bluuebunny/crossref_metadata_2025 huggingface dataset:
AUTONOMY: The First Randomized Trial Comparing Two Patient-Driven Approaches to Initiate and Titrate Prandial Insulin Lispro in Type 2 Diabetes
Authors: Edelman Steve V. , Liu Rong , Johnson Jennal , Glass Leonard C.
Published: April 2014

OBJECTIVE

To compare two self-titration algorithms for initiating and escalating prandial insulin lispro in patients with type 2 diabetes inadequately controlled on basal insulin.

RESEARCH DESIGN AND METHODS

The trial was designed as two independent, multinational, parallel, open-label studies (A and B), identical in design, to provide substantial evidence of efficacy and safety in endocrine and generalist settings. Subjects were 18–85 years old (study A: N = 528; study B: N = 578), on basal insulin plus oral antidiabetic drugs for ≥3 months, and had an HbA1c 7.0% to ≤12.0% (>53.0 to ≤107.7 mmol/mol). Once optimized on insulin glargine, subjects were randomized to one of two self-titration algorithm groups adjusting lispro either every day (Q1D) or every 3 days (Q3D) for 24 weeks. The primary outcome was the change in HbA1c from baseline. The primary and secondary objectives were evaluated for the overall population and subjects ≥65 years old.

RESULTS

Baseline HbA1c was similar (study A: Q1D 8.3% [67.2 mmol/mol] vs. Q3D 8.4% [68.3 mmol/mol], P = 0.453; study B: Q1D 8.3% [67.2 mmol/mol] vs. Q3D 8.4% [68.3 mmol/mol], P = 0.162). Both algorithms had significant and equivalent reductions in HbA1c from baseline (study A: Q3D –0.96% [–10.49 mmol/mol], Q1D –1.00% [–10.93 mmol/mol], Q3D–Q1D 0.04% [0.44 mmol/mol] [95% CI –0.15 to 0.22 (–1.64 to 2.40)]; study B: Q3D –0.92% [–10.06 mmol/mol], Q1D –0.98% [–10.71 mmol/mol], Q3D–Q1D 0.06% [0.66 mmol/mol] [95% CI –0.12 to 0.24 (–1.31 to 2.62)]). The incidence and rate of hypoglycemia were similar for Q3D and Q1D in both studies. In general, no clinically relevant differences were found between the two algorithms in subjects ≥65 years old in either study.

CONCLUSIONS

Prandial insulin lispro can effectively and safely be initiated, by either of two self-titrated algorithms, in a variety of practice settings.
Circulating Concentrations of Soluble Receptor for AGE Are Associated With Age and AGER Gene Polymorphisms in Children With Newly Diagnosed Type 1 Diabetes
Authors: Salonen Kirsi M. , Ryhänen Samppa J. , Forbes Josephine M. , Härkönen Taina , Ilonen Jorma , Laine Antti-Pekka , Groop Per-Henrik , Knip Mikael ,   for the Finnish Pediatric Diabetes Register
Published: April 2014

OBJECTIVE

We analyzed the relationship among soluble receptor for advanced glycation end products (sRAGEs), the clinical phenotype, HLA genotype, and risk-associated single nucleotide polymorphisms (SNPs) in the AGER gene in a large population of Finnish children with newly diagnosed type 1 diabetes.

RESEARCH DESIGN AND METHODS

Samples from 2,115 clinically phenotyped children <15 years of age in whom type 1 diabetes was diagnosed and 316 control subjects were analyzed for sRAGEs. Three SNPs of AGER, previously associated with HLA-DR/DQ haplotype independent diabetes risk (rs2070600, rs9469089, and rs17493811), were analyzed in 1,390 affected subjects.

RESULTS

Children with type 1 diabetes and control subjects had similar sRAGE concentrations (1,171 vs. 1,153 pg/mL, P = 0.48). There was a correlation between age at diagnosis and serum sRAGE concentrations (r = 0.10, P < 0.001) among the patients but not among the control subjects. Children <2 years of age had the lowest concentrations in the diabetic population (1,027 vs. 1,181 pg/mL, P < 0.001) and the highest among the control subjects (1,329 vs. 1,140 pg/mL, P = 0.04). Ketoacidosis at diagnosis was associated with reduced concentrations (1,086 vs. 1,190 pg/mL, P < 0.001). HLA DR3/DR4 heterozygosity and the DR3 allele were associated with reduced sRAGE concentrations. The predisposing AA genotype of rs2070600 was associated with decreased sRAGE concentrations, while the protective CC genotype of rs9469089 was linked to increased concentrations.

CONCLUSIONS

Age and AGER polymorphisms are associated with the circulating sRAGE concentration among children with type 1 diabetes. The observations of reduced sRAGE concentrations in young children, in those with ketoacidosis, and in carriers of the high-risk HLA DR3/DR4 genotype suggest that decreased sRAGE concentration reflects a more aggressive disease phenotype.
Food Activism in Italy as an Anthropology of Direct Democracy
Authors: Grasseni Cristina
Published: April 2014

This article presents qualitative and quantitative findings on provisioning activism in Italy, focusing on Solidarity Purchase Groups (Gruppi di Acquisto Solidale, GAS). By using quantitative data about GAS growth, numerical consistence and economic impact and through ethnographic insights based on prolonged fieldwork, it identifies the GAS movement as an ecological, economic and political counterculture. I discuss the implications for policy efforts at the regional and state level, highlighting both potentials and shortcomings of promoting GAS as means to sustainable development. In particular, I identify the issues of trust, informality and direct democracy as distinctive of GAS practice. However, this positions solidarity economy vis-à-vis policymaking in a potentially oppositional rather than interlocutory stance.
Use of programmable versus nonprogrammable shunts in the management of hydrocephalus secondary to aneurysmal subarachnoid hemorrhage: a retrospective study with cost-benefit analysis
Authors: Lee Lester , King Nicolas K. K. , Kumar Dinesh , Ng Yew Poh , Rao Jai , Ng Huiyu , Lee Kah Keow , Wang Ernest , Ng Ivan
Published: April 2014

Object

The choice of programmable or nonprogrammable shunts for the management of hydrocephalus after aneurysmal subarachnoid hemorrhage (SAH) remains undefined. Variable intracranial pressures make optimal management difficult. Programmable shunts have been shown to reduce problems with drainage, but at 3 times the cost of nonprogrammable shunts.

Methods

All patients who underwent insertion of a ventriculoperitoneal shunt for hydrocephalus after aneurysmal SAH between 2006 and 2012 were included. Patients were divided into those in whom nonprogrammable shunts and those in whom programmable shunts were inserted. The rates of shunt revisions, the reasons for adjustments of shunt settings in patients with programmable devices, and the effectiveness of the adjustments were analyzed. A cost-benefit analysis was also conducted to determine if the overall cost for programmable shunts was more than for nonprogrammable shunts.

Results

Ninety-four patients underwent insertion of shunts for hydrocephalus secondary to SAH. In 37 of these patients, nonprogrammable shunts were inserted, whereas in 57 programmable shunts were inserted. Four (7%) of 57 patients with programmable devices underwent shunt revision, whereas 8 (21.6%) of 37 patients with nonprogrammable shunts underwent shunt revision (p = 0.0413), and 4 of these patients had programmable shunts inserted during shunt revision. In 33 of 57 patients with programmable shunts, adjustments were made. The adjustments were for a trial of functional improvement (n = 21), overdrainage (n = 5), underdrainage (n = 6), or overly sunken skull defect (n = 1). Of these 33 patients, 24 showed neurological improvements (p = 0.012). Cost-benefit analysis showed $646.60 savings (US dollars) per patient if programmable shunts were used, because the cost of shunt revision is a lot higher than the cost of the shunt.

Conclusions

The rate of shunt revision is lower in patients with programmable devices, and these are therefore more cost-effective. In addition, the shunt adjustments made for patients with programmable devices also resulted in better neurological outcomes.
Rapid and sensitive intraoperative detection of mutations in the isocitrate dehydrogenase 1 and 2 genes during surgery for glioma
Authors: Kanamori Masayuki , Kikuchi Atsuo , Watanabe Mika , Shibahara Ichiyo , Saito Ryuta , Yamashita Yoji , Sonoda Yukihiko , Kumabe Toshihiro , Kure Shigeo , Tominaga Teiji
Published: April 2014

Object

Intraoperative diagnosis is important in determining the strategies during surgery for glioma. Because the mutations in the isocitrate dehydrogenase 1 and 2 (IDH1 and IDH2) genes have diagnostic, prognostic, and predictive values, the authors assessed the feasibility and significance of a simplified method for the intraoperative detection of IDH1 and IDH2 gene mutations.

Methods

Rapid DNA extraction, amplification with conventional polymerase chain reaction (PCR) or co-amplification at lower denaturation temperature PCR (COLD-PCR), and fluorescence melting curve analysis with adjacent hybridization probes were performed for the intraoperative detection of IDH1 and IDH2 mutations in 18 cases of suspected nonneoplastic lesions and low- and high-grade gliomas and in 3 cases of radiation necrosis.

Results

DNA extraction for detection of the mutation took 60–65 minutes. The results of this assay showed complete correlation with that of Sanger sequencing. The sensitivity for detection of mutations in a background of wild-type genes was 12.5% and 2.5% in conventional PCR and COLD-PCR, respectively. The diagnosis of glioma was established in 3 of 5 cases in which definitive diagnosis was not obtained using frozen sections, and information was obtained for the discrimination of glioblastoma or glioblastoma with an oligodendroglioma component from anaplastic glioma or secondary glioblastoma. This assay also detected a small fraction of tumor cells with IDH1 mutation in radiation necrosis.

Conclusions

These methods provide important information for establishing the differential diagnosis between low-grade glioma and nonneoplastic lesions and the diagnosis for subtypes of high-grade glioma. Although tumor cells in radiation necrosis were detected with a high sensitivity, further investigation is necessary for clinical application in surgery for recurrent glioma.
Anterior cerebral artery bypass for complex aneurysms: an experience with intracranial-intracranial reconstruction and review of bypass options
Authors: Abla Adib A. , Lawton Michael T.
Published: April 2014

Object

The authors describe their experience with intracranial-to-intracranial (IC-IC) bypasses for complex anterior cerebral artery (ACA) aneurysms with giant size, dolichoectatic morphology, or intraluminal thrombus; they determine how others have addressed the limitations of ACA bypass; and they discuss clinical indications and microsurgical technique.

Methods

A consecutive, single-surgeon experience with ACA aneurysms and bypasses over a 16-year period was retrospectively reviewed. Bypasses for ACA aneurysms reported in the literature were also reviewed.

Results

Ten patients had aneurysms that were treated with ACA bypass as part of their surgical intervention. Four patients presented with subarachnoid hemorrhage and 3 patients with mass effect symptoms from giant aneurysms; 1 patient with bacterial endocarditis had a mycotic aneurysm, and 1 patient's meningioma resection was complicated by an iatrogenic pseudoaneurysm. One patient had his aneurysm discovered incidentally. There were 2 precommunicating aneurysms (A1 segment of the ACA), 5 communicating aneurysms (ACoA), and 3 postcommunicating (A2–A3 segments of the ACA). In situ bypasses were used in 4 patients (A3-A3 bypass), interposition bypasses in 4 patients, reimplantation in 1 patient (pericallosal artery-to-callosomarginal artery), and reanastomosis in 1 patient (pericallosal artery). Complete aneurysm obliteration was demonstrated in 8 patients, and bypass patency was demonstrated in 8 patients. One bypass thrombosed, but 4 years later. There were no operative deaths, and permanent neurological morbidity was observed in 2 patients. At last follow-up, 8 patients (80%) were improved or unchanged. In a review of the 29 relevant reports, the A3-A3 in situ bypass was used most commonly, extracranial (EC)–IC interpositional bypasses were the second most common, and reanastomosis and reimplantation were used the least.

Conclusions

Anterior cerebral artery aneurysms requiring bypass are rare and can be revascularized in a variety of ways. Anterior cerebral artery aneurysms, more than any other aneurysms, require a thorough survey of patient-specific anatomy and microsurgical options before deciding on an individualized management strategy. The authors' experience demonstrates a preference for IC-IC reconstruction, but EC-IC bypasses are reported frequently in the literature. The authors conclude that ACA bypass with indirect aneurysm occlusion is a good alternative to direct clip reconstruction for complex ACA aneurysms.
Rotational vertebral artery occlusion secondary to adjacent-level degeneration following anterior cervical discectomy and fusion
Authors: Buchanan Colin C. , McLaughlin Nancy , Lu Daniel C. , Martin Neil A.
Published: April 2014

Rotational vertebral artery occlusion (RVAO), or bow hunter's syndrome, most often occurs at the C1–2 level on physiological head rotation. It presents with symptoms of vertebrobasilar insufficiency (VBI). Several previously published studies have reported on subaxial sites of vertebral artery (VA) compression by head rotation. The authors report a case of subaxial spine RVAO due to adjacent-segment degeneration. A 52-year-old man presented with dizziness when rotating his head to the left. Twenty years earlier, he had undergone a C4–5 anterior cervical discectomy and fusion (ACDF) for a herniated disc. Imaging studies including a dynamic CT angiography and dynamic catheter angiography revealed occlusion of the left VA at the C3–4 level when the patient turned his head to the left, in the setting of an aberrant vertebrobasilar system. Successful treatment was achieved by surgical decompression of the left VA and C3–4 ACDF. Expedited diagnosis and treatment are dependent on the recognition of this unusual manifestation of RVAO, especially when patients present with nonspecific symptoms of VBI.
A Newer Approach to the Management of Membrano Proliferative Glomerulonephritis  Experience from A Tertiary Level Hospital, Bangladesh
Authors: Rahman MH , Jesmin T , Begum A , Muinuddin G
Published: April 2014

DOI: http://dx.doi.org/10.3329/bjch.v37i3.18621 Bangladesh J Child Health 2013; Vol.37(3): 170-174
Mazon linguiste
Authors: Breuillard Jean
Published: April 2014

André Mazon as a Linguist

No doubt, André Mazon (1881-1967) considered himself as a philologist. All his life, he has been interested in the multidimensional approach of ancient texts which different aspects he explored: linguistic, literary (with a special interest in text history) and cultural. Mazon is nonetheless the author of several important and clearly linguistic works: two dissertations devoted to the verbal aspect, two grammars (of Czech and Russian) and several papers dealing with linguistic problems. Mazon was a Slavist in the full sense of the word, mastering several Slavic languages (Russian, Ukrainian, Bulgarian, Czech, Serbo-Croatian and Polish). He spent more than nine years in Slavic countries. After having recalled his role as a linguist during World War I, the article focuses on three aspects of his liguistic thought: 1. aspectology; 2. his approach of phonetics and resistance to Praguian phonology; 3. a classification of Russian verbs (he refused to radically separate synchrony and diachrony). The article points out the still valuable importance of his aspectologic works.
Mazon et le Slovo d’Igor
Authors: Roudet Robert
Published: April 2014

Мазон в споре о Слове о полку Игореве

В статье рассматривается роль Андре Мазона в споре о подлинности Слова о полку Игореве. До Мазона никто не предпринимал серьёзного научного исследования, в котором был бы основательно и всесторонне освещён вопрос о подлинности этого произведения. Андре Мазон первым открыл дебаты, утверждая наперекор чуть ли не всеобщему мнению, что не Задонщина является вторичной по отношению к Слову, а, наоборот, Слово вторично по отношению к Задонщине. К сожалению, как будет показано, этот научный спор очень быстро вырождается в острую полемику, порой переходящую даже в грубую брань. Причин тут много, и эта статья ставит себе целью выявить самые важные из них. Мазон в этом споре несомненно является первопроходцем, и не следует забывать о том, что первопроходец, даже заблуждающийся, всегда заслуживает уважения.
André Mazon et les relations scientifiques franco-soviétiques (1917-1939)
Authors: Rjéoutski Vladislav
Published: April 2014

André Mazon and Soviet-French Scientific Relations (1917-1939)

Mazon’s relations with the Russian scientific world start a long time before the 1917 Revolution. In the middle of the 1920’s, Mazon becomes secretary of the French Committee for the strengthening of scientific relations with Russia, which was created in 1925. He takes an active part in the renewal and further development of these relations. The role of the committee mostly covers the exchange of scholarly publications and the organization of scientific missions. But its activity strongly depends on the state of the USSR’s internal and foreign policies: the growing strength of Stalin’s regime is reflected, notably, through purges organized in the academic institutions at the end of the 1920’s, practically putting an end to scientific exchanges with France. In 1934-1935, for a brief period, it becomes suddenly possible to revive this exchange and to organize it at the highest level. André Mazon and the Committee are progressively compelled to work more and more through the VOKS (All-Union Society for Cultural Relations with Foreign Countries), which also deals with scientific relations. However, this Society is less concerned by scientific matters and more by the promotion of a certain image of the USSR. In such a context, the work of A. Mazon and of the Committee come to a dead-end.
Remembering André Mazon
Authors: Keenan Edward L.
Published: April 2014

Évocation d’André Mazon

Le professeur Keenan, qui ne semble pas avoir rencontré personnellement le professeur Mazon, reprend pourtant à son compte l’idée que le Slovo est une fabrication du XVIIIe ou du XIXe siècle (lire son texte Josef Dobrovský and the Origins of the Igor’ Tale, Harvard, 2003). Il évoque également l’opinion exprimée sur ce sujet par Roman Jakobson, N. S. Troubetzkoy, George Vernadsky et Edmund Wilson. Le professeur Keenan propose une documentation où l’on trouve, entre autres, des citations qui révèlent le point de vue de Lev Aleksandrovič Dmitriev, récemment publié par les Cahiers du monde russe.
Les cercles concentriques du trauma
Authors: Serre Geneviève , Giraud François
Published: April 2014

Exposés aux effets de la pression médiatique, les adolescents d’origine serbe résidant en France paraissent comme le montrent plusieurs situations exposées ici, subir les conséquences du trauma collectif lié à la guerre. Face à la dépression paternelle, les garçons surtout éprouvent avec force une identification à la patrie d’origine des parents, la honte de la défaite, la colère contre le pays d’accueil. Se trouve également concernée une certaine idée de la masculinité engagée dans la défense de l’honneur parental et national, ainsi que la grande proximité des mères qui compromet le processus de séparation-individuation.
Des adolescents en guerre
Authors: Lachal Christian
Published: April 2014

Les adolescents participent aux guerres, ils prennent une part active et en même temps, ils sont vulnérables. Les processus de l’adolescence peuvent être au service d’une poursuite du développement individuel, même dans ces contextes de guerre. La vulnérabilité des adolescents vient du fait que les changements internes qu’ils ressentent vont à la rencontre des changements brutaux de leur environnement, dus au contexte. Ils peuvent être alors manipulés par les adultes qui pervertissent par différents moyens leur évolution spontanée, ou encore, ils ont à se situer au regard des figures emblématiques dans lesquelles s’incarne l’adolescence en guerre. Leur évolution dépendra en particulier de leur âge (selon qu’ils soient en pré-adolescence ou plus âgés), du risque de subir des stress aigus et de développer des troubles post-traumatiques, et de l’état de leur société quand la paix sera revenue. Le concept d’expérience traumatique est utile pour ouvrir à la complexité de cette question des adolescents dans les guerres.
Avoir ou être : tribulations identitaires chez les adolescents migrants
Authors: von Overbeck Ottino Saskia , Ottino Jérôme
Published: April 2014

L’adolescence des jeunes migrants et particulièrement les remaniements identificatoires propres à cette période de vie, se heurtent à la difficulté d’intégrer différents référentiels culturels. Si l’environnement culturel familial favorise le processus adolescent grâce à une adéquation féconde entre les repères culturels et les processus psychodynamiques, l’exil menace d’exposer le jeune en devenir à des contraintes identificatoires difficiles à dépasser. La tendance, dans ces situations, à la polarisation des différents référentiels en termes exclusifs, peut amener à des difficultés cliniques, thérapeutiques et contre-transférentielles. A partir de présentations de cas, les auteurs explorent le développement adolescent en termes psychodynamiques, familiaux et transculturels et soulignent l’importance thérapeutique de favoriser la réduction du clivage entre culture d’origine et culture d’accueil.
L'attachement à l'adolescence
Authors: Golse Bernard
Published: April 2014

La question de la stabilité des schémas d’attachement tout au long de la vie est une hypothèse qui suscite de nombreuses questions. Elle se pose tout particulièrement à l’adolescence, époque de profonds remaniements. Un certain nombre de travaux plaident pour une plus grande stabilité des schémas sécurisés que des autres schémas d’attachement. Quelques-uns de ces travaux sont évoqués ici avant une réflexion sur la signification possible de remaniements transitoires ou partiels des schémas d’attachement du point de vue de la psychopathologie propre à cette période de la vie.
A propos du cauchemar dans la théorie freudienne
Authors: Pierre Danièle
Published: April 2014

A partir d’une situation clinique ethnopsychiatrique (un patient marocain rêve qu’il sacrifie son frère), l’auteur interroge les textes freudiens sur le cauchemar. Il y apparaît (notamment dans L’homme aux loups ) en proximité étonnante avec l’opération même du refoulement originaire ou de l’identification idéale. Simultanément, c’est l’élaboration secondaire de la façade du cauchemar qui inscrirait le sujet en devenir dans le contexte de sa culture.
La compréhension de la maltraitance
Authors: Labache Lucette
Published: April 2014

Depuis plus d’une dizaine d’années de pratique de la formation sur la connaissance des départements d’outre-mer, j’ai noté la récurrence d’un thème particulier, la maltraitance chez les originaires des Antilles. En effet, le public est de plus en plus demandeur d’éclaircissements sur les « châtiments corporels », sur les « brutalités » physiques et psychologiques que les parents migrants antillais exerceraient sur leurs enfants. Les appréciations portées par les professionnels en contact avec cette population sont révélatrices d’un amalgame très vite réduit à une vision culturaliste. L’objet de cet article est de montrer comment les apports de l’anthropologie et la clinique peuvent servir à comprendre un cas de maltraitance.
Informational, Physical, and Psychological Privacy as Determinants of Patient Behaviour in Health Care
Authors: Serenko Natalia
Published: April 2014

This chapter presents and describes a theoretical framework explicating how three dimensions of privacy in healthcare (i.e. informational, physical, and psychological) influence patient behaviour through trust. Informational privacy is defined as the patients' perceptions of the degree of control over their personal information when their doctor collects, uses, disseminates, and stores their information. Physical privacy refers to the patients' perceptions of the degree of their physical inaccessibility to others. Psychological privacy is the patients' perceptions of the extent to which the physician allows them to participate in their healthcare decisions and maintains their personal and cultural values, such as inner thoughts, feelings, cultural beliefs, and religious practices. These types of privacy are especially important with respect to service quality and patient safety due to the recent advancements in information and telecommunication technologies and the availability of online medical information. As a result, patients have become more educated in various health issues, and many of them want to actively participate in their health decisions. The framework proposes that these privacy dimensions affect trust in a healthcare provider. Trust, in turn, has an effect on treatment compliance, positive word-of-mouth, and commitment to stay with the current service provider in the future. Based on the framework, recommendations for healthcare stakeholders are provided.
A New Era for Safety Measurement
Authors: Jones Sarahjane , Macintyre Mairi
Published: April 2014

This chapter presents current systems thinking concerning patient safety and explores what patient safety actually means, allowing a foundation for a critical review of tools used for safety measurement. Content considers a range of content from hard measures to softer cultural perspectives, thus ensuring that the patient view is not forgotten.
Clinical Pathway Enhanced by Knowledge Management Technology
Authors: Li Weizi
Published: April 2014

Clinical pathways are complex processes based on knowledge and personal experience, which are essential for high quality patient treatment. However, the insufficient knowledge coverage and representation for detailed clinical pathways makes it difficult to provide accurate information to improve patient safety. The gap between the dynamic practical treatment process and the predefined clinical pathways knowledge becomes an important issue. This chapter discusses how knowledge management enhances the implementation of clinical pathway to achieve medical quality improvement. The relationship between patient safety and the effectiveness of clinical pathway knowledge is discussed. The clinical pathway knowledge management pattern is derived in the context of healthcare knowledge management. More specifically, a norm-based approach is proposed to represent and manage clinical pathway knowledge. Types of knowledge can be represented comprehensively with the taxonomy of norms as useful building blocks to construct the dynamic and accurate clinical pathway knowledge. The multi-agent system embedded with norms is developed to enhance clinical pathway management in the context of complicated healthcare environment. Finally, social-technical issues of implementing knowledge management technologies in practical treatment process are discussed.
Health Information Technology
Authors: Palmieri Patrick Albert , Peterson Lori T. , Noeding Miguel Noe Ramirez
Published: April 2014

Healthcare organizations are increasingly willing to develop more efficient and higher quality processes to combat the competition and enhance financial viability by adopting contemporary solutions such as Health Information Technology (HIT). However, technological failures occur and represent a contemporary organizational development priority resulting from incongruent organization-technology interfaces. Technologically induced system failure has been defined as technological iatrogenesis. The chapter offers the Healthcare Iatrogenesis Model as an organizational development strategy to guide the responsible implementation of HIT projects. By recognizing the etiology of incongruent organizational interfaces and anticipating patient safety concerns, leaders can proactively respond to system limitations and identify hidden process instabilities prior to costly and consequential catastrophic events.
Towards Interactive Virtual Environments through Handheld Devices for the Disabled
Authors: Spyridonis Fotios , Ghinea Gheorghita , Grønli Tor-Morten , Hansen Jarle
Published: April 2014

The successful integration of novel interactive virtual environments for everyday life applications may constitute an important indication towards similarly employing Virtual Reality (VR)-related technologies in primary care. This chapter presents the results of a usability study that makes use of an Android-based handheld device for investigating disabled users' performance in using an intuitive interactive VR interface for pain assessment. A convenience sample of seven wheelchair users was asked to evaluate the interface and involved the use of non-participant direct observation, note taking, and thinking-aloud protocol to collect the necessary data. The evaluation results demonstrated good acceptance and a generally positive performance of the participants when they completed a set of predefined interaction tasks. It is anticipated that the findings of this study may have good practical implications to the assessment of pain and could open the way for increasing the use of such technologies in everyday healthcare provision.
A Novel Approach for Supplying Wireless Energy to Multiple Devices Simultaneously Using Sweeping Effect
Authors: Gundogdu Askin Erdem , Afacan Erkan
Published: April 2014

There has been great interest in wireless power transmission since 2007 when a novel approach was presented by a group of scientists at MIT. With this new technique, power transmission range is possible for a couple of meters with high efficiency; however, to be able to use this technique in our lives with high efficiency and long transfer range, small structured devices and new design techniques are strongly required. In this chapter, the investigation on supplying energy by sweeping was presented. The experimental results claim that energy could be supplied to multiple devices almost at the same time. If the range of chosen frequency increases, the number of devices could be increased as well, considering slight energy efficiency loss in the transfer system. The authors hope that the proposed technique gives inspiration to the designers and to the market.
A Performance Evaluation of the Coverage Configuration Protocol and its Applicability to Precision Agriculture
Authors: Dhraief Amine , Mahjri Imen , Belghith Abdelfettah
Published: April 2014

Wireless Sensor Networks (WSNs) have recently emerged as a prominent technology for lots of civilian and military applications in both rural and urban environments. Area coverage configuration is an efficient method to alleviate the nodes' limited energy supply in high density WSNs. It consists in selecting as few active sensors as possible from all deployed nodes while ensuring sufficient sensing coverage of the monitored region. Several coverage configuration protocols have been developed; most of them presume the availability of precise knowledge about node locations and sensing ranges. Relaxing these conservative assumptions might affect the performance of coverage configuration protocols. In this chapter, the authors examine the impact of location errors, irregular sensing ranges, and packet losses on the Coverage Configuration Protocol (CCP). The authors focus more precisely on the impact of using this protocol on a real application: precision agriculture where farmers need to cover the entire terrain with sensors in order to rapidly detect and localize spots requiring chemical treatment.
Quality of Services and Optimal Management of Cloud Centers with Different Arrival Modes
Authors: Goswami V. , Patra S. S. , Mund G. B.
Published: April 2014

In Cloud Computing, the virtualization of IT infrastructure enables consolidation and pooling of IT resources so they are shared over diverse applications to offset the limitation of shrinking resources and growing business needs. Cloud Computing is a way to increase the capacity or add capabilities dynamically without investing in new infrastructure, training new personnel, or licensing new software. It extends Information Technology's existing capabilities. In the last few years, cloud computing has grown from being a promising business concept to one of the fast growing segments of the IT industry. For the commercial success of this new computing paradigm, the ability to deliver guaranteed Quality of Services is crucial. Based on the Service Level Agreement, the requests are processed in the cloud centers in different modes. This chapter deals with Quality of Services and optimal management of cloud centers with different arrival modes. For this purpose, the authors consider a finite-buffer multi-server queuing system where client requests have different arrival modes. It is assumed that each arrival mode is serviced by one or more virtual machines, and different modes have equal probabilities of receiving services. Various performance measures are obtained and optimal cost policy is presented with numerical results. A genetic algorithm is employed to search optimal values of various parameters for the system.
Connecting Real and Virtual Neighbors
Authors: Blom Robin , Morgan Jonathan S. , Zube Paul , Bowe Brian J.
Published: April 2014

Unlike most of the literature surveying the proliferation and increased usage of social media in society at large, this study analyzes the potential of blogs to mobilize local communities. It focuses on blogging in the context of a geographic locality and describes a participatory action research project in inner city Detroit built around the “Going Home” blog hosted by The Detroit News. The results of the project demonstrate that blogging can be used as a catalyst for neighborhood revitalization. United by positive feelings towards the neighborhood, geographically separated social groups of current and former residents connected online, shared sentiments and information, and combined their efforts to bring about positive social change in the physical community.
Studying Physical Activity Using Social Media
Authors: Stragier Jeroen , Mechant Peter , De Marez Lieven
Published: April 2014

Smartphones and mobile fitness applications or apps have brought a new experience to physical activities such as running, walking, and cycling. Increased sharing of these activities by users of social networking sites affords the collection of large physical activity datasets. This study assesses to what extent raw data from mobile fitness applications (MFAs) posted on Twitter can be used for studying physical activity and what added value they can provide. A total of 22,258 tweets collected over a nine-month period using RunKeeper mobile fitness app were analyzed. A quantitative analysis of the entire data set and a content analysis of a subset of 2,868 tweets were performed. The data from MFAs exchanged via Twitter provided rich information on various aspects of physical activity including timing and distance of runs, bicycle rides, and walks. Personal reflections shared by RunKeeper users contained additional details on how the activity was experienced. Although further research is needed to determine the representativeness and generalizability of such data, the results of this study may indicate an important direction for extending current methodological practices in physical activity research.
Using Conceptual Models to Implement Natural Language Pedagogic Agent-Student Conversations
Authors: Pérez-Marín Diana , Caballero Carlos
Published: April 2014

The last several decades have seen a growing trend in incorporating pedagogic conversational agents in interactive learning environments. Software systems have increasingly integrated intelligent virtual agents that can interact with students in natural language to fulfill specific tasks such as reviewing content or providing tutor training. The use of an agent-based approach in education has shown many benefits. However, certain design and development issues are still unresolved. This article focuses on the potentials of employing conceptual models to generate agent-student dialog and introduces a new mixed-initiative general domain agent called JARO. The authors report on the procedure for creating the initial conceptual model and discuss its use in guiding agent-student conversations adapted to students' individual learning needs. The stages of implementation of the model as well as the model's viability tested in a proof-of-concept experiment are addressed.
Historic Times v. Sullivan and Gertz v. Welch Supreme Court Decisions and Online Social Media Libel Law
Authors: Azriel Joshua , Mayo Charles
Published: April 2014

This article re-examines two historic Supreme Court's decisions—the 1964 Times v. Sullivan and the 1974 Gertz v. Welch—as they apply to the digital era. The Court's decision in Sullivan established the federal legal guidelines for a victim to prove a libel case including actual malice. In Gertz v. Welch the Court established three categories of public figures who must prove actual malice in a libel claim. The article reviews both cases within the context of social media defamation claims. The authors conclude that the Supreme Court decisions in Times v. Sullivan and Gertz v. Welch are still relevant in the era of online communication and social media.
A Postmigrational Switch among Skin-Derived Dendritic Cells to a Macrophage-Like Phenotype Is Predetermined by the Intracutaneous Cytokine Balance
Authors: de Gruijl Tanja D. , Sombroek Claudia C. , Lougheed Sinéad M. , Oosterhoff Dinja , Buter Jan , van den Eertwegh Alfons J. M. , Scheper Rik J. , Pinedo Herbert M.
Published: April 2014

Migration of dendritic cells (DC) to secondary lymphoid organs under proinflammatory conditions coincides with their maturation and acquisition of T cell stimulatory abilities. In contrast, impaired activation of DC, e.g., in tumor-conditioned environments, may hamper their activation and possibly their subsequent migration to lymph nodes, leading to either immunological tolerance or ignorance, respectively. In this study, the influence of cytokines in the peripheral skin microenvironment on the activation state of migrating cutaneous DC was assessed using an ex vivo human skin explant model. We observed a phenotypic shift from mature CD83+ DC to immature CD14+ macrophage-like cells within 7 days subsequent to migration from unconditioned skin. These macrophage-like cells displayed a poor T cell stimulatory ability and lacked expression of CCR7, thus precluding their migration to paracortical T cell areas in the lymph nodes. The balance of suppressive and stimulatory cytokines during the initiation of migration decided the postmigrational fate of DC with IL-10 accelerating and GM-CSF and IL-4 preventing the phenotypic switch, which proved irreversible once established. These observations indicate that, in immunosuppressed environments, a postmigrational DC-to-macrophage shift may hinder T cell activation, but also that it may be prevented by prior conditioning of the tissue microenvironment by GM-CSF and/or IL-4.
Regulation of Microtubule Formation in Activated Mast Cells by Complexes of γ-Tubulin with Fyn and Syk Kinases
Authors: Sulimenko Vadym , Dráberová Eduarda , Sulimenko Tetyana , Macůrek Libor , Richterová Vĕra , Dráber Petr , Dráber Pavel
Published: April 2014

Aggregation of the high-affinity IgE receptors (FcεRIs) on the surface of granulated mast cells initiates a chain of signaling events culminating in the release of allergy mediators. Although microtubules are involved in mast cell degranulation, the molecular mechanism that controls microtubule rearrangement after FcεRI triggering is poorly understood. In this study, we show that the activation of bone marrow-derived mast cells (BMMCs) induced by FcεRI aggregation or treatment with pervanadate leads to a rapid polymerization of microtubules. This polymerization was not dependent on the presence of Lyn kinase as determined by experiments with BMMCs isolated from Lyn-negative mice. One of the key regulators of microtubule polymerization is γ-tubulin. Immunoprecipitation experiments revealed that γ-tubulin from activated cells formed complexes with Fyn and Syk protein tyrosine kinases and several tyrosine phosphorylated proteins from both wild-type and Lyn−/− BMMCs. Pretreatment of the cells with Src-family or Syk-family selective tyrosine kinase inhibitors, PP2 or piceatannol, respectively, inhibited the formation of microtubules and reduced the amount of tyrosine phosphorylated proteins in γ-tubulin complexes, suggesting that Src and Syk family kinases are involved in the initial stages of microtubule formation. This notion was corroborated by pull-down experiments in which γ-tubulin complex bounds to the recombinant Src homology 2 and Src homology 3 domains of Fyn kinase. We propose that Fyn and Syk kinases are involved in the regulation of binding properties of γ-tubulin and/or its associated proteins, and thus modulate the microtubule nucleation in activated mast cells.
Antiangiogenic and Antitumor Activities of IL-27
Authors: Shimizu Motomu , Shimamura Mariko , Owaki Toshiyuki , Asakawa Masayuki , Fujita Koji , Kudo Motoshige , Iwakura Yoichiro , Takeda Yasutaka , Luster Andrew D. , Mizuguchi Junichiro , Yoshimoto Takayuki
Published: April 2014

IL-27 is a novel IL-6/IL-12 family cytokine playing an important role in the early regulation of Th1 responses. We have recently demonstrated that IL-27 has potent antitumor activity, which is mainly mediated through CD8+ T cells, against highly immunogenic murine colon carcinoma. In this study, we further evaluated the antitumor and antiangiogenic activities of IL-27, using poorly immunogenic murine melanoma B16F10 tumors, which were engineered to overexpress single-chain IL-27 (B16F10 + IL-27). B16F10 + IL-27 cells exerted antitumor activity against not only s.c. tumor but also experimental pulmonary metastasis. Similar antitumor and antimetastatic activities of IL-27 were also observed in IFN-γ knockout mice. In NOD-SCID mice, these activities were decreased, but were still fairly well-retained, suggesting that different mechanisms other than the immune response are also involved in the exertion of these activities. Immunohistochemical analyses with Abs against vascular endothelial growth factor and CD31 revealed that B16F10 + IL-27 cells markedly suppressed tumor-induced neovascularization in lung metastases. Moreover, B16F10 + IL-27 cells clearly inhibited angiogenesis by dorsal air sac method, and IL-27 exhibited dose-dependent inhibition of angiogenesis on chick embryo chorioallantoic membrane. IL-27 was revealed to directly act on HUVECs and induce production of the antiangiogenic chemokines, IFN-γ-inducible protein (IP-10) and monokine induced by IFN-γ. Finally, augmented mRNA expression of IP-10 and monokine induced by IFN-γ was detected at the s.c. B16F10 + IL-27 tumor site, and antitumor activity of IL-27 was partially inhibited by the administration of anti-IP-10. These results suggest that IL-27 possesses potent antiangiogenic activity, which plays an important role in its antitumor and antimetastatic activities.
TCR-Dependent Cell Response Is Modulated by the Timing of CD43 Engagement
Authors: Fierro Nora A. , Pedraza-Alva Gustavo , Rosenstein Yvonne
Published: April 2014

Binding of Ag by the Ag receptor in combination with other stimuli provided by costimulatory receptors triggers the expansion and differentiation of T lymphocytes. However, it is unclear whether the time when costimulatory molecules interact with their counterreceptors with regards to Ag recognition leads to different T cell responses. Provided that the coreceptor molecule CD43 is a very abundant molecule evenly distributed on the membrane of T cell surface protruding 45 nm from the cell, we hypothesized that CD43 is one of the first molecules that interacts with the APC and thus modulates TCR activation. We show that engaging CD43 before or simultaneously with the TCR inhibited Lck-Src homology 2 domain containing phosphatase-1 interaction, preventing the onset of a negative feedback loop on TCR signals, favoring high levels of IL-2, cell proliferation, and secretion of proinflammatory cytokines and chemokines. In contrast, the intracellular signals resulting of engaging the TCR before CD43 were insufficient to induce IL-2 production and cell proliferation. Interestingly, when stimulated through the TCR and CD28, cells proliferated vigorously, independent of the order with which molecules were engaged. These results indicate that CD43 induces a signaling cascade that prolongs the duration of TCR signaling and support the temporal summation model for T cell activation. In addition to the strength and duration of intracellular signals, our data underscore temporality with which certain molecules are engaged as yet another mechanism to fine tune T cell signal quality, and ultimately immune function.
BTNL2, a Butyrophilin-Like Molecule That Functions to Inhibit T Cell Activation
Authors: Nguyen Thang , Liu Xikui K. , Zhang Yongliang , Dong Chen
Published: April 2014

B7 family members regulate T cell activation and tolerance. Although butyrophilin proteins share sequence homology with the B7 molecules, it is unclear whether they have any function in immune responses. In the present study, we characterize an MHC class II gene-linked butyrophilin family member, butyrophilin-like 2 (BTNL2), the mutation of which has been recently associated with the inflammatory autoimmune diseases sarcoidosis and myositis. Mouse BTNL2 is a type I transmembrane protein with two pairs of Ig-like domains separated by a heptad peptide sequence. BTNL2 mRNA is highly expressed in lymphoid tissues as well as in intestine. To characterize the function of BTNL2, we produced a BTNL2-Ig fusion protein. It recognized a putative receptor whose expression on B and T cells was significantly enhanced after activation. BTNL2-Ig inhibited T cell proliferation and TCR activation of NFAT, NF-κB, and AP-1 signaling pathways. BTNL2 is thus the first member of the butyrophilin family that regulates T cell activation, which has implications in immune diseases and immunotherapy.
T Cell-Independent, TLR-Induced IL-12p70 Production in Primary Human Monocytes
Authors: Bekeredjian-Ding Isabelle , Roth Susanne Ilona , Gilles Stefanie , Giese Thomas , Ablasser Andrea , Hornung Veit , Endres Stefan , Hartmann Gunther
Published: April 2014

IL-12p70 is a key cytokine for the induction of Th1 immune responses. IL-12p70 production in myeloid cells is thought to be strictly controlled by T cell help. In this work we demonstrate that primary human monocytes can produce IL-12p70 in the absence of T cell help. We show that human monocytes express TLR4 and TLR8 but lack TLR3 and TLR7 even after preincubation with type I IFN. Simultaneous stimulation of TLR4 and TLR8 induced IL-12p70 in primary human monocytes. IL-12p70 production in peripheral blood myeloid dendritic cells required combined stimulation of TLR7/8 ligands together with TLR4 or with TLR3 ligands. In the presence of T cell-derived IL-4, but not IFN-γ, stimulation with TLR7/8 ligands was sufficient to stimulate IL-12p70 production. In monocytes, type I IFN was required but not sufficient to costimulate IL-12p70 induction by TLR8 ligation. Furthermore, TLR8 ligation inhibited LPS-induced IL-10 in monocytes, and LPS alone gained the ability to stimulate IL-12p70 in monocytes when the IL-10 receptor was blocked. Together, these results demonstrate that monocytes are licensed to synthesize IL-12p70 through type I IFN provided via the Toll/IL-1R domain-containing adaptor inducing IFN-β pathway and the inhibition of IL-10, both provided by combined stimulation with TLR4 and TLR8 ligands, triggering a potent Th1 response before T cell help is established.