bluuebunny/crossref_metadata_2025 huggingface dataset:
p-ZnTe for Back Contacts to CdTe Thin Film Solar Cells
Authors: Späth Bettina , Fritsche Jochen , Klein Andreas , Jaegermann Wolfram
Published: November 2011

CdTe thin film solar cells still suffer from problems related to back contacts which provide stable ohmic contacts without electrical losses. In previous studies metal/CdTe contacts have shown significant limitations. A promising option for the realization of ohmic back contacts is the use of a highly p-doped ZnTe interlayer on top of the CdTe absorber, in particular since metal/ZnTe contacts have shown very good electrical properties. In this work we studied the electronic und chemical properties of nitrogen doped p-ZnTe films. p-ZnTe:N films were prepared by using reactive RF magnetron sputtering with N2/Ar gas mixtures or by thermal evaporation with an additional nitrogen plasma source. Samples and their contacts have been prepared in DAISY-SOL (DArmstadt Integrated SYstem for SOLar energy research) which combines a full vacuum production with an in-situ photoelectron spectroscopy (XPS/UPS) analysis. The results of XPS/UPS investigations and electrical measurements will be discussed in comparison to previous results on metal/CdTe contacts. As ZnTe forms an interlayer in the CdTe thin film solar cell, the ZnTe/CdTe interface properties must be also taken into consideration. Our experiments have shown in agreement to previous studies that the valence band offset is nearly ideal for hole transport across the interface. Also electrical measurements have been carried out to investigate the metal/ZnTe/CdTe layer sequences in their contact properties.
Transgenic Control of Vectors: The Effects of Interspecific Interactions
Authors: Bonsall Michael B. , Yakob Laith , Alphey Nina , Alphey Luke
Published: November 2011

The control of insect vectors through conventional sterile insect or transgenic technologies (e.g., RIDL®) is an intense focus of research in the combat against vector-borne disease. While the population dynamic implications of these control strategies are reasonably well-established, the effects of interspecific competition between different vectors and control strategies have not previously been explored. Different control intervention methods can affect the interaction and potential coexistence of vector species. By altering the shape of the zero net growth isoclines, conventional and transgenic control can affect patterns of vector coexistence and/or exclusion through Allee effects and transient dynamics. Further, transgenic control methods can mediate coexistence between target and non-target species and this can have important consequences for the persistence of disease and community ecological interactions.
Resonance Frequency Analysis of 208 Straumann Dental Implants During the Healing Period
Authors: Guler Ahmet Umut , Sumer Mahmut , Duran Ibrahim , Sandikci Elif Ozen , Telcioglu Nazife Tuba
Published: November 2011

The most important prerequisite for the success of an osseointegrated dental implant is achievement and maintenance of implant stability. The aim of the study was to measure the 208 Straumann dental implant stability quotient (ISQ) values during the osseointegration period and determine the factors that affect implant stability. A total of 164 of the implants inserted were standard surface, and 44 of them were SLActive surface. To determine implant stability as ISQ values, measurements were performed at the stage of implant placement and healing periods by the Osstell mentor. The ISQ value ranges showed a significant increase during the healing period. Except for the initial measurement, the posterior maxilla had the lowest ISQ values, and there was no significant difference among anterior mandible, posterior mandible, and anterior maxilla (P < .05). Implant length did not have a significant influence on ISQ value (P > .05). The second measurement was significantly higher in men compared with women (P < .05). The second measurement was significantly higher than the others at 4.8 mm, and for the final measurement, there were no significant differences between 4.8 and 4.1 mm, which were higher than 3.3 mm (P < .05). When comparing sandblasted, large-grit, acid-etched (SLA) and SLActive surface implants, there were no significant differences for insertion measurements, but for second measurements, SLActive was significantly higher (P = 0), and for the final measurement, there was no significant difference. It appears that repeated ISQ measurements of a specific implant have some diagnostic benefit, and the factors that affect implant stability during the healing period are presented.
Estado nutricional de população adulta beneficiária do Programa Bolsa Família no município de Curitiba, PR
Authors: Lima Flávia Emília Leite de , Rabito Estela Iraci , Dias Márcia Regina Messaggi Gomes
Published: November 2011

INTRODUÇÃO: O Programa Bolsa Família é o maior programa de transferência condicionada de renda do Brasil, e tem como um dos principais objetivos reverter o quadro atual de insegurança alimentar, porém ainda são escassos os estudos que mostram o estado nutricional de população dessa população. OBJETIVO: O presente trabalho teve como objetivo descrever o estado nutricional da população adulta inscrita no Programa Bolsa Família, no Município de Curitiba, PR. MÉTODOS: Trata-se de um estudo transversal, de base populacional, aplicado nos distritos sanitários do município de Curitiba, Paraná, no período de julho de 2006 a julho de 2007. Foram entrevistados 747 adultos a partir dos 18 anos de idade, de ambos os sexos, residentes nas áreas de abrangência das unidades básicas de saúde do município. Para avaliação do estado nutricional dessa população foram aferidos peso (kg), altura (cm) e circunferência da cintura (cc), e calculado o índice de massa corpórea; foram questionados ainda quanto à idade, estado civil, ocupação, número de moradores no domicílio, procedência, escolaridade do entrevistado e do chefe da família. A associação entre excesso de peso, circunferência da cintura e as co-variáveis sociodemográficas foi avaliada por meio da técnica de regressão logística. RESULTADOS: Cerca de 40% da população foi considerada eutrófica e 27,1% obesa, segundo padrões de IMC. Avaliando-se os dados de circunferência da cintura, 48,2% da população possuem medidas que denotam risco muito aumentado para o desenvolvimento de doenças cardiovasculares. Houve uma associação estatisticamente significativa entre o aumento do IMC e a idade (OR = 2,16; IC 95%: 1,57-2,96), sexo (OR = 0,57; IC 95%: 0,33-0,97) e estado marital(OR = 1,40; IC 95% : 1,03-1,88). Para a circunferência da cintura observou-se uma associação significativa apenas com a idade (OR = 2,93; IC 95%: 2,13-4,02) e o sexo. CONCLUSÃO: Grande parte dos beneficiários apresentou excesso de peso e gordura abdominal que denota risco. Os resultados ora apresentados mostram-se como subsídio para construção e implantação de políticas públicas regionais ligadas à alimentação.
Fatores de risco e proteção para doenças crônicas não transmissíveis obtidos por inquérito telefônico - VIGITEL Brasil - 2009
Authors: Iser Betine Pinto Moehlecke , Claro Rafael Moreira , Moura Erly Catarina de , Malta Deborah Carvalho , Morais Neto Otaliba Libânio
Published: November 2011

OBJETIVO: Descrever os fatores de risco e proteção para doenças crônicas não transmissíveis resultantes do Sistema de Vigilância por Inquérito Telefônico (VIGITEL) em 2009. METODOLOGIA: Prevalências dos principais fatores de risco e proteção foram estimadas na população >18 anos a partir de entrevistas telefônicas em amostras probabilísticas da população coberta por telefonia fixa nas capitais de estados do Brasil e no Distrito Federal, segundo sexo, faixa etária e escolaridade. RESULTADOS: Foram realizadas 54.367 entrevistas. Fumantes e ex-fumantes corresponderam a 15,5e 22% da população adulta brasileira, respectivamente. O excesso de peso atinge 46,6% dos adultos; 33% relataram consumo de carne com gordura e 18,9% afirmaram consumir bebida alcoólica de forma abusiva. Tais fatores de risco são mais prevalentes em homens e em geral nos indivíduos jovens e de menor escolaridade. A prevalência de atividade física no lazer é de 18,8% (IC95% 17,4-20,1) em homens e de 11,3% (IC95% 10,6-12,0) nas mulheres. A inatividade física atinge 15,6% da população e aumenta com a idade. O consumo de frutas, legumes e verduras e a atividade física no lazer são mais frequentes em homens e mulheres com mais anos de estudo. Diagnóstico de hipertensão arterial foi referido por 21,1% (IC95% 19,6-22,5) dos homens e 27,2% (IC95% 25,8-28,5) das mulheres. A prevalência de diabetes foi de 5,8%. CONCLUSÃO: Os resultados apontaram comportamentos em saúde distintos de acordo com o sexo, idade e escolaridade da população e reforçam a tendência de queda do tabagismo e aumento no excesso de peso no Brasil.
Tendências do tabagismo na população adulta das capitais Brasileiras: uma análise dos dados de inquéritos telefônicos de 2006 a 2009
Authors: Silva Gulnar Azevedo e , Valente Joaquim Gonçalves , Malta Deborah Carvalho
Published: November 2011

O objetivo deste estudo foi analisar a tendência do tabagismo, da cessação e da intensidade de cigarros diários, entre 2006 a 2009, nas capitais brasileiras. Foram analisados os dados de indivíduos com 18 anos e mais, entrevistados pelo Sistema de Vigilância e Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico (VIGITEL), realizado nas capitais brasileiras e Distrito Federal em 2006, 2007, 2008 e 2009. Para cada ano e grandes regiões, foram calculadas as prevalências de tabagismo ajustadas por idade e por grupos etários (18 a 29, 30 a 59 e 60 ou mais anos) estratificados por sexo. Foi calculado ainda o índice de cessação do tabagismo e, para os fumantes atuais, estimou-se a proporção dos que referem fumar 20 ou mais cigarros segundo sexo e grupo etário (18 a 39 e 40 anos e mais). Os resultados mostram leve tendência à queda do tabagismo entre homens e estabilidade para mulheres, com exceção daquelas residentes nas regiões Norte e Nordeste. Em geral, as maiores prevalências entre homens aparecem nos grupos mais jovens; enquanto que, entre as mulheres, são entre as de idade intermediária (30 a 59 anos). A cessação sugere estar ligeiramente aumentando entre os homens; há forte relação inversa entre a prevalência de tabagismo e anos de escolaridade, e a proporção de fumantes de 20 ou mais cigarros diários é maior entre os mais idosos e apresenta padrão diferenciado entre as regiões brasileiras. Os resultados indicam a necessidade da priorização de estratégias de controle do tabagismo que alcancem jovens e mulheres de baixa escolaridade.
Saúde sexual dos adolescentes segundo a Pesquisa Nacional de Saúde dos Escolares
Authors: Malta Deborah Carvalho , Silva Marta Angélica Iossi , Mello Flávia Carvalho Malta de , Monteiro Rosane Aparecida , Porto Denise Lopes , Sardinha Luciana Monteiro Vasconcelos , Freitas Paula Carvalho de
Published: November 2011

O objetivo deste estudo foi descrever as situações relacionadas à saúde sexual dos adolescentes, segundo a Pesquisa Nacional de Saúde do Escolar (PeNSE). Trata-se de um estudo transversal, realizado pelo Instituto Brasileiro de Geografia e Estatística (IBGE) em parceria com o Ministério da Saúde, que envolveu 60.973 escolares e 1.453 escolas públicas e privadas. A análise dos dados aponta que 30,5% (IC95% 29,9-31,2) dos adolescentes já tiveram relação sexual alguma vez na vida, sendo mais frequente em meninos (43,7%; IC95% 42,7-44,7) do que em meninas (18,7%; IC95% 18,0-19,4), naqueles que estudam em escola pública (33,1%; IC95% 32,4-33,9), com idade acima de 15 anos (47,3%; IC95% 45,7-48,9) e aos 16 anos (63,5%; IC95% 61,5-65,4). A idade de iniciação sexual foi precoce e 40,1% dos adolescentes (IC95% 38,8-41,4) relataram ter tido um único parceiro na vida. O uso do preservativo na ultima relação sexual foi elevado tanto para proteção (75,9%; IC95% 74,8-76,9), como também para método contraceptivo na última relação sexual (74,7%; IC95% 73,6-75,7). Torna-se necessário enfatizar ações de promoção à saúde sexual voltadas aos adolescentes, visando minimizar vulnerabilidades.
Notas taxonômicas sobre Exaerete (Hymenoptera: Apidae: Euglossina), com a descrição de uma nova espécie
Authors: Oliveira Marcio Luiz de
Published: November 2011

Exaerete kimseyae sp. n., abelha de hábito cleptoparasítico e provavelmente endêmica do Panam , é aqui descrita. Esta nova espécie foi erroneamente identificada como E. trochanterica (Friese, 1910) por Kimsey (1979). Por esse motivo, Anjos-Silva & Rebêlo (2006), desconhecendo a correta identidade de Exaerete trochanterica, descreveram um exemplar desta espécie coletado em Mato Grosso, Brasil como Exaerete guaycuru. Aqui E. guaycuru é colocada como sinônimo júnior de Exaerete trochanterica.
A SYSTEMATIC EXAMINATION OF DIFFERENT PARAMETERS OF PRESESSION EXPOSURE TO TANGIBLE STIMULI THAT MAINTAIN PROBLEM BEHAVIOR
Authors: O'Reilly Mark , Lang Russell , Davis Tonya , Rispoli Mandy , Machalicek Wendy , Sigafoos Jeff , Lancioni Giulio , Didden Robert , Carr James
Published: November 2011

We examined the effects of three different presession conditions on tangibly maintained problem behavior for 2 students with autism, using individual‐participant multielement designs. First, an analogue functional analysis demonstrated that problem behavior was maintained by access to tangible items. Next, topographies of item rejection were identified. Finally, students were exposed to (a) brief access, (b) no access, and (c) satiation to the tangible items prior to tangible sessions. The results demonstrated high levels of problem behavior following the brief‐access and no‐access presession conditions and low levels of problem behavior following the satiation condition. The findings are discussed in the context of how satiation might best be defined for these sorts of evaluations.
Multiscale Characterization of Signaling Network Dynamics through Features
Authors: Capobianco Enrico , Marras Elisabetta , Travaglione Antonella
Published: November 2011

Inference methods applied to biological networks suffer from a main criticism: as the latter reflect associations measured under static conditions, an evaluation of the underlying modular organization can be biologically meaningful only if the dynamics can also be taken into consideration. The same limitation is present in protein interactome networks. Given the substantial uncertainty characterizing protein interactions, we identify at least three aspects that must be considered for inference purposes: 1. Coverage, which for most organisms is only partial; 2. Stochasticity, affecting both the high-throughput experimental and the computational settings from which the interactions are determined, and leading to suboptimal measurement accuracy; 3. Information variety, due to the heterogeneity of technological and biological sources generating the data. Consequently, advances in inference methods require adequate treatment of both system uncertainty and dynamical aspects. Feasible solutions are often made possible by data (omic) integration procedures that complement the experimental design and the computational approaches for network modeling. We present a multiscale stochastic approach to deal with protein interactions involved in a well-known signaling network, and show that based on some topological network features, it is possible to identify timescales (or resolutions) that characterize complex pathways.
A Calibrated Multiclass Extension of AdaBoost
Authors: Rubin Daniel B.
Published: November 2011

AdaBoost is a popular and successful data mining technique for binary classification. However, there is no universally agreed upon extension of the method for problems with more than two classes. Most multiclass generalizations simply reduce the problem to a series of binary classification problems. The statistical interpretation of AdaBoost is that it operates through loss-based estimation: by using an exponential loss function as a surrogate for misclassification loss, it sequentially minimizes empirical risk through fitting a base classifier to iteratively reweighted training data. While there are several extensions using loss-based estimation with multiclass base classifiers, these use multiclass versions of the exponential loss that are not classification calibrated: unless restrictions are placed on conditional class probabilities, it becomes possible to have optimal surrogate risk but poor misclassification risk. In this work, we introduce a new AdaBoost extension called AdaBoost.

SL that does not reduce the problem into binary subproblems and that uses a classification-calibrated multiclass exponential loss function. Numerical experiments show the algorithm performs well on benchmark datasets.
The Influence of Service Quality on Gamer Loyalty in Massively Multiplayer Online Role-Playing Games
Authors: Chang Ya-Ping , Zhu Dong-Hong , Wang Ho Simon
Published: November 2011

In this study we investigated how different dimensions of service quality might influence the loyalty of customers in the context of online games. By studying the gamers of massively multiplayer online role-playing games (MMORPGs), we tested our hypotheses using structural equation
modeling techniques. We found that the service quality dimensions of privacy, effectiveness, and entertainment indirectly influence the loyalty of gamers through satisfaction, whereas interaction has a direct effect on their loyalty. These findings have implications for online game companies
to improve customers' loyalty.
The Influence of Parental Marital Commitment on the Identity Formation of Japanese University Students
Authors: Utsunomiya Hiroshi
Published: November 2011

The objective in the present study was to investigate how parental commitment to marital life affects identity formation of university students. Tolerance for family differentiation was set as a mediating variable. Participants were 271 Japanese university students (mean age = 20.0)
who completed a survey. The results of analyses indicated that parental marital commitment influenced identity formation both directly and indirectly through tolerance for family differentiation. In addition, the influence process differed to some degree depending on the gender of the student.
The results suggest that it is necessary to consider identity development in adolescence in the context of quality of parental marital commitment.
Prosocial Personality Traits and Adaptation to Stress
Authors: Garcia-Banda Gloria , Servera Mateu , Chellew Karin , Meisel Victoria , Fornes Joana , Cardo Esther , Perez Gerardo , Riesco Maria , Doctor Ronald M.
Published: November 2011

Evidence suggests that personality traits may play a significant role in individual differences in cortisol reactivity in stressful situations. In this study, cortisol responses to public speaking were examined to test hypotheses that reactivity would be positively related to openness,
agreeableness, and conscientiousness, and negatively to extraversion, neuroticism, and psychoticism, respectively. A sample of 75 students (56 women and 19 men) completed the NEO Five-Factor Inventory (Costa & McCrae, 1992) and the Eysenck Personality Questionnaire-Revised (Eysenck &
Eysenck, 1985), and 2 saliva samples were taken before and after the stressor, and another 2 samples at similar times on a control day. Results revealed that conscientiousness was associated with an enhanced cortisol response to stress, while psychoticism was correlated with a blunted response.
Effects of Stress Caused by the Public Personnel Selection Examination on the Performance of Physical Education and Other Teacher Trainees in Turkey
Authors: Can Süleyman
Published: November 2011

In this study I used the scanning method to detect the effects of stress resulting from the Public Personnel Selection Examination on teacher trainees studying at state universities in Turkey. Data were gathered using the Scale of Effect of Stress on Performance (Pehlivan, 1993) and
it was found that the examination had negative impacts on students' performance and that their stress levels were high. No significant relationship was found between the effect of stress on performance and gender, but there was a significant relationship between the impact of stress on performance
and age, educational institution, and participants' self-confidence in their ability to obtain a teaching position in state schools.
The Relationship Between Virtues and Personality Traits of Chinese College Students
Authors: Mu Shou-Kuan
Published: November 2011

Many researchers agree that virtue is an important psychological concept in contemporary psychology. The main purpose in this study was to investigate the relationship between virtues and the personality traits of college students in mainland China. Participants (N = 426) completed
the Chinese Virtue Adjectives Rating Scale (CVARS; Mu, 2007) and the Chinese 16PF (Zhu & Dai, 1988). The results indicated that the 16 personality factors most closely related to the virtue factors were emotional stability, dominance, liveliness, rule-consciousness, social boldness, sensitivity,
vigilance, abstractedness, apprehension, self-reliance, perfectionism, and tension. Second-order factors of the 16PF most strongly related to the virtue factors were anxiety, extraversion, tough-mindedness, and independence.
Regional Differences in Customer Satisfaction in China
Authors: Huang Jinsong , Wang Xia , Chen Rong
Published: November 2011

Regional differences in customer satisfaction were examined, with a focus on the relationship between economic development and customer satisfaction. The moderating roles of regional economic development on the associations between customer satisfaction and its antecedents were also
examined. Participants were 11,042 consumers in 8 durable goods categories across 21 cities in China. Results based on hierarchical linear models suggest that customer satisfaction with products is negatively related to regional economic development. In addition, it was found that the impacts
of expectation and perceived value on customer satisfaction varied across regions depending on level of economic development.
Mixed ligand complexes of essential metal ions with L-glutamine and succinic acid in SLS-water mixtures
Authors: Bindu Hima , Rao Nageswara
Published: November 2011

Speciation of mixed ligand complexes of Co(II), Ni(II) and Cu(II) with
L-glutamine and succinic acid was studied in varying amounts (0.0-2.5% w/v)
of sodium lauryl sulphate in aqueous solutions maintaining an ionic strength
of 0.16 mol L-1 (NaCl) at 303.0 K. Titrations were carried out in the
presence of different relative concentrations (M : L : X = 1 : 2 : 2, 1 : 4 :
2, 1 : 2 : 4) of metal (M) to L-glutamine (L) to succinic acid (X) with
sodium hydroxide. Stability constants of ternary complexes were refined with
MINIQUAD75. The best-fit chemical models were selected based on statistical
parameters and residual analysis. The species detected were ML2X, MLX, MLXH
and MLXH2 for Co(II), Ni(II) and Cu(II). Extra stability of ternary complexes
compared to their binary complexes was believed to be due to electrostatic
interactions of the side chains of ligands, charge neutralization, chelate
effect, stacking interactions and hydrogen bonding. The species distribution
with pH at different compositions of SLS and plausible equilibria for the
formation of species were also presented.
Synthesis of biscoumarin derivatives by the reaction of aldehydes and 4-hydroxycoumarin using ruthenium (III) chloride hydrate as a versatile homogeneous catalyst
Authors: Tabatabaeian Khalil , Heidari Hannaneh , Khorshidi Alireza , Mamaghani Manouchehr , Mahmoodi Nosrat
Published: November 2011

The one-pot domino Knoevenagel-type condensation/Michael reaction of
aromatic, heteroaromatic and aliphatic aldehydes with 4-hydroxycoumarin in
aqueous media in the presence of ruthenium salt as homogeneous catalyst was
investigated. It was found that 5 mol% of RuCl3.nH2O catalyzes biscoumarin
synthesis in high yields (70-95%) under optimised, mild, green and
environmentally benign reaction conditions in short times (25-35min).
Cadmium biosorption by baker’s yeast in aqueous suspension
Authors: Tálos Katalin , Pernyeszi Tímea , Majdik Cornelia , Hegedűsova Alzbeta , Páger Csilla
Published: November 2011

The biosorption of cadmium from artificial aqueous solutions using native
baker?s yeast was investigated. The highest metal uptake value was 110 mg g-1
in a suspension of 0.3 g L-1. The effect of pH, initial cadmium
concentration, adsorption time and biosorbent dosage on biosorption by
baker?s yeast was studied. The maximum biosorption capacity of cadmium by
yeast was observed at pH 6.0. The adsorption equilibrium was reached within
sixty minutes and the sorption process followed pseudo second-order kinetics.
Cadmium biosorption isotherms were determined in the cadmium concentration
range of 10-500 mg L-1 at pH 6 in a suspension of 0.3 g L-1. For evaluation
of biosorption equilibrium Langmuir and Freundlich equations were applied to
the experimental data.
Sex differences in anatomical parameters of acetabulum among asymptomatic Serbian population
Authors: Jeremic Dejan , Zivanovic-Macuzic Ivana , Vulovic Maja
Published: November 2011

Background/Aim. Anatomical parameters of the bony components of the hip joint
are essential for better understanding of etiopathogenesis of diseases like
primary osteoarthrosis of the hip joint. The aim of this reserch was to
examine the normal acetabular morphometry in Serbian population and to
determine whether there are sex differences in anatomical parameters of the
acetabulum among asymptomatic subjects. Methods. Pelvic radiographics of 320
adult asymptomatic patients (640 hips) were analyzed in 170 men and 150 women
to determine the morphology of the acetabulum in Serbian population. For each
hip the center edge angle of Wiberg (CEA), the acetabular angle of Sharp
(AA), acetabular depth (AD), acetabular roof obliquity (ARO) and roof angle
(RA) were measured. Results. The following average measurements for
acetabulum geometry were obtained (X ? SD): CEA - 33.5 ? 6.5? (33.6 ? 5.8? in
male, 33.3 ? 6.9? in female), AA - 38.0 ? 3.8? (37.5 ? 3.6? in male, 38.5 ?
3.9? in female), AD - 11.9 ? 2.8 mm (12.5 ? 2.7 mm in male, 11.2 ? 2.7 mm in
female), ARO - 7.6 ? 5.7? (6.2 ? 4.9? in male, 9.0 ? 6.0? in female) and RA -
18.4 ? 10.0? (19.6 ? 8.5? in male, 17.1 ? 9.5? in female). There were
significant differences in the CEA, AA, AD, ARO and RA related to gender (p <
0.01, t-test). Conclusion. There are significant gender differences in
Serbian population for all the examined anatomical parameters of acetabulum.
We found sex-related differences in acetabular morphology, female acetabulum
being marginally more dysplastic than male acetabulum. There is also a clear
tendency of female hips to be more dysplastic than male ones.
Linear accelerator-based stereotactic radiosurgery in recurrent glioblastoma: A single center experience
Authors: Sirin Sait , Oysul Kaan , Surenkok Serdar , Sager Omer , Dincoglan Ferrat , Dirican Bahar , Beyzadeoglu Murat
Published: November 2011

Background/Aim. Management of patients with recurrent glioblastoma (GB)
comprises a therapeutic challenge in neurooncology owing to the aggressive
nature of the disease with poor local control despite a combined modality
treatment. The majority of cases recur within the highdose radiotherapy field
limiting the use of conventional techniques for re-irradiation due to
potential toxicity. Stereotactic radiosurgery (SRS) offers a viable
noninvasive therapeutic option in palliative treatment of recurrent GB as a
sophisticated modality with improved setup accuracy allowing the
administration of high-dose, precise radiotherapy. The aim of the study was
to, we report our experience with single-dose linear accelerator (LINAC)
based SRS in the management of patients with recurrent GB. Methods. Between
1998 and 2010 a total of 19 patients with recurrent GB were treated using
single-dose LINAC-based SRS. The median age was 47 (23-65) years at primary
diagnosis. Karnofsky Performance Score was ? 70 for all the patients. The
median planning target volume (PTV) was 13 (7-19) cc. The median marginal
dose was 16 (10-19) Gy prescribed to the 80%-95% isodose line encompassing
the planning target volume. The median follow-up time was 13 (2-59) months.
Results. The median survival was 21 months and 9.3 months from the initial GB
diagnosis and from SRS, respectively. The median progression-free survival
from SRS was 5.7 months. All the patients tolerated radiosurgical treatment
well without any Common Toxicity Criteria (CTC) grade > 2 acute side effects.
Conclusion. Single-dose LINAC-based SRS is a safe and well- tolerated
palliative therapeutic option in the management of patients with recurrent
GB.
Postexposure prophylaxis against hepatitis B, hepatitis C and human immunodeficiency virus infection in healthcare workers
Authors: Vasic Bojan , Andjelic Spaso , Lukic Relja , Jevtovic Djordje , Grbovic Leposava , Vasiljevic Tatjana , Dragovic Gordana
Published: November 2011

nema
The Use of the Lapidus Procedure for Recurrent Hallux Valgus
Authors: Ellington J. Kent , Myerson Mark S. , Coetzee J. Chris , Stone Rebecca M.
Published: November 2011

Background:

The objective of this study was to evaluate the Lapidus procedure or it's modifications for treatment of recurrent hallux valgus (HV). Our hypothesis was that the Lapidus procedure would achieve good correction of recurrent HV and patients would be satisfied.

Materials and Methods:

A retrospective review of 32 feet (30 patients) treated with the Lapidus procedure for recurrent HV with at least 1-year followup was performed. Evaluation included radiographs, examination, and chart review. Outcomes were assessed with a pain visual analog scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) hallux score, SF-12, Revised Foot Function Index (RFFI), and a survey. Twenty-three of 30 patients (25 feet) met the criteria for inclusion in the study and were available for followup evaluation. The average followup was 31.6 months.

Results:

Arthrodesis was present in 24 out of 25 feet (96%). The time from initial HV correction to revision surgery was 91 months. The initial surgery performed was a distal osteotomy (15), proximal osteotomy (five), exostectomy (two), diaphyseal osteotomy (two), and proximal/distal osteotomy (one). Preoperative evaluation revealed 96% of patients had clinical hypermobility of the first TMT joint and 52% had radiographic findings of instability. The average postoperative AOFAS hallux score was 82.8, SF-12 score was 94.5, and RFFI was 101. The average preoperative hallux valgus angle (HVA), intermetatarsal angle (IMA), and distal metatarsal articular angle (DMAA) were 36.2, 13.6,18.6 degrees, respectively, which corrected to an average of 15.2, 7.5, 11.7 degrees postoperatively (p < 0.001). The average shortening of the first ray was 2.9 mm. Average pain VAS was 2.4. Eighty-seven percent reported good to excellent results. Using a multivariable linear regression analysis, postoperative HVA along with change in length of the first ray were significant predictors of quality of life based on SF-12 ( p < 0.05).

Conclusion:

The Lapidus procedure corrected recurrent HV with a low nonunion rate and excellent radiographic correction and patients were satisfied with their outcome. Level of Evidence: IV, Retrospective Case Series
Outcomes following Pantalar Arthrodesis in Rheumatoid Arthritis
Authors: McKinley John C. , Shortt Nicholas , Arthur Calum , Gunner Charlotte , MacDonald Deborah , Breusch Steffen J.
Published: November 2011

Background:

We report a consecutive series of pantalar arthrodeses in patients with rheumatoid arthritis, using a single laterally based incision and autologous bone graft.

Materials and Methods:

All operations were performed by a single surgeon and were assessed preoperatively and at 6 and 12 months postoperatively. The levels of patient satisfaction, functional improvement, and pain scores of the foot following surgery were recorded along with radiological parameters. Seventeen patients (two male and 15 female) underwent 18 hindfoot surgeries and were assessed preoperatively using the SF-12 General Health survey questionnaire, Manchester-Oxford Foot Survey, and pain scores.

Results:

We found a significant improvement in pain levels and SF-12 scores. In addition, the patients reported a high level of satisfaction with the outcome of surgery and improvement in function.

Conclusion:

The results show that pantalar arthrodesis is a very effective operative treatment for severe ankle and concomitant hindfoot disease. The treatment period is prolonged and patients should be counseled appropriately. Level of Evidence: IV, Retrospective Case Series
The Slot Graft Technique for Foot and Ankle Arthrodesis in a High-Risk Patient Group
Authors: Klein Sandra E. , Putnam Ryan M. , McCormick Jeremy J. , Johnson Jeffrey E.
Published: November 2011

Background:

High rates of arthrodesis nonunion have been described in the ankle, hindfoot and midfoot in patients with significant risk factors. The purpose of this study was to evaluate fusion rates, risk of reoperation, postoperative pain scores and patient satisfaction for a slot graft inlay arthrodesis technique used in a high-risk group of foot and ankle patients.

Materials and Methods:

We retrospectively reviewed all ankle, hindfoot and midfoot arthrodeses by two foot and ankle surgeons in our institution between January 2000 and January 2009. Seventeen arthrodesis procedures in 16 patients using the slot graft technique were identified. Patient charts were reviewed for medical history, risk factors, previous surgery and postoperative complications. Time to union was evaluated on radiographs. Patients provided final followup by phone with an assessment of pain, overall satisfaction and use of orthotic or assistive devices.

Results:

Union occurred in 13 arthrodesis procedures (77%) with an average time to union of 5 months. Postoperative infection occurred in one patient. Additional surgery was performed in nine patients. At final followup patients reported low pain scores (3 of 10) and high satisfaction (8 of 10). Fourteen of 15 patients contacted indicated that they would choose to undergo the procedure again.

Conclusion:

The slot graft arthrodesis technique provided satisfactory results in this small group of patients with a low complication rate. Patient satisfaction rates were high with low pain scores at an average of 62 months postoperatively. Level of Evidence: IV, Retrospective Case Series
Alignment of Ankle and Hindfoot in Early Stage Ankle Osteoarthritis
Authors: Lee Woo-Chun , Moon Jeong-Seok , Lee Ho Seong , Lee Kang
Published: November 2011

Background:

Supramalleolar osteotomy has been recommended to correct varus deformity of the tibial plafond; however, we have seen only a few ankles with significant deviation of alignment in early stage osteoarthritis, in which realignment treatments might be necessary to modify the course of the disease. Our hypothesis was that there are diverse radiographic features of the tibial plafond and hindfoot in varus ankle osteoarthritis.

Materials and Methods:

The study included 154 ankles of 98 patients with medial osteoarthritis, and 80 ankles of 80 normal subjects. On weightbearing AP radiographs, the tibial anterior surface angle (TAS), tibial axis-medial malleolus angle (TMM) and talar tilt angle was measured. On weightbearing lateral radiographs, tibial lateral surface angle (TLS) was measured. On the hindfoot alignment view, the heel alignment angle and heel alignment ratio were obtained. Inter- and intraobserver reliabilities were obtained for all radiographic parameters. The radiographic parameters were compared among the normal ankles and the ankles in different stages of ankle arthritis by the Takakura classification.

Results:

Inter- and intraobserver reliability were very high for all radiographic parameters except TLS. There was no statistically significant difference in TAS among Stages 2, 3a, and 3b. TAS was 86.9 ± 2.4 degrees, 86.2 ± 3.3 degrees, and 85.4 ± 3.1 degrees in Stages 2, 3a, and 3b, respectively. There was no significant difference in hindfoot alignment among normal, Stage 2, Stage 3a. The hindfoot alignment angle was 0.5 ± 8.1 degrees, 0.5 ± 6.8 degrees, and 9.6 ± 9.1 degrees in Stages 2, 3a, and 3b, respectively.

Conclusion:

Alignment of the tibial plafond and hindfoot was variable in early stage ankle osteoarthritis. Level of Evidence: III, Retrospective Case Control Study
Perfusion Pressures and Distal Oxygenation in Individuals with Diabetes Undergoing Chronic Hemodialysis
Authors: Kay David B. , Ray Susan , Haller Nairmeen Awad , Hewit Michael
Published: November 2011

Background:

The number of diabetic patients worldwide was estimated to be approximately 285 million in 2010. Approximately 5% of all diabetic patients have foot ulcers, often preceded by neuropathy and delayed healing resulting from peripheral vascular disease which leads to increased risk of infection. Additionally, there is a concern that blood flow to the feet may be reduced in patients with diabetes, which may be further compounded by changes in lower extremity perfusion pressure during hemodialysis. Current laser Doppler technology provides the opportunity to identify changes in vascularityin a non-invasive fashion.

Materials and Methods:

A prospective, parallel-arm, comparison, pilot study was conducted. A total of 15 patients were enrolled, ten of whom had a documented history of diabetes. All patients required hemodialysis. Peripheral perfusion and oxygenation measurements were obtained before, midway and at the conclusion of three separate dialysis sessions within a 3-week interval for each subject.

Results:

Preliminary results indicate a significant reduction in toe pressure during and after hemodialysis in the diabetic patient group compared to the non-diabetic group. Significant differences were not found in skin perfusion measurements or in the oxygenation measurements at any time in diabetic and non-diabetic patients undergoing hemodialysis.

Conclusion:

Preliminary results suggest hemodialysis may significantly affect pressure of the lower extremities in diabetic patients. Trends from these data indicate the need to further investigate the effect of hemodialysis on techniques used to heal wounds and ulcers in patients with diabetes. Level of Evidence: IV, Retrospective Case Series
Locked versus Nonlocked Plate Fixation for Hallux MTP Arthrodesis
Authors: Hunt Kenneth J. , Ellington J. Kent , Anderson Robert B. , Cohen Bruce E. , Davis W. Hodges , Jones Carroll P.
Published: November 2011

Background:

Dorsal plate fixation is used commonly for arthrodesis of the hallux first metatarsophalangeal (MTP) joint. Custom dorsal plates incorporating locking technology have been developed recently for applications in the foot to provide relative ease of application and theoretically superior mechanical properties. The purpose of this study is to compare the radiographic and clinical outcomes of patients undergoing hallux MTP joint arthrodesis using a locked plate, or a nonlocked plate.

Materials and Methods:

We compared consecutive patients who underwent hallux MTP arthrodesis for a variety of diagnoses with either a precontoured locked titanium dorsal plate (Group 1) or a precontoured, nonlocked stainless steel plate (Group 2). All patients were evaluated with radiographs, visual analog pain scale, American Orthopaedic Foot and Ankle Society (AOFAS) hallux score, and a detailed patient satisfaction survey.

Results:

There were 73 feet in Group 1 and 107 feet in Group 2. There was a trend toward a higher nonunion rate in Group 1 compared to Group 2. When considering only patients without rheumatoid arthritis (RA), the union rate was significantly higher in Group 2 compared to Group 1. Hardware failure and the overall complication rate was equivalent between the two Groups.

Conclusion:

As locked plate technology continues to gain popularity for procedures in the foot, it is important that clinical outcomes are reported. Locked titanium plates were associated with higher nonunion rates. Improved plate design, patient selection, and an understanding of plate biomechanics in this unique loading environment may optimize future outcomes for hallux MTP arthrodesis. Level of Evidence: III, Retrospective Comparative Study
Fore- and Rearfoot Kinematics in High- and Low-Arched Individuals during Running
Authors: Barnes Andrew , Wheat Jonathan , Milner Clare E.
Published: November 2011

Background:

Differences in the location and incidence of lower extremity injuries have been reported between high and low arched individuals. These differences might be related to functional differences between the two foot types. In particular, the characteristics of the medial longitudinal arch may influence foot function. The purpose of this study was to investigate forefoot and rearfoot kinematics as well as tibial shock in participants with both high and low arches.

Materials and Methods:

Fifteen high arched and 15 low arched males were recruited. Tibial acceleration as well as forefoot, rearfoot and shank kinematic data were collected as participants ran at 3.5 m/s wearing gait sandals. Variables of interest included peak tibial acceleration in addition to rearfoot eversion excursion, forefoot eversion excursion, forefoot eversion velocity, forefoot abduction excursion and forefoot abduction velocity. MANOVA and effect sizes were used to investigate kinematic differences between groups.

Results:

Multivariate analysis revealed that foot type had an effect on the kinematic variables of interest ( p = 0.04). Forefoot abduction excursion (High arched = 4.7 ± 1.3 degrees, Low arched 3.8 ± 1.0 degrees) and forefoot abduction velocity (High arched = 96.0 ± 24.8 degrees/s, Low arched = 69.3 ± 13.3 degrees/s) were greater in the high arched group. Tibial shock ( p = 0.24) and other kinematic variables were similar between groups.

Conclusion:

Clear evidence of forefoot and rearfoot motion as a shock attenuation mechanism was not found. Differences in the foot kinematics during early stance were highlighted by a smaller forefoot abduction excursion and reduced forefoot abduction velocity in low arched compared to high arched individuals. It is suggested that low arched feet may have a reduced available range of motion through which the forefoot can pass before reaching the end range of motion point.

Clinical Relevance:

Foot kinematics during early stance warrant further investigation to establish a specific link to injury risk.
Tophaceous Pseudogout of the Ankle: Case Report
Authors: Seybold Jeffrey D. , Dahl William J. , Kadakia Anish R.
Published: November 2011

Level of Evidence: V, Expert Opinion
Avulsion Fracture of the Dorsal Talonavicular Ligament: A Subtle Radiographic Sign of Possible Chopart Joint Dislocation
Authors: Schmitt Jurgen W. , Werner Clement M.L. , Ossendorf Christian , Wanner Guido A. , Simmen Hans-Peter
Published: November 2011

Level of Evidence: V, Expert Opinion
Tourniquet Application on the Difficult Thigh: Technique Tip
Authors: Farber Daniel C. , Farber Jerry S.
Published: November 2011

Level of Evidence: V, Expert Opinion
Revision Rates after Total Ankle Arthroplasty in Sample-Based Clinical Studies and National Registries
Authors: Labek Gerold , Klaus Hermann , Schlichtherle Rainer , Williams Alexandra , Agreiter Mark
Published: November 2011

Background:

The aim of this study was to evaluate the outcome of specific implants in total ankle arthroplasty as reported in clinical studies and determined by national registries.

Materials and Methods:

A structured literature review was conducted regarding sample-based clinical studies and national registry data. To allow for comparative analyses, registry data had to be available for the implants included. These were STAR™ Ankle, Büchel-Pappas, Hintegra, Mobility, Agility, and Ramses Total Ankle Arthroplasty. The revision rate was used as the main outcome parameter.

Results:

On average, the revision rates published in sample-based clinical studies were about half the value found in registries. Implant developers represent a share of almost 50% of the published content and are therefore over-represented in scientific publications. The inventors of STAR™ Ankle and BP total ankle implants published data which was statistically significantly superior to the outcome achieved in average patients as documented in registries. Irrespective of the implant, the average revision rate to be expected according to the registry data available is 21.8% after 5 years, and 43.5% after 10 years.

Conclusion:

The average revision rate published in peer-reviewed scientific articles was significantly lower than the outcome achieved according to national arthroplasty registry data, which reflect actual average patient care in the respective countries. Publications by some research groups, particularly by implant inventors, show a deviation from the outcome published by other users and those shown in registry data. Level of Evidence: III, Retrospective, Comparative Study
Operative Correction of Arch Collapse with Forefoot Deformity: A Retrospective Analysis of Outcomes
Authors: Habbu Rohan , Holthusen Scott M. , Anderson John G. , Bohay Donald R.
Published: November 2011

Background:

There are many forefoot deformities, including hallux valgus, forefoot overload, and hammertoe that are treated as unrelated problems with multiple different techniques. Currently, there has been renewed interest in the role of a gastrocnemius contracture on foot deformities. Our objective was to review a specific surgical treatment plan for forefoot deformities classified by us as Type 2 arch collapse and evaluate the outcomes.

Materials and Methods:

We retrospectively reviewed the charts of 374 patients who underwent foot procedures to treat deformity classified as a Type 2 arch collapse. Data was collected regarding complications and need for secondary surgery. A phone survey was performed to assess patient satisfaction, pain level, and Foot Function Index (FFI) scores.

Results:

Of the 374 patients (412 feet), there was a 96% (357 of 371 feet) union rate at the first tarsometatarsal joint and 98% (227 of 232 feet) union rate at metatarsal shortening osteotomy sites. Recurrence of hallux valgus was 2.7% (7 of 256 feet), while hallux varus occurred in 1.6% (4 of 256 feet). There were 292 patients (78%) available for phone interview. Of those patients, 88% were satisfied with the results of the procedure. The subset of procedures relating to the highest mean FFI was hammertoe correction (22.2) and the highest mean pain score was related to metatarsal shortening osteotomy (2.6).

Conclusion:

Utilizing the arch collapse model, operative treatment of forefoot deformities with a combination of procedures including gastrocnemius recession, first TMT fusion, modified McBride, hammertoe correction, and metatarsal shortening osteotomy can produce good satisfaction rates with low complication rates. Level of Evidence: IV, Retrospective Case Series