bluuebunny/crossref_metadata_2025_split huggingface dataset:
The limits and variety of risk‐based governance: The case of flood management in Germany and England
Authors: Krieger Kristian 
Published: December 2012

AbstractRisk‐based governance is argued by many to hold the promise of a more rational and efficient state, by making explicit the limitations of state interventions and focusing finite resources on those targets where probable damage is greatest. This paper challenges the assumption that risk‐based governance has the potential for universal and uniform application, by comparing contemporary flood management in Germany and England. On first inspection, flooding appears to be a paradigmatic case of risk colonizing European policy discourses, with the traditional notion of flood defense giving way to flood risk management in the context of climate change, increasingly frequent flood disasters, political and cost pressures on flood protection, and publicly available European‐wide flood assessments. Drawing on in‐depth empirical research, this paper shows how the role, and even the definition, of “risk” is institutionally shaped, and how the respective institutional environments of German and English flood management practices impede and promote risk colonization. In particular, the use and conceptualizations of risk in governance are variously promoted, filtered, or constrained by the administrative procedures, structures, and political expectations embedded within flood management and wider polities of each country. The findings of this research are important for the design and implementation of supranational policies and regulations that endorse risk‐based approaches, such as the recent EU Flood Directive, as well as scholarly debate as to how to legitimately define the limits of governance in the face of uncertainty and accountability pressures.
Comparison of pleural N‐terminal pro‐B‐type natriuretic peptide, midregion pro‐atrial natriuretic peptide and mid‐region pro‐adrenomedullin for the diagnosis of pleural effusions associated with cardiac failure
Authors: Porcel José M. , Bielsa Silvia , Morales‐Rull José L. , Civit Carme , Cao Gonzalo , Light Richard W. , Esquerda Aureli 
Published: December 2012

AbstractBackground and objectiveThe purpose of this study was to compare the diagnostic utility of pleural fluid N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP), midregion pro‐atrial natriuretic peptide (MR‐proANP) and midregion pro‐adrenomedullin (MR‐proADM) for discriminating heart failure (HF)‐associated effusions.MethodsNT‐proBNP, MR‐proANP and MR‐proADM were measured by commercially available methodologies in the pleural fluid of a retrospective cohort of 185 consecutive patients with pleural effusions, of whom 95 had acute decompensated HF. Receiver‐operating characteristic and area under the curve (AUC) analyses allowed comparisons of the discriminative properties of these biomarkers to be made at their optimal cut‐off points.ResultsThe diagnostic accuracy of NT‐proBNP and MR‐proANP for HF as quantified by the AUC was 0.935 and 0.918, respectively, whereas MR‐proADM was of limited value (AUC = 0.62). A pleural fluid MR‐proANP >260 pmol/L or NT‐proBNP >1700 pg/mL argues for HF (likelihood ratio (LR) positive >5), while levels below these cut‐off values significantly decrease the probability of having the disease (respective LR negative 0.19 and 0.10). The optimal cut‐off points for natriuretic peptides were influenced by age, renal function and body mass index. Finally, both NT‐proBNP and the albumin gradient correctly identified more than 80% of those cardiac effusions misclassified as exudates by standard criteria.ConclusionsMR‐proANP is as valuable a diagnostic tool as NT‐proBNP for diagnosing or excluding HF as the cause of pleural effusion.
Short‐acting anticholinergic bronchodilation does not increase cardiovascular events in smokers with mild to moderate pulmonary obstruction
Authors: de Jong Emmy , van Dijk Wouter D. , Heijdra Yvonne , Lenders Jacques W. M. , van Weel Chris , Akkermans Reinier , Schermer Tjard R. J. 
Published: December 2012

AbstractBackground and objectiveWe hypothesized that bronchodilation in patients with chronic obstructive pulmonary disease (COPD) increases the smoke‐related risk to develop cardiovascular disease, and aimed to study the effect of short‐acting anticholinergic bronchodilation and smoking on cardiovascular events.MethodsWe performed a secondary analysis on data from the Lung Health Study, a large randomized clinical trial of smokers with mild to moderate pulmonary obstruction, 35–60 years old, without cardiovascular comorbidity. We used Cox proportional survival analysis, controlling for several confounders, to study the effect on 5‐year risk of fatal and/or non‐fatal cardiovascular events. Secondary outcome encompassed fatal and non‐fatal coronary events.ResultsOf 2745 participants, 23 (0.8%) died of cardiovascular disease. One hundred and sixty‐two participants were hospitalized for a cardiovascular event, and 94 participants due to a coronary event. Survival analysis revealed no effect between smoking and short‐acting anticholinergic bronchodilation on fatal and/or non‐fatal cardiovascular events, hazard ratio = 1.12 (0.58–2.19), nor on coronary events, hazard ratio = 1.46 (0.60–3.56).ConclusionsOur study results show that short‐acting anticholinergic bronchodilation had no detrimental effect on cardiovascular disease in smokers with mild to moderate pulmonary obstruction.
Blockade of the Suprascapular Nerve: A Radiological and Cadaveric Study Comparing Landmark and Ultrasound-guided Blocking Techniques
Authors: Lancaster Sarah T. , Clark Damian A. , Redpath Yvette , Hughes David M. , Crowther Mark A. , Lewis Simon M. 
Published: December 2012

Background Blockade of the suprascapular nerve (SSN) is used frequently in shoulder surgery and in chronic shoulder pain. Anatomical landmarks may be used to locate the nerve before infiltration with local anaesthetic, with ultrasound comprising a popular method for locating the nerve. Methods Twelve cadaveric shoulders from six specimens were injected with dye using both the landmark and the ultrasound technique. The shoulders were scanned by computed tomography (CT) and then dissected to determine the accuracy of each technique. Results Using the CT scan results, we found the ultrasound group to be more accurate with respect to placing the anaesthetic needle close to the suprascapular notch (and therefore nerve), with this being statistically significant ( p = 0.021). Conclusions The findings of the present study demonstrate that ultrasound-guided block is significantly more accurate than the landmark technique, therefore suggesting that ultrasound guidance be used for blockade of the SSN.
Assessment of dentally related functional competency for older adults with cognitive impairment—a survey for special‐care dental professionals
Authors: Chen Xi , Clark Jennifer J.J. 
Published: December 2012

ABSTRACTThis survey was to study whether and how dental professional assess dental‐related function in older adults with cognitive impairment (OACI). An invitation was sent to 525 special‐care dental professionals, followed by a reminder in 2 weeks. Thirteen percent of the targeted participants completed the survey. Among them, 88% completed a hospital dentistry, geriatric dentistry, or other postgraduate training program. Nearly 70% of the respondents considered somewhat to very difficult to assess dentally related function; 45% did not ever or did not regularly assess dental‐related function for OACI. Dental‐related functional assessments were often based on a subjective, unstructured approach. Only 6% of the respondents routinely used standard instruments to assess the patients’ function. These results indicate that an objective functional assessment based on a standardized instrument has not been routinely incorporated into dental care for OACI, raising concerns for quality of care in this vulnerable population.
The investigation of the skin characteristics of males focusing on gender differences, skin perception, and skin care habits
Authors: Mizukoshi Koji , Akamatsu Hisashi 
Published: December 2012

Background/purposeVarious studies have examined the properties of male skin. However, because these studies mostly involved simple measurement with non‐invasive devices, a lack of understanding of the properties of male skin remains.MethodsIn this study, we focused and investigated not only on simple instrumental measurements but also on gender differences and men's subjective perceptions of skin and daily skin care habits.ResultsBarrier function depends on corneocyte maturation level as well as sebum amount. Irrespective of the skin type, a high percentage of male subjects perceived a ‘tacky feeling’. However, the percentage of men perceiving a ‘shiny feeling’ differed by skin type. Furthermore, there was a relationship between skin care habits and skin function. Men who did not perform a daily skincare regimen demonstrated a significantly higher sebum amount and transepidermal water loss value than those who did perform a daily skincare regimen.ConclusionThe results of this study indicate that male skin has two specific characteristics: impaired barrier function because of the excess amount of sebum and a lack of an appropriate skin care regimen because of the ‘tacky feeling’ caused by excess sebum.
The skin surface pH and its different influence on the development of acne lesion according to gender and age
Authors: Youn S. H. , Choi C. W. , Choi J. W. , Youn S. W. 
Published: December 2012

BackgroundSkin pH is one of the important physiological parameters of the skin. Changes in the pH play a role in the pathogenesis of several skin diseases, including acne.PurposeTo assess the correlation between the pH and the age, and between the pH and the development of acne lesions, in a large acne patients group. We also evaluated the difference between the genders.MethodsA total of 540 patients clinically diagnosed with acne vulgaris were included. The clinical digital photographs were taken, and the acne lesions were counted. The pH was measured, using the skin‐pH‐meter®. Area‐weighted pH was calculated and statistical analysis was performed, according to age and gender.ResultsThe female had higher pH than the male acne patients. The T‐zone had higher pH than that of the U‐zone. In female acne patients, age and the area‐weight pH showed a positive correlation. Male acne patients had more inflammatory lesions. And U‐zone showed more acne lesions than T‐zone. There are negative correlations between the area‐weight pH and the number of acne lesions, in the T‐zone of the female acne patients and positive correlation at the inflammatory lesions on the T‐zone of male acne patients.ConclusionsThis is the first study to evaluate the correlations between pH, age, gender, and acne development in a large acne patients group using an objective, bioengineering method within the viewpoint of skin pH. We could expect that there are gender differences in the correlation between pH, age, and acne development. From this result, we could provide a clue to the treatment of acne, that maintaining the pH balance according to the difference of gender and age is an essential consideration.
A field‐shaping multi‐well avalanche detector for direct conversion amorphous selenium
Authors: Goldan A. H. , Zhao W. 
Published: December 2012

Purpose:A practical detector structure is proposed to achieve stable avalanche multiplication gain in direct‐conversion amorphous selenium radiation detectors.Methods:The detector structure is referred to as a field‐shaping multi‐well avalanche detector. Stable avalanche multiplication gain is achieved by eliminating field hot spots using high‐density avalanche wells with insulated walls and field‐shaping inside each well.Results:The authors demonstrate the impact of high‐density insulated wells and field‐shaping to eliminate the formation of both field hot spots in the avalanche region and high fields at the metal–semiconductor interface. Results show a semi‐Gaussian field distribution inside each well using the field‐shaping electrodes, and the electric field at the metal–semiconductor interface can be one order‐of‐magnitude lower than the peak value where avalanche occurs.Conclusions:This is the first attempt to design a practical direct‐conversion amorphous selenium detector with avalanche gain.
Survival of tumor and normal cells upon targeting with electron‐emitting radionuclides
Authors: Rajon Didier , Bolch Wesley E. , Howell Roger W. 
Published: December 2012

Purpose:Previous studies have shown that the mean absorbed dose to a tissue element may not be a suitable quantity for correlating with the biological response of cells in that tissue element. Cell survival can depend strongly on the distribution of radioactivity at the cellular and multicellular levels. Furthermore, when cellular absorbed doses are examined, the cross‐dose from neighbor cells can be less radiotoxic than the self‐dose component. To better understand how the nonuniformity of activity among cells can affect the dose response, a computer model of a 3D tissue culture was previously constructed and showed that activity distribution among cells is significantly more relevant than the mean absorbed dose for low‐energy‐electron emitters. The present work greatly expands upon those findings.Methods:In the present study, we used this same computer model but restricted the number of labeled cells to a fraction of the whole cell population (50%, 10%, and 1%, respectively). The labeled cells were randomly distributed among the whole cell population.Results:While the activity distribution is an important factor in determining the tissue response for low‐energy‐electron emitters, the fraction of labeled cells has an even more pronounced effect on survival response. For all electron energies studied, reducing the percentage of cells labeled significantly increases the surviving fraction of the whole population.Conclusions:This study provides abundant information on killing tumor and normal cells under some conditions relevant to targeted radionuclide therapy of isolated tumor cells and micrometastases. The percentage of cells labeled, activity distribution among the labeled cells, and electron energy play key roles in determining their response. Most importantly, and not previously demonstrated, lognormal activity distributions can have a profound impact on the response of the tumor cells even when the radionuclide emits high‐energy electrons.
Dynamic modulated brachytherapy (DMBT) for rectal cancer
Authors: Webster Matthew J. , Devic Slobodan , Vuong Te , Yup Han Dae , Park Justin C. , Scanderbeg Dan , Lawson Joshua , Song Bongyong , Tyler Watkins W. , Pawlicki Todd , Song William Y. 
Published: December 2012

Purpose:All forms of past and current high‐dose‐rate brachytherapy utilize immobile applicators during treatment delivery. The only moving part is the source itself. This paradigm misses an important degree of freedom that, if explored, can in some instances produce previously unachievable dose conformality; that is, the dynamic motion of the applicator itself during treatment delivery. Monte Carlo and treatment planning simulations were used to illustrate the potential benefits of moving applicators for rectal cancer applications in particular. This concept is termed dynamic modulated brachytherapy (DMBT).Methods:The DMBT system uses a high‐density, 18.0 g/cm3, 45 mm long tungsten alloy shield, cylindrical in shape, with a small window on one side to encapsulate a 192Ir source, to create collimation that results in a highly directional beam profile. This shield can be dynamically translated and rotated, using an attached robotic arm, during treatment to create a volumetric modulated arc therapy‐type delivery, but from inside the rectal cavity. Monte Carlo simulations and planning optimization algorithms were developed inhouse to evaluate the effectiveness of this new approach using 36 clinical treatment plans comprised of 13 patients each treated using the intracavitary mold applicator (ICMA, Nucletron, The Netherlands) to quantify the potential clinical benefit. The prescription dose was 10 Gy/fx and the group had an average clinical target volume of 9.0 ± 3.5 cm3. Ideal phantom geometries were used to evaluate the impact of various shield dimensions and designs on the resulting plan quality.Results:Simulations of ideal phantom geometries found that shields as small as 10 mm in diameter can produce high quality plans. For the clinical patient cases, compared to the ICMA, for equal prescription tumor coverage, the DMBT plans provided >30% decrease in D5 (high dose volume) resulting in a ∼40% decrease in dose heterogeneity index. In addition, mean dose and D98 showed a reduction (typically 40%–60%) on all critical structures evaluated. However, for a 10 Gy prescribed dose there was an increase in total treatment time on average from 7.6 to 20.8 min for a source with an air‐kerma strength of 40.25 kU (10 Ci).Conclusions:Dosimetric properties of a novel DMBT system have been described and evaluated. Comparison with the ICMA commercial applicator has shown it to be a prospective step forward in high‐dose‐rate brachytherapy192Ir technology. Dynamic motion of an applicator during treatment, for any applicator and site in general, can provide additional degrees of freedom that, if properly considered, can potentially increase the plan quality significantly.
Three‐dimensional optoacoustic tomography using a conventional ultrasound linear detector array: Whole‐body tomographic system for small animals
Authors: Gateau Jérôme , Caballero Miguel Ángel Araque , Dima Alexander , Ntziachristos Vasilis 
Published: December 2012

Purpose:Optoacoustic imaging relies on the detection of ultrasonic waves induced by laser pulse excitations to map optical absorption in biological tissue. A tomographic geometry employing a conventional ultrasound linear detector array for volumetric optoacoustic imaging is reported. The geometry is based on a translate‐rotate scanning motion of the detector array, and capitalizes on the geometrical characteristics of the transducer assembly to provide a large solid angular detection aperture. A system for three‐dimensional whole‐body optoacoustic tomography of small animals is implemented.Methods:The detection geometry was tested using a 128‐element linear array (5.0/7.0 MHz, Acuson L7, Siemens), moved by steps with a rotation/translation stage assembly. Translation and rotation range of 13.5 mm and 180°, respectively, were implemented. Optoacoustic emissions were induced in tissue‐mimicking phantoms andex vivo mice using a pulsed laser operating in the near‐IR spectral range at 760 nm. Volumetric images were formed using a filtered backprojection algorithm.Results:The resolution of the optoacoustic tomography system was measured to be better than 130μm in‐plane and 330 μm in elevation (full width half maximum), and to be homogenous along a 15 mm diameter cross section due to the translate‐rotate scanning geometry. Whole‐body volumetric optoacoustic images of mice were performed ex vivo, and imaged organs and blood vessels through the intact abdominal and head regions were correlated to the mouse anatomy.Conclusions:Overall, the feasibility of three‐dimensional and high‐resolution whole‐body optoacoustic imaging of small animal using a conventional linear array was demonstrated. Furthermore, the scanning geometry may be used for other linear arrays and is therefore expected to be of great interest for optoacoustic tomography at macroscopic and mesoscopic scale. Specifically, conventional detector arrays with higher central frequencies may be investigated.
A multitarget training method for artificial neural network with application to computer‐aided diagnosis
Authors: Liu Bei , Jiang Yulei 
Published: December 2012

Purpose:The authors propose a new training method for artificial neural networks (ANNs) in two‐class classification tasks such as classifying breast lesions on a mammogram as malignant or benign.Methods:Whereas the conventional binary training method uses binary training target values based on the diagnostic truth of a lesion being malignant or benign, the authors use multiple training target values based on more detailed histological diagnosis that presumably are related to the posterior probability of a lesion being malignant. The authors performed Monte Carlo simulation studies in which training target values were assigned based on posterior probability, and they also performed a mammography study in which training target values were assigned according to histological subtypes.Results:These studies showed that the multitarget training method produced less variability in the ANN outputs than the binary training method. The simulation studies also showed that except for when the number of training cases was extremely large, the multitarget training method produced improved overall classification performance over the binary training method.Conclusions:Therefore, the multitarget ANN training method is potentially useful for ANN applications in computer‐aided diagnosis of breast cancer.
The assessment of postural control and the influence of a secondary task in people with anterior cruciate ligament reconstructed knees using a Nintendo Wii Balance Board
Authors: Howells Brooke E , Clark Ross A , Ardern Clare L , Bryant Adam L , Feller Julian A , Whitehead Timothy S , Webster Kate E 
Published: December 2012

BackgroundPostural control impairments may persist following anterior cruciate ligament (ACL) reconstruction. The effect of a secondary task on postural control has, however, not been determined. The purpose of this case–control study was to compare postural control in patients following ACL reconstruction with healthy individuals with and without a secondary task.Participants45 patients (30 men and 15 women) participated at least 6 months following primary ACL reconstruction surgery. Participants were individually matched by age, gender and sports activity to healthy controls.MaterialsPostural control was measured using a Nintendo Wii Balance Board and customised software during static single-leg stance and with the addition of a secondary task. The secondary task required participants to match the movement of an oscillating marker by adducting and abducting their arm.Main outcome measuresCentre of pressure (CoP) path length in both medial-lateral and anterior–posterior directions, and CoP total path length.ResultsWhen compared with the control group, the anterior–posterior path length significantly increased in the ACL reconstruction patients' operated (12.3%, p=0.02) and non-operated limbs (12.8%, p=0.02) for the single-task condition, and the non-operated limb (11.5%, p=0.006) for the secondary task condition. The addition of a secondary task significantly increased CoP path lengths in all measures (p<0.001), although the magnitude of the increase was similar in both the ACL reconstruction and control groups.DiscussionACL reconstruction patients showed a reduced ability in both limbs to control the movement of the body in the anterior–posterior direction. The secondary task affected postural control by comparable amounts in patients after ACL reconstruction and healthy controls. Devices for the objective measurement of postural control, such as the one used in this study, may help clinicians to more accurately identify patients with deficits who may benefit from targeted neuromuscular training programs.