bluuebunny/crossref_metadata_2025 huggingface dataset:
TAX COMPETITION AS A CAUSE OF FALLING CORPORATE INCOME TAX RATES: A SURVEY OF EMPIRICAL LITERATURE
Authors: Leibrecht Markus , Hochgatterer Claudia
Published: December 2010

AbstractSince the mid 1980s, tax rates on corporate income have declined in most industrialized countries. Tax competition between countries for mobile capital has frequently been mentioned as an explanation for this development. A vast empirical literature dealing with tax competition for mobile capital has emerged. This paper categorizes and summarizes the existing empirical studies on this issue. Particular focus is placed on the isolation of the substantive implications the quantitative study outcomes convey. Given the empirical evidence surveyed, it appears that tax rates indeed decline due to tax competition between countries, and in particular due to competition for profits. In addition to summarizing the substantive implications of the existing empirical literature, the paper addresses the question of whether the existing studies can convincingly isolate tax competition as a driver of falling corporate income tax rates.
HEALTH CARE SPECIAL REPORT: THE CLINICIAN AS LEADER: LEADERSHIP SAVES LIVES
Authors: Lees Peter
Published: December 2010

Clinical roles are also leadership roles. Peter Lees shares insights from his leadership role with the National Health Service in the UK, the world's largest health care system.
HEALTH CARE SPECIAL REPORT: Q&A: HELPING HOSPITALS TO IMPROVE HEALTH CARE
Authors: Ramdas Kamalini
Published: December 2010

Kamalini Ramdas was convinced that good things would happen if top health care practitioners could spend a day speaking with leading‐edge business thinkers. She proposed that London Business School and Cambridge University arrange such a conference, and the event was held in July 2010. Some 100 people attended — including 27 chief executives of Hospital Trusts and Strategic Health Authorities, 10 chief executives of private‐sector businesses providing health care services to public health care providers, and a dozen or more business school faculty. The result was an invigorating interchange of new ideas.
THE EXTRAORDINARY EMERGENCE OF CHINA
Authors: Yueh Linda
Published: December 2010

China has developed into the world's second‐largest economy from being one of the poorest in 1979. Linda Yueh's research explains the country's success.
PEELING THE ONION
Authors: Crainer Stuart
Published: December 2010

Freek Vermeulen believes that discovering the truth behind the myths that dominate business thinking can provide a better competitive edge than listening to conventional wisdom gleaned from past giants of management thinking. And he's not hesitant to reveal the truths he has discovered, no matter how much, or whom, it hurts. His book, Business Exposed, targets the collective inertia of middle management, the reluctance of CEOs to pursue the new and different, the waste that results from dependence on consultants and the lack of connection between performance and rewards.
READ MY TIPS
Authors: Mullins John
Published: December 2010

John Mullins has long been associated with the world of entrepreneurship. What are his favourite books on the subject? Here are 10 that he selected if you'd like a start‐up plan for upgrading your entrepreneurial library.
FACE VALUES: NOTHING IS IMPOSSIBLE
Authors: Brass Richard
Published: December 2010

Richard Hytner is Deputy Chairman of the global advertising agency, Saatchi & Saatchi. Responsible for the company's strategy and for its programme of continuous transformation, he works with leadership teams around the world to accelerate transformational performance. Hytner joined Saatchi in 2003, having previously been UK CEO and Chairman of the advertising group, Publicis, and Chairman of The Henley Centre. He was also a co‐founder of the Manchester United Supporters’ Trust, reflecting his belief that brands are truly owned by the people who use them. In this interview with Richard Brass, Hytner discusses values, ‘Lovemarks’ and the overriding importance of purpose.
THINK AGAIN: THE BUSINESS OF ECONOMICS IS BUSINESS
Authors: Stout David
Published: December 2010

Advances in the subject have greatly developed the ways in which economists within a business can contribute to strategic decisions. In this 1997 article, David Stout draws on his experiences with Unilever to demonstrate the contribution economists can and should be making.
PROFILE: GARY HAMEL
Authors: Crainer Stuart
Published: December 2010

In this series, Business Strategy Review profiles major thinkers who have made a significant difference to how organisations are managed and how business careers have been shaped as a result.
EXECUTIVE SUMMARY: PORTS OF CALL
Authors: Crainer Stuart
Published: December 2010

Nitin Bakshi, Stephen E. Flynn and Noah Gans, ‘Estimating the operational impact of container inspections at international ports’, forthcoming in Management Science.
VOICES: WHAT TO DO BEFORE YOU WRITE A BUSINESS PLAN
Authors: Mullins John W.
Published: December 2010

Business plans are often the linchpin to starting a successful enterprise. John Mullins believes you need to think before you write.
MY DAY
Authors: Bew Robin
Published: December 2010

Robin Bew joined the Economist Intelligence Unit in 1995. Previously, he was an economist at Her Majesty's Treasury. He became the Economist Intelligence Unit's Chief Economist in 1997 and Editorial Director in 2006.
Comparing unemployment protection and social assistance in 14 European countries. Four worlds of protection for people of working age
Authors: Pfeifer Michaela
Published: December 2010

Pfeifer, M. Comparing unemployment protection and social assistance in 14 European countries. Four worlds of protection for people of working age

This article aims to show which policy responses 14 Western European countries have adopted to deal with rising unemployment levels and increased need for benefits during working age. In contrast to earlier studies, both components of unemployment benefits (UB), i.e. unemployment insurance and unemployment assistance, were taken into account in a social rights indicator that depicts the legal entitlements of the unemployed. In total, there were eight indicators of both UB and social assistance representing expenditure, generosity, problem pressure and benefit entitlements. The following cluster analysis groups countries using these indicators. The resulting typology consisted of four ways of protecting the working‐aged: anextensive safety nets typeoperating well with functioning labour markets; aliberal protection typedealing with low levels of unemployment; atargeted protection typecombined with an insider–outsider divide on the labour market; and lastly, apatchy safety nets typefacing high unemployment levels.
Assessment and management of methotrexate hepatotoxicity in psoriasis patients: report from a consensus conference to evaluate current practice and identify key questions toward optimizing methotrexate use in the clinic
Authors: Barker J. , Horn E.J. , Lebwohl M. , Warren R.B. , Nast A. , Rosenberg W. , Smith C. ,   on behalf of the International Psoriasis Council
Published: December 2010

Experts in psoriasis, hepatology, pharmacokinetics and pharmacogenetics convened to discuss the safety and monitoring of methotrexate with respect to hepatotoxicity when used in the treatment of psoriasis. Methotrexate is an efficacious and cost‐effective treatment for psoriasis, but is associated with significant safety issues, particularly relating to hepatotoxicity. Current British, Dutch, German, EU and US guidelines for baseline evaluations, monitoring and prevention of hepatotoxicity in patients with psoriasis receiving methotrexate were evaluated. Liver safety monitoring is currently reliant upon multiple methods, including biopsy, serological tests for biomarkers such as type III procollagen amino terminal propeptide (PIIINP), and liver function tests based on liver enzymes. Monitoring of patients receiving long‐term therapy is expected to be improved by the utilization of serum biomarkers currently in development such as the Enhanced Liver Fibrosis (ELF) panel and other non‐invasive tests of hepatic architecture, such as fibroelastography, microbubbles and magnetic resonance imaging. Appropriate studies to determine optimal dosing to maximize efficacy and minimize toxicity, potentially utilizing pharmacogenetic principles, are clearly needed. Key questions for future research are identified including needs for optimal screening and monitoring, identification of appropriate biomarkers, assessment of relationships between dosing and safety, utility of liver biopsy, optimal dosing regimens (including route of administration), methods to measure methotrexate levels in blood, and use of methotrexate as a standardized active comparator in trials of experimental drugs used to treat psoriasis.
Pemphigus vegetans: a clinical, histological, immunopathological and prognostic study
Authors: Zaraa I. , Sellami A. , Bouguerra C. , Sellami M.K. , Chelly I. , Zitouna M. , Makni S. , Hmida A.B. , Mokni M. , Osman A.B.
Published: December 2010

Background  Pemphigus vegetans (P Veg) is a rare clinical form of pemphigus. Studies on P Veg are rare in the literature and none has so far evaluated the prognostic parameters.

Objective  In this retrospective study of P Veg, we aimed to analyse epidemiological, clinical, immunopathological and therapeutic data. Study of prognostic factors with accuracy of patient survival was also carried out.

Methods  This is a retrospective study (1981–2009) including 17 cases of P Veg. Statistical analysis was performed with chi‐square and Fisher tests looking for a possible relationship between clinical data and prognostic factors. Follow‐up time and disease‐free survival time were estimated using Kaplan–Meier methods. Clinical data were evaluated in univariate analysis looking for a significant association with survival. Equality of survival distribution was studied using log rank test.

Results  The hospital prevalence of P Veg was 0.084‰ with a frequency of 9.1% among pemphigus. The mean age at onset was 47.6 years, with a sex‐ratio (F/M) about 4.66. Neumann P Veg was the predominant clinical form (11/17). Clinically, the lesions were multifocal (16/17), prevailed on folds and mucous membranes. Under corticosteroids the mean period for healing was 24 ± 9 days. During the follow‐up time, three patients died and 11 patients relapsed. Median of overall relapse‐free survival was 13 ± 1.7 months. No significant association between clinical data and prognostic factors was found.

Limitations  This study was a retrospective chart analysis and the number of patients was small.

Conclusion  The P Veg seems to be more frequent in Tunisia with high rate of mortality.
Cognitive training with photographs as a new concept in an education campaign for self‐detection of melanoma: a pilot study in the community
Authors: Gaudy‐Marqueste C. , Dubois M. , Richard M.‐A. , Bonnelye G. , Grob J.‐J.
Published: December 2010

Background  Cognitive education using only photographs has been shown to be more effective than the ABCD algorithm to improve melanoma recognition in the general population.

Objective  The aim of this study was to assess the feasibility and acceptability of a campaign based on cognitive education by photographs instead of the usual ABCD algorithm.

Methods  Brochures including a panel of photographs of melanoma and moles were mailed, supported by a media campaign and followed by a telephone survey of a representative sample of the district population.

Results  Among the 855 people interviewed, 38% recalled the campaign and 13% had actually read the brochures. Among the 13%, 99% found them useful, 52% reassuring and 40% anxiety provoking, while 92% agreed that using images of skin cancer was the best way to recognize melanoma. Sixty‐four percent declared that this campaign had prompted them to examine their own moles, 39% were prompted to check moles of family members, and only 11% would immediately visit a doctor.

Conclusion  This pilot study shows that a melanoma campaign based exclusively on images is well accepted in the community, and is associated with a favourable impact on self‐surveillance, while limiting overflow of unjustified consultations. We recommend this innovative concept be applied to large scale campaigns.
Advantages of preoperative hybrid SPECT/CT in detection of sentinel lymph nodes in cutaneous head and neck malignancies
Authors: Klode J. , Poeppel T. , Boy C. , Mueller S. , Schadendorf D. , Körber A. , Stoffels I. , Dissemond J.
Published: December 2010

Background  There is some controversy around the value of sentinel lymph node excision (SLNE). Especially SLNE of cutaneous head and neck malignancies has been debated intensively, in part because of the complexity of the lymphatic drainage in this region associated with potential high morbidity. In order to improve preoperative three‐dimensional mapping of sentinel lymph nodes (SLN), in the head and neck region, by means of hybrid single photon emission computed tomography/computed tomography (SPECT/CT) is gaining significance. Our study seeks to identify the potential medical and economic advantages of preoperative SPECT/CT in direct comparison to standard SLNE without SPECT/CT in patients with cutaneous head and neck malignancies.

Methods  We retrospectively analysed the data of 48 clinically lymph node‐negative patients with early stage melanoma, high risk cutaneous squamous cell carcinoma and porocarcinoma, who underwent SLNE with or without preoperative SPECT/CT within 4 years.

Results  The SLNE in the head and neck region with SPECT/CT‐technique demonstrated better postoperative aesthetic results had lower morbidity and significantly reduced operating time. Moreover, SLNE with SPECT/CT‐technique in the head and neck region was feasible using local anaesthesia (LA) and significantly reduced resulting costs (€32.65/SLNE with LA vs. €334.57/SLNE with general anaesthesia, P < 0.0001).

Conclusion  SPECT/CT is an innovative imaging technique, reliably and readily providing additional anatomical/functional information to detect and to excise SLN in the head and neck region. Therefore, SLNE with SPECT/CT‐technique is an attractive option to improve the detection of SLN in cutaneous head and neck malignancies.
Involvement of the bulge region with decreased expression of hair follicle stem cell markers in senile female cases of alopecia areata
Authors: Yoshida R. , Tanaka K. , Amagai M. , Ohyama M.
Published: December 2010

Background  Alopecia areata (AA) is a common hair loss disorder characterized by cellular autoimmune reaction predominantly involving the bulbar portion of anagen hair follicles. In most cases of AA, the bulge stem cell area remains intact. Recently, a couple of molecules, such as keratin15 (K15) and CD200, have been identified as biomarkers of human bulge cells. Of note, an immunosuppressive molecule, CD200 is speculated to provide an immune privilege for bulge stem cells.

Objective  To investigate expression levels of stem cell markers, especially CD200, in two senile female cases of AA with unusual lymphocytic cell infiltrates surrounding both the bulge and the bulbar regions. Then, compare them with those in common AA cases without the bulge involvement.

Methods  Transverse sections containing the bulge levels were prepared from unaffected and affected lesions, respectively, from each AA group and immunohistochemical investigation using anti‐K15 and CD200 antibodies was performed. Importantly, an approach to detect CD200 in paraffin sections was newly developed. Immunoreactivities of individual antibodies were compared between corresponding lesions in each patient group.

Results  In unaffected bulge lesions, K15 immunoreactivity was not different between bulge‐involving AA and common AA groups, whilst that of CD200 was decreased in the former group. Both K15 and CD200 immunoreactivities were decreased in affected bulge lesions of bulge‐involving AA compared to the bulge of common AA cases.

Conclusion  Selective downregulation of CD200 in the bulge area could contribute to the collapse of immune privilege with resultant unusual bulge involvement in a subset of AA.
Converging forest community composition along an edaphic gradient threatens landscape‐level diversity
Authors: Amatangelo Kathryn L. , Fulton Mark R. , Rogers David A. , Waller Donald M.
Published: December 2010

Aim  Plant communities across the temperate zone are changing in response to successional processes and human‐induced disturbances. Here, we assess how upland forest under‐ and overstorey community composition has changed along an edaphic gradient.

Location  Northern Wisconsin, USA.

Methods  Forest sites initially sampled in the 1950s were resampled for overstorey composition and diversity, basal area, and understorey composition and diversity. We used clustering methods to identify groups of stands based on overstorey composition, and we used similarity indices, ordination and diversity indices to evaluate changes in species abundance and overall community structure.

Results  Sites clustered into four overstorey groups along the edaphic gradient: ‘hemlock’ sites dominated by hemlock in 1950, ‘mesic’ sites dominated by northern hardwoods, ‘dry’ sites with a significant pine inclusion in the canopy and diverse ‘dry‐mesic’ sites in the middle. Collectively, forests gained maple, ash and cherry while losing pines, birches and red oaks. The hemlock forest sites gained hardwoods, while the dry‐mesic sites shifted towards a more mesic hardwood composition. Only the driest sites have remained relatively stable in species composition.

Main conclusions  These trends reflect both ‘mesification’ and homogenization among northern forests. Highly diverse mid‐gradient and mesic hemlock‐dominated stands are transitioning to maple dominance. Fire suppression may be favouring invasions of more mesic plants into historically drier sites, while high deer abundance likely limits hemlock regeneration. If current trends continue, maples will dominate the majority of northern forests, with significant losses of local native species richness and substantial shifts in understorey composition.
Fruit quantity of invasive shrubs predicts the abundance of common native avian frugivores in central Pennsylvania
Authors: Gleditsch Jason M. , Carlo Tomás A.
Published: December 2010

Aim  Biological invasions pose one of the most severe threats to global biodiversity. Still, invasions can create positive ecological relationships and services, which can sometimes result in challenges for conservation efforts. A case in point is the invasion of alien plants that form mutualisms with native frugivorous birds. Here, we examined the correlation between honeysuckles (Lonicera spp.) and the bird communities in a landscape of central Pennsylvania during the fall months.

Location  State College area in central Pennsylvania, USA.

Methods  We conducted point counts to quantify the abundance of birds and fleshy‐fruited plant species within a 187.5 km2 landscape that included forested, urban and agricultural lands. We also compared fruit‐removal rates for a native fruiting plant under low and high Lonicera densities.

Results  The abundance of birds showed a strong positive association with Lonicera fruits, with the abundance of Turdus migratorius and Dumetella carolinensis showing the strongest correlations. We also found that fruit‐removal rates were 30% larger for a native plant species in areas of high Lonicera density compared to a site with low density of Lonicera.

Main conclusions  Our results suggest that Lonicera may currently serve as a main axis for the organization of bird communities and the networks of frugivore–plant interactions in central Pennsylvania. Since populations of key bird frugivores may be currently depending on Lonicera resources, we argue that control measures should account for the negative effects that the loss of this fruit resource could have on populations of native consumers in highly invaded regions.
SHORT SELLING AND MISPRICINGS WHEN FUNDAMENTALS ARE KNOWN: EVIDENCE FROM NYSE‐TRADED CLOSED‐END FUNDS
Authors: Flynn Sean Masaki
Published: December 2010

The larger a closed‐end fund's premium over its portfolio value, the more intensely it is sold short. This behavior should reduce mispricings. However, short selling affects neither the observed rate at which premia revert to fundamental values nor the rate of return on a fund's shares. This apparent contradiction can be explained as follows: short selling does reduce prices, but the effect is impounded into prices by the time short positions are tabulated by the NYSE each month. Consequently, the monthly short selling data do not predict future price movements.
RISK AND HEDGING BEHAVIOR: THE ROLE AND DETERMINANTS OF LATENT HETEROGENEITY
Authors: Pennings Joost M. E. , Garcia Philip
Published: December 2010

The notion of heterogeneous behavior is well grounded in economic theory. Recently it has been shown in a hedging context that the influence of risk attitudes and risk perceptions varies for different segments using a generalized mixture regression model. Here, using recently developed individual risk attitude measurement techniques and experimental and accounting data from investors with differing decision environments, we examine the determinants of heterogeneity in hedging behavior in a concomitant mixture regression framework. Allowing for latent heterogeneity, we find that risk attitudes and risk perceptions do not influence behavior uniformly and that the heterogeneity is influenced by manager's focus on shareholder value and the firm's capital structure.
Effect of Pregabalin in the Treatment of Refractory Neck Pain: Cost and Clinical Evidence from Medical Practice in Orthopedic Surgery and Rehabilitation Clinics
Authors: Flórez‐García Mariano , Ceberio‐Balda Félix , Morera‐Domínguez Carles , Masramón Xavier , Pérez María
Published: December 2010

Background:  The study aims to prospectively analyze the effect of adding pregabalin upon costs and consequences in the treatment of refractory neck pain under routine medical practice.

Methods:  A secondary analysis was carried out including patients over 18 years, with 6‐month chronic neck pain refractory from a prospective, naturalistic, 12‐week two‐visit study. The analysis compared patients adding pregabalin to its therapy vs. usual care. Severity of pain, healthcare resources utilization, lost workday equivalents (LWDE) because of pain, and related cost‐adjusted reductions were assessed.

Results:  A total of 312 patients (65.3% women, age 54.2 [12.1] years), 78.2% receiving pregabalin, were analyzed. Adding pregabalin was associated with higher adjusted reduction in pain severity: −3.2 (1.8) points, 55.4% responders (≥ 50% baseline pain reduction) vs. −2.3 (2.0) and 38.2%, respectively; P < 0.001, yielding a higher reduction in mean LWDE: 20.1 (23.1) vs. 8.2 (22.4); P = 0.014, which produced significant reductions in the indirect components of cost: €1,041.0 (1,222.8) vs. €457.3 (1,132.1), P = 0.028. The costs of pregabalin (€309.8 [193.2] vs. €26.4 [79.6], P < 0.001) was offset by higher numerical reductions in the other components of costs, producing similar direct cost reductions in both groups at the end of the study: €66.8 (1,080.8) and €143.5 (1,922.4), respectively; P = 0.295.

Conclusion:  Compared with usual care, the addition of pregabalin to treat refractory neck pain seems to be associated with a higher reduction in pain severity and lost work‐days equivalents, which in turn results in a greater reduction of the indirect components of cost while maintaining similar healthcare cost levels despite its higher price.
18. Painful Diabetic Polyneuropathy
Authors: Pluijms Wouter , Huygen Frank , Cheng Jianguo , Mekhail Nagy , van Kleef Maarten , Van Zundert Jan , van Dongen Robert
Published: December 2010

In the industrialized world, polyneuropathy induced by diabetes mellitus (DM) is one of the most prevalent forms of neuropathy. Diabetic neuropathy can result from a direct toxic effect of glucose on nerve cells. Additionally, the damage of the nerve structures (central and peripheral) is accompanied by a microvascular dysfunction, which damages the vasa nervorum. More than 80% of the patients with DM‐induced polyneuropathy have a distal and symmetric presentation. The initial symptoms are: signs of diminished sensation, burning feet, which may occur particularly during the night and worsen when touched, and tingling sensation in the feet. Attacks of shooting pain may also occur.

Proper control of DM is mandatory. Based on the recently published National Institute for Health and Clinical Excellence guidelines, treatment of painful diabetic neuropathy should start with duloxetine or amitriptyline if duloxetine is contraindicated. If pain relief is inadequate, monotherapy with amitriptyline or pregabalin, or combination therapy with amitriptyline and pregabalin should be considered. If pain relief is still insufficient, tramadol instead of or in combination with a second‐line agent should be considered. In patients who are unable to take oral medication, topical lidocaine can be considered for localized pain. There are currently four studies showing that spinal cord stimulation can potentially provide pain alleviation for the longer term in patients with painful diabetic polyneuropathy. Complications are mainly implant related, though infections also occur. The available evidence (2 C+) justifies spinal cord stimulation to be considered, preferably study related.
Are Psychoactive Substance (Opioid)‐Dependent Chronic Pain Patients Hyperalgesic?
Authors: Fishbain David A. , Lewis John E. , Gao Jinrun
Published: December 2010

Objectives:  One indirect line of evidence for opioid‐induced hyperalgesia (OIH) in humans is decreased pain thresholds (PTREs) and tolerances (PTOLs) in opioid addicts on opioids. There are a number of such studies in opioid maintained addicts, but no such studies in chronic pain patients (CPPs) with current opioid addiction. The objective of this study was to determine if this group demonstrates hyperalgesia.

Methods:  CPPs were subdivided into those with psychoactive substance (opioid dependence) (PSOD) (n = 38) (addicted) and those taking opioids but without PSOD (n = 198) (not addicted). A group of opioid‐free non‐CPPs served as a control group (n = 36). PTREs/PTOLs were determined in each group by pressure pain stimulation in both the right and left index fingers. PTREs/PTOLs were compared by analysis of variance among the three groups controlling for sex/age and by analysis of covariance between the PSOD CPPs and non‐PSOD CPPs controlling for duration of pain and visual analog scale pain level over the last 24 hours.

Results:  The PSOD and non‐PSOD CPPs had significantly lower PTREs and PTOLs vs. the control group, ie, were hyperalgesic. However, they were not significantly different from each other.

Conclusions:  This study contributes to the human OIH literature. However, because of the potential confounders in this study, the issue of OIH in humans remains unresolved.
Exposure to Potential CYP450 Pharmacokinetic Drug–Drug Interactions among Osteoarthritis Patients: Incremental Risk of Multiple Prescriptions
Authors: Pergolizzi Jr Joseph V. , Labhsetwar Sumedha A. , Puenpatom R. Amy , Joo Seongjung , Ben‐Joseph Rami , Summers Kent H.
Published: December 2010

Patients taking more than one drug metabolized through the cytochrome P450 (CYP450) enzyme system experience a drug–drug exposure (DDE), which puts them at risk for a potential pharmacokinetic drug–drug interaction (DDI), defined as two or more drugs interacting in such a way that the effectiveness and/or toxicity of one or all drugs are changed. Any patient subjected to a DDE is at risk for a potentially serious DDI, the epidemiology of which has not been thoroughly studied. Many drugs are metabolized primarily via the CYP450 enzyme system, including certain opioids used to manage moderate to severe chronic pain. We conducted a retrospective analysis of a large commercial claims database and a Medicare database to assess the prevalence of DDEs among patients with osteoarthritis taking CYP450‐metabolized opioids. The overall prevalence of DDEs in this population was 26%, with females more likely to experience DDEs than males (28.4% vs. 21.0%, respectively). The number of unique concurrent prescriptions at baseline, gender, age, and Charlson Comorbidity Index were statistically significant predictors of DDEs (P < 0.05). This study challenged previous assumptions about DDEs in that advanced age was not positively associated with the risk of DDE. However, the number of prescriptions the patient received in the 90‐day window prior to the index date was a risk factor. For patients taking at least two medications in the 90‐day period prior to the index date, every additional prescription taken increased their risk for a DDE during the observation period by 138% (on average). The risk of DDE during the study period was threefold greater for patients with one medication in the 90‐day period before index date compared with similar patients with no prescriptions in that same period before the index date. DDEs are more common than may be generally believed in patients with osteoarthritis, regardless of age, and can occur even in patients taking few medications. When selecting an opioid analgesic to treat osteoarthritis, physicians should consider the potential for exposure of these patients to drugs that could interact unfavorably. ▪
Real‐World Evaluation of Health‐Care Resource Utilization and Costs in Employees with Fibromyalgia Treated with Pregabalin or Duloxetine
Authors: Harnett James , Margolis Jay , Cao Zhun , Fowler Robert , Sanchez Robert J. , Mardekian Jack , Silverman Stuart L.
Published: December 2010

Objective:  To evaluate changes in health‐care resource use and costs after initiating pregabalin or duloxetine in employees with fibromyalgia (FM).

Methods:  Employees (18 to 64 years old) with at least one claim for an FM‐attributable medication within 60 days following an FM diagnosis were identified using the Thomson Reuters MarketScan® Commercial Database (2006 to 2008). Patients newly initiated on pregabalin were propensity score matched to patients newly initiated on duloxetine. These treatment cohorts were evaluated for changes between the 6‐month pre‐ and post‐initiation periods in health‐care utilization including prescriptions, imputed medically related work loss and expenditures. Pre‐ to post‐initiation changes were compared between pregabalin and duloxetine using a difference‐in‐difference approach based on univariate statistics and multivariable models.

Results:  A total of 731 employees with FM initiated on pregabalin (89.9% female, mean age 47.1 ± 9.7 years) were matched with 731 employees initiated on duloxetine (89.5% female, mean age 47.1 ± 9.8 years); other demographic and clinical characteristics were also comparable between cohorts. The adjusted marginal effects were not statistically significant for pre‐ to post‐changes in opioid utilization (P = 0.856), number of FM‐attributable (P = 0.151) or FM‐related medications (P = 0.462), and all‐cause (P = 0.323) or FM‐attributable (P = 0.991) expenditures. Pregabalin was associated with a significantly lower probability of any medically related work loss of 3.2 percentage points (P = 0.030) compared with duloxetine, but changes in indirect costs were not significantly different (P = 0.600).

Conclusions:  The changes in health resource utilization and costs after initiation of pregabalin were not significantly different than the changes observed after initiation of duloxetine. These results not only demonstrate an overall similarity of resource utilization, but also suggest cost neutrality between pregabalin and duloxetine.
A Meta‐Analysis of Pain Response in the Treatment of Fibromyalgia
Authors: Roskell Neil S. , Beard Stephen M. , Zhao Yang , Le Trong Kim
Published: December 2010

Objective:  This meta‐analysis compared efficacy (pain response) of drugs that are licensed or commonly used in the treatment of fibromyalgia. A meta‐analysis of safety measured via discontinuation because of adverse events was also performed.

Methods:  We conducted a meta‐analysis of 21 clinical trials to estimate treatment differences vs. placebo, separately, for duloxetine, fluoxetine, gabapentin, milnacipran, pramipexole, pregabalin, either of two tricyclic antidepressants, and tramadol plus paracetamol. Indirect treatment comparisons using mixed treatment comparisons methodology were conducted for all pairwise comparisons. Pain response was analyzed as improvement of at least 30%, and separately of 50%, from baseline.

Results:  When compared with placebo, statistically significant pain responses (improvement of 30% and 50%) were observed for patients treated with duloxetine, milnacipran 200 mg/day, pregabalin 300 or 450 mg/day, and tramadol plus paracetamol. Treatment with fluoxetine, gabapentin, or milnacipran 100 mg/day resulted in significant findings for the 30% improvement in pain response. The meta‐analysis showed a statistically increased risk of discontinuation because of adverse events for milnacipran 100 and 200 mg/day (both P < 0.001), and pregabalin 300 and 450 mg/day (P = 0.009 and P < 0.001, respectively). All other treatments, except fluoxetine, showed numerically increased risk over placebo for discontinuation because of adverse events. In the indirect comparisons, no pairwise comparison of active treatments reached statistical significance for either pain response end point.

Conclusion:  All eight active treatments displayed evidence suggesting improvement over placebo in the treatment of pain in patients suffering from fibromyalgia. Indirect comparison of active treatments found no strong differences.
Novel Antiplatelet Agent Ticagrelor in the Management of Acute Coronary Syndrome
Authors: RAMARAJ RADHAKRISHNAN , MOVAHED MOHAMMAD REZA , HASHEMZADEH MEHRNOOSH
Published: December 2010

Current clinical guidelines recommend dual antiplatelet agents namely aspirin and clopidogrel for the treatment of patients suffering from acute coronary syndrome (ACS). But the efficacy of clopidogrel is variable as it is a pro‐drug, which has to be metabolized to become an active drug thus exhibiting variable platelet inhibition, increases risk of bleeding, stent thrombosis, and ischemia. To overcome this limitation, prasugrel was developed with increased antiplatelet activity thereby reducing the risk of myocardial ischemia and stent thrombosis. This action of prasugrel was associated with an increased risk of major bleeding. Finally, a novel reversible and direct‐acting oral adenosine diphosphate (ADP) receptor antagonist, ticagrelor was developed that showed consistent and increased P2Y12 inhibition with similar incidence of bleeding but greater reduction in cardiac events compared to clopidogrel. The focus of this article is to review ticagrelor as a new class of P2Y12 inhibitor. (J Interven Cardiol 2011;24:199–207)
Soft tissue development around abutments with a circular macro‐groove in healed sites of partially edentulous posterior maxillae and mandibles: a clinical pilot study
Authors: Weinländer Michael , Lekovic Vojislav , Spadijer‐Gostovic Sanja , Milicic Bilijana , Wegscheider Walther A. , Piehslinger Eva
Published: December 2010

Objectives: The aim of this study was to evaluate soft tissue development at concave circular macro‐grooved titanium abutments in healed sites.

Material and methods: In a split‐mouth pilot study 10 patients received two implants each at healed posterior sites in contralateral maxillary or mandibular jaw quadrants. Either circular macro‐grooved concave study abutments or conventional convex control abutments were immediately provisionalized and received permanent crowns 3 months postimplantation. Marginal bone level, papilla index, modified plaque and bleeding index were recorded. The esthetic outcome was evaluated with standardized perpendicular pictures according to the Pink Esthetic Score (PES). Statistical analysis included the description of all variables by mean value, standard deviation and range. PES values were compared using the Wilcoxon signed rank test for paired data.

Results: Cumulative survival rate for all 20 implants was 100%. At the 1‐year follow–up, there was no statistical significant difference of marginal bone levels between sites restored with the study (−0.11 ± 0.77 mm) vs. the control (−0.34 ± 0.53 mm) abutments (P>0.05). Esthetic evaluation (PES) revealed statistically significant differences in scores between the study group [study abutment group] (7.2 ± 2.82, 8 ± 1.89) and the control group [control abutment group] (9.5 ± 1.58, 10.5 ± 1.72) at the time of prosthetic delivery and the 1‐year follow‐up. Whereas PES scores for mesial papilla at control sites at the 1‐year follow‐up demonstrated statistically significant higher values, both soft tissue level and soft tissue contour at control sites revealed statistically significantly higher PES values (P<0.05) at time of prosthetic delivery and at 1‐year follow‐up when compared with study sites.

Conclusions: Concave macro‐grooved abutments in healed posterior maxillary and mandibular sites did not exhibit a superior soft tissue development compared with standard convex abutments.

To cite this article:
 Weinländer M, Lekovic V, Spadijer‐Gostovic S, Milicic B, Wegscheider WA, Piehslinger E. Soft tissue development around abutments with a circular macro‐groove in healed sites of partially edentulous posterior maxillae and mandibles: a clinical pilot study. Clin. Oral Impl. Res. 22, 2011; 743–752 doi: 10.1111/j.1600‐0501.2010.02054.x
Effects of a calcium phosphate coating on the osseointegration of endosseous implants in a rabbit model
Authors: Fontana Filippo , Rocchietta Isabella , Addis Alessandro , Schupbach Peter , Zanotti Gianfranco , Simion Massimo
Published: December 2010

Objectives: The aim of the present study was to evaluate a Ca–P coated implant surface in a rabbit model. The Ca–P surface (test) was compared to the titanium porous oxide surface (control) in terms of bone‐to‐implant contact (BIC) and removal torque value.

Materials and methods: Two hundred and sixteen dental implants were inserted in the tibia and in the femur of 36 rabbits. One hundred and eight were represented by Ca–P oxidized surface implant and other 108 were titanium porous oxide surface modified implants. Each rabbit received six implants. Animals were sacrificed after 2, 4 and 9 weeks of healing. Each group included 12 rabbits. The femoral implant and the proximal implant of the tibia of each animal were subjected to the histologic analysis and the distal implants of the tibia underwent removal torque test (RTQ).

Results: Histological analysis in terms of BIC and RTQ did not revealed any significant difference between the Ca–P oxidized surface and the oxidized surface at 2 and 4 weeks. At 9 weeks, the oxidized surface demonstrated better results in terms of RTQ in the tibia.

Conclusion: In conclusion, findings from the present study suggested that the Ca–P coating had no beneficial effect in improving bonding strength at the bone–implant interface either at 2, 4 and 9 weeks.

To cite this article:
 Fontana F, Rocchietta I, Addis A, Schupbach P, Zanotti G, Simion M. Effects of a calcium phosphate coating on the osseointegration of endosseous implants in a rabbit model Clin. Oral Impl. Res. 22, 2011; 760–766 doi: 10.1111/j.1600‐0501.2010.02056.x
Osteoconduction of a stoichiometric and bovine hydroxyapatite bilayer‐coated implant
Authors: Hayami Takashi , Hontsu Shigeki , Higuchi Yuichi , Nishikawa Hiroaki , Kusunoki Masanobu
Published: December 2010

Objective: To impart rapid and durable osteoconductivity to implants, a commercial titanium screw implant was coated with stoichiometric hydroxyapatite (HA; 50 nm thick), and then with bovine hydroxyapatite (B‐HA; 300 nm thick) using the pulsed laser deposition technique. As control specimens, a commercial implant coated with HA (20 μm thick) using the flame spraying method (sprayed implant) and a simple titanium implant (basic implant) was used.

Methods: The osteoconductivities of these three types of implant, after implantation for 4–24 weeks, were histologically evaluated.

Results: Peeling of HA from the sprayed implant was observed by scanning electron microscopic observation. In the fourth postoperative week, the bilayered implant was already closely adhered to bone. On the other hand, the basic implant was surrounded by a gap containing connective tissue. With the sprayed implant, the bone adhered to the thick HA coating.

Conclusion: The bilayer deposition technique supplies quick and long‐term fixation of implants to bone, because the B‐HA film dissolves to aid osteoconduction right immediately after implantation and the HA thin film maintains osteoconduction without dissolution. Neither of the thin‐film fractures easily compared with thick coatings.

To cite this article:
 Hayami T, Hontsu S, Higuchi Y, Nishikawa H, Kusunoki M. Osteoconduction of a stoichiometric and bovine hydroxyapatite bilayer‐coated implant. Clin. Oral Impl. Res. 22, 2011; 774–776 doi: 10.1111/j.1600‐0501.2010.02057.x
Dentistry a second time?
Authors: Oweis Y. , Hattar S. , Eid R. A. , Sabra A.
Published: December 2010

Introduction:  Dentistry in Jordan is an attractive profession due to the high social standard it provides. This study aimed to investigate whether dentists would choose dentistry again and whether their professional expectations would change after years of practice. Of special interest were possible differences according to gender, age, degree and place of work.

Methods:  A self‐completion questionnaire was filled by a stratified random sample of 355 dentists in Jordan using closed questions. The questionnaire included professional, social and economic factors that influenced people’s choice of dentistry and whether they would choose it again and the reasons for that.

Results:  The results showed that 52% of dentists who returned the questionnaire had dentistry as their first choice; the most important determining factor was the dentist’s grades in the general secondary education. Fifty‐two per cent stated that they would not choose it for the second time, the main reason being the health problems acquired through the profession and the low income. Helping others and the social standard dentistry provides were the main reasons given for dentists to choose dentistry again.

Conclusion:  We report that more than half of the dentists included in this study would not ‘choose dentistry again’ as their profession regardless of age, gender and degree. This is mainly due to health problems acquired and the low income. We found that job satisfaction is highly affected by the workplace, and that more females are dissatisfied by the profession. This suggests that cultural background strongly affects the career decision.
Identifying student profiles and their impact on academic performance in a Brazilian undergraduate student sample
Authors: da Silva E. T. , de Fátima Nunes M. , Santos L. B. , Queiroz M. G. , Leles C. R.
Published: December 2010

The recognition of the student profile provides strategic information for planning educational policies in the university environment. The aims of this study were to identify natural segmentation of freshman undergraduate dental students based on demographic, socioeconomic and educational variables, and to subsequently investigate their impact on academic performance of Brazilian undergraduate students. Cluster analysis (two‐step algorithm) was used to segment students who entered dental school in the time period from 1999 to 2001 (n = 158) into groups based on responses to a questionnaire completed by students at the time of the admission examination. Clustering analysis revealed three natural groups. Age, the parents’ level of education, and performance on the first admission test were the most important variables for cluster segmentation. Cluster 1 (n = 42; 26.6%) was characterized by female students with higher socioeconomic status and better previous educational indicators. Cluster 2 (n = 62; 39.2%) represented disadvantaged socioeconomic profiles, with a predominance of females and older students. Cluster 3 (n = 54; 34.2%) showed similar socioeconomic characteristics to cluster 1, except for male prevalence, higher age, and experiencing difficulty in the admission test. Clusters’ academic performance was satisfactory in both overall course and course groups (grade point average of at least 7.0), with average ranging from 7.89 (SD = 0.44) to 8.13 (SD = 0.31) and 7.37 (SD = 0.75) to 8.31(SD = 0.26), respectively. Our findings provide encouraging evidence for the current context of equality of access to education and reveal the importance of financial support to maximize successful educational experiences of socioeconomically disadvantaged dental students.
Transcultural skills content in a dental curriculum: a comparative study
Authors: Mariño R. , Hawthorne L. , Morgan M. , Ismail M.
Published: December 2010

Background:  Australia has the highest proportion of immigrants in the world (24% of the population is overseas‐born, compared to 22% in New Zealand, 19% in Canada and 12% in the USA). In this context, dental students have become increasingly diverse in a milieu where patients are derived from increasingly diverse backgrounds.

Aim:  The study aims to analyse the degree to which transcultural and communication skills content is currently embedded in the medical, physiotherapy and dental curricula at a major Australian university.

Materials and methods:  Undergraduate dental, medical and physiotherapy curricula were compared and critically assessed. Researchers considered the amount of transcultural and communication skills content, the number of formal contact hours for each course and the number of teaching staff involved. In addition, 21 interviews were conducted with staff at the three schools, who were involved in the curriculum development process.

Results:  The medical and physiotherapy curricula had an explicit focus on transcultural and communication skills as a major and continuing element, delivered by teaching staff from a wide variety of academic and professional backgrounds. In contrast, the dental course showed an under‐representation of transcultural and communication skills content which was taught by a limited number of staff from the School of Dental Science.

Conclusions:  In marked contrast to medical and physiotherapy curricula, transcultural and communication skills content had a low formal profile in the dental curriculum. A curriculum review process may be a positive step towards the development of a new training curriculum giving higher priority to transcultural and communication skills to support more effective workforce development.