bluuebunny/crossref_metadata_2025 huggingface dataset:
Global Emergency Medicine: A Review of the Literature From 2011
Authors: Schroeder Erika D. , Jacquet Gabrielle , Becker Torben Kim , Foran Mark , Goldberg Elizabeth , Aschkenasy Miriam , Bertsch Karina , Levine Adam C. ,   on behalf of the Global Emergency Medicine Literature Review (GEMLR) Group
Published: September 2012

ACADEMIC EMERGENCY MEDICINE 2012; 19:1196–1203 © 2012 by the Society for Academic Emergency Medicine

Objectives:  The Global Emergency Medicine Literature Review (GEMLR) conducts an annual search of published and unpublished articles relevant to global emergency medicine (EM) to identify, review, and disseminate the most important research in this field to a wide audience of academics and practitioners.

Methods:  This year, 7,924 articles written in seven languages were identified by our search. These articles were divided up among 20 reviewers for initial screening based on their relevance to the field of global EM. An additional two reviewers searched the grey literature. A total of 206 articles were deemed appropriate by at least one reviewer and approved by their editor for formal scoring of their overall quality and importance.

Results:  Of the 206 articles that met our predetermined inclusion criteria, 24 articles received scores of 17 or higher and were selected for formal summary and critique. Interrater reliability for our scoring system was good with an interclass correlation coefficient of 0.628 (95% confidence interval = 0.51 to 0.72).

Conclusions:  Compared to previous reviews, there was a significant increase in the number of articles that were devoted to emergency care in resource‐limited settings, with fewer articles related to disaster and humanitarian response. The majority of articles that met our selection criteria were reviews that examined the efficacy of particular treatment regimens for diseases that are primarily seen in low‐ and middle‐income countries.
The Changing Landscape of America’s Health Care System and the Value of Emergency Medicine
Authors: Sasson Comilla , Wiler Jennifer L. , Haukoos Jason S. , Sklar David , Kellermann Arthur L. , Beck Dennis , Urbina Chris , Heilpern Kathryn , Magid David J.
Published: September 2012

ACADEMIC EMERGENCY MEDICINE 2012; 19:1204–1211 © 2012 by the Society for Academic Emergency Medicine

The Patient Protection and Affordable Care Act (ACA), passed in 2010, has important implications for emergency physicians (EPs). In addition to dramatically reducing the number of uninsured in the United States, this comprehensive health care reform legislation seeks to curb the escalating costs of health care delivery, optimize resource utilization, eliminate waste, and improve the quality of service delivered by the health care system. At the annual Association of American Medical Colleges (AAMC) meeting on November 5, 2011, an expert panel from public health, emergency medicine, and health services research was convened by the Association of Academic Chairs of Emergency Medicine (AACEM) and the Society for Academic Emergency Medicine (SAEM) to discuss possible future models for the emergency care system and academic emergency medicine in the era of the ACA.
Renal cell carcinoma with inferior vena caval tumour thrombus: Surgical management and clinical outcomes at a low‐volume centre
Authors: Cheung Man‐Hung , Ho Kwan‐Lun , Chan See‐Ching , Ho Ka‐Lai , Tam Po‐Chor , Yiu Ming‐Kwong , Au Timmy W.K.
Published: September 2012

Aim

In the present study, we discuss the surgical management, complications and clinical outcomes of patients with renal cell carcinoma (RCC) extending into the inferior vena cava (IVC), who were treated with surgical resection at a teaching hospital from 1997 to 2011.

Patients and Methods

Twelve patients diagnosed with RCC and IVC tumour thrombus underwent radical nephrectomy and IVC tumour thrombectomy during the study period.

Results

Of the 12 patients (male : female: 1:1), the mean age was 65 years (range: 48–82 years). All had good premorbid performance status and no distant metastasis at the time of operation. Employing the Mayo Clinic classification, the tumour thrombus extension was level I in four cases (33 per cent), level II in four cases (33 per cent), level III in two cases (17 per cent) and level IV in two cases (17 per cent). In one patient, the renal tumour extended into the right atrium and had a solitary right pulmonary artery tumour embolus, which subsequently underwent a simultaneous right pulmonary artery tumour embolectomy. In our series, the mean blood loss in levels I–IV tumour thrombus were 1050 mL, 2075 mL, 4152 mL and 11 500 mL, respectively. Complications occurred in three cases (25 per cent), and one (8.3 per cent) required re‐laparotomy for haemostasis. There was no hospital mortality. The median follow up was 45.5 months (range: 6–125 months). Median disease‐free and overall survivals were 29 and 76 months, respectively. Five‐year disease‐free and overall survivals were 35.5 per cent and 62.5 per cent, respectively.

Conclusion

Radical nephrectomy and IVC tumour thrombectomy remain a challenging procedure. With detailed perioperative planning and multidisciplinary efforts, surgical resection is the definitive treatment of choice for patients with RCC and IVC tumour thrombus. The perioperative and survival outcomes of the present series were comparable to contemporary series.
Case report and a review of the literature of two patients with gastric MALToma and pulmonary metastasis
Authors: Chan Shannon Melissa , Chiu Philip W.Y. , Chan Anthony W.H. , Teoh Anthony Y.B. , Wong Simon K.H. , Ng Enders K.W.
Published: September 2012

Gastric mucosa‐associated lymphoid tissue lymphoma (or MALToma) is a relatively rare form of low‐grade B‐cell malignancy arising from the mucosal associated lymphoid tissue of the stomach. The majority of cases can be treated with Helicobacter pylori eradication with good prognosis. However, few reports have been published on the treatment of gastric MALToma with pulmonary metastasis. We report two such cases managed with systemic chemotherapy. At the time of writing, one of the cases was in static disease while the other had complete remission. In both patients, pulmonary metastases were detected upon staging thoracic computed tomography.
Endograft infection following emergency repair for abdominal aortic aneurysm dissection and the undervalued role of the bowel reservoir
Authors: Ferraresso Mariano , Nobili Paolo , Bortolani Ettore Maria
Published: September 2012

Endograft infection after emergency endovascular aortic repair (EVAR) procedure has received less attention than other complications, and usually occurs soon after endograft positioning. Consequently, clear guidelines for the prevention and treatment of endograft infection have yet to come. We report a case of an 85‐year‐old patient treated with an emergency EVAR procedure for a fissured abdominal aortic aneurysm, whose immediate follow up was complicated by a prolonged upper gastrointestinal occlusion. Six months, later he developed an endograft infection due to intestinal flora. After exclusion of all other possible causes, bacterial translocation from the bowel appeared the only plausible mechanism. This case highlights the importance of the gastrointestinal tract as a potential source of endograft infection, and suggests how a clinical condition representing potential reservoir of infection should be managed properly.
Neck and arm pain: Accessory nerve palsy revisited
Authors: Cheng Mina , Lam Ying‐Lee
Published: September 2012

Because of the underreporting and poor documentation of the complication of accessory nerve palsy, there are no local data on this, even after a thorough search through the computerized medical record system and hospital records. This is due to unawareness of the complication. Therefore, we suggest that every patient should be assessed after neck lymph node biopsy. This review aims to bring about awareness of iatrogenic accessory nerve injury and its consequences, so as to avoid delays in diagnosis and treatment.
Accessory middle turbinate accompanying a mucocele
Authors: Lee Dong‐Hoon , Joo Young‐Eun , Lim Sang‐Chul
Published: September 2012

Accessory middle turbinate is one of the rare anatomical variations of the nasal turbinate. To date, the accessory middle turbinate with an isolated pathological lesion has not been reported in the literature. A 62‐year‐old woman presented with the left‐sided nasal obstruction. An endoscopic examination showed a polypoid mass above the inferior turbinate. On magnetic resonance imaging, T2‐weighted imaging showed the cystic lesions of the left accessory middle turbinate and infratemporal fossa with isosignal intensity, compatible with accessory middle turbinate accompanying a mucocele. The patient underwent endoscopic sinus surgery, and the postoperative course was uneventful. In the present study, we report the first case of accessory middle turbinate accompanying a mucocele in a 62‐year‐old woman, and review the literature pertaining to this condition.
Surgical and endovascular treatment of thoracic aortic dissection combined with aberrant right subclavian artery aneurysm
Authors: Sun Nian‐Feng , Tian Ai‐Ling , Xu Li , Meng Qing‐Yi , Wang Rui‐Hua , Liu Zhao‐Xuan
Published: September 2012

Aortic dissection combined with aberrant right subclavian artery (ARSA) is very rare. The endovascular treatment of aortic dissection is less invasive than conventional open‐heart surgery because of lower surgical risk and faster recovery. In the present work, the origin of ARSA was dilated, and the aorta was also dissected down to the abdominal aorta. The aortic true lumen became narrow, but the visceral arteries had good perfusion. The patient was treated on the entry of dissection with endovascular isolation and adjunctive surgical bypass after controlling blood pressure for 2 weeks.
Surgeon‐performed intraoperative ultrasonography‐guided excision of nonpalpable breast masses with adequate surgical margins under local anaesthesia
Authors: Karadeniz Cakmak Guldeniz , Emre Ali U. , Tascilar Oge
Published: September 2012

Aim

With the improvement of expertise in technique and skills of ultrasonography (US), many surgeons now perform image‐guided procedures for breast masses themselves. To minimize operative time, and to achieve adequate surgical margins with an acceptable cosmetic outcome, we designed a safe and simple hybrid technique to excise suspicious nonpalpable masses, which is described herein for the first time.

Patients and Methods

Intraoperatively‐marked incision is performed, and a needle is advanced at a 0.5‐cm distance to the lesion according to real‐time ultrasound measurements. Four deep sutures are passed to fix and hang the predicted specimen adjacent to the needle in four directions. En bloc excision with aimed surgical margins of approximately 0.5 cm is achieved by means of retracting sutures, and confirmed by specimen and tumour bed US.

Results

In the present study, there were 25 women (17 with malignant and 8 with benign lesions), with a mean age of 50.88 years (range: 30–69) and mean tumour diameter of 10.6 mm (range: 6–15). All lesions were correctly identified and localized by intraoperative US, and free margins of excision were obtained in all malignant lesions by means of the presented technique. The combined operative technical approach with surgeon‐performed intraoperative US‐guided needle placement and retracting sutures were feasible, simple and beneficial. We achieved complete tumour removal in all dimensions with no reexcision. The procedure was performed under local anaesthesia in an outpatient fashion with no complications.

Conclusion

Our report of the operative technique demonstrates that a combination of surgeon‐performed image‐guided localizations, together with a suture‐oriented fashion to assure negative surgical margins in all dimensions, improves margin clearance rate at the time of first surgical intervention. This method can be performed with operative and cost efficiency, and might become a valuable tool to minimize operative time and yield minimal sacrifice of normal breast tissue with maximal cosmetic outcome.
Photoluminescence Investigations of the Near White Light Emitting Perovskite Ceramic SrZrO3:Dy3+ Prepared Via Gel‐Combustion Route
Authors: Gupta Santosh K. , Mohapatra Manoj , Natarajan Venkataraman , Godbole Shrikant V.
Published: September 2012

Trivalent dysprosium‐doped strontium zirconate perovskite (SrZrO3) phosphors were prepared by gel‐combustion synthesis using citric acid as fuel and ammonium nitrate as oxidizer. X‐ray diffraction patterns confirmed the formation of orthorhombic phase of SrZrO3 with minor impurity, which completely disappears at high temperature. The morphological investigation was carried out using scanning electron microscopy (SEM). Photoluminescence studies showed that no emission from the host is observed, indicating the efficient energy transfer from the ZrO32− group to Dy3+ ions. The emission line is purely because of f–f transitions of Dy3+. Moreover, these phosphors predominantly exhibit near white light emission, when excited by 229 nm UV light due to strong 4F9/2→6H13/2 transition at 577 nm (yellow), strong 4F9/2→6H15/2 transition at 482 nm (blue), and weak 4F9/2→6H9/2 transition at 677 nm (red). Enhancement in emission intensity was observed with increase in the annealing temperature of the phosphor. The CIE chromaticity coordinates of the SrZrO3:Dy3+ phosphors were observed to fall in the white light domain of the chromaticity diagram, which indicate that such fine tuning might be possible after varying the temperature of annealing.
Study of Antibacterial Activity of Metal Nanoparticle Absorbed Fly‐Ash based Ceramics
Authors: Sultana Parveen , Das Sukhen , Bhattacharya Alakananda , Basu Ruma , Nandy Papiya
Published: September 2012

The bactericidal action of silver nanoparticles has been observed by many researchers since few years. In this study, we have developed an antibacterial ceramics (ACs) by absorbing synthesized silver nanoparticles within the ceramic matrix developed by us from an abundantly available coal fly ash, an extremely hazardous by‐product of thermal power plants. Nanoparticles dispersions of different particle sizes were made absorbed in to the ceramic matrix to evaluate its bactericidal activity against both Staphylococcus aureus (Gram‐positive) and Escherichia coli (Gram‐negative) bacteria, taken as the model microorganisms. This study showed that the total bactericidal action of ACs depends on the size of absorbed nanoparticles and the content of nanoparticles in the dispersions within the ceramic matrix. ACs thus developed release very slowly a minute amount of nanoparticles and show strong and prolonged bactericidal activity against pathogenic strain of both types of bacteria. The concentration of prepared nanoparticles in dispersion and the concentration of released nanoparticles in aqueous medium from the absorbed ceramic matrix were measured using inductively coupled plasma spectrophotometer. The mechanism of the antibacterial action was also studied using transmission electron microscopy image analysis of the bacterial cross‐section of both types of bacteria.
Experimentalist governance: An introduction
Authors: Eckert Sandra , Börzel Tanja A.
Published: September 2012

This symposium critically engages with the volume Experimentalist Governance in the European Union: Towards a New Architecture (2010), edited by Charles F. Sabel and Jonathan Zeitlin. “Experimentalist Governance” (EG) opens up an original theoretical perspective on the emergent governance architecture of the EU and sheds new light on developments in key policy sectors. This symposium brings together a transatlantic group of distinguished political scientists and legal scholars to discuss the added value of EG as a concept for analysis, its theoretical underpinnings, empirical relevance, and normative implications, in terms of legitimacy. Contributors discuss EG from different disciplinary and theoretical perspectives, referring to a variety of empirical examples in the EU context and beyond. The symposium closes with a response from the authors to their critics. This collection of essays sheds new light on debates around the nature of the EU and democratic governance beyond the nation state.
Techniques for improving efficiency in the emergency department for patients with acute ischemic stroke
Authors: Jauch Edward C. , Holmstedt Christine , Nolte Justin
Published: September 2012

The past 15 years have witnessed significant strides in the management of acute stroke. The most significant advance, reperfusion therapy, has changed relatively little, but the integrated healthcare systems—stroke systems—established to effectively and safely administer stroke treatments have evolved greatly. Driving change is the understanding that “time is brain.” Data are compelling that the likelihood of improvement is directly tied to time of reperfusion. Regional stroke systems of care ensure patients arrive at the most appropriate stroke‐capable hospital in which intrahospital systems have been created to process the potential stroke patient as quickly as possible. The hospital‐based systems are comprised of prehospital care providers, emergency department physicians and nurses, stroke team members, and critical ancillary services such as neuroimaging and laboratory. Given their complexity, these systems of care require maintenance. Through teamwork and ownership of the process, more patients will be saved from potential death and long‐term disability.
A strategic plan to accelerate development of acute stroke treatments
Authors: Marler John R.
Published: September 2012

In order to reenergize acute stroke research and accelerate the development of new treatments, we need to transform the usual design and conduct of clinical trials to test for small but significant improvements in effectiveness, and treat patients as soon as possible after stroke onset when treatment effects are most detectable. This requires trials that include thousands of acute stroke patients. A plan to make these trials possible is proposed. There are four components: (1) free access to the electronic medical record; (2) a large stroke emergency network and clinical trial coordinating center connected in real time to hundreds of emergency departments; (3) a clinical trial technology development center; and (4) strategic leadership to raise funds, motivate clinicians to participate, and interact with politicians, insurers, legislators, and other national and international organizations working to advance the quality of stroke care.
Improving public education about stroke
Authors: Alberts Mark J.
Published: September 2012

Stroke is a common and serious disease. Most studies have shown that basic public knowledge about what a stroke is, symptoms of a stroke, and the proper reaction to a stroke is quite deficient. The fact that a stroke affects cognitive, communicative, and motor functions may partially explain the poor reaction to acute stroke symptoms. Several educational studies, using diverse formats and messaging paradigms, have been shown to positively affect public knowledge of stroke symptoms. Such efforts have often used mass media public education campaigns with an emphasis on recognizing symptoms of an acute stroke. Some have been able to demonstrate an increase in the chance of patients (or by‐standers) calling 911 and seeking emergency care. However, many programs were of brief duration, and their long‐term benefits are uncertain. Continual educational efforts will be needed to improve stroke knowledge and increase the percentage of patients who seek emergency care.
Temporary regression of locally invasive polypoid rhinosinusitis in a dog after photodynamic therapy
Authors: Osaki T , Takagi S , Hoshino Y , Aoki Y , Sunden Y , Ochiai K , Okumura M
Published: September 2012

A 5‐year‐old male cross‐breed dog with chronic rhinosinusitis was presented. Computed tomography (CT) revealed opacities consistent with soft tissue or fluid in the left nasal cavity and frontal sinus. A diagnosis of chronic rhinosinusitis with myxomatous polyps was based on the histology of biopsy samples, so prednisolone treatment was administered for 1 month. Although the clinical signs slightly improved, no changes were observed on the CT images. At 8 months after the initial presentation, the dog was treated with antivascular photodynamic therapy (PDT) using benzoporphyrin derivative monoacid ring A and, 11 days later, CT revealed remarkably decreased soft tissue opacity; the facial swelling and sneezing also resolved. Three additional sessions of PDT were performed at 114, 210, and 303 days after the first PDT because of recurrence of clinical signs. The disease was well controlled for approximately 10 months by antivascular PDT.
Enseignements de la réduction des retraites du deuxième pilier en Hongrie et en Pologne
Authors: Fultz Elaine
Published: September 2012

En 1997, la Hongrie et la Pologne ont été les premiers pays d'Europe centrale à privatiser partiellement leur système de retraite national en réorientant une partie des cotisations au régime de retraite public vers des comptes d'épargne‐retraite individuels gérés par le secteur privé. Puis, dans le sillage de la crise économique mondiale, elles ont l'une et l'autre réduit l'importance de ce deuxième pilier, la Hongrie en cessant de financer les comptes et en récupérant la majeure partie des sommes qui avaient été accumulées (en décembre 2010) et la Pologne en réduisant (en avril 2011) la part des cotisations affectée au deuxième pilier. Les raisons qui ont conduit à ce recul du deuxième pilier doivent être recherchées dans la manière dont il a été conçu en 1997, des aspects importants, liés au financement des comptes, aux caractéristiques des prestations privées et à l'encadrement des frais de gestion, n'ayant à l'époque pas été prévus. Dans les deux pays, les pouvoirs publics ont tenté de combler ces lacunes, mais avec un succès limité. La crise économique mondiale, en réduisant les rendements des investissements du deuxième pilier et en renchérissant le coût du crédit, a aggravé la situation. Comme le montre la conclusion, certaines questions restent ouvertes et la réponse qui leur sera apportée déterminera les incidences à long terme du recul du deuxième pilier.
Revenu de solidarité active (RSA) et incitations au retour à l'emploi en France
Authors: Anne Denis , L'Horty Yannick
Published: September 2012

Dans le présent article, nous utilisons un inventaire des transferts locaux et/ou extralégaux (ou droits connexes) dans 13 villes et agglomérations françaises pour mesurer, dans un premier temps, les gains du retour à l'emploi pour les bénéficiaires de prestations légales soumises à condition de ressources (Revenu minimum d'insertion — RMI — et Allocation de parent isolé — API) pour différents types de ménages avant 2009. Les réformes des prestations nationales et légales engagées durant les années 2000, en particulier les mesures relatives à la Prime pour l'emploi (PPE), un crédit d'impôt sur le revenu d'activité, n'ont pas permis de garantir qu'il soit toujours financièrement intéressant de retravailler pour les bénéficiaires de prestations soumises à condition de ressources. Dans la majorité des communes et pour la plupart des types de ménages, accepter un emploi à temps partiel en contrepartie du salaire minimum entraînait une diminution de revenu par rapport au fait de continuer de vivre de prestations sociales, et accepter un emploi à plein temps n'était pas toujours intéressant. Les effets des réformes ont été contrebalancés par l'impact d'autres mesures, comme l'octroi d'aides aux transports par de nombreux conseils régionaux, l'instauration de tarifs sociaux pour le téléphone et l'électricité et l'exonération de la redevance audiovisuelle. Dans un second temps, nous simulons les conséquences de l'introduction du Revenu de solidarité active (RSA), qui a remplacé le RMI en 2009, en tenant compte de l'incidence de la hausse des transferts nationaux et légaux sur les transferts locaux et/ou extralégaux. Nous observons que le RSA élimine, pour la quasi‐totalité des communes et des types de ménages, les facteurs qui avaient un effet financièrement dissuasif sur le retour à l'emploi. Nous montrons aussi que le taux marginal de prélèvement de 38 pour cent retenu par le gouvernement est très proche du taux maximal compatible avec un objectif d'incitation au retour à l'emploi.
Diminution du recours aux passerelles de substitution vers la retraite: données empiriques relevées dans le secteur de la santé néerlandais
Authors: Euwals Rob , van Vuren Annemiek , van Vuuren Daniel
Published: September 2012

Au cours des dernières décennies, les Pays‐Bas ont réformé à plusieurs reprises les régimes de retraite anticipée et l'assurance invalidité. Les réformes ont accru les mesures incitant les travailleurs âgés à continuer à travailler et diminué l'importance des «passerelles de substitution» menant à la retraite. Le présent article expose ces réformes en se fondant sur les données administratives du secteur de la santé et examine un certain nombre d'hypothèses concernant la participation des travailleurs âgés au marché du travail. Il parvient à deux conclusions principales: a) les réformes mises en place ont porté leurs fruits car le taux de participation des travailleurs âgés sur le marché du travail a augmenté et b) la notion de «passerelle de substitution» a perdu de sa pertinence depuis que l'assurance invalidité ne peut plus être utilisée comme un moyen de partir en préretraite. Il convient toutefois de rester prudent avant de pouvoir appliquer ces mesures à d'autres pays de l’OCDE, les résultats dépendant largement de la nature des institutions nationales.
Die Beschränkung der zweiten Rentensäule in Ungarn und Polen: Ein abschreckendes Beispiel
Authors: Fultz Elaine
Published: September 2012

Auszug

1997 waren Ungarn und Polen die ersten Länder in Mitteleuropa, die ihre nationalen Rentensysteme teilweise privatisierten, indem sie einen Teil der Beiträge zur staatlichen Rente auf privat verwaltete individuelle Anlagekonten leiteten. Nach der globalen Wirtschaftskrise beschränkten indes beide Regierungen die Systeme der zweiten Säule: Ungarn (im Dezember 2010) durch die Einstellung der Finanzierung dieser Konten und die Überführung der Guthaben der meisten Arbeitnehmer in den Staatshaushalt, Polen (im April 2011) durch die Verringerung der zur zweiten Säule umgeleiteten Beiträge. Die Faktoren, die Anlass zu dieser Beschränkung waren, werden bis auf die ursprüngliche Ausgestaltung der jeweiligen zweiten Säule im Jahr 1997 zurückverfolgt, bei der in beiden Fällen versäumt wurde, wichtige Fragen zur Finanzierung der Konten, zum Umfang der privaten Leistungen und zu den Gebühren für die private Anlageverwaltung zu regeln. Obwohl beide Regierungen versuchten, die fehlenden Gestaltungsregelungen während des Betriebs der zweiten Säule nachzuholen, waren die Ergebnisse beschränkt. Die globale Wirtschaftskrise verschärfte die Situation, weil sie die Anlagerenditen verringerte und die Fremdkapitalkosten erhöhte. In den Schlussfolgerungen wird auf einige offene Probleme eingegangen, deren Lösung für die langfristigen Auswirkungen der Beschränkung der zweiten Säule von Bedeutung sein wird.
Die Umverteilungswirkung von Sozialtransferprogrammen und Steuern: Verschiedene Länder im Vergleich
Authors: Wang Chen , Caminada Koen , Goudswaard Kees
Published: September 2012

Auszug 

Ziel dieses Artikels ist eine genaue Analyse der Umverteilungswirkung von sozialen Transferprogrammen und Steuern in 28 Mitgliedsstaaten der Organisation für wirtschaftliche Zusammenarbeit und Entwicklung durch eine Berechnung mit Daten, die aus der Datenbank der Mikrodaten der Luxembourg Income Study stammen. Wir kommen zum Ergebnis, dass in Sozialstaaten die Ungleichheit um durchschnittlich 35 Prozent reduziert wird. Sozialleistungen haben dabei eine viel größere Umverteilungswirkung als Steuern. Bei den Sozialprogrammen tragen die öffentlichen Renten am stärksten zur Verringerung der Einkommensungleichheit bei, wenn auch mit beträchtlichen Unterschieden von Land zu Land. Sozialhilfe, Invaliden‐ und Familienleistungen tragen in geringerem Ausmaß ebenfalls dazu bei, dass die Einkommensunterschiede kleiner werden.
Erwerbsunfähigkeitsrisiken: Der Fall Argentinien
Authors: Belliard Matías , Grushka Carlos , De Biase Marcelo
Published: September 2012

Auszug

Der vorliegende Artikel analysiert das Erwerbsunfähigkeitsrisiko für Arbeitnehmer, die Beiträge zum Argentinischen Integrierten System der sozialen Sicherheit (Sistema Integrado Previsional Argentino — SIPA) entrichten. Die verwendeten Verwaltungsunterlagen für 2000 bis 2006 ergaben, dass in diesem Zeitraum 1,46 von 1 000 Arbeitnehmern pro Jahr erwerbsunfähig wurden. Die Raten für das Erwerbsunfähigkeitsrisiko waren für Männer höher als für Frauen und nahmen für beide Geschlechter mit dem Alter zu. Die Werte für das Erwerbsunfähigkeitsrisiko wurden unter Berücksichtigung der Auswirkungen von Alter und Geschlecht auch nach Pathologie und System der sozialen Sicherheit aufgeschlüsselt.
Das RSA (Revenu de solidarité active) und Anreize zur Arbeitsaufnahme in Frankreich
Authors: Anne Denis , L'Horty Yannick
Published: September 2012

Auszug

Dieser Artikel untersucht anhand eines Katalogs lokaler und/oder nicht gesetzlich geregelter Sozialleistungen (Droits connexes) in 13 französischen Gemeinden zunächst die finanziellen Vorteile einer Rückkehr in das Erwerbsleben für Empfänger gesetzlich geregelter, bedarfsorientierter staatlicher Sozialleistungen (Revenu minimum d'insertion — RMI und Allocation parent isolé — API) vor 2009, gegliedert nach Haushaltstypen. Die Reformen der nationalen, gesetzlich geregelten Sozialleistungen während der 2000er‐Jahre, insbesondere der Beschäftigungsprämie (Prime pour l'emploi — PPE), konnten nicht sicherstellen, dass sich eine Arbeitsaufnahme für die Empfänger bedarfsorientierter Sozialleistungen in jedem Fall finanziell lohnte. In den meisten Städten war es für die meisten Haushalte ein finanzieller Verlust, eine mit dem Mindestlohn vergütete Teilzeitstelle anzunehmen, und selbst eine Vollzeitstelle lohnte sich finanziell nicht immer. Die Wirkung der Reformen wurde durch andere Maßnahmen wie die von vielen Regionalräten beschlossene Ermäßigung für den öffentlichen Nahverkehr, die Ausweitung von Sozialtarifen für Telefon und Elektrizität und die Befreiung von den Fernsehgebühren abgeschwächt. Daran anschließend präsentiert der Artikel Simulationen der Auswirkungen des Revenu de solidarité active (RSA), das im Jahr 2009 anstelle des RMI eingeführt wurde. Hierbei werden auch die Auswirkungen steigender nationaler, gesetzlich geregelter Sozialleistungen auf lokale und/oder nicht gesetzlich geregelte Sozialleistungen berücksichtigt. Es ist festzustellen, dass das RSA bei den meisten Haushaltstypen und Gemeinden die finanziellen Negativanreize einer Arbeitsaufnahme aufhebt. Der Artikel zeigt, dass der von der Regierung beschlossene Grenzsteuersatz von 38 Prozent sehr nah an der möglichen Obergrenze für einen lohnenden Wiedereinstieg in das Erwerbsleben liegt.
Geringere Nutzung alternativer Wege in den Ruhestand: Empirische Befunde aus dem niederländischen Gesundheitssektor
Authors: Euwals Rob , van Vuren Annemiek , van Vuuren Daniel
Published: September 2012

Auszug

In den Niederlanden wurden die Frührentensysteme und die Invalidenversicherung in den vergangenen Jahrzehnten mehreren Reformen unterzogen. Durch die Reformen wurde der Anreiz für ältere Arbeitnehmer, weiter beschäftigt zu bleiben, erhöht, und die Bedeutung „alternativer Wege“ in den Ruhestand ist zurückgegangen. Dieser Artikel gibt eine Übersicht über die Reformen und testet anhand von Verwaltungsdaten für Arbeitnehmer im Gesundheitssektor einige Hypothesen zur Erwerbsbeteiligung älterer Arbeitnehmer. Dabei ergeben sich zwei wichtige Befunde: i) Die niederländischen Reformen waren tatsächlich wirksam, da die Erwerbsquote älterer Arbeitnehmer zugenommen hat; und ii) das Konzept der „alternativen Wege“ ist weniger relevant geworden, da der Weg über die Invalidenversicherung als Austritt aus dem Erwerbsleben in einen vorzeitigen Ruhestand unterbunden wurde. Dennoch ist bei der Übertragung dieser Befunde aus den Niederlanden auf andere OECD‐Staaten Vorsicht geboten, da die Ergebnisse stark von den institutionellen Rahmenbedingungen der einzelnen Länder abhängen.
Topical Ranibizumab inhibits inflammatory corneal hem‐ and lymphangiogenesis
Authors: Bucher Franziska , Parthasarathy Anand , Bergua Antonio , Onderka Jasmine , Regenfuß Birgit , Cursiefen Claus , Bock Felix
Published: September 2012

Purpose:  Ranibizumab (Lucentis®) is a Fab‐Fragment of a recombinant, humanized, monoclonal VEGF (anti‐vascular endothelial growth factor) antibody. This study analyzed the ability of topical Ranibizumab to inhibit lymphangiogenesis in addition to hemangiogenesis after acute corneal inflammation in vivo. In addition, the effect of Ranibizumab on the proliferation of human lymphatic endothelial cells (LECs) and blood endothelial cells (BECs) in vitro was studied.

Methods:  The inhibitory effect of Ranibizumab on LECs and BECs was studied in vitro using a proliferation enzyme‐linked immunosorbent assay (ELISA) assay. To study the in vivo effects of Ranibizumab, the mouse model of suture induced inflammatory corneal neovascularization was used. Study mice received topical Ranibizumab as eye drops. After 1 week excised corneas were stained with LYVE‐1 and CD31. Hemangiogenesis and lymphangiogenesis were analyzed morphometrically by using a semiautomatic method based on the image analyzing program Cell^F.

Results:  An antiproliferative effect of Ranibizumab was seen in vitro on both human BECs and LECs with a significance of p < 0.0001 and p < 0.0004, respectively. In vivo experiments showed that topical application of Ranibizumab significantly inhibits both hemangiogenesis (p = 0.0026) and lymphangiogenesis (p = 0.0026) in the cornea.

Conclusion:  Ranibizumab is a potent inhibitor of inflammatory corneal hemangiogenesis and lymphangiogenesis in vivo with a direct inhibitory effect on both endothelial cell types in vitro. This study for the first time demonstrates an inhibitory effect of Ranibizumab on lymphatic vessels which could have a wider range of clinical applications.
Laparoscopic stomach‐partitioning gastrojejunostomy is an effective palliative procedure to improve quality of life in patients with malignant gastroduodenal outlet obstruction
Authors: Eguchi Hidetoshi , Yada Kazuhiro , Shibata Kohei , Matsumoto Toshifumi , Etoh Tsuyoshi , Yasuda Kazuhiro , Inomata Masafumi , Shiraishi Norio , Ohta Masayuki , Kitano Seigo
Published: September 2012

Introduction

A patient with gastroduodenal obstruction caused by an unresectable gastroduodenal or periampullary cancer cannot ingest food and/or liquid. The patient's quality of life rapidly deteriorates, resulting in a dismal prognosis. Stomach‐partitioning gastrojejunostomy has been previously reported, and here, we evaluate the laparoscopic procedure.

Methods

We performed laparoscopic stomach‐partitioning gastrojejunostomy in 18 patients with unresectable gastroduodenal or periampullary cancers. Data on operation time, blood loss, complications, and postoperative course were retrospectively collected.

Results

The mean operation time was 152 min, and conversion to open surgery was not required in any patients. Postoperative complications occurred in three patients (17%) and included cholangitis, anastomotic ulcer hemorrhage, and enterocolitis. The mean time to oral intake was 4.5 days, and the mean and median duration of oral intake were maintained for 133 and 88 days, respectively.

Conclusion

Laparoscopic stomach‐partitioning gastrojejunostomy is a safe and effective procedure that allows patients with gastroduodenal outlet obstruction to eat again and improve the quality of their remaining life.
Cannabinoid 1 receptor in fatty liver
Authors: Regnell Simon Eringsmark
Published: September 2012

The role of cannabinoids in fatty liver disease has been increasingly acknowledged in recent years, and it has been suggested that drugs targeting peripheral cannabinoid receptors could have therapeutic use. Development of such drugs would require a good understanding of the mechanisms of fat accumulation caused by cannabinoid receptor activation. This review describes in detail the enzymatic steps that lead from the stimulation of cannabinoid 1 receptor to steatosis. It identifies several signaling pathways that activate sterol regulatory element‐binding protein 1c (SREBP‐1c), the key transcription factor causing fatty liver. The downstream effects of SREBP‐1c leading to increased fatty acid synthesis and decreased fatty acid oxidation are also described.
Enhanced protocol for CD14+ cell enrichment from equine peripheral blood via anti‐human CD14 mAb and automated magnetic activated cell sorting
Authors: DURÁN M. C. , WILLENBROCK S. , CARLSON R. , FEIGE K. , NOLTE I. , ESCOBAR H. MURUA
Published: September 2012

Reasons for performing study: CD14 positive (CD14+) cells are the precursor cells of monocyte‐derived dendritic cells (DCs). In horses their potent antigen‐presenting capacity and ability to induce an effective immune response classify these cells suitable for several therapeutic approaches such as for equine sarcoid. However, in horses, the generation efficiency of DCs from adherent peripheral blood mononuclear cells (PBMCs) is currently still poor.

Objectives: Establishment of a simple short protocol to enhance DC generation in horses by using a human CD14 monoclonal antibody (mAb) and an automated magnetic activated cell sorting (MACS) system.

Methods: Peripheral blood mononuclear cells were isolated from fresh heparinised blood samples of 3 horses and primarily stained for flow cytometric analysis (FACS) with a mAb against human CD14 as well as a secondary phycoerythrin (PE) conjugated antibody to determine the initial percentage of CD14 cells in the sample. Peripheral blood mononuclear cells were used for automated MACS using the same primary and secondary antibodies and analysed by FACS. CD14+ selected cells were cultured for 4 days adding granulocyte‐macrophage colony‐stimulating factor (GM‐CSF) and interleukin‐4 (IL‐4) to the culture media. Dendritic cell generation was assessed analysing cell morphology and surface marker expression (hCD83, hCD86, eqMHCII).

Results: Prior to selection, the mean percentage of CD14+ cells in the total cell population was 5.5%, further gaiting of this cell population resulted in 78.46% CD14+ monocytes. After our positive selection the mean percentage of CD14+ cells in the population was 98% without affecting viability. After culture, DC yield was 2‐fold higher than in previous published outcomes.

Conclusions: The additional CD14 cell separation step after PBMC isolation significantly amplified the number of CD14+ cells, increasing the number of generated DCs.

Potential relevance: The number of DCs available is critical for further use of these cells and the herein described protocol will therefore help to improved DC generation for therapeutic approaches in horses.
A randomised, blinded, crossover study to assess the efficacy of a feed supplement in alleviating the clinical signs of headshaking in 32 horses
Authors: Talbot W. A. , Pinchbeck G. L. , Knottenbelt D. C. , Graham H. , Mckane S. A.
Published: September 2012

Reasons for performing study:Feed supplements are commonly used by owners to alleviate headshaking; however, randomised, controlled trials are required to assess their efficacy.

Objective:To determine the efficacy of a feed supplement for alleviation of the clinical signs of headshaking using a randomised, blinded, placebo‐controlled trial.

Methods:Using a crossover design, 44 horses previously diagnosed with chronic idiopathic headshaking received both the supplement and a matching placeboper osfor 28 days with a washout period between of 14 days. Video recordings were taken at rest and exercise prior to the study and at the end of both periods of treatment. The degree of headshaking was assessed in a blinded, randomised manner by 2 veterinary surgeons. At the same time points, owners completed a questionnaire to assess the severity of headshaking signs. A Wilcoxon signed rank test was used to compare the scores while on supplement and placebo.

Results:Using the video assessments, there was no significant difference between scores while on supplement compared with placebo (P = 0.7). Using the questionnaire responses, there was no significant difference between scores for any activity when the placebo and the supplement were compared with each other. However, owners reported significant improvement during all activities for both placebo and supplement compared with pretreatment scores.

Conclusions and potential relevance:The supplement offered no benefit over a placebo in alleviating the clinical signs of headshaking. There appeared to be a significant proxy placebo effect when the outcome was based on subjective owner perception of clinical signs. This study demonstrated no beneficial effect of this supplement on the clinical signs of headshaking. The study did show a significant placebo effect, thereby highlighting the necessity of properly conducted, randomised controlled trials, with blinding, to assess true treatment effects in trials in animals.
Systemic family psychotherapy inChina: A qualitative analysis of therapy process
Authors: Liu Liang , Miller John K. , Zhao Xudong , Ma Xiquan , Wang Jikun , Li Wentian
Published: September 2012

Objectives

Although the procedure of systemic family therapy has been extensively researched in Western culture, few studies on this subject have been conducted inChina. The aim of this study was to specify the therapy‐delivered interventions inChinese systemic family therapy and to explore how Western‐imported systemic therapy model is delivered inChinese culture.

Design

A qualitative and exploratory research approach was taken in which thematic analysis was used to analyse the transcribed psychotherapy videotapes withChinese families.

Methods

Twenty‐six hours of video‐recorded systemic family therapy sessions from 14Chinese family cases were sampled. Thematic analysis was used to analyse the transcriptions of therapy sessions and identify therapist‐generated interventions in therapy. Frequencies of different interventions were counted, and correspondence analysis (CA) was used to reveal the corresponding relationships between different interventions.

Results

Analysis led to two main themes related to therapists‐delivered interventions:Therapist's intentionandtherapy technique. Results revealed 15 types oftherapist's intentionsand 16 categories oftherapy techniques.CAindicated that therapists’ intentions changed across different therapy stages and specific techniques were used to achieve corresponding intentions.

Conclusions

Interventions delivered inChinese systemic therapy are mainly adherent withMilan and post‐Milan systemic models. Due to the shortage in systemic therapy service inChina andChinese culture advocating reverence to authority, components of psycho‐education, guidance, and metaphor are adopted inChinese systemic practice. Some directions for future research are suggested.
New insights into the control of neurotrophic growth factor receptor signaling: Implications for nervous system development and repair
Authors: Alsina Fernando C. , Ledda Fernanda , Paratcha Gustavo
Published: September 2012

Neurotrophic growth factors control neuronal development by activating specific receptor tyrosine kinase positive signaling pathways, such as Ras‐MAPK and PI3K‐Akt cascades. Once activated, neurotrophic factor receptors also trigger a cascade of molecular events, named negative receptor signaling, that restricts the intensity of the positive signals and modulates cellular behavior. Thus, to avoid signaling errors that ultimately could lead to aberrant neuronal physiology and disease, negative signaling mechanisms have evolved to ensure that suitable thresholds of neuronal stimulation are achieved and maintained during right periods of time. Recent findings have revealed that neurotrophic factor receptor signaling is tightly modulated through the coordinated action of many different protein regulators that limit or potentiate signal propagation in spatially and temporally controlled manners, acting at specific points after receptor engagement. In this review, we discuss progress in this field, highlighting the importance of these modulators in axonal growth, guidance, neural connectivity, and nervous system regeneration.
Regulon controlled by the GppX hybrid two component system in Porphyromonas gingivalis
Authors: Hirano T. , Beck D.A.C. , Wright C.J. , Demuth D.R. , Hackett M. , Lamont R.J.
Published: September 2012

The periodontal pathogen Porphyromonas gingivalis experiences a number of environmental conditions in the oral cavity, and must monitor and respond to a variety of environmental cues. However, the organism possesses only five full two‐component systems, one of which is the hybrid system GppX. To investigate the regulon controlled by GppX we performed RNA‐Seq on a ΔGppX mutant. Fifty‐three genes were upregulated and 37 genes were downregulated in the ΔGppX mutant. Pathway analyses revealed no systemic function for GppX under nutrient‐replete conditions; however, over 40% of the differentially abundant genes were annotated as encoding hypothetical proteins indicating a novel role for GppX. Abundance of small RNA was, in general, not affected by the absence of GppX. To further define the role of GppX with respect to regulation of a hypothetical protein observed with the greatest significant relative abundance change relative to a wild‐type control, PGN_0151, we constructed a series of strains in which the ΔgppX mutation was complemented with a GppX protein containing specific domain and phosphotransfer mutations. The transmembrane domains, the DNA‐binding domain and the phosphotransfer residues were all required for regulation of PGN_0151. In addition, binding of GppX to the PGN_0151 promoter regions was confirmed by an electrophoretic mobility shift assay. Both the ΔGppX mutant and a ΔPGN_0151 mutant were deficient in monospecies biofilm formation, suggesting a role for the GppX‐PGN_0151 regulon in colonization and survival of the organism.
Silencing of tomato RBOH1 and MPK2 abolishes brassinosteroid‐induced H2O2 generation and stress tolerance
Authors: NIE WEN‐FENG , WANG MENG‐MENG , XIA XIAO‐JIAN , ZHOU YAN‐HONG , SHI KAI , CHEN ZHIXIANG , YU JING QUAN
Published: September 2012

Brassinosteroids (BRs) are involved in the regulation of plant growth, development and stress responses. While the signalling pathways for BR‐regulated plant growth and development are well studied, the mechanisms by which BRs regulate plant stress tolerance remain largely unclear. Here we showed that 24‐epibrassinolide (EBR), which induced tolerance to oxidative and heat stress in tomato, was also capable of elevating the transcript levels of RBOH1, MPK1 and MPK2, increasing apoplastic H2O2 accumulation, and enhancing activation of MPK1/2. Virus‐induced gene silencing of RBOH1, MPK1, MPK2 and MPK1/2 resulted in reduced stress tolerance. Silencing of RBOH1 had no effect on the transcripts of MPK1 and MPK2 but inhibited MPK1/2 activation and H2O2 accumulation. Silencing of either MPK1 or MPK2, on the other hand, reduced RBOH1 transcript, H2O2 accumulation and MPK1/2 activity. BR‐induced tolerance and MPK1/2 activation were compromised in RBOH1‐, MPK2‐ and MPK1/2‐silenced plants but not in MPK1‐silenced plants. These results suggested that MPK2 played a more critical role than MPK1 in EBR‐induced apoplastic H2O2 accumulation. RBOH1, MPK1 and MPK2 were involved in the stress tolerance and BR‐induced stress tolerance likely involved a positive feedback loop among RBOH1, H2O2 and MPK2, leading to sustained apoplastic accumulation of H2O2 and related signalling processes.