Full Manuscripts Research Articles

Factors Impacting Dual-Career Couples

HR Discussion - Chevron’s Eve Sprunt and Susan Howes discuss results of the December 2011 Talent Council Survey The full manuscript of SPE 160928, ’Factors Impacting Dual Career Couples, Results of December 2011 Talent Council Survey,’ is available as a supplement to this article.

From the Editor

THIS issue of the Journal of Head Trauma Rehabilitation has several novel components that we want to bring to your attention. First, you will notice that the issue contains 2 topical sections. Although we have previously published topical sections (as opposed to an entire topical issue), it is new to have 2 in the same issue. You will find articles based on 2 of the plenary talks given at the 3rd Federal Interagency Conference on TBI—one by Daniel Perl, MD, from the Uniformed Services University of the Health Sciences and the other by Jennie Ponsford, PhD, from Monash University in Melbourne, Australia. Tamara Bushnik and Wayne Gordon, who co-chaired the conference, introduce the section with a recap and analysis of emerging issues. The second topical section introduces 2 additional novel features for JHTR. “TBI in Offender Populations” contains 3 articles, 2 from Elisabeth Pickelsimer's group at the Medical University of South Carolina, and a third from Huw Williams and colleagues at the University of Exeter in the United Kingdom. The prevalence of traumatic brain injury (TBI) among both youth and adult offenders underscores the importance of this topical section. Indeed, the first article is a meta-analysis of prevalence studies that first appeared in the Journal of Correctional Health Care. This is the first time that JHTR has published a reprint, but the careful methodology and striking findings convinced us that this manuscript deserved additional dissemination to the brain injury community. The topical section on TBI in Offender Populations is also unique because it is our first “ePublication only.” These articles are shown in the table of contents and their abstracts are included in the print version of JHTR, but the full manuscripts will only be found on the JHTR Web site, http://journals.lww.com/headtraumarehab. Everything else about these manuscripts is exactly the same as all articles published in JHTR, including their having undergone peer review, capture in Index Medicus and other search engines, inclusion in citation statistics, as well as the look of the PDF versions that can be distributed electronically. We will be interested in authors' and readers' reactions to ePublication—the benefit is that articles get to the field faster and the pages only count as a fraction toward our annual allocation, thus increasing the total number of articles we can publish. And finally, the icing on the cake is the issue's diverse collection of unsolicited articles. On behalf of all the Editors, we hope you enjoy this unique issue of JHTR. —John D. Corrigan, PhD, ABPP Editor-in-Chief

Single agent maintenance therapy for advanced stage non-small cell lung cancer: A meta-analysis

BackgroundMaintenance therapy is a new treatment paradigm for advanced non-small cell lung cancer (NSCLC). We conducted a meta-analysis of randomized studies with single agent maintenance therapy. MethodsAn electronic literature search of public databases (MEDLINE, EMBASE, Cochrane library) and manual search of relevant conference proceedings was performed. A formal meta-analysis was conducted using Comprehensive Meta Analysis software (Version 2.0). Outcome data were pooled and reported as hazard ratio (HR). The primary outcome of interest was overall survival (OS) and secondary outcome was progression free survival (PFS). ResultsTwelve studies were included (5 meeting abstracts, 7 full manuscripts) with a total of 4286 patients (maintenance arm/control arm – 2449/1837, median age 61years, males – 69%). The OS (HR 0.86, 95% confidence intervals [CI] 0.80–0.92; P=0.0003) and PFS (HR 0.80, 95% CI 0.77–0.84; P<0.0001) were superior with maintenance therapy. ‘Switch’ maintenance was associated with significant OS and PFS improvement (OS HR 0.84, 95% CI 0.77–0.91; P=0.00026; PFS HR 0.62, 95% CI 0.57–0.67; P<0.0001). Despite a modest improvement in PFS (HR 0.90, 95%CI 0.85–0.95; P=0.007), “continuation” maintenance was not associated with survival benefit (HR 0.927, 95%CI 0.78–1.09; P=0.33). Improvements in OS and PFS were observed with both EGFR-targeted agents (HR 0.83, 95% CI 0.74–0.92; P=0.004; HR 0.64, 95% CI 0.58–0.71 P<0.0001) and cytotoxic agents (HR 0.89, 95% CI 0.80–0.98; P=0.018; HR 0.85, 95% CI 0.80–0.89; P<0.0001). ConclusionsSingle agent maintenance therapy improves overall survival, though statistical significance was only noted with ‘switch’ maintenance.

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Systematic review of the cost-effectiveness of varenicline vs. bupropion for smoking cessation

The purpose of this systematic review was to review the cost-effectiveness of first-line non-nicotine therapies (varenicline and bupropion SR) for smoking cessation, identify differences in the models used and their conclusions of cost-effectiveness, and to determine which variables, if any, impact conclusions of cost-effectiveness. A systematic literature search was conducted in MEDLINE, PsychINFO, the National Health Service Economic Evaluation Database, the Health Technology Database and the Tufts Cost-effectiveness Analysis Registry from the earliest possible date through May 2011. To be included, studies had to compare cost-effectiveness of varenicline to bupropion using either a Markov model or discrete event simulation and be published as a full text manuscript in English or Spanish. Study selection and data extraction were done in duplicate with disagreement resolved through discussion. Data regarding the model characteristics, results and conclusions were extracted as were details to assess the quality of the study. Model characteristics and cost-effectiveness results were compared across studies and summarised qualitatively. Ten unique studies were included, all of which were Markov models. Eight studies used the Benefits of Smoking Cessation on Outcomes (BENESCO) model and all found varenicline to dominate bupropion. The two non-BENESCO models found varenicline to be cost-effective. Conclusions regarding the cost-effectives were changed upon sensitivity analysis with the following variables: time horizon, cost of bupropion, efficacy of either drug, age and the incidence of smoking related disease. Varenicline dominated bupropion in most cost-effectiveness models. However, applicability of models to clinical practice and variables which changed conclusion of cost-effectiveness should be considered in the interpretation of results.

Special issue on IEEE LASCAS2010

This special issue of the Springer Analog Integrated Circuits and Signal Processing (ALOG) is devoted to selected topics from the First IEEE Latin American Symposium on Circuits and Systems (LASCAS2010) that was held in Iguacu Falls, Brazil, 24th–26th February 2010. LASCAS is intended to be the IEEE Circuits and Systems Society flagship and international conference in Latin America. The selected papers reflect continuing trends toward higher levels of analog and digital circuit techniques covering a wide variety of subjects within the Analog and RF Integrated Circuits, Signal Processing, Digital Integrated Circuits and EDA fields, ranging from basic analog building blocks to system applications on several related domains. The major areas of Electronics, Circuits and Systems covered by LASCAS2010, drew 125 submissions from 30 countries spanning the globe (52% of submitted papers were from out of Latin America) and 53 contributions were selected by more than 75 reviewers for oral presentations and 21 for poster presentation. Among the published contributions in the LASCAS2010 proceedings, a pre-selection of 11 papers has been completed and corresponding Authors were invited for contributions to this Special issue. After receiving the full manuscripts and the assessment of reviewers, eight of them have been accepted for publication in this Special issue. The presented contributions in this Special issue deal with arithmetic circuits, IC architectures, power amplifiers, switching, FFT and variability and defects monitoring circuits dedicated for numerous building blocks of several applications. These contributions includes: (1) FPGA realization of high performance large size computational functions: multipliers and applications; (2) Design challenges of a fully integrated 65 nm CMOS half cascode SFDS PA; (3) An efficient parallel architecture for raytracing; (4) A linear 60 GHz 65 nm-CMOS power amplifier realization and characterization for OFDM signal; (5) Automatic adjustment of a medical imaging data acquisition system to unknown delays in the input communication channels; (6) Analysis of the conditions for the worst case switching activity in integrated circuits; (7) FPGA implementation and testing of a 128 FFT for a MB-OFDM receiver; (8) Delay sensing for long-term variations and defects monitoring in safety–critical applications. Selecting only 8 papers out of 125 contributions of the conference presentations is a difficult and critical task. We are aware that we probably missed many excellent contributions, but we do know that we did our best to put together a special issue as complete as possible. The Technical Program of LASCAS2010 is the result of a truly international cooperation of experts. We feel very much indebted to Technical Program Committee for their invaluable help to start LASCAS at the high standard that our scientific community has grown accustomed to expect from an CASS symposium. We wish to thank our coresearchers from all around the world, for choosing to submit their contributions to LASCAS for review. Due to their many and important contributions, we managed to create a Technical Program of high scientific quality. E. Kerherve IMS Laboratory, Universite Bordeaux 1, Bordeaux, France e-mail: eric.kerherve@ims-bordeaux.fr

The world of trauma working together

The world of trauma working together

World Trauma Congress: when dreams come true

World Trauma Congress: when dreams come true

Evidence-based Medicine for Polypropylene Mesh Use Compared With Native Tissue Vaginal Prolapse Repair

A review of the current medical literature for the use of polypropylene (PP) mesh for vaginally performed prolapse repair, including only those studies reporting prospective, randomized, controlled trials compared with native tissue repairs was undertaken. Five full manuscript publications and 4 studies still in abstract form were all consistent with PP mesh producing better anatomical results for cystocele repair, but when functional results in terms of the patient's quality of life are considered, no significant difference is found between PP mesh and native tissue repairs. PP mesh use results in better anatomical results in the short term but at a cost of repeated surgeries because of erosions and other complications. Patients do not recognize any added benefit from the use of these prostheses in their daily lives.

Systematic review of rotator cuff tears in workers' compensation patients

The burden imposed by workplace rotator cuff (RC) injuries has been reasonably defined. However, literature associated with the demographic characteristics and 'best practices' to manage such injuries among workers' compensation (WC) patients is scant. To consolidate the existing literature on full-thickness RC tears among WC patients. Subject, shoulder and injury characteristics were examined to determine if and how WC recipients may differ from their non-compensable counterparts. A systematic search (databases, clinical practice guideline web resources, conference proceedings and reference lists) revealed 450 abstracts. Two blinded reviewers independently assessed abstracts for inclusion. Sixty abstracts were subsequently included in a blinded full manuscript review. Seventeen of these manuscripts (3.8% of sample; 11 intervention and 6 determinant) were included in the present review. Previous studies demonstrate that operative interventions are appropriate for full-thickness RC tears as substantial gains in range of motion, strength and quality of life were witnessed within the first post-operative year. Non-operative interventions, including workplace-based work hardening, physical therapy and the use of an early referral system, were shown to improve outcomes. Conflicting results exist with respect to determinants such as age and sex. Importantly, WC patients had consistently poorer outcomes than non-WC patients. Our results show that although WC patients experience substantial benefits from various treatments for full-thickness RC tears, disparities exist between them and their non-WC counterparts. The lack of WC-specific literature limited our results. Larger studies, particularly ones comparing WC patients with their non-compensable counterparts, are crucial to allow for future evidence-based recommendations.

Increasing Incidence and Prevalence of the Inflammatory Bowel Diseases With Time, Based on Systematic Review

We conducted a systematic review to determine changes in the worldwide incidence and prevalence of ulcerative colitis (UC) and Crohn's disease (CD) in different regions and with time. We performed a systematic literature search of MEDLINE (1950-2010; 8103 citations) and EMBASE (1980-2010; 4975 citations) to identify studies that were population based, included data that could be used to calculate incidence and prevalence, and reported separate data on UC and/or CD in full manuscripts (n = 260). We evaluated data from 167 studies from Europe (1930-2008), 52 studies from Asia and the Middle East (1950-2008), and 27 studies from North America (1920-2004). Maps were used to present worldwide differences in the incidence and prevalence of inflammatory bowel diseases (IBDs); time trends were determined using joinpoint regression. The highest annual incidence of UC was 24.3 per 100,000 person-years in Europe, 6.3 per 100,000 person-years in Asia and the Middle East, and 19.2 per 100,000 person-years in North America. The highest annual incidence of CD was 12.7 per 100,000 person-years in Europe, 5.0 person-years in Asia and the Middle East, and 20.2 per 100,000 person-years in North America. The highest reported prevalence values for IBD were in Europe (UC, 505 per 100,000 persons; CD, 322 per 100,000 persons) and North America (UC, 249 per 100,000 persons; CD, 319 per 100,000 persons). In time-trend analyses, 75% of CD studies and 60% of UC studies had an increasing incidence of statistical significance (P < .05). Although there are few epidemiologic data from developing countries, the incidence and prevalence of IBD are increasing with time and in different regions around the world, indicating its emergence as a global disease.

Co-Twin Prognosis After Single Fetal Death

To perform a systematic review and meta-analysis of the effects on the surviving twin of single fetal death comparing monochorionic to dichorionic twins to report the rates of co-twin death, preterm delivery, and neurologic morbidity in the surviving fetus. MEDLINE (inception-December 2010), EMBASE (inception-December 2010), The Cochrane library (inception-December 2010), Web of Science (inception-December 2010), and British Nursing Index (inception-December 2010) were searched electronically. Selected studies had more than five cases of single fetal death with reports of co-twin death, neurologic morbidity, or both co-twin death and neurologic morbidity. They also must have defined the gestational age of single fetal death and chorionicity. The search yielded 1,386 citations. Full manuscripts were retrieved for 204 and 22 were included in the review and meta-analysis. Twenty manuscripts were used to calculate overall summary statistics for monochorionic and dichorionic twins showing rates of co-twin death after single fetal death (15% compared with 3%), rates of preterm delivery after single fetal death (68% compared with 54%), the rate of abnormal postnatal cranial imaging after single fetal death (34% compared with 16%), and the rate of neurodevelopmental impairment after single fetal death (26% compared with 2%). Odds ratios (ORs) were calculated from 16 manuscripts. There was no significant difference reported between preterm delivery of monochorionic or dichorionic twins (OR 1.1, 95% confidence interval [CI] 0.34-3.51, P=.9). After single fetal death, monochorionic twins had higher odds of an abnormal cranial imaging after delivery, this was not significant (OR 3.25, 95% CI 0.66-16.1, P=.12). After single fetal death, monochorionic twins were 4.81-times more likely to have neurodevelopmental morbidity (95% CI 1.39-16.6, P<.05). Monochorionic twins are at significantly increased odds of co-twin demise and neurodevelopmental morbidity after single fetal death.

Perspectives on: Information coding in mammalian sensory physiology

The purpose of the Perspectives in General Physiology is to provide a forum where scientific uncertainties or controversies are discussed in an authoritative, yet open manner. The Perspectives are solicited by the editors—often based on recommendations by members of the editorial advisory board. To frame the issue, two or more experts are invited to present brief points of view on the problem, which are published consecutively in the Journal. One or more experts and the organizer(s) review the contributions, but the comments and opinions expressed in the Perspectives are those of the authors and not necessarily those of the editors or the editorial advisory board. The Perspectives are accompanied by a few editorial paragraphs that introduce the problem and invite the submission of comments, in the form of letters to the editor, which are published in a single, predetermined issue (usually three months after publication of the Perspective). After the letters to the editor have been published, further responses are limited to full manuscripts.

Treatment of gastric cancer with peritoneal carcinomatosis by cytoreductive surgery and HIPEC: A systematic review of survival, mortality and morbidity

Introduction Gastric cancer with peritoneal carcinomatosis (PC) has an extremely poor prognosis with median survival estimated at four-months with best supportive care, and 7-10 months with aggressive chemotherapy. Cytoreductive surgery combined with heated intra-peritoneal chemotherapy (HIPEC) has been shown to improve survival in colorectal cancer with PC compared to systemic chemotherapy. The efficacy of cytoreductive surgery combined with HIPEC in gastric cancer remains unproven. Our objective is to systematically review the literature regarding the effectiveness of cytoreductive surgery combined with HIPEC in patients with gastric cancer who also have PC. Methods A comprehensive search of electronic databases was completed from 2000-2010. Unpublished and non-English-language results were excluded. All studies involving cytoreductive surgery combined with HIPEC in adults with gastric cancer with PC were included. Two authors identified potentially relevant articles and assessed the studies for inclusion, and extracted data. Results An initial screen identified 144 titles of which 36 studies met the inclusion criteria. Following full manuscript assessment, 10 articles were included. 441 patients with gastric cancer and PC were extracted with a median follow-up of 48 months. Overall median survival was 7.9 months (range: 6.1-9.2 months) and improved to 15 months (range: 9.5-43.4 months) for patients with completeness of cytoreduction scores of 0/1. The median 30-day mortality rate was 4.8% (range: 0-14.3%) with combined morbidity of 21.5%. Conclusions This systematic review demonstrates that combined cytoreductive surgery and HIPEC may improve survival in selected patients with gastric cancer with PC when a complete cytoreduction is achieved, albeit with significant risk of mortality and morbidity.

Increased live birth rates with GnRH agonist addition for luteal support in ICSI/IVF cycles: a systematic review and meta-analysis

The aim of this systematic review and meta-analysis was to evaluate whether the addition of GnRH agonist for luteal support in ICSI/IVF cycles enhances the probability of live birth. Systematic literature search (MEDLINE, EMBASE, CENTRAL and RCT registries) was conducted to identify relevant randomized controlled trials published as full manuscripts. Meta-analysis of data yielded pooled risk differences (RDs) and 95% confidence intervals (CIs). A random effects model was applied for pooling the studies. Six relevant RCTs were identified including a total of 2012 patients. The probability of live birth rate (RD: +16%, 95% CI: +10 to +22%) was significantly higher in patients who received GnRH agonist support compared with those who did not. The subgroup analysis according to the type of GnRH analogue used for LH suppression did not change the effect observed (studies in which GnRH agonist was used during ovarian stimulation, RD: +15%, 95% CI: +5 to +23%); (studies in which GnRH antagonist was used during ovarian stimulation, RD: +19%, 95% CI: +11 to +27%). The best available evidence suggests that GnRH agonist addition during the luteal phase significantly increases the probability of live birth rates.