bluuebunny/crossref_metadata_2025 huggingface dataset:
Positive surgical margins are a risk factor for significant biochemical recurrence only in intermediate‐risk disease
Authors: Corcoran Niall M. , Hovens Chris M. , Metcalfe Charles , Hong Matthew K.H. , Pedersen John , Casey Rowan G. , Peters Justin , Harewood Laurence , Goldenberg S. Larry , Costello Anthony J. , Gleave Martin E.
Published: January 2012

Study Type – Therapy (case series)

Level of Evidence 4

What's known on the subject? and What does the study add?

Positive surgical margins (PSMs) after radical prostatectomy are common, although their impact on the risk of disease recurrence is unknown.

We examined the impact of PSMs on the risk of ‘significant’ biochemical recurrence stratified by their risk of occult metastatic disease. We find that only in intermediate‐risk disease does the presence of a PSM have a significant impact on the risk of recurrence, and this represents a failure of technique. By contrast, for high‐ and low‐risk disease, the risk of recurrence is driven by intrinsic tumour biology, and the presence of a PSM has little impact on outcome.

OBJECTIVE

To determine the impact of surgical margin status on the risk of significant biochemical recurrence (prostate‐specific antigen [PSA] doubling time <3, <6 or <9 months) after prostatectomy.

MATERIALS AND METHODS

Patients undergoing radical prostatectomy with complete clinical and pathological data and detailed PSA follow‐up were identified from two prospectively recorded databases.

Patients were stratified according to their risk of occult systemic disease (low risk: PSA < 10 ng/dL, pT2 stage and Gleason score ≤6; intermediate risk: PSA 10–20 ng/dL, pT2 stage and/or Gleason score 7; high: PSA > 20 ng/dL or pT3‐4 stage or Gleason score 8–10) and the impact of a positive surgical margin (PSM) within each stratum determined by univariable and multivariable analysis.

RESULTS

Of 1514 patients identified, 276 (18.2%), 761 (50.3%) and 477 (31.5%) were classified as having low‐, intermediate‐ and high‐risk disease respectively.

A total of 370 (24.4%) patients had a PSM and with a median follow‐up of 22.2 months, and 165 (7%) patients had a biochemical recurrence.

Sufficient PSA data was available to calculate PSA doubling times in 151/165 patients (91.5%).

The PSM rate rose significantly, from 11% in low‐risk to 43% in high‐risk disease (P < 0.001), with similar positive associations noted with tumour grade, stage and serum PSA (P < 0.001).

Patients with low‐risk disease had essentially identical risks of significant biochemical recurrence over the study period, regardless of surgical margin status. By contrast, in patients with both intermediate‐ and high‐risk disease, a PSM was a strong predictor of significant biochemical recurrence on univariable analysis. On multivariable analysis, howver, PSM predicted significant disease recurrence in intermediate‐risk disease only.

CONCLUSIONS

PSM is a risk factor for significant biochemical recurrence only in intermediate risk disease.
Suprapubic catheter insertion using an ultrasound‐guided technique and literature review
Authors: Jacob Preman , Rai Bhavan Prasad , Todd Alistair W.
Published: January 2012

What's known on the subject? and What does the study add?

The conventional ‘blind’ technique for suprapubic catheter (SPC) insertion relies on adequate filling of the bladder to displace bowel away from the site of needle puncture. However, in a small percentage of patients this fails to happen, which can occasionally lead to life‐threatening bowel injury. Recently published British Association of Urological Surgeons (BAUS) guidelines have recommended that ultrasonography (US) may be helpful to identify bowel loops and recommends its usage whenever possible.

This paper describes the technique of US‐guided needle puncture and SPC insertion to reduce the likelihood of bowel injury. The paper addresses training, equipment and logistical issues associated with this advice. We have reviewed the available publications on the outcomes from this technique and also present our experience.

Suprapubic catheter (SPC) insertion is a common method of bladder drainage in contemporary urological practice. The procedure involves insertion of a sharp trocar into the bladder percutaneously, usually by palpation, percussion or cystoscopy for guidance. Although generally considered a safe procedure, the risk of bowel injury is estimated at up to 2.4% with a mortality rate of 1.8%. Recently published British Association of Urological Surgeons (BAUS) guidelines have recommended that ultrasonography (US) may be helpful to identify bowel loops and recommends its usage whenever possible. The present paper describes the use of US for SPC insertion and discusses the implications of this advice. This paper is designed to support and supplement practical techniques learnt on a course and in clinical practice.
A LABORATORY STUDY OF AUCTIONS WITH A BUY PRICE
Authors: DURHAM YVONNE , ROELOFS MATTHEW R. , SORENSEN TODD A. , STANDIFIRD STEPHEN S.
Published: January 2012

We present a series of laboratory experiments that examine auctions with buy prices, which are prices that allow a bidder to stop the auction and buy the item immediately. Two types of buy prices are considered, one that is available throughout the auction and one that disappears with an initial bid. Both are evaluated with and without proxy bidding. We find that the use of a buy price increases revenue, early bidding, and auction efficiency. Differences between outcomes in auctions with permanent and temporary buy prices are consistent with the observed choices in auction design made by online auction sites. (JEL C90, D44, C70, L81)
THE EFFECTS OF AUTOMOBILE RECALLS ON THE SEVERITY OF ACCIDENTS
Authors: BAE YONG‐KYUN , BENÍTEZ‐SILVA HUGO
Published: January 2012

The number of automobile recalls in the United States has substantially increased over the last two decades, and after a record of over 30 million cars recalled in 2004, in the last few years it has consistently reached between 15 and 17 million, and in 2010 alone 20 million cars were recalled. Toyota's recall crisis in 2010 illustrates how recalls can affect a large number of American drivers and the defects connected to them can result in loss of life and serious accidents. However, in spite of the increase in public concern over recalls and the loss of property and life attached to them, there is no empirical evidence of the effect of vehicle recalls on safety. This paper investigates whether vehicle recalls reduce accidental harm measured by the severity of injuries in vehicle accidents. The results of our analysis show that if a recall for a new‐year model is issued, then the severity of injuries of accidents continuously diminishes during the first year after the recall, something we do not find among cars not subject to recalls. This is because defects are repaired over time but also because drivers react by driving more carefully until the defects are fixed. To minimize the losses attached to having dangerously defective cars on our roads, both quick and timely recall issuance are needed and more detailed information on defects should be delivered to owners of defective vehicles. The latter can be made possible through simple but important policy changes by the U.S. government regarding recall information sharing with drivers and insurance companies. (JELL51, L62)
Electrophysiological evidence of altered memory processing in children experiencing early deprivation
Authors: Evren Güler O. , Hostinar Camelia E. , Frenn Kristin A. , Nelson Charles A. , Gunnar Megan R. , Thomas Kathleen M.
Published: January 2012

Associations between early deprivation and memory functioning were examined in 9‐ to 11‐year‐old children. Children who had experienced prolonged institutional care prior to adoption were compared to children who were adopted early from foster care and children reared in birth families. Measures included the Paired Associates Learning task from the Cambridge Neuropsychological Test and Automated Battery (CANTAB) and a continuous recognition memory task during which ERPs were also recorded. Children who experienced prolonged institutionalization showed deficits in both behavioral memory measures as well as an attenuated P300 parietal memory effect. Results implicate memory function as one of the domains that may be negatively influenced by early deprivation in the form of institutional care.
Cross‐contextual stability of bullying victimization: A person‐oriented analysis of cyber and traditional bullying experiences among adolescents
Authors: ERENTAITĖ RASA , BERGMAN LARS R. , ŽUKAUSKIENĖ RITA
Published: January 2012

Erentaitė, R., Bergman, L. R. & Žukauskienė, R. (2012). Cross‐contextual stability of bullying victimization: A person‐oriented analysis of cyber and traditional bullying experiences among adolescents. Scandinavian Journal of Psychology 53, 181–190.

Using a person‐oriented approach the study examined whether bullying victimization at school continued into cyberspace victimization in a large sample of high school students in Lithuania (N = 1667, 58% girls), age 15–19 (M = 17.29, SD = 0.95). Three forms of traditional bullying (verbal, physical and relational) and seven forms of cyberbullying victimization through cell phones and computers were included in the analysis. The findings revealed that 35% of traditional bullying victims were also bullied in cyberspace. In particular, adolescents who experienced predominantly verbal and relational bullying at school, showed a higher risk of victimization in cyberspace a year later, while this was not observed for predominantly physical forms of traditional bullying. The findings point to the importance of a cross‐contextual perspective in studies on stability of bullying victimization.
A Framework for Exploring the Policy Implications of UK Medical Tourism and International Patient Flows
Authors: Lunt Neil T. , Mannion Russell , Exworthy Mark
Published: January 2012

It is estimated that over 50,000 individuals from the UK each year elect to fund their own treatment abroad. Such treatments commonly include cosmetic and dental surgery; cardio, orthopaedic and bariatric surgery; IVF treatment; and organ and tissue transplantation. The UK has also experienced inward flows of patients who travel to receive treatment and pay out of pocket, being treated in both private and NHS facilities.

The rise of ‘medical tourism’ presents new opportunities and challenges in terms of treatment options for consumers/patients and health policymakers. Such developments denote a commercialization, commodification and internationalization of health care in a way that UK policy has not experienced to date.

This article addresses four key issues. We explain the rise of medical‐related travel (applied to the UK), identify key policy considerations for the future, highlight important research gaps and explore conceptual frameworks which might help us understand better the observed patterns of medical tourism. Whilst the context for policy and practice is undoubtedly dynamic, we argue the need for greater clarity in understanding the emergent implications for health policy and health care delivery.
A PASSIONATE BUDDHIST LIFE
Authors: McRae Emily
Published: January 2012

This paper addresses the ways that we can understand and transform our strong emotions and how this project contributes to moral and spiritual development. To this end, I choose to think with two Tibetan Buddhist thinkers, both of whom take up the question of how passionate emotions can fit into spiritual and moral life: the famous, playful yogin Shabkar Tsodruk Rangdrol (1781–1851) and the wandering, charismatic master Patrul Rinpoche (1808–1887). Shabkar's The Autobiography of Shabkar provides excellent examples of using one's own passionate emotions to connect to others and gain insight into the world. Patrul Rinpoche's The Words of My Perfect Teacher (kun bzang bla ma'i zhal lung) focuses on passionate empathy with the emotions of others. Drawing on these texts, I present a (distinctly Buddhist) conception of a passionate life and argue that passionate emotional experience is a central part of moral and spiritual development more broadly construed.
MUSLIM IMAGINARIES AND IMAGINARY MUSLIMS: Placing Islam in Conversation with A Secular Age
Authors: Barre Elizabeth A.
Published: January 2012

This essay begins by exploring the extent to which the narrative of secularization presented in Charles Taylor's A Secular Age might be complicated or otherwise challenged by taking account of parallel processes within Islamic thought and practice. It then considers whether Taylor's argument might nevertheless be applicable to, or illuminative of, contemporary struggles with modernity in the Muslim world.
Word reading and word spelling in French adult literacy students: the relationship with oral language skills
Authors: Eme Elsa , Lambert Eric , Alamargot Denis
Published: January 2012

We analysed word reading and spelling in French adults with low levels of literacy (A‐IL). As well as examining phonological and lexical processes, we explored the relationship between literacy and oral language skills. Fifty‐two adult literacy students were compared with reading level‐matched pupils in Years 1–3 of primary school on reading tasks (pseudoword reading, word reading, text comprehension), spelling tasks (pseudoword spelling, text dictation) and oral language tasks. A‐IL scored the same as children on word reading and spelling but less well on pseudoword reading and spelling. They also produced fewer phonologically acceptable errors in the dictation. Regarding oral language skills, as a group A‐IL encountered greater difficulty in phonology than in morphosyntax and semantics, and correlations revealed strong relationships between literacy levels and oral skills, particularly in the domain of phonology. Within their group, however, A‐IL displayed several distinct language profiles. These could reflect different risk factors leading to functional illiteracy and are discussed regarding the cognitive and environmental causes of impaired reading acquisition.
Antiretroviral therapy prescribing in hospitalized HIV clinic patients
Authors: Rao N , Patel V , Grigoriu A , Kaushik P , Brizuela M
Published: January 2012

Objectives

Antiretroviral therapy (ART) medication prescribing errors in hospitalized patients still remain common. This study aimed to examine the initial prescribing of antiretroviral drug regimens for HIV clinic patients admitted to an urban academic teaching hospital.

Methods

A retrospective chart review of all patients with a discharge diagnosis of HIV or AIDS was performed. Only patients actively managed by the hospital out‐patient HIV clinic at the time of discharge were included in the final analysis. We compared the ART initially prescribed during hospitalization with the clinic records. Medication errors were separated by type and the prescriber's area of specialty was noted.

Results

From 1 January 2009 to 31 December 2009, 90 admissions in 62 patients were included in the final analysis. In 47 of those admissions, the patient had an initial regimen considered to be incorrectly prescribed; in 17 of these 47 admissions, the patient was not prescribed any ART, and in the remainder the errors were related to drug omissions, incorrect frequency/dose, and prescription of the wrong drug. The majority of admissions were by an internal medicine or non‐infectious disease (ID) specialist. Average time to ART initiation was comparable among all prescribers. No statistically significant correlation was found between the number of admissions per patient or the prescriber's area of specialty and the percentage of incorrect regimens ordered.

Conclusion

Hospital HIV medication management still remains an area of focus because of the complexity of regimens, poor medication reconciliation and limited non‐HIV/ID specialist knowledge.
An integrated approach to the management of Alzheimer's disease: assessing cognition, function and behaviour
Authors: Galasko Douglas
Published: January 2012

Alzheimer's disease is characterized by deterioration in the domains of cognition, function and behaviour. Cognitive decline is manifest as short‐term memory, language and visuospatial deficits. These, along with deficits in perception and executive function affect the patient's ability to function, as indicated by loss of ability to perform activities of daily living (ADLs). Abnormal behaviours, including depression, delusions and aggression are frequently a feature of Alzheimer's disease, occurring at different stages of the disease. Although Alzheimer's disease is primarily associated with cognitive deficits, functional decline and aberrant behaviours are its most problematic aspects for both patients and their caregivers. Loss of ability to perform ADLs imposes the need for increased levels of care. Moreover, caregiver burden is closely associated with the type and severity of behavioural disturbances. Although cognition is correlated with ability to perform ADLs, the fact that behavioural symptoms also play a role in deteriorating function means that cognitive testing alone cannot accurately predict disease progression. Hence, an integrated approach, involving measurement of cognition, function and behaviour is required for accurate diagnosis, assessment of the stage and progression of dementia, the effects of intervention, and the amount and type of assistance that the Alzheimer's disease patient requires.
Easing the burden of Alzheimer's disease: therapeutic options
Authors: Baumel Barry
Published: January 2012

The loss of ability to function, as well as abnormal behavioural symptoms that accompany cognitive decline in Alzheimer's disease, place a steadily intensifying burden upon caregivers to provide for patients' needs. This burden frequently manifests among caregivers as ill‐health and depression. The rapidly growing numbers of demented patients in the population means that society, too, is faced with increasingly intractable issues concerning health resource allocation. As the greatest part of the cost of caring for an Alzheimer's disease patient is incurred by their institutionalization, the maintenance of demented patients in the community for as long as possible is a desirable goal from a health economic perspective. A vital part of this strategy is the development of effective symptomatic treatments. Such treatment may modulate the behavioural symptoms of Alzheimer's disease that are the major indicator of institutionalization, or may preserve a patient's function, enabling them to live independently, or cared for at home for longer periods before institutionalization is warranted. Several different pharmacological strategies for managing Alzheimer's disease are currently being investigated. While there is some evidence that non‐steroidal anti‐inflammatory drugs and oestrogen can act as protective agents against Alzheimer's disease, cholinergic therapy represents the best approach to the symptomatic treatment of the disease; cholinesterase inhibitors have been demonstrated to improve the symptoms of Alzheimer's disease in a number of large‐scale clinical trials. However, antioxidants such as vitamin E have also demonstrated efficacy in some studies. The findings of these key areas of therapeutic enquiry are described in this review.
Representativeness: A Tool to Structure Interest Intermediation in the European Union?
Authors: PÉREZ‐SOLÓRZANO BORRAGÁN NIEVES , SMISMANS STIJN
Published: January 2012

This article analyzes how the concept of ‘representativeness/representativity’ has been used by the European Union institutions to structure interest intermediation. It examines how the concept emerged and has been defined, and identifies its scope of application. ‘Representativeness’ is mostly used to refer to organizational features of the interest groups (organizational representativeness), but is occasionally used in relation to representative aspects of the overall system of interest representation (system representativeness). The focus is primarily on aspects of ‘descriptive representativeness’– in particular, territorial and thematic representativeness – rather than on ‘procedural representativeness’ that guarantees authorization and accountability. Originally applied to the social partners only, the White Paper on European Governance proposed to extend the use of representativeness to the wider category of civil society organizations. It will be shown that the application of the concept to these organizations proves more problematic than it does to the social partners. The European Transparency Initiative subsequently abandons representativeness, but it is argued that it contains the seeds for its re‐emergence.
Justifying Enlargement in a Multi‐level Polity: A Discursive Institutionalist Analysis of the Elites–Public Gap over European Union Enlargement*
Authors: HERRANZ‐SURRALLÉS ANNA
Published: January 2012

In view of the decreasing levels of public support for successive European Union enlargements, this article examines how political elites attempt to bridge this growing gap. Drawing insights from discursive institutionalism, the article undertakes a systematic analysis of an aspect that has been widely neglected in the existing literature on enlargement: the relation between the discursive interaction among policy‐makers at the EU level (co‐ordinative discourse) and direct political communication at the national level (communicative discourse). Focusing on the case of Germany, the article argues that debates on enlargement at the EU and national levels have been growing apart since the 1970s, and discusses the implications of this discursive gap for the public legitimization of past and future enlargements.
The effects of Asparagus racemosus (shatavari) extract on oxidative stability of ghee, in relation to added natural and synthetic antioxidants
Authors: PAWAR NILKANTH , ARORA SUMIT , BIJOY RAM RAN , WADHWA BALBIR KAUR
Published: January 2012

The potential of Asparagus racemosus (shatavari) extract was evaluated in comparison with natural (rosemary, green tea) and synthetic (butylated hydroxyanisole, tert‐butyl hydroquinone) antioxidants, in ghee using accelerated oxidation tests. Its aqueous and ethanolic extracts significantly retarded deterioration of ghee relative to the control (without addition of synthetic or natural herb extract), as observed in peroxide value (8.3, 13.2 and 25.8 mmolO2/g fat respectively), conjugated diene% (1.30, 1.44 and 1.78, respectively), radical‐scavenging potential (40.0, 25 and 5.5% inhibition, respectively) and oxidative stability index (16.8, 13.5 and 10.3 h respectively) after 21 days. However, these were less effective than the natural and synthetic antioxidants. The ethanolic extract of shatavari, having polyphenol content of 24.99 ± 0.74 mg gallic acid equivalent/g, exhibited some antioxidative and radical‐scavenging activities.
Cost‐effectiveness of cervical cancer screening: cytology versus human papillomavirus DNA testing
Authors: van Rosmalen J , de Kok IMCM , van Ballegooijen M
Published: January 2012

Please cite this paper as: van Rosmalen J, de Kok I, van Ballegooijen M. Cost‐effectiveness of cervical cancer screening: cytology versus human papillomavirus DNA testing. BJOG 2012;119:699–709.

Objective  To determine the most cost‐effective screening programme for cervical cancer.

Design  Cost‐effectiveness analysis from a societal perspective.

Setting  The Netherlands.

Population  Dutch women who have not been invited for human papillomavirus (HPV) vaccination.

Methods  We calibrated the microsimulation screening analysis (MISCAN) model to Dutch epidemiological data. We used this model to consider nine screening strategies that use: (i) cytological testing with cytology triage for borderline/mildly abnormal smears; (ii) HPV testing with cytology triage for HPV‐positive smears; or (iii) cytological testing with HPV triage for borderline/mildly abnormal smears. For each strategy, we varied the number of screening rounds, the time interval, the age of the first screening, and the type of cytological testing (conventional or liquid‐based cytology).

Main outcome measures  Quality‐adjusted life years (QALYs) gained and costs from a societal perspective.

Results  Under the base‐case assumptions, primary HPV testing with cytology triage is the most cost‐effective strategy. Using cost‐effectiveness thresholds of €20 000 and €50 000 per QALY gained yields optimal screening programmes with three and seven screening rounds, respectively. The results are sensitive to several uncertain model inputs, most importantly the costs of the HPV test. For women aged 32 years or younger, primary cytology screening is more cost‐effective than primary HPV testing.

Conclusions  Increasing the interval between screening rounds and changing the primary test from cytology to HPV testing can improve the effectiveness and decrease the costs of cervical cancer screening in the Netherlands.
HIV care need not hamper maternity care: a descriptive analysis of integration of services in rural Malawi
Authors: van den Akker T , Bemelmans M , Ford N , Jemu M , Diggle E , Scheffer S , Zulu I , Akesson A , Shea J
Published: January 2012

Please cite this paper as: van den Akker T, Bemelmans M, Ford N, Jemu M, Diggle E, Scheffer S, Zulu I, Akesson A, Shea J. HIV care need not hamper maternity care: a descriptive analysis of integration of services in rural Malawi. BJOG 2012;119:431–438.

Objective  To evaluate the use of reproductive health care and incidence of paediatric HIV infection during the expansion of antiretroviral therapy and services for the prevention of mother‐to‐child transmission in rural Malawi, and the influence of integration of these HIV‐related services into general health services.

Design  Descriptive analysis.

Setting  Thyolo District, with a population of 600 000, an HIV prevalence of 21% and a total fertility rate of 5.7 in 2004.

Population  Women attending reproductive health services care in 2005 and 2010.

Methods  Review of facility records and databases for routine monitoring.

Main outcome measures  Use of antenatal, intrapartum, postpartum, family planning and sexually transmitted infection services; incidence of HIV infection in infants born to mothers who received prevention of mother‐to‐child transmission care.

Results  There was a marked increase in the uptake of perinatal care: pregnant women in 2010 were 50% more likely to attend at least one antenatal visit (RR 1.50, 95% CI 1.48–1.51); were twice as likely to deliver at a healthcare facility (RR 2.05, 95% CI 2.01–2.08); and were more than four times as likely to present for postpartum care (RR 4.40, 95% CI 4.25–4.55). Family planning consultations increased by 40% and the number of women receiving treatment for sexually transmitted infections doubled. Between 2007 and 2010, the number of HIV‐exposed infants who underwent testing for HIV went up from 421 to 1599/year, and the proportion testing positive decreased from 13.3 to 5.0%; infants were 62% less likely to test HIV positive (RR 0.38, 95% CI 0.27–0.52).

Conclusions  During the expansion and integration of HIV care, the use of reproductive health services increased and the outcomes of infants born to HIV‐infected mothers improved. HIV care may be successfully integrated into broader reproductive health services.
Dissemination of public health information: key tools utilised by the NECOBELAC network in Europe and Latin America
Authors: De Castro Paola , Marsili Daniela , Poltronieri Elisabetta , Calderón Carlos Agudelo
Published: January 2012

Background:  Open Access (OA) to scientific information is an important step forward in communication patterns, yet we still need to reinforce OA principles to promote a cultural change of traditional publishing practices. The advantages of free access to scientific information are even more evident in public health where knowledge is directly associated with human wellbeing.

Objectives:  An OA ‘consolidation’ initiative in public health is presented to show how the involvement of people and institutions is fundamental to create awareness on OA and promote a cultural change. This initiative is developed within the project NEtwork of COllaboration Between Europe and Latin American Caribbean countries (NECOBELAC), financed by the European Commission.

Methods:  Three actions are envisaged: Capacity building through a flexible and sustainable training programme on scientific writing and OA publishing; creation of training tools based on semantic web technologies; development of a network of supporting institutions.

Results:  In 2010–2011, 23 training initiatives were performed involving 856 participants from 15 countries; topic maps on scientific publication and OA were produced; 195 institutions are included in the network.

Conclusions:  Cultural change in scientific dissemination practices is a long process requiring a flexible approach and strong commitment by all stakeholders.
Efficacy of tadalafil in chronic hypobaric hypoxia–induced pulmonary hypertension: possible mechanisms
Authors: Rashid Masrat , Fahim Mohammad , Kotwani Anita
Published: January 2012

The present study was carried out to investigate the effects of long‐acting phosphodiesterase five inhibitor, tadalafil, on pulmonary hypertension induced by chronic hypobaric hypoxia in rats. Adult Albino Wistar rats were exposed to 2 weeks of hypobaric hypoxia for 8 h daily and treated with tadalafil or tempol, a standard antioxidant agent. Right ventricular systolic pressure (RVSP) was taken as an index for pulmonary arterial pressure; malondialdehyde, reduced glutathione and superoxide dismutase were chosen as the markers of oxidative stress; serum tumour necrosis factor alpha (TNF‐α) levels and inflammatory changes in lungs were assessed for inflammation. Chronic hypobaric hypoxia was found to induce pulmonary hypertension, as it significantly (P < 0.001) increased RVSP. Chronic hypobaric hypoxia also leads to an increase in oxidative stress as was evidenced by an increase in malondialdehyde levels (P < 0.001) and a significant decrease in (P < 0.001) reduced glutathione levels and superoxide dismutase activity. Chronic hypobaric hypoxia–induced inflammation was revealed by lung histology and increase in serum TNF‐α levels. Tadalafil significantly prevented (P < 0.001) rise in hypobaric hypoxia–induced rise in RVSP. Tadalafil partially while tempol completely reversed hypobaric hypoxia–induced oxidative stress. Lung inflammation and serum TNF‐α levels were significantly attenuated by both tadalafil and tempol. However, effect of tadalafil on inflammation was more marked than that of tempol. These data indicate that tadalafil possess antioxidant as well as antinflammatory action in addition to its vasodilatory property. All these three actions combined may have positive impact of tadalafil in the treatment of hypobaric hypoxia–induced pulmonary hypertension.
The risk of preterm delivery prior to 34 weeks in women presenting with antepartum haemorrhage of unknown origin
Authors: Yeung Sik Wing , Tam Wing Hung , Cheung Rachel Y.K.
Published: January 2012

Background

The management of antepartum haemorrhage of unknown origin (APHUO) remote from term remains controversial.

Aim

To determine the rate and risk factors in predicting preterm delivery among women presenting with APHUO before 34 weeks of gestation.

Methods

All singleton pregnancies with the first episode of APHUO before 34 weeks of gestation who delivered between January 1995 and December 2004 were reviewed. The predictability of risk factors was assessed by both univariate and multivariate analysis. The cumulative rates of preterm delivery prior to 34 weeks were compared by using the Kaplan–Meier survival analysis and log‐rank test between those with and those without risk factors.

Results

The rates of preterm delivery prior to 34 and 37 weeks of gestation were 7.3 and 17%, respectively. Uterine contractions, persistent bleeding, two or more episodes of APHUO and a history of spontaneous preterm deliveries were significant risk factors for preterm birth prior to 34 weeks in a multivariate logistic regression. Women with one risk factor had a hazard ratio of 5.5 (95% CI: 3.2–9.6) in having preterm delivery prior to 34 weeks compared with those without risk factors, whereas women with any two risk factors had a hazard ratio of 5.2 (95% CI: 2.1–12.9) compared with those with one risk factor.

Conclusions

APHUO prior to 34 weeks of gestation is associated with three to fivefold increased risk of preterm delivery. Identification of several risk factors could further help to predict early preterm delivery and appropriate triage management.
How continuous and precise is the record of P–T paths? Insights from combined thermobarometry and thermodynamic modelling into subduction dynamics (Schistes Lustrés, W. Alps)
Authors: PLUNDER A. , AGARD P. , DUBACQ B. , CHOPIN C. , BELLANGER M.
Published: January 2012

Pressure–temperature (P–T) paths as complete as possible and with a precision on the km‐scale or less are needed to further improve the knowledge of deformation, re‐equilibration processes and element/fluid transfer, in particular along subduction zones. This contribution attempts to (i) critically evaluate the precision and continuity with which metamorphic P–T histories are retrieved today and (ii) discuss implications for regional‐scale accretionary processes in subduction zones, through application to the Schistes Lustrés complex (Haute Maurienne, W. Alps). P–T estimates are compared and combined using several independent approaches: (i) from minerals assumed to be in textural equilibrium; (ii) from electron microprobe compositional maps; and (iii) from pseudosection modelling predictions. Multi‐equilibrium calculations were performed with tweequ and thermocalc, and pseudosections were built with Perple_X and Theriak/Domino. These P–T estimates were also compared with maximum temperatures (Tmax) deduced from the Raman spectroscopy of carbonaceous matter. The different methods used here yield the peak of pressure for the lower structural unit of the Schistes Lustrés at 480 °C and 23 kbar and document the retrograde path for both the Median and Lower Units. The results show that P–T conditions are recorded almost continuously and can be determined with a precision of ±1 kbar and ±30 °C at best. This study underlines the complementarity of the various thermobarometric methods and demonstrates that precision could be increased by improving solid solution models for chlorite. Observed tectonic patterns, major lithological boundaries, pressure–temperature and Tmax data suggest that underplating processes and early structural development played a key role in the Schistes Lustrés accretionary complex.
Wet‐Wrap Treatment in Children with Atopic Dermatitis: A Practical Guideline
Authors: Devillers Arjan C. A. , Oranje Arnold P.
Published: January 2012

Abstract:  Treatment of children with severe atopic dermatitis (AD) can be especially challenging because several possible intervention treatments have (relative) contraindications in childhood. In recent years, wet‐wrap treatment (WWT) has been advocated as a relatively safe and efficacious intervention in children with severe or refractory AD. The goal of this article is to provide a practical guideline as a starting point for clinicians who are interested in using WWT in their own clinical practice. We will address several practical issues surrounding the use of WWT by describing our own experiences, supplemented with data from the literature.
Competition in Regulated Markets with Sluggish Beliefs about Quality
Authors: Brekke Kurt R. , Cellini Roberto , Siciliani Luigi , Straume Odd Rune
Published: January 2012

We investigate the effect of competition on quality in regulated markets (e.g., health care, higher education, public utilities), using a Hotelling framework, in the presence of sluggish beliefs about quality. We take a differential‐game approach, and derive the open‐loop solution (providers choose the optimal quality investment plan based on demand at the initial period) and the feedback closed‐loop solution (providers observe demand in each period and choose quality in response to current demand). If variable costs are strictly convex, and the degree of cost complementarity between quality and output is not too strong, the steady‐state quality is higher under the open‐loop solution than under the feedback solution. In both solutions, quality and demand move in opposite directions over time on the equilibrium path to the steady‐state. While lower transportation costs or less sluggish beliefs lead to higher quality in both solutions, the quality response is weaker when players use feedback strategies.
On the Grouping of Tasks into Firms: Make‐or‐Buy with Interdependent Parts*
Authors: Novak Sharon , Wernerfelt Birger
Published: January 2012

We study the division of labor within production systems and look for the optimal grouping of tasks into firms. Using a unique dataset on the global automobile industry, we present evidence consistent with the prediction that pairs of tasks requiring more frequent mutual adaptation are more likely to be performed by the same firm. By taking account of interdependencies between tasks, our econometric approach generalizes standard make‐or‐buy analysis and yields improvements in predictive accuracy.
Credibility and Monitoring: Outsourcing as a Commitment Device
Authors: Bental Benjamin , Deffains Bruno , Demougin Dominique
Published: January 2012

We analyze an environment plagued by double moral hazard where the agent’s effort level and the principal’s precision in monitoring are not contractible. In such an environment, the principal tends to over‐monitor thereby inducing low effort. To ease the latter problem, the principal may choose to increase monitoring costs by outsourcing the activity. As a result equilibrium monitoring is reduced and incentives become more powerful. This choice is particularly likely when the worker’s effort is an important factor in determining output.
The Effect of Appeals on Assessment Ratio Distributions: Some Nonparametric Approaches
Authors: McMillen Daniel P.
Published: January 2012

A variety of nonparametric methods—locally weighted regression, nonparametric quantile regression and conditional density functions—are used to evaluate the effect of appeals on assessment uniformity. Unlike previous studies, the focus is on the full distribution of assessment ratios rather than on central moments. Data for single‐family homes in Chicago for 2006 suggest that appeals lead to a modest reduction in assessment variability, but the density of extremely high assessment ratios is higher among homes without appeals. Whereas traditional methods simply indicate that assessment ratios decline with sale price, nonparametric approaches reveal that higher prices have a more pronounced effect on the variance than on the conditional expectation of the assessment ratio distribution and that the most pronounced degree of regressivity occurs at very low sales prices.
Exploring the Heart: Entrepreneurial Emotion is a Hot Topic
Authors: Cardon Melissa S. , Foo Maw–Der , Shepherd Dean , Wiklund Johan
Published: January 2012

Entrepreneurial emotion refers to the affect, emotions, moods, and/or feelings—of individuals or a collective—that are antecedent to, concurrent with, and/or a consequence of, the entrepreneurial process, meaning the recognition/creation, evaluation, reformulation, and/or the exploitation of a possible opportunity. In this paper, we explore this working definition of entrepreneurial emotion, what it means, and some important advances the field has made in this area of research. We also highlight fundamental avenues for future research that are sorely in need of study. Finally, we introduce the seven papers in this special issue on the Heart of Entrepreneurship and how they move the conversation on entrepreneurial emotion forward.
Epidural Fever and Its Implications for Mothers and Neonates: Taking the Heat
Authors: Shatken Sarit , Greenough Kaitlyn , McPherson Christina
Published: January 2012

Epidural fever is a maternal temperature elevation seen in women who use epidural analgesia during labor. It occurs in a subset of laboring women after epidural administration and is noninfectious in origin. Epidural fever is not associated with neonatal sepsis, but it often is difficult to distinguish from chorioamnionitis, a condition that can cause neonatal sepsis. Because of this, neonates born to mothers who experience fever during labor are often evaluated for sepsis. Potential solutions to this problem include establishing better methods to distinguish between epidural fever and chorioamnionitis and making alternative methods of pain relief available to laboring women.
Clinician Perceptions of Providing Natural Family Planning Methods in Title X Funded Clinics
Authors: Kelly Patricia J. , Witt Jacki , McEvers Kimberly , Enriquez Maithe , Abshier Patricia , Vasquez Magda , McGee Eve
Published: January 2012

Introduction: Natural family planning (NFP) methods are effective for contraception with proper and consistent use. However, only 1% of patients at federally funded Title X family planning clinics select NFP as a contraceptive method. The goal of this study was to understand from clinicians’ perspectives the barriers and facilitators to providing NFP methods.

Methods: Six telephone focus groups were conducted with 29 clinicians from Title X clinics across the United States and Puerto Rico. A hermeneutic method was used to analyze data for related themes.

Results: The overarching theme from the study was that participants had a strong desire to teach their patients how their bodies work and to empower them to learn to control fertility. Four subthemes emerged: patient misinformation and misunderstanding about fertility; provider ideas about ideal types of candidates for NFP; inconsistent patient teaching strategies; and lack of time to teach NFP methods.

Discussion: There is a need for increased NFP training for providers and efficient NFP patient teaching strategies to meet the needs of patients with limited knowledge about fertility.
First Birth Cesarean and Risk of Antepartum Fetal Death in a Subsequent Pregnancy
Authors: Osborne Cara , Ecker Jeffrey L. , Gauvreau Kimberlee , Lieberman Ellice
Published: January 2012

Introduction: To examine the relationship between first birth by cesarean and antepartum fetal death in a subsequent pregnancy in a large, hospital‐based population.

Methods
: Data for this retrospective cohort study were taken from a database of all women who gave birth at Brigham and Women's Hospital during 4 waves of data collection beginning in 1994 and ending in 2002. We calculated the risk of antepartum fetal death in the subsequent pregnancy for women whose first birth was by cesarean compared to women with a vaginal first birth. Survival analysis was used to examine the influence of gestational age at birth.

Results: Of 10,996 women who met inclusion criteria, 22% (n = 2450) had first births by cesarean, and 78% (n = 8546) had vaginal first births. The risk of antepartum fetal death in the subsequent pregnancy for women whose first birth was by cesarean was significantly greater than the risk for women whose first birth was vaginal (odds ratio 2.6; 95% confidence interval, 1.1‐6.2). The relationship between first birth cesarean and antepartum fetal death in a subsequent pregnancy differed by gestational age at birth, with no excess risk among women with a previous cesarean birth who gave birth before 34 weeks’ gestation but with a substantially increased risk for women who gave birth at 34 or more weeks’ gestation (unadjusted hazard ratio = 5.6; 95% confidence interval, 1.6‐19.8). Hazard ratio estimates for the association remained significant in bivariate models when adjusted for maternal height, weight, age, hypertension, and diabetes.

Discussion: In these data, first birth by cesarean was associated with an increased risk of antepartum fetal death in a subsequent pregnancy. Our findings suggest that antepartum fetal deaths in subsequent pregnancies might be prevented by avoiding primary cesarean birth.
Metal Oxides Mono‐Dimensional Nanostructures for Gas Sensing and Light Emission
Authors: Soldano Caterina , Comini Elisabetta , Baratto Camilla , Ferroni Matteo , Faglia Guido , Sberveglieri Giorgio
Published: January 2012

The present Review opens with an overview of metal oxides and the description of their material properties.
The first part mainly deals with various preparation techniques and growth mechanisms, which have been largely developed in the last few decades to fabricate different types of metal oxide nanostructures.
The second part, on the other hand, will provide the Reader with an up‐to‐date summary of different applications in which metal oxides nanostructures have been successfully implemented and/or suggested. In particular, great attention will be dedicated to the implementation of metal oxide nanostructures for gas sensing as well as light emission applications, for which both working principles and integration, as well as the latest reported cutting edge results are herein reported.
Finally, we emphasize on the current potentials of metal oxide nanostructured materials and future challenges that this field in continuous expansion is currently facing.
Empowering Students to Create and Claim Value through the Thomas–Kilmann Conflict Mode Instrument
Authors: Brown Jennifer Gerarda
Published: January 2012

In a world of problem‐solving lawyering, principled negotiation, and integrative bargaining, to describe a negotiation as “distributional” may strike some as heretical. Still, we disserve our students if we ignore distributional bargaining altogether. Unfortunately, many law students who are drawn to negotiation classes bring with them a fundamental discomfort with claiming value. Contrary to the stereotypes that attribute aggression and “sharp practices” to lawyers, many law students struggle to become more assertive.

The Thomas–Kilmann Conflict Mode Instrument (TKI) is one tool that I have found can help raise students' awareness of, and comfort with, the reflexive responses to conflict that can impede their attempts to claim as well as create value in negotiation. The insights students gain from taking the TKI can be quickly put to use in the next negotiation role play. Although it may help students realize their dominant response to conflict, the TKI highlights that no single approach to negotiation is always best. Thus, the TKI can both encourage the reticent to claim more value in negotiation and suppress the seemingly insatiable appetites for value claiming that drive other students.

When administering the TKI, I encourage students to learn at least four major lessons:

A negotiator has a choice in resolving the dilemma between value claiming and value creating. We are not just stuck with our reflexes.

Still, it is good to know what our reflexive response to conflict is likely to be so that we are more mindful of the choices as we make them.

Departing from reflexes requires energy: preparation, planning, mindfulness, and conscious effort.

Adaptability is desirable. A well‐integrated negotiator might move from one TKI “type” to another as a negotiation progresses.

In this article, I seek to give a very brief overview of the ways I have used the TKI to convey these lessons, increasing students' comfort with, and management of, value claiming. To this end, the article will describe the TKI, explain how I administer and debrief the students' encounter with it, and point out some potential pitfalls of this process.