bluuebunny/crossref_metadata_2025 huggingface dataset:
Dp71 gene disruption alters the composition of the dystrophin-associated protein complex and neuronal nitric oxide synthase expression in the hypothalamic supraoptic and paraventricular nuclei
Authors: Benabdesselam Roza , Dorbani-Mamine Latifa , Benmessaoud-Mesbah Ouahiba , Rendon Alvaro , Mhaouty-Kodja Sakina , Hardin-Pouzet Hélène
Published: April 2012

DP71 is the major cerebral dystrophin isoform and exerts its multiple functions via the dystrophin-associated protein complex (DAPC), also comprised of β-dystroglycan (β-DG) and α1-syntrophin (α1-Syn). Since DP71 disruption leads to impairment in the central control of the osmoregulatory axis, we investigated: 1) the DAPC composition in the hypothalamic supraoptic nucleus (SON) and paraventricular nucleus (PVN) of Dp71-null mice; and 2) the expression and activity of neuronal nitric oxide synthase (nNOS), because it is a potential partner of the DAPC and a functional index of osmoregulatory axis activity. In wild-type mice, dystrophins and their autosomal homologs the utrophins, β-DG, and α1-Syn were localized in astrocyte end feet. In Dp71-null mice, the levels of β-DG and α1-Syn were lower and utrophin expression did not change. The location of the DAPC in astrocytic end feet suggests that it could be involved in hypothalamic osmosensitivity, which adapts the osmotic response. The altered composition of the DAPC in Dp71-null mice could thus explain why these mice manifest an hypo-osmolar status. In the SON and PVN neurons of Dp71-null mice, nNOS expression and activity were increased. Although we previously established that DP140 is expressedde novoin these neurons, the DAPC remained incomplete due to the low levels of β-DG and α1-Syn produced in these cells. Our data reveal the importance of DP71 for the constitution of a functional DAPC in the hypothalamus. Such DAPC disorganization may lead to modification of the microenvironment of the SON and PVN neurons and thus may result in a perturbed osmoregulation.
Effects of androgens on cardiovascular remodeling
Authors: Ikeda Yasumasa , Aihara Ken-ichi , Yoshida Sumiko , Akaike Masashi , Matsumoto Toshio
Published: April 2012

Androgens, the male sex hormones, exert various biological effects on many target organs through the transcriptional effects of the nuclear androgen receptor (AR). ARs are expressed not only in classical target organs, such as the brain, genital organs, bone, and skeletal muscles, but also in the cardiovascular system. Because the female sex hormones estrogens are well-known to protect against cardiovascular disease, sex has been considered to have a significant clinical impact on cardiovascular mortality. However, the influence of androgens on the cardiovascular system has not been fully elucidated. To clarify this issue, we analyzed the effects of administration of angiotensin II and doxorubicin, an anticancer agent, in a loading model in male wild-type and AR-deficient mice. In this review, we focus on the actions of androgens as potential targets for the prevention of cardiovascular diseases in males.
Long-term experiments of composite beams and connections
Authors: Al-deen Safat , Ranzi Gianluca , Vrcelj Zora
Published: April 2012

Composite steel–concrete solutions are commonly used in Australia for floor building applications. In these situations secondary beams are usually connected to primary beams or columns by means of composite web side plate connections, also known as fin or single plate joints, with the slab continuous at the connection. The rigidity of this arrangement can lead to extensive cracking at the joint and to significant compressive forces in the web side plate connection, which can compromise one of the design limit states. In this context, this paper focuses on serviceability limit state and presents the results of two sets of experiments aimed at investigating how the time-dependent behaviour of the concrete affects the response of such joints. The first set included six simply supported specimens subjected to a sustained negative moment with the connection placed at their mid-span. These were used to study the behaviour of the negative moment region of a continuous floor beam in isolation. The second set consisted of a full-scale two-span continuous composite beam with the joint specified at the internal support. The long-term response of these composite members was monitored measuring the changes in deflection, end rotation, strain and slip occurring over time. Design considerations are provided at the end of the paper and it is envisaged that these new experimental data will be useful for the validation and benchmarking of analytical and numerical models.
Tram priority at signal-controlled junctions
Authors: Sermpis Dimitris , Papadakos Panos , Fousekis Kostas
Published: April 2012

The introduction of the new tramway system in Athens was combined with the enhancement of the transport infrastructure in the city centre. To accomplish efficient use of the new transportation mode, priority was given to the tram over the rest of the motorised traffic. This paper discusses the adopted signal control approaches which were designed and implemented aiming at achieving tram priority. Features of these strategies included several signal control characteristics such as the minimum allowed green indication for a phase, the extension of the stage including the tram movement and the installation of an amber and red signal head.
Immunosuppressive Regimen and Interstitial Fibrosis and Tubules Atrophy at 12 Months Postrenal Transplant
Authors: Gelens Mariëlle A.C.J. , Steegh Floor M.E.G. , van Hooff Johannes P. , Jan van Suylen Robert , Nieman Frederikus H.M. , van Heurn Lodewijk W.E. , Peutz-Kootstra Carine J. , Christiaans Maarten H.L.
Published: April 2012

Background and objectives

Chronic renal transplant dysfunction is histopathologically characterized by interstitial fibrosis and tubular atrophy. This study investigated the relative contribution of baseline donor, recipient, and transplant characteristics to interstitial fibrosis and tubular atrophy score at month 12 after renal transplantation.

Design, setting, participants, & measurements

This retrospective study includes all 109 consecutive recipients with adequate implantation and month 12 biopsies transplanted between April of 2003 and February of 2007. Immunosuppression regimen was tacrolimus and steroids (10 days) plus either sirolimus or mycophenolate mofetil.

Results

Average interstitial fibrosis and tubular atrophy score increased from 0.70 to 1.65 (P<0.001). In an adjusted multiple linear regression analysis, interstitial fibrosis and tubular atrophy score at month 12 was significantly related to donor type (donors after cardiac death versus living donor had interstitial fibrosis and tubular atrophy score+0.41, 95% confidence interval=0.05–0.76, P=0.02), baseline interstitial fibrosis and tubular atrophy, and immunosuppression regimen. Because of interaction between the latter two variables (P=0.002), results are given separately: recipients with a baseline interstitial fibrosis and tubular atrophy score of zero had a 0.60 higher score at month 12 (95% confidence interval=0.09–1.10, P=0.02) when mycophenolate mofetil-treated, whereas recipients with a baseline interstitial fibrosis and tubular atrophy score more than zero had a 0.38 higher score at month 12 (95% confidence interval=0.01–0.74, P=0.04) when sirolimus-treated. A higher score at month 12 correlated with a lower estimated GFR (ρ=−0.45, P<0.001).

Conclusions

These findings suggest that histologic assessment of a preimplantation biopsy may guide choice of immunosuppresion to maximize transplant survival and its interaction with type of immunosuppression.
Osteoprotegerin/RANKL Axis and Progression of Coronary Artery Calcification in Hemodialysis Patients
Authors: Ozkok Abdullah , Caliskan Yasar , Sakaci Tamer , Erten Gaye , Karahan Gonca , Ozel Alper , Unsal Abdulkadir , Yildiz Alaattin
Published: April 2012

Background and objectives

Vascular calcification is associated with increased cardiovascular mortality in chronic hemodialysis patients. This prospective study investigated the relationship between serum osteoprotegerin, receptor activator of NF-κB ligand, inflammatory markers, and progression of coronary artery calcification score.

Design, setting, participants, & measurements

Seventy-eight hemodialysis patients were enrolled. Serum IL-1β, IL-6, TNF-α, osteoprotegerin, receptor activator of NF-κB, fetuin A, and bone alkaline phosphatase were measured by ELISA. Coronary artery calcification score was measured two times with 1-year intervals, and patients were classified as progressive or nonprogressive.

Results

Baseline and first-year serum osteoprotegerin levels were significantly higher in the progressive than nonprogressive group (17.39±9.67 versus 12.90±6.59 pmol/L, P=0.02; 35.17±18.35 versus 24±11.65 pmol/L, P=0.002, respectively). The ratio of serum osteoprotegerin to receptor activator of NF-κB ligand at 1 year was significantly higher in the progressive group (0.26 [0.15–0.46] versus 0.18 [0.12–0.28], P=0.004). Serum osteoprotegerin levels were significantly correlated with coronary artery calcification score at both baseline (r=0.36, P=0.001) and 1 year (r=0.36, P=0.001). Importantly, progression in coronary artery calcification score significantly correlated with change in serum osteoprotegerin levels (r=0.39, P=0.001). In addition, serum receptor activator of NF-κB ligand levels were significantly inversely correlated with coronary artery calcification scores at both baseline (r=−0.29, P=0.01) and 1 year (r=−0.29, P=0.001). In linear regression analysis for predicting coronary artery calcification score progression, only baseline coronary artery calcification score and change in osteoprotegerin were retained as significant factors in the model.

Conclusions

Baseline coronary artery calcification score and serum osteoprotegerin levels were significantly associated with progression of coronary artery calcification score in hemodialysis patients.
National trends in carotid artery revascularization surgery
Authors: Dumont Travis M. , Rughani Anand I.
Published: April 2012

Object

Several randomized trials have emerged with conflicting data on the overall safety of carotid artery stenting (CAS) in comparison with carotid endarterectomy (CEA). The authors hypothesize that changes in national trends correspond to publication of randomized trials, including an increase in utilization of CAS after publication of trials favorable to CAS (for example, Carotid and Vertebral Artery Transluminal Angioplasty Study [CAVATAS] and Stenting and Angioplasty with Protection in Patients at High Risk for Endarterectomy [SAPPHIRE]) and decrease in utilization of CAS after publication of trials favorable to CEA (for example, Endarterectomy versus Stenting in Patients with Symptomatic Severe Carotid Stenosis [EVA3-S] and Stent-Supported Percutaneous Angioplasty of the Carotid Artery versus Endarterectomy [SPACE]).

Methods

The Nationwide Inpatient Sample was obtained for the years 1998–2008. Individual cases were isolated for principal diagnosis of unilateral or bilateral carotid artery stenosis or occlusion undergoing CEA or CAS. The percentage of CAS for all carotid revascularization procedures was calculated for each year. Perioperative inpatient morbidity, including stroke or death, were calculated and compared.

Results

The percentage of patients undergoing CAS increased yearly from the start of the observed period to the end, with the exception of a decrease in 2007. The peak utilization of CAS for carotid artery revascularization procedures was 15% of all cases in 2006. The stroke or death rate was consistent at 5% among all patients undergoing CEA for all years, while the incidence of stroke or death decreased among patients undergoing CAS from 9% in 1998 to 5% in 2008.

Conclusions

The practice of CAS in the US is expanding, from less than 3% of all carotid artery revascularization procedures to 13% in 2008. The utilization of CAS was seen to correlate with publication of randomized trials. Utilization nearly doubled in 2005 after publication of the CAS-favorable SAPPHIRE in 2004, and decreased by 22% after publication of the CEA-favorable EVA-3S and SPACE in 2007. With the publication of Carotid Revascularization Endarterectomy Versus Stenting Trial (CREST), the authors predict a resultant increase in the rate of CAS for carotid artery disease in the upcoming years.
Multimodality management of Spetzler-Martin Grade III arteriovenous malformations
Authors: Pandey Paritosh , Marks Michael P. , Harraher Ciara D. , Westbroek Erick M. , Chang Steven D. , Do Huy M. , Levy Richard P. , Dodd Robert L. , Steinberg Gary K.
Published: April 2012

Object

Grade III arteriovenous malformations (AVMs) are diverse because of their variations in size (S), location in eloquent cortex (E), and presence of central venous drainage (V). Because they may have implications for management and outcome, the authors evaluated these variations in the present study.

Methods

Between 1984 and 2010, 100 patients with Grade III AVMs were treated. The AVMs were categorized by Spetzler-Martin characteristics as follows: Type 1 = S1E1V1, Type 2 = S2E1V0, Type 3 = S2E0V1, and Type 4 = S3E0V0. The occurrence of a new neurological deficit, functional status (based on modified Rankin Scale [mRS] score) at discharge and follow-up, and radiological obliteration were correlated with demographic and morphological characteristics.

Results

One hundred patients (49 female and 51 male; age range 5–68 years, mean 35.8 years) were evaluated. The size of AVMs was less than 3 cm in 28 patients, 3–6 cm in 71, and greater than 6 cm in 1; 86 AVMs were located in eloquent cortex and 38 had central drainage. The AVMs were Type 1 in 28 cases, Type 2 in 60, Type 3 in 11, and Type 4 in 1. The authors performed embolization in 77 patients (175 procedures), surgery in 64 patients (74 surgeries), and radiosurgery in 49 patients (44 primary and 5 postoperative).

The mortality rate following the management of these AVMs was 1%. Fourteen patients (14%) had new neurological deficits, with 5 (5%) being disabling (mRS score > 2) and 9 (9%) being nondisabling (mRS score ≤ 2) events. Patients with Type 1 AVMs (small size) had the best outcome, with 1 (3.6%) in 28 having a new neurological deficit, compared with 72 patients with larger AVMs, of whom 13 (18.1%) had a new neurological deficit (p < 0.002). Older age (> 40 years), malformation size > 3 cm, and nonhemorrhagic presentation predicted the occurrence of new deficits (p < 0.002). Sex, eloquent cortex, and venous drainage did not confer any benefit.

In 89 cases follow-up was adequate for data to be included in the obliteration analysis. The AVM was obliterated in 78 patients (87.6%), 69 of them (88.5%) demonstrated on angiography and 9 on MRI /MR angiography. There was no difference between obliteration rates between different types of AVMs, size, eloquence, and drainage. Age, sex, and clinical presentation also did not predict obliteration.

Conclusions

Multimodality management of Grade III AVMs results in a high rate of obliteration, which was not influenced by size, venous drainage, or eloquent location. However, the development of new neurological deficits did correlate with size, whereas eloquence and venous drainage did not affect the neurological complication rate. The authors propose subclassifying the Grade III AVMs according to their size (< 3 and ≥ 3 cm) to account for treatment risk.
Cigarette smoking: a risk factor for postoperative morbidity and 1-year mortality following craniotomy for tumor resection
Authors: Lau Darryl , Ziewacz John E. , Siddiqi Hasan K. , Pelly Amanda , Sullivan Stephen E. , El-Sayed Abdulrahman M.
Published: April 2012

Object

Identifying risk factors for surgical morbidity and mortality might improve the safety and efficacy of neurosurgical intervention. Cigarette smoking is a relatively common practice and is associated with several adverse health outcomes. The authors examined the relationship between smoking and intraoperative blood loss, postoperative outcomes, and survival following craniotomy for tumor resection.

Methods

A consecutive population of patients undergoing craniotomy for tumor resection between 2006 and 2009 was identified. Using multivariable models and Cox proportional hazard regression analysis, the authors assessed the relation between smoking and operative outcomes including blood loss, complication rates, hospital length of stay, 30-day mortality, and 1-year survival among patients who underwent craniotomy for tumor resection.

Results

A total of 453 patients were included in this study: 237 patients never smoked, 54 quit smoking for at least 1 year, and 162 were current smokers. Current smoking status was an independent risk factor for higher intraoperative blood loss, complication risk, and lower 1-year survival following intervention relative to patients who never smoked. Patients who quit smoking had significantly higher mean blood loss, but did not carry a higher risk for other outcomes such as postoperative complications and 1-year mortality compared with patients who never smoked.

Conclusions

Current cigarette smoking is associated with poor surgical outcome and lower 1-year survival after undergoing craniotomy for tumor resection. However, quitting smoking and implementing strict smoking cessation programs may help mitigate these risks. Future research might investigate mechanisms underlying these associations.
Individuality as Reliability: A Dog Trainer's Guide to Nietzsche
Authors: Havas Randall
Published: April 2012

Meaning, in the sense that interests Nietzsche, is possible only on the basis of what he calls “obedience over a long period of time and in a single direction” (BGE 188). That he considers one's authority as a speaker to be in this way a function of obedience suggests that a better understanding of training more generally might help us understand his conception of the achievement of intelligibility. To that end, I begin an exploration in this article of the notions of authority and obedience in Nietzsche's work through the perspective of the formal obedience training of dogs. I contend that understanding the distinction between predictability and reliability in the context of dog training sheds new light on what we might think of as the normative dimension of the sovereign individual's reliability as described in the Genealogy and helps to make clear why, for Nietzsche, individuality is best understood as a form of mutuality.
Translating Nietzsche: The Case of Kaufmann
Authors: Schacht Richard
Published: April 2012

No one has loomed larger in Nietzsche's English-language translation history (and interpretation history) than Walter Kaufmann. We owe much to him. It seems to me, however, that just as he needed surpassing as an interpreter, he also needs surpassing as a translator; for there is a good deal that is problematic about his Nietzsche translations, in a variety of respects—some of which has affected his interpretation in ways that I consider unfortunate. I identify and discuss a number of my specific concerns, drawing attention to some of the texts and aspects of Nietzsche's thought that tend to be perceived and understood (by English-speaking readers) in questionable ways to which Kaufmann's translation decisions have contributed. My larger intention is to use this “case” to underscore the need for English-speaking interpreters of Nietzsche to pay close and careful attention to what he actually says in his German texts.
Schwann cell glycogen selectively supports myelinated axon function
Authors: Brown Angus M. , Evans Richard D. , Black Joel , Ransom Bruce R.
Published: April 2012

Objective:

Interruption of energy supply to peripheral axons is a cause of axon loss. We determined whether glycogen was present in mammalian peripheral nerve, and whether it supported axon conduction during aglycemia.

Methods:

We used biochemical assay and electron microscopy to determine the presence of glycogen, and electrophysiology to monitor axon function.

Results:

Glycogen was present in sciatic nerve, its concentration varying directly with ambient glucose. Electron microscopy detected glycogen granules primarily in myelinating Schwann cell cytoplasm, and these diminished after exposure to aglycemia. During aglycemia, conduction failure in large myelinated axons (A fibers) mirrored the time course of glycogen loss. Latency to compound action potential (CAP) failure was directly related to nerve glycogen content at aglycemia onset. Glycogen did not benefit the function of slow‐conducting, small‐diameter unmyelinated axons (C fibers) during aglycemia. Blocking glycogen breakdown pharmacologically accelerated CAP failure during aglycemia in A fibers, but not in C fibers. Lactate was as effective as glucose in supporting sciatic nerve function, and was continuously released into the extracellular space in the presence of glucose and fell rapidly during aglycemia.

Interpretation:

Our findings indicated that glycogen is present in peripheral nerve, primarily in myelinating Schwann cells, and exclusively supports large‐diameter, myelinated axon conduction during aglycemia. Available evidence suggests that peripheral nerve glycogen breaks down during aglycemia and is passed, probably as lactate, to myelinated axons to support function. Unmyelinated axons are not protected by glycogen and are more vulnerable to dysfunction during periods of hypoglycemia. ANN NEUROL 2012;72:406–418.
Stakeholder perspectives on dissemination and implementation of a prospective surveillance model of rehabilitation for breast cancer treatment
Authors: Stout Nicole L. , Andrews Kimberly , Binkley Jill M. , Schmitz Kathryn H. , Smith Robert A.
Published: April 2012

The prospective surveillance model proposes a paradigm shift in the delivery of care for patients with breast cancer. The model is based on clinical research and clinical practice experience that was reviewed and discussed at a multidisciplinary meeting. The model identifies critical physical sequelae of treatment as well as timeframes for identification of and surveillance for these issues. Although the model of ongoing assessment for physical impairment and early rehabilitative intervention creates a framework for care, broad support and active dissemination among a variety of stakeholders will be required to transform patient care. Translating research findings to transform practice often occurs on a protracted timeline. The authors sought participation from a variety of stakeholder representatives throughout the process of creating this model in an effort to ensure that it reflects the realities of the patient experience and care delivery, to incorporate their input regarding the construct and viability of the model, and to potentiate effective and efficient strategies for implementation. This article summarizes comments from stakeholder representatives concerning the prospective surveillance model for rehabilitation for women treated for breast cancer. Concerns addressed include the scope of impairments included in the model, the potential creation of barriers to exercise and participation in community exercise programs, and cost and feasibility issues. Stakeholder disseminations strategies are also presented. Overall, there is recognition by the stakeholder group that this model calls attention to important unmet needs and defines a crucial opportunity to improve care for breast cancer survivors. Cancer 2012;118(8 suppl):. © 2012 American Cancer Society.
Integrating a prospective surveillance model for rehabilitation into breast cancer survivorship care
Authors: Gerber Lynn H. , Stout Nicole L. , Schmitz Kathryn H. , Stricker Carrie T.
Published: April 2012

At some point during or after treatment, breast cancer may be considered a chronic illness, presenting many choices for managing the disease, its adverse treatment‐related effects, other medical comorbidities as well as the biobehavioral burden of having a life‐threatening disease, even for individuals with potentially curable breast cancer. Health care models, such as the chronic care model, the medical home, and the shared care model, provide a context for building survivorship health care models. Goals and characteristics of recently proposed shared care models for cancer survivorship health care delivery closely align with the goals and concepts of the prospective surveillance model (PSM) proposed elsewhere in this supplement to the journal Cancer. Given these similarities, along with the growth and expansion of survivorship care models and impending mandates for delivery, there is merit to considering how implementation of the PSM can be integrated with models of survivorship care delivery. The PSM model will likely face many similar challenges and barriers that have impeded widespread dissemination of other survivorship models of care. There exist opportunities to integrate lessons learned as well as to align efforts to achieve greater impact on the shared goal of improving health outcomes for breast cancer survivors. Cancer 2012;118(8 suppl):. © 2012 American Cancer Society.
Cost considerations regarding the prospective surveillance model for breast cancer survivors
Authors: Cheville Andrea L. , Nyman John A. , Pruthi Sandhya , Basford Jeffrey R.
Published: April 2012

For this article, the authors examined the cost implications of the prospective surveillance model (PSM) for breast cancer (BC) survivors, a comprehensive framework designed to preemptively reduce the incidence and virulence of common impairments. The model clearly has the potential of providing significant benefits. However, its accompanying costs and resource requirements remain unclear and may be substantial. Thus, it is critical to examine which BC survivors may benefit from the PSM, how much they will benefit, and the costs of this benefit before its implementation. Because the PSM is not rigidly prescriptive, its examination must allow for different scenarios with emphasis on 4 critical determinants of cost—whether all or only high‐risk BC survivors participate, assessment frequencies and locations, the credentials of the assessors, and requirements for supportive equipment. Another issue is the distribution of its cost: hypothetical implementation strategies vary widely in their distribution of fiscal burden across key stakeholders—survivors, providers, and payers—whose financial responsibilities will be an important factor in whether and how rapidly they adopt the PSM. Accurate valuation of the PSM will require capture of direct and indirect cost savings and benefits. Currently, a lack of data regarding these parameters, as well as outcomes that can be reliably attributed to the PSM, impedes cost‐effectiveness analyses. Because the PSM may enhance many health state characteristics, assessments that integrate overall composite measures with evaluations of common, discrete impairments may be required to comprehensively assess its benefits. Cancer 2012;118(8 suppl):. © 2012 American Cancer Society.
A prospective surveillance model for rehabilitation for women with breast cancer
Authors: Stout Nicole L. , Binkley Jill M. , Schmitz Kathryn H. , Andrews Kimberly , Hayes Sandra C. , Campbell Kristin L. , McNeely Margaret L. , Soballe Peter W. , Berger Ann M. , Cheville Andrea L. , Fabian Carol , Gerber Lynn H. , Harris Susan R. , Johansson Karin , Pusic Andrea L. , Prosnitz Robert G. , Smith Robert A.
Published: April 2012

BACKGROUND:

The current model of care for individuals with breast cancer focuses on treatment of the disease, followed by ongoing surveillance to detect recurrence. This approach lacks attention to patients' physical and functional well‐being. Breast cancer treatment sequelae can lead to physical impairments and functional limitations. Common impairments include pain, fatigue, upper‐extremity dysfunction, lymphedema, weakness, joint arthralgia, neuropathy, weight gain, cardiovascular effects, and osteoporosis. Evidence supports prospective surveillance for early identification and treatment as a means to prevent or mitigate many of these concerns. This article proposes a prospective surveillance model for physical rehabilitation and exercise that can be integrated with disease treatment to create a more comprehensive approach to survivorship health care. The goals of the model are to promote surveillance for common physical impairments and functional limitations associated with breast cancer treatment; to provide education to facilitate early identification of impairments; to introduce rehabilitation and exercise intervention when physical impairments are identified; and to promote and support physical activity and exercise behaviors through the trajectory of disease treatment and survivorship.

METHODS:

The model is the result of a multidisciplinary meeting of research and clinical experts in breast cancer survivorship and representatives of relevant professional and advocacy organizations.

RESULTS/CONCLUSIONS:

The proposed model identifies time points during breast cancer care for assessment of and education about physical impairments. Ultimately, implementation of the model may influence incidence and severity of breast cancer treatment‐related physical impairments. As such, the model seeks to optimize function during and after treatment and positively influence a growing survivorship community. Cancer 2012;118(8 suppl):. © 2012 American Cancer Society.
Judicial settlement‐seeking in parenting disputes: Consensus and controversy
Authors: Semple Noel
Published: April 2012

The judicial role in child custody and visitation disputes has traditionally been understood as one of authoritative decision‐making. However this new empirical research suggests that many family court judges prioritize the pursuit of voluntary settlement in pre‐trial conferences, using evaluative and facilitative mediation techniques. Drawing on qualitative interviews with judges and other family law professionals in Toronto and New York City, this article identifies points of consensus and controversy among settlement‐seeking family judges. Despite the general support for settlement‐seeking, there are substantial differences of opinion regarding coercion, due process, and the meaning of the best interests of the child standard.
Consciousness and conflict (explained better?)
Authors: McGuigan Richard , Popp Nancy
Published: April 2012

Integral Conflict presents a new map of conflict. Drawing on the work of James Mark Baldwin, William James, Ken Wilber, Leslie Combs, and others, we focus on the evolution of consciousness within the experience of conflict, refracting human experience into its four fundamental dimensions: individual and collective; internal and external. Using the River Conflict as a real‐life case study, the authors illustrate how an integral approach to conflict analysis and action allows practitioners to choose among the most relevant and effective tools, techniques, and insights to more effectively support the constructive engagement of conflict.
Hyponatremia in cirrhosis
Authors: Sigal Samuel H.
Published: April 2012

Hyponatremia is common in patients with cirrhosis. Portal hypertension, diuretics, large volume paracentesis without albumin, infection, and multiple medications are connected with the development or worsening of hyponatremia. Hyponatremia in cirrhosis, particularly advanced cirrhosis, is a common development.1 In a population survey of 997 patients with cirrhosis, 486 (49.4%) and 211 (21.6%) had a serum sodium concentration ([Na+]) <135 mEq/L and ≤130 mEq/L, respectively.2 Hyponatremia and its severity correlate with the presence of severe complications of cirrhosis such as hepatorenal syndrome, encephalopathy, and spontaneous bacterial peritonitis. The presence of hyponatremia frequently complicates the management of the cirrhotic patient. Journal of Hospital Medicine 2012; 7:S14–S17. © 2012 Society of Hospital Medicine
Analysis of bladder vascular resistance before and after prostatic surgery in patients with lower urinary tract symptoms suggestive of benign prostatic obstruction
Authors: Wada Naoki , Watanabe Masaki , Kita Masafumi , Matsumoto Seiji , Kakizaki Hidehiro
Published: April 2012

Aims

To evaluate bladder vascular resistance before and after transurethral resection of the prostate (TURP).

Methods

Thirty‐three patients with lower urinary tract symptoms (LUTS) suggestive of benign prostatic obstruction were prospectively studied. We analyzed correlations of bladder vascular resistance with various factors including age, vascular risk factors, symptom score, prostate volume (PV), and urodynamic parameters before and 3 months after TURP. Using contrast‐enhanced color Doppler ultrasonography for measuring bladder vascular resistance, resistive index (RI) of vesical arteries was calculated.

Results

Compared with healthy young male (n = 10) and age‐matched controls (n = 10), the study patients had a higher preoperative RI (0.403 ± 0.100, 0.436 ± 0.042, and 0.561 ± 0.089, respectively; P < 0.01). Preoperative RI was significantly higher in patients with PV ≥ 60 ml versus <60 ml (0.604 ± 0.078 vs. 0.525 ± 0.082; P < 0.01), and in patients with severe obstruction versus mild/moderate obstruction (0.615 ± 0.087 vs. 0.534 ± 0.078; P = 0.017). Overall RI decreased significantly after TURP (from 0.561 ± 0.089 to 0.450 ± 0.086; P < 0.001). In patients with persistent urgency after TURP, RI was less improved than in those without urgency after TURP (change of RI 0.068 ± 0.098 vs. 0.135 ± 0.090; P < 0.05). This study was limited by a small sample size.

Conclusions

Bladder vascular resistance in patients with LUTS was elevated in correlation with PV and severity of obstruction. Although bladder vascular resistance decreased significantly after TURP in overall patients, less reduction of vascular resistance was related to persistent urgency after TURP, implying that persistent urgency after TURP might be caused by persistent bladder ischemia. Neurourol. Urodynam. 31:659–663, 2012. © 2012 Wiley Periodicals, Inc.
Prevalence of bladder dysfunction, urodynamic findings, and their correlation with outcome in Guillain‐Barre syndrome
Authors: Naphade Pravin Umakant , Verma Rajesh , Garg Ravindra Kumar , Singh Maneesh , Malhotra Hardeep Singh , Shankwar Satya Narayan
Published: April 2012

Aims

The micturitional disturbances and related urodynamic studies are infrequently reported in Guillain Barre syndrome (GBS). In the present study, we evaluated patients of GBS for bladder dysfunction and urodynamic abnormalities. We also tried to assess relation between urodynamic findings with disability in patients diagnosed as GBS.

Methods

In this study, 38 patients of GBS were assessed for micturitional disturbances and disability using Hughes motor grade, Overall Disability Sum Score (ODSS), Medical Research Council (MRC) sum score. Urodynamic studies were carried out at baseline and at 2 months.

Results

Out of 38 patients, 10 patients had urinary symptoms, 23 patients had urodynamic abnormalities and most common being detrusor underactivity in 15 patients. Other findings were detrusor sphincter dyssynergia in six patients, acontractile bladder in five patients, and detrusor overactivity in three patients. Decreased uroflow rates were seen in 14 patients. Severe disability in the form of Hughes motor grades 4–5, ODSS leg scores 4–7, low MRC scores were significantly more common in patients with urodynamic abnormalities. The axonal variant of GBS patients demonstrated more frequent abnormal urodynamic findings.

Conclusions

Our study revealed fair incidence of micturitional disturbances and urodynamic dysfuctions in GBS. The subclinical bladder involvement was frequently observed, substantiated by urodynamic assessment. The disability, particularly of lower limbs had positive correlation with urodynamic abnormality. Neurourol. Urodynam. 31:1135–1140, 2012. © 2012 Wiley Periodicals, Inc.
Clustering biomolecular complexes by residue contacts similarity
Authors: Rodrigues João P. G. L. M. , Trellet Mikaël , Schmitz Christophe , Kastritis Panagiotis , Karaca Ezgi , Melquiond Adrien S. J. , Bonvin Alexandre M. J. J.
Published: April 2012

Inaccuracies in computational molecular modeling methods are often counterweighed by brute‐force generation of a plethora of putative solutions. These are then typically sieved via structural clustering based on similarity measures such as the root mean square deviation (RMSD) of atomic positions. Albeit widely used, these measures suffer from several theoretical and technical limitations (e.g., choice of regions for fitting) that impair their application in multicomponent systems (N > 2), large‐scale studies (e.g., interactomes), and other time‐critical scenarios. We present here a simple similarity measure for structural clustering based on atomic contacts—the fraction of common contacts—and compare it with the most used similarity measure of the protein docking community—interface backbone RMSD. We show that this method produces very compact clusters in remarkably short time when applied to a collection of binary and multicomponent protein–protein and protein–DNA complexes. Furthermore, it allows easy clustering of similar conformations of multicomponent symmetrical assemblies in which chain permutations can occur. Simple contact‐based metrics should be applicable to other structural biology clustering problems, in particular for time‐critical or large‐scale endeavors.Proteins 2012; © 2012 Wiley Periodicals, Inc.
Synthesis of superconducting Bi2Sr2CaCu2O8+δ single crystals using alumina crucibles with different purities
Authors: Ishida Hiroki , Kato Takahiro , Takasaki Masashi , Hamasaki Katsuyoshi
Published: April 2012

A self‐flux method is the simplest technique for synthesizing Bi2Sr2CaCu2O8+δ (Bi‐2212) superconducting single crystals. However, the crystals are inevitably contaminated because of the Bi‐2212 stoichiometric melt reacting with the crucible material. In this paper, we investigate the nonsuperconducting subproduct that forms during heating in the self‐flux method for synthesizing Bi‐2212. This subproduct was identified as BiSr2CaAl3O9 by X‐ray diffraction. Bi‐2212 crystal growth was performed using A12O3 crucibles with three different purities (nominally 97, 99.7, and 99.9%). For both the 97 and 99.7% purity crucibles, the subproduct was observed in all five samples out of five, whereas for the 99.9% purity crucible, it was observed in only two samples out of five. Furthermore, the 99.9% purity crucible gave a much lower subproduct volume than the 97% purity crucible. The average superconducting critical temperature (Tc,zero) varied depending on the crucible purity; it was 89.6, 90.8, and 91.8 K for the 97, 99.7, and 99.9% purity crucibles, respectively. Finally, we fabricated Bi‐2212 stacked devices with intrinsic Josephson junctions (Bi‐2212 stack) using as‐grown crystals from the 97 and 99.9% purity crucibles. The Bi‐2212 stacks exhibited a highly hysteretic current–voltage characteristic even at liquid N2 temperature and they had identical quality parameters for Josephson junctions (i.e., Ir/Ic and voltage jump Vj). We conclude that the subproduct formation has little effect on the electrical characteristics of a Josephson junction device at 77 K. © 2012 Institute of Electrical Engineers of Japan. Published by John Wiley & Sons, Inc.
Diversifying risk in portfolios using a variable‐size genetic relation algorithm
Authors: Parque Victor , Mabu Shingo , Hirasawa Kotaro
Published: April 2012

One important concept in financial risk management is the diversification process of capital allocation. This paper proposes an evolutionary approach for the optimal diversification when making asset allocation using variable‐size genetic relation algorithm (vs‐GRA), whose main role is to model and evolve structures toward effective and diversified portfolios through its graph structure. Simulations using heterogeneous and globally located asset classes in the United States, Europe, and Asia show that the proposed scheme offers competitive economic advantages. © 2012 Institute of Electrical Engineers of Japan. Published by John Wiley & Sons, Inc.
Effects of Preoperative Oral Carbohydrate Supplementation on Postoperative Metabolic Stress Response of Patients Undergoing Elective Abdominal Surgery
Authors: Viganò Jacopo , Cereda Emanuele , Caccialanza Riccardo , Carini Roberta , Cameletti Barbara , Spampinato Marcello , Dionigi Paolo
Published: April 2012

Background

The goal of the present study was to evaluate the effects of preoperative oral carbohydrate supplementation (OCH) on the postoperative metabolic stress response of patients undergoing elective abdominal surgery.

Methods

The study was designed as a controlled, prospective, cohort study including 38 patients treated with OCH (800 mL the day before surgery and 400 mL within 3 h before the induction of anesthesia) and 38 controls matched for surgical procedure. Fasting glucose, insulin, insulin resistance (HOMA‐IR index), cortisol, and interleukin 6 (IL‐6) were assessed before and after surgery (postoperative day (POD) 1, 2, and 3).

Results

The administration of OCH resulted in lower fasting glucose, HOMA‐IR index, cortisol, and IL‐6 on both POD 1 and POD 2. At multivariable regression analyses, the reduction of these parameters was independent of sex, age, body mass index, and major abdominal surgery. Particularly, models including OCH treatment explained 70, 63, and 66 % of the variance of the increase in IL‐6 levels at POD 1, POD 2, and POD 3, respectively. The effect of OCH on changes in glucose, insulin resistance, and cortisol on POD 1 and POD 2 disappeared after the inclusion of IL‐6 in the models.

Conclusions

Treatment with OCH was associated with attenuation of the postoperative metabolic stress response. We hypothesize that modulation of the inflammatory response is one of the mechanisms involved.
Walking the walk: The moderating role of proactive parenting on adolescents' value‐congruent behaviors
Authors: Padilla‐Walker Laura M. , Fraser Ashley M. , Harper James M.
Published: April 2012

The current study longitudinally examined adolescents' internalization of values in four domains (drug use, prosocial, school, friends), and how these values were differentially related to behaviors (delinquency, prosocial behavior, school engagement, and deviant peer association) as a function of proactive parenting. Participants included 335 adolescents (M age of child at Time 2 = 12.28, SD = .99, 51% female) and their parents. Analyses examined associations between adolescents' values at Time 3 and corresponding behaviors at Time 4, and the moderating role of proactive parenting (assessed at Time 2 using cluster analysis). Results suggested that adolescents with the most consistent value‐congruent behavior had parents who used deference or reasoned deference as an approach to proactive parenting, highlighting the importance of autonomy supportive parenting in the encouragement of self‐generated values and corresponding behaviors. Discussion focused on value‐congruent behaviors and associations between values and behaviors across domains.
Patient Management in the Emergency Department by Advanced Care Paramedics
Authors: Campbell Samuel G. , Janes Sandra E. , MacKinley Robert P. , Froese Patrick C. , Harris Susan , Etsell Glen R. , Warren Donna A. , Stewart David A. , Priest Mark J. , Snook Anil J. , Urquhart David G.
Published: April 2012

We describe an emergency department process using Advanced Care Paramedics in the management of patients identified as ambulatory and low acuity, or those able to be managed without an emergency nurse. Patients streamed in this way had shorter stays than other emergency patients, without affecting the care of the latter. The process was associated with improved patient flow indicators in spite of an increased patient burden.
Enhanced Activation and Restorative Care
Authors: Crawford Heather , Anderson Sherry , TeKamp Robin , Chatzikiriakos Vaughnette , Osborne Deanne
Published: April 2012

As the Canadian population ages, it becomes increasingly important for hospitals to address and implement programs and policies that ensure elderly patients are receiving the right care in the right place at the right time. Despite the vast majority of elderly patients being healthier than ever, it is important to recognize the rapid deconditioning that occurs when they are admitted to an acute care hospital. Although it is recognized that children need to be treated differently, we fail to recognize the same is true for older adults. The Enhanced Activation Program was conceptualized during consultation with community partners while discussing the aging at home strategy. It was during these consultations that gaps in service for the frail elderly were identified and the Enhanced Activation Program was developed.
Building an International Public Health Academic Partnership: The Alberta-Lithuania Experience
Authors: Zakariasen Ken , Veryga Aurelijus
Published: April 2012

The schools of public health at the University of Alberta and the Lithuanian University of Health Sciences have developed a partnership committed to a variety of collaborations (eg, faculty/student exchanges and joint projects). Our initial efforts have resulted in the initiation of joint projects, important connections between numerous institutions/academics, and planning for future efforts within and beyond the partnership. The positive potential for such partnerships is significant, and a number of strategies for successful implementation are suggested.
Clinical, surgical, and histopathologic outcomes following failed medical abortion
Authors: Fuchs Weizman Noga , Maymon Ron , Ben‐Ami Ido , Mendlovic Sonia , Schneider David , Pansky Moty , Halperin Reuvit
Published: April 2012

Objective

To address the consequences of surgical curettage following failed medical abortion.

Methods

A retrospective case–control study was performed in a tertiary gynecologic department. The case group comprised 104 women who underwent surgical curettage following failed medical abortion; the control group included 104 women who underwent early surgically induced abortion. Clinical characteristics and surgical findings were examined. The extent of inflammation was quantified following immunohistochemical staining for cell‐surface markers characteristic of T lymphocytes, B lymphocytes, and macrophages. The extent of necrosis was evaluated morphologically.

Results

Abnormal findings during surgical curettage were significantly more prevalent among women in the case group than in the control group (10.6% versus 1.9%; P = 0.019). The most frequent abnormality in the case group was the presence of intimately adherent products of conception, necessitating sharp curettage. The extent of inflammation (represented by increased numbers of T and B lymphocytes) was greater in the case group than in the control group (P = 0.046 and P = 0.001, respectively), as was the extent of necrosis (P < 0.05).

Conclusion

Curettage following failed medical abortion harbors particular difficulties, which may be attributed to an inflammatory response. The long‐term consequences of curettage following failed medical abortion warrant further investigation.