bluuebunny/crossref_metadata_2025 huggingface dataset:
Artistic freedom through subsidy: The British model of reviving American musicals
Authors: Peck Ellen Marie
Published: October 2011

In the last two decades, a host of British-directed revivals of American musicals have opened in London and on Broadway, in many cases to great acclaim. These productions have received critical praise for their fresh staging and dark psychological character exploration. This article
suggests that British government subsidizing of the arts has opened the doors for not-for-profit theatres to explore radical reinterpretations of classic American musicals, without the pressures of having to cater to audience expectations in order to back the shows financially. Because of
government support, British directors have been free to experiment with staging, physical design, cross-racial casting and character interpretation to get at the emotional core of the material. In many cases, the shows have generated enough critical support to allow them to transfer into the
commercial sector – the West End, Broadway, or both – and the original producing theatres benefit from the transfer. This article examines two subsidized theatres in England that have produced some of the most influential musical revivals of the last fifteen years: the Royal National
Theatre and the Donmar Warehouse. Through an overview of their histories, subsidy arrangements, and a few of the musical revivals they mounted and later transferred to Broadway, this article illustrates how not having to focus on the box office take can lead to innovation and creativity in
musical theatre staging, and how theatrical experimentation in turn creates more opportunities for public funding.
How many musicians does it take? A history and analysis of the shrinking Broadway pit orchestra
Authors: Meffe Robert
Published: October 2011

Over the last 40 years, the size of the Broadway pit orchestra has diminished. Contractual rules, known as minimums, guarantee a certain number of musicians in each Broadway theatre. On one hand, producers argue that they should not have to pay for any more musicians than they need.
On the other hand, the musicians’ union wants to maintain jobs and preserve the sound of a live orchestra. In 1993, the Special Situations clause was negotiated to allow producers to petition for an exemption from the minimums rule for shows whose artistic integrity would be impaired
by a large orchestra. Here at the intersection of art and commerce, decisions are made as to what kind of sound will support a musical based on the artistic desires of the creative staff and the bottom line of a producer’s budget. This article examines the history of Broadway minimums
and the Special Situations clause, using data about musician employment and interviews with producers, music directors, orchestrators and representatives from the musicians’ union, AFM, Local 802.
Intercity differences in university, R&D and industry interactions in biomedical sector research in India
Authors: Banerjee Parthsarathi , Roy Santanu
Published: October 2011

The Triple Helix model of innovation has emerged as the key driver for innovative activities in today's world. The interactions among university, research and development (R&D) sector, government and the industry have come to occupy a pivotal position in such a framework. However,
theoretical considerations apart, there has been a lack of analytical work in this area. The work presented in this article is an effort to bridge this gap. Further, the discourse on institutions and their asset formation and distribution have important implications in the context of Triple
Helix. The spatial distribution of biomedical knowledge assets across different Indian cities, big and small, has been analysed over a period of ten years (1991–2001) with this perspective. The implications of the results have been discussed.
Canadian oil sands: How innovation and advanced technologies can support sustainable development
Authors: Bloomer Adam , Jagoda Kalinga , Landry Jeffrie
Published: October 2011

An increase in greenhouse gas emissions, coupled with elevated environmental awareness, has triggered the necessity of focusing on effective management of the Canadian oil sands. From Kyoto to Copenhagen, Canada's industry practices have been criticized. The deployment of sustainable
production technologies is crucial for the survival of Canada's oil sands industry. Current literature is dominated by science and engineering scholars, yet a major problem appears to be a lack of full understanding of the multiple dimensions of the oil sands projects and the many players
involved in innovation of sustainable technologies. A focused attempt to understand the development and commercialization process, with a view towards developing guidelines for individuals and institutions in managing innovation, would therefore be a useful contribution to the oil sands literature.
This article proposes such an approach. The framework developed in this article is applied to a case study, with specific attention paid to identifying facilitating and inhibiting factors.
Collaborative lifecycle design A viable approach to sustainable rural technology development
Authors: Dunmade Israel
Published: October 2011

The purpose of this article is to present a lifecycle design methodology for rural technology development that promotes stakeholders' participation throughout the developmental process. The model was based on findings from rural development studies, several years of experience in rural
technology development and on lifecycle management principles. This article explained what collaborative lifecycle design for rural technology development is, and how it can be implemented. It also described how stakeholders involved rural technology design and development framework was used
in developing low-cost, potable multi-purpose threshers. The performance characteristics of the machines developed through the use of this methodology were within the same functional performance range with imported models. In addition, the use of the methodology resulted in lower production
cost, better acceptance and improved maintainability. It also fostered rapport between stakeholders, led to attainment of self-reliance in that technology instead of dependence on imported machinery and improved our post-harvest technology capacity building. Moreover, it led to the development
of a technology that is socio-culturally compatible and environmentally friendly.
Incorporating sustainability into information technology management
Authors: Rahman Nayem , Akhter Shameem
Published: October 2011

Information technology (IT) industry accounts for approximately 2% of global carbon dioxide (CO2) emissions. Data centres use a significant amount of energy. This has become problematic during the last few years. Power intensities have been increasing over time, largely because
of the increasing heat density of IT equipment. The number and usage of PCs have been rapidly increasing worldwide. By implementing IT sustainability programmes, organizations can drastically reduce the amount of energy spent, develop efficient technology products, keep e-waste out of landfills
and adopt recycle and reuse programmes. Using more efficient technologies can help consume fewer resources and emit less waste. This article discusses various aspects of sustainable IT programmes and proposes sustainability metrics for IT to demonstrate a positive impact on the environment.
Paying attention
Authors: Rinder Lawrence
Published: October 2011

In this article I explore the difference between individual and collective attention. I discuss the ways in which museum experience is impacted by the number of visitors in attendance and the social qualities of the environment. The Berkeley Art Museum’s L@TE Friday evening programme
is introduced as an example of a programme that fosters collective attention. In this context, I discuss the performance of György Ligeti’s Poème Symphonique (1962), which resulted in a remarkable experience of collective attention.
Teaching Che: a picture is worth a thousand words (or t-shirts)
Authors: Shestakow Stephanie
Published: October 2011

The familiarity of iconic photographs make them helpful tools for building young people’s visual literacy, particularly those with limited art experience. In a seminar designed to introduce first-year college students to the rigours of academic work, Alberto Korda’s photograph
of Ernesto ‘Che’ Guevara is the icon of choice. History has given Guevara many guises; throughout the course students consider how Guevara and others constructed his image, and how the replication of that image can be deconstructed in terms of various art media. Wedding word and
image, and using museum-education techniques combined with traditional art-historical modes of inquiry, students explore the meaning of the man behind the t-shirt.
Finding civic identity: a review of Sarah Schrank’s Art and the City: Civic Imagination and Cultural Authority in Los Angeles
Authors: Moser Shelby
Published: October 2011

Los Angeles, once recognized solely for its orange groves and Hollywood glamour, has become a leading locale in the cultural art world. Author Sarah Schrank chronicles the events that shaped LA’s civic identity in her book, Art and the City: Civic Imagination and Cultural Authority
in Los Angeles. Starting with the early twentieth century, Schrank illustrates how social unrest and political conflict dictated the city’s identity and art, even exposing how LA’s perception of minorities stipulated its freeway system. Oscillating between civic censorship and
promotion, artists were often held captive by the current ethnic and political environment. From landmark schools to civic icons, Art and the City is a useful compendium for understanding the influences that gave Los Angeles its urban identity.
No folds barred: a review of the documentary film, Between the Folds
Authors: Moser Shelby
Published: October 2011

In this award-winning documentary, Between the Folds, film-maker Vanessa Gould follows various artists and scientists and explores their shared love for paperfolding. Blurring the lines between ‘the science of art, the art of science’, Gould reveals how the creativity and
intricacies of origami mimic nature’s own mysteries. This art form, once associated as a simple pastime for children, ranges in its expression. The provocative folds mimic all aspects of life, from human emotion to the detailed structure of a double helix. These artists-scientists appear
qualified to solve any mystery, all with paper-folding. Between the Folds is an intriguing film about an art discipline that utilizes creativity and science.
Metaphor, hyperbole and simile: A pragmatic approach
Authors: Carston Robyn , Wearing Catherine
Published: October 2011

According to recent work on lexical pragmatics within the relevance-theoretic framework, grasping the intended meaning of a metaphorically used word requires a process of adjusting the linguistically encoded concept to derive an ad hoc concept whose denotation is broader than that of the lexical concept. Metaphorical uses are claimed to be one kind of loose use of language, on a continuum with approximations, hyperboles and other kinds of meaning extension. The question addressed in this paper is whether this account fully captures the processes involved in understanding metaphors and the kinds of cognitive effects they have. We tackle this question by examining the similarities and differences between metaphors and hyperboles and between metaphors and similes. The upshot of our analyses is two proposals, both requiring further investigation: (a) that a distinction should be drawn between the kind of ad hoc concepts derived for hyperbolic and other loose uses, on the one hand, and metaphorical uses, on the other, and (b) that the understanding of some metaphorical uses, in particular extended and/or novel creative cases, is achieved by a different mode of processing altogether, one which gives much greater weight to the literal meaning.
Verbs in the lexicon: Why is hitting easier than breaking?
Authors: McKoon Gail , Love Jessica
Published: October 2011

Adult speakers use verbs in syntactically appropriate ways. For example, they know implicitly thatthe boy hit at the fenceis acceptable butthe boy broke at the fenceis not. We suggest that this knowledge is lexically encoded in semantic decompositions. The decomposition forbreakverbs (e.g.crack, smash) is hypothesized to be more complex than that forhitverbs (e.g.kick, kiss). Specifically, the decomposition of abreakverb denotes that “an entity changes state as the result of some external force” whereas the decomposition for ahitverb denotes only that “an entity potentially comes in contact with another entity.” In this article, verbs of the two types were compared in a lexical decision experiment—Experiment 1—and they were compared in sentence comprehension experiments with transitive sentences (e.g.the car hit the bicycleandthe car broke the bicycle)—Experiments 2 and 3. In Experiment 1, processing times were shorter for thehitthan thebreakverbs and in Experiments 2 and 3, processing times were shorter for thehitsentences than the break sentences, results that are in accord with the complexities of the postulated semantic decompositions.
Irradiation of strontium chloride targets at proton energies above 35 MeV to produce PET radioisotope Y-86
Authors: Medvedev Dmitri G. , Mausner Leonard F. , Srivastava Suresh C.
Published: October 2011

Proton irradiation of natural and enriched SrCl2 targets was used to produce PET radioisotope 86Y. The proton energy was degraded from the incident 117.8 MeV to induce the 88Sr(p,3n) reaction. For the irradiation three pellets made of natSrCl2 (6.61 and 74.49 g) and 88SrCl2 (5.02 g) were pressed and individually encapsulated in stainless steel target bodies. The two smaller targets were irradiated for 0.5–1 h at the energy ∼ 46→37 MeV to take advantage of the peak in the excitation function of the 88Sr(p,3n) reaction. The larger target was irradiated at 66.4→44.6 MeV. The irradiated pellets were chemically processed to selectively separate 86Y radioisotope using Eichrom DGA (N,N,N´,N´-tetra-n-octyldiglycolamide) resin. The production yields of 86Y were determined to be 10–13 mCi/μA h. Coproduction of 87mY in the final product was 34% for natSrCl2 and 54% for 88SrCl2 target. The chemical separation yield of yttrium reached 88–92%. The developed chemical procedure allows for the same day processing and shipment of the isotope to users.
Early Climate Change Consensus at the National Academy: The Origins and Making of Changing Climate
Authors: Nierenberg Nicolas , Tschinkel Walter R. , Tschinkel Victoria J.
Published: October 2011

The 1983 National Academy of Sciences report entitled Changing Climate, authored by a committee of physical and social scientists chaired by William Nierenberg, was an early comprehensive review of the effects of human-caused increases in the levels of atmospheric CO2. Study of the events surrounding the committee's creation, deliberations, and subsequent report demonstrates that the conclusions of the report were the consensus of the entire committee and in line with the scientific consensus of the time. This result contraverts a 2008 paper in which Naomi Oreskes, Erik M. Conway, and Matthew Shindell asserted that the report contradicted a growing consensus about climate change, and that Nierenberg for political reasons deliberately altered the summary and conclusions of the report in a way that played down the concerns of the other physical scientists on the committee. Examining the production of the report and contextualizing it in contemporaneous scientific and political discussion, we instead show how it was a multi-year effort with work divided among the various members of the committee according to their expertise. The synthesis and conclusions were expressly a joint statement of the committee and were consistent with other assessments of that time expressing deep concern over the potential issues while stopping short of recommending major policy changes due to the uncertainties, and to a lack of good alternatives.
Craniofacial and Dental Features in Kabuki Syndrome Patients
Authors: Sobral Samantha Do Prado , Leite André Ferreira , Figueiredo Paulo Tadeu Sousa , Ferrari Íris , Safatle Heloísa Pires Neto , Córdoba Mara Santos , Versiani Beatriz Ribeiro , Acevedo Ana Carolina , Mestrinho Heliana Dantas
Published: October 2011

Objective

To describe oral manifestations in Brazilian individuals with Kabuki syndrome, a multiple congenital anomaly/mental retardation syndrome.

Study Design

A total of 16 Kabuki syndrome individuals, aged between 8 to 24 years and of both sexes, were referred by the Department of Clinical Genetics for oral treatment and follow-up to the Oral Care Center for Inherited Diseases, University Hospital of Brasília, Brasília, Brazil. Each individual underwent complete physical examination, as well as intraoral and radiographic examinations.

Results

Craniofacial and dental alterations were observed in all Kabuki syndrome patients examined. In addition, atypical shape of the molars' crowns, occlusal convergence of the premolars' crowns, and root dilaceration were also observed. Enamel diffuse opacities were observed in permanent dentition (n = 10).

Conclusion

A great clinical heterogeneity was observed in Kabuki syndrome individuals in line with previous studies in the literature. Further clinical and molecular studies are necessary in order to better understand the presence of dental anomalies in this syndrome.
Team-Oriented Care for Orofacial Clefts: A Review of the Literature
Authors: Mcgrattan Katlyn , Ellis Charles
Published: October 2011

Objective

To examine the process of team-oriented care for children with orofacial clefts.

Design

Systematic review of available studies reporting team-oriented management of children and adults with orofacial clefts. We identified studies from OVID, PsychINFO, REHABDATA, PubMed, and The Cleft Palate–Craniofacial Journal to complete this review.

Main Outcome Measures

Process of team-oriented treatment, which included use of team-oriented care, continuity of team-oriented care, and approaches to team-oriented care.

Results

We identified nine studies including 1398 participants. We found that studies examining team-oriented approaches to orofacial clefts were limited. Studies of orofacial teams suggest that use of team-oriented approaches to care are highly variable. It is unclear how these inconsistencies in approaches to care influence long-term outcomes.

Conclusions

Although the literature suggests that the process of team-oriented care results in better outcomes in individuals with orofacial clefts, process of care as a measurable outcome has yet to be adequately examined. Future studies are needed to investigate the impact on clinical outcomes and their relationship to cost effectiveness and efficiency of care.
Shine: On Race, Glamour, and the Modern
Authors: Cheng Anne Anlin
Published: October 2011

Is the fetish the only way to understand glamour, especially when it comes to the glamour of racialized women? How do we talk about agency and embodiment for a mediated figure? How does celebrity affect a subject whose body has been overembodied yet depersonalized? This essay suggests that the unlikely conjunction among celebrity, glamour, and racial difference may be the place where we are compelled to confront the intimacy, rather than opposition, between person-hood and objectification. Turning to Anna May Wong, an iconic “race beauty” in the early twentieth century, this essay argues that Wong's glamour is achieved neither through her apparently racialized performances nor through her uncomplicated assumption of female agency but rather through a paradoxical staging and erasure of her own body and skin. By asking how a celebrated body might operate subjunctively rather than materially, we can begin to question the imperatives of personhood that drive both celebrity and race studies.
The First “Royal”: Charles I as Celebrity
Authors: Skerpan-Wheeler Elizabeth
Published: October 2011

The seventeenth-century royalist bookEikon Basiliké(1649), probably the most successful political tract of the English revolution, was unlike any other royalist work published in the period. Its unique qualities suggest that it did something genuinely new. Those qualities may be best appreciated from the perspective ofcelebrity.While celebrity is ordinarily considered a modern phenomenon, the reception ofEikon Basilikéshows that the idea of celebrity arises in the early modern period, when a new relation between text and audience presented a commodified image of a famous person, an image that was consumed by its audience in a democratized marketplace. Ironically,Eikon Basilikéachieved commodification by relying on the traditional techniques of the art of memory—the fourth part of rhetoric—to create the illusion of closeness between king and subject that converted the king into a celebrity.
Trends over time in tree and seedling phylogenetic diversity indicate regional differences in forest biodiversity change
Authors: Potter Kevin M. , Woodall Christopher W.
Published: October 2011

Changing climate conditions may impact the short‐term ability of forest tree species to regenerate in many locations. In the longer term, tree species may be unable to persist in some locations while they become established in new places. Over both time frames, forest tree biodiversity may change in unexpected ways. Using repeated inventory measurements five years apart from more than 7000 forested plots in the eastern United States, we tested three hypotheses: phylogenetic diversity is substantially different from species richness as a measure of biodiversity; forest communities have undergone recent changes in phylogenetic diversity that differ by size class, region, and seed dispersal strategy; and these patterns are consistent with expected early effects of climate change. Specifically, the magnitude of diversity change across broad regions should be greater among seedlings than in trees, should be associated with latitude and elevation, and should be greater among species with high dispersal capacity. Our analyses demonstrated that phylogenetic diversity and species richness are decoupled at small and medium scales and are imperfectly associated at large scales. This suggests that it is appropriate to apply indicators of biodiversity change based on phylogenetic diversity, which account for evolutionary relationships among species and may better represent community functional diversity. Our results also detected broadscale patterns of forest biodiversity change that are consistent with expected early effects of climate change. First, the statistically significant increase over time in seedling diversity in the South suggests that conditions there have become more favorable for the reproduction and dispersal of a wider variety of species, whereas the significant decrease in northern seedling diversity indicates that northern conditions have become less favorable. Second, we found weak correlations between seedling diversity change and latitude in both zones, with stronger relationships apparent in some ecoregions. Finally, we detected broadscale seedling diversity increases among species with longer‐distance dispersal capacity, even in the northern zone, where overall seedling diversity declined. The statistical power and geographic extent of such analyses will increase as data become available over larger areas and as plot measurements are repeated at regular intervals over a longer period of time.
Planning and Execution of the Longest Horizontal Well in ADCO
Authors: Kuyken Chris , Al-Bakr Salem , Abu Aishah Abdel Nasser , El-Hadidy Khaled , El-Reyami Mazin , Gomes Jorge Salgado , James Ron , Hahne Ulrich
Published: October 2011

This paper discusses the planning process, execution and lessons learned of an advanced horizontal water injector in a tight carbonate reservoir, onshore United Arab Emirates. The well design required a 10,000 ft horizontal section, to be geosteered in a 6⅛-in. hole through a narrow TVD window of 5 ft, just above the oil water contact.

The challenges were multiple, not only from the rig capability and BHA design point of view, but also from the geosteering and formation evaluation aspects pertaining to borehole hydraulics, completion and stimulation. For injection monitoring analysis the completion had to be run with a perforated 3 1/2-in. stinger design to deploy a 19,500 ft distributed temperature sensing (DTS) system to TD. Four main justifications to execute this pilot project were identified:

to improve injectivity and therefore the area sweep efficiency in the down flank area of the field to segment the wellbore to provide for future selective stimulation along 10,000 ft of horizontal section to deploy a DTS system to continuously monitor the water injection profile to minimize the number of injection wells in the field, reducing CAPEX, OPEX, surface hook ups and field footprint.

The paper discusses the business case for this project, which includes an initial pilot well containing a 5,100 ft lateral section and four extended reach drilling (ERD) wells, each with a 10,000 ft lateral hole section. Furthermore, best practices from the detailed planning phase to the execution of the first extended reach well are reviewed in this paper.
Strengthening the Kawa Model: Japanese Perspectives on Person, Occupation, and Environment
Authors: Wada Mineko
Published: October 2011

Background. The Kawa model emerged to meet a need for occupational therapy models and theories relevant to Japanese clients and since its inception has evolved considerably.

Purpose. To provide an overview of the Kawa model and to contribute to a critique of the model from Japanese perspectives on person, occupation, and environment.

Key Issues. The paper notes that the Kawa model does not portray inner self nor does it integrate one's active belonging; the author identifies the challenges of addressing issues related to occupations, and introduces the concept of seken (day-to-day community).

Implications. The model would be strengthened by presenting inner self and a discrete layer of seken in the environment to effectively articulate belonging. The ways of presenting occupation need to be improved to capture relationships between occupation and belonging, effects of occupations, and positive and negative meanings attributed to an occupation. Exploring relationships between self, occupation, life flow, and harmony is warranted.
Analysis of risk factors in the development of retinopathy of prematurity
Authors: Knezevic Sanja , Stojanovic Nadezda , Oros Ana , Savic Dragana , Simovic Aleksandra , Knezevic Jasmina
Published: October 2011

Introduction. Retinopathy of prematurity (ROP) is a multifactorial disease
that occurs most frequently in very small and very sick preterm infants, and
it has been identified as the major cause of childhood blindness. Objective.
The aim of this study was to evaluate ROP incidence and risk factors
associated with varying degrees of illness. Methods. The study was conducted
at the Centre for Neonatology, Paediatric Clinic of the Clinical Centre
Kragujevac, Serbia, in the period from June 2006 to December 2008.
Ophthalmologic screening was performed in all children with body weight lower
than 2000 g or gestational age lower than 36 weeks. We analyzed eighteen
postnatal and six perinatal risk factors and the group correlations for each
of the risk factors. Results. Out of 317 children that were screened, 56
(17.7%) developed a mild form of ROP, while 68 (21.5%) developed a severe
form. Univariate analysis revealed a large number of statistically
significant risk factors for the development of ROP, especially the severe
form. Multivariate logistical analysis further separated two independent risk
factors: small birth weight (p=0.001) and damage of central nervous system
(p=0.01). Independent risk factors for transition from mild to severe forms
of ROP were identified as: small birth weight (p=0.05) and perinatal risk
factors (p=0.02). Conclusion. Small birth weight and central nervous system
damage were risk factors for the development of ROP, perinatal risk factors
were identified as significant for transition from mild to severe form of
ROP.
Soft tissue thickness of face profile conditioning by dento-skeletal anomalies
Authors: Tanic Tatjana , Blazej Zorica , Mitic Vladimir
Published: October 2011

Introduction. Orthodontic treatment of dento-skeletal anomalies is generally
based on the correction of teeth and jaws relationship, while it is expected
that soft facial tissue spontaneously adapts to therapeutically achieved
relationship and to accompany hard tissue changes. Objective. To establish
facial soft tissue thickness conditioning by the presence of dento-skeletal
anomalies. Methods. The study was performed at the Dental Clinic of Nis, and
involved the analysis of cephalometric rendgenograms in 121 patients, aged
12-18 years, with no previous orthodontical treatment. According to
dento-skeletal relationship between teeth and jaws the patients were divided
into four groups; class I (control group), class II of division 1, class II
of division 2 and class III. The standard analysis of dento-skeletal profile
was done according to Steiner and soft tissue profile according to Burstone
was done in all. Results. The patients of class II/1 had a significantly
thinner upper lip (t=2.650; p<0.05) and thinner upper lip sulcus (t=1.999;
p<0.05). The patients of class II/2 had a significantly thicker upper lip
(t=2.912; p<0.01), while those of class III had a significantly thinner lower
lip (t=3.900; p<0.001). Conclusion. The thickness of facial soft tissue
considerably influences facial profile appearance in persons with a
dento-skeletal anomaly. Not only do soft tissues adapt to the existing jaws
relationship, but can also camouflage present anomalies.
C-reactive protein as an inflammatory marker in monitoring therapy effectiveness of acute odontogenic infections
Authors: Drazic Radojica , Jurisic Milan , Markovic Aleksa , Colic Snjezana , Gacic Bojan , Stojcev-Stajcic Ljiljana
Published: October 2011

Introduction. Clinical presentation of acute odontogenic infections may vary,
while adequate evaluation of its severity is of great importance for
determination of appropriate and effective therapy. Objective. The aim of the
present study was to monitor changes of C-reactive protein (CRP) levels, to
correlate its values with symptoms of different acute odontogenic infections
(AOI), and to monitor the effectiveness of the applied therapy. Methods.
Fifty-four patients with AOI were included in the study. Eighteen patients
with good drainage and normal body temperature were treated only by surgical
incision without using antibiotics. Twenty-two patients with poor drainage
after incision and normal body temperature were treated by surgical incision
and antibiotics. Fourteen patients with elevated body temperature were
treated by incision and antibiotics, irrespective of the quality of the
drainage. CRP levels were measured on admission, on the 3rd and 7th day after
therapy initiation. Results. On admission CRP levels were higher in AOI with
elevated body temperature compared to poorly and well-drained AOI. There
were no differences in CRP levels between well and poorly drained AOI on
admission. On the 3rd day, a decline in the CRP levels was evident in all
three groups of patients, and there was no difference among the groups. On
the 7th day, the CRP levels normalized in all groups. Conclusion. CRP levels
correlate well with the severity and resolution of AOI and could be used as a
reliable parameter in monitoring the effectiveness of AOI therapy.
Surgical revascularization on the beating heart in patients with low ejection fraction
Authors: Putnik Svetozar , Velinovic Milos , Mikic Aleksandar , Vranes Mile , Nikolic Bojan , Krstic Nevena , Ristic Miljko
Published: October 2011

Introduction. The subset of patients most likely to benefit from off-pump
coronary artery bypass grafting (OPCABG) remains a controversial issue, but
the technique has been proposed to decrease postoperative mortality and
morbidity. Coronary artery bypass grafting (CABG) with a cardiopulmonary
bypass carries a significant risk for patients with severe left ventricular
(LV) dysfunction. Objective. The objective of this study was to compare
off-pump to on-pump CABG in patients with ejection fraction (EF) lower than
30%. Methods. Prospective randomized study was carried out between June 2004
and March 2006 at the Institute for Cardiovascular Diseases of the Clinical
Centre of Serbia. Sixty prospectively randomized high-risk patients divided
into two groups to undergo off-pump or on-pump CABG. All recruited patients
had left ventricular ejection fraction lower than 30%. Results. Thirty
patients averaging 59.2 years of age underwent 2.30 grafts on pump, and
another 30 averaging 59.6 years of age underwent 2.03 grafts off pump. OPCABG
patients exhibited a significantly less release of TnI (average 0.71 ?/L)
than on-pump patients (3.00 ?/L). Inotropic requirements were less in the
off-pump group. The patients undergoing OPCABG received fewer units of blood
and had shorter postoperative length of stay in intensive care unit and
hospital stay. There was no significant difference in hospital mortality and
complication rate. Conclusion. The present study suggests that off-pump CABG
in patients with poor LV function when compared with conventional CABG
achieved similar number of grafts per patient, similar in-hospital outcomes,
shorter length of stay, reduced transfusion requirement, and less myocardial
injury.
The occurrence of new arrhythmias after catheter-ablation of accessory pathway: Delayed arrhythmic side-effect of curative radiofrequency lesion?
Authors: Mujovic Nebojsa , Grujic Miodrag , Mrdja Stevan , Kocijancic Aleksandar , Mujovic Natasa
Published: October 2011

Introduction. New arrhythmias (NA) may appear late after accessory pathway
(AP) ablation, but their relation to curative radiofrequency (RF) lesion is
unknown. Objective. The aim of this study was to determine the prevalence and
predictors for NA occurrence after AP ablation and to investigate
pro-arrhythmic effect of RF. Methods. Total of 124 patients (88 males, mean
age 43?14 years) with Wolff-Parkinson-White syndrome and single AP have been
followed after successful RF ablation. Post-ablation finding of arrhythmia,
not recorded before the procedure, was considered a NA. The origin of NA was
assessed by analysis of P-wave and/or QRS-complex morphology, and,
thereafter, it was compared with locations of previously ablated APs.
Results. Over the follow-up of 4.3?3.9 years, NA was registered in 20
patients (16%). The prevalence of specific NAs was as follows:
atrioventricular (AV) block 0.8%, atrial premature beats 1.6%, atrial
fibrillation 5.4%, atrial flutter 0.8%, sinus tachycardia 4.8%, ventricular
premature beats (VPBs) 7.3%. Multivariate Cox-regression analysis
identified (1) pre-ablation history of pathway-mediated tachyarrhythmias >10
years (HR=3.54, p=0.016) and (2) septal AP location (HR=4.25, p=0.003), as
the independent predictors for NA occurrence. In four NA cases (two cases of
septal VPBs, one of typical AFL and one of AV-block) presumed NA origin was
identified in the vicinity of previous ablation target. Conclusion. NAs were
found in 16% of patients after AP elimination. In few of these cases, late
on-site arrhythmic effect of initially curative RF lesion might be possible.
While earlier intervention could prevent NA occurrence, closer follow-up is
advised after ablation of septal AP.
Anthropometric and lipid parameters trends in school children: One decade of YUSAD study
Authors: Simeunovic Slavko , Nedeljkovic Srecko , Milincic Zeljka , Vukotic Milija , Novakovic Ivana , Majkic-Singh Nada , Nikolic Dejan , Risimic Dijana , Simeunovic Dejan , Petronic Ivana , Radlovic Vladimir
Published: October 2011

Introduction. Athersclerosis is a multifactorial disease that begins in
childhood. There are few reports regarding influence of risk factors on the
atherosclerotic processes in early period of life and adolescence. Objective.
The aim of this study was to present and analyze risk factor trends in school
children over a 10-year period that were included and followed-up by the
Yugoslav Study of Atherosclerosis Precursors in School Children (YUSAD
Study). Methods. There were three examinations of selected population from 13
centres. The first examination was performed when children were 10 years of
age (first group; N=6381 participants), the second examination on the same
population when they were 15 years of age (second group; N=5017) and third
when children were 19/20 years of age (third group; N=1293). Evaluated
parameters included: BMI, waist circumference (WaC) and lipid profile (total
cholesterol, HDL cholesterol, LDL cholesterol and triglyceride). Results. A
significant elevation of values (p<0.001) of BMI, WaC and triglycerides and a
significant decline (p<0.001) of total cholesterol and LDL cholesterol in
boys over 5 and 10-year period was noticed. There was a significant elevation
(p<0.001) of BMI, WaC and HDL values and a significant decline in LDL
cholesterol values in girls over the 5 and 10-year period. Conclusion. Our
results point out that girls between 10 and 19/20 years have a better lipid
profile during growth. It should be stressed out that childhood and
adolescence can be more beneficial in the observation of risk factor
influences on pathological, genetic and clinical levels.
Breast reconstruction: Correlation between different procedures, reconstruction timing and complications
Authors: Andjelkov Katarina , Sforca Markos , Granic Miroslav , Ivanov Dejan , Colic Miodrag
Published: October 2011

Introduction. Improved psychophysical condition after breast reconstruction
in women has been well documented Objective. To determine the most optimal
technique with minimal morbidity, the authors examined their results and
complications based on reconstruction timing (immediate and delayed
reconstruction) and three reconstruction methods: TRAM flap, latissimus
dorsi flap and reconstruction with tissue expanders and implants. Methods.
Reconstruction was performed in 60 women of mean age 51.1 years. We analyzed
risk factors: age, body mass index (BMI), smoking history and radiation
therapy in correlation with timing and method of reconstruction.
Complications of all three methods of reconstruction were under 1.5-2-year
follow-up after the reconstruction. All data were statistically analyzed.
Results. Only radiation had significant influence on the occurrence
of complications both before and after the reconstruction, while age,
smoking and BMI had no considerable influence of the development of
complications. There were no statistically significant correlation between
the incidence of complications, time and method of reconstruction.
Conclusion. Any of the aforementioned breast reconstruction techniques can
yield good results and a low rate of re-operations. To choose the best
method, the patient needs to be as well informed as possible about the
options including the risks and benefits of each method.
Infantile nephropathic cystinosis
Authors: Peco-Antic Amira , Kostic Mirjana , Bogdanovic Radovan , Spasojevic Brankica , Djordjevic Maja , Paripovic Dusan , Kovacevic Dragana
Published: October 2011

Introduction. Infantile nephropathic cystinosis (INC) is a metabolic disorder
due to impaired carrier-mediated transport of cystine out of cellular
lysosomes. Objective. To examine the prevalence and clinical characteristics
of INC in paediatric patients with end- stage renal disease (ESRD) in Serbia
and give a recent statement of the disease. Methods. ESRD database of the
Centre for Paediatric Renal Replacement Therapy (RRT) in Serbia was used to
identify all patients with INC who started RRT before age of 19 years during
the period January 1980 - December 2008; their records concerning clinical
characteristics, therapy and outcome were evaluated. Results. Only three of
298 paediatric patients with ESRD had INC. The first signs of the illness
were recognised during infancy. Fancony syndrome was diagnosed in the second
year, but the diagnosis of cystinosis was delayed at mean 6 years. ESRD
occurred in the first decade of life. All patients under- went cadaver kidney
transplantation. At the end of the study period all patients were alive. A
31-year-old female patient was on maintenance chemodialysis due to graft
failure after functioning for 11 years. She was growth retarded, single,
unemployed, with severe signs of renal dystrophy. Two male patients (14.3 and
14.7 years old) had normal graft function, normal education, and good quality
of life, although they were also severe growth retarded. Conclusion. The
prevalence of infantile nephropathic cystinosis is low in Serbia. The
diagnosis of cystinosis was delayed in all patients, although they exhibited
the typical course of the disease.
Surgical treatment of displaced acetabular fractures
Authors: Milenkovic Sasa , Saveski Jordan , Radenkovic Mile , Vidic Goran , Trajkovska Neda
Published: October 2011

Introduction. Acetabular fractures are severe injuries, generally caused by
high-energy trauma, most frequently from traffic accidents or falls from
heights. Fractures of the extremities, head injuries, chest, abdomen and
pelvic ring injuries are most commonly associated injuries. Objective. The
purpose of this study was to evaluate the results of open reduction and
internal fixation of acetabular fractures. The open anatomical reduction of
the articular surface combined with a rigid internal fixation and early
mobilisation have become the standard treatment of these injuries. Methods.
We conducted a retrospective analysis of 22 patients of average age 43.13
years. The patients were treated by open reduction and internal fixation at
the Orthopaedic Clinic of Nis from 2005-2009. The follow-up was 12 to 60
months, with the average of 21.18 months after surgery. Results. All injured
patients were operated on between 4 and 11 days (5.7 days on the average).
According to the classification by Judet and Letournel, 15 (68.18%) patients
had an elementary acetabular fracture, whereas 7 (31.82%) patients had
associated fracture. A satisfactory postoperative reduction implying less
than 2 mm of displacement was achieved in 19 (86.36%) patients. The
radiological status of the hip joint, determined according to Matta score,
was excellent in 15 (68.18%) patients, good in 4 (18.18%) patients and
moderate in 3 (13.63%) patients. According to Merle d?Aubign? Scale, the
final functional results of the treatment of all operated patients were
excellent in 12 (54.54%) patients, good in 7 (31.81%) patients and moderate
in 3 (13.63%) patients. Conclusion. Surgical treatment of dislocated
acetabular fractures requires an open reduction and a stable internal
fixation. Excellent and good results can be expected only if anatomical
reduction and stable internal fixation are achieved.
Operating cost analysis of anaesthesia: Activity based costing (ABC analysis)
Authors: Majstorovic Branislava , Kastratovic Dragana , Vucovic Dragan , Milakovic Branko , Milicic Biljana
Published: October 2011

Introduction. Cost of anaesthesiology represent defined measures to determine
a precise profile of expenditure estimation of surgical treatment, which is
important regarding planning of healthcare activities, prices and budget.
Objective. In order to determine the actual value of anaestesiological
services, we started with the analysis of activity based costing (ABC)
analysis. Methods. Retrospectively, in 2005 and 2006, we estimated the direct
costs of anestesiological services (salaries, drugs, supplying materials and
other: analyses and equipment.) of the Institute of Anaesthesia and
Resuscitation of the Clinical Centre of Serbia. The group included all
anesthetized patients of both sexes and all ages. We compared direct costs
with direct expenditure, ?each cost object (service or unit)? of the
Republican Health-care Insurance. The Summary data of the Departments of
Anaesthesia documented in the database of the Clinical Centre of Serbia.
Numerical data were utilized and the numerical data were estimated and
analyzed by computer programs Microsoft Office Excel 2003 and SPSS for
Windows. We compared using the linear model of direct costs and unit costs of
anaesthesiological services from the Costs List of the Republican Health-care
Insurance. Results. Direct costs showed 40% of costs were spent on salaries,
(32% on drugs and supplies, and 28% on other costs, such as analyses and
equipment. The correlation of the direct costs of anaestesiological services
showed a linear correlation with the unit costs of the Republican Healthcare
Insurance. Conclusion. During surgery, costs of anaesthesia would increase by
10% the surgical treatment cost of patients. Regarding the actual costs of
drugs and supplies, we do not see any possibility of costs reduction. Fixed
elements of direct costs provide the possibility of rationalization of
resources in anaesthesia.
Anti-TNF treatment and miliary tuberculosis in Crohn’s disease
Authors: Milenkovic Branislava , Dudvarski-Ilic Aleksandra , Jankovic Goran , Martinovic Lena , Mijac Dragana
Published: October 2011

Introdution. Tumour necrosis factor alpha (TNF?) has a central role in the
host immune response to mycobacterial infection. TNF? blockade may therefore
result in reactivation of recent or remotely acquired infection. In reported
mycobacterium tuberculosis infections, extra-pulmonary and disseminated
tuberculosis (TB) was common, appeared rapidly, and if unrecognized, with
fatal outcome. We present a female patient with miliary TB following
treatment with infliximab for fistulizing Crohn?s disease. Case Outline. Five
years before admission, the patient was diagnosed with Crohn?s disease, with
inflammation limited to the terminal ileum and sigmoid colon and has been on
azathioprine 100 mg/day for the last 10 months. Three months before admission
to the hospital she developed an enterocutaneous fistula for which therapy
with infliximab was started in addition to azathioprine therapy. A tuberculin
skin test and a chest x-ray were performed prior to the first infusion with
normal findings. She presented with a 6-week history of fever, weakness,
weight-loss and a 2-week dry cough. Chest x-ray and computed tomography
displayed remarkable bilateral hilar and mediastinal lymphadenopathy and
uniformly distributed fine nodules throughout both lung fields varying in
size from 2 to 3 mm, without any signs of cavitation. Since there were
clinical and morphological signs that indicated miliary TB, the treatment
with antituberculous therapy was started and six weeks later all of the
symptoms completely resolved and the lesions visible on x-ray diminished.
Conclusion. The clinical use of TNF-inhibitors is associated with increased
risk of developing tuberculosis. Physicians should be aware of the increased
risk of reactivation of TB among patients treated with anti-TNF agents and
regularly look for usual and unusual symptoms of TB.
The treatment of subtrochanteric fractures
Authors: Vucetic Cedomir , Dulic Borislav , Vukasinovic Zoran , Tulic Goran , Kalezic Nevena , Todorovic Aleksandar
Published: October 2011

Subtrochanteric fractures of the femur have a special place because of a
significant number of complications following treatment. Powerful loading
forces asymmetrically acting to this bone segment, as well as poor
vascularization interfere with bone union. There are basically two current
approaches in the fixation of subtrochanteric fractures; the first involves a
plate with a compression screw and another one is intramedullary (IM) nail,
with two options: centromedullary (standard interlocking femoral nail) and
cephalomedullary femoral nail with two modifications, reconstructive and
trochanteric. All IM nails may be used by open technique or closed minimal
invasive method. IM nailing is favoured in view of a shorter operative time,
shorter hospitalisation and complications. Indirect fracture reduction and
knowledge of biology of bone fracture may result in full success without any
bone graft.