bluuebunny/crossref_metadata_2025 huggingface dataset:
Expression of Proteasomal Immunosubunit ß1i Is Dysregulated in Inflammatory Infiltrates of Minor Salivary Glands in Sjögren’s Syndrome
Authors: MORAWIETZ LARS , MARTINEZ-GAMBOA LORENA , SCHEFFLER SONJA , HAUSDORF GERT , DANKOF ANJA , KUCKELKORN ULRIKE , DOERNER THOMAS , EGERER KARL , BURMESTER GERD-R. , FAUSTMAN DENISE L. , FEIST EUGEN
Published: October 2009

Objective.

Minor salivary gland specimens were analyzed to investigate dysregulation of the proteasome system in patients with Sjögren’s syndrome (SS) and patients with sicca syndrome.

Methods.

Labial biopsy specimens from 17 patients with SS and 11 patients with non-autoimmunesicca syndrome were analyzed by immunohistochemistry for expression of the inducible proteasomal subunits ß1i, ß2i, and ß5i. The infiltrating subsets of lymphocytes were characterized using immunofluorescence stainings against the cell-surface markers CD20 and CD27. Two-dimensional electrophoresis and immunoblotting were used for detection of the proteasomal subunits ß1 and ß1i in peripheral blood monocyte cells. Gene expression of the constitutive subunits ß1, ß2, and ß5 and the corresponding inducible subunits ß1i, ß2i, and ß5i was further investigated at the mRNA level in small lip biopsies using real-time polymerase chain reaction.

Results.

The expression of ß1i in infiltrating and peripheral immune cells was altered in patients with SS compared to patients with non-autoimmune sicca syndrome and healthy controls. No significant differences were found in ß2i and ß5i expression between the same groups in small lip biopsies. Chisholm-Mason grade and ß1i expression were found to be inversely correlated (Spearman r = −0.461, p = 0.014). The phenotype and distribution of the lymphocytic infiltrate showed no differences between patients with primary and secondary SS regardless of ß1i expression.

Conclusion.

The proteasomal ß1i subunit is dysregulated in peripheral white blood cells and in inflammatory infiltrates of minor salivary glands in patients with SS.
Reevaluation of the Role of Duration of Morning Stiffness in the Assessment of Rheumatoid Arthritis Activity
Authors: KHAN NASIM A. , YAZICI YUSUF , CALVO-ALEN JAIME , DADONIENE JOLANTA , GOSSEC LAURE , HANSEN TROELS M. , HUISMAN MARGRIET , KALLIKORM RIINA , MULLER RAILI , LIVEBORN MARGARETH , ODING ROLF , LUCHIKHINA ELENA , NARANJO ANTONIO , REXHEPI SYLEJMAN , TAYLOR PETER , TLUSTOCHOWICH WITOLD , TSIROGIANNI AFRODITE , SOKKA TUULIKKI
Published: October 2009

Objective.

To evaluate the utility of the duration of morning stiffness (MS), as a patient-reported outcome (PRO), in assessing rheumatoid arthritis (RA) disease activity.

Methods.

We acquired information on 5439 patients in QUEST-RA, an international database of patients with RA evaluated by a standard protocol. MS duration was assessed from time of waking to time of maximal improvement. Ability of MS duration to differentiate RA activity states, based on Disease Activity Score (DAS)28, was assessed by analysis of variance; and a receiver-operating characteristic (ROC) curve was plotted for discriminating clinically active (DAS28 > 3.2) from less active (DAS28 ≤ 3.2) RA. Mixed-effect analysis of covariance (ANCOVA) models were used to assess the utility of adding MS duration to Routine Assessment of Patient Index Data (RAPID)3, a PRO index based on physical function, pain, and general health (GH), in predicting the 3-variable DAS28 (DAS28v3).

Results.

MS duration had moderate correlation (r = 0.41–0.48) with pain, Health Assessment Questionnaire, and GH; and weak correlation (r = 0.23–0.39) with joint counts and erythrocyte sedimentation rate. MS duration differed significantly among patients with different RA activity (p < 0.001). The area under the ROC curve of 0.74 (95% CI 0.72–0.75) showed moderate ability of MS duration to differentiate clinically active from less active RA. ANCOVA showed significant interactive effects between RAPID3 and the MS duration categories (p = 0.0005) in predicting DAS28v3. The effect of MS was found to be clinically important in patients with the low RAPID3 scores (< 6) in whom the presence of MS may indicate clinically active disease (DAS28v3 > 3.2).

Conclusion.

MS duration has a moderate correlation with RA disease activity. Assessment of MS duration may be clinically helpful in patients with low RAPID3 scores.
Changes Over Time in the Diagnosis of Rheumatoid Arthritis in a 10-year Cohort
Authors: MORVAN JOHANNE , BERTHELOT JEAN-MARIE , DEVAUCHELLE-PENSEC VALÉRIE , JOUSSE-JOULIN SANDRINE , LE HENAFF-BOURHIS CATHERINE , HOANG SYLVIE , THOREL JEAN-BAPTISTE , MARTIN ANTOINE , YOUINOU PIERRE , SARAUX ALAIN
Published: October 2009

Objective.

We assessed levels of agreement between a diagnosis of rheumatoid arthritis (RA) at inclusion in a recent-onset arthritis cohort, then 2 and 10 years later. Performance of American College of Rheumatology (ACR) criteria alone or combined with rheumatologist diagnosis, and of recent new criteria adding antibodies to cyclic citrullinated peptides (“anti-CCP-revised criteria”) to existing ACR criteria, was evaluated.

Methods.

In total, 270 patients with recent-onset arthritis of less than 1 year duration were included between 1995 and 1997 and followed for 2 years. A diagnosis was recorded by an office-based rheumatologist (OBR) at inclusion, then 2 years later. In 2007, a questionnaire was sent to each rheumatologist to collect the final diagnosis, which was considered the reference.

Results.

Final diagnosis was available for 164 patients: 57 had RA. Agreement was low (κ = 0.27) between the baseline and final diagnoses, and substantial (κ = 0.69) between the 2-year and final diagnoses. Anti-CCP-revised criteria had sensitivity of 65% to 81% and specificity of 55% to 75%. Sensitivity and specificity of ACR criteria were 57.9% (44.1%–70.9%) and 74.8% (65.5%–82.7%) at inclusion, 80.7% (70.5%–90.0%) and 63.6% (54.5%–72.7%) at 2 years. The combination OBR diagnosis/ACR criteria after 2 years showed considerably increased specificity (87% vs 64%) and slightly decreased sensitivity (77% vs 81%).

Conclusion.

ACR criteria for RA showed poor performance even at 2 years. The absence of exclusion criteria may explain the lack of specificity, which improved when combined with the OBR diagnosis. Adding anti-CCP criteria to the existing criteria could help in diagnosing RA.
Fibromyalgia Is Common and Adversely Affects Pain and Fatigue Perception in North Indian Patients with Rheumatoid Arthritis
Authors: DHIR VARUN , LAWRENCE ABLE , AGGARWAL AMITA , MISRA RAMNATH
Published: October 2009

Objectives.

Fibromyalgia (FM) has been shown to be common in patients with rheumatoid arthritis (RA), but studies on Asian patients are lacking. It remains unclear whether FM has an adverse influence on pain, fatigue, quality of life, and mood in these patients, and what its relationship is with disease activity. We studied prevalence and effects of FM in North Indian patients with RA and associations of RA with disease activity.

Methods.

This cross-sectional study included 200 RA patients and an equal number of controls. Presence of FM was defined using the American College of Rheumatology 1990 criteria. Pain and fatigue scores were assessed using a 10 cm visual analog scale. Quality of life and presence of depression/anxiety were determined using validated questionnaires. Disease activity and functional disability in RA patients was assessed using the Disease Activity Score 28-3 and Health Assessment Questionnaire, respectively.

Results.

FM was present in 15% of patients with RA compared to 2.5% of controls in the North Indian population. RA patients with FM did not differ from those without FM in terms of age, gender, current disease-modifying agents, or steroid use. RA patients with FM had higher disease activity and worse functional disability. The number of tender and swollen joints was higher in patients with FM, but correlated poorly with each other. RA patients with FM had higher pain and fatigue scores but were not different in the quality of life or mood.

Conclusion.

FM is more common in North Indian patients with RA compared to controls. It adversely affects the pain and fatigue felt by RA patients. Disease activity and FM influence each other.
Autoantibodies and the Risk of Cardiovascular Events
Authors: LIANG KIMBERLY P. , MARADIT-KREMERS HILAL , CROWSON CYNTHIA S. , SNYDER MELISSA R. , THERNEAU TERRY M. , ROGER VERONIQUE L. , GABRIEL SHERINE E.
Published: October 2009

Objective.

Inflammation and autoimmunity are associated with increased cardiovascular (CV) risk in patients with rheumatoid arthritis. This association may also be present in those without rheumatic diseases. Our purpose was to determine whether rheumatoid factor (RF), antinuclear antibody (ANA), and cyclic citrullinated peptide antibody (CCP) positivity are associated with increased risk of CV events and overall mortality in those with and without rheumatic diseases.

Methods.

We performed a population-based cohort study of all subjects who had a RF and/or ANA test performed between January 1, 1990, and January 1, 2000, and/or CCP test performed between September 1, 2003, and January 1, 2005, with followup until April 1, 2007. Outcomes were ascertained using diagnostic indices from complete medical records, including CV events [myocardial infarction (MI), heart failure (HF), and peripheral vascular disease (PVD)] and mortality. Cox models were used to analyze the data.

Results.

There were 6783 subjects with RF, 7852 with ANA, and 299 with CCP testing. Of these, 10.4%, 23.9%, and 14.7% were positive for RF, ANA, and CCP, respectively. Adjusting for age, sex, calendar year, comorbidity, and rheumatic disease, RF and ANA positivity were significant predictors of CV events [hazard ratio (HR) 1.24 and 1.26] and death (HR 1.43 and 1.18). Adjusting for age, CCP positivity was associated with CV events, but this association was not statistically significant (HR 3.1; 95% CI 0.8, 12.3).

Conclusion.

RF and ANA positivity are significant predictors of CV events and mortality in both those with and those without rheumatic diseases. These results support the role of immune dysregulation in the etiology of CV disease.
Serum Amyloid A and C-Reactive Protein Concentrations Are Differently Associated with Markers of Autoimmunity in Patients with Primary Sjögren’s Syndrome
Authors: PERTOVAARA MARJA , JYLHÄVÄ JUULIA , UUSITALO HANNU , PUKANDER JUHANI , HELIN HEIKKI , HURME MIKKO
Published: October 2009

Objective.

Primary Sjögren’s syndrome (pSS) is an autoimmune disease in which the concentration of the acute-phase protein serum C-reactive protein (CRP) is low. We investigated whether levels of another acute-phase protein, serum amyloid A (SAA), are increased in patients with pSS and whether the immunological markers in patients with pSS are associated with variation in SAA levels.

Methods.

Serum SAA concentrations were measured by ELISA in 74 patients with pSS and in 56 control subjects with sicca symptoms.

Results.

Median SAA levels did not differ significantly between patients with pSS and subjects with sicca symptoms. In patients with pSS SAA concentrations correlated significantly with age, leukocyte count, CRP, interleukin 6, and C4. Unlike CRP, there was a significant inverse correlation between SAA and serum IgG levels and anti-SSA antibody titers, as well as a trend towards an inverse correlation between SAA and antinuclear antibody and rheumatoid factor titers.

Conclusion.

Our data imply that high SAA production could constitute a protective element in pSS: high SAA levels inhibit in particular various signs of B cell hyperreactivity, i.e., IgG and autoantibody production.
Serum Cardiac Troponin T, But Not Troponin I, Is Elevated in Idiopathic Inflammatory Myopathies: Figure 1.
Authors: AGGARWAL ROHIT , LEBIEDZ-ODROBINA DOROTA , SINHA ALPANA , MANADAN AUGUSTINE , CASE JOHN P.
Published: October 2009

Objective.

To study the association of serum cardiac troponin T (cTnT) and cardiac troponin I (cTnI) with creatine kinase (CK) in patients with idiopathic inflammatory myopathies (IIM).

Methods.

We performed a retrospective study on patients with IIM followed by the rheumatology service of a county hospital from 2004 to 2008. Patients with myocardial ischemia and/or with renal failure were excluded. Clinical data including electromyogram, muscle biopsy, and CK, cTnT and cTnI were recorded. Patients who had simultaneous analysis of CK and cardiac troponin (cTnT or cTnI) levels were studied. CK levels were correlated with cTnT and cTnI by chi-square test and Spearman correlation.

Results.

We identified 49 patients with IIM (69 observations) who satisfied our inclusion criteria. The primary diagnosis was polymyositis in 23, dermatomyositis in 16, and myositis associated with connective tissue disease in 10 patients. There were 33/49 women with average age 45.8 years. Twenty-eight patients with IIM had simultaneous CK and cTnT values assayed. Of those patients, 18/23 with elevated CK also had elevated cTnT, and 5/5 patients with normal CK levels had normal cTnT levels (p = 0.005). In 41 patients with IIM who had simultaneous CK and cTnI levels assayed, only 1/29 with elevated CK had elevated cTnI, and 12/12 patients with normal CK had normal cTnI (p = 0.5). CK correlated strongly with the cTnT (r = 0.62, p = 0.001) but did not correlate with cTnI.

Conclusion.

Elevated cTnT, but not cTnI, was highly associated with CK in patients with IIM despite the absence of myocardial ischemia.
Malnutrition Is Common in Systemic Sclerosis: Results from the Canadian Scleroderma Research Group Database
Authors: BARON MURRAY , HUDSON MARIE , STEELE RUSSELL
Published: October 2009

Objective.

Systemic sclerosis (SSc) is a multisystem disease associated with significant morbidity and increased mortality. Little is known about nutritional status in SSc. We investigated the prevalence and demographic and clinical correlates of nutritional status in a large cohort of patients with SSc.

Methods.

This was a cross-sectional multicenter study of patients (n = 586) from the Canadian Scleroderma Research Group Registry. Patients were assessed with detailed clinical histories, medical examinations, and self-administered questionnaires. The primary outcome was risk for malnutrition using the “malnutrition universal screening tool” (MUST). Multiple logistic regression was used to assess the relationship between selected demographic and clinical variables and MUST categories.

Results.

Of the 586 patients in the study, MUST scores revealed that almost 18% were at high risk for malnutrition. The significant correlates of high malnutrition risk included the number of gastrointestinal (GI) complaints, disease duration, diffuse disease, physician global assessment of disease severity, hemoglobin, oral aperture, abdominal distension on physical examination, and physician-assessed possible malabsorption. Among 14 GI symptoms, only poor appetite and lack of a history of abdominal swelling and bloating predict MUST. These factors accounted for 24% of the variance in MUST scores.

Conclusion.

The risk for malnutrition in SSc is moderate and is associated with shorter disease duration, markers of GI involvement, and disease severity. Patients with SSc should be screened for malnutrition, and potential underlying causes assessed and treated when possible.
Lateral Decubitus Positioning for Intramedullary Nailing of the Femur Without the Use of a Fracture Table
Authors: Carr James B. , Williams Daniel , Richards Mike
Published: October 2009

In closed intramedullary nailing of the femur in the lateral decubitus position without the use of a fracture table, access to the proximal femur is enhanced as compared to supine nailing, especially in large patients. The hip is typically flexed during the nailing, which allows the nail to be placed posterior to the gluteus medius, thus minimizing abductor damage. The deforming forces of flexion and abduction in proximal fracture patterns can be readily overcome by this technique. Proper rotation of the leg can be assessed clinically or with the use of a femoral neck anteversion guide wire. Fluoroscopic visualization of the proximal femur is excellent, including the femoral head, thus facilitating reconstruction nailing.
A Re-exploration of the Use of Barbed Sutures in Flexor Tendon Repairs
Authors: Trocchia Aron M. , Aho Heather N. , Sobol Gregory
Published: October 2009

Flexor tendon repairs continue to improve thanks to advancements in suture material and technique. The role of barbed sutures in flexor tendon repairs has been previously investigated, but with the advent of a new material, interest in their use has been rekindled. We hypothesized that the use of modern barbed sutures will have comparable maximum tensile strength and 2-mm gapping strength to that of conventional sutures, allowing their use to theoretically decrease adhesions and tissue damage in flexor tendon repairs.

Flexor tendon repairs were performed on a cadaver model using either 3-0 Ethibond (Ethicon, Inc, Somerville, New Jersey) (Kessler repair) or 2-0 Quill sutures (Angiotech, Vancouver, British Columbia, Canada) (Kessler-Bunnell repair) and were biomechanically tested. The mode of failure for the Ethibond sutures was suture pullout 2 times and knot failure 18 of 20 times, while the Quill sutures failed entirely by pullout. Maximum load to failure was 34.7±5.4 N and 29.6±3.6 N for Ethibond and Quill, respectively. This was found to be statistically significant (
P
=.001). Tensile load at 2-mm gapping was 22.8±6.3 N and 22.2±4.0 N for Ethibond and Quill, respectively. No statistical significance was found (
P
=.723).

This study helps substantiate the possible role of modern barbed sutures in flexor tendon repair. Additional biomechanical studies will need to be performed to further assess the use of barbed sutures in flexor tendon repair.
Double- Versus Single-incision Technique for Open Carpal Tunnel Release
Authors: Hamed A. Rami , Makki Daoud , Chari Raymond , Packer Greg
Published: October 2009

A prospective, randomized, controlled trial was performed comparing the double incision technique to the conventional open method used in carpal tunnel decompression surgery, with pillar pain, scar sensitivity, and recovery of grip strength each assessed independently. Forty patients (40 hands) were operated on, 21 hands with the standard single-incision technique and 19 hands with the double-incision technique. Patients were assessed throughout 6 months of follow-up.

The results showed that the double-incision technique caused less pillar pain and scar sensitivity compared to the single-incision technique. No difference in recovery of grip strength was noted between the 2 techniques. The limited open technique using the double incision in carpal tunnel decompression surgery is advantageous over the standard technique in tackling scar-related morbidities.
Brachial Plexus Palsy Caused by Secondary Fracture Displacement in a Patient With Closed Clavicle Fracture
Authors: Lin Chen-Chiang , Lin Jinn
Published: October 2009

In adults, brachial plexus injury due to clavicle fractures is rare, and is most commonly caused by nonunion, malunited fragments, hypertrophic callus, or pseudoaneurysm of the subclavicular artery or vein. Brachial plexus palsy in acute fractures caused by direct fragment compression is exceptional. Conservative treatment of nondisplaced and displaced midclavicle fractures in adults usually produces satisfactory outcomes. This article presents a case of a 74-year-old man who sustained a closed, midshaft right clavicle fracture complicated by secondary displacement and brachial plexus injury. Initially, the fracture was nondisplaced, and he was treated conservatively. However, he returned 2 weeks later with shoulder pain and coldness, progressive numbness, and weakness of the right extremity. Physical examination revealed weakness of the flexion and extension of his elbow, wrist, and finger joints with slightly diminished right side radial pulsation. Radiographs demonstrated a displaced clavicle fracture with a vertically angulated intermediate fragment and narrowed costoclavicular space. Magnetic resonance imaging revealed bony fragments with a perifocal soft tissue mass encroaching on the brachial plexus and axillary artery. During surgery, the brachial plexus was found to be markedly stretched due to compression by the bony fragments and an organized blood clot. After meticulous neurolysis, the blood clot and intermediate bony fragments were removed and the distal fragments were reduced and fixed with a metal plate and interfragmentary screws. Secondary fracture displacement is possible after a nondisplaced clavicle fracture if the arm is not well protected, even if the original fracture appears stable and no neurological or circulatory symptoms are present.
Giant Medial Parameniscal Cyst in an Osteoarthritic Knee
Authors: Choi Edmund H. , Huang James , Bryk Diana , Bryk Eli
Published: October 2009

Medial parameniscal cysts of the knee are typically 0.3 to 9 mm in diameter. Few cases of unusually large medial parameniscal cysts have been reported. We describe the treatment of a patient with osteoarthritis of the knee who presented with an extraordinarily large, ipsilateral, medial parameniscal cyst, 10 cm in diameter. We believe this to be the largest medial parameniscal cyst reported in the English literature.

Based on the patient's severe tricompartmental arthritis and associated symptoms, total knee arthroplasty (TKA) was indicated with simultaneous excision of the parameniscal cyst. Perioperativley, the cyst was found to have penetrated beyond the meniscocapsular attachments that were adjacent to a degenerative posterior horn horizontal medial meniscal tear. Following excision of the cyst, the mass was measured with surgical tape to be 10×10×5 cm. After complete excision of the parameniscal cyst, TKA was performed. Histological examination confirmed a benign parameniscal synovial cyst. At 2-year follow-up, the patient was ambulating unassisted without difficulty. The wound had completely healed with no evidence of recurrence of the cyst. The patient's range of motion was 0° to 110° with no signs of instability.

Our patient's pathology was most significant for the heretofore unseen large size of the paramensical cyst. Open excision of this giant parameniscal cyst followed by TKA was effective in treating the patient's degenerative joint disease and extraordinarily large, painful soft tissue mass.
Upper Airway Compromise by Extravasated Fluid: A Rare Complication After Arthroscopic Repair of Atrophic Cuff Tear
Authors: Venkat Gorthi , Moon Young Lae , Na Woong Chae , So Keum Young
Published: October 2009

During arthroscopic procedures, leakage of irrigation fluid into surrounding tissue planes is a frequently noticed phenomenon usually clinically asymptomatic and resolving within 12 hours postoperatively. Although rare, this fluid may produce life-threatening complications such as airway compromise. This article describes a case of upper airway obstruction in a 60-year-old man undergoing arthroscopic repair for an atrophic rotator cuff tear.

The patient presented with a 6-month history of pain and weakness in the left shoulder. Magnetic resonance imaging studies revealed a massive rotator cuff tear with significant retraction and fatty degeneration of cuff musculature. Perioperatively, all vital cardiorespiratory parameters were within normal limits. Postoperatively, immediately on extubation, he was dyspneic, and examination revealed a diffuse swelling extending from the left shoulder up to the neck and face. He was reintubated and sent to the recovery room, where he recovered 12 hours later.

This article highlights the possibility of respiratory compromise due to the extravasation of irrigation fluid into the neck and chest during arthroscopic repair of massive and atrophied cuff tears, even with shorter surgical time as is this case. The widened suprascapular space will offer less resistance to the spread of fluid into the neck and chest from the shoulder. We advocate monitoring the patient continuously to prevent this serious complication from becoming life-threatening.
Update on Marijuana
Authors: McGuinness Teena M.
Published: October 2009

Marijuana, the illicit drug most widely used by adolescents, is not a benign substance. Inhalation of marijuana smoke is more harmful than tobacco smoke; cannabis smoke delivers 50% to 70% more carcinogens. Other physiological effects include decreased immune function, higher rates of cardiac arrhythmias, and documented cases of cerebellar infarction. Mood and cognitive effects of marijuana include exacerbation of depression and anxiety (including panic attacks), as well as memory problems that may persist for a month after last use. Cannabis abuse is a risk factor for psychosis in genetically predisposed people and may lead to a worse outcome of schizophrenia. The cumulative respiratory, cardiovascular, metabolic, and mental health risks of marijuana are significant and should be emphasized by nurses who work with adolescents.
Impact on the Corneal Endothelium of Mitomycin C During Photorefractive Keratectomy
Authors: Roh Danny S. , Funderburgh James L.
Published: October 2009

Purpose:

This brief review examines both basic science and clinical studies to evaluate the potential impact on the health of the corneal endothelium of mitomycin C (MMC) usage during photorefractive keratectomy (PRK).

Methods:

The mechanism of action and consequences of MMC are reviewed within the context of in vitro, animal, and clinical studies and a hypothesis of how this vital cell layer responds to MMC at both the cellular and clinical levels is formed.

Results:

Seven basic science studies were reviewed demonstrating significant MMC toxicity to corneal endothelial cells. Of the five clinical studies reviewed, three demonstrated no effect on corneal endothelial density, whereas two studies found significant cell loss after MMC usage.

Conclusions:

Although all of the basic science studies reviewed highlight the toxicity of MMC on the corneal endothelium, current clinical studies are less conclusive. Given the corneal penetration of MMC and the fragile nature of the corneal endothelium, additional follow-up studies are needed to determine the long-term impact of MMC usage during PRK on the corneal endothelium. [
J Refract Surg
. 2009;25:894–897.]
Early Outcomes of INTRACOR Femtosecond Laser Treatment for Presbyopia
Authors: Holzer Mike P. , Mannsfeld Annett , Ehmer Angela , Auffarth Gerd U.
Published: October 2009

Purpose:

To investigate early functional outcomes of the INTRACOR femtosecond laser–based intrastromal procedure to treat presbyopia.

Methods:

Twenty-five eyes of 25 presbyopic patients were enrolled in this prospective, ethics committee–approved study. Following detailed preoperative examination, the INTRACOR procedure was performed using the TECHNOLAS femtosecond laser (Technolas Perfect Vision GmbH) in the non-dominant eye. Postoperatively, follow-up examinations were performed at 1 day, 1 week, and 1 and 3 months, including near and distance visual acuity, slit-lamp microscopy, and corneal topography.

Results:

All 25 surgeries were uneventful. The mean postoperative uncorrected near visual acuity increased from 0.7±0.16 logMAR to 0.26±0.21 logMAR and the mean uncorrected distance visual acuity changed slightly from 0.11±0.11 logMAR to 0.05±0.1 logMAR at 3 months postoperative. Regarding best distance correction, mean sphere changed from +0.75±0.23 diopters (D) preoperatively to +0.15±0.31 D postoperatively and mean cylinder from −0.33±0.17 D to −0.42±0.23 D. Postoperative healing was uneventful, and in all eyes, the cornea was clear within a few hours after surgery without any remaining cavitation gas bubbles.

Conclusions:

The INTRACOR procedure for presbyopia showed good visual acuity outcomes in the early postoperative period. The short treatment time in combination with maintained corneal integrity suggests this new technique has good potential for the treatment of presbyopia. [
J Refract Surg
. 2009;25:855–861.]
Corneal Power Measurements Using Scheimpflug Imaging in Eyes With Prior Corneal Refractive Surgery
Authors: Holladay Jack T. , Hill Warren E. , Steinmueller Andreas
Published: October 2009

Purpose:

To evaluate the accuracy of central corneal power measurements by Scheimpflug imaging (Pentacam) for eyes that had corneal refractive surgery.

Methods:

This study comprised two groups: a pilot group of 100 eyes with prior hyperopic or myopic LASIK that did not have cataract surgery, and a test group of 41 eyes with prior radial keratotomy (RK) and cataract surgery. In the pilot group, Pentacam images and refraction were taken preoperatively and 3 months after LASIK. The historical method was used to compute the theoretical postoperative keratometry (K) -reading and then compared to the measured equivalent K-reading (EKR) from the Pentacam. The EKR is the same value measured by standard keratometry or topography on the front surface, adjusted for the effect of the back surface power difference from normal. In the test group of RK eyes, the postoperative refraction and EKR were measured 3 months after cataract surgery. The Holladay IOL Consultant Program was used to back-calculate the theoretical K-reading. The EKR measurements were then compared to the back-calculated corneal power.

Results:

The optimal zone sample size was determined to be 4.5 mm for the pilot group. The mean prediction error for this group was −0.06±0.56 diopters (D) (range: −1.63 to +1.34 D). Using the 4.5-mm zone determined in the pilot group, the EKR value for the test group of 41 RK eyes had a mean prediction error of −0.04±0.94 D (range: −1.84 to +2.27 D).

Conclusions:

When historical refractive data are not available, Scheimpflug imaging with the Pentacam provides an alternative method of measuring the central corneal power in eyes that previously received corneal refractive surgery. [
J Refract Surg
. 2009;25:862–868.]
Effect of Aging on Corneal Biomechanical Parameters Using the Ocular Response Analyzer
Authors: Kamiya Kazutaka , Shimizu Kimiya , Ohmoto Fumiko
Published: October 2009

Purpose:

To assess the effect of aging on corneal biomechanical parameters in a normal population.

Methods:

We prospectively examined 204 normal eyes of 204 healthy Japanese volunteers (68 men, 136 women; mean age 46.7±19.4 years [range: 19 to 89 years]). Corneal hysteresis, corneal resistance factor, corneal-compensated intraocular pressure (IOP
cc
), and Goldmann-correlated intraocular pressure (IOP
G
) were qualitatively assessed using a Reichert Ocular Response Analyzer. Central corneal thickness was measured using an ultrasound pachymeter. This measurement was performed 3 times, and the mean value obtained was used for statistical analysis. The relationships between patient age and corneal biomechanical parameters, or age and intraocular pressure (IOP), were investigated.

Results:

Mean corneal hysteresis and corneal resistance factor were 10.1±1.5 mmHg and 10.1±1.6 mmHg, respectively. Mean central corneal thickness was 539.1±30.9 µm. A weak, but significant, negative correlation was found between age and corneal hysteresis (Pearson's correlation coefficient r=−0.17,
P
=.02) and corneal resistance factor (r=−0.18
P
=.01). On the other hand, no significant correlation was found between age and central corneal thickness (r=−0.06,
P
=.41), age and IOP
cc
(r=−0.02,
P
=.82), or age and IOP
G
(r=−0.11,
P
=.11).

Conclusions:

Corneal biomechanical parameters are significantly decreased by aging without significant changes in central corneal thickness or IOP, suggesting that age-related structural changes resulting from collagen cross-linking may lead to a reduction of corneal biomechanical variables independent of central corneal thickness or IOP. [
J Refract Surg
. 2009;25:888–893.]
Comparación y evaluación de las bases de datos ERIC, LISA e ISA sobre el tema "Recuperación de la Información"
Authors: Salvador Oliván J. A. , Angós Ullate J. M. , Fernández Ruiz Mª J.
Published: October 2009

Se ha realizado una búsqueda bibliográfica sobre «recuperación de la información» en las bases de datos ERIC, LISA e ISA del distribuidor DIALOG, durante el período de tiempo de enero de 1995-junio de 1997, exigiendo que apareciera el término sólo en el título. Los objetivos son estudiar las características y factores relacionados con la cobertura, actualización e indización de las bases de datos, así como determinar los temas de investigación más frecuentes y el coste-beneficio de las bases de datos. En los resultados de la evaluación, una característica común y negativa de las tres bases de datos es el considerable tiempo de demora en su actualización. Respecto a la indización, es LISA la que adolece de especificidad y exhaustividad en los términos índice, si bien es la que mayor número de revistas y de documentos cubre. Debido a la existencia de referencias no pertinentes, puede resultar la base de datos más cara. ERIC destaca por ser económica, buen grado de especificidad, exhaustividad y precisión en la indización; sin embargo cubre pocas revistas aunque son las más importantes. ISA es una base de datos con una cobertura importante e indizada con precisión y exhaustividad; por contra, es la más cara de todas.
Calidad de la indización e incidencia de errores en la base de datos ECOSOC
Authors: Extremeño Ana
Published: October 2009

Se presentan los resultados del análisis y de la evaluación de la base de datos ECOSOC, producida y distribuida por el CINDOC, relativos a los registros sobre Ciencia Política. Se aplican indicadores de calidad para la evaluación del proceso de indización de los términos empleados en la descripción temática de la base de datos, así como indicadores formales con el fin de analizar la estructura de los registros bibliográficos e identificar el índice de errores contenidos en cada uno de los campos que componen dichos registros.
Veinte años de producción historica sobre la Guerra Civil Española (1975-1995): Una aproximación bibliométrica
Authors: Ruiz Franco María del Rosario , Riesco Roche Sergio
Published: October 2009

Análisis cuantitativo e historiográfico de la producción histórica sobre la guerra civil española (1936-1939) a través de lo publicado en libros y publicaciones periódicas españolas e internacionales de 1975 a 1995, obtenido en bases de datos, catálogos, repertorios bibliográficos y bibliografías especializadas. A partir del análisis de los datos, se presentan resultados en los siguientes aspectos: producción por materias, producción por años, áreas geográficas más estudiadas, aspectos editoriales más destacados, valoración de revistas y autores más prolíficos.
Nuevas perspectivas para la catalogación: Metadatos Versus Marc
Authors: Ortiz-Repiso Jiménez Virginia
Published: October 2009

Se analizan los sistemas de metadatos que existen en diferentes colectivos para solucionar los problemas que plantea la búsqueda y recuperación efectiva de recursos en Internet. Se comparan, además, los nuevos sistemas con los registros bibliográficos utilizados en las bibliotecas. Por último, se estudia la posibilidad de que estos sistemas puedan reemplazar a las herramientas que se utilizan de forma generalizada en las bibliotecas: el formato MARC y las reglas de catalogación.
La protección jurídica de los autores de las bases de datos en el derecho comunitario y en el español
Authors: Pajuelo Macías Antonio
Published: October 2009

El artículo analiza la protección jurídica de los autores de las bases de datos: la extensión de la protección a las bases de datos electrónicas y no electrónicas; la originalidad del autor en la selección o disposición del contenido de las bases de datos como criterio exclusivo o condición "sine qua non" para su protección; la distinción entre los derechos de autor sobre el contenido de las bases de datos (artículos de revistas, estadísticas...) y los derechos de autor sobre la selección o disposición de este contenido y, por último, las excepciones o limitaciones a estos derechos.
El consumo de información en la industria farmaceútica. I. Resultados del análisis de la demanda del CINDOC.
Authors: Ordóñez Vergara María José
Published: October 2009

En este artículo se exponen los principales resultados de una parte del trabajo de investigación realizado por la autora sobre las empresas pertenecientes al sector farmacéutico ubicadas en la Comunidad Autónoma de Madrid (CM). La finalidad del estudio ha sido conocer el consumo de información de los laboratorios farmacéuticos de la CM clientes fijos del Centro de Información y Documentación Científica (CINDOC, dependiente del CSIC) a través de los datos recogidos de su archivo administrativo, referentes a las peticiones de información realizadas por estas empresas en el período 1994-95. Mediante el uso de indicadores bibliométricos se ha realizado un análisis pormenorizado de los tipos y la temática de los documentos más demandados, su actualidad, idioma y país de publicación, la localización topográfica y el suministro de los mismos, principalmente.
XML como medio de normalización y desarrollo documental.
Authors: De la Rosa Antonio , Senso José A.
Published: October 2009

El Web, como entorno de trabajo para los profesionales de la documentación, requiere la utilización de nuevas herramientas que permitan gestionar la información de forma estructurada y organizada. XML y las especificaciones que se derivan de él ofrecen una amplia gama de soluciones a los diversos problemas que atañen a nuestra disciplina, tanto para el desarrollo de software documental como para las tareas cotidianas. En este artículo se presenta brevemente la norma XML y se evalúa su posible impacto en la profesión así como las posibilidades de utilizarlo como vehículo para la creación de sistemas de información.
Rendimiento de los sistemas de recuperación en la world wide web: revisión metodológica.
Authors: Olvera Lobo María Dolores
Published: October 2009

Este estudio pretende contribuir a establecer una metodología para la evaluación de la recuperación de información de las herramientas de búsqueda en el entorno de la World Wide Web. Se detalla el método diseñado (y aplicado con éxito), para evaluar los resultados de las búsquedas, adaptando las técnicas tradicionales de evaluación a las particularidades de la Web y empleando las medidas de la precisión y exhaustividad, basadas en la relevancia, para los 20 primeros resultados recuperados.
Tesauros en HTML. Un modelo de diseño y estructura para su consulta en la malla mundial (WWW).
Authors: Valle Bracero Antonio , Del Rey Guerrero Alfredo , Páez Mañá Jorge , Valle Bracero Reyes
Published: October 2009

Se describe un modelo de diseño y estructura de tesauros para su consulta y utilización en tratamientos de indización de bases de datos a través de la malla mundial (WWW). Como fuentes de estudio de partida se analizaron los modelos empleados en diferentes gestores de documentación de ayuda: AcroRead, HTML Help, NetHelp, etc., utilizados para facilitar, a los usuarios de las diferentes aplicaciones, las normas de uso de las mismas. Para la elaboración del trabajo, se han adoptado las directrices expuestas en «Microsoft's HTML Help».El formato origen de los tesauros piloto, empleados en las pruebas, ha sido el establecido para la aplicación CAT (Confección Automática de Tesauros) desarrollada en el CINDOC. Desde dicho formato, con la metodología descrita en el presente trabajo, se ha obtenido un árbol de ficheros HTML que incorpora índices de búsqueda, localización y enlace, que permiten al usuario, mediante un programa navegador, un posicionamiento en el lugar del texto que hace referencia al término objeto de su búsqueda. En dicho posicionamiento pueden observarse indicaciones sobre las relaciones del término seleccionado con otros términos. Estos últimos pueden servir, a su vez, como elementos idóneos para realizar nuevos posicionamientos.Las pruebas realizadas sobre diferentes tesauros, tanto en red como en CD-ROM, han sido satisfactorias.
Conducta informativa de los investigadores argentinos en Humanidades y Ciencias Sociales.
Authors: Romanos de Tiratel Susana
Published: October 2009

Se expone una investigación que intenta responder a dos cuestiones: ¿es correcto transferir las conclusiones de los estudios de usuarios en Humanidades y Ciencias Sociales llevados a cabo en los países anglosajones al medio universitario argentino que presenta realidades diferentes, tiene ambientes organizacionales distintos y sistemas y servicios bibliotecarios menos desarrollados? Y, si a pesar de las disimilitudes de recursos, existe un sustrato común que tipifica al investigador en Humanidades y en Ciencias Sociales respecto de sus actividades de acceso a la información, sus preferencias y sus necesidades informativas, independientemente del lugar donde desarrolle sus tareas y de las facilidades materiales de las que disponga. A partir de los problemas planteados se fijó como objetivo establecer perfiles, modalidades de acceso y preferencias en la utilización de la información de los investigadores en Humanidades y Ciencias Sociales de la Facultad de Filosofía y Letras (UBA), Una vez hecho esto, comprobar similitudes y diferencias con los resultados de investigaciones similares efectuadas, principalmente, en los países anglosajones. Se utilizó una metodología que combinó encuestas, entrevistas y análisis de citas. Los resultados llevan a concluir que, en primer lugar, no existen diferencias sustanciales en la conducta informativa de los investigadores de ambas áreas entre sí, ni tampoco marcadas disimilitudes con la que se ha descrito en otros países; por lo tanto, las dos hipótesis iniciales se han visto confirmadas por los resultados de este estudio.
Aspectos sobre el depósito legal de publicaciones españolas de Bellas Artes andaluzas (1987-1996).
Authors: Herrera Morilla José Luis
Published: October 2009

Después de localizar los documentos producidos en las ocho provincias andaluzas y en el resto de España, desde 1987 a 1996, que tienen por contenido las Bellas Artes y que hacen referencia a Andalucía, se realiza un estudio comparativo entre las obras localizadas y depositadas en la Biblioteca Nacional y la Biblioteca de Andalucía, distinguiendo las obras publicadas en cada año, las diferentes materias, las tipologías documentales y los lugares de publicación. Esta comparación y cuantificación de los datos permite también comprobar algunos aspectos relacionados con el cumplimiento del Depósito Legal en Andalucía. Éste se compara con el nacional y se aportan una serie de reflexiones y conclusiones al respecto.
Soil Genesis and Development, Lesson 2: Weathering Processes of Rocks and Minerals
Authors: Mamo Martha , Kettler Timothy , Ippolito James , Reuter Ronald , McCallister Dennis , Morner Patricia , Soester Jody
Published: October 2009

Weathering of rocks and minerals, which include physical, chemical, and biological processes, contributes to the development of soil. The degree of weathering depends not only on the rock and mineral composition but also on climate and biological activities. Experiential learning activities for different global regions support the learning objectives.
Soil Genesis and Development, Lesson 3: Soil Forming Factors
Authors: Ippolito James , Mamo Martha , Timothy Kettler  , Reuter Ronald , McCallister Dennis , Morner Patricia , Soester Jody
Published: October 2009

This lesson explores the five major factors of soil formation—(1) climate, (2) organisms, (3) time, (4) topography, and (5) parent material—and their influence in forming soil. The distinction between active and passive factors, moisture and temperature regimes, organism and topographic influences, and parent material sources are described.
Critical Thinking for Natural Resource, Agricultural, and Environmental Ethics Education
Authors: Quinn Courtney , Burbach Mark E. , Matkin Gina S. , Flores Kevin
Published: October 2009

Future decision makers in natural resource fields will be required to make judgments on issues that lack clear solutions and with information complicated by ethical challenges. Therefore, natural resource, environmental, and agricultural professionals must possess the ability to think critically about the consequences of policy, economic systems, and individual human behaviors on the environment. To ensure that future professionals can examine competing claims, university students must develop critical thinking skills that allow them to examine ethical issues surrounding the environment. We review literature on critical thinking specifically in regard to necessary components to creating critical thinking opportunities in the classroom. We then discuss special considerations for teaching critical thinking in the context of natural resource and agriculture ethics education.
Automated sleep–wake staging combining robust feature extraction, artificial neural network classification, and flexible decision rules
Authors: Chapotot Florian , Becq Guillaume
Published: October 2009

The classification of sleep–wake stages suffers from poor standardization in scoring criteria and heterogeneous conditioning of polysomnographic signals. To improve applicability of fully automated sleep staging, we have designed a formal classification framework to rigorously (1) select robust candidate features, (2) emulate artificial neural network classifiers, and (3) assign sleep–wake stages using flexible decision rules. An extensive database of 48 PSG records scored in 20 s epochs by two independent clinicians was used. A small subset of 2 s elementary epochs representative of each stages with unequivocal expert scores was selected to form a limited set of learning exemplars. From 16 statistical, spectral and non‐linear candidate features extracted in 2 s epochs from EEG and EMG signals, a sequential forward search selected an optimal set of five features with a 22% error rate. Multiple layer perceptrons were trained from this optimal feature set while classification accuracy was assessed using the unequivocal instance subset. A simple majority vote among 10 consecutive classifier outputs ensured a final scoring resolution comparable to that of the experts. Poor classification performance was obtained for movement time, wakefulness, and intermediate sleep stages with a 36±15% error rate (Cohen's kappa 0.48±0.18). In contrast, deep and paradoxical sleep was classified with an 82% accuracy not far from inter‐expert expert agreement (83±3%). Significant improvements should be expected using a larger learning set compensating for a high inter‐individual variability, and decision rules incorporating more domain‐knowledge. Copyright © 2009 John Wiley & Sons, Ltd.
Characteristics of teens with and without work permits
Authors: Dal Santo Janet Abboud , Bowling J. Michael
Published: October 2009

Background

Factors associated with the issuance of mandated work permits for teens, and their enforcement are currently unknown.

Methods

A cross‐sectional survey was administered to 1945 teens at 16 randomly selected North Carolina high schools. Predictor variables examined included teens' socio‐demographic characteristics, employment patterns, and labor law knowledge.

Results

One thousand and ninety‐four non‐working and 844 working teens participated. Seventy‐seven percent of working teens worked during the school year and 39% started working younger than 16. The majority (80%) worked in retail and services. Forty‐four percent worked without work permits. Factors associated with being less likely to be issued a work permit included white race, employment in a family‐owned business, being a laborer, and limited or no knowledge of child labor laws.

Conclusions

Adherence to and enforcement of the work permit system is low. Interventions should specifically target teens who work in family owned businesses, in unskilled labor and in hazardous industries. Am. J. Ind. Med. 52:841–849, 2009. © 2009 Wiley‐Liss, Inc.