es la pregunta por la esencia del arte. Ortega piensa que el arte es desrealización e irrealidad. Esto significa que el arte es algo esencialmente diferente de la realidad. Para Ortega, esa diferencia es estética y ontológica. Esa diferencia es su pensamiento estético fundamental y lo quedistingue su filosofía estética de la hermenéutica, la deconstrucción y el arte conceptual. Para Ortega, arte y realidad son dos mundos absolutamente diferentes, pero en la filosofía contemporánea hermenéutica y deconstructiva esta delimitación no es evidente. La pregunta ‘¿qué es el arte?’ es ya una respuesta.
European League Against Rheumatism Sjögren's Syndrome Disease Activity Index and European League Against Rheumatism Sjögren's Syndrome Patient‐Reported Index: A Complete Picture of Primary Sjögren's Syndrome Patients
Authors: Seror R. , Gottenberg J. E. , Devauchelle‐Pensec V. , Dubost J. J. , Le Guern V. , Hayem G. , Fauchais A.‐L. , Goeb V. , Hachulla E. , Hatron P. Y. , Larroche C. , Morel J. , Pedriger A. , Puechal X. , Rist S. , Saraux A. , Sene D. , Sibilia J. , Vittecoq O. , Zarnitsky C. , Labetoulle M. , Ravaud P. , Mariette X.
Published: February 2013

Objective

The European League Against Rheumatism (EULAR) Sjögren's Syndrome (SS) Disease Activity Index (ESSDAI) and the EULAR SS Patient‐Reported Index (ESSPRI) were recently developed. We aimed to determine whether patients' symptoms differed between patients with and without systemic involvement and if the disease‐specific indices correlated with each other in primary SS.

Methods

Fifteen French centers included 395 primary SS patients in the Assessment of Systemic Signs and Evolution in Sjögren's Syndrome Cohort. At enrollment, physicians completed the ESSDAI, the SS Disease Activity Index (SSDAI), and the Sjögren's Systemic Clinical Activity Index (SCAI), and patients completed the ESSPRI, the Sicca Symptoms Inventory, and the Profile of Fatigue and Discomfort. All scores were compared between patients with and without systemic involvement. Correlations between scores of systemic activity and patients' symptoms were obtained.

Results

At enrollment, 120 (30.4%) patients had never experienced systemic complication and 155 (39.2%) patients and 120 (30.4%) patients had, respectively, only past or current systemic manifestations. Past or current systemic patients had higher levels of symptoms, except dryness. The ESSDAI did not correlate with the patient‐scored ESSPRI (rho = 0.06, P = 0.30), whereas the SSDAI and the SCAI, which include subjective items, did correlate (rho = 0.28 and 0.25, respectively; P < 0.0001 for both).

Conclusion

Alterations of common patient‐reported outcomes are present in all patients with primary SS, including those with systemic complications. However, patient symptoms and systemic complications are 2 different facets of primary SS. Therefore, the use of both systemic and patients' indices, such as the ESSDAI and ESSPRI, are useful. Since these 2 facets weakly overlap, one should identify which of both components is the main target of the treatment to test, when designing clinical trials in primary SS.
Addition of Cilostazol to Conventional Dual Antiplatelet Therapy Reduces the Risk of Cardiac Events and Restenosis After Drug‐Eluting Stent Implantation: A Meta‐Analysis
Authors: Chen Zhangwei , Qian Juying , Chen Yinghua , Ma Jianying , Ge Junbo
Published: February 2013

This meta‐analysis was performed to compare the risk of cardiac events and restenosis between triple antiplatelet therapy (TAT, addition of cilostazol to aspirin and clopidogrel) and conventional dual antiplatelet therapy (DAT, aspirin and clopidogrel) in drug‐eluting stents (DES) implantation patients. We performed PUBMED, MEDLINE, EMBASE, and Cochrane CENTRAL searches for randomized clinical trials of TAT versus DAT in patients after DES implantation. Five clinical trials were involved in the study. TAT was associated with a 36% reduction in major adverse cardiac events (MACE; odds ratio (OR) = 0.64; 95% confidence interval (CI) = 0.51–0.81, P < .01), a 40% reduction (OR = 0.60, 95% CI = 0.44–0.80; P < .01) in target vessel revascularization (TVR), a 44% reduction (OR = 0.56, 95% CI = 0.34–0.91; P = .02) in target lesion revascularization (TLR) and a 47%/44% reduction in in‐segment/in‐stent restenosis (P < .01) and lower in‐segment/in‐stent late loss (P < .01). As regards to the safety assessment, there was no significant difference about the risk of stent thrombosis and bleeding between TAT and DAT group, while the risk of gastrointestinal trouble was significantly higher in TAT group (OR = 2.46, 95% CI = 1.25–4.86; P < .01). Addition of cilostazol to DAT reduced the incidence of MACE, TVR, and TLR after DES implantation. TAT also reduced the risk of restenosis and late loss in patients after DES implantation.
Forty years later: Updating the Fossilization Hypothesis
Authors: Han ZhaoHong
Published: February 2013

A founding concept in second language acquisition (SLA) research, fossilization has been fundamental to understanding second language (L2) development. The Fossilization Hypothesis, introduced in Selinker's seminal text (1972), has thus been one of the most influential theories, guiding a significant bulk of SLA research for four decades; 2012 marks its fortieth anniversary. This article revisits the Fossilization Hypothesis, starting with the earliest set of questions (still the most comprehensive) (Selinker & Lamendella 1978) and using them as a basis for updating the Hypothesis. The current understanding of fossilization is presented by introducing an alternative hypothesis, the Selective Fossilization Hypothesis (Han 2009) and, in the light of that alternative, reviewing a selection of fossilizable structures documented in the recent literature.
Modifiable diarrhoea risk factors in Egyptian children aged <5 years
Authors: MANSOUR A. M. , MOHAMMADY H. EL , SHABRAWI M. EL , SHABAAN S. Y. , ZEKRI M. ABOU , NASSAR M. , SALEM M. E. , MOSTAFA M. , RIDDLE M. S. , KLENA J. D. , MESSIH I. A. ABDEL , LEVIN S. , YOUNG S. Y. N.
Published: February 2013

By conducting a case-control study in two university hospitals, we explored the association between modifiable risk behaviours and diarrhoea. Children aged <5 years attending outpatient clinics for diarrhoea were matched by age and sex with controls. Data were collected on family demographics, socioeconomic indicators, and risk behaviour practices. Two rectal swabs and a stool specimen were collected from cases and controls. Samples were cultured for bacterial pathogens using standard techniques and tested by ELISA to detect rotavirus andCryptosporidiumspp. Four hundred cases and controls were enrolled between 2007 and 2009. The strongest independent risk factors for diarrhoea were: presence of another household member with diarrhoea [matched odds ratio (mOR) 4·9, 95% CI 2·8–8·4] in the week preceding the survey, introduction to a new kind of food (mOR 3, 95% CI 1·7–5·4), and the child being cared for outside home (mOR 2·6, 95% CI 1·3–5·2). While these risk factors are not identifiable, in some age groups more easily modifiable risk factors were identified including: having no soap for handwashing (mOR 6·3, 95% CI 1·2–33·9) for children aged 7–12 months, and pacifier use (mOR 1·9, 95% CI 1·0–3·5) in children aged 0–6 months. In total, the findings of this study suggest that community-based interventions to improve practices related to sanitation and hygiene, handwashing and food could be utilized to reduce the burden of diarrhoea in Egyptian children aged <5 years.
Impact of random fabrication errors on backward-wave small-signal gain in traveling wave tubes with finite space charge electron beams
Authors: Sengele Sean , Barsanti Marc L. , Hargreaves Thomas A. , Armstrong Carter M. , Booske John H. , Lau Y. Y.
Published: February 2013

A one-dimensional small-signal theory for the backward-wave mode in a traveling-wave tube (TWT) is developed, which includes the effects of random fabrication errors. This is of interest since the backward-wave mode is the spatial harmonic typically responsible for instability in a TWT. The described model examines how gain and instantaneous 1-dB bandwidth of the backward-wave mode is affected by random fabrication errors, which are modeled as random perturbations of the phase velocity, interaction impedance, and loss along the TWT's length. Random variation of the phase velocity is found to have the largest effect on both the backward-wave gain and the bandwidth while having only a minor effect on fundamental, forward-wave mode behavior.
Note: Cavity enhanced self-absorption spectroscopy: A new diagnostic tool for light emitting matter
Authors: Walsh Anton J. , Zhao Dongfeng , Linnartz Harold
Published: February 2013

We introduce the concept of Cavity Enhanced Self-Absorption Spectroscopy (CESAS), a new sensitive diagnostic tool for analyzing light-emitting samples. The technique works without an additional light source and its implementation is straight forward. In CESAS, a sample (plasma, flame, or combustion source) is located in an optically stable cavity consisting of two high reflectivity mirrors, and here it acts both as light source and absorbing medium. A modest portion of the emitted light is trapped inside the cavity, making 104–105 cavity round trips while crossing the sample and an artificial augmentation of the path length of the absorbing medium occurs as the light transverses the cavity. Light leaking out of the cavity simultaneously provides emission and absorption features. The performance is illustrated by CESAS results on supersonically expanding pulsed hydrocarbon plasma. We expect CESAS to become a generally applicable analytical tool for real time and in situ diagnostics.
A simple formulation for magnetoresistance in metal-insulator granular films with increased current
Authors: Boff M. A. S. , Canto B. , Baibich M. N. , Pereira L. G.
Published: February 2013

We studied the tunnel magnetoresistance in metal/insulator granular films when the applied current is varied. The tunnel magnetoresistance shows a strong modification related to a non-Ohmic behaviour of theses materials. It was verified that spin-dependent tunnelling is the main mechanism for magnetoresistance at low applied current. However, when the current is high, another mechanism gets to be important: it is independent of the magnetization and is associated to variable range hopping between metallic grains. In this work, we propose a simple modification of Inoue and Maekawa's model for tunnelling magnetoresistance in granulars, rewriting the expression for resistance as a function of magnetic field and temperature, also taking into account the two different contributions.
Prevalence of enteroaggregative Escherichia coli and its virulence-related genes in a case–control study among children from north-eastern Brazil
Authors: Lima Ila Fernanda Nunes , Boisen Nadia , Silva Josiane da Quetz , Havt Alexandre , de Carvalho Eunice Bobo , Soares Alberto Melo , Lima Noélia Leal , Mota Rosa Maria Salani , Nataro James P. , Guerrant Richard Littleton , Lima Aldo Ângelo Moreira
Published: February 2013

EnteroaggregativeEscherichia coli(EAEC) is an important agent that causes endemic and epidemic diarrhoeal diseases worldwide. Several EAEC virulence-related genes (VRGs) have been described but their role in the clinical outcome of infection is not completely defined. This study investigated the prevalence of EAEC and potential associations of its VRGs with risk of or protection from diarrhoeal diseases in children from urban communities in north-eastern Brazil. The case–control study included 166 children, who had their stools evaluated for the EAEC diagnostic genes (aaiCandaatA) using PCR. Positive samples were further analysed by multiplex PCR and identified 18 VRGs. EAEC was found in the same proportion in both groups (41 %). The plasmid-borne gene encoding a hexosyltransferase homologue (capU) was the most frequently detected (89.6 %), followed by dispersin protein (aap, 58.2 %) and EAECHilAhomologue (eilA, 57.8 %). The AAF/III fimbrial subunit (agg3A) gene was observed at lower frequency (1.5 %). Plasmid-encoded toxin (pet) or AAF/II fimbrial subunit (aafA) was associated significantly with disease. AAF/IV fimbrial subunit (agg4A) or hypothetical plasmid-encoded haemolysin (orf61) was detected significantly more in controls than in children with diarrhoea. In addition, one set of genes in combination,aaiCandagg3/4Cbut lackingagg4Aandorf61, was associated with diarrhoea cases; and another one,orf61in the absence ofpetandaafA, was correlated with control children. These data confirm a high prevalence, endemicity and heterogeneity of EAEC strains in the developing urban areas of north-eastern Brazil. Statistical correlation between cases and controls was seen with either isolated or combined sets of genes, suggesting that the pathophysiology of EAEC infection involves a complex and dynamic modulation of several VRGs.
Quality and quantity in primary care mixed‐payment models: evidence from family health organizations in Ontario
Authors: Kralj Boris , Kantarevic Jasmin
Published: February 2013

Abstract We study the impact of a mixed capitation model (the Family Health Organization, FHO) on quality and quantity outcomes among primary care physicians in Ontario. Using a panel of administrative data covering one year before and two years after the FHO model was introduced, we find that physicians in the FHO model provide about 6% to 7% fewer services and visits per day, but are between 7% and 11% more likely to achieve preventive care quality targets. These results suggest that the mixed capitation model with contractible quality indicators may be welfare improving relative to the FFS model.
Imperfect financial integration and asymmetric information: competing explanations of the home bias puzzle?
Authors: Mondria Jordi , Wu Thomas
Published: February 2013

Abstract This paper shows that imperfect financial integration and informational asymmetries are not competing theories but rather complementary ideas to a single explanation of the home bias puzzle. We develop a rational expectations model of asset prices with investors that face informational constraints and find that informational advantages arise endogenously as a response to small financial frictions. We also present empirical evidence that (i) international financial frictions are correlated to observed patterns of US investors’ attention and that (ii) the attention US investors allocate to foreign stocks helps explain home bias towards those countries, even after controlling for financial integration levels.
Phylogenomics ofAnnelida revisited: a cladistic approach using genome‐wide expressed sequence tag data mining and examining the effects of missing data
Authors: Kvist Sebastian , Siddall Mark E.
Published: February 2013

We present phylogenomic analyses of the most comprehensive molecular character set compiled forAnnelida and its constituent taxa, including over 347 000 aligned nucleotide sites for 39 taxa. The nucleotide data set was recovered using a pre‐existing amino acid data set of almost 48 000 aligned sites as a backbone fortBLASTn searches againstNCBI. In addition, orthology determinations of the loci in the original amino acid data set were scrutinized using anAll vsAllReciprocalBestHit approach, employingBLASTp, and examining for statistical interdependency among the loci. This approach revealed considerable sequence redundancy among the loci in the original data set and a new data set was compiled, with the redundancy removed. The newly compiled nucleotide data set, the original amino acid data set, and the new reduced amino acid data set were subjected to parsimony analyses and two forms of bootstrap resampling. The last‐named data set also was analysed using a maximum‐likelihood approach. There were two main objectives to these analyses: (i) to examine the general topology, including support, resulting from the analyses of the new data sets and (ii) to assess the consistency of the branching patterns across optimality criteria by comparison with previous probabilistic approaches. The phylogenetic hypotheses resulting from analyses of the three data sets are largely unsupported, reflecting the continued difficulty of finding numerous, reliable, and suitable loci for a group as ancient asAnnelida. Resulting parsimonious hypotheses disagree, in some respects, with the previous probabilistic approaches; Sedentaria and, in most cases, Errantia are not supported as monophyletic groups butPleistoannelida is recovered as a (unsupported) monophyletic group in one of the three parsimony analyses as well as the likelihood analysis. In addition, we performed missing data titration studies to estimate the impact of missing data on overall support and support for specific clades.
The relational model of spiritual engagement depicted by palliative care clients and caregivers
Authors: Penman Joy , Oliver Mary , Harrington Ann
Published: February 2013

This paper aims to explicate the essence of spiritual engagement from the perspective of palliative care clients and their caregivers. Van Manen's hermeneutic phenomenological approach guided this study. In‐depth interviews of 14 rural Australian participants with experience of a life‐limiting condition provided rich discourse of the lived experience of spiritual engagement. This research highlights spiritual engagement represented in a relational model developed from a creative synthesis of the emerging themes. Spiritual engagement is associated with ‘personal transformation’, ‘human values of love, compassion and altruism’, ‘maintaining relationships’, ‘participating in religious practices’ and ‘culture’. The findings of this research are supported by Mayes’ observations on spirituality, that is, the ‘pursuit of a trans‐personal and trans‐temporal reality that serves as the ontological ground for an ethic of compassion and service’.
Characteristics of fever, etiologic factors, antibiotic use and prognosis in febrile dermatology inpatients
Authors: Göktay Fatih , Ceran Nurgül , Aydıngöz İkbal Esen , Mansur Ayşe Tülin
Published: February 2013

Background  Generally, fever is observed in >30% of hospitalized patients. However, little is known about fever in dermatology inpatients.

Objectives  The aim of this study was to investigate and document the incidence, characteristics, and etiologic factors of fever in febrile dermatology inpatients and to describe the practice of antibiotic use and prognosis in the same group.

Methods  The medical records for 928 inpatients were retrospectively analyzed.

Results  The incidence of fever was found to be 16.2%. Mean length of hospital stay was found to be longer in febrile patients. Of the 176 febrile episodes, 79 (44.9%) occurred in patients without infections, 43 (24.4%) in patients with community‐acquired infections, 25 (14.2%) in patients with healthcare‐associated infections, 18 (10.2%) in patients classified with fever of non‐infectious/infectious causes, and 11 (6.3%) in a group for whom the etiologic factors of fever were undetermined. Antibiotic treatment was started in 36.2% of febrile inpatients. The overall mortality rate was 0.6%.

Conclusions  This is the first study to investigate febrile episodes in dermatology inpatients. Fever is a frequently encountered symptom in dermatology inpatients. Febrile episodes resulted from mostly non‐infectious entities, mainly consisting of inflammatory dermatologic disorders. Antibiotics were ordered in a higher percentage of patients in the febrile group. Dermatologists started prophylactic or empiric antibiotic therapy in febrile patients with non‐infectious or inflammatory diagnoses on the assumption that these patients had an increased risk for infection as a result of impaired skin integrity and use of immunosuppressive drug therapy. The overall mortality rate was very low in the study group of dermatology inpatients.