bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical Outcomes and Static and Dynamic Assessment of Foot Posture After Lateral Column Lengthening Procedure
Authors: Barske Heather , Chimenti Ruth , Tome Josh , Martin Elizabeth , Flemister Adolph S. , Houck Jeff
Published: January 2013

Background:

Lateral column lengthening (LCL) has been shown to radiographically restore the medial longitudinal arch. However, the impact of LCL on foot function during gait has not been reported using validated clinical outcomes and gait analysis.

Methods:

Thirteen patients with a stage II flatfoot who had undergone unilateral LCL surgery and 13 matched control subjects completed self-reported pain and functional scales as well as a clinical examination. A custom force transducer was used to establish the maximum passive range of motion of first metatarsal dorsiflexion at 40 N of force. Foot kinematic data were collected during gait using 3-dimensional motion analysis techniques.

Results:

Radiographic correction of the flatfoot was achieved in all cases. Despite this, most patients continued to report pain and dysfunction postoperatively. Participants post LCL demonstrated similar passive and active movement of the medial column when we compared the operated and the nonoperated sides. However, participants post LCL demonstrated significantly greater first metatarsal passive range of motion and first metatarsal dorsiflexion during gait than did controls ( P < .01 for all pairwise comparisons).

Conclusion:

Patients undergoing LCL for correction of stage II adult-acquired flatfoot deformity experience mixed outcomes and similar foot kinematics as the uninvolved limb despite radiographic correction of deformity. These patients maintain a low arch posture similar to their uninvolved limb. The consequence is that first metatarsal movement operates at the end range of dorsiflexion and patients do not obtain full hindfoot inversion at push-off. Longitudinal data are necessary to make a more valid comparison of the effects of surgical correction measured using radiographs and dynamic foot posture during gait.

Level of Evidence:

Level III, comparative series.
A retrospective study of patients’ out-of-pocket costs for granulocyte colony-stimulating factors
Authors: Tomic Karen , Long Stacey , Li Xiaoyan , Fu An-Chen , Yu Tzy-Chyi , Barron Richard
Published: January 2013

Objective

With rising healthcare costs, there is an increasing concern with the burden of out-of-pocket costs on cancer patients. This study examined patients’ out-of-pocket expenditures for granulocyte colony-stimulating factors, pegfilgrastim and filgrastim, which are given to cancer patients receiving myelosuppressive chemotherapy and have been shown to decrease the incidence of febrile neutropenia.

Methods

Adult patients who received chemotherapy and granulocyte colony-stimulating factors in the outpatient setting in the United States between January 2007 and June 2010 were evaluated using medical and pharmacy claims data from two healthcare data sources, the MarketScan® Commercial and Medicare Supplemental Databases and the HealthCore Integrated Research DatabaseSM. The distribution of out-of-pocket costs for granulocyte colony-stimulating factors per patient and per administration was described for each quarter. Longitudinal analyses of out-of-pocket costs for granulocyte colony-stimulating factors were also performed for patients with continuous health plan eligibility during each calendar year from 2007 to 2009.

Results

The pattern of out-of-pocket expenditures for pegfilgrastim and filgrastim was generally consistent between the databases and over time. On average, about 65%–75% of patients had zero quarterly out-of-pocket costs for granulocyte colony-stimulating factors. Across the years, the mean quarterly out-of-pocket costs per patient were $100–$150 and $50–$80 for pegfilgrastim and filgrastim, respectively. The mean quarterly out-of-pocket costs for granulocyte colony-stimulating factors per administration were $40–$70 and $8–$10, respectively.

Conclusion

In this retrospective analysis of medical and pharmacy claims data, most patients who received chemotherapy and granulocyte colony-stimulating factors in 2007 to 2010 had incurred no quarterly out-of-pocket costs associated with G-CSF use.
Syndrome of Inappropriate Antidiuretic Hormone after vinorelbine treatment
Authors: Hoang Mai , Varughese Joyce , Ratner Elena
Published: January 2013

Background

Among oncologic patients, Syndrome of Inappropriate Antidiuretic Hormone is a common cause of hyponatremia, a prevalent electrolyte disorder. There are many causes for Syndrome of Inappropriate Antidiuretic Hormone, including chemotherapy medications. To date, only three cases associating vinorelbine and Syndrome of Inappropriate Antidiuretic Hormone have been published.

Case

A 47-year-old woman with stage IIIC serous ovarian adenocarcinoma developed life-threatening hyponatremia (124 mmol/L) after three cycles of vinorelbine. Assessment revealed Syndrome of Inappropriate Antidiuretic Hormone as the most likely culprit. Conservative managements including free fluid restriction normalized her sodium level and Syndrome of Inappropriate Antidiuretic Hormone resolved after vinorelbine discontinuation.

Conclusion

Vinorelbine can cause Syndrome of Inappropriate Antidiuretic Hormone. It is important to monitor sodium concentration during vinorelbine treatment to avoid serious neurological complications of hyponatremia and to improve patient's quality of life.
Clinically relevant cancer biomarkers and pharmacogenetic assays
Authors: Patel Jai N , Mandock Katherine , McLeod Howard L
Published: January 2013

Background

The number of pharmacogenetic assays available is continuously expanding as more molecularly targeted anticancer drugs are under clinical development. While the literature regarding drug–gene associations and therapeutic implications is often robust, reviews regarding clinical assay availability and profiling methodologies of commonly used cancer biomarkers are often lacking.

Objective

To concisely identify and describe cancer biomarkers and their respective pharmacogenetic assays currently available in clinical practice.

Discussion

Analysis of germ-line DNA mutations can often help to predict pharmacokinetic and pharmacodynamic responses, whereas somatic DNA mutations are particularly useful in predicting tumor response. Molecular profiling and pre-emptive identification of cancer biomarkers can help to predict disease prognosis as well as response to anticancer therapy. Dozens of pharmacogenetic assays, utilizing several common methodologies, are currently available in clinical practice. It is essential for clinicians to understand the molecular pathways for anticancer drugs, the therapeutic implications of mutations within these pathways, the clinical assay(s) available to test for pharmacogenetic differences, and the common profiling methodology employed.

Conclusion

As research continues to unveil more drug–gene and disease–gene associations, it is critical that clinicians understand which pharmacogenetic assays are available to identify inter-individual differences that predict safety and efficacy of anticancer drugs as we move toward the concept of personalized medicine.
Holistic Health and People With Spinal Cord Injuries
Authors: Shroff Farah M. , Sahota Inderjeet S.
Published: January 2013

We examined the perspectives of rehabilitation professionals in British Columbia on the use of holistic practices (HP) by their clients with spinal cord injury (SCI). This was a qualitative descriptive study with 13 rehabilitation professionals.Results show that health care practitioners serving those with SCI noted interest in and use of HP between 75% and 90% among their client groups. Most rehabilitation professionals already work in an interdisciplinary fashion with HP practitioners. Some were skeptical about HP, others saw a great benefit to their clients and others still only pursued HP when asked about it by their clients. Conclusions are that health care professionals are willing to acquire more knowledge about HP to provide the best available care. Participants showed interest in incorporating other aspects of health care to aid rehabilitation.
Fiber in Whole Foods
Authors: Alpert Patricia T.
Published: January 2013

Fiber has more health benefits than treating or preventing constipation or hemorrhoids. But most individuals do not include foods with adequate amounts of fiber to their diet. Perhaps low consumption of fiber is due to poor food choices or because one is not aware of the food high in fiber content. In this issue the facts about fiber are discussed including a list of commonly consumed foods and their fiber content.
The Promise and Pitfalls of Venture Capital as an Asset Class for Clean Energy Investment
Authors: Marcus Alfred , Malen Joel , Ellis Shmuel
Published: January 2013

If venture capital’s role in clean energy is to be more transformative in creating a sustainable society then the trends we reveal in this paper must gain momentum, but whether these trends will continue to gain momentum is not certain. We therefore encourage organization and natural environment scholars to follow up on the claims we make in this paper and pursue the questions we raise further. This paper reviews both the potential and the limitations of venture capital (VC) as a source of funding for clean energy. We provide preliminary evidence that venture capitalists (VCs) have been adjusting their operating procedures to accommodate clean energy. First, they have been investing larger amounts of money for longer periods of time. Second, they have started to avoid funding high risk production, distribution, and installation manufacturing and production companies and to a greater degree have been funding companies that focus on the intersection between information technology and energy. Third, besides making bigger bets, stretching out their timetables, and avoiding high risk and capital intensive companies, they have been experimenting with investments in companies with very risky technologies. Were these companies to succeed in commercializing these technologies the impact on the natural environment would be very great. We challenge organization and natural environment scholars to take up questions like these and others that deal with clean energy funding. Amongst a number of possible funding sources, what role is venture capital best suited to play? How would it need to change to play a more significant role? What would have to happen for venture capital to stimulate a major breakthrough, one that was of the magnitude of the Internet in transforming our economy and society in a more sustainable direction?
Accounting for the Landscape of Regeneration
Authors: Smith Robin James
Published: January 2013

This article is concerned with members’ talk-in-interaction relating to place and, more specifically, how spatial membership categorization devices serve to delineate parts of the area being discussed thus establishing commonsense topographies. This area under consideration, and in which the interviews were conducted, is Cardiff Bay, a setting constructed within a large-scale program of urban regeneration. Complimenting the foundations established by Sacks and Schegloff, and contributing to recent concerns with the relationship between place and identity, the article pays attention to the way in which “place,” far from being a fixed “container” of action is implicated and mobilized in moral accounts relating to spatial organization, membership, and belonging. It is suggested that in paying attention to the use of spatial categorizations one gains access to members’ sense-making practices and, thus, how contemporary complex urban settings come to be organized in situated action.
The Politics of Race and Class and the Changing Spatial Fortunes of the McCarren Pool in Brooklyn, New York, 1936-2010
Authors: Chronopoulos Themis
Published: January 2013

This paper explores the changing spatial properties of the McCarren Pool and connects them to the politics of race and class. The pool was a large liberal government project that sought to improve the leisure time of working class Brooklynites and between 1936 and the early 1970s it was a quasi-public functional space. In the 1970s and the early 1980s, the pool became a quasi-public dysfunctional space because the city government reduced its maintenance and staffing levels. Working class whites of the area engaged into neighborhood defense in order to prevent the influx of Latinos and African Americans into parts of Williamsburg and Greenpoint and this included the environs of the McCarren Pool. The pool was shut down in 1983 because of a mechanical failure. Its restoration did not take place because residents and storekeepers near the vicinity of the pool complained that by the 1970s, it was only African Americans and Latinos who patronized the pool and that their presence in the neighborhood undermined white exclusivity. For two decades, the McCarren Pool became a multi-use alternative space frequented by homeless people, graffiti artists, heroin users, teenagers, and drug dealers. Unlike previous decades, during this period, people of various racial and ethnic backgrounds frequented the pool area in a relatively harmonious manner. In the early part of the twenty-first century, a neoliberal city administration allowed a corporation to organize music concerts in the pool premises and promised to restore the facility into an operable swimming pool. The problem with this restoration project is that the history of the pool between the early 1970s and the early 2000s is downplayed and this does not serve well former or future users of the pool.
Trans-Species Urban Politics
Authors: Holmberg Tora
Published: January 2013

The article investigates the emergence and continuation of a spatial conflict, concerning a “dog beach” in Santa Cruz, California, that led to the creation of local interest organizations and came to involve city and state authorities and regulations, local news and social media, and not least, park visitors (both humans and dogs). Through the debate, positions for and against dogs being off leash were consolidated—however, not necessarily positions for and against dogs. Several themes emerge through the analysis: safety/risk, disturbance, excrements, and “dogginess,” meaning the perceived nature of dogs. The case study is used as an example of not only how urban politics affects the bodies, practices, and movement of people and dogs but also, similarly, how this politics is constantly under the threat of civil disobedience and subversive acts of counterpolitics. It illustrates the dialectics of everyday lives—of the bodies, practices, and movement of people and dogs—and space: the liminal case of the beach. Furthermore, the collective movement of dogs and people is conceptualized as a trans-species urban crowd, threatening a certain ideal public order.
Brave rebels stay home
Authors: Ceron Andrea
Published: January 2013

Sanctions and homogeneity of intra-party preferences are the two main pathways to party unity in roll-call votes. However, only a few works have managed to properly measure the degree of polarization within the party, and therefore the link between ideological preferences and parliamentary voting behaviour has not yet been fully tested. Looking at the internal debates held during party congresses and analysing motions presented by party factions through quantitative text analysis, the present article provides a new measure of intra-party polarization that is exogenous to the parliamentary arena. This measure is used to disentangle the effect of ideological heterogeneity on MPs voting behaviour, net of the party whip. Our results show that factional heterogeneity negatively affects party unity. This effect, however, is conditional on the strength of whipping resources available to the party leader. When the electoral system or the intra-party candidate selection process allows strong discipline to be enforced, the negative effect of heterogeneous preferences on party unity is lower or no longer significant. However, since absences can be a strategy by which to express dissent while avoiding sanctions, they should be considered as an additional voting option and this is crucial to understanding the impact of intra-party heterogeneity on party unity.
Impact of dementia on marriage: A qualitative systematic review
Authors: Evans David , Lee Emmanuel
Published: January 2013

This qualitative review explored the impact of dementia on marriage. The method was informed by systematic review and qualitative research methodologies. A comprehensive search of major databases was undertaken. The search identified 115 studies on the topic; 23 met the inclusion criteria and 19 were appraised as being of good methodological quality. Two major themes and five sub-themes emerged from the analysis of included studies, transition and loss. The theme of transition encompassed the three sub-themes of relationship, roles and intimacy and reflected the changes in the marriage and marital relationship that accompanied dementia. The theme of loss encompassed the two sub-themes of loss of a partner and loss of a marriage, which reflected the many losses that accompanied dementia. However, transition and loss were inter-related, because each change was accompanied by loss and each loss produced another change in the marriage.
Fault diagnosis in gearbox using adaptive wavelet filtering and shock response spectrum features extraction
Authors: Hussain Sajid , Gabbar Hossam A
Published: January 2013

A wavelet adaptive filtering technique is presented for enhanced fault identification in gearboxes. Based on Morlet wavelet analysis and conventional optimization methods, an adaptive filtering is performed for the background noise removal of vibration signals emanating from gearboxes. A fourth-order statistical moment, kurtosis, is used as an objective function to optimize. A filtered signal is obtained by choosing the suitable Morlet wavelet that maximizes the kurtosis. The optimization framework uses one-dimensional and multidimensional accelerated search techniques to speed up the convergence in solution search space. A novel, transient-based features extraction method based on the shock response spectrum is used to extract characteristic features representing the health state of the gearbox. The effectiveness and feasibility of the proposed method have been demonstrated on experimental gearbox data. The proposed technique enables a high signal-to-noise ratio for gearbox fault detection.
Factors that limit and enable preschool-aged children’s physical activity on child care centre playgrounds
Authors: Coleman Bianca , Dyment Janet E
Published: January 2013

The incidence of childhood obesity amongst preschool-aged children has increased dramatically in recent years and can be attributed, in part, to a lack of physical activity amongst children in this age group. This study explores the social factors that stand to limit and/or enable children’s physical activity opportunities in outdoor settings in child care centres. In-depth qualitative interviews were conducted with 16 educators from four child care centres in Tasmania, Australia, to ascertain the educators’ perceptions of children’s physical activity and the child care centre policies and practices that stand to limit and/or enable physical opportunities on outdoor playgrounds in child care centres. The major finding of this study is that, despite educators’ positive perceptions of the importance of physical activity for preschool-aged children, child care centre policies and practices relating to children’s safety and supervision during outdoor times are limiting educators’ abilities to facilitate more structured physical activity opportunities for children in care. Educators also recognized that a lack of training limited their ability to provide physical activity opportunities. This article discusses the implications of these findings and concludes with a number of recommendations for future childhood obesity intervention strategies that can be implemented for preschool-aged children in child care centres.
Canadian parents’ knowledge and satisfaction regarding their child’s day-care experience
Authors: Howe Nina , Jacobs Ellen , Vukelich Goranka , Recchia Holly
Published: January 2013

The purpose of this study was to examine parental selection criteria and satisfaction with day care, knowledge about centre philosophy, teacher education and quality of the day-care environment. Parents ( n = 261) and educators ( n = 94) in 44 non-profit centres in three Canadian cities participated. Parent knowledge was assessed by phone interview, and day-care quality was rated. Many parents reported knowledge of the centre’s philosophy and were highly satisfied with the care but sometimes held inaccurate views of the teacher’s education. Parent education positively predicted parental knowledge of centre philosophy, while a trend was evident between parent knowledge of centre philosophy and the quality of the day-care environment (i.e. educator–child interaction), after accounting for site effects. Given that parent knowledge about their child’s day-care experience may sometimes be incomplete, more frequent and informative parent–educator communication is required, particularly about children’s learning and development.
Young children engaging with technologies at home: The influence of family context
Authors: Stephen Christine , Stevenson Olivia , Adey Claire
Published: January 2013

This article is about the ways in which young children engage with technological toys and resources at home and, in particular, the ways in which the family context makes a difference to young children’s engagement with these technologies. The data reviewed come from family interviews and parent-recorded video of four case study children as they used specific resources: a screen-based games console designed for family use, a technology-mediated reading scheme, a child’s games console and two technological ‘pets’. We found the same repertoire of direct pedagogical actions across the families when they supported their children’s use of the resources, yet the evidence makes it clear that the child’s experience was different in each home. The article goes on to present evidence that four dimensions of family context made a difference to children’s engagement with technological toys and resources at home. We argue that understanding children’s experiences with technologies at home necessitates finding out about the distinct family contexts in which they engage with the resources.
Integrative Review of the Literature on Adults With Limited Education and Skills and the Implications for Human Resource Development
Authors: Hamilton David W. , Torraco Richard J.
Published: January 2013

Adults with limited education and skills—those who lack the education and skills needed for full participation in U.S. culture and economy—are increasing in numbers. However, the knowledge base addressing this population and their educational needs is fragmented across the literature of several disciplines. A comprehensive review and critique of the literature on adults with limited education and skills have not been done. This study fills this void by reviewing literature from five streams of research that address this population and synthesizing it into a framework that offers an integrated perspective on the topic. Implications for human resource development and an agenda for further research are discussed.
Supportive and Insight-Oriented Psychodynamic Psychotherapy for Posttraumatic Stress Disorder in an Adult Male Survivor of Sexual Assault
Authors: Abbas Amineh , Macfie Jenny
Published: January 2013

This is a single case study of a middle-aged man with posttraumatic stress disorder (PTSD) and Dissociative Disorder Not Otherwise Specified following sexual assault as an adult. Treatment consisted of supportive psychodynamic psychotherapy, focusing on reintegrating the patient into his community, followed by insight-oriented psychodynamic psychotherapy with an emphasis on processing trauma and decreasing PTSD and dissociative symptoms. Daily subjective, self-report measures were used to track his symptoms over a 29-month period. Simulation Modeling Analysis for time-series was utilized to assess the phase change from pretreatment baseline phase to total treatment phase and also between supportive psychotherapy phase and insight-oriented psychotherapy phase. Symptoms tracked included overall distress, preoccupation with the trauma, and dissociation. All symptoms significantly improved from the pretreatment baseline phase to the total treatment phase. Overall distress and preoccupation with the trauma significantly improved from the supportive to the insight-oriented psychotherapy phase.
The National Cancer Institute Best Case Series Program
Authors: Olaku Oluwadamilola , Zia Farah , Santana Jeans M. , White Jeffrey D.
Published: January 2013

Objectives. The National Cancer Institute (NCI) Best Case Series (BCS) Program provides an independent review of medical records, imaging, and pathology of cancer patients treated with unconventional therapies. The goal of the NCI BCS Program is to identify preliminary evidence of tumor regression and assess whether there is sufficient evidence to move forward with NCI-initiated research. The objective was to review case reports submitted by 4 practitioners from India who used ayurvedic and homeopathic therapies to treat cancer. Design. Retrospective review of case reports of 4 practitioners from India who used ayurvedic and homeopathic therapies to treat cancer. Results. A total of 68 cases were submitted to the NCI BCS Program. Fifty-one percent of the cases represented homeopathy and 49% ayurveda. Of the 68 cases, 32 (47%) of the cases were collectively designated as “persuasive” (P) or “supportive”(S), and 36 (53%) as “not evaluable.” Forty-one (60%) patients did not have any prior conventional treatment. Conclusion. The challenge for submitters rests in their ability to supply sufficient documentation for the NCI BCS Program. The NCI BCS Program represents a unique avenue for the rigorous evaluation of “best cases” to identify complementary and alternative medicine modalities that are promising for prospective preclinical evaluation or prospective research.
Covert Visuospatial Attention Orienting in a Brain-Computer Interface for Amyotrophic Lateral Sclerosis Patients
Authors: Marchetti Mauro , Piccione Francesco , Silvoni Stefano , Gamberini Luciano , Priftis Konstantinos
Published: January 2013

Background. Brain-computer interfaces (BCIs) allow people to control devices by translating brain signals into commands. BCIs represent a concrete solution with regard to communication and motor control disabilities of patients with amyotrophic lateral sclerosis (ALS). Most of the BCIs rely on visual interfaces in which patients must move their eyes to achieve efficient BCI control. This fact represents a limitation of BCI use in ALS patients who are in the final stages of the disease. Objective. We aimed to improve visual interfaces for ALS patients to control the movement of a cursor on a monitor by orienting their covert visuospatial attention (ie, orienting without eye movements). Methods. A total of 10 ALS patients with different levels of impairment used 2 new visual interfaces in an event-related potential (ERP)–based BCI. In the first interface, they were required to use exogenous visuospatial attention orienting (VAO), whereas in the second interface, they were required to use endogenous VAO. Results. ALS patients were able to use the 2 interfaces for controlling the ERP-based BCI system in real time. Nevertheless, better target classification and information transfer rate were associated with the interface that was based on endogenous VAO. Conclusions. ALS patients can exploit their covert VAO to control a BCI that does not require eye movements. The implementation of endogenous VAO in the design of covert visuospatial attention-based interfaces seems to be suitable for designing more ergonomic and efficient BCIs for ALS patients with impaired eye movements.
A review of the effectiveness of game-based training for dismounted soldiers
Authors: Whitney Susannah J. , Temby Philip , Stephens Ashley
Published: January 2013

Computer games are increasingly being used by armed forces to supplement conventional training methods. However, despite considerable anecdotal claims about their training effectiveness, empirical evidence is lacking. This paper critically reviews major studies conducted in the past decade that have examined game-based training with dismounted soldiers. The findings indicate that these studies are characterized by methodological limitations and that the evidence regarding the effectiveness of game-based training for this military population is not compelling. Furthermore, due to methodological limitations with the studies, the possibility of negative training effects cannot be discounted. The paper concludes with implications for the scientific and military communities, as well as recommendations for the conduct of future studies in this area.
The Resting Electrophysiological Profile in Adults With ADHD and Comorbid Dysfunctional Anger
Authors: Jaworska Natalia , Berrigan Lindsay , Ahmed Adekunle Garba , Gray Johnathan , Korovessis Athanassia , Fisher Derek James , Bradford John , Federoff Paul , Knott Verner Joseph
Published: January 2013

Although dysfunctional anger is not a Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition, Text Revision [DSM-IV-TR]) diagnosis, it sometimes presents as a primary clinical complaint and as a comorbid feature in a subset of adults with attention-deficit/hyperactivity disorder (ADHD). No known studies have examined electroencephalographic (EEG) profiles in adults with comorbid dysfunctional anger and ADHD (ADHD + anger). Resting EEG was recorded in 14 ADHD + anger adults (11 males) and 14 controls. Relative power was assessed at standard frequencies, as was frontal absolute α power asymmetry. A modest increase was noted in β1 power in the ADHD + anger group. Unexpectedly, relatively decreased left (or increased right) frontocortical activity (α assessed) was noted in the ADHD + anger group, which was also characterized by a more diffuse θ/β ratio scalp distribution. Nonmedicated ADHD + anger adults exhibited modest resting cortical hyperarousal, consistent with the findings in a subset of children with ADHD characterized by anger-associated problems. The unexpected frontal α asymmetry may reflect enhanced activity of frontal inhibitory mechanisms.
NiTi Shape Memory Compression Anastomosis Clip in Small- and Large-Bowel Anastomoses
Authors: Kusnierz Katarzyna , Morawiec Henryk , Lekston Zbigniew , Zhavoronkov Dmytro , Lucyga Magdalena , Lampe Pawel
Published: January 2013

The aim of the study was to present a clinical use of compression anastomosis clip (CAC) implants made of shape memory materials—nickel titanium alloys (NiTi). The concept involved in the use of CAC was to compress 2 bowel walls together, cause necrosis, and detach the CAC from the tissue to be expelled with the stool. The CAC is a double-ring elliptical device with a diameter of 30 mm. The device has the ability to recover its original closed shape when it senses a change in ambient temperature. In all, 20 anastomoses using CACs were performed: 6 of the small with the large bowel and 14 between the small bowel and small bowel. Two patients experienced complications. Although the anastomosis is not difficult to perform, the rules on how to apply the CAC must be well known. Because only a small number of anastomoses have been performed by us to date, this procedure requires further study.
Education and Training in NOTES
Authors: Moghul Masood R. , Sodergren Mikael H. , Clark James , Teare Julian , Yang Guang-Zhong , Darzi Ara
Published: January 2013

Introduction. Since the first published work on natural orifice translumenal endoscopic surgery (NOTES) a decade ago, progress has been made in the domain of education and training, although questions posed by the original White Paper remain. This article aims to review the current status of education and training in NOTES. Methods. A review of the literature was conducted to evaluate the following: (1) What are the current training methods/modalities used for NOTES; what is the level of evidence to support their use? (2) How has NOTES clinical training been quantified; what is the evidence relating to performance of different NOTES operators? (3) What clinical NOTES training programs have been established and what are the wider training needs? Results. A total of 25 studies were included: 11 nonanimal studies, 8 animal studies, and 6 descriptions of education programs. Several animal and simulator models demonstrated construct validity, but no study showed human predictive validity. Logarithmic learning curves in animal models demonstrate 10 to 15 cases achieving a proficiency level. Current trends are that gastroenterologists prefer it for diagnostic and basic procedures, whereas surgeons prefer it for complex therapeutic cases. Conclusion. The development of a new specialty is intriguing but currently unviable. Training programs have been initiated, but information is limited; the common theme is surgeons receiving endoscopic training. Despite the research done, our knowledge of training and educating in NOTES procedures is limited, preventing a meta-analysis or formal review from being performed. Further research is needed to integrate NOTES into routine clinical procedure.
Attachment and Health Care Utilization Among Middle-Aged and Older African-Descent Men
Authors: Consedine Nathan S. , Tuck Natalie L. , Fiori Katherine L.
Published: January 2013

Although health care utilization occurs in interpersonal contexts, little is known regarding how interpersonal preferences or styles among patients may be relevant. A small body of work has identified links between attachment—a dispositional style of relating to others—and patterns of health care use. The current report examined how attachment characteristics predicted the frequency of digital rectal exam and prostate-specific antigen testing in a sample of African-descent men. Four hundred and fourteen African-descent men aged 45 to 70 years completed measures of prostate screening and attachment, together with measures of traditional predictors of screening (demographics, insurance, family history, physician variables, knowledge, perceived risk, and accessibility). Consistent with predictions, dismissiveness—the most common relational style among older men—predicted less frequent prostate-specific antigen testing and digital rectal examination. However, attachment security—a comfort with intimate relationships—also predicted lower screening frequency. Identifying the interpersonal characteristics predicting screening may help identify men at risk of suboptimal health care use and guide the development of interventions suited to the normative relational preferences of current cohorts of older, African-descent men.
Reliability evaluation and optimization of series–parallel systems with k-out-of-n: G subsystems and mixed redundancy types
Authors: Boddu Prashanthi , Xing Liudong
Published: January 2013

This article considers the redundancy allocation problem pertaining to k-out-of- n: G heterogeneous series–parallel systems. Different from existing approaches that consider either hot or cold standby redundancy for a parallel subsystem, our approach considers a mix of cold and hot standby redundancies within one subsystem to achieve a balance between fast recovery and energy conservation in the optimal system design. Given the available versions of hot and cold standby units and minimum number of operating components ( k) for each subsystem to function, the objective of the optimal design is to select versions of components, and hot and cold standby redundancy levels within the subsystem to minimize the system unreliability while satisfying a system-level constraint on cost. To formulate the objective function, an analytical method is proposed for the reliability analysis of a k-out-of- n: G subsystem with both hot and cold standby units. The method has no limitation on the type of time-to-failure distributions for the system components. The proposed analytical method is demonstrated using several examples and verified using a Markov-based method. An optimization solution methodology based on the penalty-guided genetic algorithm is presented for obtaining the optimal design configuration. The proposed system reliability optimization methodology is tested on several example data sets.
Immunotherapeutic approaches in triple-negative breast cancer: latest research and clinical prospects
Authors: Stagg John , Allard Bertrand
Published: January 2013

Triple-negative breast cancer (TNBC), as defined by the absence of estrogen receptor, progesterone receptor and human epidermal growth factor receptor 2 expression, is a challenging disease with the poorest prognosis of all breast cancer subtypes. Importantly, there are currently no known molecular targets for this subgroup of patients. Recent advances in genomics and gene expression profiling have shed new light on the molecule heterogeneity of TNBC. We present an overview of the scientific evidence suggesting that clinical outcome in TNBC is affected by tumor-infiltrating immune cells. We also describe tumor-associated antigens recently identified in TNBC. Finally, we review the current literature on promising immunotherapies for TNBC, including tumor vaccine approaches, immune-checkpoint inhibitors, antagonists of immunosuppressive molecules and adoptive cell therapies. It is our contention that selected patients with TNBC with lymphocytic tumor infiltrates at diagnosis may benefit from immune-based therapies and that these immunotherapies will be most beneficial in combination with cytotoxic drugs that potentiate adaptive anti-tumor immunity.
Continuous Weight and Height Gain Among At-Risk Children Discharged From a Supplementary Feeding Center in Kabul, Afghanistan
Authors: Morikawa Masahiro , Polanc Andreas , Becker Sabine
Published: January 2013

Feeding in emergencies has been based on anthropometric measurements that mostly depend on weight measures and tend to focus on short-term weight gain as its goal. One of the new trends in emergency feeding is to provide feeding therapy at the community where patients are rather than keeping them as inpatients. A community-based feeding program has made the feeding program more sustainable, which is particularly important in the era of protracted emergencies and civil war. Little is known, however, about the impact of nutritional support on long-term neurocognitive development in chronic emergencies. KinderBerg International, eV, has implemented a long-term supplementary feeding program for 6 months after children were discharged from our feeding center. After establishing mother–child bonding before discharge, the children were followed-up for 6 months through monthly visits with anthropometric measurements and neurocognitive assessments. We report our initial findings, which indicate that there are significant continuous gain in both weight and height in children aged 5 years and younger after discharge.
A Preliminary Investigation on the Acceptance and Feasibility of Acupuncture in the Intensive Care Unit
Authors: Yeh Eugene C. , Mirocha James M. , Brantman Anna , Ma Xiu Ling , Qiao Yi , Merz C. Noel Bairey , Jones Heather D.
Published: January 2013

Objective. Acupuncture has been shown to decrease opioid requirements and respiratory distress in selected patients, and it may be helpful as an adjunctive therapy to sedatives and analgesics in the ICU. This preliminary study investigated the acceptance and feasibility of acupuncture in the ICU. Design. Forty-eight patients in a 12-bed medical–surgical ICU at Cedars-Sinai Medical Center who met eligibility criteria were offered the opportunity to receive free-of-charge daily acupuncture treatments during their time in the ICU. Primary endpoints were percentage of patients offered acupuncture who accepted treatment, the percentage of eligible days acupuncture therapy was received, and the incidence of adverse events related to acupuncture treatment. Main Results. Of the 48 patients who were eligible and offered acupuncture therapy, 20 (41%) patients enrolled in the study with an average age of 56 years (range = 18-91 years). The median and average number of days which patients received acupuncture was 2 and 3, respectively (range = 0-11 days), and a majority of patients (13/20) received acupuncture for each of the days for which they were eligible. One patient reported dizziness, which resolved spontaneously and was not associated with hemodynamic changes. No other adverse effects occurred in a total of 64 acupuncture treatments. Conclusions. This preliminary study demonstrates that acupuncture therapy in the ICU is a feasible treatment modality. Further clinical trials are warranted to determine the efficacy of acupuncture therapy as an adjunct to sedative and analgesics in critically ill patients.
Personal lives? The effects of nonwork behaviors on organizational image
Authors: Umphress Elizabeth E. , Tihanyi Laszlo , Bierman Leonard , Gogus Celile Itir
Published: January 2013

Organizational leaders may respond to employee nonwork behaviors because of the possible influence on organizational image. We describe a typology of nonwork behaviors and discuss their potential implications for organizational image. We explore conditions under which organizational leaders may attempt to control employee nonwork behaviors and review the available alternatives for organizational control. We conclude by discussing the theoretical and practical implications of research on nonwork behavior.
Does Gallbladder Wall Thickening of Cirrhotic Patients Increase the Risk of Formation of Gallstones?
Authors: Wu Size , Liu Guangqing
Published: January 2013

The objective of this study was to investigate whether gallbladder wall thickening in cirrhotic patients adds risk to the formation of gallstones. In this retrospective study, 259 patients with cirrhosis resulting from hepatitis B or hepatitis C were included (152 men, 107 women; mean ± SD, age 48.8 ± 11.4 years [range, 29–77 years]) and compared with 300 healthy participants comprising the control group. All participants had a standard abdominal sonographic assessment. The prevalence of gallstones in cirrhotic patients with and without gallbladder wall thickening was studied, and the distribution of gallstones and gallbladder wall thickening in different Child-Pugh classes was compared. The prevalence of gallstones in cirrhotic patients, cirrhotic patients with and without gallbladder wall thickening, and healthy participants was 27.4%, 28.8%, 13.0%, and 5.3%, respectively. The prevalence of gallstones in cirrhotic patients with gallbladder wall thickening was not significantly higher than in those without gallbladder wall thickening ( P > .05). Gallbladder wall thickening occurred with a higher frequency in Child-Pugh B and C patients, and normal thickness of the gallbladder wall was seen more frequently in Child-Pugh A patients ( P < .05). Gallstones were found more frequently in Child-Pugh A and C patients ( P < .05). In conclusion, gallbladder wall thickening in cirrhotic patients does not significantly add any risk for the formation of gallstones.
Cellular and molecular basis of von Willebrand disease: studies on blood outgrowth endothelial cells
Authors: Starke Richard D. , Paschalaki Koralia E. , Dyer Clare E. F. , Harrison-Lavoie Kimberly J. , Cutler Jacqueline A. , McKinnon Thomas A. J. , Millar Carolyn M. , Cutler Daniel F. , Laffan Mike A. , Randi Anna M.
Published: January 2013

Key Points

BOECs from VWD patients provide novel insight into the cellular mechanisms of the disease.
CD161 defines the subset of FoxP3+ T cells capable of producing proinflammatory cytokines
Authors: Pesenacker Anne M. , Bending David , Ursu Simona , Wu Qiong , Nistala Kiran , Wedderburn Lucy R.
Published: January 2013

Key Points

CD161 defines proinflammatory FoxP3+ cells that have classic Treg signatures, yet share effector T-cell properties. CD161+ Treg proinflammatory phenotype is stable upon Treg expansion and thus should be considered in therapeutic strategies using Treg.
Control of iron deficiency anemia in low- and middle-income countries
Authors: Pasricha Sant-Rayn , Drakesmith Hal , Black James , Hipgrave David , Biggs Beverley-Ann
Published: January 2013

Despite worldwide economic and scientific development, more than a quarter of the world’s population remains anemic, and about half of this burden is a result of iron deficiency anemia (IDA). IDA is most prevalent among preschool children and women. Among women, iron supplementation improves physical and cognitive performance, work productivity, and well-being, and iron during pregnancy improves maternal, neonatal, infant, and even long-term child outcomes. Among children, iron may improve cognitive, psychomotor, and physical development, but the evidence for this is more limited. Strategies to control IDA include daily and intermittent iron supplementation, home fortification with micronutrient powders, fortification of staple foods and condiments, and activities to improve food security and dietary diversity. The safety of routine iron supplementation in settings where infectious diseases, particularly malaria, are endemic remains uncertain. The World Health Organization is revising global guidelines for controlling IDA. Implementation of anemia control programs in developing countries requires careful baseline epidemiologic evaluation, selection of appropriate interventions that suit the population, and ongoing monitoring to ensure safety and effectiveness. This review provides an overview and an approach for the implementation of public health interventions for controlling IDA in low- and middle-income countries, with an emphasis on current evidence-based recommendations.
How I assess comorbidities before hematopoietic cell transplantation
Authors: Sorror Mohamed L.
Published: January 2013

The hematopoietic cell transplantation-comorbidity index (HCT-CI) is a comorbidity tool suited for recipients of HCT. The index has been shown to sensitively capture the prevalence and magnitude of severity of various organ impairments before HCT and to provide valuable prognostic information after HCT. Many investigators have validated the discriminative power of the HCT-CI, but others have not. One concern is the consistency in comorbidity coding across different evaluators, particularly in view of the relatively recent addition of the HCT-CI to the transplant evaluation process. In this article, comorbidity scoring was tested across different evaluators, and only a fair interobserver agreement rate could be detected. To address these issues, a brief training program is proposed here, consisting of systematic methodology for data acquisition and consistent guidelines for comorbidity coding that were summarized in a Web-based calculator. In a validation patient cohort, this training program was shown to improve the interevaluator agreement on HCT-CI scores to an excellent rate with weighted κ values in the range of 0.89 to 0.97. This proposed training program will facilitate reliable assessment of comorbidities in the clinic and for research studies leading to standardization of the use of comorbidities in prediction of HCT outcomes.