bluuebunny/crossref_metadata_2025 huggingface dataset:
Teaching Nutrition Integration: MUST Screening in Cancer
Authors: Boléo-Tomé Carolina , Chaves Mariana , Monteiro-Grillo Isabel , Camilo Maria , Ravasco Paula
Published: January 2011

Rationale.

Nutritional risk screening should be routine in order to select patients in need of nutrition care; this conduct change has to rely on education. In this project, radiotherapy department health professionals were trained on how to use the Malnutrition Universal Screening Tool (MUST), to foster its integration into cancer outpatient management; we also aimed to identify those more adherent to screening.

Methods.

Research dieticians (the standard) conducted interactive sessions with all physicians, nurses, and radiotherapy (RT) technicians, who were closely supervised to facilitate routine MUST integration. There were two phases: after the first session, phase 1 assessed 200 patients over 4 months; after the second session, phase 2 screened 450 patients, always before RT. Validity was evaluated comparing results from the standard against all other health professionals, adjusted for number.

Results.

RT technicians were most adherent to the MUST: 80% of patients in phase 1, increasing to 85% in phase 2. Nurses doubled their input, from 19% to 36%. Physicians had poor MUST integration, yet they progressively incorporated percentage weight loss into patient records, increasing from 57% in phase 1 to 84% in phase 2, independently of diagnosis and stage. The highest concordance (κ coefficient) with dieticians was found with RT technicians' use of the MUST (p < .002) and percentage weight loss determination by physicians (p < .001).

Conclusions.

We show that systematic screening in cancer is feasible by all professionals involved, once a proximity teaching project is put into practice. RT technicians, who daily treat patients, were highly adherent to integrate the MUST and might be in charge of selecting at-risk patients. Physicians are unlikely to use the MUST, but acknowledged nutrition value and changed their routine by integrating recent percentage weight loss into their approach to patients. Our structured methodology may be used as a model for the development of teaching adapted to different departments with other realities.
Management of Skin Toxicity Associated with Cetuximab Treatment in Combination with Chemotherapy or Radiotherapy
Authors: Pinto Carmine , Barone Carlo Antonio , Girolomoni Giampiero , Russi Elvio Grazioso , Merlano Marco Carlo , Ferrari Daris , Maiello Evaristo
Published: January 2011

Background.

Cetuximab was demonstrated by clinical trials to improve response rate and survival of patients with metastatic and nonresectable colorectal cancer or carcinoma of the head and neck. Appropriate management of skin toxicity associated with epidermal growth factor receptor inhibitor (EGFR-i) therapy is necessary to allow adequate drug administration and to improve quality of life and outcomes.

Methods.

A group of Italian Experts produced recommendations for skin toxicity management using the RAND/UCLA Appropriateness Method. Statements were generated on the basis of a systematic revision of the literature and voted twice by a panel of 40 expert physicians; the second vote was preceded by a meeting of the panelists.

Results.

Skin toxicity included skin rash, skin dryness, pruritus, paronychia, hair abnormality, and mucositis. Recommendations for prophylaxis and therapeutic interventions for each type of toxicity were proposed.

Conclusions.

Interventions that were considered appropriate to improve compliance and outcomes of cancer patients treated with EGFR-i were identified.
Effect of sonication on the reactivity of silica fume in Portland cement mortars
Authors: Martínez-Velandia D. , Payá J. , Monzó J. , Borrachero M. V.
Published: January 2011

Currently, the use of silica fume for the production of mortars and high-performance concrete is of great importance to the construction materials sector. Different applications of silica fume have generated extensive studies about its high reactivity as a pozzolanic material, in addition to its effect on the properties of some materials within which it is incorporated. In this study a sonication process was applied by means of which the deagglomeration of the larger particles of densified silica fume (CSF) was achieved. The result is a CSF treated with the ultrasound probe, which is obtained for different tests where the parameters of sonication such as sonication power level and sonication time are varied. This treatment makes it possible to increase the quantity of submicrometric particles in the sample. The effect of sonication process on CSF produces a greater quantity of very fine particles, which improve the pozzolanic reactivity of silica fume and increase the fixation of hydrated lime. This behaviour also produces higher mechanical strength in mortars manufactured with sonicated silica fume (SSF). The mechanical strengths of SSF mortars were greater than those for control and CSF mortar. Different percentages of cement were substituted (between 0 and 15% by weight), and in all cases the SSF mortars showed important differences from the CSF mortar. It was observed that for the longest sonication times and highest sonication power levels, mechanical strengths were increased.
Flexural strength and microstructure of alkali-resistant glass fibre reinforced calcium aluminate-phenol resin composite
Authors: Emami S. , Nooranian H. , Kamalloo A.
Published: January 2011

Calcium aluminate-phenol resin composites are a new class of macro-defect-free cements that have better water resistivity compared with polyvinyl acetate high alumina cement composites. In this paper the effects of alkali-resistant (AR) glass fibre reinforcement on the flexural strength and microstructure of calcium aluminate-phenol resin composite were investigated. The results showed that the flexural strength can be increased by adding fibres, but there is an optimum condition that is influenced by various factors, including fibre length and fibre content. The flexural strength of composites without fibre was 120 MPa but with 5%wt. AR glass fibre with 6 mm length reached 165 MPa. The microstructural studies with scanning electron microscopy are also consistent with flexural strength tests; it was shown that the dispersing of fibre in a matrix was difficult when the fibre content was too high.
Influence of condensed silica fume on characteristics of cement-based solidified heavy metals-contaminated soil for road pavement
Authors: Hassani A. , Ganjidoust H. , Rajabpour Ashkiki A.
Published: January 2011

The solidification/stabilisation of heavy metals-contaminated soil using ordinary Portland cement and the influence of condensed silica fume (CSF) on the characteristics of solidified soil for possible pavement application were investigated in the present study. The soil to cement ratio was 1 : 12·5 and CSF was added at 3, 5 and 8% of cement by weight to mixtures during specimen preparation. The tests carried out included compressive strength, water absorption and toxicity characteristic leaching procedure, X-ray diffraction and scanning electron microscopy. At early curing ages, heavy metals-contaminated soil intensively decreased the compressive strength from 12·3 N/mm2 in cement mixture to 0·14 N/mm2 in the soil–cement mixture; and CSF had no noticeable effect on compressive strength but increased the consolidation of the relevant mixtures which satisfied the minimum US Environmental Protection Agency's regulatory limit for safe land disposal. During ageing, CSF gradually enhanced the retarded and diverted cement hydration reactions and the relevant solidified mixtures met the ACI 299R-99 requirement for controlled low strength materials in limited constructions. As an important result, the 28-day-cured soil–cement mixture which included CSF (8% by cement weight) achieved compressive strength of 45 N/mm2, which was greater than UK transportation requirement for pavement concrete. Leaching results showed that CSF with a particle size finer than 150 μm and at the added amounts had no significant and noticeable effect on the leaching characteristics. Based on X-ray diffraction patterns, the hydration reactions appeared to be diverted through the production of subsidiary products and as a result, major crystalline phases grew and developed irregularly and consequently coated the aggregates poorly, as observed in scanning electron micrographs. CSF decreased the water absorption of the solidified mixtures in which it was included and their structure became dense.
Jacking the box: a 101 h squeeze under West Coast main line
Authors: Ogborn Simon , Sreeves John , Beech Steve
Published: January 2011

One of the last level-crossings on the West Coast main line was finally removed following its replacement by an under-bridge installed as a jacked box during a 101 h track possession. The Owen Street level-crossing next to Tipton station was a notorious local bottleneck, with the barriers typically closed for 75% of the day. This paper describes the planning and construction of its replacement that opened in January 2010, which was undertaken in a highly constrained site between the railway and a canal, and in very difficult ground conditions. The box straddling a geological fault, and the post-industrial nature of the site meant that old mine workings, a canal basin and bridge abutments had to be dealt with along with major utilities.
Turning segmental tunnels into sources of renewable energy
Authors: Franzius Jan Niklas , Pralle Norbert
Published: January 2011

Geothermal energy is a universal low-grade renewable energy source and can be built into any engineering structures that provide large interface areas with the ground. There are already a number of case studies on retrieving geothermal energy from tunnels lined with sprayed concrete, but this paper presents a new system for segmental tunnel linings. Following a field trial in Germany it has been successfully installed in a new high-speed railway tunnel in Austria to supply a municipal building with heating energy. The paper demonstrates how subsurface urban structures can contribute both to sustainable city planning and the provision of decentralised renewable energy.
The four major rivers restoration project in South Korea
Authors: Shin Jong-Ho , Chung Jae-Yong
Published: January 2011

A massive and fast-moving £12 billion programme is underway throughout South Korea to restore its four major rivers, which following decades of poor management have become silted, polluted and flood-prone. In addition to delivering permanent measures for controlling water volumes and quality, the 3-year ‘Korean Green New Deal’ project looks set to bring significant environmental and economic benefits to much of the country. This paper describes the vast scale of the works, which include restoring 700 km of waterways, dredging over 500 million m3 of silt, building 16 dams, constructing over 1000 water-treatment facilities and installing nearly 280 GW of hydropower.
Modelling gender perception of quality in interurban bus services
Authors: Rojo Marta , Gonzalo-Orden Hernan , dell'Olio Luigi , Ibeas Angel
Published: January 2011

This paper models how women and men perceive the quality of interurban bus services and proposes a new methodology for detecting the highest priority service variables to act on. Service quality perception was modelled using both ordered logit and ordered probit models using data from revealed preference surveys. The methodology for detecting different priority levels uses the graphic representation of the relationships between influence in the model and average evaluation by users. The modification of certain variables increases the knowledge of how woman evaluate quality in bus services to help promote the use of interurban public transport. Statistical analysis of the data provides some conclusions such as: the proportion of users increases as age decreases for both men and women; and women seem to make shorter and more frequent trips than men. The best model for this data set was ordered logit. As expected, the most relevant variable is the relationship between quality and price. Other important variables are the condition of the bus and the frequency of service.
Mapping landfill gas migration using resistivity monitoring
Authors: Rosqvist Håkan , Leroux Virginie , Dahlin Torleif , Svensson Mats , Lindsjö Magnus , Månsson Carl-Henrik , Johansson Sara
Published: January 2011

Results of geoelectrical resistivity monitoring at two landfill sites, a bioreactor landfill and a conventional municipal solid waste landfill site over a week are reported. The main objective was to investigate if geoelectrical resistivity can be used for localising paths for landfill gas migration. The resistivity results were also related to local pore pressure measurements and to methane emission measurements using a laser-scanning instrument. The results suggest that the use of the interpreted resistivity and of its temporal variation can be suitable for the intended purpose, and confirm the applicability of resistivity imaging at landfills. It is also concluded that better knowledge about the dependence of resistivity variation to temperature, porosity and moisture content variations would improve the interpretation and that measuring or monitoring at least one of these additional parameters together with resistivity would be useful.
Supporting landfill development through geophysical surveys
Authors: Martínez Kerim , Mendoza José Alfredo
Published: January 2011

Landfill operators require rapid site characterisations in order to optimise economics and meet environmental regulation during both site monitoring and expansion. Geophysical surveys are increasingly filling this need, with geoelectrical and seismic methods among the most commonly demanded methods. This paper presents and discusses two cases in which geophysical methods were applied to map the subsurface in landfills and their surroundings. The applications aimed to facilitate further expansions of the landfills while complying with environmental regulations. Both electrical resistivity and seismic refraction surveys were used. The results led to the identification of sand-filled fractures and thinning clay lenses and allowed further definition of the depth to limiting geological units. These applications of geophysical methods demonstrate a dynamic and cost-efficient methodology to assist in the planning and managing of active landfills.
Influence of Thermal Extraction of Extracellular Polymeric Substances on Cell Integrity in Activated Sludge and Membrane Bioreactor Samples
Authors: Antonelli M. , Bialek K. , Teli A. , Citterio S. , Malpei F.
Published: January 2011

The influence of the soluble microbial products (SMP) and extracellular polymeric substances (EPS) heating extraction method on cell viability was evaluated for each phase of the protocol using epifluorescence microscopy. In addition, the effect of different centrifugation conditions (2700 g at 24 °C; 12 000 g at 4 °C) was also tested. Sludge samples were collected from a conventional wastewater treatment and a membrane bioreactor (MBR) pilot plant fed in parallel. Results show that different centrifugation parameters do not induce cell membrane damaging. Heating significantly influences membrane integrity; for instance, 75 to 90% of initial viable cells are damaged during this phase, possibly leading to the predominance of protein compared to carbohydrate content. The protein content in EPS is 60 to 88 mg bovine serum albumin/g volatile suspended solids (VSS); higher values observed in MBR sludge samples are probably attributable to the different characteristics of microbial flocs and process operating parameters. Carbohydrate concentrations are not significantly different regardless of applied procedure and sludge type, and are between 10.4 to 11.6 mg glucose/g VSS.
Decolorization of the AO24 Azo Dye and Reduction of Toxicity and Genotoxicity in Trickling Biofilters
Authors: Garzón‐Zúñiga Marco A. , Sandoval‐Villasana Ana M. , Moeller‐Chávez Gabriela E.
Published: January 2011

Acid Orange 24 (AO24) dye was degraded in a trickling biofilter packed with peat and wood chips and inoculated with biomass from a petrochemical industry wastewater system. Different operating strategies were tested; in the first stage, two biofilters were operated independently—one non‐aerated biofilter (passive) and the other with aeration—subsequently, the systems were operated serially, and effluent from the non‐aerated biofilter was fed to the biofilter with aeration. This treatment train was used to test three different filtration velocities—0.141, 0.282, and 0.423 m/d. The results show that, when operating the systems with a dye charge of 0.035 kg AO24 m2/d and treating the effluent in a single step, good removal efficiencies of AO24 (95 and 89%), COD (63 and 53%), and acute toxicity (63 and 78%) were obtained in both biofilters (with and without air), although mutagenic and potentially carcinogenic intermediary compounds were not removed, because genotoxicity exhibits values higher than 2.0 units for the mutation rate. When using the non‐aerated biofilter/aerated biofilter treatment train, it is possible to treat a dye charge 3 times greater (0.106 kg AO24 m2/d) and efficiently remove 98% AO24, 76% COD, 100% acute toxicity, and 100% genotoxicity, which indicates that, with this biological system, an advanced degree of biotransformation and mineralization of the azo dye AO24 is achieved.
Production and Characterization of Foam in the Anoxic Zone of a Membrane‐Enhanced Biological Phosphorus Removal Process
Authors: Hall Eric R. , Monti Alessandro , Mohn William W.
Published: January 2011

A pilot‐scale membrane‐enhanced biological phosphorus removal process accumulated substantial quantities of stable foam on the surface of the anoxic zone. The foam contained 4 to 6% dry matter, with specific nitrogen and phosphorus contents that were similar to those of the underlying anoxic zone mixed liquor. Kinetic studies demonstrated that the specific rate of phosphorus release from the foam was only 25 to 30% of that observed with mixed liquor from the aerobic zone. Molecular techniques demonstrated that the calculated similarity of the microbial communities in the foam and the underlying mixed liquor was approximately 80%, with two phylotypes (Gordonia amarae and Microthrix parvicella) being uniquely enriched in the foam and one phylotype (Epistylis sp.) more abundant in the underlying mixed liquor. The production of foam was demonstrated to be a consistent phenomenon that depended on the concentration of the suspended solids in the bioreactor.
Effect of Concentration on the Primary and Ultimate Biodegradation of Alkylpolyglucosides in Aerobic Biodegradation Tests
Authors: Jurado E. , Fernández‐Serrano M. , Núñez‐Olea J. , Lechuga M. , Jiménez J.L. , Ríos F.
Published: January 2011

This study examines the primary and ultimate biodegradation of a non‐ionic surfactant, an alkylpolyglucoside, in ready biodegradability tests. The surfactant concentration was tested by the anthrone method, while the ultimate biodegradation (mineralization) was analyzed by the total organic carbon determinations. The influence of the concentration on the extent of primary and ultimate biodegradation and the kinetics of degradation also were determined. The primary and ultimate biodegradation was studied at different initial concentrations—15, 25, 50, 75, and 100 mg/L. The increasing concentration of test chemical from 15 to 100 mg/L resulted in a decrease in the relative maximum mineralization rate and longer estimated lag times by a factor of approximately 4.3. During the degradative process, two different stages were noted; these are better described with Quiroga and first‐order kinetic models, respectively. For the study of the influence of concentration, the parameters characteristic of the biodegradation profiles in the different biodegradation assays were evaluated.
Phosphate Adsorption on Granular Palygorskite: Batch and Column Studies
Authors: Fangqun Gan , Jianmin Zhou , Huoyan Wang , Changwen Du , Wenzhao Zhang , Xiaoqin Chen
Published: January 2011

A method to prepare granular palygorskite (GPA) was put forward in this research, and its potential use to remove phosphate species from aqueous solution was assessed. Batch experiments were performed to study the adsorption equilibrium and influence of contact time and pH on the adsorption and desorption of phosphate onto GPA in water. The maximum phosphate adsorption capacity of GPA was 13.1 mg/g. Kinetic data revealed that more than 90% of phosphate was adsorbed onto GPA within 2 hours. Phosphate adsorption capacity was 0.10 mg/g in column experiments, and co‐existing anions could decrease phosphate removal. The saturated column was regenerated by 0.2 mol/L sodium hydroxide, and the GPA could be reused in phosphate removal. The data obtained from both batch and column studies indicated that GPA could be used effectively to remove phosphate from water.
Effect of Ferric Chloride Addition and Holding Time on Gravity Belt Thickening of Waste Activated Sludge
Authors: Kozak Joseph , Patel Kamlesh , Abedin Zainul , Lordi David , O'Connor Catherine , Granato Thomas , Kollias Louis
Published: January 2011

Phosphorus removal using ferric chloride (FeCl3) addition was demonstrated at the Egan Water Reclamation Plant. Concurrently, sludge thickening performance problems occurred in the gravity belt thickeners (GBTs). Blinding problems and polymer demand change were attributed to FeCl3 and long sludge holding times. Laboratory tests were conducted to gain insight to the GBT problems. Sludge holding time effects before polymer conditioning and thickening and prolonged contact of the solids with FeCl3 were evaluated via modified time‐to‐filter and blinding tests developed for this study. The tests assessed the sludge filterability under polymer and FeCl3 conditioning treatments and varying sludge holding and FeCl3 contact times. It was determined that fresh sludge was the easiest to thicken compared with sludge stored for any length of time. The FeCl3 improved thickening; however, when both the FeCl3 and polymer were used as conditioners, higher FeCl3 concentrations resulted in thickening inhibition compared with polymer alone.
"Now Serving 300 Million": How the United States Government Plans to Stop Terrorists from Using U.S. Ports and Imported Food as Instruments of Terror
Authors: Gardner Chris
Published: January 2011

This paper examines the application of the Bioterrorism Act through the regulations set by the FDA and looks at one of the numerous potential foods that could be utilized as a host for a bioterrorism agent.
Quarantine Powers, Biodefense, and Andrew Speaker
Authors: Kvinta Brad
Published: January 2011

In January 2007, Andrew Speaker (Speaker) underwent a chest X-ray and CT scan, which revealed an abnormality in his lungs. However, tests results indicated that he did not have tuberculosis (TB). In March 2007, Fulton County officials informed Andrew Speaker that he was diagnosed with a form of non-infectious form of tuberculosis. He was prescribed a regimen of first-line anti-TB drugs. Fulton County officials confirmed the positive TB result, and further tests were ordered. These tests indicated that Speaker had MDR-TB. Fulton County officials told Speaker not to travel abroad for his upcoming wedding in Europe; however, he ignored them. Unbeknownst to any health official, Speaker departed Atlanta for Europe on May 12, 2007. Two weeks later, the Center for Disease Control (CDC) informed him that his diagnosis had changed and that he had a drug-resistant form of tuberculosis named XDR-TB. Speaker was in Rome at the time. CDC officials directed him to turn himself into Italian authorities for isolation and asked that he not return home on commercial airlines. Speaker was even placed on a no fly list by the CDC. Again, Speaker ignored CDC officials and returned to the United States via Canada. From Prague, Speaker flew back to Montreal on two commercial aircrafts, and on May 25, 2007, Speaker entered the United States from Canada by car. Despite being aware of the border alert, the border guard allowed Speaker into the United States. Once in the United States, CDC officials served Speaker with an isolation order and hospitalized him at Bellevue Hospital in New York City. CDC officials placed him in a secure part of the hospital, where he underwent a medical evaluation to determine the status of his TB. Speaker was then allowed to return to Atlanta, where he faced intense media scrutiny. He then was transferred to the National Jewish Medical Center in Denver for further treatment of his XDR-TB. Eventually, however, officials downgraded his diagnosis to MDR-TB as they had originally. Speaker had surgery to remove the lung infected with MDR-TB at the end of July, and he was declared non-contagious.Clearly, Speaker sparked significant interest in public health on both the national and international levels. Speakers initial disregard for United States authority created an opportunity for criticism of local, state, and federal public health laws, while Speakers subsequent disregard of authorities while abroad allowed for questioning of international public health law and in particular, the effectiveness of the International Health Regulations. This overview explains certain areas of national and international public health law, and Speakers impact on these areas.
Introduction: The Launch of the Journal of Biosecurity, Biosafety & Biodefense Law
Authors: Sutton Victoria
Published: January 2011

Introduction and welcome to the Journal of Biosecurity, Biosafety & Biodefense Law
Race Disparities in U.S. Nephrology Fellowship Training
Authors: Onumah Chavon , Kimmel Paul L. , Rosenberg Mark E.
Published: January 2011

Background and objectives

Renal disease disproportionately affects African-American patients. Trust has been implicated as an important factor in patient outcomes. Higher levels of trust and better interpersonal care have been reported when race of patient and physician are concordant. The purpose of this analysis was to examine trends in the racial background of U.S. medical school graduates, internal medicine residents, nephrology fellows, and patients with ESRD.

Design, setting, participants, & measurements

Data for medical school graduates were obtained from the Association of American Medical Colleges and data for internal medicine and nephrology trainees from GME Track. ESRD data were obtained from U.S. Renal Data System (USRDS) annual reports.

Results

A significant disparity continues to exist between the proportional race makeup of African-American nephrology fellows (3.8%) and ESRD patients (32%). The low numbers of African-American nephrology fellows, and consequently new nephrologists, in light of the increase in ESRD patients has important implications for patient-centered nephrology care.

Conclusions

Efforts are needed to increase minority recruitment into nephrology training programs, to more closely balance the racial background of trainees and patients in hopes of fostering improved trust between ESRD caregivers and patients, increasing access to care, alleviating ESRD health care disparities, and improving patient care.
Randomized, Double-blind Study with Glycerol and Paraffin in Uremic Xerosis
Authors: Balaskas Elias , Szepietowski Jacek C. , Bessis Didier , Ioannides Dimitrios , Ponticelli Claudio , Ghienne Corinne , Taberly Alain , Dupuy Patrick
Published: January 2011

Background and objectives

Uremic xerosis is a bothersome condition that is poorly responsive to moisturizing and emollient therapy.

Design, setting, participants, & measurements

A randomized, double-blind, intraindividual (left versus right comparison), multicentric clinical study was performed on 100 patients with moderate to severe uremic xerosis for 7 days, during which the patients applied twice daily an emulsion combining glycerol and paraffin (test product) on one allocated lower leg, and the emulsion alone (comparator) on the other lower leg. This was followed by an open-labeled use of the test product on all of the xerotic areas for 49 days. The main efficacy parameter was treatment response on each lower leg, as defined by a reduction from baseline of at least two grades in a five-point clinical score on day 7.

Results

Among the 99 patients analyzed, the test product was highly effective with a treatment response in 72 patients (73%), whereas 44 patients (44%) responded to the comparator (P < 0.0001, intergroup analysis). This was associated with an objective reduction in the density and thickness of the scales on day 7 (P < 0.0001 compared with the comparator) and a substantial improvement of the uremic pruritus (75%) and quality of life of the patients at study end (P < 0.001, intragroup analysis). The test product was very well tolerated, with product-related local intolerance (exacerbated pruritus, local burning, or erythema) occurring in only five patients (5%).

Conclusions

Uremic xerosis can be managed successfully when an appropriate emollient therapy is used.
A Validation Study of the Canadian Organ Replacement Register
Authors: Moist Louise M. , Richards Heather A. , Miskulin Dana , Lok Charmaine E. , Yeates Karen , Garg Amit X. , Trpeski Lilyanna , Chapman Ann , Amuah Joseph , Hemmelgarn Brenda R.
Published: January 2011

Background and objectives

Accurate and complete documentation of patient characteristics and comorbidities in renal registers is essential to control bias in the comparison of outcomes across groups of patients or dialysis facilities. The objectives of this study were to assess the quality of data collected in the Canadian Organ Replacement Register (CORR) compared with the patient's medical charts.

Design, setting, participants, & measurements

This cohort study of a representative sample of adult, incident patients registered in CORR in 2005 to 2006 examined the prevalence, sensitivity, specificity, positive and negative predictive values, and κ of comorbid conditions and agreement in coding of patient demographics and primary renal disease between CORR and the patient's medical record. The effect of coding variation on patient survival was evaluated.

Results

Medical records on 1125 patients were reviewed. Agreement exceeded 97% for health card number, date of birth, and sex and 71% (range 46.6 to 89.1%) for the primary renal disease. Comorbid conditions were under-reported in CORR. Sensitivities ranged from 0.89 (95% confidence interval 0.80, 0.92) for hypertension to 0.47 (0.38, 0.55) for peripheral vascular disease. Specificity was >0.93 for all comorbidities except hypertension. Hazard ratios for death were similar whether calculated using data from CORR or the medical record.

Conclusions

Comorbid conditions are under-reported in CORR; however, the associated risks of mortality were similar whether using the CORR data or the medical record data, suggesting that CORR data can be used in clinical research with minimal concern for bias.
Breast Arterial Calcification
Authors: Duhn Valerie , D'Orsi Ellen T. , Johnson Samuel , D'Orsi Carl J. , Adams Amy L. , O'Neill W. Charles
Published: January 2011

Background and objectives

Because previous studies have not distinguished between intimal (atherosclerotic) and medial vascular calcification, the prevalence and clinical significance of either condition in chronic or end-stage kidney disease (CKD or ESKD) are unknown. We hypothesized that breast arterial calcification (BAC) is exclusively medial and that mammography can serve as a useful marker of generalized medial calcification in CKD and ESKD.

Design, setting, participants, & measurements

Arterial calcification was identified histologically in breast tissue or visually in mammograms and radiographs of extremities from patients with CKD or ESKD.

Results

Medial calcification but no intimal calcification was present in all 16 specimens from patients with CKD or ESKD. In 71 women with ESKD, BAC was present on mammograms in 63% compared with 17% in women without renal insufficiency matched for age, race, and diabetes (P < 0.001). Age and ESKD duration were significant, independent predictors of BAC. BAC was also present in 36% of mammograms from the same patients performed 5.5 ± 0.7 years before the onset of ESKD (P < 0.05 versus control) but in only 14% of patients with stage 3 CKD. Comparison of mammograms and extremity radiographs revealed that BAC was present in over 90% of patients with peripheral arterial calcification (PAC), and PAC was observed in less than 6% of patients without BAC.

Conclusions

BAC is a specific and useful marker of medial vascular calcification in CKD, and its prevalence is markedly increased in ESKD and advanced CKD.
Does Greater Risk-Bearing in Stock Option Compensation Reduce the Influence of Problem Framing On Managerial Risk-Taking Behavior?
Authors: Sawers Kimberly , Wright Arnold , Zamora Valentina
Published: January 2011

ABSTRACT: We examine the extent to which the behavioral agency model reflects the relation between greater risk-bearing in stock option compensation and managerial risk-taking. The behavioral agency model predicts that managers with greater wealth at stake will avoid risky projects that threaten their wealth. This greater risk-bearing effect moderates the problem-framing effect, which predicts that loss-averse managers will be more (less) risk-taking when choosing among loss (gain) projects. Using a 2 × 2 between-subjects experiment with 108 M.B.A. students acting as managers, we find that managers are more risk-taking in the loss context than in the gain context when they have at-the-money stock options but not when they have wealth at stake through in-the-money stock options. Further, we find that managers with in-the-money stock options are less risk-taking than managers with at-the-money stock options in the loss context. These findings support the behavioral agency model prediction that greater risk-bearing in stock option compensation (moving from at-the-money stock options to in-the-money stock options) reduces the problem framing effect on risk-taking behavior, particularly when the firm faces a loss decision context. Our results point to the importance of considering the implications of risk-bearing in stock option compensation for managers choosing risky projects that affect firm value.
An Exploration of Accountants, Accounting Work, and Creativity
Authors: Bryant Stephanie M. , Stone Dan , Wier Benson
Published: January 2011

ABSTRACT: In two studies, we explore whether creativity is essential—or antithetical—to professional accounting work. In Study 1, archival analysis of U.S. Department of Labor data indicates that: (1) professional accounting work requires no less creativity than do three competing professions and a diverse sample of U.S. occupations, and (2) greater creativity may be required in financial than in auditing and taxation accounting work. In Study 2, a survey contrasts the self-assessed and number-of-uses creativity of governmental accounting professionals and Master’s of Accountancy (M.Acc.) students with that of M.B.A. students. Results indicate lower creativity among accountants and M.Acc. students compared with M.B.A. students, and no systematic relationship between ethics and creativity. We conclude that while creativity matters to accounting work—more to some areas of accounting practice than others—accountancy education and work may attract or reward entrants with less than desirable levels of creativity, perhaps due to the common belief that creativity is unneeded in, or even deleterious to, professional accountancy work.
The 25-Year Cumulative Incidence of Lower Extremity Amputations in People With Type 1 Diabetes
Authors: Sahakyan Karine , Klein Barbara E.K. , Lee Kristine E. , Myers Chelsea E. , Klein Ronald
Published: January 2011

OBJECTIVE

To examine the 25-year cumulative incidence of lower-extremity amputation (LEA) in people with type 1 diabetes.

RESEARCH DESIGN AND METHODS

Cumulative incidence of LEA was ascertained in Wisconsin Epidemiologic Study of Diabetic Retinopathy participants (n = 943) using the Kaplan-Meier approach accounting for competing risk of death. Relationships of baseline characteristics with incidence of LEA were explored using a proportional hazards approach with discrete linear regression modeling.

RESULTS

The overall 25-year incidence of LEA was 10.1%. In multivariate analyses (results reported as odds ratio; 95% CI), being male (3.90; 2.29–6.65), heavy smoking (2.07; 1.11–3.85), having hypertension (3.36; 1.91–5.93), diabetic retinopathy (2.62; 1.13–6.09), neuropathy (1.68; 1.02–2.76), and higher HbA1c (per 1% 1.40; 1.24–1.58) were independently associated with the incidence of LEA.

CONCLUSIONS

Our results show a high 25-year incidence of LEA and suggest that glycemic control and blood pressure control and preventing heavy smoking may result in reduction in its incidence.
Underdiagnosed and Undertreated Depression Among Racially/Ethnically Diverse Patients With Type 2 Diabetes
Authors: Sorkin Dara H. , Ngo-Metzger Quyen , Billimek John , August Kristin J. , Greenfield Sheldon , Kaplan Sherrie H.
Published: January 2011

OBJECTIVE

To examine racial/ethnic differences in the prevalence of depressive symptoms and in provider recognition of depression among Latino, Asian, and non-Hispanic white patients with type 2 diabetes.

RESEARCH DESIGN AND METHODS

Patients (n = 1,209) with type 2 diabetes were recruited from five university-affiliated primary care clinics for an observational study.

RESULTS

Vietnamese American (133, 59.4%) and Mexican American (351, 50.2%) patients were more likely to report symptoms consistent with clinical depression (Center for Epidemiological Studies Depression [CES-D] scale score ≥22) than non-Hispanic whites (119, 41.6%; F [2, 1206] = 8.05, P < 0.001). Despite comparable diabetes care, Vietnamese and Mexican patients with high depressive symptoms were less likely to be diagnosed and treated than non-Hispanic whites (all P values < 0.001). Minority patients who reported low levels of trust in their provider were less likely to have been diagnosed or treated for depression (adjusted odds ratio 0.65, 95% CI 0.44–0.98, P < 0.05).

CONCLUSIONS

Innovative strategies are needed to improve recognition of depressive symptoms in minority patients.
Oncogenic osteomalacia of the cervical spine: a rare case of curative resection and reconstruction
Authors: Akhter Murtaza , Sugrue Patrick A. , Bains Rick , Khavkin Yevgeniy A.
Published: January 2011

Oncogenic osteomalacia (OO) is a rare paraneoplastic syndrome, with only 100 reported cases in the literature. The majority of OO-associated mesenchymal tumors are due to a lesion called phosphaturic mesenchymal tumor, mixed connective tissue (PMTMCT) variant. There have been only 6 reported cases of OO of the spine. With this paper the authors present a case of OO of the cervical spine in a patient who initially presented with multiple pathological fractures of unknown cause, and who eventually underwent staged C-5 spondylectomy followed by circumferential stabilization. Resection of the cervical lesion led to resolution of his hypophosphatemia and prevention of any further pathological fractures. The authors describe a rare cervical neoplasm, its treatment, and review the literature on this rare bony pathological entity.
Arteriovenous malformation of the conus supplied by the artery of Desproges-Gotteron
Authors: Tubbs R. Shane , Mortazavi Martin M. , Denardo Andrew J. , Cohen-Gadol Aaron A.
Published: January 2011

The artery of Desproges-Gotteron is rarely mentioned in the literature and is unfamiliar to most neurosurgeons. The authors report a unique case of an arteriovenous malformation (AVM) of the conus in an adult woman, which received blood supply from an artery of Desproges-Gotteron. The patient presented with intermittent pain radiating down the right posterior thigh and foot and transient bladder incontinence. On examination, there was weakness of the right lower limb with hypalgesia of the plantar aspect of the right foot. Magnetic resonance imaging revealed a mass near the anterior aspect of the conus medullaris and angiography confirmed a spinal AVM at the L-1 level and a shunt located at the inferior L-3 level. The patient underwent transarterial embolization, and at 2-year follow-up, repeat angiography demonstrated no evidence of residual or recurrent spinal AVM, intermittent and tolerable pain without treatment interventions, and a normal neurological examination. The artery of Desproges-Gotteron appears to be a rare arterial variation. Moreover, the authors believe this to be the first case of a conal AVM supplied by such an artery. The anatomy and implications of such an arterial variant are discussed.
Serum triglyceride level in type 2 diabetes mellitus patients with or without Frozen shoulder
Authors: Salek AKM , Mamun MAA , Haque MA , Mannan M , Ali E , Islam S , Rizvi AN , Chowdhury AZ , Islam J , Rahman MH , Ferdous C
Published: January 2011

Background: Musculoskeletal disorders are very common among the diabetic patients and frozen shoulder is one of the disabling conditions. The present study was conducted to compare the serum triglyceride level among the patients of type 2 diabetic presented with and without frozen shoulder.Methodology: This case control study was conducted from January 2008 to December 2009, in the department of Physical Medicine and Rehabilitation, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka with an aim to compare the serum triglyceride level among diabetic patients presented with, and without frozen shoulder. Thirty types 2 diabetic patients with frozen shoulder were selected as cases and similar number well matched type 2 diabetic patients without frozen shoulder were selected as control.Results: We prospectively studied 30 diabetes mellitus (type 2) patients with the diagnosis of frozen shoulder. The blood sugar both fasting and 2 hours after breakfast, HbA1c and serum triglyceride levels were measured in all patients and compared with those in 30 diabetic patients without frozen shoulder. The blood sugar, fasting and 2 hours after breakfast, HbA1C and serum triglyceride levels were significantly elevated in the frozen-shoulder group (fasting blood sugar p = 0.012; blood sugar 2 hours after breakfast p<0.01; HbA1C p<0.05; and triglyceride p < 0.001).Conclusion: Diabetic type 2 patients presented with frozen shoulder had higher serum triglyceride level compare to the diabetic type 2 patients without frozen shoulder. DOI: 10.3329/bmrcb.v36i2.6990Bangladesh Med Res Counc Bull 2010; 36: 64-67
« Entretanto/que el sol al mundo alumbre... », una hipérbole fosilizada
Authors: Navarro Durán Rosa
Published: January 2011

Al final de la elegía I, Garcilaso intensifica la alabanza de don Fernando de Toledo con la formulación de dos tópicos. La hipérbole « se cantará de ti por todo el mundo », referida al espacio, se une a otra fórmula que quiere plasmar una duración temporal indefinida, con los mismos límites que la del mundo y su orden, « entretando / que el sol al mundo alumbre... ». Sus comentaristas señalan la doble raíz virgiliana : Égloga V y Eneida, I. El tópico, opuesto a los adynata, pero con función semejante, responde al esquema « mientras..., en tanto que (dum...) + el orden natural siga », y se utiliza para asegurar la eternidad de la alabanza, la permanencia del nombre del loado, o en otros casos, la perennidad del amor, la promesa de fidelidad amorosa eterna. Es frecuente en la poesía latina (Ovidio lo desarrolla ampliamente en Amores, I, 15). En la poesía de la Edad de Oro aparece tanto en elegías como en églogas.
La conversion de Guzmán de Alfarache : de la justification marchande à la stratégie de la Raison d'État
Authors: Cavillac Michel
Published: January 2011

Dans ce travail, centré sur les deux derniers chapitres de V Atalaya, on analyse comment Guzmán, conformément aux coordonnées augustiniennes de sa trajectoire, se voit providentiellement « justifié » dans sa vocation marchande avant de projeter la logique capitaliste de sa conversion sur le plan politique « du service de Sa Majesté ». En mobilisant la théologie au profit d'une conflictuelle stratégie du « bien commun », dans la ligne de la « raison d'État catholique » exaltée alors par les réformateurs mercantilistes, le taci- tiste Alemán plaide à l'évidence pour l'avènement en Espagne d'une modernité qui, malheureusement, lui apparaît tout aussi problématique que la libération finale de son héros-narrateur.
Du « Justo Juez » à la « Santa Cruz de Caravaca » [Contribution à l'étude des oraisons populaires hispano-mexicaines]
Authors: Ricard Robert
Published: January 2011

Partiendo de la oración de El Justo Juez, estudia el autor de este trabajo las variantes que presenta un texto análogo, señalando la mezcla de supersticiones y devoción ortodoxa muy propia de esos impresos populares. El culto de la Santa Cruz de Aravaca, que parece haberse difundido en México y por otros países también, es muy popular en España. Se examina el texto de un folleto titulado « La Santa Cruz de Aravaca », impreso en México. Se trata de una compilación de las oraciones más variadas dirigidas a los más diversos santos. Este espigueo basta para probar que el estudio de la religión popular en México habrá de fundarse en el atento examen de esos impresos.
Análisis de « La muerte y la brújula » de Jorge Luis Borges
Authors: Fama A
Published: January 2011

L'étude de certaines particularités formelles, de la structure de cette nouvelle et de la signification symbolique, permet de montrer que « La mort et la boussole » est un récit policier avec de nettes implications métaphysiques et dans le même temps un simple jeu intellectuel non seulement entre les deux rivaux LOnnrot et Scharlach, mais encore entre Borges et son lecteur.
« El Castillo interior » y el « Arte de la memoria ».
Authors: Gerli M
Published: January 2011

« El castillo interior » et V « Arte de la memoria ».

L'aspect iconographique du castillo interior de sainte Thérèse révèle une influence de Vars memorativa, c'est-à-dire de la méthode utilisée dans les cultures et sociétés de tradition orale pour structurer la connaissance et faciliter la mémorisation. Sainte Thérèse employa la méthodologie de l'art de la mémoire pour organiser son livre et pour garantir ainsi le souvenir des voies de sa nouvelle spiritualité. Le propos du Castillo interior est de fixer la doctrine carmélite de l'oraison dans la mémoire de ses lecteurs et d'offrir une exposition claire et cohérente des croyances de la secte de sainte Thérèse. Au-delà de la piété et la conviction, il y a dans le fond de cet ouvrage une propagande réformiste qui se manifeste par un procédé rigoureux et délibéré de composition.
El simbolismo de los nombres en "Miau", historia gatuna de Madrid
Authors: Iglesias Angel
Published: January 2011

Ensayo de interpretación de una novela de Galdós a partir del valor predestinante del nombre poético. Miau es título programático y sobrenombre de los principales personajes, descritos como individuos integrados en / excluidos de la fauna de Madrid, de cuyo blasón popular Gatos es aquél derivado sinonímico. La felinidad evocada en el mote constituye el núcleo sémico de un relato con múltiples llamadas en la literatura y el folklore, de los que la novela viene a ser el intertexto en que el novelista teje la pasión y la muerte (Miau = inri) de un ejemplar de las clases pasivas : el cesante administrativo.
Una crisis de conciencia en la edad de oro en España : La Inquisición contra "Limpieza de Sangre"
Authors: Kamen H.
Published: January 2011

La existencia de leyes racistas contra los conversos de origen judío en España muy a menudo dio a suponer que todos los conversos estaban excluidos de los cargos y que este racismo fue aceptado por todos los españoles. Este artículo sugiere que muy al contrario muchos españoles (y no solamente estos de origen judío) se opusieron a los estatutos de limpieza, y que incluso la Inquisición, principalmente entre 1580 y 1640, adoptó una postura abierta contra la práctica del racismo.