bluuebunny/crossref_metadata_2025 huggingface dataset:
INR vs. thrombin generation assays for guiding VKA reversal: a retrospective comparison
Authors: Herpers Robert , van Rossum André P. , van Beem Rachel T. , Michel W. Margot , Strijbis Viola J.F. , Strengers Paul F.W. , Castel Ad , Brinkman Herm Jan M.
Published: January 2015

Prothrombin complex concentrate (PCC) is used to reverse vitamin K antagonist (VKA)-induced anticoagulation. Prothrombin time-derived international normalized ratio (INR) measurements are widely used in determining the required PCC dose, but this approach requires reappraisal. The aim of the present study was to determine the added value of the thrombin generation assay (TGA) compared with the INR in guidance of VKA reversal by PCC.

In an open, observational study, INR and TGA measurements were carried out on plasma samples from phenprocoumon-treated patients receiving VKA reversal. Following both analytical methods, PCC dosing correlates were calculated and compared retrospectively. Alternatively, in vitro PCC spiking experiments were performed.

As expected, an exponential relationship between PCC dose and INR was found. For the TGA parameters peak thrombin and endogenous thrombin potential (ETP), however, this relationship was found to be linear throughout the full therapeutic range. Additional computational analysis showed a positive correlation (r

Our results support the current debate questioning the rationale for the use of the INR in the management of anticoagulation by VKA. Compared with INR, TGA-based calculations may enable a more accurate PCC dosing regimen for patients requiring VKA reversal.
Analytic function theory for operator-valued free probability
Authors: Williams John D.
Published: January 2015

It is a classical result in complex analysis that the class of functions that arise as the Cauchy transform of probability measures may be characterized entirely in terms of their analytic and asymptotic properties. Such transforms are a main object of study in non-commutative probability theory as the function theory encodes information on the probability measures and the various convolution operations. In extending this theory to operator-valued free probability theory, the analogue of the Cauchy transform is a non-commutative function with domain equal to the non-commutative upper-half plane. In this paper, we prove an analogous characterization of the Cauchy transforms, again, entirely in terms of their analytic and asymptotic behavior. We further characterize those functions which arise as the Voiculescu transform of

⊞

{\boxplus}

-infinitely divisible operator-valued distributions. As consequences of these results, we provide a characterization of infinite divisibility in terms of the domain of the relevant Voiculescu transform, provide a purely analytic definition of the semigroups of completely positive maps associated to infinitely divisible distributions and provide a Nevanlinna representation for non-commutative functions with the appropriate asymptotic behavior.
Fabrication of High-Efficiency Piezoelectric Energy Harvesters of Epitaxial Pb(Zr,Ti)O3 Thin Films by Laser Lift-off
Authors: Suwa Eisaku , Tsujiura Yuichi , Kurokawa Fumiya , Hida Hirotaka , Kanno Isaku
Published: January 2015

We fabricated piezoelectric vibration energy harvesters of c-axis-oriented epitaxial Pb(Zr,Ti)O3 (PZT) thin films on stainless steel (SS304) cantilevers in an effort to improve their power-generation efficiency and toughness. Using radio-frequency magnetron sputtering, we deposited the epitaxial PZT thin films on the MgO substrates, and then transferred the PZT films onto microfabricated SS304 cantilevers using laser lift-off (LLO). LLO did not degrade the transferred epitaxial PZT thin films, which exhibited a high piezoelectric coefficient (e
31,f
=–4.8 C/m2) and a low relative dielectric constant (ε
r=340), comparable to those of the original PZT thin film on MgO. At a resonance frequency of 143 Hz, the energy harvesters generated large output power of 1.8 μW at an acceleration of 1.0 m/s2, and the output power reached a maximum of 49 μW at an acceleration of 7.5 m/s2.
Cork structural discontinuities studied with X-ray microtomography
Authors: Oliveira Vanda , Van den Bulcke Jan , Van Acker Joris , de Schryver Thomas , Pereira Helena
Published: January 2015

Cork is a natural cellular material with a rather unique set of properties, and its best known application is as stopper for wine bottles. The cork tissue contains structural discontinuities, for example, lenticular channels (LCh), that influence the in-use performance of cork products. X-ray microtomography, in combination with image analysis, has been used for cork characterisation and provided new insights into the three-dimensional location of discontinuities, which are hidden for a visual inspection. It was demonstrated that the presence of LCh is positively correlated with cork density, and the void fraction of LCh in the lower part of a cork stopper is strongly related to the oxygen ingress in the bottle during the first month after bottling. The results contribute to better understanding the natural variation of cork properties.
Chondrocalcinosis related to familial hypomagnesemia with hypercalciuria and nephrocalcinosis
Authors: Cimbek Emine Ayça , Şen Yaşar , Yuca Sevil Arı , Peru Harun
Published: January 2015

Calcium pyrophosphate dehydrate (CPPD) crystal deposition disease (also known as chondrocalcinosis, CC) is a rare metabolic arthropathy mostly seen in elderly patients. Chondrocalcinosis may be associated with metabolic diseases such as hypomagnesemia when it occurs in young people. We report here a case with hypomagnesemia due to familial hypomagnesemia with hypercalciuria and nephrocalcinosis (FHHNC) who developed CC during clinical follow-up. To our best knowledge this is the first case of a young patient with CPPD associated with FHHNC.
Childhood obesity, thyroid function, and insulin resistance – is there a link? A longitudinal study
Authors: Santos Maria Inês , Limbert Catarina , Marques Filipa Carlota , Rosário Frederico , Lopes Lurdes
Published: January 2015

Serum thyroid stimulating hormone (TSH) levels are frequently elevated in obese children and are most likely to be associated with insulin resistance. However, clinical relevance of this association remains unclear.

To assess the prevalence of hyperthyrotropinemia; to analyze the relationship between TSH and homeostasis model assessment – insulin resistance (HOMA-IR); and to verify whether TSH levels and HOMA-IR vary with weight loss in obese children.

Retrospective longitudinal study with data from baseline and 1 year after lifestyle intervention in a pediatric obese group (344 children were recruited and 100 among them completed follow-up). For postintervention analysis, three groups were considered according to body mass index-standard deviation score (BMI-SDS) variations: ≤–0.5 (significant weight loss); 0.5–0 (weight loss); and >0 (weight gain). Statistical analysis was performed using SPSS 19.0

The prevalence of increased TSH levels was 9.3%. At baseline TSH (p=0.007), fT4 (p=0.006), and HOMA-IR (p<0.001) were positively correlated to BMI-SDS (n=344). Weight reduction was verified in 67 out of 100 cases but significant loss was present in only 21 cases. Decreases in both TSH and BMI-SDS were independently associated with decreases in HOMA-IR (p=0.005 and p=0.016, respectively). There was no correlation between TSH and BMI-SDS variation. Significant decreases in the HOMA-IR (p=0.006) were only achieved in the significant weight loss group.

The prevalence of hyperthyrotropinemia was lower than previously reported. However, cutoff values were adjusted to pubertal stage, suggesting an over report in other studies. Insulin resistance and TSH were positively correlated, independent of body status. Although weight loss was not associated with TSH variation, a decrease in TSH levels was independently associated with decreases in HOMA-IR.
Habitat use of Himalayan grey goral in relation to livestock grazing in Machiara National Park, Pakistan
Authors: Ashraf Nasra , Anwar Maqsood , Hussain Iftikhar , Mirza Sarwat N. , Latham M. Cecilia , Latham A. David M.
Published: January 2015

The Himalayan grey goral (
Instructional impact on high school physics students’ nanoscience conceptions
Authors: Tretter Thomas R.
Published: January 2015

The impact of a 5-day sequence of nanoscience instruction for 207 high school physics students in eight classrooms and three schools was investigated. The instructional sequence was organized around key big ideas in nanoscience that were identified by a panel of 39 US national experts in nanoscience and nanoscience education. Pretest and posttest measures included measures of conceptions of scale boundary distinctions (particularly nanoscale), accuracy of conceptions of spatial scale of nanoscale objects, and a new instrument (conceptions of nanoscale instrument – CNI, with Cronbach’s α=0.79) designed to specifically measure the targeted big ideas in nanoscience. Results for scale conceptions showed that students developed a clear distinction of a scale difference between microscale and nanoscale worlds, including accurate knowledge of which objects are representative of each scale world. Nanoscale accuracy also improved. Conceptions across the breadth of big ideas in nanoscience were significantly enhanced by the instruction, with effect sizes in the large range. Analysis of subscores within the CNI showed differential impacts on particular nanoscience concepts. Implications for potential challenges and successes for influencing high school physics students’ conceptions of nanoscience are addressed.
On the solubility of non-ionic organic solutes in seawater
Authors: Marcus Yizhak
Published: January 2015

Given the solubilities of non-ionic organic solutes in water, their solubilities in seawater are obtained by correlation expressions involving two descriptors for the constituent ions (or salts) of seawater and two descriptors of the solutes. The former are the standard partial molar volumes and the intrinsic molar volumes and the latter are the molar volume (the Le Bas variant of it) and either the Hildebrand solubility parameter δ
H or the Kamlet–Taft solvatochromic π*.
Removal of organic sulfur compounds from diesel by adsorption on carbon materials
Authors: Yu Moxin , Zhang Nan , Fan Liangwei , Zhang Chen , He Xiaojun , Zheng Mingdong , Li Zhong
Published: January 2015

Removal of organic sulfur compounds from diesel by adsorption on different carbon materials, including activated carbons (ACs), carbon aerogels, carbon nanotubes, and AC cloths, was reviewed. The effect of the textural and surface chemistry property of carbon on desulfurization performance, carbon surface modification, adsorption mechanism, and adsorbent regeneration and the effect of other components, including aromatics, additives, nitrogen compounds, and moisture, on adsorptive desulfurization of diesel fuel were also discussed in detail. Carbon materials showed very high selectivity for removing the dibenzothiophenes, especially for 4,6-dimethyldibenzothiophene, which is very difficult with hydrodesulfurization and other adsorbents. Both the textural and chemical properties of AC have an important impact on the adsorption of DBTs. Adsorption selectivity and capacity can be enhanced further by carbon surface modification. Considering the effect of diffusion hindrance and regeneration, mesoporous carbon is more suitable than microporous carbon with pore size <2 nm. It is necessary to eliminate the inhibiting effect of fuel additive and nitrogen compounds on the DBTs before carbon materials are used for desulfurization of real diesel fuel. In the end, some useful suggestions are also made.
Investigation of the WEDM of Al/B4C/Gr reinforced hybrid composites using the Taguchi method and response surface methodology
Authors: Motorcu Ali Riza , Ekici Ergün , Kuş Abdil
Published: January 2015

In this study, the effects of machining parameters on the material removal rate (MRR) and surface roughness (Ra) were investigated during the cutting of Al/B4C/Gr hybrid composites by wire electrical discharge machining (WEDM). Wire speed (WS), pulse-on time (Ton) and pulse-off time (Toff) were chosen as the control factors. The L27 (33) orthogonal array in the Taguchi method was used in the experimental design and for the determination of optimum control factors. Response surface methodology was also used to determine interactions among the control factors. Variance analysis (ANOVA) was applied in the determination of the effects of control factors on the MRR and Ra. According to the ANOVA results, the most effective parameters on MRR and Ra were wire speed with a 85.94% contribution ratio, and pulse-on-time with a 47.7% contribution ratio. The optimum levels of the control factors for MRR and Ra were determined as A3B3C3 and A1B1C2. In addition, second-order predictive models were developed for MRR and Ra; correlation coefficients (R2) were calculated as 0.992 and 0.63.
Free vibration analysis of axially layered functionally graded short beams using experimental and finite element methods
Authors: Yilmaz Yasin , Evran Savas
Published: January 2015

Free vibration behavior of short beams made of axially layered functionally graded material (FGM) was investigated experimentally and numerically. Beams, which have gradation of the material properties in the axial direction, are fabricated by powder metallurgy technique using different weight fractions of aluminum and silicon carbide powders. In order to determine elasticity modulus of axially layered functionally graded (FG) beams, homogeneous beams containing different weight fractions of Al (aluminum) and SiC (silicon carbide) are produced, and these homogeneous beams are subjected to tensile tests. Density of each homogeneous layer is also calculated experimentally. After determination of the mechanical properties of each layer of the FG beams, they are modeled in a finite element program (ANSYS) according to Timoshenko beam theory, and free vibration analyses are performed. Fundamental frequencies of the axially layered FG beams produced are also calculated experimentally. FG beams with clamped-free boundary conditions are considered. Layers of the axially FG beams are considered to have symmetric configurations. Effect of the change in weight fractions of SiC particles and sorting order of layers to fundamental frequency of the beam is investigated. Experimental results obtained are compared with numerical results.
Uncertainty Analysis in Fatigue Life Prediction of Gas Turbine Blades Using Bayesian Inference
Authors: Li Yan-Feng , Zhu Shun-Peng , Li Jing , Peng Weiwen , Huang Hong-Zhong
Published: January 2015

This paper investigates Bayesian model selection for fatigue life estimation of gas turbine blades considering model uncertainty and parameter uncertainty. Fatigue life estimation of gas turbine blades is a critical issue for the operation and health management of modern aircraft engines. Since lots of life prediction models have been presented to predict the fatigue life of gas turbine blades, model uncertainty and model selection among these models have consequently become an important issue in the lifecycle management of turbine blades. In this paper, fatigue life estimation is carried out by considering model uncertainty and parameter uncertainty simultaneously. It is formulated as the joint posterior distribution of a fatigue life prediction model and its model parameters using Bayesian inference method. Bayes factor is incorporated to implement the model selection with the quantified model uncertainty. Markov Chain Monte Carlo method is used to facilitate the calculation. A pictorial framework and a step-by-step procedure of the Bayesian inference method for fatigue life estimation considering model uncertainty are presented. Fatigue life estimation of a gas turbine blade is implemented to demonstrate the proposed method.
A New Turbo-shaft Engine Control Law during Variable Rotor Speed Transient Process
Authors: Hua Wei , Miao Lizhen , Zhang Haibo , Huang Jinquan
Published: January 2015

A closed-loop control law employing compressor guided vanes is firstly investigated to solve unacceptable fuel flow dynamic change in single fuel control for turbo-shaft engine here, especially for rotorcraft in variable rotor speed process. Based on an Augmented Linear Quadratic Regulator (ALQR) algorithm, a dual-input, single-output robust control scheme is proposed for a turbo-shaft engine, involving not only the closed loop adjustment of fuel flow but also that of compressor guided vanes. Furthermore, compared to single fuel control, some digital simulation cases using this new scheme about variable rotor speed have been implemented on the basis of an integrated system of helicopter and engine model. The results depict that the command tracking performance to the free turbine rotor speed can be asymptotically realized. Moreover, the fuel flow transient process has been significantly improved, and the fuel consumption has been dramatically cut down by more than 2% while keeping the helicopter level fight unchanged.
Mehr als Historikergeplänkel
Authors: Brechtken Magnus
Published: January 2015

Vorspann

Der Umgang mit der nationalsozialistischen Vergangenheit treibt die Gesellschaft der Bundesrepublik seit Jahrzehnten um. Kontroversen über den historischen Ort des Nationalsozialismus, über den Einfluss seiner personellen Hinterlassenschaft, über das Verhältnis von Kontinuität und Bruch und über die Voraussetzungen für das Gelingen des demokratischen Experiments in einer vom Nationalsozialismus durchtränkten Gesellschaft sind untrennbar mit der Geschichte der Bundesrepublik verbunden. Der vorliegende Aufsatz ordnet die teils mit harten Bandagen geführte Debatte um „Das Amt“ in den historischen Kontext ein, benennt die Defizite des Abschlussberichts der von Außenminister Joschka Fischer einberufenen Unabhängigen Historikerkommission - und zieht mit Blick auf die positiven Impulse des vergangenheitspolitischen Diskurses eine durchaus optimistische Gesamtbilanz.
Failure to achieve disease control in acromegaly: cause analysis by a registry-based survey
Authors: Schöfl Christof , Grussendorf Martin , Honegger Jürgen , Tönjes Anke , Thyroke-Gronostay Daniel , Mayr Bernhard , Schopohl Jochen , _ _
Published: January 2015

Context

Disease control is a prime target in acromegaly treatment. This should be achievable in the vast majority of patients by available treatment options. For unknown reasons, however, a significant number of patients do not achieve disease control.

Objective

To investigate reasons for failure to achieve disease control in long-standing acromegaly.

Design and methods

Survey based on the German Acromegaly Registry database (1755 patients in 57 centres). Questionnaires were sent to 47 centres treating 178 patients with elevated disease markers (IGF1 and GH) at the last documented database visit out of 1528 patients with a diagnosis dated back ≥2 years. Thirty-three centres returned anonymised information for 120 patients (recall rate 67.4%).

Results

Median age of the 120 patients (58 females) was 57 years (range 17–84). Ninety-four patients had at least one operation, 29 had received radiotherapy and 71 had been previously treated medically. Comorbidities were reported in 67 patients. In 61 patients, disease activity had been controlled since the last documented database visit, while 59 patients still had biochemically active disease. Reasons were patients' denial to escalate therapy (23.3%), non-compliance (20.6%), fluctuating insulin-like growth factor 1 (IGF-1) and growth hormone (GH) levels with normal values at previous visits (23.3%) and modifications in pharmacotherapy (15.1%). Therapy resistance (9.6%), drug side effects (4.1%) and economic considerations (4.1%) were rare reasons.

Conclusions

Main reasons for long-standing active acromegaly were patients' lack of motivation to agree to therapeutic recommendations and non-compliance with medical therapy. Development of patient education programmes could improve long-term control and thus prognosis of acromegalic patients.
Chronic lymphocytic thyroiditis: could it be influenced by a petrochemical complex? Data from a cytological study in South-Eastern Sicily
Authors: Arena Salvatore , Latina Adele , Baratta Roberto , Burgio Giuseppe , Gullo Damiano , Benvenga Salvatore
Published: January 2015

Introduction

In genetically predisposed individuals, exogenous factors (including pollution) influence the development of Hashimoto's thyroiditis/chronic lymphocytic thyroiditis (CLT). CLT may also be a risk factor for associated thyroid cancer. Few data are available on the role of pollution from petrochemical complexes, one of which is located in the Siracusa province (South-Eastern Sicily), in the pathogenesis of CLT.

Aims

i) To study the frequency of CLT in fine-needle aspiration cytology (FNAC)-interrogated thyroid nodules from patients who were stably resident in their zones, comparing it in patients living in the petrochemical complex area (zone A) with that of patients from a control area (zone B). ii) To study the frequency of CLT in the FNAC categories of malignancy risk, comparing the two zones.

Patients and methods

We retrospectively evaluated cytologically adequate slides of 1323 nodules in 1013 outpatients who underwent ultrasound-guided FNAC from 2006 to 2012. We stratified by area of residence, gender, and FNAC categories of malignancy risk.

Results

CLT was detected with significantly greater frequency in either patients or nodules from zone A compared with zone B (32.0% vs 23.1%,P=0.002 or 28.2% vs 18.8%,P=0.0001), with a female preponderance (F=35.2% vs M=21.1% or 30.4% vs 20.4%, zone A and F=26.5% vs 12.3% or 21.6% vs 9.5%, zone B). Regardless of zone, CLT was approximately twofold more frequent in the suspiciously malignant+malignant classes (TH4+THY5=47.6%, zone A and 32.4%, zone B) compared with the benign+intermediate classes (THY2+THY3=27.3%, zone A and 18.2%, zone B), but with a clear stepwise THY2 through THY5 increase only in zone A (THY2=25.3%, THY5=66.7%; THY2=18.6%, THY5=28.6% in zone B).

Conclusions

The petrochemical complex-related pollution is an environmental factor involved in the development of CLT and, likely, in the CLT association with thyroid neoplasms.
Circulating acylghrelin levels are suppressed by insulin and increase in response to hypoglycemia in healthy adult volunteers
Authors: Lauritzen Esben S , Voss Thomas , Kampmann Ulla , Mengel Annette , Vendelbo Mikkel H , Jørgensen Jens O L , Møller Niels , Vestergaard Esben T
Published: January 2015

Objective

Ghrelin has glucoregulatory and orexigenic actions, but its role in acute hypoglycemia remains uncertain. We aimed to investigate circulating levels of acylghrelin (AG) and unacylated ghrelin (UAG) in response to hyperinsulinemia and to hypoglycemia.

Design

A randomized, single-blind, placebo-controlled crossover study including 3 study days was performed at a university hospital clinical research center.

Methods

Nine healthy men completed 3 study days: i) saline control (CTR), ii) hyperinsulinemic euglycemia (HE) (bolus insulin 0.1 IE/kg i.v. and glucose 20% i.v. for 105 min, plasma glucose ≈5 mmol/l), and iii) hyperinsulinemic hypoglycemia (HH) (bolus insulin 0.1 IE/kg i.v.).

Results

HH and HE suppressed AG concentrations at t=45–60 min as compared with CTR (P<0.05). At t=90 min, a rebound increase in AG was observed in response to HH as compared with both HE and CTR (P<0.05). UAG also decreased during HH and HE at t=45 min (P<0.05), whereas the AG-to-UAG ratio remained unaffected.

Conclusions

This study demonstrates that AG and UAG are directly suppressed by hyperinsulinemia and that AG concentrations increase after a latency of ≈1 h in response to hypoglycemia, suggesting a potential counterregulatory role of AG.
Computed tomography criteria for discrimination of adrenal adenomas and adrenocortical carcinomas: analysis of the German ACC registry
Authors: Petersenn Stephan , Richter Paul-Ajoy , Broemel Thomas , Ritter Christian O , Deutschbein Timo , Beil Frank-Ulrich , Allolio Bruno , Fassnacht Martin , _ _
Published: January 2015

Objective

Thresholds of 2–20 hounsfield units (HU) in unenhanced computed tomography (CT) are suggested to discriminate benign adrenal tumors (BATs) from malignant adrenal tumors. However, these studies included only low numbers of adrenocortical carcinomas (ACCs). This study defines a HU threshold by inclusion of a large cohort of ACCs.

Design

Retrospective, blinded, comparative analysis of CT scans from 51 patients with ACCs (30 females, median age 49 years) and 25 patients with BATs (12 females, median age 64 years) diagnosed during the period of 2005–2010 was performed.

Methods

Tumor density was evaluated in unenhanced CT by two blinded investigators.

Results

Median tumor size was 9 cm (range 2.0–20) for ACCs vs 4 cm (2.0–7.5) for BATs (P<0.0001). In ACCs, the median unenhanced HU value was 34 (range 14–74) in comparison with 5 (−13 to 40) in BATs (P<0.0001). ROC analysis revealed a HU of 21 as threshold with the best diagnostic accuracy (sensitivity 96%, specificity 80%, and AUC 0.89). However, two ACCs that were 5 and 6 cm in size would have been missed. Setting the threshold to 13.9 allowed for 100% sensitivity, but a lower specificity of 68%.

Conclusions

This first large study on ACCs confirmed that the vast majority of ACCs have unenhanced HU >21. However, to avoid misdiagnosing an ACC as benign, a threshold of 13 should be used.
Involvement of TLR7 and TLR8 in conceptus development and establishment of pregnancy in sheep
Authors: Ruiz-González Irene , Minten Megan , Wang Xiaoqiu , Dunlap Kathrin A , Bazer Fuller W
Published: January 2015

Toll-like receptors (TLRs) belong to the innate immune system and regulate inflammatory events that affect mammalian reproduction. In Study 1, we demonstrated that abundance of ovine TLR1–TLR9 mRNAs in the uterus differs due to reproductive status (TLR2, TLR3, TLR7, and TLR8) and the day of the estrous cycle and pregnancy (TLR1–TLR3, TLR5–TLR7, and TLR9). Expression of TLR7 and TLR8 proteins was localized primarily to uterine epithelia and stroma and regulated in a temporal manner. In Study 2, we determined that ovine conceptuses express TLR7 and TLR8 on all days studied and that expression of the envelope protein of ovine endogenous retrovirus (enJSRV-Env) declined in conceptus trophectoderm from Day 13 to Day 16 of pregnancy. In Study 3, loss-of-function experiments were conducted in vivo using morpholino antisense oligonucleotides (MAOs) injected into the uterine lumen to block synthesis of TLR7 and TLR8 proteins, individually and jointly. Conceptuses were recovered on Day 16 to assess their morphology. MAO-treated conceptuses were developmentally retarded, produced less interferon tau (IFNT), and had fewer binucleate cells (BNCs) compared with MAO-Controls. Moreover, expression of enJSRV-Env mRNA in MAO-TLR7 conceptuses was greater than that for MAO-Control and MAO-TLR8 conceptuses, but similar to MAO-TLR7/TLR8 conceptuses. Results of this study indicated differences in TLR1–TLR9 expression due to reproductive status and the day of the estrous cycle and pregnancy. TLR7 and TLR8 also influence development, enJSRV-Env abundance, secretion of IFNT, and formation of BNCs by conceptuses. These findings corroborate our hypothesis that TLR7 and TLR8 mediate pathways whereby enJSRV-Env regulates key peri-implantation events in conceptus development and differentiated functions of trophectoderm cells.
Theoretical Analysis and Experimental Study of Time-Varying Electric Field and Electrostatic Adhesion Force Generated by Interdigital Electrode Arrays
Authors: Rui Chen  , Xiaohong Chen  , Long Bai  , Qian Tang
Published: January 2015

A theoretical model is presented for the analysis of the electric field and electrostatic adhesion force produced by interdigital electrode arrays. The electric field is derived by solving the Laplace equation for the electrical potential in each subregion. The electrostatic adhesion force is calculated using the Maxwell stress tensor formulation. The dynamic properties of the electric field and electrostatic adhesion force are assessed by evaluating the transient response of the field and force under a step in applied voltages. Experimental studies are carried out to evaluate the adhesion performance of an electrode panel on a glass pane, and the experimental results verify the correctness of the theoretical model.
Cognitive Ability at Kindergarten Entry and Socioeconomic Status
Authors: Larson Kandyce , Russ Shirley A. , Nelson Bergen B. , Olson Lynn M. , Halfon Neal
Published: January 2015

OBJECTIVE:

To examine how gradients in socioeconomic status (SES) impact US children’s reading and math ability at kindergarten entry and determine the contributions of family background, health, home learning, parenting, and early education factors to those gradients.

METHODS:

Analysis of 6600 children with cognitive assessments at kindergarten entry from the US Early Childhood Longitudinal Birth Cohort Study. A composite SES measure based on parent’s occupation, education, and income was divided into quintiles. Wald F tests assessed bivariate associations between SES and child’s cognitive ability and candidate explanatory variables. A decomposition methodology examined mediators of early cognitive gradients.

RESULTS:

Average reading percentile rankings increased from 34 to 67 across SES quintiles and math from 33 to 70. Children in lower SES quintiles had younger mothers, less frequent parent reading, less home computer use (27%–84%), and fewer books at home (26–114). Parent’s supportive interactions, expectations for their child to earn a college degree (57%–96%), and child’s preschool attendance (64%–89%) increased across quintiles. Candidate explanatory factors explained just over half the gradients, with family background factors explaining 8% to 13%, health factors 4% to 6%, home learning environment 18%, parenting style/beliefs 14% to 15%, and early education 6% to 7% of the gaps between the lowest versus highest quintiles in reading and math.

CONCLUSIONS:

Steep social gradients in cognitive outcomes at kindergarten are due to many factors. Findings suggest policies targeting levels of socioeconomic inequality and a range of early childhood interventions are needed to address these disparities.
Quality of Life and Obstructive Sleep Apnea Symptoms After Pediatric Adenotonsillectomy
Authors: Garetz Susan L. , Mitchell Ron B. , Parker Portia D. , Moore Reneé H. , Rosen Carol L. , Giordani Bruno , Muzumdar Hiren , Paruthi Shalini , Elden Lisa , Willging Paul , Beebe Dean W. , Marcus Carole L. , Chervin Ronald D. , Redline Susan
Published: January 2015

BACKGROUND AND OBJECTIVES:

Data from a randomized, controlled study of adenotonsillectomy for obstructive sleep apnea syndrome (OSAS) were used to test the hypothesis that children undergoing surgery had greater quality of life (QoL) and symptom improvement than control subjects. The objectives were to compare changes in validated QoL and symptom measurements among children randomized to undergo adenotonsillectomy or watchful waiting; to determine whether race, weight, or baseline OSAS severity influenced changes in QoL and symptoms; and to evaluate associations between changes in QoL or symptoms and OSAS severity.

METHODS:

Children aged 5 to 9.9 years with OSAS (N = 453) were randomly assigned to undergo adenotonsillectomy or watchful waiting with supportive care. Polysomnography, the Pediatric Quality of Life inventory, the Sleep-Related Breathing Scale of the Pediatric Sleep Questionnaire, the 18-item Obstructive Sleep Apnea QoL instrument, and the modified Epworth Sleepiness Scale were completed at baseline and 7 months. Changes in the QoL and symptom surveys were compared between arms. Effect modification according to race and obesity and associations between changes in polysomnographic measures and QoL or symptoms were examined.

RESULTS:

Greater improvements in most QoL and symptom severity measurements were observed in children randomized to undergo adenotonsillectomy, including the parent-completed Pediatric Quality of Life inventory (effect size [ES]: 0.37), the 18-item Obstructive Sleep Apnea QoL instrument (ES: –0.93), the modified Epworth Sleepiness Scale score (ES: –0.42), and the Sleep-Related Breathing Scale of the Pediatric Sleep Questionnaire (ES: –1.35). Effect modification was not observed by obesity or baseline severity but was noted for race in some symptom measures. Improvements in OSAS severity explained only a small portion of the observed changes.

CONCLUSIONS:

Adenotonsillectomy compared with watchful waiting resulted in significantly more improvements in parent-rated generic and OSAS-specific QoL measures and OSAS symptoms.
Quality Improvement Measures in Pulse-Oximetry Newborn Heart Screening: A Time Series Analysis
Authors: Pflugeisen Bethann Mangel , Amoroso Paul J. , Zook Diane , Welke Karl F. , Reedy Anne , Park Matthew V.
Published: January 2015

BACKGROUND AND OBJECTIVES:

The use of pulse-oximetry screening to detect critical congenital heart defects in newborns has gained national and international momentum in the past decade. Our hospital system began screening in 2008. Since then, our program has undergone leadership changes and multiple quality improvement interventions. The aims of this study are to evaluate the evolution of our pulse-oximetry program and to provide insights from lessons learned over the course of a long-standing program.

METHODS:

We reviewed 6 years of screening data and evaluated trends of missed screens, false-positives, protocol violations, and parental decline of screening. We implemented 3 quality improvement interventions (change in protocol, redesign of an electronic medical record documentation system to autocalculate results, and transition from research to standard-of-care) and reviewed the impact of a rigorous quality assurance review process. We used linear regression and statistical process control charts to evaluate the data.

RESULTS:

A total of 18 363 newborns were screened; we identified 5 critical cases. We observed a significant decrease in missed (P < .001) and false-positive (P = .03) screens over time but found no significant trend in the rate of percentage of protocol violations (P = .26) or decline of screening (P = .99). Each metric showed behavior attributable to at least 1 quality improvement intervention.

CONCLUSIONS:

We established a sustainable pulse-oximetry screening program in our community hospital system, and the screening has now become routine. The quality of our screening was influenced by choice of screening protocol, rigor of quality assurance reviews, and the process used to interpret screening results.
Age at Gluten Introduction and Risk of Celiac Disease
Authors: Aronsson Carin Andrén , Lee Hye-Seung , Liu Edwin , Uusitalo Ulla , Hummel Sandra , Yang Jimin , Hummel Michael , Rewers Marian , She Jin-Xiong , Simell Olli , Toppari Jorma , Ziegler Anette-G. , Krischer Jeffrey , Virtanen Suvi M. , Norris Jill M. , Agardh Daniel ,   for the TEDDY STUDY GROUP
Published: January 2015

OBJECTIVES:

The goal of this study was to determine whether age at introduction to gluten was associated with risk for celiac disease (CD) in genetically predisposed children.

METHODS:

TEDDY (The Environmental Determinants of Diabetes in the Young) is a prospective birth cohort study. Newborn infants (N = 6436) screened for high-risk HLA-genotypes for CD were followed up in Finland, Germany, Sweden, and the United States. Information about infant feeding was collected at clinical visits every third month. The first outcome was persistent positive for tissue transglutaminase autoantibodies (tTGA), the marker for CD. The second outcome was CD, defined as either a diagnosis based on intestinal biopsy results or on persistently high levels of tTGA.

RESULTS:

Swedish children were introduced to gluten earlier (median: 21.7 weeks) compared with children from Finland (median: 26.1 weeks), Germany, and the United States (both median: 30.4 weeks) (P < .0001). During a median follow-up of 5.0 years (range: 1.7–8.8 years), 773 (12%) children developed tTGA and 307 (5%) developed CD. Swedish children were at increased risk for tTGA (hazard ratio: 1.74 [95% CI: 1.47–2.06]) and CD (hazard ratio: 1.76 [95% CI: 1.34–2.24]) compared with US children, respectively (P < .0001).Gluten introduction before 17 weeks or later than 26 weeks was not associated with increased risk for tTGA or CD, adjusted for country, HLA, gender, and family history of CD, neither in the overall analysis nor on a country-level comparison.

CONCLUSIONS:

In TEDDY, the time to first introduction to gluten introduction was not an independent risk factor for developing CD.
Tapentadol Toxicity in Children
Authors: Borys Douglas , Stanton Matthew , Gummin David , Drott Tracy
Published: January 2015

BACKGROUND:

Tapentadol (Nucynta) is indicated for the treatment of moderate to severe pain in adults. Tapentadol’s mechanism of action consists of acting as an agonist on the μ-opioid receptor and by inhibiting the reuptake of norepinephrine. There are no published reports on the toxicity of tapentadol in pediatric patients. The goals of this study are to describe the incidence, medical outcomes, clinical effects, and treatment secondary to tapentadol exposure.

METHODS:

This retrospective observational study used data from the National Poison Data System. Inclusion criteria were exposure to tapentadol from November 1, 2008 to December 31, 2013; age 0 to 17 years; single ingestion; and followed to a known outcome.

RESULTS:

There were 104 patients who met the inclusion criteria. Eighty patients were aged ≤6, 2-year-olds the most common age group (60.6%). There were 52 male and 52 female patients. Of the 104 patients, 93 had unintentional exposures. No deaths were reported. Sixty-two of the patients had no effect, 34 had minor effects, 6 had moderate and 2 had major effects. Thirty patients reported drowsiness and lethargy. Other effects reported included nausea, vomiting, miosis, tachycardia, respiratory depression, dizziness/vertigo, coma, dyspnea, pallor, vomiting, edema, hives/welts, slurred speech, pruritus, and hallucinations/delusions. Fifty-three patients were reported to have no medical intervention.

CONCLUSIONS:

This is the first study examining the toxic effects of tapentadol in a pediatric population. Although a majority of the patients in this review developed no effect from their exposure, two had life-threatening events. The most common effects reported were opioidlike.
Development of Hospital-Based Guidelines for Skeletal Survey in Young Children With Bruises
Authors: Wood Joanne N. , Fakeye Oludolapo , Mondestin Valerie , Rubin David M. , Localio Russell , Feudtner Chris
Published: January 2015

OBJECTIVE:

To develop guidelines for performing an initial skeletal survey (SS) for children <24 months of age presenting with bruising in the hospital setting, combining available evidence with expert opinion.

METHODS:

Applying the Rand/UCLA Appropriateness Method, a multispecialty panel of 10 experts relied on evidence from the literature and their own clinical expertise in rating the appropriateness of performing SS for 198 clinical scenarios characterizing children <24 months old with bruising. After a moderated discussion of initial ratings, the scenarios were revised. Panelists re-rated SS appropriateness for 219 revised scenarios. For the 136 clinical scenarios in which SS was deemed appropriate, the panel finally assessed the necessity of SS.

RESULTS:

Panelists agreed that SS is “appropriate” for 62% (136/219) of scenarios, and “inappropriate” for children ≥12 months old with nonpatterned bruising on bony prominences. Panelists agreed that SS is “necessary” for 95% (129/136) of the appropriate scenarios. SS was deemed necessary for infants <6 months old regardless of bruise location, with rare exceptions, but the necessity of SS in older children depends on bruise location. According to the panelists, bruising on the cheek, eye area, ear, neck, upper arm, upper leg, hand, foot, torso, buttock, or genital area necessitates SS in children <12 months.

CONCLUSIONS:

The appropriateness and necessity of SS in children presenting for care to the hospital setting with bruising, as determined by a diverse panel of experts, depends on age of the child and location of bruising.
Evaluación de la gestión financiera: empresas del sector automotriz y actividades conexas en el Atlántico
Authors: Fontalvo Herrera Tomás
Published: January 2015

Este artículo de investigación presenta los resultados la aplicación del análisis discriminante en la evaluación de lagestión financiera de las empresas del sector automotriz y actividades conexas en el Atlántico. En la metodología secalcularon los indicadores financieros, a las 14 empresas del sector. Seguidamente, se utilizó la técnica de análisismultivariante para explicar la pertenencia y discriminación de cada grupo, teniendo como resultado la correlación,incremento y la incidencia de la gestión financiera de las empresas del sector estudiado. De la función discriminantese puede concluir que los indicadores Razón Corriente (RC), Rentabilidad Operativa del Activo (RO), Apalancamientoa Corto Plazo (ACP) y Apalancamiento a Largo Plazo (ALP) presentan diferencias significativas; en el análisisde las medias los indicadores Razón Corriente (RC), Prueba Acida (PA), Rentabilidad Operativa del Activo (RO),Apalancamiento a Largo Plazo (ALP) y Nivel de Endeudamiento (NDE) mejoraron en el transcurso del 2004 y 2009
Diseño de un modelo de responsabilidad social empresarial en una empresa de consultoría a traves de la aplicación del mercadeo social
Authors: Rojas Escarria María Victoria
Published: January 2015

De acuerdo con el auge de la responsabilidad social como parte de las ventajas competitivas para desarrollarsecomo negocio, el presente artículo busca reflexionar y estudiar la importancia e incidencia de esta clave del éxitoen los escenarios empresariales dedicados a la consultoría tomando como referencia una Multinacional dedicadaa la ingeniería, consultoría e interventoría, cuya intención es convertir en elemento estratégico el conceptode responsabilidad Social. Se propone un modelo, sostenible a largo plazo, que crea una interrelación entre losstakeholders y el valor social, económico, ambiental, y operacional desarrollado en la Industria como criterio parael mejoramiento del clima organizacional, el incremento del valor de la empresa, el mejoramiento en la comunicacióninterna y externa y la confiabilidad y respaldo de los mercados financieros e inversionistas. A partir de éste,se define una estructura de mercadeo social que permite consolidar el compromiso ético y moral desarrollado encada pilar del negocio.
La Responsabilidad Social Empresarial (rse) y su implicación en la inclusión y movilidad del capital humano
Authors: Patiño Díazgranados Luz Angélica
Published: January 2015

El presente artículo aporta información relacionada con la movilidad del talento humano en empresas globalizadasy las circunstancias que rodean la movilidad del personal, entre las que se cuentan las motivaciones que los impulsana ser movilizados, las competencias requeridas para poder participar de estos procesos, los aspectos quedeterminan su adaptación al nuevo ambiente laboral así como también las circunstancias que definen el regreso asu ciudad natal. De igual manera se analiza como principio de Responsabilidad Social Empresarial, la inclusión enlos procesos de movilidad, las bondades que ofrece y el manejo de la diversidad que viene implícita en la mismay que carece de un estándar para manejarla adecuadamente en cada organización. Así mismo trata sobre la discriminaciónque trae consigo esta inclusión, a cuyos tratamientos inhumanos que se presentan con regularidad,están expuestas las minorías que son empleadas, relacionando éstas con grupos que profesan religiones o depreferencias sexuales diferentes, discriminación por sexo (hombre o mujer en cargos directivos), etnias, edad ydiscapacidad entre otras obligando a la empresa a que considere desarrollar estrategias que conduzcan a ofrecerleal trabajador un trato digno y respetuoso durante el desempeño de su labor.
Patrón autoorganizativo comunicativo de la empresa: de la intención a la acción
Authors: Ariza López Ricardo
Published: January 2015

De acuerdo con lo establecido en la intencionalidad investigativa del proyecto M arketing holístico, la empresa está enmarcada dentro de los supuestos que implican considerarla como un sistema vivo constituido por: un patrón de organización (la conﬁguración de las relaciones que determinan las características esenciales del sistema); una estructura (la corporización física del patrón de organización del sistema); y el proceso vital (la actividad involucrada en la continua corporización física del patrón de organización del sistema).  Este artículo propone una lectura sistémica de carácter complejo para determinar el patrón autoorganizativo comunicativo de la empresa  (sea cual fuere ella y el sector económico y productivo donde se encuentre caliﬁcado o inscrito) que posibilite, en el transcurso de la investigación m arketing holístico, considerar las bases para la construcción de modelos de sistemas viables para plataformas estratégicas competitivas.
El marketing holístico en la oferta de prestación de servicios de salud en Colombia
Authors: Cardenas Munévar Juan Manuel
Published: January 2015

Este texto insinúa una relación de causalidad entre el marketing holístico, el mejoramiento de los niveles de calidad y el aumento en la eﬁciencia de los procesos de prestación de servicios de salud en Colombia. El texto presenta inicialmente, la conceptualización de “mercadotecnia sanitaria”, luego la situación de la salud en Colombia anterior a la expedición y la puesta en marcha de la Ley 100 de 1993 y del Sistema de Salud derivado de la misma. Posteriormente, concep- tualiza sobre holismo y Marketing Holístico, citando  a Jan Smuts, y fragmentos de una entrevista a Philip Kotler. Finalmente deja, de alguna forma, la inquietud en el lector sobre qué tanto ha incidido el marketing holístico en la ampliación de la cobertura en la prestación de servicios de salud, mostrando en cifras la situación de los últimos seite años, de 2000 a 2006.
Mercadeando causas ambientales
Authors: Forero Diana
Published: January 2015

En el presente escrito se presentan varias alternativas para el desarrollo del mercadeo de causas ambientales a través de entidades sin ánimo de lucro. En la primera parte se exploran los modelos de mercadeo que se han empelado con mayor regula-ridad: la ﬁlantropía estratégica, el mercadeo social y el mercadeo de causas. Se muestran las actividades más comunes en cada tipo de mercadeo y algunos puntos clave para desarrollarlo. En la segunda parte se presentan las barreras para la gestión del mercadeo de causas ambientales, señalando en qué consisten esas barreras, los puntos críticos y algunas alternativas planteadas desde la comunicación organizacional, la negociación, la gestión de relaciones con clientes y el control de gestión.
Comunicar para conservar Estrategias de comunicación como apoyo a procesos de educación ambiental
Authors: Cueto Gómez Ivonne
Published: January 2015

Este articulo pretende hacer una propuesta acerca del papel de la comunicación en la transformación de nuestra relación con la naturaleza. En su primera parte hace una reﬂexión sobre la manera en que hemos construido el concepto de ambiente comosociedad, para luego establecer algunas de las principales funciones de la comunicación social en la construcción de ese concepto entre la opinión pública. Esta propuesta reúne elementos de diferentes teóricos que han aportado los fundamentos para la Comunicación para el Desarrollo haciendo especial énfasis en la importancia de la educación ambiental y su imprescindible alianza con la comunicación para construir estrategias que vinculen a las comunidades, sus realidades y sus necesidades especíﬁcas. Finalmente es una invitación a repensar la comunicación, a hacerla participativa, a hacer de esta una herramienta fundamental en la conservación, protección o recuperación de la naturaleza y en la construcción de una relación cada vez más armónica con todo aquello que nos rodea, incluyéndonos nosotros mismos.