bluuebunny/crossref_metadata_2025 huggingface dataset:
A Blood Pressure Genetic Risk Score Is a Significant Predictor of Incident Cardiovascular Events in 32 669 Individuals
Authors: Havulinna Aki S. , Kettunen Johannes , Ukkola Olavi , Osmond Clive , Eriksson Johan G. , Kesäniemi Y. Antero , Jula Antti , Peltonen Leena , Kontula Kimmo , Salomaa Veikko , Newton-Cheh Christopher
Published: March 2013

Recent genome-wide association studies have identified genetic variants associated with blood pressure (BP). We investigated whether genetic risk scores (GRSs) constructed of these variants would predict incident cardiovascular disease (CVD) events. We genotyped 32 common single nucleotide polymorphisms in several Finnish cohorts, with up to 32 669 individuals after exclusion of prevalent CVD cases. The median follow-up was 9.8 years, during which 2295 incident CVD events occurred. We created GRSs separately for systolic BP and diastolic BP by multiplying the risk allele count of each single nucleotide polymorphism by the effect size estimated in published genome-wide association studies. We performed Cox regression analyses with and without adjustment for clinical factors, including BP at baseline in each cohort. The results were combined by inverse variance–weighted fixed-effects meta-analysis. The GRSs were strongly associated with systolic BP and diastolic BP, and baseline hypertension (all
P
<10
−62
). Hazard ratios comparing the highest quintiles of systolic BP and diastolic BP GRSs with the lowest quintiles after adjustment for age, age squared, and sex were 1.25 (1.07–1.46;
P
=0.006) and 1.23 (1.05–1.43;
P
=0.01), respectively, for incident coronary heart disease; 1.24 (1.01–1.53;
P
=0.04) and 1.35 (1.09–1.66;
P
=0.005), respectively, for incident stroke; and 1.23 (1.08–1.40;
P
=2×10
−6
) and 1.26 (1.11–1.44;
P
=5×10
−4
), respectively, for composite CVD. In conclusion, BP findings from genome-wide association studies are strongly replicated. GRSs comprising bona fide BP-single nucleotide polymorphisms predicted CVD risk, consistent with a lifelong effect on BP of these variants collectively.
A Sucker Punch of Horror: The Oyoun Theatre's Gaza Mono-Logues
Authors: Jannarone Kimberly
Published: March 2013

The Oyoun Theatre brought their performance of The Gaza Mono-logues from Gaza to Haifa for the RS/PS: Richard Schechner and Performance Studies conference, hosted by the University of Haifa. They were part of the larger Gaza Mono-Logues project, conceived by the Ashtar Theatre in Ramallah, which commissioned 33 first-person pieces written by children about their experiences during the three-week-long 2008 war in Gaza.
Just-in-Time: Performance and the Aesthetics of Precarity
Authors: Jackson Shannon
Published: March 2013

Integrating post-Operaismo social theory with recent turns in performance studies shows how such theory complicates and is complicated by cross-arts questions around virtuosity and affective labor. Such complications emerge, not only in the contemporary art sphere, but also in the history and theory developed by performance studies as a discipline.
Occupational Realism
Authors: Bryan-Wilson Julia
Published: March 2013

Since the 1970s, some artists have self-consciously inhabited their workaday jobs as art; this “occupational realism” invokes questions about the performance of labor and the value of art-making. What does it mean to be (emotionally, physically, mentally) “occupied” by one's work? And what does it mean to “occupy” labor as a strategic artistic operation?
It Seems As If…I Am Dead: Zombie Capitalism and Theatrical Labor
Authors: Schneider Rebecca
Published: March 2013

Reading the zombie marches of the Occupy Wall Street movement beside a 2011 production of Ibsen's play John Gabriel Borkman raises questions about theatrical labor in neoliberal capitalism. What happens when “dead labor” plays live onstage? Or when live protest actions are played across the living dead? Perhaps the answers can be found in considering economic precarity and precarity in/as performance together.
Performance and Cross-Racial Storytelling in Post-Katrina New Orleans: Interviews with John O'Neal, Carol Bebelle, and Nicholas Slie
Authors: Michna Catherine
Published: March 2013

Interviews with three leading community-engaged theatre makers in New Orleans underscore why practices of public storytelling became crucial to the work of artists in New Orleans after Hurricane Katrina. Connecting their work to New Orleans' heritage of African American neighborhood-based cultural performance traditions, O'Neal, Bebelle, and Slie emphasize the importance of cross-racial and cross-generational collaboration for generating theatre practices that are part of a collective struggle for pluralistic, democratic social change.
Re-membering the Tribe: Networks of Recovery in Rex Nettleford's Katrina
Authors: Cahill-Booth Lara
Published: March 2013

Rex Nettleford's Katrina, performed by Jamaica's National Dance Theatre Company, projects both the un/natural disaster that befell North America's Gulf Coast in 2005 and the ways in which the Greater Caribbean has transformed experiences of bondage, marginalization, and suffering into a culturally affirmative creative impulse.
Dashing at a Nightmare: Haunting Macbeth in Sleep No More
Authors: Koumarianos Myrto , Silver Cassandra
Published: March 2013

What happens when hundreds of sweaty, masked bodies run through a warehouse in Chelsea? Punchdrunk's massive commercial success, an adaptation of Shakespeare's Macbeth, is a giddy and sometimes gaudy spectatorial treat that pushes the limits of participatory theatre.
Resolving an enigma by integrative taxonomy: Madagascarophis fuchsi (Serpentes: Lamprophiidae), a new opisthoglyphous and microendemic snake from northern Madagascar
Authors: GLAW FRANK , KUCHARZEWSKI CHRISTOPH , KÖHLER JÖRN , VENCES MIGUEL , NAGY ZOLTÁN T.
Published: March 2013

Herpetological surveys in the dry forests of the limestone massif Montagne des Français in the far north of Madagascarhave recently yielded a number of undescribed reptile species. Here we describe an additional new and potentially microendemic species of the snake genus Madagascarophis (Squamata: Serpentes: Pseudoxyrhophiinae) which lives in this massif syntopically with M. colubrinus septentrionalis and differs distinctly from M. colubrinus and M. meridionalis in its mitochondrial and nuclear DNA sequences. Morphologically Madagascarophis fuchsi sp. nov. is characterized by a broad contact between the posterior inframaxillaries (genials), 25 dorsal scale rows at midbody, and a low number of ventrals (171–172). We re-describe the holotype of M. ocellatus and present new data on the morphological variation of the northern subspecies M. c. septentrionalis and M. c. citrinus. Although Montagne des Français has recently been included into the network of nature reserves inMadagascar, continuous deforestation is strongly threatening this important center of reptile endemism. In line with the assessment of other microendemic reptiles of this massif we suggest to consider the new species as Critically Endangered according to the IUCN criteria and encourage new efforts to protect this area more efficiently
On the Fluctuating Buoyancy Fluxes Simulated in a OGCM
Authors: Li Hongmei , Storch Jin-Song von
Published: March 2013

Subgrid-scale fluctuations with zero means have generally been neglected in ocean modeling, despite their potential role in affecting the oceanic state following Hasselmann's seminal paper on stochastic climate models and series of studies conducted thereafter. When representing effects of these fluctuations in a stochastic parameterization, knowledge of basic properties of these fluctuations is essential. Here, the authors quantify these properties using hourly output of a simulation performed with a global OGCM. This study found that fluctuating buoyancy fluxes are strong in the sense that their strengths are up to one order of magnitude larger than the magnitudes of the respective mean eddy fluxes and that the fluctuations originate not only from mesoscale eddies and tropical instability waves but also from near-inertial waves, especially in the low- and midlatitude oceans. It is this wave contribution that makes the basic properties of fluctuations distinctly different from those expected from mesoscale eddies. The geographical distribution of fluctuation intensity differs from that of mesoscale eddy activity and is strongest in the low- and midlatitude oceans complemented by additional and secondary maxima in the Gulf Stream, the Kuroshio, and the Southern Ocean. The seasonality in most of the low- and midlatitude oceans, characterized by stronger fluctuations in winter than in summer, is just the opposite of that of mesoscale eddies. In the tropical oceans, the correlation length scales reach 500 km in the zonal direction but only about 30–40 km in the meridional direction, reflecting near-inertial waves with nearly zonally oriented wavecrests. Overall, these results provide an important basis for stochastically describing the effects of subgrid-scale fluctuations.
An Intercomparison of Acoustic Current Meter Measurements in Low to Moderate Flow Regions
Authors: Drozdowski Adam , Greenan Blair J. W.
Published: March 2013

Instrumented, subsurface moorings deployed in the Scotian shelf and slope regions of the North Atlantic provide data in low to moderate flows for a current meter intercomparison. The primary instruments being evaluated are two acoustic Doppler single-point current meters, the Aanderaa Seaguard (SG) and the Teledyne RD Instruments (RDI) Doppler volume sampler (DVS), which are compared against older-generation single-point current meters and acoustic Doppler current profilers. Analysis showed that the root-mean-square (RMS) of the speed difference between concurrent instrument combinations was in the range of 1.0–1.6 cm s−1, which is about 3%–6% of the upper limit of speeds observed at these sites. Best agreement was between the DVS and the nearby Seaguard (RMS speed difference of 1.2 cm s−1), during the shelf deployment, and between the Aanderaa recording current meter 11 (RCM11) and the nearby Seaguard (1.0 cm s−1), during the slope deployment. Speed differences larger than 4 cm s−1 were uncommon, occurring less than 1.5% of the time. Slight overspeeding of one of the Seaguards is traced to an intentional alteration in the instruments' sampling strategy. The DVS compass had a slight meandering tendency that caused it to routinely disagree with other instruments by as much as 15° for hours at a time. The disagreement was random in direction and had no impact on most of the comparisons, but it did produce a 15% smaller magnitude of mean current. Subsequent to this field test, Teledyne RDI redesigned the DVS and replaced the compass with a new sensor.
Environmental Flow Impacts on Tropical Cyclone Structure Diagnosed from Airborne Doppler Radar Composites
Authors: Reasor Paul D. , Rogers Robert , Lorsolo Sylvie
Published: March 2013

Following a recent demonstration of multicase compositing of axisymmetric tropical cyclone (TC) structure derived from airborne Doppler radar measurements, the authors extend the analysis to the asymmetric structure using an unprecedented database from 75 TC flights. In particular, they examine the precipitation and kinematic asymmetry forced by the TC's motion and interaction with vertical wind shear. For the first time they quantify the average magnitude and phase of the three-dimensional shear-relative kinematic asymmetry of observed TCs through a composite approach. The composite analysis confirms principal features of the shear-relative TC asymmetry documented in prior numerical and observational studies (e.g., downshear tilt, downshear-right convective initiation, and a downshear-left precipitation maximum). The statistical significance of the composite shear-relative structure is demonstrated through a stratification of cases by shear magnitude. The impact of storm motion on eyewall convective asymmetry appears to be secondary to the much greater constraint placed by vertical wind shear on the organization of convection, in agreement with prior studies using lightning and precipitation data.
Influence of Mesonet Observations on the Accuracy of Surface Analyses Generated by an Ensemble Kalman Filter
Authors: Knopfmeier Kent H. , Stensrud David J.
Published: March 2013

The expansion of surface mesoscale networks (mesonets) across the United States provides a high-resolution observational dataset for meteorological analysis and prediction. To clarify the impact of mesonet data on the accuracy of surface analyses, 2-m temperature, 2-m dewpoint, and 10-m wind analyses for 2-week periods during the warm and cold seasons produced through an ensemble Kalman filter (EnKF) approach are compared to surface analyses created by the Real-Time Mesoscale Analysis (RTMA). Results show in general a similarity between the EnKF analyses and the RTMA, with the EnKF exhibiting a smoother appearance with less small-scale variability. Root-mean-square (RMS) innovations are generally lower for temperature and dewpoint from the RTMA, implying a closer fit to the observations. Kinetic energy spectra computed from the two analyses reveal that the EnKF analysis spectra match more closely to the spectra computed from observations and numerical models in earlier studies. Data-denial experiments using the EnKF completed for the first week of the warm and cold seasons, as well as for two periods characterized by high mesoscale variability within the experimental domain, show that mesonet data removal imparts only minimal degradation to the analyses. This is because of the localized background covariances computed for the four surface variables having spatial scales much larger than the average spacing of mesonet stations. Results show that removing 75% of the mesonet observations has only minimal influence on the analysis.
I Am What I Am, by Looking Past the Present
Authors: Van der Werff Ellen , Steg Linda , Keizer Kees
Published: March 2013

A strong environmental self-identity increases the likelihood of a wide range of proenvironmental actions. But which factors influence identity and can we strengthen it? We propose that the environmental self-identity depends on biospheric values and on past behavior and that the strength of one’s environmental self-identity can be changed somewhat by reminding people of their past environmental behavior. We tested our model in a series of studies and show that biospheric values and past environmental behavior influence the environmental self-identity, which is in turn related to subsequent environmental judgments and intentions. Furthermore, we found that although the strength of the environmental self-identity changed when we reminded people of their past environmental actions, biospheric values remained an important predictor of self-identity, suggesting that the environmental self-identity has a stable core. Our results further suggest that environmental-friendly behavior can be promoted by reminding people of their past proenvironmental actions as this will strengthen one’s environmental self-identity.
Does Elastic Resistance Affect Finger Pinch Discrimination?
Authors: Han Jia , Waddington Gordon , Anson Judith , Adams Roger
Published: March 2013

Objective:

The sensitivity of pinch movement discrimination between the thumb and index finger was assessed with and without elastic resistance.

Background:

Researchers have examined the effect of elastic resistance on control of single upper-limb movements; however, no one has explored how elastic resistance affects proprioceptive acuity when using two digits simultaneously in a coordinated movement.

Method:

For this study, 16 right-handed, healthy young adults undertook an active finger pinch movement discrimination test for the right and left hands, with and without elastic resistance. We manipulated pinch movement distance by varying the size of the object that created the physical stop to end the pinch action.

Results:

Adding elastic resistance from a spring to the thumb–index finger pinch task did not affect accuracy of pinch discrimination measured as either the just noticeable difference, F(1, 15) = 1.78, p = .20, or area under the curve, F(1, 15) = 0.07, p = .80.

Conclusion:

Having elastic resistance to generate lever return in pincers, tweezers, and surgical equipment or in virtual instruments is unlikely to affect pinch movement discrimination.

Application:

Elastic resistance did not affect finger pinch discrimination in the present study, suggesting that return tension on equipment lever arms has a practical but not perceptual function. An active finger pinch movement discrimination task, with or without elastic resistance, could be used for hand proprioceptive training and as a screening tool to identify those with aptitude or decrements in fine finger movement control.
Domestic legal traditions and states’ human rights practices
Authors: Mitchell Sara McLaughlin , Ring Jonathan J , Spellman Mary K
Published: March 2013

Empirical analyses of domestic legal traditions in the social science literature demonstrate that common law states have better economic freedoms, stronger investor protection, more developed capital markets, and better property rights protection than states with civil law, Islamic law, or mixed legal traditions. This article expands upon the literature by examining the relationship between domestic legal traditions and human rights practices. The primary hypothesis is that common law states have better human rights practices on average than civil law, Islamic law, or mixed law states because the procedural features of common law such as the adversarial trial system, the reliance on oral argumentation, and stare decisis result in greater judicial independence and protection of individual rights in these legal systems. We also examine how the quality of a state’s legal system influences repression focusing on colonial legacy, judicial independence, and the rule of law. A global cross-national analysis of state-years from 1976 to 2006 shows that states with common law traditions engage in better human rights practices than states with other legal systems. This result holds when controlling for the quality of the legal system and standard explanations for states’ human rights practices (economic growth, regime type, population size, military regime, and war involvement).
Stopping the legal flow of weapons
Authors: Erickson Jennifer L
Published: March 2013

This article examines sending state compliance with arms embargoes. Arms embargoes are one of the most frequently used types of economic sanctions but they are perceived as one of the least effective. One major problem with arms embargoes, many argue, is sending states’ failure to implement them. Yet studies tend to focus on cases of arms embargo violations, not compliance in the context of arms export practice more broadly. Using a series of new arms embargo variables, I conduct a statistical analysis of the relationship between arms embargoes and small and major conventional arms transfers from 1981 to 2004. Contrary to popular expectations, I find that arms embargoes on average restrain sending states’ arms exports. If arms embargoes do indeed have difficulty changing targets’ behavior, or achieving other measures of ‘success’, additional explanations must also be considered. I suggest that arms embargo target selection and the intractable challenge of cutting off illicit arms flows are two important plausible alternatives. This finding also provides optimism for compliance with international commitments in the absence of institutionalized enforcement mechanisms. Major exporters overall appear to implement sanctions, despite strong economic incentives to ignore them and a lack of formal accountability mechanisms to punish violators.
The Influence of Green Building Certification Schemes on Real Estate Investor Behaviour: Evidence from Singapore
Authors: Heinzle Stefanie Lena , Boey Ying Yip Augustin , Low Yu Xing Melissa
Published: March 2013

Based on an adaptive choice-based conjoint analysis, the aim of this paper is to ascertain the extent to which various characteristics of a condominium unit, and in particular the Building and Construction Authority (BCA) Green Mark Scheme, influence prospective real estate investors’ preferences for condominium units in Singapore. Through the analysis, this study determines that premium buyers would be willing to pay for property certified by the Green Mark Scheme. The results suggest that the price premium buyers would be willing to pay for green certification varies within the different levels of the Green Mark Scheme, ranging from 3.78 per cent for the Certified award to 7.98 per cent for the Platinum award. The results thus suggest a strong business case for developers of green buildings.
From Short-term Mission to Global Discipleship: A Peruvian Case Study
Authors: Farrell B. Hunter
Published: March 2013

This article is a case study of how short-term missions in Peru were transformed into long-term involvement in a way that contributed to the transformation of the host community, the missioners, and their understanding of God’s mission. A complex environmental conflict in a highly polluted city in the Andes Mountains provided the context where a Christian mission network engaged more than 90 U.S. and 40 Peruvian Christians to transform short-term missions into a platform for long-term engagement and peaceful change.
Decentralized global output feedback stabilization for a class of uncertain nonlinear systems
Authors: Ai Wei-qing , Zhai Jun-yong , Fei Shu-min , Zha Wen-ting
Published: March 2013

This paper considers the problem of decentralized global stabilization via output feedback for a class of uncertain nonlinear systems with unknown output functions, in which the nonlinear terms are interconnected by unmeasurable states and the inputs of each subsystem. First, we design the controller for each nominal subsystem without the perturbing nonlinearities. Then, we apply the homogeneous domination approach to design scaled homogeneous observers and controllers with an appropriate choice of gain to render the nonlinear system globally asymptotically stable. Finally, two simulation examples are shown to illustrate the effectiveness of the proposed scheme.
Beauty From Within
Authors: Wæraas Arild
Published: March 2013

While much of our knowledge about public sector values is generated from surveys of public managers, this study explores the official core value statements of 75 U.S. government agencies. These values represent the characteristics with which the agencies want to be associated, rather than the values that guide the administrative behavior and decision making of public officials. A key finding in this study is that values that have been set as standards in many OECD countries, and reiterated in ethical guidelines for the U.S. federal government, are not among the most frequently stated on agency web sites. In light of these findings, the study discusses the role of public sector values in relation to agency identity and image.
Return to Competitive Sports After Medial Epicondyle Fractures in Adolescent Athletes
Authors: Lawrence J. Todd R. , Patel Neeraj M. , Macknin Jonathan , Flynn John M. , Cameron Danielle , Wolfgruber Hayley C. , Ganley Theodore J.
Published: March 2013

Background:

The optimal treatment of medial epicondyle fractures in pediatric athletes remains unclear.

Purpose:

To evaluate the outcomes of operative and nonoperative management of medial epicondyle fractures in young athletes.

Study Design:

Case series; Level of evidence, 4.

Methods:

The records of all children with fractures of the medial epicondyle over a 5-year period, with a minimum 2 years of follow-up at a pediatric tertiary referral center, were reviewed. Patients with intra-articular entrapment of the fracture fragment or ulnar nerve entrapment were excluded. Treatment decisions were made primarily based on injury mechanism and elbow laxity or instability. Patients were contacted and asked to complete a modified Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire.

Results:

Complete data with 2-year follow-up were available for 20 athletes: 6 treated nonoperatively and 14 treated operatively. At the latest follow-up, both groups achieved excellent DASH scores. Half of each cohort required physical therapy, and 6 of 14 patients who received operative treatment reported numbness. All patients were either very or completely satisfied with their treatment. Fourteen patients were overhead athletes (8 treated operatively, 6 nonoperatively). Excellent DASH scores were achieved in both groups, and all overhead athletes were able to return to their sport at the next appropriate level. Seven patients were baseball pitchers and sustained a fracture while throwing (4 treated operatively, 3 nonoperatively). None felt their performance was limited after treatment, and excellent DASH scores were achieved in both groups.

Conclusion:

These data demonstrate that nonoperative treatment can be successful in young athletes with low-energy medial epicondyle avulsions, a stable elbow, and minimal fracture displacement. Surgical management can be successful in athletes who sustain more significant trauma, who have elbow laxity or instability, or who have significant fracture fragment displacement after a fracture of the medial epicondyle.
Acknowledged Versus Unacknowledged Sexual Assault Among College Women
Authors: Cleere Colleen , Lynn Steven Jay
Published: March 2013

Research suggests that many sexually victimized women do not acknowledge their unwanted sexual experiences as assaults. The majority of the research on this topic has focused on rape acknowledgment; however, this pattern holds true for other forms of sexual assault as well. The present study examined differences among university women with acknowledged, unacknowledged, and no histories of sexual assault. Relevant groups were compared in terms of current psychological distress, the situational factors of the assault, and the labeling of the assault. Similar to studies examining only rape, acknowledged victims of sexual assault reported clearer refusal, the experience of a more forceful assault, and more intense resistance against the perpetrator. Unacknowledged victims were more likely to endorse a prior romantic relationship with their assailant and a more recent assault. The great majority of women who endorsed an unwanted sexual experience also reported they were intoxicated at the time.
Business Incentive Adoption in the Recession
Authors: Warner Mildred E. , Zheng Lingwen
Published: March 2013

Business incentive use rose dramatically among U.S. municipalities after the Great Recession. This article seeks to explain that rise using national surveys of local government economic development practice for 2004 and 2009. The authors differentiate business incentive use by three types (tax abatements, labor support, and planning) and by new and experienced users. We find that higher business incentive use is a response to lower property tax and higher unemployment. We also find that higher business incentive use is associated with greater attention to accountability, even among the new business incentive users. Governments that rely more heavily on tax incentives to firms face more competition and lower tax revenue than governments that use more incentives focused on labor and planning. We also find broadening attention to accountability measures and a widening of community development investment to arenas that target improved quality of life.
Not Lack of Ability but More Choice
Authors: Wang Ming-Te , Eccles Jacquelynne S. , Kenny Sarah
Published: March 2013

The pattern of gender differences in math and verbal ability may result in females having a wider choice of careers, in both science, technology, engineering, and mathematics (STEM) and non-STEM fields, compared with males. The current study tested whether individuals with high math and high verbal ability in 12th grade were more or less likely to choose STEM occupations than those with high math and moderate verbal ability. The 1,490 subjects participated in two waves of a national longitudinal study; one wave was when the subjects were in 12th grade, and the other was when they were 33 years old. Results revealed that mathematically capable individuals who also had high verbal skills were less likely to pursue STEM careers than were individuals who had high math skills but moderate verbal skills. One notable finding was that the group with high math and high verbal ability included more females than males.
Polymerase chain reaction assay based on ratA gene allows differentiation between Salmonella enterica subsp. enterica serovar Gallinarum biovars Gallinarum and Pullorum
Authors: Batista Diego Felipe Alves , de Freitas Neto Oliveiro Caetano , Lopes Priscila Diniz , de Almeida Adriana Maria , Barrow Paul Andrew , Berchieri Angelo
Published: March 2013

Salmonella Pullorum and Salmonella Gallinarum are classified as biovars of Salmonella enterica subsp. enterica serovar Gallinarum. These salmonellae are the causative agents of Pullorum disease and fowl typhoid, respectively, and are widely distributed throughout the world. Although many developed countries have eradicated these diseases from commercial poultry, they are still the cause of significant economic loss in developing countries. When serovar Gallinarum is isolated, it is difficult to immediately differentiate between biovars because they are antigenically identical by serotyping. However, they cause distinct diseases with different epidemiology, and therefore it is important to differentiate them. This may be done biochemically but takes 2 to 3 days. In the present study, S. Pullorum and S. Gallinarum whole genomes were compared, and 1 genomic region of difference, which is part of the ratA gene, was chosen as a molecular marker for a polymerase chain reaction assay to differentiate rapidly between these organisms. In all, 26 strains of S. Gallinarum and 17 S. Pullorum strains were tested and successfully differentiated by the assay.
Sexual Dysfunction in Women After Low Anterior Resection
Authors: Yu-Hua Lin
Published: March 2013

Low anterior resection procedures are likely to negatively affect pelvic floor function, which are correlated with sexual dysfunction. The purpose of the study was to explore the prevalence of sexual problems in women with rectal cancer after low anterior resection (LAR). The study consisted of an LAR group ( n = 32) and a group of healthy women ( n = 32). Female sexual function was evaluated using the Female Sexual Function Index (FSFI). A total of 71.8% of those with LAR reported sexual dysfunction, compared to 18.8% in those who are healthy. The FSFI domain scores were significantly lower for the LAR group relative to the healthy group. Logistic regression revealed that group, education, and age were predictors of female sexual functioning. Women who have had an LAR are at higher risk of sexual function problems. The sexual function of women with LAR should be evaluated in patient discharge planning; nurses should provide more information regarding the impact of LAR on sexual function.
Articular Chondral Damage of the First Metatarsal Head and Sesamoids
Authors: Doty Jesse F. , Coughlin Michael J. , Schutt Shane , Hirose Christopher , Kennedy Michael , Grebing Brett , Smith Bertil , Cooper Truitt , Golano Pau , Viladot Ramon , Remington Richard
Published: March 2013

Background:

Evidence of successful correction on postoperative hallux valgus imaging studies may not always correlate with patient satisfaction. Recent attention to the association of cartilaginous degeneration and hallux valgus may provide new insight into treatment algorithms and patient expectations. The purpose of this cadaveric study was to evaluate the degree of chondral damage as it relates to increasing hallux valgus deformity.

Methods:

A total of 39 cadaver first metatarsophalangeal joints were evaluated by radiography, and then dissected to evaluate for chondral damage. Chondral lesion grade, size, and location were recorded and then analyzed based on patient demographics and hallux valgus angle.

Results:

Twenty-nine of 39 specimens were considered to have hallux valgus characterized by a hallux valgus angle of 15 degrees or greater. Four of 39 (10%) specimens revealed absence of chondral lesions, and 3 of those were found in the group with a hallux valgus angle of less than 15 degrees. Chondral lesions of increasing size and grade were seen more commonly with a more severe hallux valgus deformity. Particular locations on the metatarsal head appeared to be more prone to cartilaginous lesions when compared to other locations.

Conclusion:

Assessment of first metatarsophalangeal joint articular damage with regard to hallux valgus may be an important clinical parameter for consideration.

Clinical Relevance:

Operative intervention to realign the first metatarsophalangeal joint may correct malalignment and relieve pressure on the widened forefoot, but residual pain within the joint may emanate from preexisting articular cartilaginous lesions. These findings support the concept that earlier intervention with operative realignment of a hallux valgus deformity and specifically the sesamoid complex may diminish degenerative changes.
Delighting Consumers Click by Click
Authors: Bartl Christopher , Gouthier Matthias H. J. , Lenker Markus
Published: March 2013

The increasing importance of information technology as a means to access and communicate information has prompted firms to enhance their corporate websites to establish relationships with potential and current customers. Likewise, the value of satisfaction has decreased in favor of customer delight. To develop innovative and delighting websites, however, firms require a more detailed understanding of how they can optimize their websites’ user impact. In two empirical studies, this research shows that delight has a stronger impact on purchase intentions than website satisfaction does. This means that companies can benefit from positive repercussions after investing up front to enhance their website. This research also identifies individual website quality factors that firms can manipulate to create delightful consumer web experiences. By examining and distinguishing between their effects on delight and surprise, this research sheds light on how consumers perceive website quality factors. Overall, this research shows how firms can attain customer delight in an online environment and clarifies its effects on consumer behavior.
Examining the Penalty Resolution Process
Authors: Xia Lan , Kukar-Kinney Monika
Published: March 2013

In this research, we develop a comprehensive theoretical model of the consumer response to penalties and the penalty resolution process. Two mechanisms of consumers’ response to penalty resolution are proposed: the perceptions of penalty fairness and feelings of gratitude. We delineate and test differences between gratitude and perceived fairness and identify factors differentially affecting them. Factors influencing feeling of entitlement, such as nature of the error, and consumer history and status with the provider, contribute to fairness perceptions. On the other hand, firm-customer interactions influence both gratitude and fairness assessments. Specifically, the penalty outcome provides benefits, hence induces gratitude, and is also perceived as the right thing to do, hence induces perceptions of fairness. However, factors that contribute to benefits received, but do not align with equity, such as type and uniqueness of compensation, influence gratitude only. The findings also confirm that, compared with fairness, gratitude more strongly influences active profirm behaviors, such as advocacy. This research offers important managerial implications. The findings suggest that service providers should consider customer history and relationship status in the penalty resolution process. Meeting customer expectations will enhance fairness perceptions and minimize the negative effect on loyalty. Further, flexible procedures for handling penalties, preferred type of compensation, and selectivity in treatment should stimulate feelings of gratitude and motivate consumers to actively promote the company via positive word of mouth.
Sexualization of Adolescent Boys
Authors: Vandenbosch Laura , Eggermont Steven
Published: March 2013

This study ( N = 911) investigated how exposure to sexualizing prime-time television programs, music television, men’s magazines, and pornographic websites was related to the internalization of appearance ideals, self-objectification, and body surveillance among adolescent boys. A structural equation model showed direct relationships between exposure to sexualizing television and pornographic websites and the internalization of appearance ideals. Indirect relationships between these types of sexualizing media, and self-objectification and body surveillance through the internalization of appearance ideals were also reported. A direct relationship with self-objectification was only found for sexualizing pornographic websites. Discussion warns attention for adolescent boys at risk of sexualization.
Methods of symptom evaluation and their impact on peripheral artery disease (PAD) symptom prevalence: A review
Authors: Schorr Erica N , Treat-Jacobson Diane
Published: March 2013

Peripheral artery disease (PAD) is a common progressive atherosclerotic occlusive disease that causes insufficient blood flow to the lower extremities. The symptom that health care professionals most often associate with PAD is claudication. However, patient reporting of claudication is highly variable. A structured literature review was conducted to evaluate how PAD symptoms are identified, defined, and categorized. This review focuses on the development and performance characteristics of PAD symptom questionnaires and the identification of a spectrum of leg symptoms beyond classic claudication. Additionally, potential confounders of PAD symptom reporting and strategies for a more comprehensive assessment of PAD symptoms are discussed. Overall, there is a lack of consistency in the utilization of PAD claudication questionnaires which impacts PAD symptom reporting and categorization. Based on this review, atypical symptoms are commonly reported, but poorly understood. Additional research is needed to gain a better understanding of the presentation of atypical symptoms, as well as the role of age, gender, race, and comorbid conditions on the symptom experience of patients with PAD.
Virtual Reality Simulator Training of Laparoscopic Cholecystectomies — A Systematic Review
Authors: Ikonen T. S. , Antikainen T. , Silvennoinen M. , Isojärvi J. , Mäkinen E. , Scheinin T. M.
Published: March 2013

Background and Aims:

Simulators are widely used in occupations where practice in authentic environments would involve high human or economic risks. Surgical procedures can be simulated by increasingly complex and expensive techniques. This review gives an update on computer-based virtual reality (VR) simulators in training for laparoscopic cholecystectomies.

Materials and Methods:

From leading databases (Medline, Cochrane, Embase), randomised or controlled trials and the latest systematic reviews were systematically searched and reviewed. Twelve randomised trials involving simulators were identified and analysed, as well as four controlled studies. Furthermore, seven studies comparing black boxes and simulators were included.

Results:

The results indicated any kind of simulator training (black box, VR) to be beneficial at novice level. After VR training, novice surgeons seemed to be able to perform their first live cholecystectomies with fewer errors, and in one trial the positive effect remained during the first ten cholecystectomies. No clinical follow-up data were found. Optimal learning requires skills training to be conducted as part of a systematic training program. No data on the cost-benefit of simulators were found, the price of a VR simulator begins at EUR 60 000.

Conclusions:

Theoretical background to learning and limited research data support the use of simulators in the early phases of surgical training. The cost of buying and using simulators is justified if the risk of injuries and complications to patients can be reduced. Developing surgical skills requires repeated training. In order to achieve optimal learning a validated training program is needed.
Single-Incision Laparoscopic Colectomy Using the Gelport System for Early Colon Cancer
Authors: Egi H. , Okajima M. , Hinoi T. , Takakura Y. , Kawaguchi Y. , Shimomura M. , Tokunaga M. , Adachi T. , Hattori M. , Urushihara T. , Itamoto T. , Ohdan H.
Published: March 2013

Background

Laparoscopic surgery has spread quickly during the past twenty years, and has become one of the important treatments in the field of colorectal surgery. Recently, natural orifice transluminal endoscopic surgery (NOTES) has been studied as the next generation of minimally-invasive surgery, but the feasibility and safety of the NOTES method have not been evaluated. In such a situation, single-incision laparoscopic surgery has attracted interest from surgeons worldwide. However, single-incision laparoscopic colorectal surgery has not yet been standardized.

Methods

From February 2010, single-incision laparoscopic colectomy was performed for 7 patients presenting with early colon cancer. All procedures were performed by two experts with the License of Endoscopic Surgical Skill Qualification System (ESSQS) of Japan Society for Endoscopic Surgery (JSES) in the field of colorectal Surgery.

Results

We used the Gelport system (Applied Medical, Rancho Santa Margarita, CA, USA) as the access port and 3 trocars of different sizes (Ethicon, Inc., Cincinnati, OH, USA). Using this technique, we did not experience any difficulties or use any articulated instruments. All of the present 7 patients underwent the single-incision laparoscopic colectomy successfully and had no complications.

Conclusion:

Single-incision laparoscopic surgery using the Gelport was performed safely in the present cases. The use of the Gelport as an access port can address the technical difficulty associated with this new technique.
Surveillance after Distal Revascularization for Critical Limb Ischaemia
Authors: Arvela E. , Dick F.
Published: March 2013

Patients with critical limb ischaemia (CLI) are usually elderly and suffer from several co-morbidities. The goal of surveillance after both endovascular and surgical revascularization for CLI is not only the protection of re-established distal perfusion and sustained ambulation but also the reduction of systemic atherothrombotic risk and mortality by ensuring continued best medical care. However, preferred format and rhythm of structured follow-up programs have remained controversial, mainly because of lack of compelling evidence. This review aims to summarize and to appraise available information critically. Thereby, it underlines the importance of systematic surveillance after both surgical and endovascular revascularization for CLI. Recent European guidelines are considered and areas of uncertainty are highlighted and discussed. According to currently available literature and recent guidelines, the early duplex scan is justified in all patients undergoing endovascular or surgical distal revascularization for CLI. There is no best level evidence supporting continued long term duplex surveillance of revascularizations with normal findings at early duplex scan, whereas those patients with abnormal early duplex scan or high risk revacularization are likely to benefit from continued duplex surveillance. Regular clinical follow-up is suggested and clinical deterioration should trigger duplex scanning to ensure revascularization patency.
Distal Pancreatectomy Using a No-Touch Isolation Technique
Authors: Hirota M. , Hashimoto D. , Ishiko T. , Satoh N. , Takamori H. , Chikamoto A. , Tanaka H. , Sugita H. , Sand J. , Nordback I. , Baba H.
Published: March 2013

Background and Aims:

Distal pancreatectomy is the only effective treatment for cancers of the pancreatic body and tail. The recurrence rate after DPhas remained high. In an effort to overcome this problem, we developed a no-touch surgical technique for DP. This is a pilot study to see if distal pancreatectomy can be technically done using a no-touch surgical technique without deteriorating the post-operative prognosis.

Patients and Methods:

From November 2000 through May 2011, 16 pancreatic ductal adenocarcinoma patients have been operated on using a no-touch technique by a single operator. We described the surgical technique, and we reported our preliminary experience. During the procedure, the pancreatic body and tail is neither grasped nor squeezed by the surgeon. And all drainage vessels from the pancreatic body and tail are ligated and divided during the early phase of the operation. Furthermore, for improved dissection of the retroperitoneal tissue (rightward and posterior margins), we use a hanging and clamping maneuver and dissection behind Gerota's fascia.

Results:

In the current series, the posterior and rightward resection margins were free in all patients, although seven were positive for anterior serosal invasion. The post-operative prognosis was not deteriorated with this technique.

Conclusion:

No-touch distal pancreatectomy technique may have some theoretical advantages, which merit future investigation in randomized controlled trials.
Predictors of Failure of Endovascular Revascularization for Critical Limb Ischemia
Authors: Korhonen M. , Halmesmäki K. , Lepäntalo M. , Venermo M.
Published: March 2013

Background and Aims:

To characterize predictors of failure when treating critical limb ischemia (CLI) patients with an endovascular intervention as the first-line strategy.

Patients and Methods:

This retrospective, registry-based study included 217 consecutive patients with 240 chronic critically ischemic limbs treated with infrainguinal percutaneous transluminal angioplasty (PTA) during 2006–2007 at Helsinki University Central Hospital, Finland. The primary outcome measures were death, major (above-ankle) amputation, and the need for surgical re-intervention within 6 months after the primary procedure. The secondary outcome measures were overall major amputation and survival rates as well as the overall need for surgical or any other (surgical or endovascular) type of re-intervention. Predictors of outcome endpoints were identified with a univariate screen, and a Cox regression model was used in the multivariate analysis.

Results:

Compared to ulcer, gangrene was significantly more strongly associated with amputation within 6 months post-procedurally as well as during the whole follow-up period (p ≤ 0.028). The patient's inability to walk upon hospital arrival was a significant predictor of death, amputation and surgical re-intervention. Mediasclerotic ankle-brachial index (ABI) was an independent predictor of amputation as well as endovascular re-interventions.

Conclusions:

The strong predictors of poor outcome after endovascular revascularization for patients with CLI are cardiac morbidity, the inability to ambulate upon hospital arrival, and gangrene as a manifestation of CLI. The risk of amputation seems to be significantly higher for gangrene than for ulcer and this matter should be taken into account in the clinical classifications for CLI.