bluuebunny/crossref_metadata_2025 huggingface dataset:
Testing Two Explanations of the Liberal Peace
Authors: Kim Nam Kyu
Published: April 2013

Considerable evidence suggests that economic interdependence and integration reduce the likelihood of militarized conflict. However, scholars have devoted remarkably scant attention to testing different explanations of the liberal peace. This article offers an empirical test that can help adjudicate the two main arguments on the liberal peace: the opportunity cost and signaling arguments. Under the incomplete information assumption, I derive different observable implications of the competing arguments regarding how target states respond when challenged. By estimating selection models comprising dispute initiation and reciprocation, I find that, as challengers are more dependent on bilateral trade, targets are less likely to reciprocate disputes, which is supportive of the signaling argument. Regarding dispute initiation, increases in foreign direct investment and financial openness are associated with a decrease in the probability of conflict initiation. Last, the pacifying effects of the liberal economic variables are much more pronounced in contiguous and major dyads than in other dyads.
More Human Than Others, but Not Always Better
Authors: Park Joonha , Haslam Nick , Shimizu Hiroshi , Kashima Yoshihisa , Uchida Yukiko
Published: April 2013

Research has shown that people perceive themselves as more human than the average person, independent of their tendencies to self-enhance. This self-humanizing (SHN) effect has been examined in comparisons of the self with fictional or average others, but not with actual others such as a real, though unfamiliar, classmate or a friend. In Study 1, European Australian and Japanese undergraduates compared themselves with either an unfamiliar classmate or average university students to examine their tendencies for SHN. SHN was consistently found across the two comparisons and across the two cultures. Study 2 extended the findings by examining self-other comparisons involving close friend or unfamiliar peer among Australian, Japanese, and Korean undergraduates. As predicted, SHN was obtained in every culture, and SHN effect was greater in East Asia than in Australia. In contrast, self-enhancement was weak and inconsistent across samples and comparisons. The findings extend the current theory of SHN, indicating that the effect is robust and present even in comparisons involving individuated actual others.
Intra-oral PTH Administration Promotes Tooth Extraction Socket Healing
Authors: Kuroshima S. , Kovacic B.L. , Kozloff K.M. , McCauley L.K. , Yamashita J.
Published: April 2013

Intermittent parathyroid hormone (PTH) administration increases systemic and craniofacial bone mass. However, the effect of PTH therapy on healing of tooth extraction sites is unknown. The aims of this study were to determine the effect of PTH therapy on tooth extraction socket healing and to examine whether PTH intra-oral injection promotes healing. The mandibular first molars were extracted in rats, and subcutaneous PTH was administered intermittently for 7, 14, and 28 days. In a second study, maxillary second molars were extracted, and PTH was administered by either subcutaneous or intra-oral injection to determine the efficacy of intra-oral PTH administration. Healing was assessed by micro-computed tomography and histomorphometric analyses. PTH therapy accelerated the entire healing process and promoted both hard- and soft-tissue healing by increasing bone fill and connective tissue maturation. PTH therapy by intra-oral injection was as effective as subcutaneous injection in promoting tooth extraction socket healing. The findings suggest that PTH therapy promotes tooth extraction socket healing and that intra-oral injections can be used to administer PTH.
A full-scale simulation model to reproduce urban traffic in real conditions in driving simulators
Authors: Felez Jesus , Maroto Joaquin , Cabanellas Jose M , Mera Jose M
Published: April 2013

This paper describes a model capable of simulating large-scale traffic in an urban environment. The goal is of this work is the realistic and detailed simulation of the traffic, reproducing the behavior of each vehicle involved in the environment individually. This model has been developed in order to be integrated in an immersive driving simulator, where the driving position is the center of the simulation and the traffic model reproduces what happens around them. The general behavior of the traffic model is based on the following theory. Depending on the size of the urban environment to be simulated, the number of vehicles involved, and the traffic density, the environment can be studied as a whole or segmented in adjacent areas. Each vehicle model has two components. First, the behavior of the vehicle is simulated individually, modeling acceleration and braking, depending on the type and characteristics of each vehicle (mass, power, size, etc.). Second, the behavior of the drivers is also modeled, by type (passive, moderate, aggressive), playing various maneuvers also common in urban traffic circulation, such as lane changes, behavior at crossings and intersections, etc. A traffic light regulation model and the complete signposting of the urban environment are also included. As a result, the developed traffic model is applicable to large-scale traffic simulation integrated in an immersive driving simulator and is very useful when investigating complex behaviors of these environments. The model has been validated comparing it with results obtained from various references and very satisfactory results have been obtained.
Modification of cellulose non-woven substrates for preparation of modern wound dressings
Authors: Pivec Tanja , Peršin Zdenka , Kolar Mitja , Maver Tina , Dobaj Andreja , Vesel Alenka , Maver Uroš , Stana-Kleinschek Karin
Published: April 2013

Different ways are presented of modifying cellulosic non-woven substrates, which can serve as potential wound dressings with satisfactory antimicrobial and hydrophilic properties. For safe attachment of silver particles without a measurable release from the used materials, a sol–gel derived process was used. Alkaline and oxygen plasma treatments were used to improve the hydrophilicity of the materials. Their efficiency was determined by measuring contact angles and water retention values. Scanning electron microscopy (SEM) was used for determination of sample morphology prior to and after treatment. The efficiency of silver attachment and activity was evaluated by in vitro release studies and antimicrobial tests. Atomic force microscopy (AFM) and SEM, combined with dynamic light scattering, were used for determination of silver particle size. Additionally, we evaluated the influence of treatment on technological parameters, important for application performance, i.e. mechanical properties and air permeability.
Intergroup Boundaries and Attitudes
Authors: Gulker Jill E. , Monteith Margo J.
Published: April 2013

Many prejudice reduction strategies involve linking the self to outgroup members. We tested the novel question of whether establishing a potent link with a single outgroup member can reduce explicit and implicit prejudice toward the outgroup as a whole. White participants completed a mock adoption procedure where they “adopted” a baby from another country. Three experiments showed that this single link fostered perceived overlap between the self and the ethnic outgroup. This overlap mediated the effect of the adoption manipulation on explicit prejudice, which was significantly reduced. Whereas the single link was insufficient to reduce implicit prejudice significantly when the self–outgroup member link was not practiced, repeatedly practicing this connection reduced prejudice significantly in comparison with a control group that had no connection to the outgroup member. Furthermore, unlike explicit attitudes, this effect was direct.
Are Virtuous People Happy All Around the World? Civic Virtue, Antisocial Punishment, and Subjective Well-Being Across Cultures
Authors: Stavrova Olga , Schlösser Thomas , Fetchenhauer Detlef
Published: April 2013

Psychological research postulates a positive relationship between virtue and happiness. This article investigates whether this relationship holds in cultures where virtue is not socially appreciated. We specifically focus on civic virtue, which is conceptualized as citizens’ honesty in interactions with state institutions (e.g., tax compliance). Two indicators served as measures of the degree to which civic virtue is a part of a country’s normative climate: These were each country’s mean level of punishment directed at above-average cooperative players in public good experiments and the extent to which citizens justify fraud and free-riding. The results of two studies with data from 13 and 73 countries demonstrate that a positive relationship between civic virtue and happiness/life satisfaction is not universal: In countries where antisocial punishment is common and the level of justification of dishonest behaviors is high, virtuous individuals are no longer happier and more satisfied with life than selfish individuals.
Preferred place of death for children and young people with life-limiting and life-threatening conditions: A systematic review of the literature and recommendations for future inquiry and policy
Authors: Bluebond-Langner Myra , Beecham Emma , Candy Bridget , Langner Richard , Jones Louise
Published: April 2013

Background:

Home is often cited as preferred place of death in the United Kingdom and elsewhere. This position, however, usually relies on data concerning adults and not evidence about children. The latter data are scant, primarily retrospective and from parents.

Aim:

To review the literature on preference for place of death for children and young people with life-limiting or life-threatening illnesses.

Design and data sources:

The databases MEDLINE, CINAHL and EMBASE were searched from 2004 to 2012, as well as bibliography, key author and grey literature searches. Policy documents, empirical, theoretical and peer-reviewed studies and conference abstracts were included. Articles were assessed for study quality.

Results:

Nine studies were included from five countries. Six reported a majority of parents (only one study interviewed adolescents) expressing preference for death at home. Other studies differed significantly in their findings; one reporting 35.1% and another 0% preferring death at home. Some parents did not express a preference. Six of the studies included only parents of children who died from cancer while being treated at tertiary centres that offered palliative care services. Such results cannot be generalised to the population of all life-limiting and life-threatening illnesses. Furthermore, the methods of the studies reviewed failed to accommodate the full range and dynamic character of preference.

Conclusion:

The evidence base for current policies that stress the need to increase home death rates for children and young people with life-limiting and life-threatening conditions is inadequate. Further rigorous research should collect data from parents, children and siblings.
Informal hospice caregiver pain management concerns: A qualitative study
Authors: Kelley Marjorie , Demiris George , Nguyen Huong , Oliver Debra P , Wittenberg-Lyles Elaine
Published: April 2013

Background:

Informal, unpaid, family caregivers provide much hospice care in the United States. These caregivers suffer physically, psychologically, emotionally, and socially from the burden of caring. The most often identified area of caregiver burden is the management of end-of-life pain. However, little empirical evidence exists of effective interventions to help caregivers manage end-of-life pain, and issues surrounding caregiver pain management remain vague and undefined. Understanding these concerns will inform the design of effective caregiver interventions.

Aim:

The purpose of this study was to describe and organize caregiver pain management challenges faced by home hospice caregivers of cancer patients.

Design:

A content analysis of secondary data, namely, recordings of caregiver interviews, was conducted to describe pain management issues. These interviews were part of a larger clinical trial.

Setting/participants:

Multiple sessions with 29 informal caregivers, of patients dying of cancer, were audio-recorded. Subjects were purposively selected from two hospice programs in the Northwestern United States. Caregivers of noncancer patients were excluded from the study sample.

Results:

A framework of six major themes with subordinate subthemes was developed through a literature review and peer review. The framework was used to organize the content of 87 caregiver interviews. The six major themes identified in the analysis included Caregiver-Centric Issues, Caregiver Medication Skills and Knowledge Issues, End-of-Life Symptom Knowledge Issues, Communication and Teamwork Issues, Organizational Skill Issues, and Patient-Centric Issues.

Conclusion:

This analysis clearly articulated and classified caregiver issues surrounding pain management. Future hospice research may benefit from the use of this analysis and framework in the development of tools to alleviate this major cause of caregiver burden.
Lower Injury Rates for Newcomers to Professional Soccer
Authors: Kristenson Karolina , Waldén Markus , Ekstrand Jan , Hägglund Martin
Published: April 2013

Background:

No study has investigated whether newcomers to professional soccer have a different injury rate than established players.

Purpose:

The primary objective was to investigate whether being a newcomer to professional soccer influences injury rates. The secondary objective was to evaluate whether playing position and player age influence injury rates.

Study Design:

Cohort study; Level of evidence, 2.

Methods:

Twenty-six soccer clubs, with 1401 players, were followed prospectively over 9 consecutive seasons between 2001 and 2010. Club medical staff recorded time-loss injuries and soccer exposure on an individual level. Cox regression analyses were used to evaluate associations between time-loss injuries and time in professional soccer, playing position, and age.

Results:

In total, 6140 injuries and 797,389 hours of exposure were registered. A decreased general injury rate was observed for newcomers (n = 116) compared with established players (n = 3091) (hazard ratio [HR], 0.77; 95% confidence interval [CI], 0.61-0.99). In contrast, newcomers had a higher rate of fractures (rate ratio [RR], 1.77; 95% CI, 1.05-2.97), especially stress-related bone injuries (RR, 2.68; 95% CI, 1.08-6.69). Using goalkeepers as a reference, all outfield playing positions had significantly higher adjusted injury rates: defenders with an HR of 1.91 (95% CI, 1.64-2.24), midfielders with an HR of 1.78 (95% CI, 1.53-2.07), and forwards with an HR of 1.82 (95% CI, 1.55-2.14). Using players aged ≤21 years as a reference, the overall adjusted injury rate increased with age, with a peak injury rate among players aged 29 to 30 years (HR, 1.44; 95% CI, 1.24-1.68).

Conclusion:

Newcomers to professional soccer had a lower general injury rate than established players but a higher rate of stress-related bone injuries. Being a goalkeeper was associated with lower injury rates than all outfield playing positions. Injury rates increased with age, a pattern that persisted after adjusting for playing position and match exposure.
Bone Age in Children With Obstetrical Brachial Plexus Palsy
Authors: Oktay Fügen , Cömert Didem , Gökkaya Nilüfer Kutay Ordu , Özbudak Sibel Demir , Uysal Hilmi
Published: April 2013

The purpose of this retrospective study was to analyze the effect of peripheral nerve injury on the skeletal maturation process. The bone ages of the affected and unaffected hand-wrists of 42 children with obstetrical brachial palsy were determined according to the Greulich and Pyle atlas. In 23 patients, the bone ages of the both sides were identical (bone-age-symmetrical group), in 19 patients the bone age of the affected side was delayed (bone-age-delayed group). The mean bone age of the affected side was delayed 0.48 ± 0.25 years that of the unaffected side ( P = .000), and the delay of bone age was inversely correlated with chronological age ( R2 = .45, P < .02) in the bone-age-delayed group. Skeletal retardation can be recognized after appearance of ossification centers by plain radiography, dating from the third month of life, in early infancy. Thus, bone age determination method might be helpful for predicting potential future limb shortness.
The Impact of Congenital and Childhood Myotonic Dystrophy on Quality of Life
Authors: Johnson Nicholas E. , Luebbe Elizabeth , Eastwood Eileen , Chin Nancy , Moxley Richard T. , Heatwole Chad R.
Published: April 2013

This study systematically evaluated the symptoms associated with congenital and childhood myotonic dystrophy, and how these symptoms affect health related quality of life. We conducted interviews with patients affected by congenital or childhood myotonic dystrophy and their affected parent to identify which symptoms have the greatest effect on their lives. Each interview was recorded, coded, and analyzed using a qualitative framework technique. In 34 interviews with 13 parents and 21 patients, we identified 189 symptoms, representing 22 themes in physical, emotional, social, and disease-specific quality of life. Communication difficulties, cognitive impairment, and social role limitations were the most frequently identified themes. These interviews identified multiple themes and symptoms, some previously under-recognized, which play a key role in the disease burden associated with congenital and childhood myotonic dystrophy.
A Homozygous Deletion in GRID2 Causes a Human Phenotype With Cerebellar Ataxia and Atrophy
Authors: Utine G. Eda , Haliloğlu Göknur , Salancı Bilge , Çetinkaya Arda , Kiper P. Özlem , Alanay Yasemin , Aktaş Dilek , Boduroğlu Koray , Alikaşifoğlu Mehmet
Published: April 2013

GRID2 is a member of the ionotropic glutamate receptor family of excitatory neurotransmitter receptors. GRID2 encodes the glutamate receptor subunit delta-2, selectively expressed in cerebellar Purkinje cells. The phenotype associated with loss of GRID2 function was described only in mice until now, characterized by different degrees of cerebellar ataxia and usually relatively mild abnormalities of the cerebellum. This work describes for the first time the human phenotype associated with homozygous partial deletion of GRID2 in 3 children in one large consanguineous Turkish family. Homozygous deletion of exons 3 and 4 of GRID2 (94 153 589-94 298 037 bp) in the proband and similarly affected cousins, and heterozygous deletions in parental DNA were shown using Affymetrix® 6.0 single-nucleotide polymorphism array, confirmed by real-time polymerase chain reaction. The phenotype includes nystagmus, hypotonia with marked developmental delay in gross motor skills in early infancy followed by a static encephalopathy course with development of cerebellar ataxia, oculomotor apraxia, and pyramidal tract involvement.
Modern Trends in Infection Control Practices in Intensive Care Units
Authors: Gandra Sumanth , Ellison Richard T.
Published: April 2013

Hospital-acquired infections (HAIs) are common in intensive care unit (ICU) patients and are associated with increased morbidity and mortality. There has been an increasing effort to prevent HAIs, and infection control practices are paramount in avoiding these complications. In the last several years, numerous developments have been seen in the infection prevention strategies in various health care settings. This article reviews the modern trends in infection control practices to prevent HAIs in ICUs with a focus on methods for monitoring hand hygiene, updates in isolation precautions, new methods for environmental cleaning, antimicrobial bathing, prevention of ventilator-associated pneumonia, central line-associated bloodstream infections, catheter-associated urinary tract infections, and Clostridium difficile infection.
Accuracy of Noninvasive and Continuous Hemoglobin Measurement by Pulse Co-Oximetry During Preoperative Phlebotomy
Authors: Dewhirst Elisabeth , Naguib Aymen , Winch Peter , Rice Julie , Galantowicz Mark , McConnell Patrick , Tobias Joseph D.
Published: April 2013

Background:

In recent years, the continuous noninvasive hemoglobin measurement has been offered by devices using advanced pulse oximetry technology. Accuracy has been established in healthy adults as well as in surgical and intensive care unit patients but not in the setting of acute hemorrhage. In this study, we evaluated the accuracy of such a device in the clinical setting of preoperative phlebotomy thereby mimicking a scenario of acute blood loss.

Methods:

This prospective study included patients undergoing surgical repair of congenital heart disease (CHD) for whom preoperative phlebotomy was planned. Blood was removed after the induction of anesthesia and prior to the start of the surgical procedure. Replacement with crystalloid was guided by hemodynamic variables and cerebral oxygenation measured by near-infrared spectroscopy. Hemoglobin was measured by bedside whole blood analysis (total hemoglobin [tHb]) before and after phlebotomy, and concurrent measurements from the pulse co-oximeter (noninvasive, continuous, or spot-check testing of total hemoglobin [SpHb]) were recorded.

Results:

The study cohort included 45 patients ranging in age from 3 months to 50 years. Preoperative phlebotomy removed an average of 9.2 mL/kg of blood that was replaced with an average of 7.2 mL/kg of crystalloid. The pre- and postphlebotomy tHb values were 13.0 ± 1.9 and 12.4 ± 1.8 g/dL, respectively. The absolute difference between the tHb and SpHb (▵Hb) was 1.2 ± 0.1 g/dL. Bland-Altman analysis revealed a bias of 0.1 g/dL, a precision of 1.5 g/dL, and 95% limits of agreement of −2.8 to 3.1 g/dL. In 52.2% of the sample sets, the SpHb was within 1 g/dL of the actual hemoglobin value (tHb), and in 80% of the sample sets, the SpHb was within 2 g/dL. No variation in the accuracy of the deviation was noted based on the patient’s age, weight, or type of CHD (cyanotic versus acyanotic).

Conclusion:

The current study demonstrates that the accuracy of continuous, noninvasive hemoglobin measurement was not affected by acute blood loss simulated by preoperative phlebotomy. Although the device provided a clinically acceptable correlation with the actual hemoglobin value and offers the value of a continuous trend monitor, given the precision of the device, it does not appear that actual transfusion decisions can be based on the device alone.
Data Quality in PC and Mobile Web Surveys
Authors: Mavletova Aigul
Published: April 2013

The considerable growth in the number of smart mobile devices with a fast Internet connection provides new challenges for survey researchers. In this article, I compare the data quality between two survey modes: self-administered web surveys conducted via personal computer and those conducted via mobile phones. Data quality is compared based on five indicators: (a) completion rates, (b) response order effects, (c) social desirability, (d) non-substantive responses, and (e) length of open answers. I hypothesized that mobile web surveys would result in lower completion rates, stronger response order effects, and less elaborate answers to open-ended questions. No difference was expected in the level of reporting in sensitive items and in the rate of non-substantive responses. To test the assumptions, an experiment with two survey modes was conducted using a volunteer online access panel in Russia. As expected, mobile web was associated with a lower completion rate, shorter length of open answers, and similar level of socially undesirable and non-substantive responses. However, no stronger primacy effects in mobile web survey mode were found.
Effect of natural convection on conjugate heat transfer characteristics in liquid minichannel during phase change material melting
Authors: Mansour M Khamis
Published: April 2013

This article presents numerical and experimental simulation of three-dimensional conjugate heat transfer problem in mini-scaled thermal storage system. The conjugate problem includes melting process of phase change material in the presence of natural convection during laminar flow of heat transfer fluid through circular minichannel. The paraffin wax is used as a phase change material while the water is used as a heat transfer fluid. The main objective of this study is to investigate the effect of the phase change material natural convection during the melting process on the heat transfer fluid thermal characteristics as well as the impact of the natural convection on the melting performance itself. The thermal characteristics are represented by local Nusselt number ( Nu) and local surface temperature. The melting performance is evaluated by fusion time and liquid fraction profile. Two inlet temperatures and velocities of the heat transfer fluid are adopted to highlight the effect of the natural convection. Combination of the inlet temperatures and velocities of the heat transfer fluid forms four cases: case_1 (at [Formula: see text] = 353 °K, [Formula: see text] = 1 m/s), case_2 (at [Formula: see text] = 453 °K, [Formula: see text] = 1 m/s), case_3 (at [Formula: see text] = 353 °K, [Formula: see text] = 0.1 m/s), and case_4 (at [Formula: see text] = 453 °K, [Formula: see text] = 0.1 m/s). Experimental test rig was constructed to verify the computational results and good agreement between both results was achieved. The study shows that the heat transfer fluid encounters an erratic thermal behavior during the phase change material melting process. For example, the local surface temperature experiences dramatic increase and decrease at certain sections of the channel length. The magnitude of this temperature inconsistency interrelates closely to the strength of natural convection impact, and this can expose the minichannel (which has short length) to severe wall thermal stress. The local Nu experiences improvement in some section of the channel and at the same time it suffers from drastic deterioration in its value particularly at the channel end at which the convection current accommodates. The case with the lowest inlet velocity and the highest inlet temperature has the smallest fusion time at expense of the largest heat transfer fluid bulk temperature gradient before reaching the fusion time. The study is considered as a benchmark and helpful guidelines in the design of small-scaled thermal storage systems of phase change material.
A record of Holocene summer-season palaeohydrological changes from the southern margin of Chihuahua Desert (Mexico) and possible forcings
Authors: Roy Priyadarsi D , Rivero-Navarette Axel , Lopez-Balbiaux Nayeli , Pérez-Cruz Ligia L , Metcalfe Sarah E , Sankar G Muthu , Sánchez-Zavala Jose Luis
Published: April 2013

Proxy records of runoff, lake water salinity and aeolian activity, reconstructed by analyzing the concentrations of Ti, Ca and Zr/Ti in the sediments of palaeolake Las Cruces, provide information about millennial-scale summer season palaeohydrological changes at the southern margin of Chihuahua Desert over the last 8.4 cal. kyr BP. The data indicate generally higher-than-average runoff between c. 8.4 and 5 cal. kyr BP, correlative to the early Holocene Thermal Maximum. Except for the c. 2.2–2 cal. kyr BP humid event, runoff was lower than average over the last c. 5 cal. kyr BP. Latitudinal shifts in average position of the Inter-Tropical Convergence Zone (ITCZ) caused by long-term changes in summer insolation was the principal forcing behind the varying summer season precipitation and El Niño Southern Oscillation (ENSO) activity may explain some of the hydrological variability (e.g. higher-than-average summer precipitation during c. 2.2–2 cal. kyr BP). In general, the basin received more runoff during the periods of less frequent and weak ENSO, similar to the modern response to ENSO activity of the region. Significant increases in lake water salinity and aeolian activity over the last 2 cal. kyr BP correspond to stronger and more frequent ENSO during the late Holocene.
Anti B-cell therapy against refractory thrombocytopenia in SLE and MCTD patients: long-term follow-up and review of the literature
Authors: Jovancevic B , Lindholm C , Pullerits R
Published: April 2013

Objective

The objective of this study was to retrospectively evaluate the clinical and immunological effects of anti-B cell treatment in patients with systemic lupus erythematosus (SLE) and mixed connective-tissue disease (MCTD) with autoimmune thrombocytopenia (AITP) refractory to conventional immunosuppressive treatment.

Methods

Rituximab (RTX) was added to the ongoing treatment of 16 patients (median age 36 years, range 17–84, all female) with treatment-resistant AITP. Thirteen patients had SLE and three had MCTD. RTX was given intravenously on four occasions during four consecutive weeks at a dose of 375 mg/m2. Clinical and laboratory disease activity variables recorded at every follow-up visit were analyzed.

Results

The median disease duration before RTX treatment was nine years (range 0.2–27) and the median post-treatment follow-up time was 28 months (range 3 to 92). Ten patients (63%) were treated repeatedly with RTX during the follow-up period. Complete depletion of B cells was achieved in 94% of cases one month after RTX treatment. A significant increase ( p = 0.0001) of platelet counts was seen already after one month (median 58 × 109/ml vs 110 × 109/ml) whereas within three months platelet counts normalized in 10 patients (median 223 × 109/ml). Three patients did not respond to RTX treatment (median platelet count 69 × 109/ml). High titers of anti-platelet antibodies were detected in seven patients before RTX treatment, and the autoantibody titers decreased significantly ( p < 0.03) after RTX treatment in six of these patients who also achieved complete remission. A review of the literature revealed 24 articles including 18 case reports, one retrospective cohort study and five prospective studies documenting the outcomes of 65 RTX-treated patients with SLE- or MCTD-related thrombocytopenia with an overall treatment response rate of 80%. In conclusion, these findings indicate that RTX is an additional potent therapeutic treatment option for SLE patients with AITP refractory to conventional immunosuppressive treatment whereas best response may be expected in patients with high titers of anti-platelet antibodies at baseline.
Innovative firms behind the regions: Analysis of regional innovation performance in Portugal by external logistic biplots
Authors: de Noronha Vaz Teresa , Galindo Purificación Vicente , de Noronha Vaz Eric , Nijkamp Peter
Published: April 2013

The strategic choices regarding innovation and research and development (R&D) policy in Portugal have, over the past two decades, produced various positive benefits, in which the regions of Lisbon and Algarve, in particular, have taken the lead. These are the only regions in Portugal which converge towards the European average growth rate with respect to gross production, investment and employment creation. It is now timely to evaluate firms’ contributions to national and regional growth, their obstacles, and impacts. After a conceptualization of innovation policy in Portugal, the present paper treats innovation as a major criterion for the policy evaluation process referred to above. Our empirical investigation aims to explain the innovation performance of Portuguese firms throughout the country, and to explore those determinants of innovation which are region-specific. Therefore, the analysis addresses a set of firms’ achievement patterns, by focusing on ways in which institutions interact in the process of innovation at the regional level. In our modelling study, we employ a new methodology, viz. the external logistic biplot method, which is applied to an extensive sample of innovative institutions in Portugal. Variables identified as crucial determinants in earlier studies are used to describe regional institutional profiles. Such profiles exhibit a great variety of ways in which these determinants are able to promote regional innovation. The creation of a Gradient of Capacity to Dynamically Innovate associated with each firm enables an analysis of the innovation gradient of each region in Portugal. Our paper presents and investigates these findings, and offers some policy lessons.
Tibiotalocalcaneal Fusion Using the Hindfoot Arthrodesis Nail
Authors: Rammelt Stefan , Pyrc Jaroslaw , Ågren Per-Henrik , Hartsock Langdon A. , Cronier Patrick , Friscia David A. , Hansen Sigvard T. , Schaser Klaus , Ljungqvist Jan , Sands Andrew K.
Published: April 2013

Background:

Tibiotalocalcaneal arthrodesis is a salvage option for severe ankle and hindfoot deformities, arthritis of the ankle and subtalar joints, avascular necrosis of the talus, failed total ankle arthroplasty, and Charcot arthropathy. This multicenter study reports clinical experience with the hindfoot arthrodesis nail (HAN) in the treatment of patients with severe ankle and foot abnormalities.

Methods:

Seven participating clinics from Europe and North America recruited 38 patients who underwent ankle/subtalar arthrodesis using retrograde nailing with the HAN. Information was collected regarding technical details, complications, and functional and quality of life outcomes (Short Form-36 [SF-36], American Academy of Orthopaedic Surgeons—Foot and Ankle Outcomes [AAOS-FAO], and numeric rating scale [NRS] for pain) after an average of 2 years of follow-up.

Results:

The rate of superficial wound infection was 2.4%. No deep soft tissue or bone infections were reported. The overall union rate was 84%. At the time of follow-up, low pain levels were reported, with a mean NRS of 2.2; the mean AAOS-FAO score was 38; and the SF-36 mean physical and mental health component scores were 41.2 and 52.5, respectively. All 13 patients who were unable to work prior to surgery were able to fully return to work.

Conclusions:

The HAN offered a safe and reliable salvage option for tibiotalocalcaneal arthrodesis in patients with severe ankle and hindfoot disease. It achieved acceptable functional outcome and low complication rates despite the challenging patient cohort. A considerable socioeconomic benefit appeared to result based on the high proportion of patients who were able to return to work postoperatively.

Level of Evidence:

Level IV, retrospective case series.
Allograft Reconstruction of Peroneal Tendons
Authors: Mook William R. , Parekh Selene G. , Nunley James A.
Published: April 2013

Background:

Irreparable peroneal tendon tears are uncommon and require complex surgical decision making. Intercalary segment allograft reconstruction has been previously described as a treatment option; however, there are no reports of the outcomes of this technique in the literature. We describe our technique and present our results using this method.

Methods:

A retrospective chart review was conducted to identify all patients who underwent intercalary allograft reconstruction of the peroneal tendons. Mechanism of injury, concomitant operative procedures, pertinent radiographic findings, pre- and postoperative physical examination, intercalary graft length, medical history, visual analog scale (VAS) score for pain, Short Form-12 (SF-12) physical health survey, Lower Extremity Functional Score (LEFS), and complications were reviewed.

Results:

Fourteen patients with peroneal tendon ruptures requiring reconstruction were identified. Mean follow-up was 17 months (range, 7-47 months; median, 12 months). The average length of the intercalary segment reconstructed was 10.8 ± 3.8 cm (range, 6-20 cm). The average postoperative VAS score decreased to 1.0 ± 1.4 ( P = .0005). No patient had a higher postoperative pain score than preoperative pain score. Average postoperative eversion strength as categorized by the Medical Research Council grading scale improved to 4.8 ± 0.5 ( P = .001). The average SF-12 score improved to 48.8 ± 7.8 ( P = .02). The average LEFS improved to 86.4. ± 14.9 ( P = .00001). Four patients experienced sensory numbness in the sural nerve distribution, and 2 of these were transient. There were no postoperative wound healing complications, infections, tendon reruptures, or reoperations. No allograft associated complications were encountered. All patients returned to their preinjury activity levels.

Conclusion:

Allograft reconstruction of the peroneal tendons can improve strength, decrease pain, and yield satisfactory patient-reported outcomes. It can be performed without incurring the deleterious effects associated with tendon transfer procedures. We believe that allograft reconstruction is a safe and useful alternative in the treatment of irreparable peroneal tendon ruptures.

Level of Evidence:

Level IV, retrospective case series.
Hypercoagulation Assessed by Thromboelastography is Neither Related to Infarct Size nor to Clinical Outcome After Primary Percutaneous Coronary Intervention
Authors: Dridi Nadia Paarup , Lønborg Jacob T. , Radu Maria D. , Clemmensen Peter , Engstrøm Thomas , Kelbæk Henning , Jørgensen Erik , Helqvist Steffen , Saunamäki Kari , Christensen Troels H. , Baeres Florian M.M. , Johansson Pär I. , Holmvang Lene
Published: April 2013

Objectives:

We investigated the relationship between coagulation assessed by thromboelastography (TEG) and myocardial damage in ST-segment elevation myocardial infarction (STEMI).

Methods:

We measured platelet activity with TEG-maximum amplitude (TEG-MA) in 233 patients undergoing urgent percutaneous coronary intervention (PCI). Infarct size and myocardial salvage index were evaluated using cardiac magnetic resonance, and the relation of these parameters to posttreatment coagulation was examined retrospectively. Adverse events were adjudicated and related to the coagulation status during the index event.

Results:

Hypercoagulation was found in 82 (35.2%) patients and was neither correlated to infarct size nor correlated to myocardial salvage index ( P = .28 and .65, respectively) or clinical adverse events. Patients who experienced an adverse event during follow-up had a slightly higher TEG-MA value than patients with an event-free follow-up, but this was not statistically significant (68.1 vs 67.3, P = .44).

Conclusions:

The TEG-MA does not appear to be a sensitive predictor of reperfusion success and prognosis in urgent PCI for STEMI.
Carbonic Anhydrase IX in the Prediction of Right Ventricular Dysfunction in Patients With Hemodynamically Stable Acute Pulmonary Embolism
Authors: Abul Yasin , Ozsu Savas , Mentese Ahmet , Durmus Ismet , Bektas Hayriye , Pehlivanlar Mehtap , Turan Oguzhan Ekrem , Sumer Aysegul , Orem Asim , Ozlu Tevfik
Published: April 2013

Right ventricular dysfunction (RVD) defined by echocardiography and/or by natriuretic peptides is a well-known predictor of prognosis in patients with pulmonary embolism (PE). This study investigated carbonic anhydrase IX (CA IX) levels for predicting echocardiographic RVD in patients with PE. A total of 150 normotensive patients with PE were included. The levels of CA IX, N-terminal pro-brain-type natriuretic peptide (NT-proBNP), and high-sensitive cardiac troponin T were significantly elevated in patients with PE with RVD on echocardiography. A receiver–operating characteristic curve analysis showed a value of 0.751 for CA IX, 0.714 for NT-proBNP, and 0.650 for high-sensitive troponin-T to predict RVD on echocardiography. The cutoff value to predict RVD was 32.45 pg/mL for CA IX (sensitivity: 89.3% and specificity: 51.1%). There was a significant positive correlation between the CA IX level and the systolic pulmonary arterial pressure on echocardiography (ρ = .21; P = .035). The CA IX is a significant serologic predictor of RVD in acute PE and correlates with systolic pulmonary arterial pressure.
The magnetic resonance imaging ‘rule of five’: predicting the occurrence of relapse
Authors: Morgan Charity J , Ranjan Ashutosh , Aban Inmaculada B , Cutter Gary R
Published: April 2013

Background:

Clinical intuition suggests that a sharp increase in the number of enhancing lesions should signal an increased risk of relapse. The ‘rule of five’ recommends that subjects exhibiting at least five lesions over the baseline level be referred for closer monitoring. This rule has been used as an informal safety criterion with limited formal evaluation.

Objective:

The purpose of this study was to determine the best threshold for the rule and to demonstrate its predictive validity for risk of subsequent relapses for multiple sclerosis (MS) trials.

Methods:

We used logistic regression modeling to apply the rule to patient data from a phase II clinical trial. Predictive validity was ascertained using rate ratios and receiver operating characteristic (ROC) curves.

Results:

We found that, for these data, a threshold of five lesions over the baseline constituted the best definition of a threshold. Overall, 35% of subjects broke the rule at least once. Breaking the rule increased the odds of imminent relapse by a factor of 3.2 (95% confidence interval (CI): 1.8–5.5).

Conclusion:

Breaking the rule of five was found to be a significant predictor of an imminent relapse. Length of follow-up and the number of lesions discovered via magnetic resonance imaging (MRI) were also significant predictors of relapse.
Theorizing participatory intensities
Authors: Jenkins Henry , Carpentier Nico
Published: April 2013

This conversation started in Prague, the Czech Republic, during a panel moderated by Irena Reifová at the symposium ‘On Empowered and Impassioned Audiences in the Age of Media Convergence’. The event was organized by the Faculty of Social Sciences at Charles University. The text contains a series of discussions. First, there is a conversation about the nature of the participatory democratic utopia and participatory culture and how groups take (or do not take) advantage of the affordances of new and emerging media. It also emphasizes the political nature and potential of popular culture and touches upon its connection to institutionalized politics. Three other key areas are mentioned: the role of different cultures of leadership, the significance of organizations in structuring participatory processes, and the need to enhance civic learning, providing more support for participatory cultures. This is combined with an interlocking discussion about the definition of participation and how it is tied up with power. It covers the differences between participation and interaction, engagement, interpretation, production, curation, and circulation. Finally, there is an underlying strand of discussion about the role of academia, focusing on the relationship between critical theory and cultural studies, the need to deconstruct our own frameworks and the question of which language to use to communicate academic research to the public.
Queering Paradise: Toni Morrison’s anti-capitalist production
Authors: Tapley Heather
Published: April 2013

I map a queer reading of Toni Morrison’s novel Paradise at the intersection of sexuality, gender, race and class. Both poststructuralist and materialist in its approach, the analysis reads the identity formations reflected in the 8-Rock men and the Convent women as discursive fictions of stable subjectivity that, despite their apparent differences, actually constitute each other in capitalist networks of power.
I See Me the Way You See Me
Authors: Festekjian Arpi , Tram Susanna , Murray Carolyn B. , Sy Thomas , Huynh Ho P.
Published: April 2013

This research investigated two key questions central to research on leadership and race: (a) How are leadership perceptions influenced by target’s race? (b) What are the consequences of race-based leadership perceptions on the target? These questions were specifically focused on Asian Americans (AAs), who are disproportionately underrepresented in leadership positions. Study 1 clarified previous research to demonstrate that Caucasian Americans (CAs) were perceived as more prototypic leaders compared with AAs. Study 2 supported the prediction that interpersonal leadership perceptions were affected by race via the activation of two leadership prototypes: competent and agentic leadership prototypes of AAs and CAs, respectively. Going beyond the contribution of clarifying previous research, Study 3 revealed that AAs had lower intrapersonal (self-directed) leadership perceptions and leadership aspirations than CAs and that the relationship between race and leadership aspiration was mediated by intrapersonal leadership perceptions. Implications of these findings are discussed with regard to leadership advancement opportunities for AAs and other racial minorities.
Vascularized dorsal digital fascial flap improves flexor tendon repairs
Authors: Sun L.-Q. , Zhao G. , Gao S.-H. , Chen C.
Published: April 2013

We report a new method of flexor tendon repair in zone II using a standard modified Kessler technique combined with a vascularized dorsal fascial flap from the finger pedicled on a dorsal cutaneous branch of the proper digital artery, which is placed as a mechanical barrier between the flexor digitorum superficialis and profundus tendons. The functional outcomes of 14 patients (Group A) with flexor tendon repairs in zone II by this new technique were compared with those of 32 patients (Group B) with flexor tendon repairs in zone II using a standard modified Kessler technique only. Patients in Group A had a higher proportion of excellent results (on the modified Strickland system) and more movement in the distal interphalangeal joint than the patients in Group B.
Wrist biomechanics during snowboard falls
Authors: Greenwald Richard M , Simpson Frank H , Michel Frank I
Published: April 2013

Wrist injuries during snowboarding are very common. An instrumented snowboarding glove was developed to measure flexion/extension of the wrist in the sagittal plane, as well as forces and moments at the hand and wrist joint during snowboarding. On-slope data were analyzed from 128 falls resulting in hand impacts for 20 snowboarders. Impact forces and wrist extension moments varied widely by age, experience level, and fall direction. Backward falls resulted in significantly higher maximum force than forward falls ( p = 0.038). Adults had significantly higher maximum force ( p = 0.026) and maximum extension moments compared to young adults ( p = 0.049). Beginners suffered more impacts that resulted in higher maximum loads generated and wrist angles that did not reach terminal extension. A significant percentage of all falls resulted in wrist extension near terminal extension. This study provides novel hand and wrist biomechanical data in snowboarding falls that can be used to guide the development of wrist protector standards and products.
Therapeutic advances in the management of chronic hepatitis B infection
Authors: Brooks Johanne , Gelson William , Rushbrook Simon M.
Published: April 2013

Hepatitis B virus (HBV) is a small nonenveloped DNA virus that is a member of the Hepadnaviridae family. Chronic HBV infection is estimated to effect more than 350 million people worldwide with over 2 billion people being exposed to the virus. Risk factors for chronic infection include age of exposure to the virus, concurrent immunosuppression and HIV infection. Individuals chronically infected are 200 times more likely to develop hepatocellular carcinoma (HCC) than uninfected individuals and are at risk of developing cirrhosis and the risks of decompensated liver disease. This article focuses on the recent therapeutic advances that reduce the risk of developing these complications, those that prevent the spread of HBV and strategies for the prevention of post-liver-transplantation recurrence of HBV.