bluuebunny/crossref_metadata_2025 huggingface dataset:
Intergovernmental Relations in the UK: Continuity in a Time of Change?
Authors: McEwen Nicola , Swenden Wilfried , Bolleyer Nicole
Published: April 2012

Party political incongruence in the UK after 2007 has had a moderate effect on both the machinery of intergovernmental relations and the dominant modes of intergovernmental interaction. In assessing changes in intergovernmental structures, we find more frequent meetings and more formalised interactions. A preference for informal bilateral exchange, however, still prevails. In assessing changes in the nature of intergovernmental relations, we find some intensification of conflict, but amid continued co-operation. While one might find more pronounced changes after longer periods of party political incongruence, we argue that the limited effect observed thus far can be traced back to: (i) formal-legal features of the UK multi-level polity; (ii) the nature of the policy sectors requiring intergovernmental co-ordination (iii); the specific political dynamics within the constituent governments; and (iv) the mitigating role and structure of non-elected institutions such as the civil service and the judiciary.
Intergovernmental Relations in Scotland: What was the SNP Effect?
Authors: Cairney Paul
Published: April 2012

In Scotland, the formation of a minority government in 2007 by the Scottish National Party (SNP) provided the potential for profound changes in intergovernmental relations. This followed eight years of a Scottish Labour-led coalition government characterised by a low-key and informal relationship with the UK Labour government. From 1999 to 2007, discussions were conducted informally and almost entirely through political parties and executives (ministers and civil servants). Although formal mechanisms for negotiation and dispute resolution existed—including the courts, concordats and Joint Ministerial Committees—they were used rarely. The Scottish Executive also played a minimal role in EU policy-making. Yet, an ‘explosive’ new era of relations between the Scottish and UK governments did not arrive in tandem with the new era of party incongruence. The aim of this article is to explore these issues by asking two main questions: why were formal mechanisms used so rarely from 1999 to 2007, and what factors produced muted rather than problematic IGR in the third parliamentary session, between 2007 and 2011?
The Courts and Devolution in the UK
Authors: Trench Alan
Published: April 2012

The courts have hitherto played a remarkably limited role in the working of devolution in the United Kingdom. In this respect, the UK has been an exception to practice in most federal or decentralised systems, where the courts have tended to assume a prominent role in adjudicating intergovernmental disputes. This article examines whether political congruence contributed to this minimal role for the courts in IGR. It argues that additional factors are also at play: the limited role accorded to lawyers and legal issues in the UK's system of government, the flexibility of the devolution settlements, and the political nature of the UK's constitution, which make it both possible and desirable to resolve intergovernmental disputes by different means. While the courts are likely to become more prominent as a result of third-party litigation, particularly as devolved legislatures become more active, the limited role of the courts in most intergovernmental matters appears unlikely to change.
Intergovernmental Relations and Political Parties in Northern Ireland
Authors: Birrell Derek
Published: April 2012

Intergovernmental relations (IGR) as a political principle and a mechanism of governance have played a major and distinctive role in Northern Ireland's political and constitutional development. This distinctiveness is apparent in the interpretation and scope of IGR, in party representation in intergovernmental fora and in the meaning and context of party incongruence. This article seeks to analyse the development and nature of IGR since the restoration of devolved government in 1999 but particularly since 2007, in light of this distinctiveness. It sets out the wide range and nature of the processes and institutions of IGR involving the Northern Ireland government and its form of consociational representation. The article then examines how the different political parties have engaged in IGR.
BOOTSTRAPPING COVARIATE UNIT ROOT TESTS: AN APPLICATION TO INFLATION RATES
Authors: Lee Cheng‐Feng , Tsong Ching‐Chuan
Published: April 2012

This paper proposes a bootstrap procedure for the covariate point optimal tests (CPT) of Elliott and Jansson. Although the covariate tests enjoy large power gains over the traditional univariate unit root tests, our simulations show that they still suffer from severe size distortions at finite samples. Through simulations, we demonstrate the superiority of the bootstrap procedure in the sense that it can yield desirable size and power properties for the CPT tests when the Akaike's information criterion is used. Moreover, we show the empirical relevance of the bootstrap tests by applying them to inflation in the G‐10 countries, and then obtain strong evidence against the unit root hypothesis for most countries at the 5% significance level.
Gaze Following, Gaze Reading, and Word Learning in Children at Risk for Autism
Authors: Gliga Teodora , Elsabbagh Mayada , Hudry Kristelle , Charman Tony , Johnson Mark H. ,   The BASIS Team
Published: April 2012

This study investigated gaze‐following abilities as a prerequisite for word learning, in a population expected to manifest a wide range of social and communicative skills—children with a family history of autism. Fifty‐three 3‐year‐olds with or without a family history of autism took part in a televised word‐learning task. Using an eye‐tracker to monitor children’s gaze behavior, it was shown that the ability to follow gaze was necessary but not sufficient for successful word learning. Those children who had poor social and communicative skills followed gaze to the labeled object but did not then learn the associated word. These findings shed light on the conditions that lead to successful word learning in typical and atypical populations.
Does Dampened Physiological Reactivity Protect Youth in Aggressive Family Environments?
Authors: Saxbe Darby E. , Margolin Gayla , Spies Shapiro Lauren A. , Baucom Brian R.
Published: April 2012

Is an attenuated physiological response to family conflict, seen in some youth exposed to early adversity, protective or problematic? A longitudinal study including 54 youth (average age 15.2 years) found that those with higher cumulative family aggression exposure showed lower cortisol output during a laboratory‐based conflict discussion with their parents, and were less likely to show the normative pattern of increased cortisol reactivity to a discussion they rated as more conflictual. Family aggression interacted with cortisol reactivity in predicting youth adjustment: Adolescents from more aggressive homes who were also more reactive to the discussion reported more posttraumatic stress symptoms and more antisocial behavior. These results suggest that attenuated reactivity may protect youth from the negative consequences associated with aggressive family environments.
725. IMPATIENS SOULIEANA
Authors: Grey‐Wilson Christopher
Published: April 2012

Impatiens soulieana Hook. fil., from the mountains of western China is illustrated and described along with some observations on its author, renowned for his work on the genus.
726. PRIMULA MELANANTHA
Authors: Rankin David W. H.
Published: April 2012

Primula melanantha (Franch.) C. M. Hu, a taxon known from a single location in the south‐west of Sichuan Province of China and with a long and confused taxonomic history, is described and illustrated. Its relationships with other members of subsection Maximowiczii of section Crystallophlomis are discussed, new keys are provided, and factors relevant to its successful cultivation are described.
The development and validation of the Relational Self‐Esteem Scale
Authors: DU HONGFEI , KING RONNEL B. , CHI PEILIAN
Published: April 2012

Du, H., King, R.B. & Chi, P. (2012). The development and validation of the Relational Self‐Esteem Scale. Scandinavian Journal of Psychology 53, 258–264.

According to the tripartite model of the self (Brewer & Gardner, 1996), the self consists of three aspects: personal, relational, and collective. Correspondingly, individuals can achieve a sense of self‐worth through their personal attributes (personal self‐esteem), relationship with significant others (relational self‐esteem), or social group membership (collective self‐esteem). Existing measures on personal and collective self‐esteem are available in the literature; however, no scale exists that assesses relational self‐esteem. The authors developed a scale to measure individual differences in relational self‐esteem and tested it with two samples of Chinese university students. Between and within‐network approaches to construct validation were used. The scale showed adequate internal consistency reliability and results of the confirmatory factor analysis showed good fit. It also exhibited meaningful correlations with theoretically relevant constructs in the nomological network. Implications and directions for future research are discussed.
Two‐Sample Test Against One‐Sided Alternatives
Authors: LEDWINA TERESA , WYŁUPEK GRZEGORZ
Published: April 2012

Abstract.  This paper proposes, implements and investigates a new non‐parametric two‐sample test for detecting stochastic dominance. We pose the question of detecting the stochastic dominance in a non‐standard way. This is motivated by existing evidence showing that standard formulations and pertaining procedures may lead to serious errors in inference. The procedure that we introduce matches testing and model selection. More precisely, we reparametrize the testing problem in terms of Fourier coefficients of well‐known comparison densities. Next, the estimated Fourier coefficients are used to form a kind of signed smooth rank statistic. In such a setting, the number of Fourier coefficients incorporated into the statistic is a smoothing parameter. We determine this parameter via some flexible selection rule. We establish the asymptotic properties of the new test under null and alternative hypotheses. The finite sample performance of the new solution is demonstrated through Monte Carlo studies and an application to a set of survival times.
Interleukin‐17 regulates visceral obesity in HIV‐1‐infected patients
Authors: Zizza A , Guido M , Grima P
Published: April 2012

Objective

The aim of the study was to evaluate the interleukin‐17 (IL‐17) plasma level in HIV‐1‐infected patients and its relation to central obesity.

Methods

Eighty‐four HIV‐1‐infected patients [42 with visceral obesity (group A) and 42 without visceral obesity (group B)] and 46 HIV‐negative subjects [23 with visceral obesity (group C) and 23 without visceral obesity (group D)] were enrolled in the study. Sonographic measurements of perirenal fat diameter/body mass index (PRFD/BMI) were used to assess visceral adipose tissue thickness.

Results

HIV‐1‐infected patients had higher plasma levels of IL‐17 than HIV‐negative subjects [837.8 ± 260 pg/mL (mean ± standard deviation) vs. 395.3 ± 138.6 pg/mL, respectively; P < 0.001]. Furthermore, HIV‐1‐infected patients with a diagnosis of visceral obesity had lower levels of IL‐17 than HIV‐infected lean patients (756.9 ± 282.9 pg/mL vs. 918.7 ± 208.4 pg/mL, respectively; P < 0.01). IL‐17 (r = −0.21; P = 0.03) and waist circumference (r = 0.48; P < 0.001) were significantly associated with visceral adipose tissue thickness. A negative correlation of IL‐17 (r = −0.23; P < 0.001) with PRFD/BMI was found.

Conclusions

This study suggests a linear negative association between IL‐17 and visceral adipose tissue thickness.
Fibroblast growth factor 23 in hypophosphataemic HIV‐positive adults on tenofovir
Authors: Bech A , Van Bentum P , Nabbe K , Gisolf J , Richter C , De Boer H
Published: April 2012

Objectives

Hypophosphataemia is common in HIV‐positive patients, in particular in those using tenofovir disoproxil fumarate (TDF). Its pathogenesis is not well understood. The importance of fibroblast growth factor 23 (FGF‐23), the most potent phosphaturic hormone known today, has not been studied in these patients. The aim of the study was to investigate whether FGF‐23 might be involved in the aetiology of hypophosphataemia in HIV‐positive patients on tenofovir.

Methods

Calcium and phosphate metabolism was studied in 36 HIV‐positive patients on TDF. Hypophosphataemia was defined as a serum phosphate level < 0.75 mmol/L.

Results

Fifteen patients (42%) had hypophosphataemia (group 1), and 21 had a normal serum phosphate level (group 2). The renal phosphate reabsorption threshold [tubular maximum phosphate reabsorption per glomerular filtration rate (TmP/gfr)] was significantly lower in group 1 than in group 2 (0.58 ± 0.04 vs. 0.91 ± 0.03 mmol/L, respectively; P < 0.0001). The serum phosphate concentration was strongly correlated with TmP/gfr (R = 0.71; P < 0.0001). Both groups had normal serum FGF‐23 levels, and serum phosphate and TmP/gfr were not related to serum parathyroid hormone (PTH) or FGF‐23 levels.

Conclusion

FGF‐23 is not involved in the pathogenesis of hypophosphataemia in HIV‐positive patients on TDF. The data suggest that a PTH‐like factor may be involved.
A national epidemiological study of Myasthenia Gravis in Australia
Authors: Gattellari M. , Goumas C. , Worthington J. M.
Published: April 2012

Background and purpose:  Existing epidemiological studies of Myasthenia Gravis have generally examined small populations. Few national studies have been conducted, and published incidence and prevalence rates vary widely. We report one of the largest national studies of Myasthenia Gravis, and the first incidence and prevalence rates for Australia.

Methods:  Prescriptions for Pyridostigmine Bromide in 2009 were utilized from a national prescribing database to estimate incidence and the prevalence of symptomatic and treated disease. Crude rates were age‐standardized to the WHO world population. We compared standardized rates to recent national studies from Norway and Taiwan.

Results:  In 2009, there were 2574 prevalent cases of symptomatic and treated Myasthenia Gravis, corresponding to an annual crude prevalence rate of 117.1 per 1 million residents. There were 545 incident cases, yielding a crude incidence rate of 24.9 per 1 million residents. The crude incidence in women and men was estimated to be 27.9 and 21.9 per 1 million, respectively. Prevalence and incidence rates were higher in women than men between the ages of 15 and 64 years, and were higher in men than women in those older than 65 years. Rates peaked between the ages of 74 and 84 years, declining thereafter. Standardized incidence was higher in Australia than Norway, but similar to Taiwan (P‐values = 0.007 and 1.00, respectively).

Conclusions:  This first Australian epidemiological study of symptomatic Myasthenia Gravis is one of the largest population‐based studies ever reported and supports higher incidence rates for Myasthenia Gravis. Myasthenia Gravis disproportionately affected younger females and older males.
Evaluation of protective and restoring effects of a mixture of silanols on photoaging. Use of a device allowing the quantification of contractile strengths of human fibroblasts after UVA irradiation
Authors: Robin S. , Courderot‐Masuyer C. , Tauzin H. , Guillon S. , Gaborit J. , Harbon S. , Humbert P.
Published: April 2012

Synopsis

Chronic sun exposure and especially UVA wavelengths are responsible for long‐term clinical skin changes such as photoageing and photocancers. The objectives of the present study were to analyse the contractile activity of fibroblasts irradiated with several doses of UVA and to evaluate the preventive, protective and restoring effects of a mixture of monomethylsilanetriol mannuronate and dimethylsilanediol salicylate. The forces generated by fibroblasts in tense collagen lattices were quantified using Glasbox device before and after UVA irradiation and the addition of a mixture of monomethylsilanetriol mannuronate and dimethylsilanediol salicylate. The production of collagen was also evaluated before and after irradiation and with and without the presence of a mixture of monomethylsilanetriol mannuronate and dimethylsilanediol salicylate. A dose of 3 J cm−² of UVA showed more than 50% of mortality in fibroblast population after 48 h and significant decreases in contractile forces developed by irradiated fibroblasts and collagen I production. One percentage of a mixture of monomethylsilanetriol mannuronate and dimethylsilanediol salicylate protected fibroblasts from UVA irradiation and made it possible to restore their capacity to the same level as fibroblasts that were not irradiated. It also tended to restore the capacity to synthesize collagen I. These results show that the use of the new device Glasbox makes it possible to evaluate a possible preventive and repairing effect of a cosmetic functional active on photoageing.
The effect of adding sour cherry pulp into yoghurt on the physicochemical properties, phenolic content and antioxidant activity during storage
Authors: ŞENGÜL MEMNUNE , ERKAYA TUBA , ŞENGÜL MUSTAFA , YILDIZ HILAL
Published: April 2012

This study investigated the effect of adding sour cherry pulp into yoghurt on its physicochemical properties, phenolic content, antioxidant activity and sensory characteristics. Sour cherry pulp was added at 0%, 8%, 12% and 16% into the yoghurt, and measures were checked through 14 days cold storage. The increasing sour cherry pulp concentration in yoghurt resulted in increasing pH and whey separation, whereas the values of the other parameters, total solid, fat, protein, ash, titratable acidity and viscosity decreased. During storage, total phenolic contents and antioxidant activity in yoghurts ranged from 20 to 81 μg gallic acid equivalent per mg of sample and from 48% to 86%, respectively.
Content analysis as a means of exploring research opportunities from a conference programme
Authors: Fourie Ina
Published: April 2012

Background:  Health librarians should keep up‐to‐date in a dynamic environment and accept the importance of continuing personal development (CPD) and growth in their critical reflection and creative thinking skills. They also need to acknowledge the potential value of research activity and the challenges of ongoing improvement and development. Conference programmes may prove a useful source of stimulation, especially if supplemented by creativity techniques, action research and the ideal of ‘finding flow’.

Objectives:  The article analyses the themes and papers presented at the 10th International Conference on International Medical Librarianship (ICML) to identify opportunities for further research, literature reviews, assessment of practices and services, etc.

Methods:  Content analysis approach to conference papers and suggestions for further action including supplementing with techniques of creativity and group input.

Results:  A fairly extensive list of further actions (although not intended to be exhaustive) is suggested for the sixteen conference themes. Although subjective, the list might help to stimulate growth in research on health librarianship and demonstrate how one source of stimulation – conference programmes (regularly presented to medical library communities) – can be used.

Conclusions:  Content analysis has proven a constructive means of generating research questions from a conference programme. Content analysis and other methods aimed at stimulating creative and progressive thinking, including brainstorming, force field analysis, De Bono’s 6 hats, creative swiping and creative visualisation, may prove equally useful and require further investigation. To ensure an ongoing cycle, these can be linked to action research.
A new agonist of the erythropoietin receptor, Epobis, induces neurite outgrowth and promotes neuronal survival
Authors: Pankratova Stanislava , Gu Bing , Kiryushko Darya , Korshunova Irina , Køhler Lene B. , Rathje Mette , Bock Elisabeth , Berezin Vladimir
Published: April 2012

J. Neurochem. (2012) 121, 915–923.

Apart from its hematopoietic activity, erythropoietin (EPO) is also known as a tissue‐protective cytokine. In the brain, EPO and its receptor are up‐regulated in response to insult and exert pro‐survival effects. EPO binds to its receptor (EPOR) via high‐ and low‐affinity binding sites (Sites 1 and 2, respectively), inducing conformational changes in the receptor, followed by the activation of downstream signaling cascades. Based on the crystal structure of the EPO:EPOR2 complex, we designed a peptide, termed Epobis, whose sequence encompassed amino acids from binding Site 1. The present study shows that the Epobis peptide specifically binds to EPOR and induces neurite outgrowth from primary neurons in an EPOR‐expression dependent manner. Furthermore, Epobis promoted the survival of hippocampal and cerebellar neuronal cultures after kainate treatment and KCl deprivation, respectively. Thus, we identified a new functional agonist of EPOR with the potential to promote neuroregeneration and neuroprotection.
NEUTRON TOMOGRAPHIC ASSESSMENT OF INCISIONS ON PREHISTORIC STONE SLABS: A CASE STUDY FROM WONDERWERK CAVE, SOUTH AFRICA*
Authors: JACOBSON L. , DE BEER F.C. , NSHIMIRIMANA R. , HORWITZ L. K. , CHAZAN M.
Published: April 2012

This study presents the application of neutron tomography to the analysis of ironstone slabs found in a late Earlier Stone Age context (Fauresmith industry) at the back of Wonderwerk Cave, Northern Cape Province, South Africa. These slabs have markings on the surface that might be anthropogenic, and thus significant to understanding the emergence of human symbolic behaviour. Neutron tomography proved to be an effective tool for distinguishing surface incisions from lines that are the expression of internal fissures in the rock.
GAUSSIAN CURVES FOR VISUALIZING CHRONOLOGICAL PATTERNS OF CERAMIC FINDS AND RESIDUALITY*
Authors: LUPI A. FERRARESE , LELLA P.
Published: April 2012

This paper describes a particular statistical approach to chronological data from assemblages of archaeological finds (namely pottery) using Gaussian curves: the method enables us to obtain a graphic representation of chronological patterns that avoids an excessive flattening of data, adding an extra dimension to the usual linear temporal concepts. This enables us to arrive at more likely absolute dating and also visualize residuality. The method has been built during the study of a stratigraphic context from the Site of Ancient Ships of Pisa – San Rossore, Italy, and applied to its pottery. Archaeologists may find in the model a useful tool that is easy to apply.
STUDYING TECHNOLOGICAL PRACTICES AT A LOCAL LEVEL: NEUTRON ACTIVATION AND PETROGRAPHIC ANALYSES OF EARLY CERAMIC PERIOD POTTERY IN CENTRAL CHILE*
Authors: FALABELLA F. , SANHUEZA L. , CORREA I. , GLASCOCK M. D. , FERGUSON T. J. , FONSECA E.
Published: April 2012

We discuss neutron activation and petrographic analyses of domestic ceramics and some raw materials from five archaeological sites in the Valdivia de Paine locality, in Central Chile. During the time period studied, the area was occupied by small‐scale horticultural groups with disperse and sedentary or semi‐sedentary settlement patterns. The analyses indicate that diverse local raw material sources were used in pottery production, and shared by members of different co‐residential units and between different cultural groups. The data indicate as many similarities as differences among the technological practices of pottery‐producing groups who lived in spatial proximity. The results have implications for the understanding of pottery‐producing communities at a local level, as well as small‐scale groups in general.
Hospital‐Level Variation in the Use of Intensive Care
Authors: Seymour Christopher W. , Iwashyna Theodore J. , Ehlenbach William J. , Wunsch Hannah , Cooke Colin R.
Published: April 2012

Objective

To determine the extent to which hospitals vary in the use of intensive care, and the proportion of variation attributable to differences in hospital practice that is independent of known patient and hospital factors.

Data Source

Hospital discharge data in the State Inpatient Database for Maryland and Washington States in 2006.

Study Design

Cross‐sectional analysis of 90 short‐term, acute care hospitals with critical care capabilities.

Data Collection/Methods

We quantified the proportion of variation in intensive care use attributable to hospitals using intraclass correlation coefficients derived from mixed‐effects logistic regression models after successive adjustment for known patient and hospital factors.

Principal Findings

The proportion of hospitalized patients admitted to an intensive care unit (ICU) across hospitals ranged from 3 to 55 percent (median 12 percent; IQR: 9, 17 percent). After adjustment for patient factors, 19.7 percent (95 percent CI: 15.1, 24.4) of total variation in ICU use across hospitals was attributable to hospitals. When observed hospital characteristics were added, the proportion of total variation in intensive care use attributable to unmeasured hospital factors decreased by 26–14.6 percent (95 percent CI: 11, 18.3 percent).

Conclusions

Wide variability exists in the use of intensive care across hospitals, not attributable to known patient or hospital factors, and may be a target to improve efficiency and quality of critical care.
Decision Making, Impulsivity, and Personality Traits in Alcohol‐Dependent Subjects
Authors: Tomassini Annarita , Struglia Francesca , Spaziani Daniela , Pacifico Roberta , Stratta Paolo , Rossi Alessandro
Published: April 2012

The aim of the study was to assess the relationship among decision‐making (DM) ability (as measured by the Iowa Gambling Task [IGT]), impulsivity, and temperament and character traits in a long‐term abstinent alcohol‐dependent sample. Twenty‐six abstinent alcohol‐dependent subjects, referred to a Drug Addiction Unit of the National Health Service of L’Aquila, were evaluated using the IGT, the Barratt Impulsiveness Scale, version 11 (BIS‐11), and the Temperament and Character Inventory 125‐item (TCI‐125) version. Twenty‐four control subjects were recruited and assessed with IGT only. The clinical and control samples were significantly different in their IGT performance, the former sample making disadvantageous choices leading to lower scores. Significant negative correlations between IGT total score and BIS Non‐Planning Impulsivity and a trend toward significance with TCI Novelty Seeking dimension were reported. Our data confirm the results of other studies suggesting DM impairment related to impulsive dimension as an important feature in subjects with alcohol dependence: the finding suggests a role of DM impairment in increasing proneness to a chronic relapsing course. (Am J Addict 2012;24:263–267)
Acute Inpatient Presentation of Kwashiorkor: Not Just a Diagnosis of the Developing World
Authors: Boyd Kevin P. , Andea Aleodor , Hughey Lauren C.
Published: April 2012

Abstract:  We present the case of an infant with presumed Stevens–Johnson syndrome. Through a history, physical, and histopathology, we were able to diagnose the patient with kwashiorkor. Physicians should be aware of this disorder, which is commonly thought of as a developing world problem, because it is increasing in incidence in industrialized nations because of changing dietary habits.
Levetiracetam may favorably affect seizure outcome after temporal lobectomy
Authors: Jehi Lara E. , Irwin Anna I. , Kayyali Hussam , Vadera Sumeet , Bingaman William , Najm Imad
Published: April 2012

Purpose: To study the prognostic implications of antiepileptic drug (AED) use on seizure freedom following temporal lobe resections for intractable epilepsy.

Methods: Seizure outcome implications of epilepsy characteristics and AED use were studied in patients who underwent temporal lobectomy patients at the Cleveland Clinic between September 1995 and December 2006. Survival analysis and multivariate regression with Cox proportional hazard modeling were used. Complete seizure freedom was defined as a favorable outcome.

Key Findings: Records of 312 patients were analyzed (mean ± standard deviation follow‐up 3.5 ± 1.7 years). The estimated probability of complete seizure freedom was 69% at 12 months (95% confidence interval [CI] 66–72%), and 48% at 36 months (95% CI 45–52%). The mean number of AEDs used per patient at the time of surgery was 1.78 (range 1–4), dropping to 1.02 at last follow‐up (range 0–4). Following multivariate analysis, a lower preoperative seizure frequency and perioperative use of levetiracetam predicted a favorable outcome (risk ratio [RR] 0.62, 95% CI 0.43–0.89, and RR = 0.57, 95% CI 0.39–0.83, respectively), whereas nonspecific pathology (RR 1.71, 95% CI 1.15–2.47) and a higher number of AEDs used at the time of surgery correlated with higher rates of seizure recurrence (whole‐model log‐rank test p‐value < 0.0001). Better outcomes within the levetiracetam group were seen despite a higher proportion of several poor prognostic indicators within this patient group, and started as early as 4 months after surgery, gradually increasing to a 15–20% survival advantage by 5 years. No similar outcome correlations were identified with another AED.

Significance: AED use may be a potential new modifiable seizure‐outcome predictor after temporal lobectomy. This possible prognostic indicator is discussed in light of proposed seizure recurrence mechanisms.
The most cited works in epilepsy: Trends in the “Citation Classics”
Authors: Ibrahim George M. , Carter Snead O. , Rutka James T. , Lozano Andres M.
Published: April 2012

The number of times that a published article is cited is one indicator of its scientific impact. An article is termed a “Citation Classic” once it has accumulated more than 400 citations. Trends in these highly cited works allow projection of future directions of high‐impact research within a field. Herein, we identified 89 articles in the field of epilepsy published in 35 different journals that have been cited more than 400 times (citation range 401–3,749). The journal that published the greatest number of Citation Classics was Epilepsia (9 articles with 656 mean citations per article). Laboratory studies constituted the fastest growing area of highly cited epilepsy research, whereas clinical studies showed a bimodal distribution in representation among Citation Classics. There were also considerably fewer epilepsy‐specific Citation Classics compared to other disciplines. In this study, we find that the Citation Classics of epilepsy comprise a heterogeneous group of articles and that changes in the trends of these highly cited works represent the evolution of epilepsy research over time. The results of this study should inform the academic community and provide a guide of essential literature for scientists who are engaged in epilepsy research.
Life Cycle Greenhouse Gas Emissions of Utility‐Scale Wind Power
Authors: Dolan Stacey L. , Heath Garvin A.
Published: April 2012

A systematic review and harmonization of life cycle assessment (LCA) literature of utility‐scale wind power systems was performed to determine the causes of and, where possible, reduce variability in estimates of life cycle greenhouse gas (GHG) emissions. Screening of approximately 240 LCAs of onshore and offshore systems yielded 72 references meeting minimum thresholds for quality, transparency, and relevance. Of those, 49 references provided 126 estimates of life cycle GHG emissions.

Published estimates ranged from 1.7 to 81 grams CO2‐equivalent per kilowatt‐hour (g CO2‐eq/kWh), with median and interquartile range (IQR) both at 12 g CO2‐eq/kWh. After adjusting the published estimates to use consistent gross system boundaries and values for several important system parameters, the total range was reduced by 47% to 3.0 to 45 g CO2‐eq/kWh and the IQR was reduced by 14% to 10 g CO2‐eq/kWh, while the median remained relatively constant (11 g CO2‐eq/kWh). Harmonization of capacity factor resulted in the largest reduction in variability in life cycle GHG emission estimates.

This study concludes that the large number of previously published life cycle GHG emission estimates of wind power systems and their tight distribution suggest that new process‐based LCAs of similar wind turbine technologies are unlikely to differ greatly. However, additional consequential LCAs would enhance the understanding of true life cycle GHG emissions of wind power (e.g., changes to other generators’ operations when wind electricity is added to the grid), although even those are unlikely to fundamentally change the comparison of wind to other electricity generation sources.
Life Cycle Assessment in the Print Industry
Authors: Bousquin Justin , Gambeta Eni , Esterman Marcos , Rothenberg Sandra
Published: April 2012

This article compares life cycle assessment studies performed on imaging equipment for the consumer market in order to identify common practices, limitations, areas for improvement, and opportunities for standardization. The analysis suggests that comparisons across studies are significantly hampered by variability in scope, transparency, data sources, and assumptions; it identifies sources of discrepancy and variability. Of particular concern to printing devices was the definition of a functional unit, which can vary significantly depending on the capabilities and use patterns of a printer. Standardization of the functional unit and related assumptions has a high potential to increase quantitative comparability across studies. At the same time, standardizing the functional unit by paper usage excludes the possibility of comparison to alternative communication media.
Relationship Between Swallowing Problems and Tooth Loss in Community‐Dwelling Independent Elderly Adults: The Fujiwara‐Kyo Study
Authors: Okamoto Nozomi , Tomioka Kimiko , Saeki Keigo , Iwamoto Junko , Morikawa Masayuki , Harano Akihiro , Kurumatani Norio
Published: April 2012

Objectives

To investigate the relationship between swallowing problems and the number of remaining teeth in healthy elderly people.

Design

Cross‐sectional.

Setting

Nara, Japan.

Participants

Three thousand six hundred sixty‐three male and female volunteers aged 65 and older who were living independently were analyzed.

Measurements

Swallowing problems were defined operationally using a questionnaire and the 30‐mL water swallow test. Data were collected on the number of remaining teeth, maximum bite force, occlusal status, presence or absence of oral dryness, and medical history.

Results

The prevalence of swallowing problems was 15.1% (n = 554) in this population. A positive correlation was observed between the number of remaining teeth and maximum bite force. The number of remaining teeth was categorized according to tertiles. Multiple logistic regression analysis revealed that the adjusted odds ratios for 0 to 13 or 14 to 24 remaining teeth to 25 to 32 remaining teeth for swallowing problems were 2.04 (95% confidence interval (CI) = 1.60–2.60) and 1.31 (95% CI = 1.02–1.70), respectively. Significant increases in these odds ratios were found in a trend test (P < .001).

Conclusion

Tooth loss is associated with swallowing problems. Having fewer teeth inhibits masticatory ability, which disturbs the execution of smooth swallowing. Preventive measures against tooth loss at a younger age may be effective at reducing the risk of laryngeal penetration and aspiration at an older age.
A Preliminary Study on the Relationships between Global Health/Quality of Life and Specific Head and Neck Cancer Quality of Life Domains in Puerto Rico
Authors: Psoter Walter J. , Aguilar Maria L. , Levy Andrea , Baek Linda S. , Morse Douglas E.
Published: April 2012

Purpose: Health‐related quality of life (HRQOL) is an important treatment outcome for head and neck cancer (HNC) patients. By ascertaining the most important HNC HRQOL issues, research and practice can be directed toward enhancing patient QOL.

Materials and Methods: A cross‐sectional study of 46 ENT clinic HNC patients in Puerto Rico (PR) was completed. The European Organization for Research and Treatment of Cancer (EORTC) QLQ‐C30 (general QOL), and the QLQ‐H&N35 (HNC QOL) instruments were administered. Correlations and multivariable regressions were separately conducted for QLQ‐H&N35 variables on the three QLQ‐C30 outcome variables: overall health, overall QOL, and the global health/QOL domain.

Results: Correlation findings included statistically significant negative correlations between the three QLQ‐C30 outcome variables and the QLQ‐H&N35 variables pain, swallowing, social eating, social contact, and sexuality. Multivariable linear regression identified statistically significant inverse indicators of the outcomes: (1) “lessening of sexuality” with “overall health” (p= 0.02), (2) “problem with social eating” (p= 0.023), “taking pain killers” (p= 0.025), and “problem with social contact” (p= 0.035) with “overall QOL,” and (3) “problems with social eating” (p < 0.009) and “taking pain killers” (p= 0.016) with the “global health/QOL” domain.

Conclusions: We conclude that problems with pain, social eating, social interactions, and loss of sexuality are critical indicators of degraded HRQOL in HNC patients living in Puerto Rico. Our results add to the overall knowledge base regarding QOL among HNC patients. The promise of improved QOL for the HNC patient is attainable through additional research in conjunction with advances in clinical treatments and patient management protocols.
The Delayed Appearance of Neurological Signs in Intrathecal Granuloma Warrants Imaging Surveillance: A Case Series and Review of the Literature
Authors: Zimmerman Amanda , Rauck Richard L.
Published: April 2012

Abstract:  Intrathecal pump therapy (ITP) has become a mainstay of treatment for the chronic, refractory nonmalignant pain patient. Increasingly, ITP therapy is being instituted for the failed back pain population. Inflammatory mass or granuloma is a complication that is considered “rare” or “uncommon.” In this patient population, the symptoms of granuloma can often mimic the symptoms for which the patient is being treated. The case series reported here illustrates 4 cases of inflammatory mass. One patient presented with paralysis before she was diagnosed, and the remainder of the patients were asymptomatic at the time of diagnosis. The cases presented illustrate the need for broader education of inflammatory mass among nonpain specialists. Etiology, diagnosis and treatment guidelines of inflammatory mass are reviewed. The literature reviewed highlights the number of patients who present with paralysis as well as the need for regular screening of ITP patients.
Differential Epidural Block Predicts the Success of Visceral Block in Patients with Chronic Visceral Abdominal Pain
Authors: Rizk Maged K. , Tolba Reda , Kapural Leonardo , Mitchell Justin , Lopez Rocio , Mahboobi Ramatia , Vrooman Bruce , Mekhail Nagy
Published: April 2012

Abstract:  Background and Aims:  Differential thoracic epidural regional block, also known as a differential neural block (DNB), involves the placement of an epidural catheter placed in the thoracic epidural space to achieve appropriate anesthesia in a dermatomal distribution. This is a retrospective case series evaluating how well a DNB may predict success of subsequent visceral blockade in patients with chronic abdominal pain of visceral origin.

Methods:  Of 402 patients who had a DNB performed for unexplained abdominal pain from January 2000 to January 2009, 81 patients were found to have results consistent with visceral pain and thus underwent subsequent visceral blockade. Basic demographic data, years of chronic pain, history of psychosocial issues, initial visual analog scale (VAS) pain score, pain location, and medication usage were documented in our electronic medical record database. Parameters regarding DNB and visceral blocks also were documented. Descriptive statistics were computed for all variables. The positive predictive value (PPV) for DNB for whom visceral block was successful (at least a 50% reduction in VAS) was calculated. Additionally, subjects with successful visceral blocks were compared to those with unsuccessful visceral blocks.

Participants:  All patients with chronic abdominal pain with normal gastrointestinal studies who underwent DNB.

Setting:  Tertiary Outpatient Pain Management Clinic.

Design:  Retrospective Cohort Study.

Results:  Mean age of patients was 46 (± 15) years, 73% were female, and median duration of pain was 5 years. 67% of subjects were taking opioid analgesics. PPV of DNB was 70.4%. Only factor found to be statistically significant with visceral block success was baseline VAS with higher scores associated with DNB predictive success (6.8 ± 1.7 vs. 5.5, 1.8; P = 0.004). Use of membrane stabilizing medications was significantly more common in subjects for whom visceral block was not successful (46% vs. 25%; P = 0.058). Area underneath curve (AUC) for VAS was found to be 0.70 (95% CI: 0.57, 0.82), which signifies fair discrimination.

Conclusion:  Differential neural block is fairly predictive of subsequent visceral block success in patients with chronic abdominal pain of visceral origin. An initial VAS ≥ 5 provides a sensitivity of 93%, which implies that VAS < 5 may predict unsuccessful visceral block. Contrarily, a value of ≥ 8 would provide a specificity of 92% and may be used to predict success of subsequent visceral block.
Right‐Sided Implantation and Subpectoral Position are Predisposing Factors for Fracture of a 6.6 French ICD Lead
Authors: BERNSTEIN NEIL E. , KARAM EDMUND T. , AIZER ANTHONY , WONG BRIAN C. , HOLMES DOUGLAS S. , BERNSTEIN SCOTT A. , CHINITZ LARRY A.
Published: April 2012

Background: The Medtronic Sprint Fidelis (Medtronic Inc., Minneapolis, MN, USA) lead family is associated with an unacceptable incidence of premature lead failure. There are limited data on risk factors for lead fracture. We hypothesized that factors leading to potential increased forces on the lead related to device implantation or technique may be associated with premature lead failure.

Methods: We reviewed the implant data from our group and identified 176 patients who received active fixation Medtronic Fidelis (Model 6931, single coil and Model 6949, dual coil) leads. Implant data, including age, sex, venous access site, implant side, implant location, and number of venous leads were reviewed. Hospital, pacemaker clinic, and Medtronic registration databases were reviewed for evidence of lead failure, replacement, or abandonment. Data was evaluated in univariate and multivariate regression analyses.

Results:

Of the 176 leads implanted, 10 (5.7%) were noted to develop malfunction. This presented as inappropriate shocks from sensed noise or elevated impedance measurements. Of the above noted implant features, only right‐sided (vs left‐sided) implant (hazard ratio [HR] 18.8, 95% confidence intervals [CI] 3.8, 93.3), and subpectoral implant (vs prepectoral; HR 14.31, 95% CI 3.2, 64.0) were predictive of lead failure in maximally adjusted models.

Conclusions: We have identified both right‐sided implantation and subpectoral generator positioning as factors associated with premature lead malfunction in Fidelis active fixation leads. Clinical decisions regarding patient management should incorporate these findings in regard to lead replacement in high‐risk patients. (PACE 2012; 35:659–664)
Depression and nonadherence predict mortality in hemodialysis treated end‐stage renal disease patients
Authors: Rosenthal Asher Deborah , Ver Halen Nisha , Cukor Daniel
Published: April 2012

The scientific evaluation of depression's impact on mortality in hemodialysis (HD) patients has yielded mixed results, with the more recent, more rigorous studies detecting a significant relationship. In this study, 130 HD patients from an urban North American hospital were evaluated for depressive affect and then observed for up to 5 years. In a corrected Cox regression model, which held constant age, gender, dialysis vintage, illness severity and diabetic status, depressive affect emerged as a modest but significant predictor of mortality (relative risk = 1.05, 95% confidence interval = 1.01–1.08). When the subjects were divided according to depressive affect severity, those with severe depressive affect had significantly shorter time to death (β = 0.452, P = 0.044). In a subgroup of 85 subjects, self‐reported medication adherence was also predictive of mortality, with higher rates of nonadherence being associated with increased mortality risk. This paper lends support to the burgeoning literature on depression and reduced survival in HD populations, as well as begins the investigation of understanding the underlying mechanisms.
The Role of Binder Adsorption for High Solid Loading Nano‐Zirconia Extrusion Pastes
Authors: Burghardt Andreas , Satet Raphaelle , Eisele Ulrich , Hoffmann Michael J.
Published: April 2012

The viscosity behavior of extrusion pastes comprised of a PVB melt and varying amounts of nano‐zirconia powder have been explored with special emphasis on the impact of a dispersant to reduce the viscosity. In contrast to suspensions with nanopowders, the maximum solid loading in the highly viscous extrusion pastes studied is not limited by attractive interparticle forces. However, at a solid loading >30 vol% the pastes had too high viscosity to be processed due to the high number of adsorbed polymer molecules. By adding a decoupling agent that reduced the work of adhesion of the polymer molecules on the zirconia particles, the viscosity of the pastes could be lowered significantly. The calculated work of adhesion is consistent with the viscosity behavior of the feedstock and is confirmed by wetting angles that have been experimentally determined. It is shown that the effect of the dispersant cannot be explained by electrostatic or steric stabilization of the particles in the melt. A unifying scheme is proposed where the limiting factors “agglomeration” and “adsorption” for a high solid loading combined with the necessary mode of function of the dispersant are illustrated as a function of the viscosity of the medium and the particle size. The viscosity‐lowering decoupling effect of the dispersant was a prerequisite for reaching a solid loading of 50 vol% in the additional feedstock development. The feedstock with 50 vol% nano‐zirconia could be extruded to a tape and sintered to a relative density of 97% at 1200°C.
Thermoelectric Responses in Layered Strontium‐Niobates Via Two Ways of Charge Carrier Control Techniques
Authors: Sakai Akihiro , Kanno Tsutomu , Takahashi Kouhei , Omote Atsushi , Adachi Hideaki , Yamada Yuka
Published: April 2012

We have systematically examined the thermoelectric properties of the perovskite‐related layered strontium‐niobates SrnNbnO3n+2 (n = 4, 4.33, 4.5, and 5) and Sr2−xLaxNb2O7, prepared using two charge carrier control techniques. Both have a similar anisotropic crystal structure that gives all the samples prepared a relatively low thermal conductivity. However, the two systems show very different behaviors with respect to Seebeck coefficient and resistivity. In SrnNbnO3n+2, an n‐driven semiconductor‐metal transition occurs between n = 4.33 and 4.5, with highly metallic properties observed in their magnitudes and temperature dependence at higher values of n. We also observed the microstructures to gain a further understanding of their properties, and elucidated the unconventional charge distribution in the intermediate n = 4.5 material. By contrast, in Sr2−xLaxNb2O7, thermally activated behaviors were displayed even in heavily La‐doped materials. Strong electron lattice interactions due to low symmetric NbO6 octahedra appeared to be present over the whole doping range, with Sr2−xLaxNb2O7 showing a lower electrical conductivity than metallic SrnNbnO3n+2. However, the ZT of Sr2−xLaxNb2O7 is one order of magnitude larger than for SrnNbnO3n+2 due to the much larger Seebeck coefficient, and increased up to 0.048 at room temperature on increasing the La dopant level.