bluuebunny/crossref_metadata_2025 huggingface dataset:
Antimicrobial Efficacy of the Silver Wound Dressing Biatain Ag in a Disc Carrier Test Simulating Wound Secretion
Authors: Ebert M. , Assadian O. , Hübner N.-O. , Koburger T. , Kramer A. ,   on behalf of the ‘International Society of Chemotherapy Working Group Antiseptics’ and the ‘Working Section for Clinical Antiseptic of the German Society for Hospital Hygiene’
Published: August 2011

Aim: The efficacy of antimicrobial compounds included in wound dressings has been determined using the quantitative suspension test according to EN 13727 before. However, as suspension tests are not an accurate reflection of the conditions under which wound antiseptics are used, it was investigated if a disc carrier test would yield results simulating practical conditions on wound surfaces. A silver-leaching foam wound dressing was used for evaluation of the disc carrier test method. Method: The disc carriers consisted of circular stainless-steel discs measuring 2 cm in diameter and 1.5 mm in thickness, complying with the requirements of EN 10088-2. Carriers were contaminated with Staphylococcus aureus, methicillin-resistant S. aureus or Pseudomonas aeruginosa, respectively, together with an artificial wound secretion and left to dry at room temperature for 30 min. The wound dressings being tested were placed on the discs for the length of the exposure time, and after neutralization by thioglycolate in phosphate-buffered saline the number of surviving test organisms was then counted. The logarithmic reduction factor was calculated from the difference between the initial inoculum and the number of recovered test organisms. Results: The disc carrier test allowed determination of an antimicrobial efficacy in a realistic setting. It also imposed more stringent requirements on efficacy over time than the quantitative suspension test. The silver foam wound dressing showed a time-dependent antimicrobial efficacy. After 24-hour application time, the reduction factors against S. aureus, P. aeruginosa and the methicillin-resistant S. aureus were 1.9 ± 0.15, 2.1 ± 0.14 and 3.1 ± 0.18, respectively. Conclusion: The disc carrier test was a useful method for testing the antimicrobial efficacy of a foam silver dressing. The antimicrobial dressing exhibited an antimicrobial effect after 3 h and achieved a reduction >2 log against the tested bacterial strains in the presence of a simulated wound secretion after 24 h.
In families with inherited thrombophilia the risk of venous thromboembolism is dependent on the clinical phenotype of the proband
Authors: Rossi Elena , Ciminello Angela , Za Tommaso , Betti Silvia , Leone Giuseppe , Stefano Valerio
Published: August 2011

The utility of laboratory investigation of relatives of individuals with inherited thrombophilia is uncertain. To assess the risk of venous thromboembolism (VTE) among the carriers, we investigated a family cohort of 1,720 relatives of probands with thrombophilia who were evaluated because of VTE (n=1,088), premature arterial thrombosis (n=113), obstetric complication (n=257), or universal screening before pregnancy or hormonal contraception or therapy (n=262); 968 relatives were carriers of thrombophilia. A first deep venous thrombosis (DVT) occurred in 44 carriers and 10 non-carriers during 37,688 and 29,548 observationyears from birth, respectively. The risk of DVT among the carriers compared with non-carriers was estimated as a hazard ratio (HR). If the proband had VTE and factor V Leiden (FVL) and/or prothrombin (PT)20210A, the HR for DVT was 2.77 (95%CI 1.21–4.82) in the carriers overall, and 5.54 (95%CI 3.20–187.00) in those homozygous or double heterozygous for FVL and PT20210A. If the proband had VTE and a deficiency of antithrombin (AT), protein C or S, the HR for DVT was 5.14 (95%CI 0.88–10.03) in the carriers overall, and 12.86 (95%CI 2.46–59.90) in those with AT deficiency. No increase in risk was found among the carriers who were relatives of the probands who were evaluated for reasons other than VTE. In conclusion, familial investigation for inherited thrombophilia seems justified for probands with previous VTE, but appears of doubtful utility for the relatives of probands without VTE. This should be taken with caution regarding families with deficiency of natural anticoagulants, given the low number of cases analysed.
Disease burden and unmet needs for prevention of venous thromboembolism in medically ill patients in Europe show underutilisation of preventive therapies
Authors: Welner Sharon , Kubin Maria , Folkerts Kerstin , Haas Sylvia , Khoury Hanane
Published: August 2011

It was the aim of this review to assess the incidence of venous thromboembolism (VTE) and current practice patterns for VTE prophylaxis among medical patients with acute illness in Europe. A literature search was conducted on the epidemiology and prophylaxis practices of VTE prevention among adult patients treated in-hospital for major medical conditions. A total of 21 studies with European information published between 1999 and April 2010 were retrieved. Among patients hospitalised for an acute medical illness, the incidence of VTE varied between 3.65% (symptomatic only over 10.9 days) and 14.9% (asymptomatic and symptomatic over 14 days). While clinical guidelines recommend pharmacologic VTE prophylaxis for patients admitted to hospital with an acute medical illness who are bedridden, clear identification of specific risk groups who would benefit from VTE prophylaxis is lacking. In the majority of studies retrieved, prophylaxis was under-used among medical inpatients; 21% to 62% of all patients admitted to the hospital for acute medical illnesses did not receive VTE prophylaxis. Furthermore, among patients who did receive prophylaxis, a considerable proportion received medication that was not in accord with guidelines due to short duration, suboptimal dose, or inappropriate type of prophylaxis. In most cases, the duration of VTE prophylaxis did not exceed hospital stay, the mean duration of which varied between 5 and 11 days. In conclusion, despite demonstrated efficacy and established guidelines supporting VTE prophylaxis, utilisation rates and treatment duration remain suboptimal, leaving medical patients at continued risk for VTE. Improved guideline adherence and effective care delivery among the medically ill are stressed.
Haemophilia B: impact on patients and economic burden of disease
Authors: Thomson Thomas , Strandberg-Larsen Martin , Gater Adam
Published: August 2011

Worldwide, haemophilia is the most common hereditary bleeding disorder. The incidence of haemophilia B, however, is considerably less than haemophilia A and consequently appears to have received less attention in the research literature. This article aims to summarise the available evidence documenting the patient and economic burden associated with haemophilia B and current methods of disease management. Both the immediate and long-term clinical consequences of haemophilia B can have significant implications for patients in terms of functional limitations and diminished health-related quality of life (HRQOL). Evidence demonstrates that primary prophylaxis is the optimal strategy for replacing missing clotting factor IX (FIX) and managing haemophilia B. Use of recombinant FIX (rFIX) over plasma-derived FIX (pd-FIX) is also generally preferred for safety reasons. Prophylaxis using currently available rFIX products, however, requires a demanding regimen of intravenous infusions 2–3 times a week which may have significant implications for adherence and ultimately the long-term efficacy of such regimens. Only limited assessments of the cost-effectiveness of prophylactic versus on-demand FIX treatment regimens have been conducted to date. Prophylaxis, however, is generally more costly as greater quantities of FIX are consumed. Any reduction in FIX replacement dosing frequency is expected to improve patient adherence and contribute to improved clinical outcomes, further supporting the costeffectiveness of such interventions. Although a rare disease, as economic constraints for healthcare increase, generating further information regarding the key clinical, patient and economic outcomes associated with haemophilia B will be essential for supporting improvements in care for people with haemophilia B.
Suboptimal anticoagulation with pre-hospital heparin in ST-elevation myocardial infarction
Authors: Hermanides Renicus , Dambrink Jan-Henk , Boer Menko-Jan , Hoorntje Jan , Gosselink A. T. , Suryapranata Harry , Zijlstra Felix , van ’t Hof Arnoud , Ottervanger Jan ,   the Zwolle Myocardial Infarction Study Group
Published: August 2011

This is a prospective, observational study performed in all consecutive ST-elevation myocardial infarction (STEMI) patients who had activated clotting time (ACT) measurement on arrival in the cathlab before coronary angiography. We studied the therapeutic effects of a pre-hospital fixed heparin bolus dose in consecutive patients with STEMI. A total of 1,533 patients received pre-hospital administration of aspirin, high dose clopidogrel (600 mg) and a fixed bolus dose of 5,000 IU unfractionated heparin (UFH), according to the national ambulance protocols. Some patients were also treated with glycoprotein IIb/IIIa inhibitors (GPI) in the ambulance. A therapeutic ACT range was defined according to the ESC guidelines as 200–250 seconds when patients had GPI pretreatment and 250–350 seconds when no GPI pretreatment. Of the 1,533 patients, 216 patients (14.1%) had an ACT within the therapeutic range, 82.3% of the patients had a too low ACT, whereas 3.5% of the patients had a too high ACT. After multivariable analysis, the only independent predictor of a too low ACT was increasing weight (odds ratio 1.02/kg, 95% confidence interval 1.01–1.03, p=0.001). Patients with a too low ACT had less often an open infarct related vessel (initial TIMI flow 2,3) as compared to patients with an ACT in range (36.5% vs. 45.9%, p=0.013). In only a minority of patients with STEMI, pre-hospital treatment with a fixed bolus dose UFH is within the therapeutic ACT range. Increased weight is an independent determinant of a too low ACT. We strongly recommend weight adjusted administration of UFH in the ambulance.
Phase II prospective open-label trial of recombinant interleukin-11 in women with mild von Willebrand disease and refractory menorrhagia
Authors: Jankowitz Rachel , Jaworski Kristen , Merricks Elizabeth , Kloos Mark , Nichols Timothy , Ragni Margaret
Published: August 2011

Lack of effective treatment for menorrhagia is the greatest unmet healthcare need in women with von Willebrand disease (VWD). We conducted a single-centre phase II clinical trial to determine efficacy and safety of recombinant IL-11 (rhIL-11, Neumega®) given subcutaneously for up to seven days during six consecutive menstrual cycles each in seven women with mild VWD and menorrhagia refractory to haemostatic or hormonal agents. rhIL-11 reduced menstrual bleeding severity as measured by pictorial blood assessment chart (PBAC) ≥50% (to <100) in 71% of subjects, cycle severity ≥50% in 71%, and bleeding duration ≥2 days in 85%, all p≤0.01. After rhIL-11, plasma VWF:RCo increased 1.1-fold, but did not correlate with PBAC, r=0.116, bleeding duration, r=0.318, or cycle severity, r=-0.295, or hsCRP, r=-0.003, all p>0.05. Platelet VWF mRNA expression by quantitative PCR increased mean four-fold (1.0–13.5). rhIL-11 was well tolerated with grade 1 or less fluid retention, flushing, conjunctival erythema, and local bruising. In summary, rhIL-11 reduces menorrhagia safely and warrants further study.
Identification of thrombin-like activity in ovarian cancer associated ascites and modulation of multiple cytokine networks
Authors: Morena Emilia , Belotti Dorina , Carraro Fabio , Allavena Paola , Giavazzi Raffaella , Naldini Antonella
Published: August 2011

Blood coagulation cascades can be activated by different mechanisms and to different levels in cancer patients. In a study conducted on the transcriptional profile of epithelial ovarian cancer patients a number of possible links between coagulation and inflammation have been suggested and we and others have reported that, in addition to its central role in blood coagulation and haemostasis, thrombin is a powerful regulator of inflammatory responses. Here, we report that thrombin-like activities were present in the malignant ascites of patients with ovarian carcinoma. Malignant ascites significantly enhanced the release of cytokines/chemokines, which have been previously shown to support tumour progression, such as interleukin (IL)-6, IL-1β, CCL2 and CXCL8, in human peripheral blood mononuclear cells of healthy volunteers. Interestingly, ascites enhanced the release of the anti-inflammatory cytokine IL-10 and inhibited the production of interferon-γ and IL-12. The presence of the anticoagulant antithrombin reversed IL-12 inhibition induced by ascites in human monocytes. Finally, the use of thrombin and of the specific thrombin receptor (PAR) agonist peptides, TFLLRN and AYGPK, suggests that IL-12 inhibition is thrombin-specific and related to PAR-1, but not to PAR-4. These findings underline the tight relationship between the coagulation pathway, where thrombin is the key enzyme, and cytokine modulation, including IL-12 inhibition, which is a critical feature of the tumour microenvironment, and may represent a powerful strategy used by tumours to escape immune surveillance.
Heterozygosity for R1141X in
ABCC6
and Risk of Ischemic Vascular Disease
Authors: Hornstrup Louise S. , Tybjærg-Hansen Anne , Haase Christiane L. , Nordestgaard Børge G. , Sillesen Henrik , Grande Peer , Frikke-Schmidt Ruth
Published: August 2011

Background—

Pseudoxanthoma elasticum (PXE) is an autosomal recessive disease caused by loss-of-function mutations in ABCC6 and characterized by elastic calcification leading to dermal, ocular, and ischemic vascular disease. We tested the hypothesis that heterozygosity for R1141X, the most frequent PXE-causing mutation in Caucasians, associated with risk of ischemic vascular disease, as previous studies suggested 4- to 11-fold risk of ischemic heart disease (IHD) in heterozygotes.

Methods and Results—

We studied 10 276 persons from the general population, including 1985 with IHD and 989 with ischemic cerebrovascular disease (ICVD). We examined 45 603 individuals from a cross-sectional general population study, of whom 3738 had IHD and 2335 had ICVD. Finally, we compared 4851 patients with IHD and 625 patients with ICVD with, respectively, 4851 and 625 matched control subjects. We genotyped participants in all studies for ABCC6 R1141X. The frequency of R1141X was 0.6% in all populations studied. ABCC6 R1141X genotype was not associated with an increased risk of IHD, myocardial infarction, ICVD, or ischemic stroke. Furthermore, R1141X genotype did not interact with age on risk of the largest end point, IHD. Finally, R1141X genotype did not associate with variation in plasma levels of high-sensitivity C-reactive protein, fibrinogen, blood pressure, or lipid and lipoproteins in the general population.

Conclusions—

In 4 studies including 66 831 participants and 13 642 cases with ischemic vascular events, heterozygosity for ABCC6 R1141X did not associate with risk of IHD, myocardial infarction, ICVD, or ischemic stroke.
A Shift in Western Tropical Pacific Sea Level Trends during the 1990s
Authors: Merrifield Mark A.
Published: August 2011

Pacific Ocean sea surface height trends from satellite altimeter observations for 1993–2009 are examined in the context of longer tide gauge records and wind stress patterns. The dominant regional trends are high rates in the western tropical Pacific and minimal to negative rates in the eastern Pacific, particularly off North America. Interannual sea level variations associated with El Niño–Southern Oscillation events do not account for these trends. In the western tropical Pacific, tide gauge records indicate that the recent high rates represent a significant trend increase in the early 1990s relative to the preceding 40 years. This sea level trend shift in the western Pacific corresponds to an intensification of the easterly trade winds across the tropical Pacific. The wind change appears to be distinct from climate variations centered in the North Pacific, such as the Pacific decadal oscillation. In the eastern Pacific, tide gauge records exhibit higher-amplitude decadal fluctuations than in the western tropical Pacific, and the recent negative sea level trends are indistinguishable from these fluctuations. The shifts in trade wind strength and western Pacific sea level rate resemble changes in dominant global modes of outgoing longwave radiation and sea surface temperature. It is speculated that the western Pacific sea level response indicates a general strengthening of the atmospheric circulation over the tropical Pacific since the early 1990s that has developed in concert with recent warming trends.
Quantitative Flood Forecasting on Small- and Medium-Sized Basins: A Probabilistic Approach for Operational Purposes
Authors: Silvestro Francesco , Rebora Nicola , Ferraris Luca
Published: August 2011

The forecast of rainfall-driven floods is one of the main themes of analysis in hydrometeorology and a critical issue for civil protection systems. This work describes a complete hydrometeorological forecast system for small- and medium-sized basins and has been designed for operational applications. In this case, because of the size of the target catchments and to properly account for uncertainty sources in the prediction chain, the authors apply a probabilistic framework. This approach allows for delivering a prediction of streamflow that is valuable for decision makers and that uses as input quantitative precipitation forecasts (QPF) issued by a regional center that is in charge of hydrometeorological predictions in the Liguria region of Italy. This kind of forecast is derived from different meteorological models and from the experience of meteorologists. Single-catchment and multicatchment approaches have been operationally implemented and studied. The hydrometeorological forecasting chain has been applied to a series of case studies with encouraging results. The implemented system makes effective use of the quantitative information content of rainfall forecasts issued by expert meteorologists for flood-alert purposes.
Charles Brenner
Authors: Friedman Lawrence
Published: August 2011

To avoid certain errors in practice, Charles Brenner offered an holistic substitute for the Freudian structural model of the mind. He used the term compromise formation ambiguously to refer to both actions and states, so as to render unnecessary what he considered artificial, judgmental attitudes embodied in images of psychic structures. He believed that a theory of conflicting structures transforms the phenomenological drama of the patient’s actual life-world into an artificial drama of contending intrapsychic parties that may reflect the analyst’s values. According to Brenner, the meaning of life, with its desires, fears, and regrets, is structured forever in the first articulation of the family drama, and that is all the structure a practitioner should have in mind. In principle, the ambiguity of the term compromise formation allows for observed continuities in human life, and might have inspired an ambitious theoretician to exploit that option for an account of character, but that aspect of theory moves in a direction opposite to Brenner’s practical mission. For the same practical reason Brenner refused to acknowledge gradations of mental operation, such as differences in maturity, or style or level of thinking, so the theory cannot say how change can take place, analytic or otherwise. These lacunae in theory were unblinkingly (if implicitly) accepted in pursuit of Brenner’s goal, which was not to polish up theory but to cleanse the analyst’s mind of concepts that subtly interfere with the essential nondirectiveness of treatment. His theoretical minimalism and exclusive concern with practical consequences can be recognized as a peculiarly North American attitude to psychoanalysis.
Repairing Links
Authors: Keller L. Eileen
Published: August 2011

A psychoanalytic model of preschool consultation is presented, born of the conviction that psychoanalysis has powerful tools with which to tackle some of our most difficult and entrenched community problems. Since trauma is known to impact our ability to think reflectively and symbolically (Fonagy, Moran, and Target 1993), the clinical methods of psychoanalysis—drawing on the ideas of container/contained, the capacity to hold alternate points of view, and the capacity to reflect empathically (here with teachers in the face of their at times harsh and insensitive treatment of students)—are crucial to success in work with cumulatively traumatized staff (Khan 1963). The strongest resistances to consultation arise from an anti-attachment system developed as a result of cumulative trauma and operating at multiple levels in the preschool. Consultation services are organized around an understanding of this anti-attachment system. At various levels of the system, including staff, parents, and children, consultants work to facilitate secure relationships in the preschool setting. These relationships foster recognition of children’s emotional complexities and build cooperative links between staff and parents, in an atmosphere that otherwise might often push adults into fearful, self-protective states that interfere with their contact with children’s states of mind.
White Perceptions of Whether African Americans and Hispanics are Prone to Violence and Support for the Death Penalty
Authors: Unnever James D. , Cullen Francis T.
Published: August 2011

Objective: To explore whether the impact of racial and ethnic pejorative stereotypes and prejudice on White support for the death penalty changes over time. Methods: The data were drawn from the 1990 and 2000 General Social Surveys. This trend analysis included a four-item racial–ethnic prejudice scale and two stereotype or “typification” measures that assessed the extent to which the respondents believed that African Americans and Hispanics were more prone to violence than Whites. Controls were introduced for standard demographic measures and for known covariates of punitiveness, such as conservative political ideology and religious beliefs and involvement. The dependent variable was whether the respondents favored the death penalty for persons convicted of murder. Results: The analyses revealed that racial and ethnic prejudice increases Whites' embrace of capital punishment in both periods of time. By contrast, the negative stereotypes that typify African Americans and Hispanics as prone to violence exerted a significant impact on support for the death penalty in 1990 but not in 2000. Conclusions: These findings suggest that Whites' views on minority group members' proneness to violence potentially shift over time and exert significant impacts on death penalty support depending on the broader social context that prevails at a given historical juncture. Racial–ethnic feelings of animus appear to be a stable, if not intractable source of punitiveness. Future research should continue to unpack the complex nature of Whites' racial and ethnic views and to explore how, in given sociopolitical contexts, they potentially serve to justify punitive policy agendas.
Constructive Politics as Public Work
Authors: Boyte Harry C.
Published: August 2011

This essay argues that fulfilling the promise of participatory democratic theory requires ways for citizens to reconstruct the world, not simply to improve its governance processes. The concept of public work, expressing civic agency, or the capacity of diverse citizens to build a democratic way of life, embodies this shift. It posits citizens as co-creators of the world, not simply deliberators and decision-makers about the world. Public work is a normative, democratizing ideal of citizenship generalized from communal labors of creating the commons, with roots in diverse cultures. Shaped through contention with forces which threaten shared ways of life and their commons, grounded in an understanding of human plurality, public work has political qualities that unmask sentimentalized civic discourses of modern elites. Public work places citizens, not markets or states, as the foundational agents of democracy. It opens a path beyond the political crisis.
‘Praise the Lord, All you Gentiles’: The Encoded Audience of Romans 15.7-13
Authors: Das A. Andrew
Published: August 2011

Romans 15.7-13 addresses an encoded gentile audience. The best solution to the syntactical challenges posed by 15.8-9a places the focus on the gentiles who now glorify God as a result of Christ’s servanthood. Paul’s identification of the Jewish people as ‘the circumcision’, a negative category earlier in the letter (2.25—3.30; 9.18), is hardly apt if he is also addressing Jewish Christians. Romans 15.6-9a links the Roman audience’s mutual welcoming ‘for the glory of God’ to the gentiles’ glorifying God. The Scripture citations in 15.9b-12 remain riveted on God’s purpose for the gentiles and address the Romans as gentiles. Romans 15.12-13 links the Roman audience’s hope with the hope of the gentiles. The preceding context identifies the ‘weak’ not as Jews but by customs that were popular among gentile sympathizers. Romans 15.14-21 conforms to Paul’s pattern elsewhere in the letter of identifying the encoded audience as the recipients of his gentile ministry.
Estimating Energy Needs in Nutrition Support Patients
Authors: Frankenfield David C. , Ashcraft Christine M.
Published: August 2011

Determination of energy needs is a fundamental part of nutrition support. The amount of metabolically active tissue mass is the major determinant of metabolic rate. The other components of total energy requirement in an adult are physical activity, diet‐induced thermogenesis, and illness hypermetabolism. Measurement with indirect calorimetry is possible but not common. Measurement can capture the effect of body size, diet‐induced thermogenesis, and illness on metabolic rate but usually not the effect of physical activity. More often, the energy need is calculated based on its association with body weight and composition. Many equations have been proposed over the years, as have adjustments to body weight in an attempt to capture the distorting effect of body composition in obesity and emaciation. Some equations capture the effects of illness and diet‐induced thermogenesis without the need for modification; some require multiplication with various factors. None predict the energy expenditure from physical activity. In determining the energy prescription, all of the component parts must be considered, regardless of whether energy expenditure is measured or calculated.
From secrecy to transparency
Authors: Bodei Remo
Published: August 2011

From Machiavelli and Guicciardini to Gracián and Richelieu, secrecy is a defining element in the politics of reasons of state, in the art of simulation and dissimulation. These techniques were considered instrumental in order to procure the very survival of the state in situations of permanent emergency. From politics as a secret art centered on the prince’s cabinet, we move gradually along an historical and theoretical path. From English liberalism that places the parliament at the center of politics and the French Enlightenment that exalted the capacity of reason to enlighten the mind and help humankind to leave the state of minority, we move toward democracy as public knowledge, as a ‘house of glass', exposed to the scrutiny and control of public opinion. It is nonetheless clear that neither the proto-liberal parliament nor the subsequent parliamentary democracies will ever become the ‘houses of glass' that democratic ideologies champion. This is true in the recent decades in which populism and demobilization of masses are changing the essence of democracy.
Youth Sports
Authors: Coakley Jay
Published: August 2011

There is a widespread belief that sport participation inevitably contributes to youth development because sport’s assumed essential goodness and purity is passed on to those who partake in it. Promoted and perpetuated by sport evangelists and kindred spirits, this belief inspires the strategy of using sports to create among young people the attributes needed to achieve personal success. This neoliberal approach to development is perpetuated by anecdotes and unsystematic observations that uncritically support the evangelistic promise that sport participation produces positive development among young people. Although a few scholars in the sociology of sport have studied sport participation and identified conditions under which particular outcomes are likely to occur, there remains a need for critical research and theory that identifies the processes through which sport participation is or is not linked with subsequent forms of civic engagement and efforts to produce progressive change transcending the lives of particular individuals. Strategies for doing this are identified.
Comparison of Minimally Invasive Techniques in Tongue Base Surgery in Patients with Obstructive Sleep Apnea
Authors: Babademez Mehmet Ali , Yorubulut Mehmet , Yurekli Muge Fethiye , Gunbey Emre , Baysal Selcan , Acar Baran , Karaşen Rıza Murat
Published: August 2011

Objective

To compare the effectiveness and morbidity of 3 microinvasive tongue base surgical procedures combined with uvulopalatopharyngoplasty (UPPP) in supine‐dependent obstructive sleep apnea (OSA) patients.

Study Design

A prospective, randomized clinical study.

Setting

A tertiary referral center.

Methods

Fifty OSA patients were randomly advised to undergo UPPP combined with low‐temperature bipolar radiofrequency (group 1), submucosal minimally invasive lingual excision with radiofrequency (SMILE‐R; group 2), or submucosal minimally invasive lingual excision with a harmonic scalpel (SMILE‐H; group 3). The Epworth Sleepiness Scale, the visual analog scale (VAS) for snoring, the pre‐ and postoperative 3‐month polysomnography (PSG) findings, and the decrease in tongue volume using magnetic resonance imaging (MRI) were compared. The operation times, the postoperative pain VAS score, the analgesic requirement, and the time in commencing a normal diet were compared in the 3 groups.

Results

The decrease in apnea‐hypopnea index (AHI) and supine AHI values at the postoperative 3‐month time point was significant in group 2 (P <. 05). The decrease in tongue volume at the 3‐month postoperative time point according to the MRI evaluations was higher in groups 1 and 2 (P <. 05). In the subjective comparison of effectiveness, there was no significant difference. The operation time was significantly lower in group 3. In the assessment of postoperative pain, no significant difference was found between the groups.

Conclusion

When the PSG findings and MRI were evaluated, UPPP + SMILE‐R were found to be more effective. No significant difference was found between the 3 techniques when morbidity and complications were compared.
ICTs and Immaterial Labor From a Feminist Perspective
Authors: Fortunati Leopoldina
Published: August 2011

In this article, I discuss an issue which lies at the core of today’s “political economy” of the domestic sphere. The issue in question is that human beings are pushed to “outsource” their emotions, information, communication, education, organization, and entertainment, while they are left with scarce new technological support with which to cope with the fatigue, stress, boredom, and complexity of housework. My question is “Why has technology which is related to the material aspects of housework ceased to develop, whereas the technology connected to its immaterial aspects (information and communication technologies or ICTs) has grown at an increasing rate?” For answering this question, I analyze briefly how the machinization of the domestic sphere has developed the technologies connected to material labor such as means of transportation and domestic appliances and those connected to immaterial labor such as mass media, ICTs, and new media. A double strategy has always been pursued: a specific strategy is applied to immaterial labor, involving a great deal of technology, and an opposite strategy, involving much less technology, is applied to material labor. This bifurcation is necessary to maintain a high level of value production in everyday life. Nowadays immaterial labor not only creates value in the process of reproduction of the labor force but also generates capital directly. One only needs to think, for example, of Facebook, Twitter, Myspace, and so on. They are basically enterprises which extract value directly from sociability, friendship, and emotion for producing capital.
Measuring success: subjective reputation or evidence of impact?
Authors: Johnson Ian M.
Published: August 2011

How is the success of Schools of Librarianship and Information Studies measured? Should it be? How could it be? Might an international ‘league table’ of Schools be developed in a way that is fair to all and free from criticism?
Internet browsing behavior: a case study of executive postgraduate students in Ghana
Authors: Hinson Robert Ebo
Published: August 2011

This paper examines the motivation for Internet browsing amongst Executive MBA (EMBA) students at the University of Ghana Business School. It underscores the importance of the environmental influences on the social, academic and professional use of the Internet by executive masters students in Ghana. This paper is executed via a qualitative research design. Data for the study was gathered through structured focus group interviews with 24 Executive Master of Business Administration (EMBA) students of the University of Ghana Business School. The study revealed that students browse the Internet for social, academic and professional purposes. The social use of the Internet includes sending and receiving email, socializing through Facebook, chatting, and making new friends. Professionally, students browse the Internet to obtain trade information, interact with clients, check on conference alerts, and access databases of clients. The academic motivations for browsing the Internet include research, getting access to academic journal databases, interacting with lecturers and supervisors, registering for professional courses and obtaining information on specific courses of study.
The potential of e-reserves for the Main Library, University of the West Indies, St. Augustine, Trinidad
Authors: Ramlogan Rabia , Papin-Ramcharan Jennifer
Published: August 2011

This article presents the perspective of an academic library in Trinidad and Tobago that looks to implement an e-reserves service. To provide such a service, the background preparation involves a survey of the subject literature and current library practices to assess the benefits and challenges of e-reserves. Other factors considered include increased access to local content and local copyright legislation. The implementation of the e-reserves pilot is discussed, followed by the pilot’s preliminary findings and lessons learned from the pilot experience. The article ends with a list of recommendations aimed at moving the project forward, given the service’s importance regarding increased availability and accessibility of core teaching materials.
A randomized controlled trial of the effects of muscle stretching, manual therapy and steroid injections in addition to ‘stay active’ care on health-related quality of life in acute or subacute low back pain
Authors: Grunnesjö Marie I , Bogefeldt Johan P , Blomberg Stefan IE , Strender Lars-Erik , Svärdsudd Kurt F
Published: August 2011

Objective: To evaluate the health-related quality of life effects of muscle stretching, manual therapy and steroid injections in addition to ‘stay active’ care in acute or subacute low back pain patients.

Study design: A randomized, controlled trial during 10 weeks with four treatment groups.

Setting: Nine primary health care and one outpatient orthopaedic hospital department.

Subjects: One hundred and sixty patients with acute or subacute low back pain.

Interventions: Ten weeks of ‘stay active’ care only (group 1), or ‘stay active’ and muscle stretching (group 2), or ‘stay active’, muscle stretching and manual therapy (group 3), or ‘stay active’, muscle stretching, manual therapy and steroid injections (group 4).

Main measures: The Gothenburg Quality of Life instrument subscales Well-being score and Complaint score.

Results: In a multivariate analysis adjusted for possible outcome affecting variables other than the treatment given Well-being score was 68.4 (12.5), 72.1 (12.4), 72,3 (12.4) and 72.7 (12.5) in groups 1–4, respectively ( P for trend <0.05). There were significant trends for the well-being components patience ( P < 0.005), energy ( P < 0.05), mood ( P < 0.05) and family situation ( P < 0.05). The remaining two components and Complaint score showed a non-significant trend towards improvement.

Conclusion: The effects on health-related quality of life were greater the larger the number of treatment modalities available. The ‘stay active’ treatment group, with the most restricted number of modalities, had the most modest health-related quality of life improvement, while group 4 with the most generous choice of treatment modalities, had the greatest improvement.
Effective home programme intervention for adults: a systematic review
Authors: Novak Iona
Published: August 2011

Objective: To summarize evidence on effective home programme intervention for adults and describe characteristics of successful home programmes.

Data sources: A search was conducted of MEDLINE, CINAHL, PsycINFO, EMBASE, DARE, The Physiotherapy Evidence Database, Cochrane Database of Systematic Reviews, OTSeeker and Google Scholar and references in manuscripts retrieved.

Review methods: Two independent reviewers determined whether retrieved study abstracts met inclusion criteria: human subjects; adults; home programme intervention; systematic reviews, randomized controlled trials or controlled trials. Included papers were appraised for study design, participants, type and intensity of intervention, and outcomes. Methodological quality of trials was rated using the PEDro scale (1–10 highest).

Results: Thirty-two papers were retrieved (6 systematic reviews, 26 trials). The 23 randomized controlled trials and 3 controlled trials were appraised. All the retrieved papers were level 1a, 1b or 2b evidence. Major findings were: (a) home programme intervention was more effective than no intervention at all; (b) home programme intervention was equally effective to expert-provided therapy, except when therapeutic modalities were used; and (c) different instruction formats produced similar outcomes. Home programmes with favourable outcomes were more likely to: involve the patients in establishing the programme; intervene on the person, task and environment; and provide feedback about progress. Dose did not appear to be related to outcome.

Conclusion: There is grade 1A evidence supporting the effectiveness of home programmes for adults. Home programmes are as effective as expert-provided therapy.
Junior doctors’ learning and development in foundation year 1 posts in palliative medicine
Authors: Morrison Catherine , Forbes Karen
Published: August 2011

Background:

The ability to provide good palliative care to patients is increasingly recognised as a core clinical skill that all doctors should possess. Few junior doctors, however, feel competent in breaking bad news, pain relief and the care of dying patients by the time they are fully registered to practice.

Aim:

The aim of this study was to explore doctors’ experiences in foundation year 1 (F1) palliative medicine posts.

Design:

Participants underwent semi-structured interviews and interview transcripts were analysed using Interpretative Phenomenological Analysis.

Setting/participants:

The study involved a purposive sample of six F1 doctors matched in 2005-2006 to rotations incorporating palliative medicine posts at two acute hospital National Health Service (NHS) Trusts and one NHS hospice in the UK.

Results:

F1 doctors were satisfied with the learning opportunities provided by the posts, which achieved the right balance between supported and autonomous working. They described learning through their day-to-day interactions with staff, including specialist nurses, and by practising their skills on the job. Some struggled, however, to make the transition to a more independent learning style in the clinical environment. Trainees felt the post helped them to develop generic skills, such as symptom control, diagnosing dying and breaking bad news. Whilst they found split posts and on-call rotas disrupted their palliative care learning, these offered important opportunities to learn additional F1 skills.

Conclusions:

F1 posts in palliative medicine in the UK have positive influences on perceived generic skills development and practice. These findings might encourage the development of more rotations incorporating palliative medicine in the future.
A cascaded method to detect aircraft in video imagery
Authors: Dey Debadeepta , Geyer Christopher , Singh Sanjiv , Digioia Matthew
Published: August 2011

Unmanned Aerial Vehicles (UAVs) have played vital roles recently in both military and non-military applications. One of the reasons UAVs today are unable to routinely fly in US National Airspace (NAS) is because they lack the sense and ability to avoid other aircraft. Although certificates of authorization can be obtained for short-term use, it entails significant delays and bureaucratic hurdles. Therefore, there is a great need to develop a sensing system that is equivalent to or has greater performance than a human pilot operating under Visual Flight Rules (VFR). This is challenging because of the need to detect aircraft out to at least 3 statute miles, while doing so on field-of-regard as large as 30°( vertical) × 220°( horizontal) and within the payload constraints of a medium-sized UAV. In this paper we report on recent progress towards the development of a field deployable sense-and-avoid system and concentrate on the detection and tracking aspect of the system. We tested a number of approaches and chose a cascaded approach that resulted in 100% detection rate (over about 40 approaches) and 98% tracking rate out to 5 statute miles and a false positive rate of 1 every 50 frames. Within a range of 3.75 miles we can achieve nearly 100% tracking rate.
Predictors of Quality of Life in Pediatric Survivors of Arterial Ischemic Stroke and Cerebral Sinovenous Thrombosis
Authors: Friefeld Sharon J. , Westmacott Robyn , MacGregor Daune , deVeber Gabrielle A.
Published: August 2011

Predictors of quality of life can define potentially modifiable factors to increase favorable outcomes after pediatric stroke. Quality of life was measured using the Centre for Health Promotion’s Quality of Life Profile (CHP-QOL) in 112 children surviving arterial ischemic stroke or cerebral sinovenous thrombosis at mean 3 years after stroke. Overall quality of life was poor in 17.8% children despite mean scores (3.52) in the “adequate” range. Quality of life related to school and play was most problematic and that related to physical and home environment was least problematic. Female gender, cerebral sinovenous thrombosis stroke, and older age at testing predicted reduced overall and domain-specific quality of life ( P < .05), whereas neurological outcome and family socioeconomic status did not. Cognitive/behavioral deficit and low Verbal IQ adversely affected socialization and quality of life, especially among older children and females. Altered cognition/behavior has a major impact on quality of life after pediatric stroke. Implementation of ameliorative strategies warrants further study.
The Performative Reading of the Hodayot: The Arousal of Emotions and the Exegetical Generation of Texts*
Authors: Harkins Angela Kim
Published: August 2011

This article examines two anonymous Hodayot (1QH 11.6-19 and 13.22—15.8) from the perspective of performance theory (method acting), post-structuralist understandings of subjectivity, and recent studies on the emotions. It is here proposed that when a reader was expected to read performatively, he—the readerly audience is likely to have been predominantly male—was not only expected to imitate the behaviors that are described in the text, but to re-enact the specific emotions that are aroused by it. In this way the reader could hope to form the appropriate subjectivity that is a necessary precondition for religious experience. In the case of the Qumran hodayot, the reading of 1QH 11.6-19 led to the exegetical generation of 1QH 13.22—15.8. If a text is rightly performed, the appropriate emotional signs will be exhibited in the reader and observed by the community (blushing, tears, perspiration, etc.). In this proposal, the reader’s physical display of emotion authenticates the new text that is produced.
Introductory Reflections on Embodiment in Hellenistic Judaism*
Authors: Mirguet Françoise
Published: August 2011

This article examines different uses of the body to express identity in Judeo-Hellenistic narratives. It analyzes four interplays where the body stands for the human self, either as a factor of recognition, as expression of national and religious identity, as a way to mock one’s religion and ethnicity, and as a representation of the living self. The body therefore appears, well before the Rabbinic period, as a frequent resource to express and construct identity. The research confirms recent studies, which have shown that Diasporic communities tend to inscribe identity on the body, rather than use territorial markers.
Judith’s Embodiment as a Reversal of the Unfaithful Wife of YHWH in Ezekiel 16
Authors: Tan Nancy
Published: August 2011

The interpretation of Judith as a literary figure of metaphorization or personification of Israel is not new. However, to focus our lenses on the embodiment of the Jewish aspirations in the figure of Judith may shed new light to interpreting this book. This article presents an interpretation of Judith’s body as a defence of the Jewish faith. At the same time, it understands such portrayals as a means of negotiating for the faithful feminine Jew in exchange for the earlier prophetic condemnation of the female bodies of unfaithful Israel/Judah, in particular Ezekiel 16. In other words, Judith becomes a means of reconstructing a new feminine identity for faithful Jews, a replacement for the metaphorical unfaithful wife of YHWH. This article shows how Judith’s body resonates the body of unfaithful Israel/Judah in four aspects: the portrayal of Judith as an embodiment of beauty, an embodiment of devout piety, an embodiment of seduction, and an embodiment of her social status.