bluuebunny/crossref_metadata_2025 huggingface dataset:
Immobilized contrast‐enhanced MRI: Gadolinium‐based long‐term MR contrast enhancement of the vein graft vessel wall
Authors: Mitsouras Dimitris , Vemula Praveen Kumar , Yu Peng , Tao Ming , Nguyen Binh T. , Campagna Christina M. , Karp Jeffrey M. , Mulkern Robert V. , Ozaki C. Keith , Rybicki Frank J.
Published: January 2012

An implantable MR contrast agent that can be covalently immobilized on tissue during surgery has been developed. The rationale is that a durable increase in tissue contrast using an implantable contrast agent can enhance postsurgical tissue differentiation using MRI. For small‐vessel (e.g., vein graft) MRI, the direct benefit of such permanent “labeling” of the vessel wall by modification of its relaxation properties is to achieve more efficient imaging. This efficiency can be realized as either increased contrast leading to more accurate delineation of vessel wall and lesion tissue boundaries, or, faster imaging without penalizing contrast‐to‐noise ratio, or a combination thereof. We demonstrate, for the first time, stable long‐term MRI enhancement using such an exogenous contrast mechanism based on immobilizing a modified diethylenetriaminepentaacetic acid gadolinium3+ dihydrogen complex on a human vein using a covalent amide bond. Signal enhancement due to the covalently immobilized contrast agent is demonstrated for excised human vein specimens imaged at 3 T, and its long‐term stability is demonstrated during a 4‐month incubation period. Magn Reson Med, 2010. © 2010 Wiley‐Liss, Inc.
Living Well with Rheumatoid Arthritis
Authors: Squire Ruth
Published: January 2012

Purpose

The overall aim of this study was to understand the occupational lives of people with rheumatoid arthritis. Further aims were to identify the creative agency that occurs while performing these occupations and to understand the socio‐cultural aspects of engaging in valued occupations.

Methods

Five participants were recruited and various qualitative methods of data collection were engaged, including open interviews, participant observation and gathering occupational diaries. A combination of thematic and narrative analysis was performed.

Results

Findings uncovered six themes, including; changing occupations; environmental factors count; taking control over occupations; being or becoming normal; people and objects are important; hopes and dreams matter. Subthemes uncovered how individuals constantly adapt and alter their occupations; some radically changing lifestyles for the better, while others work towards regaining occupational control. Meaning of occupations became apparent. People were creative agents. Work and leisure occupations featured strongly. Objects and other individuals were significant factors to individuals when engaging in occupations. People strived to be ‘normal’ in their occupational worlds.

Conclusion

The implication of these results in relation to professional practice for therapists is that attention should be refocused on the occupational narratives of clients, working with the positive, creative aspects that people are already employing and building on these in areas that might not been seen as traditional, such as work and leisure. Copyright © 2012 John Wiley & Sons, Ltd.
A systematic review of validated methods for identifying cerebrovascular accident or transient ischemic attack using administrative data
Authors: Andrade Susan E. , Harrold Leslie R. , Tjia Jennifer , Cutrona Sarah L. , Saczynski Jane S. , Dodd Katherine S. , Goldberg Robert J. , Gurwitz Jerry H.
Published: January 2012

Purpose

To perform a systematic review of the validity of algorithms for identifying cerebrovascular accidents (CVAs) or transient ischemic attacks (TIAs) using administrative and claims data.

Methods

PubMed and Iowa Drug Information Service searches of the English language literature were performed to identify studies published between 1990 and 2010 that evaluated the validity of algorithms for identifying CVAs (ischemic and hemorrhagic strokes, intracranial hemorrhage, and subarachnoid hemorrhage) and/or TIAs in administrative data. Two study investigators independently reviewed the abstracts and articles to determine relevant studies according to pre‐specified criteria.

Results

A total of 35 articles met the criteria for evaluation. Of these, 26 articles provided data to evaluate the validity of stroke, seven reported the validity of TIA, five reported the validity of intracranial bleeds (intracerebral hemorrhage and subarachnoid hemorrhage), and 10 studies reported the validity of algorithms to identify the composite endpoints of stroke/TIA or cerebrovascular disease. Positive predictive values (PPVs) varied depending on the specific outcomes and algorithms evaluated. Specific algorithms to evaluate the presence of stroke and intracranial bleeds were found to have high PPVs (80% or greater). Algorithms to evaluate TIAs in adult populations were generally found to have PPVs of 70% or greater.

Conclusions

The algorithms and definitions to identify CVAs and TIAs using administrative and claims data differ greatly in the published literature. The choice of the algorithm employed should be determined by the stroke subtype of interest. Copyright © 2012 John Wiley & Sons, Ltd.
Design considerations in an active medical product safety monitoring system
Authors: Gagne Joshua J. , Fireman Bruce , Ryan Patrick B. , Maclure Malcolm , Gerhard Tobias , Toh Sengwee , Rassen Jeremy A. , Nelson Jennifer C. , Schneeweiss Sebastian
Published: January 2012

Active medical product monitoring systems, such as the Sentinel System, will utilize electronic healthcare data captured during routine health care. Safety signals that arise from these data may be spurious because of chance or bias, particularly confounding bias, given the observational nature of the data. Applying appropriate monitoring designs can filter out many false‐positive and false‐negative associations from the outset. Designs can be classified by whether they produce estimates based on between‐person or within‐person comparisons. In deciding which approach is more suitable for a given monitoring scenario, stakeholders must consider the characteristics of the monitored product, characteristics of the health outcome of interest (HOI), and characteristics of the potential link between these. Specifically, three factors drive design decisions: (i) strength of within‐person and between‐person confounding; (ii) whether circumstances exist that may predispose to misclassification of exposure or misclassification of the timing of the HOI; and (iii) whether the exposure of interest is predominantly transient or sustained. Additional design considerations include whether to focus on new users, the availability of appropriate active comparators, the presence of an exposure time trend, and the measure of association of interest. When the key assumptions of self‐controlled designs are fulfilled (i.e., lack of within‐person, time‐varying confounding; abrupt HOI onset; and transient exposure), within‐person comparisons are preferred because they inherently avoid confounding by fixed factors. The cohort approach generally is preferred in other situations and particularly when timing of exposure or outcome is uncertain because cohort approaches are less vulnerable to biases resulting from misclassification. Copyright © 2012 John Wiley & Sons, Ltd.
The Food and Drug Administration's Post‐Licensure Rapid Immunization Safety Monitoring program: strengthening the federal vaccine safety enterprise
Authors: Nguyen Michael , Ball Robert , Midthun Karen , Lieu Tracy A.
Published: January 2012

In 2009, the Department of Health and Human Services created the new Post‐Licensure Rapid Immunization Safety Monitoring (PRISM) program, which used data from national health insurance plans and immunization registries to monitor the safety of the H1N1 influenza vaccine. PRISM has now been integrated into the FDA's Mini‐Sentinel pilot program. It strengthens the federal vaccine safety enterprise in two important ways. First, PRISM monitors the largest US general population cohort designated for active surveillance of vaccine safety. Second, PRISM links data from health plans with data from state and city immunization registries, which were a crucial source of exposure data in the H1N1 vaccine evaluation. The Mini‐Sentinel data that support PRISM are updated quarterly, and PRISM can conduct medical record review for validation of computerized data.

The FDA has structured PRISM as a program that includes specific vaccine evaluations, development of an operational framework to guide the design of vaccine safety evaluations, and development of new statistical methods. A human papillomavirus vaccine, Gardasil, and two rotavirus vaccines, RotaTeq and Rotarix, have been chosen for surveillance in the current cycle because their evaluations would benefit most from PRISM's large cohort size.

The PRISM program creates important opportunities by offering a robust, responsive new surveillance program with features complementary to existing systems. Methodological and logistical lessons can be shared among PRISM and other surveillance systems, offering potential synergies. FDA and PRISM will work to maximize the program's unique strengths and contributions to a unified federal vaccine safety enterprise. Copyright © 2012 John Wiley & Sons, Ltd.
Challenges in the design and analysis of sequentially monitored postmarket safety surveillance evaluations using electronic observational health care data
Authors: Nelson Jennifer C. , Cook Andrea J. , Yu Onchee , Dominguez Clara , Zhao Shanshan , Greene Sharon K. , Fireman Bruce H. , Jacobsen Steven J. , Weintraub Eric S. , Jackson Lisa A.
Published: January 2012

Purpose

Many challenges arise when conducting a sequentially monitored medical product safety surveillance evaluation using observational electronic data captured during routine care. We review existing sequential approaches for potential use in this setting, including a continuous sequential testing method that has been utilized within the Vaccine Safety Datalink (VSD) and group sequential methods, which are used widely in randomized clinical trials.

Methods

Using both simulated data and preliminary data from an ongoing VSD evaluation, we discuss key sequential design considerations, including sample size and duration of surveillance, shape of the signaling threshold, and frequency of interim testing.

Results and Conclusions

All designs control the overall Type 1 error rate across all tests performed, but each yields different tradeoffs between the probability and timing of true and false positive signals. Designs tailored to monitor efficacy outcomes in clinical trials have been well studied, but less consideration has been given to optimizing design choices for observational safety settings, where the hypotheses, population, prevalence and severity of the outcomes, implications of signaling, and costs of false positive and negative findings are very different. Analytic challenges include confounding, missing and partially accrued data, high misclassification rates for outcomes presumptively defined using diagnostic codes, and unpredictable changes in dynamically accessed data over time (e.g., differential product uptake). Many of these factors influence the variability of the adverse events under evaluation and, in turn, the probability of committing a Type 1 error. Thus, to ensure proper Type 1 error control, planned sequential thresholds should be adjusted over time to account for these issues. Copyright © 2012 John Wiley & Sons, Ltd.
A systematic review of validated methods for identifying suicide or suicidal ideation using administrative or claims data
Authors: Walkup James T. , Townsend Lisa , Crystal Stephen , Olfson Mark
Published: January 2012

Purpose

As part of the Mini‐Sentinel pilot program, under contract with the Food and Drug Administration, an effort has been made to evaluate the validity of algorithms useful for identifying health outcomes of interest, including suicide and suicide attempt.

Method

Literature was reviewed to evaluate how well medical episodes associated with these events could be identified in administrative or claims data sets from the USA or Canada.

Results

Six studies were found to include sufficient detail to assess performance characteristics of an algorithm on the basis of International Classification of Diseases, Ninth Revision, E‐codes (950–959) for intentional self‐injury. Medical records and death registry information were used to validate classification. Sensitivity ranged from 13.8% to 65%, and positive predictive value range from 4.0% to 100%. Study comparisons are difficult to interpret, however, as the studies differed substantially in many important elements, including design, sample, setting, and methods. Although algorithm performance varied widely, two studies located in prepaid medical plans reported that comparisons of database codes to medical charts could achieve good agreement.

Conclusions

Insufficient data exist to support specific recommendations regarding a preferred algorithm, and caution should be exercised in interpreting clinical and pharmacological epidemiological surveillance and research that rely on these codes as measures of suicide‐related outcomes. Copyright © 2012 John Wiley & Sons, Ltd.
A systematic review of validated methods for identifying ventricular arrhythmias using administrative and claims data
Authors: Tamariz Leonardo , Harkins Thomas , Nair Vinit
Published: January 2012

Background

Drug‐induced pro‐arrhythmia is a serious and unexpected event. Large administrative and claims databases can potentially identify drugs or interactions leading to cardiac arrhythmias. The purpose of this study is to evaluate the evidence supporting the validity of algorithms or codes to identify ventricular arrhythmias using administrative and claims data.

Methods

A search of MEDLINE database is supplemented by manual searches of bibliographies of key relevant articles. We selected all studies in which an administrative and claims data algorithm or code was validated against a medical record. We report the positive predictive value (PPV) for ICD‐9 codes compared to medical records.

Results

Our search strategy yielded 664 studies, of which only seven met our eligibility criteria. Two additional studies were identified by peer reviewers. The most commonly included databases were Medicare and Medicaid, and the most commonly evaluated ICD‐9 codes were 426.x and 427.x. The individual use of ICD‐9 codes 427.x yielded a high PPV (78%–100%). The highest PPV was seen when both ICD‐9 codes 427.x and 798.x were used (92%). The same codes yielded the highest PPV when found in the principal diagnosis position (100%).

Conclusions

The use of ICD‐9 codes 427.x, alone or in combination with code 798.x, in the principal position is appropriate for the identification of ventricular arrhythmias in administrative and claims databases. Copyright © 2012 John Wiley & Sons, Ltd.
The Criticality of Risk Factors in Customer Relationship Management Projects
Authors: Papadopoulos Thanos , Ojiako Udechukwu , Chipulu Maxwell , Lee Kwangwook
Published: January 2012

Customer relationship management (CRM) remains an area of considerable interest in contemporary project management literature, due to its association with high failure rates. This research examined the criticality of four risk factors. Quantitative data analyzed using PASW17 were collected from a sample of 250 CRM project practitioners. Although we found strong evidence to support the focus on these risk factors, which include “user training,” “top management support,” “business strategy and technology alignment,” and “effective project feedback,” the authors found that, although some risk factors may be identified as “critical,” their criticality is dependent on the context of the project.
Amino‐rich Plasma Polymer Films Prepared by RF Magnetron Sputtering
Authors: Hanuš Jan , Ceccone Giacomo , Rossi François
Published: January 2012

Radio frequency magnetron sputtering of nylon 6.6 followed by N2/H2 plasma post‐treatment was used for deposition of nitrogen‐rich film with amino functionalities on the surface. The maximal NH2/C concentration obtained was 11% and the NH2/N reached 13.5%. The films are positively charged with an isoelectric point of 4.5. The interaction between the film and the buffer solution was studied and shows that the films are stable in cell culture conditions. A quartz crystal microbalance study showed the ability of the films to adsorb different proteins and their antigens and quantifies the protein adsorbed as a function of the films properties.

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Effects of Additives on ε‐HNIW Crystal Morphology and Impact Sensitivity
Authors: Chen Huaxiong , Li Lijie , Jin Shaohua , Chen Shusen , Jiao Qingze
Published: January 2012

Crystals of γ‐HNIW were transformed into crystals of ε‐HNIW by application of a drowning‐out process in the presence of different additives, namely ethylene glycol, triacetin, and aminoacetic acid. They show different effects on the crystal morphology of ε‐HNIW and cause less angular and more regular structures. Investigation of the sensitivities of the different ε‐HNIW crystals shows that their angles and regularity have an influence on the impact sensitivity. Aminoacetic acid selectively inhibits the growth of individual ε‐HNIW crystal faces to modify the morphology into spherical shape, these ε‐HNIW crystals are of much lower sensitivity, even compared with general RDX and HMX explosives.
Persistent photoconductivity in ZnO nanostructures induced by surface oxygen vacancy
Authors: Yin Z. G. , Zhang X. W. , Fu Z. , Yang X. L. , Wu J. L. , Wu G. S. , Gong L. , Chu Paul K.
Published: January 2012

ZnO nanowall networks grown on SiO2/Si substrate were found to exhibit persistent photoconductivity (PPC). The relaxation rate of the persistent photocurrent is enhanced by a higher oxygen level in the ambient suggesting that PPC is closely related to the ZnO surface. Surface modification with hydrogen peroxide can significantly reduce the PPC relaxation time, implying that surface oxygen deficiency is responsible for the effect. The transition between the neutral and the metastable singly ionized states of the surface oxygen vacancy is suggested to account for the phenomenon and it is supported by the temperature and wavelength dependence of the PPC. (© 2012 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)
Structural and tribological properties of polytetrafluoroethylene composites in atomic oxygen environment
Authors: Liu Baixing , Pei Xianqiang , Wang Qihua , Wang Tingmei , Sun Xiaojun
Published: January 2012

Effects of atomic oxygen (AO) irradiation on the structural and tribological behaviors of glass fiber (GF) and MoS2 filled polytetrafluoroethylene (PTFE) composites were investigated in a ground‐based simulation facility, in which the average energy of AO was about 5 eV and the flux was 5.0 × 1015 cm–2 s–1. The structural changes were characterized by XPS and attenuated total‐reflection Fourier transform infrared spectroscopy, and the tribological changes were evaluated by friction and wear tests and SEM analysis of the worn surfaces. It was found that AO irradiation induced the degradation of PTFE molecular chains, and the primary erosion mechanism is collisionally induced rather than chemically induced. The addition of MoS2 filler significantly increased the AO resistance of PTFE composites. Friction and wear tests indicated that GF and MoS2 improved the tribological properties of materials before and after AO irradiation. Short GF and MoS2 exhibited a good synergistic effect for improving the AO resistant and tribological properties of PTFE material. Copyright © 2012 John Wiley & Sons, Ltd.
Investigation of the benzotriazole inhibition mechanism of bronze disease
Authors: Mezzi A. , Angelini E. , De Caro T. , Grassini S. , Faraldi F. , Riccucci C. , Ingo G. M.
Published: January 2012

Benzotriazole (BTA) is an inhibitor molecule, commonly used to protect copper and copper‐based archaeological artefacts from degradation processes such as the ‘bronze disease’. The aim of the present work was to study in details the inhibition mechanism of the BTA molecule on pure copper and copper–tin alloy (called CNR 128) by the surface‐sensitive techniques (field emission SEM with energy‐dispersive X‐ray spectrometer and XPS). To perform this investigation, the typical corrosion products of the patina, including cuprite (Cu2O) and atacamite (Cu2Cl(OH)3) compounds, were grown on pure copper and CNR 128 alloy. The BTA molecule was then applied on the surface of the prepared samples, following the method that is commonly used in the conservation of artefacts in cultural heritage. During the analyses of pure copper substrate, it was revealed by XPS that BTA molecule favours the formation of Cu(I) species, when it is adsorbed on an atacamite‐enriched surface. On the contrary, when BTA molecule is adsorbed on a cuprite‐enriched surface, it is promoted the formation of Cu(II) species. Instead, for degraded CNR 128 alloy where atacamite or cuprite were the main component of the patina, XPS results showed that the chemical nature of the bronze surface is present Cu(II) oxidation state. Copyright © 2012 John Wiley & Sons, Ltd.
Functionalization of Amorphous SiO2 and 6H‐SiC(0001) Surfaces with Benzo[ghi]perylene‐1,2‐dicarboxylic Anhydride via an APTES Linker
Authors: Bhowmick Deb Kumar , Linden Steffen , Devaux André , De Cola Luisa , Zacharias Helmut
Published: January 2012

The successful covalent functionalization of quartz and n‐type 6H‐SiC with organosilanes and benzo[ghi]perylene‐1,2‐dicarboxylic dye is demonstrated. In particular, wet‐chemically processed self‐assembled layers of aminopropyltriethoxysilane (APTES) and benzo[ghi]perylene‐1,2‐dicarboxylic anhydride are investigated. The structural and chemical properties of these layers are studied by contact angle measurements, attenuated total reflection infrared (ATR‐IR) spectroscopy, and X‐ray photoelectron spectroscopy (XPS). The optical properties are measured by confocal microscopy. The wetting angles observed for the organic layers are α = 68° for the APTES‐functionalized surface, while angles of α = 85° and 78° are determined for dye‐functionalized quartz and 6H‐SiC surfaces, respectively. However, not all amino groups of the APTES‐functionalized surfaces react to bind dye molecules. Further dye functionalization is not uniform throughout the surface, showing different island sizes of the dye and including different chemical environments. The quartz surface exhibits a higher packing density of dyes than the 6H‐SiC surface. The fluorescence lifetimes of the surface‐attached dye show double exponential decays of about 1.4 and 4.2 ns, largely independent of the substrates.
Preparation and drug release properties of lignin–starch biodegradable films
Authors: Çalgeris İlker , Çakmakçı Emrah , Ogan Ayşe , Kahraman M. Vezir , Kayaman‐Apohan Nilhan
Published: January 2012

Starch is one of the most commonly available natural polymers which are obtained from agro‐sources. It is renewable and abundant in nature. Unfortunately due to its poor mechanical properties and hygroscopic nature, there are some strong limitations to the development of starch‐based products. Usually blends of starch are prepared and plasticized with glycerol to improve some of its properties. In this study, lignin was extracted from hazelnut shells and investigated as a potential additive for starch biofilms. The structural characterization of hazelnut lignin was performed by employing UV spectroscopy and Fourier transform infrared (FTIR) spectroscopy. Lignin was blended with corn starch in different ratios to obtain biofilms. Mechanical and thermal properties of the biofilms were enhanced as the lignin amount was increased in the formulations. Water absorption tests were performed at pH 2.0, 4.0, and 6.0. The percent swelling values of the starch/lignin films increased as pH increased. Also, the biofilm exhibiting the best properties was chosen for the drug release studies. Biofilms showed a fast ciprofloxacin (CPF) release within an hour and then the drug release rate decreased. A pH dependent drug release mechanism was also observed according to Koshner–Peppas model. The drug release increased with a decrease in pH.
Modeling seasonal detection patterns for burrowing owl surveys
Authors: Latif Quresh S. , Fleming Kathleen D. , Barrows Cameron , Rotenberry John T.
Published: January 2012

To guide monitoring of burrowing owls (Athene cunicularia) in the Coachella Valley, California, USA, we analyzed survey‐method‐specific seasonal variation in detectability. Point‐based call‐broadcast surveys yielded high early season detectability that then declined through time, whereas detectability on driving surveys increased through the season. Point surveys without call‐broadcasts yielded the lowest detectability rates overall. To maximize detectability, we recommend coupling early season point‐based call‐broadcast surveys with late‐season driving surveys. Occupancy models proved useful for integrating data from multiple methods to analyze distributional patterns while accounting for variation in detectability. © 2012 The Wildlife Society.
Morbidity and Mortality Results From a Prospective Randomized Controlled Trial Comparing Billroth I and Roux‐en‐Y Reconstructive Procedures After Distal Gastrectomy for Gastric Cancer
Authors: Imamura Hiroshi , Takiguchi Shuji , Yamamoto Kazuyoshi , Hirao Motohiro , Fujita Junya , Miyashiro Isao , Kurokawa Yukinori , Fujiwara Yoshiyuki , Mori Masaki , Doki Yuichiro
Published: January 2012

Background

Billroth I (B‐I) and Roux‐en‐Y (R‐Y) reconstructions are commonly performed after distal gastrectomy. Which reconstruction procedure is superior remains controversial. We conducted a randomized controlled trial to compare the clinical efficacy of B‐I and R‐Y.

Methods

Between August 2005 and December 2008, a total of 332 patients with potentially curable gastric cancer enrolled from 18 institutions were intraoperatively randomized to either the B‐I group or the R‐Y group. Postoperative morbidity and hospital mortality were recorded prospectively in a fixed format and were compared between these two groups.

Results

The operating time was significantly longer in the R‐Y group than in the B‐I group (214 vs. 180 minutes, P < 0.0001). Regarding clinical symptoms during the postoperative hospital stay, the incidence of nausea, vomiting, and discontinuance of food intake was significantly higher in the R‐Y group than in the B‐I group (12.4% vs. 3.7%, P = 0.0027; 8.9% vs. 3.1%, P = 0.022; and 12.4% vs. 4.3%, P = 0.0064, respectively). There was no significant difference in the overall operative morbidity rate between the R‐Y and B‐I groups (13.6% vs. 8.6%, respectively, P = 0.14). Anastomotic leakage occurred in two patients (1.2%) in the B‐I group and in none in the R‐Y group; the difference did not reach statistical significance (P = 0.09). Postoperative hospital stay was significantly longer in the R‐Y group than in the B‐I group (16.4 vs. 14.1 days, P = 0.019).

Conclusions

We concluded that B‐I reconstruction was superior to R‐Y reconstruction in terms of perioperative complications.
Log Odds of Positive Lymph Nodes in Colon Cancer: A Meaningful Ratio‐based Lymph Node Classification System
Authors: Persiani Roberto , Cananzi Ferdinando C. M. , Biondi Alberto , Paliani Giuseppe , Tufo Andrea , Ferrara Francesco , Vigorita Vincenzo , D’Ugo Domenico
Published: January 2012

Background

The log odds of positive lymph nodes (LODDS), defined as the log of the ratio between the numbers of positive and negative lymph nodes, has recently been proposed as a new prognostic index in surgical oncology. The aim of the present study was to investigate whether the LODDS system of lymph node classification was a more accurate prognostic tool than the tumor node metastasis (TNM) and lymph node ratio (LNR) classifications in colon cancer patients.

Materials and methods

Clinicopathologic data from 258 colon cancer patients who had undergone surgical resection were reviewed. Lymph node parameters were categorized according to the Internation Union Against Cancer/American Joint Cancer Commission (UICC/AJCC) TNM staging system, the LNR (LNR0 with ratio ≤ 0.05, LNR1 with 0.05 < ratio ≤ 0.20, LNR2 with ratio > 0.20), and the log odds ratio (LODDS0 ≤ –1.36, –1.36 < LODDS1 ≤ –0.53, and LODDS2 > –0.53).

Results

The LODDS was able to identify patients who would have been included in different prognostic categories, according to both the TNM and LNR. In addition, LODDS was significantly related to the number of positive and negative lymph nodes, as well as the number of examined lymph nodes. In multivariate analysis, LODDS classification (LODDS0: HR 1; LODDS1: HR 3.687, p = 0.003; LODDS2: HR 9.440, p < 0.001) was identified as an independent prognostic factor.

Discussion

The LODDS system is a highly reliable staging system with strong predictive ability for patient outcome. Compared with other nodal staging systems, the prognostic power of LODDS is less influenced by the number of lymph nodes dissected and examined.
Comparison of Outcomes of Laparoscopic Versus Open Appendectomy in Children: Data from The Nationwide Inpatient Sample (NIS), 2006–2008
Authors: Masoomi Hossein , Mills Steven , Dolich Matthew O. , Ketana Noor , Carmichael Joseph C. , Nguyen Ninh T. , Stamos Michael J.
Published: January 2012

Background

The benefits of laparoscopic appendectomy (LA) remain undefined as compared to open appendectomy (OA) in children, particularly in cases of perforated appendicitis. The purpose of the present study was to evaluate the outcomes of LA versus OA in perforated and nonperforated appendicitis in children.

Methods

Using the Nationwide Inpatient Sample database, we evaluated the clinical data of children (<18 years old) who underwent LA and OA from 2006 to 2008. Incidental and elective appendectomies were excluded.

Results

A total of 212,958 children underwent urgent appendectomy in the United States during these years.

The overall rate of perforated appendicitis was 27.7, and 56.9% of all cases were performed laparoscopically. In nonperforated cases, LA was associated with comparable overall complication rate (LA: 2.56 vs. OA: 2.66%; p = 0.26), shorter length of hospital stay (LOS, LA: 1.6 vs. OA: 2.0 days; p < 0.01), comparable mortality (LA: 0.01 vs. OA: 0.02%; p = 0.25); and higher hospital charges (LA: $20,328 vs. OA: $16,830; p < 0.01) compared to OA. In perforated cases, LA had a lower overall complication rate (LA: 16.03 vs. OA: 18.07%; p < 0.01), shorter LOS (LA: 5.1 vs. OA: 5.8 days; p < 0.01), lower mortality (LA: 0.0% versus OA: 0.06%; p < 0.01), and similar hospital charges (LA: $33,361 versus OA: $33, 662; p = 0.71) compared to OA.

Conclusions

LA is safe in children with acute perforated and nonperforated appendicitis, and is associated with shorter hospital stay than OA. The laparoscopic approach is associated with lower morbidity and mortality in perforated cases. However, in nonperforated cases, these benefits are modest and are associated with higher hospital charges.
No Impact of Perioperative Blood Transfusion on Recurrence of Hepatocellular Carcinoma after Hepatectomy
Authors: Kuroda Shintaro , Tashiro Hirotaka , Kobayashi Tsuyoshi , Oshita Akihiko , Amano Hironobu , Ohdan Hideki
Published: January 2012

Background

Although several studies have shown that perioperative blood transfusion is a poor prognostic factor of outcome after hepatectomy for hepatocellular carcinoma (HCC), the impact of perioperative blood transfusion on the prognosis of HCC remains unknown.

Methods

Data from 835 patients (76 transfused patients and 759 nontransfused patients) who underwent curative hepatectomy for HCC were retrospectively collected and analyzed. To overcome bias due to the different distribution of covariates for the two groups, a one‐to‐one match was created using propensity score analysis. After matching, patient outcomes were analyzed.

Results

After one‐to‐one matching, 60 transfused patients and 60 nontransfused patients had the same preoperative and operative characteristics (excluding operative blood loss). Although the morbidity rate of hepatectomy was significantly higher in the transfused group than in the nontransfused group (P = 0.016), there was no significant difference in mortality rate (P = 0.242). Additionally, the overall survival rate of transfused patients was similar to that of nontransfused patients (P = 0.466), and the difference in disease‐free survival rate between the two groups was insignificant (P = 0.621).

Conclusions

Perioperative blood transfusion did not influence the overall and disease‐free survival rate in the HCC patients studied. Perioperative blood transfusion may not be considered a poor prognostic factor for patients with HCC.
Adjuvant chemotherapy for resectable biliary tract cancer: current status and future direction
Authors: Konishi Masaru
Published: January 2012

The prognosis of patients with biliary tract cancer remains unsatisfactory even with surgery owing to the high recurrence rate. Therefore, an effective adjuvant chemotherapy is required to prolong survival. A few randomized controlled trials in patients with limited biliary tract cancer have been reported, but the efficacy of adjuvant chemotherapy could not be clarified. To date, effective adjuvant chemotherapy with evidence has not been established, and the standard therapy for patients with resectable biliary tract cancer has only been surgical treatment. Recently, a number of newer toxic agents have been shown to induce response in patients with advanced biliary tract cancer. Moreover, the morbi‐mortality rate of operation for this cancer has been decreasing owing to advances in operative techniques and perioperative management. Given this background, a number of adjuvant chemotherapy trials have been started using gemcitabine, capecitabine, S‐1, and combination chemotherapy with platinum. The results of these trials will be reported in the near future. Overall, the important aspects of adjuvant chemotherapy for biliary tract cancer are to establish well‐organized and active clinical trial study groups, to conduct well‐designed multicenter randomized controlled trials, and to continue such trials without interruption in the future.
Testicular volume discrepancy is associated with decreased semen quality in infertile Japanese males with varicoceles
Authors: Komiya Akira , Watanabe Akihiko , Kawauchi Yoko , Fuse Hideki
Published: January 2012

Purpose

We retrospectively reviewed infertile Japanese males for testicular volume discrepancies (D) and semen parameters to evaluate whether left grade II–III varicoceles (V) cause testicular damage.

Methods

Seventy‐seven patients who had idiopathic male infertility and 88 who had V without other causes of infertility were examined. We excluded cases of azoospermia. Testicular volume was measured using a punched‐out orchidometer. D was defined as a size difference of at least 3 ml. The frequency of D was compared between the patients with and without V. The semen parameters were reviewed in association with D and V.

Results

The mean left and right testicular volumes were 19.4 and 20.1 ml, respectively (p < 0.001). D with a smaller left testis was more common in V+ cases than in V− cases (26.1 vs. 13.0%, p = 0.0351). The sperm count and motility were also significantly lower (p = 0.0213 and p = 0.0217, respectively) in the D+ patients with a smaller left testicular volume.

Conclusions

In the patients with V, D was more common than in those without V. The semen parameters were worse if D was present in the patients with V. These results indicated that V could induce testicular atrophy and negatively affect semen quality. Therefore, the ipsilateral reduced testicular volume is considered to be a sign of persisting testicular damage by V.
Beyond the Culture War: Managing Sexual Relationships inside a Congregation of Gay Evangelicals
Authors: Thomas Jeremy N. , Olson Daniel V. A.
Published: January 2012

America's popular culture war narrative has often portrayed the evangelical community and the gay community as fundamentally oppositional groups whose range of disagreements center around arguments over the morality and nature of homosexuality. Against the backdrop of these arguments, we undertake a qualitative study of a congregation of gay evangelicals, specifically investigating how pastoral leadership attempts to manage sexual relationships amid a congregation that is firmly and self-consciously rooted in both its gay and evangelical identities. We look at the particular goals and ideals that pastoral leadership espouses for sexual relationships, and we explore how these goals and ideals represent, draw from, and potentially help integrate the congregation's competing cultural identities. We find that pastoral leadership strives for what we are calling a “blended approach” to managing sexual relationships—an approach that simultaneously emphasizes traditional evangelical sexual norms (such as commitment, stability, monogamy, and longevity), while allowing these norms to be significantly tempered by a strong recognition of the private and public contexts that have shaped the gay community's understanding of sexual and relational life. We speculate that this blended approach to managing sexual relationships may be pointing the way toward future developments within some predominantly-heterosexual evangelical congregations.
National Institute on Aging–Alzheimer's Association guidelines for the neuropathologic assessment of Alzheimer's disease
Authors: Hyman Bradley T. , Phelps Creighton H. , Beach Thomas G. , Bigio Eileen H. , Cairns Nigel J. , Carrillo Maria C. , Dickson Dennis W. , Duyckaerts Charles , Frosch Matthew P. , Masliah Eliezer , Mirra Suzanne S. , Nelson Peter T. , Schneider Julie A. , Thal Dietmar Rudolf , Thies Bill , Trojanowski John Q. , Vinters Harry V. , Montine Thomas J.
Published: January 2012

A consensus panel from the United States and Europe was convened recently to update and revise the 1997 consensus guidelines for the neuropathologic evaluation of Alzheimer's disease (AD) and other diseases of brain that are common in the elderly. The new guidelines recognize the pre‐clinical stage of AD, enhance the assessment of AD to include amyloid accumulation as well as neurofibrillary change and neuritic plaques, establish protocols for the neuropathologic assessment of Lewy body disease, vascular brain injury, hippocampal sclerosis, and TDP‐43 inclusions, and recommend standard approaches for the workup of cases and their clinico‐pathologic correlation.
MAKING MUSIC, MAKING MONEY: INFORMAL MUSICAL PRODUCTION AND PERFORMANCE IN VENDA, SOUTH AFRICA
Authors: McNeill Fraser G.
Published: January 2012

This article presents an ethnographic analysis of the popular economy of informal musical production in the Venda region of South Africa. It focuses on the activities surrounding the Burnin' Shak Studio, a recording house that specializes in reggae music. Reliant on second-hand computers, pirated software, borrowed instruments, networks of trust and cycles of debt, musicians and producers in the Burnin' Shak occupy a distinctly peripheral position in South Africa's music industry. Unlike artists in the formal sphere of musical production, who sign deals with specific record labels, musicians in the informal sector seek out sponsors – usually young local businessmen – to fund their recordings with local producers. Marketing and distribution is the sole responsibility of the artist and the sponsor, who often develop a ‘patron–client’ relationship. And yet whilst the artists' entrepreneurial activity often earns them significant airplay on local radio stations, and associated cultural capital, the financial benefits are slim. In order to convert their cultural capital into cash, musicians in the informal sector must compete in the market for performances at government-sponsored shows. These shows are well funded by lucrative tenders, but they present musicians with a double-edged sword. To secure a contract with tender holders – or to entertain hopes of regular paid performances – musicians must ensure that these performances do not express critical political sentiment. As purveyors of a genre renowned for its critical social commentary, reggae musicians are particularly affected by this expectation of self-censorship. Informal musical production in the post-apartheid era thus affords musicians little artistic freedom. Rather, whilst the products of this culture industry may appear to be part of a ‘secondary’ economy, removed from the spheres of formalized production and control, they are in fact regulated and standardized through the process of tender allocation.
What is a multiple treatments meta-analysis?
Authors: Cipriani A. , Barbui C. , Rizzo C. , Salanti G.
Published: January 2012

Standard meta-analyses are an effective tool in evidence-based medicine, but one of their main drawbacks is that they can compare only two alternative treatments at a time. Moreover, if no trials exist which directly compare two interventions, it is not possible to estimate their relative efficacy. Multiple treatments meta-analyses use a meta-analytical technique that allows the incorporation of evidence from both direct and indirect comparisons from a network of trials of different interventions to estimate summary treatment effects as comprehensively and precisely as possible.
Grundschule oder Gymnasium? Zur Motivation ein Lehramt zu studieren
Authors: Retelsdorf Jan , Möller Jens
Published: January 2012

Zusammenfassung: Die Entscheidung für ein bestimmtes Lehramt hängt auch von der Motivation der Studierenden ab. Bisherige Studien haben dabei eher allgemeine als lehramtsspezifische motivationale Prädiktoren untersucht. In dieser Untersuchung wurde an 3449 Lehramtsstudierenden überprüft, inwieweit sich Studierende unterschiedlicher Lehrämter im «Fragebogen zur Erfassung der Motivation für die Wahl des Lehramtsstudiums» (FEMOLA) unterscheiden. In multinomialen logistischen Regressionsanalysen wurde der Zusammenhang der Lehramtswahl mit Studienwahlmotivation, Geschlecht, sozialem Hintergrund sowie Leistungs- und Persönlichkeitsmerkmalen untersucht. Unter anderem zeigte sich, dass fachliches Interesse eher mit der Wahl eines gymnasialen Lehramts und pädagogisches Interesse eher mit der Wahl eines anderen Lehramts assoziiert ist. Zudem ergab sich eine weitere Unterteilung der Skalen des FEMOLA (finanzielle und familiäre Nützlichkeit) und die Annahme (partieller) Invarianz des Verfahrens konnte gestützt werden.
Verarbeitung von konkreten und abstrakten Wörtern bei Kindern im Schulalter
Authors: Kauschke Christina , Nutsch Cornelia , Schrauf Judith
Published: January 2012

Zusammenfassung. Die Verarbeitung abstrakter Begriffe ist ein wichtiger Bestandteil der sprachlichen und kognitiven Entwicklung, der gerade in der späteren Kindheit relevant ist. In der vorliegenden Studie wurde ein Reaktionszeitexperiment zum lexikalischen Entscheiden über konkrete und abstrakte Nomen durchgeführt, an dem je 20 Kinder im Alter von acht bzw. zwölf Jahren sowie Erwachsene teilnahmen. Die Ergebnisse zeigen, dass Qualität und Geschwindigkeit der Wortverarbeitung in Abhängigkeit vom Alter und vom Konkretheitsgrad variieren. Achtjährige Kinder verarbeiteten konkrete Begriffe sowohl sicherer als auch schneller als abstrakte. Auch Zwölfjährige konnten Konkreta sicherer verarbeiten, die Reaktionszeiten für konkrete und abstrakte Wörter unterschieden sich hingegen nicht. Erwachsene Probanden verarbeiteten Konkreta und Abstrakta gleich schnell und zeigten sogar etwas bessere Leistungen für Abstrakta. Damit deutet sich ein Umschwung in der Verarbeitung abstrakter Begriffe zwischen acht und zwölf Jahren an, der im Zusammenhang mit einer zunehmenden Abstraktionsfähigkeit und Lösung vom Konkreten in dieser Altersstufe diskutiert wird.
Occurrence of elves and lightning during El Niño and La Niña
Authors: Wu Y. J. , Chen A. B. , Hsu H. H. , Chou J. K. , Chang S. C. , Lee L. J. , Lee Y. J. , Su H. T. , Kuo C. L. , Hsu R. R. , Frey H. U. , Mende S. B. , Takahashi Y. , Lee L. C.
Published: January 2012

We analyzed the ISUAL‐FORMOSAT2 elves, the LIS‐TRMM lightning, the sea surface temperature (SST), and the El Niño southern oscillation (ENSO) indices (the Niño 3.4 Index and the Southern Oscillation Index ‐ SOI) in the period between June 2005 and May 2010 to explore the impacts of ENSO on the occurrences of the mesospheric elves and the troposphere lightning. The standardized anomalies of the elve and the lightning occurrence densities are used to quantify the deviation of the elve and lightning occurrences during an ENSO event. The areas in the ENSO‐sensitive western Pacific, central Pacific and Tahiti regions with a significant event anomaly are taken to be the impact indicators of ENSO. Also the SOI is used to examine the correlation of the temporal intensity variation between ENSO, elve and lightning. The results indicate that elve shows clear responses to ENSO with a correlation over 0.6 in the coastal and the oceanic regions. The lightning occurrence is responsive to ENSO in the oceanic regions, but shows a low correlation in the coastal regions, due the overwhelming influence of the landmass. Therefore, between elve and lightning as proximity indices of ENSO, elve has a broader applicable geographic range. However, elve is known to be the mesospheric luminous manifestations of the high‐peak‐current lightning, and the response of the intense lightning to ENSO would be similar to that of the elve. Hence, alternatively, the intense lightning can also be used as an indicator of ENSO.
Strong magnetic field fluctuations within filamentary auroral density cavities interpreted as VLF saucer sources
Authors: Knudsen D. J. , Kabirzadeh R. , Burchill J. K. , Pfaff R. F. , Wallis D. D. , Bounds S. R. , Clemmons J. H. , Pinçon J.‐L.
Published: January 2012

The Geoelectrodynamics and Electro‐Optical Detection of Electron and Suprathermal Ion Currents (GEODESIC) sounding rocket encountered more than 100 filamentary density cavities associated with enhanced plasma waves at ELF (<3 kHz) and VLF (3–10 kHz) frequencies and at altitudes of 800–990 km during an auroral substorm. These cavities were similar in size (∼20 m diameter in most cases) to so‐called lower‐hybrid cavities (LHCs) observed by previous sounding rockets and satellites; however, in contrast, many of the GEODESIC cavities exhibited up to tenfold enhancements in magnetic wave power throughout the VLF band. GEODESIC also observed enhancements of ELF and VLF electric fields both parallel and perpendicular to the geomagnetic fieldB0within cavities, though the VLF E field increases were often not as large proportionally as seen in the magnetic fields. This behavior is opposite to that predicted by previously published theories of LHCs based on passive scattering of externally incident auroral hiss. We argue that the GEODESIC cavities are active wave generation sites capable of radiating VLF waves into the surrounding plasma and producing VLF saucers, with energy supplied by cold, upward flowing electron beams composing the auroral return current. This interpretation is supported by the observation that the most intense waves, both inside and outside cavities, occurred in regions where energetic electron precipitation was largely inhibited or absent altogether. We suggest that the wave‐enhanced cavities encountered by GEODESIC were qualitatively different from those observed by earlier spacecraft because of the fortuitous timing of the GEODESIC launch, which placed the payload at apogee within a substorm‐related return current during its most intense phase, lasting only a few minutes.