bluuebunny/crossref_metadata_2025 huggingface dataset:
Telemedicine improves diagnosis of essential hypertension compared with usual care
Authors: Rogers Mary A M , Buchan Debra A , Small David , Stewart Christine M , Krenzer Barbara E
Published: February 2003

A randomized controlled trial was conducted to assess the efficacy of a telemedicine service for the diagnosis of essential hypertension. The telemedicine service consisted of using an automatic home blood pressure monitor connected to an ordinary telephone line for the transmission of the data to a central computer. After use of the home monitor for a week, the results were converted to a report form and faxed to the patient's physician. The gold standard for assessment of true hypertension status was 24 h ambulatory blood pressure monitoring. A total of 74 patients from outpatient clinics were randomized into either the telemedicine service or usual care. Use of the telemedicine service significantly improved the detection of essential hypertension compared with usual care: in the telemedicine group, 64% of patients with essential hypertension were diagnosed; in the usual care group, 26% of patients with essential hypertension were diagnosed. Furthermore, diagnosis occurred earlier in the telemedicine group than in patients receiving usual care. Specificity and positive predictive value were similar in the two groups.
Cardiac picture archiving and communication systems and telecardiology-technologies awaiting adoption
Authors: Crowe Bernard , Hailey David
Published: February 2003

summary

Diagnostic and therapeutic procedures associated with cardiology are heavily supported by diagnostic imaging technology. The management of such images, including radiographs, echocardiography examinations and cardiac angiography studies, requires a suitable means of handling the data. A number of manufacturers are now offering picture archiving and communication systems (PACS) and telecardiology options. These could greatly improve the efficiency of data management for cardiac examinations, including linkage to radiology and hospital information systems and electronic patient records. A barrier to the implementation of cardiac PACS has been the relatively high capital cost. There have also been technical difficulties in implementing a suitable interface. Historical problems have included ‘turf wars’ between different specialist groups and a reluctance to shift from well established practice patterns. Early cooperative work between radiologists and cardiologists in the development of coronary arteriography has been replaced by contention between cardiologists, radiologists and vascular surgeons, often driven by economic considerations rather than the needs of the patient. At this stage, cardiac PACS and telecardiology have great potential for improving the coordinated care of cardiac patients in Australia.
Tele-otology: Planning, design, development and implementation
Authors: Eikelboom Robert H , Atlas Marcus D , Mbao Mathew N , Gallop Mark
Published: February 2003

summary

The view of the tympanic membrane of the ear provides the specialist with important information for the assessment of ear disease and for treatment planning. In rural and remote areas, the incidence of ear disease is high but access to ear specialists is limited. As part of a project to deliver tele-otoscopy services to remote Western Australia, we have investigated various aspects of a tele-otoscopy system. We found that the MedRX video-otoscope is relatively safe to use and produces images of very good quality. A confident diagnosis could be made from still images compressed to 20 kByte. Video sequences could be compressed to a ratio of 1:300. Furthermore, a software package has been developed, and we are developing a training course for health-care workers in remote areas.
The use of telemedicine in primary care for women with cervical cytological abnormalities
Authors: Etherington Ian J , Watts Anne D , Hughes Elisabeth , Lester Helen E
Published: February 2003

summary

Telemedicine can be used in two different ways in the context of the National Health Service Cervical Screening Programme. The first method allows primary health-care providers to offer direct online booking of clinic appointments according to predefined algorithms based on the woman's cytological abnormality. The second method is telecolposcopy, which is designed to be used by nurses in primary care. Preliminary data confirm that such a system can be used reliably to make diagnoses. The technology is easily adaptable for realtime teleconsultation.
Child development services: A multidisciplinary approach to professional education via videoconference
Authors: Fitzgerald Antoinette , Bailey Maggie , Smith Anthony C , Webb Kerri , Keating Diane , Klepper Karin , Gibney Eileen
Published: February 2003

summary

We have piloted a monthly series of multidisciplinary case discussions via videoconference in the area of child development. The project provided a forum for clinical discussion of complex cases, peer review, professional development and networking for allied health professionals and paediatricians. Six sites in Queensland participated in the project; each site presented at least one case for discussion. The videoconferences ran for 90 min each and were attended by an average of 26 health professionals. The response rate for a questionnaire survey was 71%. The respondents rated the effectiveness of case summaries and the follow-up newsletter very positively. Despite some early difficulties with the technical aspects of videoconferencing, the evaluation demonstrated the participants’ satisfaction with the project and its relevance to their everyday practice.
Videoconferencing training for those working with at-risk young people in rural areas of Western Australia
Authors: Haythornthwaite Sarah
Published: February 2003

summary

Rural Links is a videoconference training initiative developed for those who work with at-risk young people in remote and rural regions of Western Australia. The training programme was run twice (in parallel) for two groups of participants: 17 workers from the Great Southern and South West regions of Western Australia and 15 workers from the Wheatbelt, Pilbara and Kimberley regions of Western Australia. The programme consisted of seven 2 h sessions presented over 12 weeks. Objectives of the training programme centred on increasing participants’ knowledge and confidence in relation to the training topics. The initiative also aimed to enhance consultation between rural youth networks and a metropolitan-based youth mental health service (YouthLink). Analyses indicated that there were improvements in workers’ knowledge and confidence in relation to training topics following participation in the programme. Comparisons of the improvements made by these rural participants, who accessed training via videoconferencing, and metropolitan participants, who accessed training face to face, revealed few significant differences. Rural participants reported high levels of satisfaction, decreased feelings of professional isolation and an increased likelihood of accessing YouthLink for consultative support as a result of completing the Rural Links training programme.
Controlled trial of discharge planning by video-link in a UK urban mental health service: Responses of staff and service users
Authors: Mclaren Paul , Jegan Sab , Ahlbom Johanna , Gallo Fidel , Gaughran Fiona , Forni Carlos
Published: February 2003

summary

We examined the use of videoconferencing in a UK urban mental health service for discharge planning within the framework of the Care Programme Approach (CPA). The study was an AB design. Baseline data were collected over three months, before the introduction of the CPA by videoconferencing. Twenty-seven CPA meetings were held in the baseline phase of the study and 23 during the video-link phase. Service users and professional participants were asked to complete the Guy's Communication Questionnaire (GCQ) at the end of the meeting. A total of 204 GCQs were completed (88% of those issued). Responses were compared between the face-to-face and video-link conditions. No significant differences were found in satisfaction measures between the two conditions. These data suggest that the video-link medium is acceptable to service users and professionals alike for discharge planning.
Teleneurology in Northern Ireland: A success
Authors: Patterson Victor
Published: February 2003

summary

In March 1998 two neurologists and a professor of telemedicine met to solve a clinical problem -how to get neurological expertise to patients admitted acutely to hospitals which had no resident neurologist. Four years later, two new consultant neurologists were appointed in Northern Ireland with sessions in telemedicine, possibly the first such appointments anywhere in the world. This feat was achieved by combining science with politics. First, we chose the most appropriate telemedicine equipment and bandwidth for our needs. Second, we altered our neurological consultation to use the technology efficiently. Third, we were able to show scientifically that teleneurology was reproducible, feasible in practice, safe, acceptable and cost-effective. This required money to pay for a research fellow and equipment, which was obtained initially from some departmental research funds and a local hospital. Conventional research funding bodies were, on the whole, unhelpful. It was serendipitous that a review of neurology services in Northern Ireland was set up by the Department of Health. This identified our original problem as one that it wanted solved and we were in the fortunate position of being able to offer telemedicine as a tested solution. One final political push was required to get the money released. The result of this juxtaposition of science and politics should bring benefit to our neurological patients and will perhaps help others trying to establish similar projects elsewhere.
Telenursing: Clinical nurse consultancy for rural paediatric nurses
Authors: Rosina Robyn , Starling Jean , Nunn Kenneth , Dossetor David , Bridgland Kim
Published: February 2003

summary

Videoconferencing is increasingly being accepted as a medium for health-care. Telenursing is in its infancy in Australia but has enormous potential for nursing care in remote areas. The Child and Adolescent Psychological Telemedicine Outreach Service (CAPTOS) began in 1997 and in its first evaluation recommended more support for paediatric nurses. CAPTOS telenursing began as a new initiative in late 2001. The telenursing project aims to link ward nurses to CAPTOS and local community teams, and to provide both clinical consultancy on nursing and interdisciplinary issues and locally based professional development. Telenursing supports nurses via site visits, videoconferencing sessions, an interactive Website and sabbatical opportunities. Telehealth works with existing services to enhance the nursing care of young people with a complex mixture of psychological and physical health problems.
A comparison of telepaediatric activity at two regional hospitals in Queensland
Authors: Smith Anthony C , Williams Michael , Van Der Westhuyzen Jasper , Mccrossin Robert , Isles Alan , Wootton Richard
Published: February 2003

summary

We conducted a 15-month feasibility study of telepaediatrics. A novel service was offered to two hospitals in Queensland (Mackay and Hervey Bay). We used data from all other hospitals throughout the state as the control group. Although both intervention hospitals were provided with the same service, the telepaediatric activity generated and the effect on admissions and outpatient activity were markedly different. There was a significant decrease in the number of patient admissions to Brisbane from the Mackay region. In addition, there was an increase in the number of Mackay patients treated locally (as outpatients). In contrast, little change was observed in Hervey Bay. We assessed whether the observed differences between the two hospitals were due to various factors which influenced the use of the telepaediatric service. These factors included the method of screening patients before transfer to the tertiary centre and the physical distance between each facility and the tertiary centre. We believe that the screening method used for patient referrals was the most important determinant of the use of the telepaediatric service.
International distance education and the transition from ISDN to high-bandwidth Internet connectivity
Authors: Vincent Dale S , Berg Benjamin W , Chitpatima Suwicha , Hudson Donald
Published: February 2003

summary

The Thailand-Hawaii Assessment of Interactive Healthcare Initiative (THAI-HI) is an international distance-education project between two teaching hospitals in Honolulu and Bangkok that uses videoconferencing over three ISDN lines. A ‘morning report’ format is used to discuss clinical cases primarily covering infectious disease and critical-care topics. An audience response system is used at both sites to add interactivity. From July 2001 to May 2002, 816 health-care providers attended 20 clinical conferences. Audiences rated the conferences as highly relevant and as having high training value. Since the ISDN connection is expensive, we plan to convert the telecommunications to a high-bandwidth Internet connection. The Honolulu site will use a 45 Mbit/s commercial connection to the Hawaii Intranetwork Consortium, which links to the Abilene Network on the US mainland. The Bangkok hospital will use a 155 Mbit/s wireless optical connection to UNINET Thailand, which has a 45 Mbit/s circuit to Abilene.
The diffusion of innovation: Factors influencing the uptake of telehealth
Authors: Walker Judi , Whetton Sue
Published: February 2003

summary

The actual use of telehealth, particularly for clinical consultations, has in many cases been less than anticipated. The literature identifies a number of factors or barriers. These include legal issues, technical difficulties, time and convenience, cost and training/familiarity with the equipment. No single factor has been identified as being consistently present. Rogers’ diffusion of innovation theory suggests that organizational structures and cultures will affect health professionals’ perceptions of telehealth. The introduction of telehealth services affects existing work practices and workflows. We believe that it is necessary to develop strategies for the introduction of telehealth applications which take into account the idiosyncrasies of the health service sector, and the particular structures and cultures of individual organizations within that sector.
Logistical aspects of large telemedicine networks. 1: Site directories
Authors: Wootton Richard , Smith Anthony C , Gormley Sinead , Patterson Jessica
Published: February 2003

summary

We carried out a survey of the site coordinators in a mature telemedicine network of about 200 sites. The site directory contained information about 221 videoconference facilities. There were 191 site coordinators in all (i.e. some coordinators were responsible for more than one site). Of the 221 sites, we were able to contact 87 on first attempt and 155 by the fourth attempt. Thus there were 66 sites (30%) which were not contactable. We asked each site coordinator to describe any videoconference activity that had taken place over the previous five working days. Of the contacted 155 sites, 78 reported some videoconference activity during the period in question. The total reported videoconference activity was 12,800 min during the one-week monitoring period, that is, an estimated 924 h per month. The most common categories of work were education or training (511 h) and management or administration (225 h), which between them accounted for 80% of all reported videoconference activity. Fifty of the 155 sites (32%) reported that the equipment was not located in an area suitable for patient consultations. In addition, 20 sites (13%) volunteered that their videoconferencing facilities were not in working order at the time of the survey. We did not ask this question in the survey, so that this result represents a lower bound for the true number of inoperable systems.
Government relations, government regulations: Jumping through the hoops
Authors: Yellowlees Peter
Published: February 2003

summary

Over the last decade, telehealth in Australia has been primarily facilitated and driven by government funding. The government now has a major policy initiative in online health. However, in pursuing the broad initiative there is a danger that some of the smaller components can get lost, and this is probably what has happened to telehealth. There appear to be a number of steps required if telehealth in Australia is to keep up the pace of development that occurred in the 1990s, as we move into what is now being called the era of e-health, involving broadband Internet health service delivery. This area is changing extremely rapidly and is increasingly migrating away from the public sector in Australia, where most of the developmental work has occurred, and into the private sector. Many of the issues that require consideration within the domain of e-health in Australia are also relevant to other countries. E-health will significantly change the way that health-care is practised in future, and it is clear that it is the human factors that are more difficult to overcome, rather than the technological ones.
Structural and Textural Properties of Perchlorated and Persulphated Mixed (Hydr)Oxides of Zirconium and Titanium
Authors: Shafei Gamal M.S. El , Zahran Afaf A.
Published: February 2003

Perchlorated and persulphated mixed hydroxides of zirconium and titanium were prepared by coprecipitation and impregnation in aqueous HClO4 or (NH4)2S2O8 solutions of 0.05, 0.10, 0.20 and 0.40 M concentrations. An alternate sequence of impregnation followed by calcination or vice versa was conducted and the samples obtained studied using XRD, FT-IR, pyridine titration and low-temperature (–196°C) nitrogen adsorption methods. XRD indicated that the presence of titanium stabilized the tetragonal modification of zirconia and almost completely prevented the usual tetragonal → monoclinic transformation upon calcination at 650°C.

Both S2O82– and ClO4− anions at their lowest concentration level (0.05 M) partially retarded the crystallization which occurred upon calcination at 650°C in their absence. However, the two anions showed different effects. Whereas the perchlorate anion prevented the formation of a crystalline titania phase (anatase) to a greater extent than that of crystalline zirconia, the persulphate anion showed the opposite effect. Complete inhibition was observed with both anions at a concentration of 0.4 M. This effect was attributed to adsorption of the anions on the hydroxy species of zirconium and titanium formed initially, as demonstrated by IR spectroscopy which showed that the anions were of lower symmetry, viz. C2v, due to their bonding to the hydroxy species.

Calcination at 650°C caused the material formed initially to lose virtually all its initial high surface area because of crystallization. The prevention of crystallization by added anions was reflected in the retention of a relatively high surface area even after calcination at 650°C. The recorded difference in the interactions of the anions with the hydroxy species formed initially was also reflected in the texture of the anion-modified solids. The protecting influence of the ClO4− anion increased with its increasing concentration in the system, whereas the corresponding effect with the S2O82– anion increased up to 0.10 M concentration and then decreased at higher concentrations.
Adsorption Characteristics of Powders of Nanometric Gallium Nitride and Aluminium Nitride
Authors: Czepirski L. , Janik J.F. , Komorowska-Czepirska E. , Wells R.L.
Published: February 2003

The results of studies on new precursors for the preparation of gallium nitride and aluminium nitride were presented. The samples obtained were characterised by argon adsorption at 77 K. The variation of the porous structure parameters with the pyrolysis temperature was discussed. The adsorption of water vapour and the selectivity of adsorption with respect to some gases at 298 K were also investigated.
The Adsorption of Anionic Surfactants by Iron(III) and Aluminium Hydroxides
Authors: Streltsova E.A. , Hromysheva E.A. , Tymchuk A.F.
Published: February 2003

The adsorption of sodium dodecyl sulphate and sulphanol NP-3 by iron(III) and aluminium hydroxides was studied. The applicability of the Langmuir, Freundlich and Hill–de Boer adsorption equations for the description of the adsorption isotherms obtained experimentally was verified. Values of various parameters characterising the adsorption of the anionic surfactants investigated by iron(III) and aluminium hydroxides have been calculated. These allowed assumptions to be made about the adsorption mechanism. The possibility of using air as an adsorbent for anionic surfactants was studied.
An Investigation into the Adsorption Characteristics of Grafted Mesoporous Silicates for the Removal of Tetramethyl Ammonium Hydroxide from Aqueous Solution
Authors: Kelleher Brian P. , Doyle Aidan M. , Hodnett Benjamin K. , O'Dwyer Thomas F.
Published: February 2003

Four cubic mesoporous silicates (CMS), one unmodified and three grafted with amine, carboxylic and cyano surface functional groups, were prepared, characterised and compared as adsorbents for tetramethyl ammonium hydroxide (TMAH) from aqueous solution. The adsorption process was studied as a function of molecular size and CMS pore volume. Sorption on the unmodified, cyano- and carboxylic-grafted adsorbents closely followed the Langmuir model while adsorption on the amine-treated silicate conformed to the Freundlich model. A comparison of the adsorbent pore volume and the volume of sorbed TMAH molecules suggested that monolayer sorption occurred, there being some evidence that surface functional groups influenced the adsorption process. The presence or absence of structural order, as defined by X-ray diffraction analysis, had no significant influence on the adsorption, as all materials, both ordered and disordered, had relatively high adsorption capacities.
Heavy Metal Ion Adsorption Properties of Methacrylamidocysteine-Containing Porous Poly(Hydroxyethyl Methacrylate) Chelating Beads
Authors: Denizli Adil , Garipcan Bora , Emir Sibel , Patir Süleyman , Say Ridvan
Published: February 2003

Details of the adsorption performance of poly(2-hydroxyethylmethacrylate–methacrylamidocysteine) [p(HEMA–MAC)] beads towards the removal of heavy metal ions from aqueous solution were studied. The metal-complexing ligand and/or co-monomer MAC was newly synthesized from methylacrylochloride and cysteine. Spherical beads of average size 150–200 mm were obtained by the radical suspension polymerization of MAC and HEMA conducted in an aqueous dispersion. The p(HEMA–MAC) beads obtained had a specific surface area of 18.9 m2/g.

p(HEMA–MAC) beads were characterized by swelling studies, FT-IR spectroscopy and elemental analysis. Such beads with a swelling ratio of 72%, and containing 3.9 mmol MAC/g, were used for heavy metal removal studies. The adsorption capacities of the beads for selected metal ions, i.e. CdII, AsIII, CrIII, HgII and PbII, were investigated in aqueous media containing different amounts of these ions (10–750 mg/l) and at different pH values (3.0–7.0). The adsorption rate was fast in all cases. The maximum adsorption capacities of the p(HEMA–MAC) beads were 1058.2 mg/g for CdII, 123.4 mg/g for AsIII, 199.6 mg/g for CrIII, 639.1 mg/g for PbII and 1018.6 mg/g for HgII. On a molar basis, the following affinity order was observed: CdII > HgII > CrIII > PbII >AsIII. The adsorption capacity of the MAC-incorporated beads was affected significantly by the pH value of the aqueous medium.

The adsorption of heavy metal ions from artificial wastewater was also studied. In this case, the adsorption capacities were 52.2 mg/g for CdII, 23.1 mg/g for CrIII, 83.4 mg/g for HgII, 62.6 mg/g for PbII and 11.1 mg/g for AsIII at an initial metal ion concentration of 0.5 mmol/l. The chelating beads could be regenerated easily with a higher effectiveness by 0.1 M HNO3. These features make p(HEMA–MAC) beads potential candidates for heavy metal ion removal at high capacity.
Poly(Methacrylic Acid) Adsorption and Electrical Surface Properties of Titanium Dioxide Suspensions
Authors: Soltys M.M. , Yaremko Z.M. , Tkachenko N.H. , Havryliv V.D.
Published: February 2003

The influence of adsorbed poly(methacrylic acid) (PMAA) of molecular weight 10 × 103 on the aggregation stability of titanium dioxide suspensions and on the zeta potential of the particles has been studied over a wide range of pH (from 2.0 to 12.0). The dependence of the zeta potential of titanium dioxide particles in aqueous suspension on the pH of the system was typical for metal oxides and passed through an isoelectric point at pH0 = 6.2. Adsorption of poly(methacrylic acid) on to titanium dioxide particles had a considerable effect on the dependence of the zeta potential of the particles on the pH of the suspension medium. The change of zeta potential both in the absence and presence of PMAA correlated well with the aggregation stability of the suspensions, which was estimated from the mean radius of the particles.

The influence of the adsorbed poly(methacrylic acid) macromolecules on the zeta potential of the particles can be explained according to a scheme which envisages both a decrease in the particle surface potential and a change in the potential distribution in the electrical double layer.
Adsorption Characteristics of New Coccine Dye on to Sludge Ash
Authors: Weng Chih-Huang
Published: February 2003

The adsorption characteristics of an anionic azo dye (New Coccine) on to sewage sludge ash were studied. Results showed that the ash could remove the dye effectively from aqueous solution. The adsorption rate was fast and could be expressed by the modified Freundlich equation. It was found that pH is the most important parameter affecting the adsorption characteristics. The experimental data were correlated well to the non-linear multilayer adsorption isotherm. The ash adsorption capacities for the dye were in the range 3.25–5.70 mol/g and were affected by the pH, ionic strength and temperature. Decreasing pH, ionic strength and temperature increased the adsorption density. The effect of electrical double-layer thickness on the adsorption was discussed. Thermodynamic parameters indicated that the adsorption was an exothermic process. Values of the first-layer adsorption energy, ΔG10, ranged from −6.86 to −7.45 kcal/mol, suggesting that the adsorption could be considered as a physical process simultaneously enhanced by the electrostatic effect. The multilayer adsorption energy, ΔG20, ranged from −4.33 to −4.51 kcal/mol, suggesting that the adsorption was of the typical physical type. On the basis of the monolayer dye adsorption capacity, the specific surface area of the ash was calculated as 3.84–6.73 m2/g.
Studies on the Utilisation of Spent Palladium–Activated Carbon (Pd/AC) Catalysts
Authors: Dαbek L. , Świątkowski A. , Dziaduszek J.
Published: February 2003

The present paper offers an assessment of using wastes such as palladium–activated carbon (Pd/AC) catalysts through their regeneration or metal recovery. In order to regenerate a catalyst it has been found necessary to clean up its surface completely and restore the original form of the metal. Supercritical fluid extraction can be useful in removing organic substances from the surface of a spent catalyst whereas microwave mineralisation can be used to recover palladium from the mass of a spent catalyst.
Surface Characterization and Catalytic Activity of Alumina and Alumina-Supported ZnSO4 Catalysts Prepared from Different Alumina Sources
Authors: Mohamed Farid Sh.
Published: February 2003

Three alumina samples were prepared from different sources including aluminium isopropoxide, aluminium chloride and aluminium nitrate, and were then used to prepare supported ZnSO4 catalysts via the impregnation method. The alumina and ZnSO4-supported samples were characterized by X-ray diffraction (XRD), FT-IR spectroscopy and nitrogen physisorption methods. Dehydration of 1-butanol and the cracking of cumene were undertaken over the prepared samples using a pulse microcatalytic technique. For a given alumina sample, the surface area and total pore volume decreased continuously with increasing ZnSO4 content. Loading alumina samples with ZnSO4 improved their dehydration and cracking activities. The source of alumina played a role in determining the surface acidity and catalyst activity of alumina and alumina-supported ZnSO4 catalysts. Impregnation of ZnSO4 on alumina samples resulted in an increase in the concentration of Lewis sites and the creation of Brönsted acid sites on their surfaces. The catalytic activity of the investigated catalysts was found to depend strongly on both the chemical composition and the type of acid site present on the catalyst surface.
Evaluation of Deployable Structures for Space Enclosures
Authors: Hanaor A. , Levy R.
Published: February 2003

The paper is a critical review of different structural systems that have been proposed to date for the purpose of deployable space enclosure. The structural systems are classified by their morphological and kinematic characteristics, and comparatively evaluated in terms of their structural efficiency, technical complexity and deployment/stowage efficiencies. Although the main focus is on kinematically deployable structures, some retractable and dismountable configurations are also reviewed. The paper includes an extended list of references.
About Some Tensegrity Structures
Authors: Selfridge R. G.
Published: February 2003

Tensegrity structures are structures where there are, typically, a few struts and many links, which are nevertheless stable structures. This paper considers structures where the platform and base are regular planar n-gons, with the appropriate connections and derives a very simple formula for their realizeable/unique construction. The effects of changing a single length can also be studied.
Continuous-Discrete Variable Optimization of Space Structures with Sizing Variables Using Approximation Methods
Authors: Salajegheh E. , Salajegheh J.
Published: February 2003

Optimum design of structures is achieved while the design variables are continuous and discrete. To reduce the computational work involved in the optimization process, all the functions that are expensive to evaluate, are approximated. To approximate these functions, a semi quadratic function is employed. Only the diagonal terms of the Hessian matrix are used and these elements are estimated from the first derivatives that are available from the previous iterations. The second order approximation is obtained for both direct and reciprocal approximations. In addition, a hybrid form of the approximation is introduced. With the help of this approximation, the continuous optimization is obtained. The results are used as the starting point for the discrete optimization. A new penalty function is introduced for discrete optimum design and the discrete variables are obtained in conjunction with the same function approximation. Examples are given and the numerical results are discussed.
Optimal Design of Cable Structures with Genetic Algorithms
Authors: Gandhi J. B. , Patodi S. C.
Published: February 2003

Genetic Algorithm is employed for cable structures subjected to large displacements, stress and diameter constraints. Design solution is governed by nonlinear interaction of cable sag, amount of pretension and stiffness of cable with deformations under transverse loads. Geometrical nonlinear finite element method with total Lagrangian approach is integrated in the present work with genetic algorithm to evaluate optimum values of design parameters, i.e. diameter of cable and amount of prestress. Study is performed on steel and carbon fibre cable stays, cable nets and cable roofs. Different types of crossover operators are applied along with single- and multi-level optimization techniques in order to obtain true optimum in the search space of global optimum.
Red Light, Green Light: Making Sense of the Organizational Context for Issue Selling
Authors: Dutton Jane E. , Ashford Susan J. , Lawrence Katherine A. , Miner-Rubino Kathi
Published: February 2003

This paper analyzes the contextual cues female managers attend to when considering raising gender-equity issues at work. Study 1 provides a qualitative look at the range of cues indicating context favorability, including demographic patterns, top management qualities, and cultural exclusivity. Study 2 experimentally manipulates these cues and reveals that the exclusiveness of organizational culture is the most potent cue affecting willingness to sell a gender-equity issue. A discussion of mediators sheds lights on why cultural exclusivity affects issue selling.
Exchanging Preliminary Information in Concurrent Engineering: Alternative Coordination Strategies
Authors: Terwiesch Christian , Loch Christoph H. , Meyer Arnoud De
Published: February 2003

Successful application of concurrent development processes (concurrent engineering) requires tight coordination. To speed development, tasks often proceed in parallel by relying on preliminary information from other tasks, information that has not yet been finalized. This frequently causes substantial rework using as much as 50% of total engineering capacity. Previous studies have either described coordination as a complex social process, or have focused on the frequency, but not the content, of information exchanges. Through extensive fieldwork in a high-end German automotive manufacturer, we develop a framework of preliminary information that distinguishes information precision and information stability. Information precision refers to the accuracy of the information exchanged. Information stability defines the likelihood of changing a piece of information later in the process.

This definition of preliminary information allows us to develop a time-dependent model for managing interdependent tasks, producing two alternative strategies: iterative and set-based coordination. We discuss the trade-offs in choosing a coordination strategy and how they change over time. This allows an organization to match its problem-solving strategy with the interdependence it faces. Set-based coordination requires an absence of ambiguity, and should be emphasized if either starvation costs or the cost of pursuing multiple design alternatives in parallel are low. Iterative coordination should be emphasized if the downstream task faces ambiguity, or if starvation costs are high and iteration (rework) costs are low.
A Pragmatic View of Knowledge and Boundaries: Boundary Objects in New Product Development
Authors: Carlile Paul R.
Published: February 2003

This study explores the premise that knowledge in new product development proves both a barrier to and a source of innovation. To understand the problematic nature of knowledge and the boundaries that result, an ethnographic study was used to understand how knowledge is structured differently across the four primary functions that are dependent on each other in the creation and production of a high-volume product. A pragmatic view of 'knowledge in practice' is developed, describing knowledge as localized, embedded, and invested within a function and how, when working across functions, consequences often arise that generate problematic knowledge boundaries. The use of a boundary object is then described as a means of representing, learning about, and transforming knowledge to resolve the consequences that exist at a given boundary. Finally, this pragmatic view of knowledge and boundaries is proposed as a framework to revisit the differentiation and integration of knowledge.
FOXL2‐mutations in blepharophimosis‐ptosis—epicanthus inversus syndrome (BPES); challenges for genetic counseling in female patients
Authors: Fokstuen Siv , Antonarakis Stylianos E. , Blouin Jean‐Louis
Published: February 2003

Mutations in the forkhead transcription factor gene 2 (FOXL2) were recently reported to cause blepharophimosis‐ptosis‐epicanthus inversus syndrome (BPES) types I and II. Evidence was provided that BPES type I (eyelid abnormalities and female infertility) is caused by mutations resulting in a truncated FOXL2 protein. In contrast, mutant FOXL2 proteins, either with inserted aminoacids in the forkhead domain or polyalanine tract, or with novel aminoacids at the carboxyl end, were found in BPES type II, in which fertility is generally normal. We report a 32‐year‐old female patient with sporadic BPES and a history of menstrual cycle irregularities and periods of secondary amenorrhoea. A heterozygous frameshift mutation (c959‐960insG) was found in the FOXL2 gene, resulting in a predicted FOXL2 protein with 212 novel aminoacids in the carboxyl end, suggesting BPES type II despite menstrual irregularities. The clinical presentations of our patient and of three female patients with BPES type II in the report of De Baere et al. [2001: Hum Mol Genet 10:1591–1600.] indicate phenotypic overlap between BPES type I and II. These observations do not support a clear‐cut prediction of female fertility based on the FOXL2 molecular defect. As a consequence, FOXL2 mutation testing in female patients of child‐bearing age with BPES should be handled with caution, and a two‐step genetic counseling approach, including an initial pre‐test information session, is proposed. © 2003 Wiley‐Liss, Inc.
Routine cytogenetic and FISH studies for 17p11/15q11 duplications and subtelomeric rearrangement studies in children with autism spectrum disorders
Authors: Keller Kory , Williams Charles , Wharton Paul , Paulk Martha , Bent‐Williams Angela , Gray Brian , Ward Angie , Stalker Heather , Wallace Margaret , Carter Randy , Zori Roberto
Published: February 2003

To assess the frequency of cytogenetic abnormalities in children with autism spectrum disorders (ASDs), routine G‐banded cytogenetic analyses and FISH studies to rule out 15q11.2 and 17p11.2 duplications were performed on 49 children with ASDs. Blood samples were further studied using a complete set of subtelomeric FISH probes. Routine chromosome study showed that one child had a small duplication of chromosome 5: 46,XY,dup(5)(p?14.2p?15.1). Another child had an interstitial duplication of the Prader‐Willi and Angelman syndrome critical region of chromosome 15, detected by FISH analysis. The detection of these two cases underscores the importance of obtaining routine chromosome and 15q11‐q13 FISH analyses in children with ASDs. No instance of 17p11.2 duplication was observed. Subtelomeric analysis did not reveal abnormalities in any of the subjects. © 2003 Wiley‐Liss, Inc.
Genetic heterogeneity in inherited spastic paraplegia associated with epilepsy
Authors: Lo Nigro Cristiana , Cusano Roberto , Gigli Gian Luigi , Forabosco Paola , Valente Mariarosaria , Ravazzolo Roberto , Diomedi Marina , Seri Marco
Published: February 2003

We have recently mapped a new rare form of spastic paraplegia complicated by bilateral cataracts, gastroesophageal reflux with persistent vomiting, and amyotrophy to chromosome 10q23.3‐q24.2. This locus, named SPG9, is located in an interval spanning about 12 cM of genomic DNA, between markers D10S536 and D10S603, where different neurological disorders have been mapped. In particular, a gene for partial epilepsy has been assigned to a 3 cM interval between markers D10S185 and D10S577, which is completely included in the SPG9 critical region. A few families affected with spastic paraplegia and epilepsy have been reported; in the present study, we tested a pedigree with concurrence of spastic paraplegia, epilepsy, and mental retardation inherited as an autosomal dominant trait, using markers located in the SPG9 interval. Haplotype reconstruction excluded the linkage to 10q23.3‐q24.2. In addition, the seven different loci so far reported to be associated with autosomal dominant pure forms of spastic paraplegia have been tested and excluded by linkage analysis and haplotype reconstruction, including SPG4 on chromosome 2p22‐p21, where a familial form of spastic paraplegia associated with dementia and epilepsy has been mapped. These data confirm genetic heterogeneity in familial spastic paraplegia with epilepsy and suggest a specific locus for the family here analyzed. © 2003 Wiley‐Liss, Inc.
Molecular characterization of a 12q22‐q24 deletion associated with congenital deafness: Confirmation and refinement of the DFNA25 locus
Authors: Petek Erwin , Windpassinger Christian , Mach Monika , Rauter Ludwig , Scherer Stephen W. , Wagner Klaus , Kroisel Peter M.
Published: February 2003

The DFNA25 locus for autosomal dominant nonsyndromic hereditary hearing loss has been mapped to 12q21‐q24 by linkage analysis. A de novo deletion in a six‐year‐old boy with congenital hearing loss as well as mental and motor retardation now provides independent confirmation of this genetic localization and narrows the critical interval to 13 cM in the 12q22‐q24.1 region. Mapping of the deletion was performed using fluorescence in situ hybridization (FISH) analysis with region‐specific yeast artificial chromosome (YAC) clones. Ten YACs 929_e_4, 959_c_3, 746_h_7, 817_h_10, 886_a_6, 916_h_9, 969_c_12, 747_e_2, 812_h_12, and 959_f_8 were absent from one chromosome 12 from the patient. Molecular analyses of eight polymorphic markers helped to narrow down the breakpoints and demonstrated that the derivative chromosome 12 is of paternal origin. Several known genes including ATP2A2, UBE3B, and VR‐OAC that map in the 12q22‐q24.1 region are included in the deletion. These results provide evidence that haploinsufficiency for a gene or genes in 12q22‐q24.1 is associated with autosomal dominant deafness. © 2003 Wiley‐Liss, Inc.
Previously undescribed nonsense mutation in SHH caused autosomal dominant holoprosencephaly with wide intrafamilial variability
Authors: Marini Monica , Cusano Roberto , De Biasio Pierangela , Caroli Francesco , Lerone Margherita , Silengo Margherita , Ravazzolo Roberto , Seri Marco , Camera Gianni
Published: February 2003

Holoprosencephaly (HPE) is the most common developmental defect of the forebrain and midface in humans, with a frequency of 1/16,000 live births. Different genes are implicated in the pathogenesis of HPE; these include SHH, ZIC2, SIX3, TGIF, and human DKK1. We describe here a family with recurrence of autosomal dominant HPE in different members showing a wide clinical variability. The mother presents a single central maxillary incisor and mild hypotelorism as signs of the diseases, while three of her sons were affected by HPE. By direct sequencing and restriction analysis of exon 2 of the SHH gene, we have identified a previously undescribed nonsense mutation at codon 128 (W128X). The identification of this mutation allowed us to give a prenatal diagnosis in this family and confirms a wide intrafamilial variabilty in the phenotypic spectrum. © 2003 Wiley‐Liss, Inc.
CHARGE association and secondary hypoadrenalism
Authors: James Paul A. , Aftimos Salim , Hofman Paul
Published: February 2003

Hypogonadotrophic hypogonadism is a well‐described part of the CHARGE association. It has been suggested that more extensive defects of the pituitary function may occur, but this has not been reported in the medical literature. We report a patient with CHARGE association who, in addition to the cardinal manifestations, was found to have hypoadrenalism of pituitary/hypothalamic origin. The patient also has findings typical of the overlap of CHARGE and the 22q11 deletion syndrome, as well as an unusual cervical vertebral abnormality. © 2002 Wiley‐Liss, Inc.
Teebi hypertelorism syndrome: Additional cases
Authors: Machado‐Paula Ligiane Alves , Guion‐Almeida Maria Leine
Published: February 2003

We report on two unrelated Brazilian boys who have craniofacial and digital anomalies resembling those reported with Teebi hypertelorism syndrome. Additional features such as cleft lip and palate, large uvula, atypical chin and abnormal scapulae were observed. © 2002 Wiley‐Liss, Inc.
Broad phenotypic spectrum caused by an identical heterozygous CDMP‐1 mutation in three unrelated families
Authors: Savarirayan Ravi , White Susan M. , Goodman Frances R. , Graham John M. , Delatycki Martin B. , Lachman Ralph S. , Rimoin David L. , Everman David B. , Warman Matthew L.
Published: February 2003

CDMP‐1, a cartilage‐specific member of the TGFß superfamily of secreted signaling molecules, plays a key role in chondrogenesis, growth and patterning of the developing vertebrate skeleton. Homozygous CDMP‐1 mutations cause Hunter‐Thompson and Grebe types of acromesomelic chondrodysplasia and DuPan syndrome in humans, as well as brachypodism in mice, while heterozygous mutations cause brachydactyly type C (BDC). We present clinical and radiographic data from three unrelated families in which 12 members share the same heterozygous CDMP‐1 mutation, an insertion (insG206), resulting in a frameshift predicted to cause functional haploinsufficiency. Although eight mutation carriers display BDC, four have normal hands and feet, confirming nonpenetrance of BDC with CDMP‐1 mutations. In addition, several carriers have other skeletal abnormalities, including severe bilateral vertical talus (in two), developmental hip dysplasia (in one), and short stature (in two, who are otherwise unaffected). Premature vertebral end‐plate disease was observed in four mutation carriers and was associated with spondylolysis and spondylolisthesis in three of these. Axial skeletal involvement has not been previously reported in association with CDMP‐1 mutations. This finding is consistent with CDMP‐1 expression in human hypertrophic chondrocytes, which are present in the ring epiphyses of vertebral end plates. Phenotypic variation in BDC has previously been attributed either to locus heterogeneity or to the varied functional effects of different CDMP‐1 mutations. The remarkable range of phenotypes caused by this identical CDMP‐1 mutation in these families emphasizes the crucial role of genetic background, stochastic variation and/or environmental factors in modifying the observed phenotype. Our findings illustrate that nonpenetrance for the typical features of BDC can be appreciable and that atypical skeletal features that have been reported in some patients with BDC (i.e., clubfoot, short stature, spondylolysis) may also result from CDMP‐1 mutation. © 2002 Wiley‐Liss, Inc.
Spondyloepimetaphyseal dysplasia with joint laxity leptodactylic form: Clinical course and phenotypic variations in four patients
Authors: Nishimura Gen , Honma Tomomi , Shiihara Takashi , Manabe Noriyo , Nakajima Eiji , Adachi Masanori , Mikawa Makoto , Fukushima Yoshimitsu , Ikegawa Shiro
Published: February 2003

We describe a 5‐year‐old boy and a 33‐year‐old woman with spondyloepimetaphyseal dysplasia with joint laxity leptodactylic form (spondyloepimetaphyseal dysplasia with multiple dislocations) (MIM 6003546), and two 12‐year‐old girls with the disorder who were previously reported as examples of a variant of sponatrime dysplasia. Their clinical manifestations included midface hypoplasia, micromelic short stature, and generalized joint laxity that caused multiple joint problems, including thoracolumbar scoliosis, hip subluxation, progressive genu valgum with knee and patellar subluxation, elbow subluxation, and malalignment of the wrist. Laryngotracheomalacia was present in two individuals, and myopathy was noted in one. The radiological findings in the four individuals included mild platyspondyly most conspicuous in infancy, narrow interpediculate distances of the lumbar spine evident in infancy, retarded epiphyseal ossification that evolved to epiphyseal dysplasia and later to degenerative joint disease, metaphyseal irregularities and striations present in early childhood, and leptodactylic appearance (slender short tubular bones) of the hand. © 2002 Wiley‐Liss, Inc.