bluuebunny/crossref_metadata_2025 huggingface dataset:
Cryopreservation of sperm
Authors: Kamischke A. , Nieschlag Eberhard
Published: July 2011

Malignant diseases in adolescence and younger adults such as testicular cancer, lymphomas and leukaemia have long-term survival rates of up to 80% if treated adequately. As a result, long-term quality of life, including reproductive health, has become increasingly important. The cryopreservation of sperm from oncological patients represents the most frequent indication for the procedure. Depending on the substance and dosages administered, chemo- and/or radiotherapy, as well as surgical intervention, can lead to persistent azoospermia independent of the patienńs pubertal status. Theoretically, hormonal gonadal protection and retransplantation of germ cell stem cells preserved prior to chemotherapy offer options to preserve fertility, but neither approach has yet proven to be of clinical benefit. Therefore at present, cryopreservation of sperm prior to oncological therapy offers the only possibility of circumventing the deleterious effects of disease and therapy on fertility, thereby contributing to the personal stabilization of the predominantly young patients in this critical situation.

Currently, men undergoing diagnostic and therapeutic testicular biopsies, performed to detect sperm possibly remaining in the testis for use in intracytoplasmic sperm injection (ICSI) (Chapter 9.4.14), may opt for cryopreservation. Until histological examination is complete, the remaining tissue remains frozen, for later use or subsequent thawing or disposal.
Sexuality and erectile dysfunction
Authors: Carani Cesare , Rochira Vincenzo , Granata Antonio R. M.
Published: July 2011

Sexuality is a complex concept encompassing far more than the simple sexual act. Sexuality in fact includes the physiological, behavioural and relational aspects of human sexual life, which are variously influenced by psychological factors (e.g. sexual fantasies, desire, arousal, psychosexual orientation, and the choice of the sexual object), as well as social and organic (vascular, nervous, and endocrine) factors.

From a functional point of view, a normal penile erection may be defined as an erection which permits the penetration of a lubricated vagina without additional assistance. Concerning the erectile mechanism, the haemodynamic changes in the penis require a high degree of central and peripheral nervous coordinated control and an unaffected endocrine system.
Environmental influences on male reproductive health
Authors: Giwercman Aleksander
Published: July 2011

Male patients referred for infertility problems are often curious as to whether their problem may be caused by environmental influences, and thus whether their chances of becoming a father can be increased by a change in lifestyle or occupation. The present level of knowledge does not allow a definitive, evidence based recommendation to be made. Except for some very few, rather extreme, occupational (e.g. 1,2-dibromo-3-chloropropane; DBCP) or iatrogenic (e.g. irradiation, cytotoxic drugs) exposures known to cause temporary or even permanent sterility, it is difficult to point to specific environmental influences as definite causes of male infertility. Nevertheless, recent research has generated some interesting information regarding the possible impact of the environment on male reproductive functions (1). This research was stimulated by reports on a possible time-related decline in male fertility (2)—a question still remaining controversial. However, there is now a considerable amount of information showing that environmental and lifestyle related exposure during early fetal development is of crucial importance for reproductive health in adult life (3).
Application of microdroplet PCR for large-scale targeted bisulfite sequencing
Authors: Komori H. Kiyomi , LaMere Sarah A. , Torkamani Ali , Hart G. Traver , Kotsopoulos Steve , Warner Jason , Samuels Michael L. , Olson Jeff , Head Steven R. , Ordoukhanian Phillip , Lee Pauline L. , Link Darren R. , Salomon Daniel R.
Published: July 2011

Cytosine methylation of DNA CpG dinucleotides in gene promoters is an epigenetic modification that regulates gene transcription. While many methods exist to interrogate methylation states, few current methods offer large-scale, targeted, single CpG resolution. We report an approach combining bisulfite treatment followed by microdroplet PCR with next-generation sequencing to assay the methylation state of 50 genes in the regions 1 kb upstream of and downstream from their transcription start sites. This method yielded 96% coverage of the targeted CpGs and demonstrated high correlation between CpG island (CGI) DNA methylation and transcriptional regulation. The method was scaled to interrogate the methylation status of 77,674 CpGs in the promoter regions of 2100 genes in primary CD4 T cells. The 2100 gene library yielded 97% coverage of all targeted CpGs and 99% of the target amplicons.
Changes in group size and composition of the blue monkeys (Cercopithecus mitis stuhlmanni) between 1984 and 2009 at Ngogo, Kibale National Park, Uganda
Authors: Angedakin Samuel , Lwanga Jeremiah
Published: July 2011

Group counts were conducted on five groups of blue monkeys at the Ngogo study site, Kibale National Park, Uganda between January and June 2009. Group sizes were compared with those obtained using similar methods at the same site during 1983‐84 by Tom Butynski. During the present study, group size ranged from 16 to 28 monkeys. The results show that the group size of blue monkeys (Cercopithecus mitis stuhlmanni) has increased significantly between 1984 and 2009. Mean group size has increased over two‐fold from 9 after the fission of group 33 during Butynski s study to 21.6 animals per group in 2009. These results strongly suggest that the density of blue monkeys at Ngogo has increased although census data indicate that group density has remained more or less the same.
TPI ASM8 reduces eosinophil progenitors in sputum after allergen challenge
Authors: Imaoka H. , Campbell H. , Babirad I. , Watson R. M. , Mistry M. , Sehmi R. , Gauvreau G. M.
Published: July 2011

Background TPI ASM8 contains two modified phosphorothioate antisense oligonucleotides (AON), one targeting the common beta chain (βc) of the IL‐3/IL‐5/GM‐CSF receptors and the other targeting the chemokine receptor CCR3. Inhalation of TPI ASM8 significantly improves lung function and sputum eosinophilia after allergen inhalation challenge in asthmatics.

Objective This study assessed whether TPI ASM8 reduces airway levels of haemopoietic progenitor cells.

Methods This open‐label study was conducted in 14 stable, allergic mild asthmatic subjects with early‐ and late‐phase allergen‐induced bronchoconstriction. Subjects underwent allergen challenges after 4‐day treatment with placebo, 4 mg b.i.d. and 8 mg o.d. of TPI ASM8. Sputum was induced before, 7 and 24 h after allergen challenges for progenitor measurements. Treatments were separated by 2–3 weeks.

Results TPI ASM8 reduced allergen‐induced sputum eosinophils, and the early and late asthmatic responses (P<0.05). TPI ASM8 also reduced the number of CD34+CCR3+ cells (P=0.004) and CD34+IL‐5Rα+ cells (P=0.016), and the proportion of CD34+ cells expressing IL‐5Rα (P=0.036).

Conclusions and Clinical Relevance TPI ASM8 was safe and well tolerated. The results of this study demonstrate blocking of CCR3 and βc expression by TPI ASM8 significantly inhibits the accumulation of eosinophils and eosinophil progenitors in the airways after allergen challenge. Inhibition of airway progenitor cell accumulation presents a novel therapeutic target.

Cite this as: H. Imaoka, H. Campbell, I. Babirad, R. M. Watson, M. Mistry, R. Sehmi and G. M. Gauvreau, Clinical & Experimental Allergy, 2011 (41) 1740–1746.
Aberrant plasmacytoid dendritic cell distribution and function in patients with Crohn's disease and ulcerative colitis
Authors: Baumgart D C , Metzke D , Guckelberger O , Pascher A , Grötzinger C , Przesdzing I , Dörffel Y , Schmitz J , Thomas S
Published: July 2011

Dendritic cell (DC) function is believed to be of critical importance for the pathogenesis of inflammatory bowel disease (IBD). To date, most research in animal models and the few human data available is restricted to myeloid DC, while plasmacytoid DC (pDC) capable of controlling both innate and adaptive immune responses have not yet been investigated systematically in human Crohn's disease (CD) or ulcerative colitis (UC). CD11c−, CD303+/CD304+ and CD123+ pDC from peripheral blood (n = 90), mucosal tissue (n = 28) or mesenteric lymph nodes (n = 40) (MLNs) of patients with UC and CD or controls were purified and cultured. Thereafter, pDC were enumerated, phenotyped and cytokine secretion measured by flow cytometry (FACS), immunohistochemistry and/or cytometric bead array, respectively. Interferon (IFN)-α secretion following cytosine phosphatidyl guanine (CpG) A oligodeoxynucleotide (ODN) 2216 (5′-GGGGGACGATCGTCGGGGGG-3′) stimulation was assessed by enzyme-linked immunosorbent assay (ELISA). We found a significantly higher frequency of pDC in the inflamed colonic mucosa and MLN of IBD patients. Moreover, the fraction of CD40 and CD86 expressing cultured peripheral blood pDC was significantly higher in flaring UC and CD patients and their secretion of tumour necrosis factor (TNF)-α, interleukin (IL)-6 and IL-8 were increased significantly compared with controls. In contrast, the IFN-α secretion of peripheral blood pDC isolated from flaring IBD, particularly in UC patients, was reduced significantly compared with controls. Our data suggest an aberrant distribution and function of pDC in IBD, contrary to their generally implicated role as inducers of tolerance. We speculate that the impaired IFN-α secretion may relate to the hypothesized defect in innate immunity in IBD and could also impact upon the generation of regulatory T cells (Treg).
Biogeochemical properties of fine particulate organic matter as an indicator of local and catchment impacts on forested streams
Authors: Sakamaki Takashi , Richardson John S.
Published: July 2011

1. The magnitude and spatial scales of human effects on stream habitats need to be correctly measured to achieve sound ecosystem management. We investigated whether the biogeochemical properties of fine particulate organic matter (FPOM) might be indicative of reach‐scale vs. catchment‐scale effects on forested stream ecosystems.

2. Along each of three forested streams, we established 4–5 sampling stations at 0·6–2·0‐km intervals, which represent a range of local riparian forest conditions (e.g. vegetation types and forestry practices). At each station, rock biofilm (considered as a representative of stream‐origin POM), FPOM in sediment (FPOMS) and suspended in water (FPOMW) and three species of benthic macroinvertebrates were collected during a summer low‐flow period.

3. Measures of δ13C, C:N and chlorophyll a:C for FPOMW, FPOMS and biofilm were longitudinally heterogeneous, reflecting the reach‐scale, local environment. δ13C, C:N and chlorophyll a:C of FPOMS were significantly related to irradiance and streambed coarse particulate organic matter (CPOM) abundance, suggesting that the relative contribution of in‐stream primary production and CPOM breakdown are dominant controls of FPOM properties.

4. In redundancy analysis, variations in FPOM properties were principally explained by local environmental factors correlated with stream size and/or longitudinal position of the sampling stations (irradiance, streambed CPOM, stream gradient, discharge, riparian vegetation). No significant effect of riparian forestry activities (logged, riparian reserve or no harvest in the past 75 years) was found on FPOM properties.

5. Resource use by primary consumers was species dependent. δ13C of larval Lepidostoma roafi depended on the relative abundance of stream‐origin POM in pools of stored FPOM. Selective intake/assimilation of stream‐origin POM by this species was probably enhanced when stream‐origin POM was abundant. δ13C of larval Despaxia augusta or larval Paraleptophlebia spp. were not related to FPOMSδ13C, suggesting no linkage with FPOM composition.

6. Synthesis and applications. The tight linkages between biogeochemical properties of FPOM, resource use by primary consumers, and reach‐scale environment indicate that local effects were greater than signals transmitted from upstream in this study. The use of in‐stream FPOM properties can help managers to measure reach‐scale effects of environmental changes on forested stream habitats.
ABO‐incompatible pediatric liver transplantation in very small recipients: Birmingham’s experience
Authors: Gelas Thomas , McKiernan Patrick J. , Kelly Deirdre A. , Mayer David A. , Mirza Darius F. , Sharif Khalid
Published: July 2011

Gelas T, McKiernan PJ, Kelly DA, Mayer DA, Mirza DF, Sharif K. ABO‐incompatible pediatric liver transplantation in very small recipients: Birmingham’s experience. Pediatr Transplantation 2011: 15: 706–711. © 2011 John Wiley & Sons A/S.

Abstract:  Liver transplantation (LT) for very small recipients is challenging but in experienced centres, good results can be achieved. Despite the risk of antibody‐mediated acute rejection, some studies have demonstrated the safety of ABO incompatible liver transplantation (ILT) in children and particularly in infants. The aim of our study was to describe the outcome of liver transplantation in infants <5 kg and the safety of using ILT in this group. All LT performed between 1991 and 2010 in children <5 kg were reviewed. Twenty‐nine patients were included, five of whom had an ILT. Acute liver failure was encountered in 20 cases. The recipient age and weight at transplantation were respectively 63 days (range: 14–268 days) and 4 kg (range: 2.4–5 kg). The graft‐to‐recipient ratio was 6.1% (range 2.3–9%). An aortic conduit and delayed abdominal closure were used respectively in 76% and 81% of the procedures. The ABO compatible liver transplantation (CLT) and ILT groups were similar regarding recipient’s demographics, graft types or technical transplantation data. The one‐ and five‐yr patient and graft survival were respectively 62%, 62% and 62%, 57.9% with a median follow‐up of 95 months. Vascular complications occurred in six cases (21.4%) and biliary complications were encountered in five patients (17%). Acute and chronic rejection developed respectively in 37% and 26% of the recipients. The five patients undergoing ILT are all alive without graft lost after a median follow‐up of 34 months (range 7–55 months). When compared with the CLT group, no significant differences were found regarding patient or graft survival, vascular or biliary complications and rejection rates. In our experience, ILT in small infants has short and long term outcomes comparable to ABO‐compatible grafts and excellent results can be achieved with a standard immunosuppressive protocol. To avoid mortality on the waiting list for neonatal recipients, ABO‐incompatible liver grafts can be used safely.
Favorable preliminary results using TLI/ATG‐based immunomodulatory conditioning for matched unrelated donor allogeneic hematopoietic stem cell transplantation in pediatric severe aplastic anemia
Authors: Pillai Asha , Hartford Christine , Wang Chong , Pei Deqing , Yang Jie , Srinivasan Ashok , Triplett Brandon , Dallas Mari , Leung Wing
Published: July 2011

Pillai A, Hartford C, Wang C, Pei D, Yang J, Srinivasan A, Triplett B, Dallas M, Leung W. Favorable preliminary results using TLI/ATG‐based immunomodulatory conditioning for matched unrelated donor allogeneic hematopoietic stem cell transplantation in pediatric severe aplastic anemia. Pediatr Transplantation 2011: 15: 628–634. © 2011 John Wiley & Sons A/S.

Abstract:  To assess whether a tolerance‐induction regimen could be applied for unrelated (MUD) HCT in SAA, we retrospectively reviewed our HCT experience using unmanipulated 10/10 HLA‐matched bone marrow grafts from MSD vs. MUD donors. Conditioning was CTX 200 mg/kg (CTX) + rabbit ATG 10 mg/kg (ATG) for MSD (n = 9) and TLI (800 cGy) + CTX/ATG for MUD HCT (n = 5). Immunoprophylaxis was CSA and short‐course MTX. Median patient age was 14.7 yr, median time to HCT 1.5 yr, and median follow‐up 3 yr. Outcome measures included EFS, time to engraftment, and cumulative incidence of GVHD (CIN of GVHD) for MSD and MUD cohorts. EFS and stable engraftment rate were 100%. CIN of acute GVHD was: MSD, Grade I–II: 1 (11%), Grade III–IV: 0%; MUD, Grade I–II: 1 (20%), Grade III–IV: 1 (20%). CIN of chronic GVHD was: MSD, limited: 1 (11%), extensive: 0%; MUD, limited: 0%, extensive: 0%. All immunosuppressive‐compliant patients successfully weaned immunosuppression. Although in limited patients, our results suggest that immunomodulatory TLI added to backbone CTX/ATG conditioning is a promising option for MUD HCT in SAA patients, which we will examine in a prospective clinical trial.
Total body irradiation and melphalan as a conditioning regimen for children with hematological malignancies undergoing transplantation with stem cells from HLA‐identical related donors
Authors: Watanabe Nobuhiro , Takahashi Yoshiyuki , Matsumoto Kimikazu , Horikoshi Yasuo , Hama Asahito , Muramatsu Hideki , Yoshida Nao , Yagasaki Hiroshi , Kudo Kazuko , Horibe Keizo , Kato Koji , Kojima Seiji
Published: July 2011

Watanabe N, Takahashi Y, Matsumoto K, Horikoshi Y, Hama A, Muramatsu H, Yoshida N, Yagasaki H, Kudo K, Horibe K, Kato K, Kojima S. Total body irradiation and melphalan as a conditioning regimen for children with hematological malignancies undergoing transplantation with stem cells from HLA‐identical related donors. Pediatr Transplantation 2011: 15: 642–649. © 2011 John Wiley & Sons A/S.

Abstract:  Although some studies have reported that TBI and MEL offer an effective conditioning regimen for autologous SCT in acute leukemia, little has been reported regarding outcomes of allogeneic SCT. We retrospectively evaluated outcomes for 50 pediatric patients who underwent allo‐SCT conditioned with intravenous MEL (180–210 mg/m2) and fractionated TBI (12–13.2 Gy) from HLA‐identical related donors. Nineteen patients were in CR1, 18 were in CR2, and 13 showed advanced‐stage disease (≥CR3). Patients had received allo‐SCT from HLA‐identical siblings (n = 45) or phenotypically HLA‐identical family donors (n = 5). Median duration of follow‐up for all disease‐free patients was 61 months (range, 8.8–177 months). At the time of analysis, 12 patients had died. Eleven of those died of relapse, and one died of TRM. DFS rates for all patients, patients with AML (n = 12), and patients with lymphoid malignancy (n = 38) were 61.4% and 82.1%, respectively. DFS rates for CR1, CR2, and ≥CR3 cases were 89.2%, 88.1%, and 23.1%, respectively (p < 0.05). MEL/TBI for pediatric patients with hematological malignancies was associated with lower relapse rates and no increase in toxicity, resulting in better survival.
Finding middle ground: negotiating university and tribal community interests in community‐based participatory research
Authors: Mohammed Selina A. , Walters Karina L. , LaMarr June , Evans‐Campbell Teresa , Fryberg Sheryl
Published: July 2011

MOHAMMED SA, WALTERS KL, LAMARR J, EVANS‐CAMPBELL T and FRYBERG S. Nursing Inquiry 2012; 19: 116–127 [Epub ahead of print]

Finding middle ground: negotiating university and tribal community interests in community‐based participatory research

Community‐based participatory research (CBPR) has been hailed as an alternative approach to one‐sided research endeavors that have traditionally been conducted on communities as opposed to with them. Although CBPR engenders numerous relationship strengths, through its emphasis on co‐sharing, mutual benefit, and community capacity building, it is often challenging as well. In this article, we describe some of the challenges of implementing CBPR in a research project designed to prevent cardiovascular disease among an indigenous community in the Pacific Northwest of the United States and how we addressed them. Specifically, we highlight the process of collaboratively constructing a Research Protocol/Data Sharing Agreement and qualitative interview guide that addressed the concerns of both university and tribal community constituents. Establishing these two items was a process of negotiation that required: (i) balancing of individual, occupational, research, and community interests; (ii) definition of terminology (e.g., ownership of data); and (iii) extensive consideration of how to best protect research participants. Finding middle ground in CBPR requires research partners to examine and articulate their own assumptions and expectations, and nurture a relationship based on compromise to effectively meet the needs of each group.
‘In a way, you have to pull the patient out of that state …’: the competency of ventilator weaning
Authors: Haugdahl Hege S , Storli Sissel L
Published: July 2011

HAUGDAHL HS and STORLI SL. Nursing Inquiry 2012; 19: 238–246  ‘In a way, you have to pull the patient out of that state …’: the competency of ventilator weaning

The introduction of the weaning protocol has reduced weaning time and improved results in patients. However, the evidence is inconsistent. This may reflect that the use of a protocol should not exclude individual considerations and clinical judgement. However, the significant aspects of the context and the competency important in the nurse–patient relationship in weaning have not yet been sufficiently described. This study aimed at exploring these aspects of weaning. Qualitative data from six in‐depth interviews and field observations of three experienced intensive care nurses in weaning situations were analysed through systematic text condensation within a hermeneutic‐phenomenological approach. Competency appeared to be based on thorough knowledge of physiology and ventilator skills, but also on knowing the patient, helping the nurse connect the meaningless to the meaningful for the patient. Behaving competently involves a continuous dialogue with the situation, observation of the patient’s body language and symptoms over a period of time and the ability to see the interrelationships of all these elements. Competency in ventilator weaning may thus be linked to personal qualifications, while it is simultaneously dependent on a professional community that both confirms and acknowledges this competency.
A methylation assay for the detection of non‐muscle‐invasive bladder cancer (NMIBC) recurrences in voided urine
Authors: Zuiverloon Tahlita C.M. , Beukers Willemien , van der Keur Kirstin A. , Munoz Jesrael R. , Bangma Chris H. , Lingsma Hester F. , Eijkemans Marinus J.C. , Schouten Jan P. , Zwarthoff Ellen C.
Published: July 2011

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

Multiple studies report on the detection of methylation in voided urine samples as a possible approach for the follow‐up of non‐muscle invasive bladder cancer patients. Previous studies analyze methylation gene panels in a mixture of primary and recurrent tumours. As primary tumours are larger than recurrent tumours and thus easier to detect in urine, validation of methylation markers in urine samples from patients with primary tumours will result in a test sensitivity that does not reflect the true sensitivity of the assay.

This study is the first to select a subset of genes specifically methylated in non‐muscle invasive bladder cancer recurrences and validates the gene panel in two independent sets of urine samples from recurrent patients, thus simulating the disease course according to the clinical presentation.

OBJECTIVE

To develop a methylation‐specific multiplex ligation‐dependent probe amplification (MS‐MLPA) assay for the detection of non‐muscle invasive bladder cancer (NMIBC) recurrences in voided urine.

PATIENTS AND METHODS

Genes frequently methylated in NMIBC tumours (n= 37) were selected to develop a BC‐specific MS‐MLPA assay.

Genes methylated in blood from patientswith BC (n= 29) and genes methylated in urine from patients with no history of BC (n= 46) were excluded.

A four‐gene panel with the highest predictive value was selected from the initial assay. This four‐gene panel was tested and validated on urine from patients with a histologically confirmed recurrence (n= 68 test set; n= 49 validation set) and urine samples from patients without BC (n= 91, test set) and urine from recurrence‐free BC (rec‐free BC) patients (n= 60, validation set).

A model was developed to predict the probability of having a recurrence based on methylation of the four‐gene panel and a threshold probability with the highest sensitivity and specificity was determined.

The outcome of the model was validated on BC urine samples (n= 65) and on urine samples from rec‐free BC patients (n= 29).

RESULTS

The BC MS‐MLPA assay consisted of 23 methylation probes. The selected four‐gene panel included: APC_a, TERT_a, TERT_b, and EDNRB. This panel reached an area under the receiver operating characteristic curve (AUC) of 0.82 (test set) and AUC 0.69 (validation set). Sensitivity and specificity for the detection of a concomitant tumour were 63.3% and 58.3% respectively (test set) and 72.3% and 55.2%, respectively (validation set).

CONCLUSIONS

We have developed a methylation detection assay specifically for the detection of recurrences in patients with NMIBC in voided urine.

The findings are promising and improvement of this test could eventually contribute to a more individualized patient friendly surveillance.
Different levels of psychotherapeutic competence
Authors: Fruggeri Laura
Published: July 2011

In this article, I argue for a both – and position in regard to manuals. I suggest that manuals are appropriate when describing therapeutic strategizing and technical competence. However, I also argue that they are an inappropriate tool for understanding the contribution of the client's family in family therapy. This argument fuels a further view that manuals cannot capture the dance that occurs between therapist and family. For this type of knowledge, a relational type of competence needs to be developed.

We encourage you to listen to the JFT Editor, Mark Rivett, as he interviews the author on Manuals in the Practice and Research of Family Therapy. Available at http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1467-6427/homepage/jft_podcast_series.htm.
Progressive Expectation‐Maximization for Hierarchical Volumetric Photon Mapping
Authors: Jakob Wenzel , Regg Christian , Jarosz Wojciech
Published: July 2011

State‐of‐the‐art density estimation methods for rendering participating media rely on a dense photon representation of the radiance distribution within a scene. A critical bottleneck of such kernel‐based approaches is the excessive number of photons that are required in practice to resolve fine illumination details, while controlling the amount of noise. In this paper, we propose a parametric density estimation technique that represents radiance using a hierarchical Gaussian mixture. We efficiently obtain the coefficients of this mixture using a progressive and accelerated form of the Expectation‐Maximization algorithm. After this step, we are able to create noise‐free renderings of high‐frequency illumination using only a few thousand Gaussian terms, where millions of photons are traditionally required. Temporal coherence is trivially supported within this framework, and the compact footprint is also useful in the context of real‐time visualization. We demonstrate a hierarchical ray tracing‐based implementation, as well as a fast splatting approach that can interactively render animated volume caustics.
Regional cortical thickness and cognitive functions in non‐demented Parkinson’s disease patients: a pilot study
Authors: Pellicano C. , Assogna F. , Piras F. , Caltagirone C. , Pontieri F. E. , Spalletta G.
Published: July 2011

Background and purpose:  The pathology of neuropsychological deficits in Parkinson’s disease (PD) is incompletely defined.

Methods:  We investigated cortical thickness and neuropsychological performances in non‐demented patients with PD and healthy controls.

Results:  Patients showed significant cortical thinning in right middle temporal and left fusiform cortices. Verbal memory performance was related with left fusiform thinning.

Conclusions:  Cognitive and cortical changes in non‐demented patients with PD are detectable and clearly related.
Foreign language production and avoidance in US university Spanish‐language education
Authors: Hubert Michael D.
Published: July 2011

Uno de los componentes principales de la gran mayoría de los cursos de lengua extranjera (LE) ofrecidos en las universidades estadounidenses es un enfoque explícito en la gramática de la lengua, y muchos de estos cursos enseñan un gran número de conceptos gramaticales durante el progreso del semestre universitario. Sin embargo, puede ser que los estudiantes de la LE no estén utilizando toda esta gramática nueva para cumplir con las metas comunicativas centrales de las tareas de sus cursos de español. Para investigar esta cuestión, se recolectaron muestras de habla y de escritura de 32 estudiantes universitarios que estudiaban el español en cada uno de los cuatro niveles de instrucción universitaria. Estas muestras se analizaron en términos de uso de gramática, de exactitud, y de complejidad. Los resultados indicaron que estos estudiantes están utilizando muy pocos de los conceptos gramaticales presentados en sus cursos universitarios de lengua española.

Although the communicative language teaching (CLT) approach continues to enjoy the status of dominant orthodoxy in second language teaching, CLT is not without its drawbacks. As learners are encouraged to communicate in the target language despite a lack of necessary linguistic resources, they engage in a large amount of linguistic avoidance in order to meet their communicative goals. In order to describe how grammar is being employed in US university course assignments, speaking and writing samples were collected from 32 US university students studying Spanish at all four major levels of instruction. Samples were analyzed in terms of grammar usage and accuracy. Results indicate that these learners are using almost none of the more difficult grammatical structures presented to them in their Spanish‐language university courses.
The Relationship between Carbon, Commodity and Financial Markets: A Copula Analysis*
Authors: GRONWALD MARC , KETTERER JANINA , TRÜCK STEFAN
Published: July 2011

This article applies different copulas to investigate the complex dependence structure between EU emission allowance (EUA) futures returns and those of other commodities, equity and energy indices. The analysis yields important insights into the relationship between carbon, commodities and financial markets. Firstly, we find a significant relationship between EUA returns and those of the other considered variables that is most appropriately modelled by a Gaussian and Student‐t copula. These results contradict some earlier studies that report no statistically significant or even negative correlations between returns of emission allowances and other financial variables. Secondly, considering time‐varying copulas shows that the estimated copula parameters are not constant over time. We find in particular that the dependence is stronger during the period of the financial crisis. In a Value‐at‐Risk (VaR) analysis, finally, we further illustrate the advantages of copula methods. In particular, the Student‐t copula provides an appropriate quantification of VaR at different confidence levels while other models fail to specify the risk correctly. This analysis shows that ignoring the actual nature of dependence might lead to an underestimation of the risk for portfolios combining EUAs with commodities or equity investments.
Variation in Hospital Costs, Payments, and Profitabilty for Cardiac Valve Replacement Surgery
Authors: Robinson James C.
Published: July 2011

Objective. Examine the variation for Medicare and privately insured patients in hospital costs, payments, and contribution margins and their association with characteristics of the patients, hospitals, and hospital markets.

Data Sources. Administrative records for 1,858 patients undergoing cardiac valve replacement surgery were obtained from 37 hospitals in 7 states for 2008.

Study Design. Bivariate and multivariate statistical analyses of costs, payments, and profitability (contribution margin) for Medicare and privately insured patients, adjusting for patient, hospital, and market characteristics.

Data Collection. Integrated Health Care Association, Aspen Health Metrics, American Hospital Association Annual Survey of Hospitals.

Principal Findings. Cardiac valve replacement surgery is an expensive but profitable procedure, with average cost and contribution margin per case of U.S.$38,667 and U.S.$21,967, respectively. Average costs per case for Medicare patients are 16.1 percent higher in concentrated than in competitive local markets after adjusting for patient comorbidities, complications, and other relevant factors (p<.01). Payments per case were 33.2 percent (p<.01) lower from Medicare than from private insurers. The average contribution margin earned by hospitals from Medicare was U.S.$30,986 lower than the margin earned from private insurers (p<.01), after adjusting for patient, hospital, and market characteristics.

Conclusions. Hospitals charge significantly higher prices and earn significantly higher contribution margins from private insurers than from Medicare for patients undergoing cardiac valve replacement.
International Comparability of Patient Safety Indicators in 15 OECD Member Countries: A Methodological Approach of Adjustment by Secondary Diagnoses
Authors: Drösler Saskia E. , Romano Patrick S. , Tancredi Daniel J. , Klazinga Niek S.
Published: July 2011

Objective. To improve the international comparability of patient safety indicators based on administrative hospital data, adjustment of country‐specific rates by a proxy measure of diagnostic coding intensity was tested.

Data Sources. Secondary data (numerator and denominator counts of patient safety indicators) based on adults discharged from acute care hospitals between 2006 and 2008 was used.

Study Design. A retrospective cross‐sectional study using hospital administrative data was performed.

Data Collection. Belgium, Canada, Denmark, Germany, Italy, Ireland, New Zealand, Norway, Portugal, Singapore, Spain, Sweden, Switzerland, the United Kingdom, and the United States provided data according to detailed instructions.

Principal Findings. Age‐ and sex‐standardized rates varied across countries. An ordinary least squares regression model was estimated for each Patient Safety Indicator (PSI) using the mean number of secondary diagnoses among denominator cases as the predictor (R2=23 percent to 56 percent). Estimated country‐specific residuals were linearly transformed into adjusted PSI rates. Variation among age–sex standardized PSI rates decreased substantially after this adjustment.

Conclusions. International comparisons of health system performance based on unadjusted patient safety indicators are problematic due to suspected coding or ascertainment bias. The model could be an interim approach to provide comparable information on hospital quality, with a long‐term goal of improving international consistency in diagnostic reporting in administrative data.
Association of Experiences of Medical Home Quality with Health‐Related Quality of Life and School Engagement among Latino Children in Low‐Income Families
Authors: Stevens Gregory D. , Vane Christina , Cousineau Michael R.
Published: July 2011

Objective. This study examines whether patient‐reported indicators of a quality medical home are associated with measures of health among Latino children in low‐income families.

Data Sources. Data on 3,258 children ages 2–18 years are from a cross‐sectional survey of parents of children affiliated with California's Healthy Kids insurance.

Study Design. Medical home quality was assessed using the Parents' Perception of Primary Care and was associated with health‐related quality of life (HRQOL) overall and in four domains (physical, emotional, social, and school/daycare) and four measures of school engagement.

Principal Findings. A higher total medical home score was associated with a higher total Pediatric Quality of Life Inventory score and scores in four subdomains (total beta [B]=1.77, physical B=1.71, social B=1.36, emotional B=2.22, and school/daycare B=1.69, all p<0.001). It was also associated with missing fewer than three school days due to illness (odds ratio [OR]=1.12, 95 percent confidence intervals [CI]: 1.05, 1.19), excellent/above average school performance overall (OR=1.10, 95 percent CI: 1.03, 1.17) and performance in reading (OR=1.13, 95 percent CI: 1.06, 1.20) and math (OR=1.10, 95 percent CI: 1.03, 1.16).

Conclusions. Patient‐reported medical home quality indicators are favorably associated with HRQOL and measures of school engagement among Latino children in low‐income families.
A novel allocation strategy for blood transfusions: investigating the tradeoff between the age and availability of transfused blood
Authors: Atkinson Michael P. , Fontaine Magali J. , Goodnough Lawrence T. , Wein Lawrence M.
Published: July 2011

BACKGROUND: Recent studies show that transfusing older blood may lead to increased mortality. This raises the issue of whether transfusing fresher blood can be achieved without jeopardizing blood availability.

STUDY DESIGN AND METHODS: We propose a simple family of policies that is defined by a single threshold: rather than transfusing the oldest available blood that is younger than 42 days, we transfuse the oldest blood that is younger than the threshold, and if there is no blood younger than the threshold then we transfuse the youngest blood that is older than the threshold. To assess this policy, we build a simulation model using data from Stanford University Medical Center. We focus on the tradeoff between the mean age of transfused blood and the fraction of transfused blood that is imported.

RESULTS: For hospitals in which the local supply is greater than demand, our policy with a threshold of 14 days leads to a decrease of 10 to 20 days in the mean age of transfused blood while increasing the fraction of imported blood to less than 0.005 (i.e., 0.5%). If the health benefits from transfusing fresher blood can be confirmed by randomized clinical trials, then conservative assumptions suggest that this policy could reduce the annual number of transfused patients who die within 1 year by 20,000.

CONCLUSION: The proposed allocation policy with a threshold of 14 days could allow many US hospitals to significantly reduce the age of transfused blood, thereby possibly reducing morbidity and mortality, while having a negligible impact on supply chain operations.
Home therapy with intravenous human C1‐inhibitor in children and adolescents with hereditary angioedema
Authors: Kreuz Wolfhart , Rusicke Eva , Martinez‐Saguer Inmaculada , Aygören‐Pürsün Emel , Heller Christine , Klingebiel Thomas
Published: July 2011

BACKGROUND: C1‐esterase inhibitor (C1‐INH) replacement therapy is the treatment of choice for acute edema attacks in patients with hereditary angioedema (HAE).

STUDY DESIGN AND METHODS: Our retrospective, observational study assessed the efficacy and safety of home therapy with a human plasma‐derived C1‐INH concentrate (pC1‐INH) in 20 pediatric patients with HAE who had previously been treated with physician‐based therapy. While on home therapy, 15 patients received on‐demand treatment and five received individual replacement treatment (IRT).

RESULTS: The switch to home therapy did not involve a significant increase in the dose of pC1‐INH administered, but there was a significant increase in dosing frequency. Although only two patients were affected, the frequency of laryngeal attacks appeared to decrease on home therapy. All attacks, including laryngeal edema, were treated successfully during home therapy with pC1‐INH. The mean annual number of days hospitalized was reduced from 3.8 during physician‐based therapy to 0.11 during home therapy. No side effects or injection site complications were reported. The median time from onset of attack to administration of pC1‐INH was reduced from 67.5 minutes during physician‐based therapy to 15 minutes after switching to home therapy. The corresponding median time to initial symptom relief for all types of attack was reduced from 60 to 40 minutes.

CONCLUSION: As in adults, home therapy with pC1‐INH is effective and safe in the treatment of HAE attacks in pediatric patients; a larger, randomized study should ideally confirm our findings before this approach can be considered the standard of care for pediatric patients.
Coxiella burnetii infection among blood donors during the 2009 Q‐fever outbreak in the Netherlands
Authors: Hogema Boris M. , Slot Ed , Molier Michel , Schneeberger Peter M. , Hermans Mirjam H. , van Hannen Erik J. , van der Hoek Wim , Cuijpers H. Theo , Zaaijer Hans L.
Published: July 2011

BACKGROUND: In 2007, 2008, and 2009 outbreaks of Q‐fever occurred in the Netherlands with increasing magnitude. The 2009 outbreak with 2354 reported cases is the largest human Q‐fever outbreak ever recorded. To assess the extent of infection and the safety of donated blood, we tested local blood donations for presence of Coxiella burnetii antibodies and DNA.

STUDY DESIGN AND METHODS: Starting May 2009, more than 40,000 serum samples were collected from all consenting blood donors in the areas with high Q‐fever incidence. The 1004 samples from the areas with the highest number of reported cases were tested for C. burnetii DNA by polymerase chain reaction; seroprevalence and incidence were determined using enzyme‐linked immunosorbent assay and immunofluorescence assays (IFAs) in the subset of 543 donors of whom a follow‐up sample was available.

RESULTS: A total of 6 of 1004 donor samples tested reactive for C. burnetii DNA. Confirmatory testing (IFA) on the index and follow‐up samples demonstrated seroconversion in two donors, high‐level preexisting antibodies in one donor, and no seroconversion in three donors. Immunoglobulin (Ig)G testing of the 543 serum pairs showed that 66 were reactive in the latest sample, of which 10 represented seroconversions.

CONCLUSION: In the area with highest incidence during a large Q‐fever outbreak, 3 of 1004 blood donations contained C. burnetii DNA (0.3%; 95% confidence interval, 0.1%‐1.0%). A total of 66 of 543 (12.2%) donors tested positive for anti‐Coxiella IgG. Ten seroconversions were detected, resulting in an incidence of 5.7% per year, which is more than 10‐fold higher than the local number of reported clinical cases (0.47% per year).

[Correction added after online publication 14‐Jul‐11: high‐level existing antibodies has been updated to highlevel preexisting antibodies.]
Local Multiplicity Adjustment for the Spatial Scan Statistic Using the Gumbel Distribution
Authors: Gangnon Ronald E.
Published: July 2011

Summary The spatial scan statistic is an important and widely used tool for cluster detection. It is based on the simultaneous evaluation of the statistical significance of the maximum likelihood ratio test statistic over a large collection of potential clusters. In most cluster detection problems, there is variation in the extent of local multiplicity across the study region. For example, using a fixed maximum geographic radius for clusters, urban areas typically have many overlapping potential clusters, whereas rural areas have relatively few. The spatial scan statistic does not account for local multiplicity variation. We describe a previously proposed local multiplicity adjustment based on a nested Bonferroni correction and propose a novel adjustment based on a Gumbel distribution approximation to the distribution of a local scan statistic. We compare the performance of all three statistics in terms of power and a novel unbiased cluster detection criterion. These methods are then applied to the well‐known New York leukemia dataset and a Wisconsin breast cancer incidence dataset.
Enhanced Sensitivity and Reduced Noise Floor in Magnetoelectric Laminate Sensors by an Improved Lamination Process
Authors: Li Menghui , Berry David , Das Jaydip , Gray David , Li Jiefang , Viehland Dwight
Published: July 2011

The effect of lamination process on the performance of Metglas/Pb(Zr,Ti)O3‐based composite magnetoelectric (ME) sensors has been studied. Improved sensor processing can lead to higher coupling between the magnetostrictive and piezoelectric phases. A higher coupling factor results in higher magnetic field sensitivity and lower equivalent magnetic noise floors. Spin‐coat/vacuum‐bag application and cure of interfacial epoxy, in addition to the use of Metglas foils with enhanced magnetostriction (λ = 42 ppm), has led to an increase in the ME coefficient from 6 to 21.6 V/cm·Oe, and a decrease in the 1 Hz equivalent magnetic noise from 2 × 10−10 to 4 × 10−11 T/√Hz.
Fast Sol–Gel Preparation of Silicon Carbide–Silicon Oxycarbide Nanocomposites
Authors: Clark Michael D. , Walker Luke S. , Hadjiev Viktor G. , Khabashesku Valery , Corral Erica L. , Krishnamoorti Ramanan
Published: July 2011

Silicon carbide nanofiber dispersion within a silicon oxycarbide glassy ceramic was achieved through a combination of a fast sol–gel procedure for in situ ceramic matrix synthesis and nanofiber conversion from sacrificial multiwalled carbon nanotube templates. Nanotubes were dispersed using both surfactant adsorption and a covalent sidewall modification scheme with gel‐grafting capabilities. The combination of high temperature processing and silicon monoxide precursor concentrations allowed substantial carbothermal reduction of the nanotube templates, yielding silicon carbide nanofibers. The resulting nanocomposites were examined for density, Vickers microhardness, Young's modulus, and fracture toughness. The surfactant‐assisted route inhibited ceramic densification, offering virtually no mechanical property enhancement. In contrast, the covalently functionalized nanotube templates at 0.8 wt% loading enhanced tensile modulus of 77% while simultaneously maintaining both Vickers microhardness and fracture toughness. These results indicate strong interfacial adhesion between the nanofiber surface and host matrix despite the abrupt chemical changes experienced during the high temperature processing.
Normal to Relaxor Ferroelectric Transition and Domain Morphology Evolution in (K,Na)(Nb,Sb)O3–LiTaO3–BaZrO3 Lead‐Free Ceramics
Authors: Zuo Ruzhong , Fu Jian , Lu Shengbo , Xu Zhengkui
Published: July 2011

A normal to relaxor ferroelectric transition was induced by the substitution of BaZrO3 for LiTaO3 in a typical lead‐free (K,Na)(Nb,Sb)O3–LiTaO3–BaZrO3 system and this was found to accompany a tetragonal to rhombohedral phase structural transformation. The typical relaxor behavior characterized by diffuse phase transition and frequency dispersion was identified by the measurement of frequency‐dependent dielectric permittivity. The transmission electron microscopy studies demonstrated that the above phenomenon would be closely related to the domain morphology evolution from normal micron‐sized lamellar domains, to tweed‐like domains and finally to polar nanodomains. Selected area and convergent beam electron diffraction patterns further confirmed that the composition (2.5 mol% BaZrO3) exhibited rhombohedral and tetragonal phase coexistence. The evolution of domain morphology with temperature also disclosed the diffuseness of ferroelectric phase transition.