bluuebunny/crossref_metadata_2025 huggingface dataset:
Evidence‐based practice and the need for paradigmatic pluralism in cognitive behavioural psychotherapy
Authors: GRANT A.
Published: April 2009

The scientist‐practitioner model, which is based on positivistic methodological assumptions, is influential in the development, training and practice of cognitive behavioural psychotherapists. As the emergence of ‘Nurse Cognitive Behavioural Therapist’ training in the early 1970s in Britain, many of those trained have been mental health nurses and with the emergence of the Increased Access to Psychological Therapies agenda many more are likely to undergo training. Despite some acceptance of its relevance, the scientist‐practitioner model is subject of criticism on the grounds of its achievability and contemporary relevance, and its exclusion of other modalities of counselling and psychotherapy without an, as yet, disseminated evidence base. In line with key policy‐related work, the empirical and political issues inscribed within the scientist‐practitioner model have direct implications for the educational preparation and ongoing professional development of cognitive behavioural practitioners. Specifically, in this polemical paper it is argued that there is a moral and educational need for ‘senior’ practitioners to question the philosophy of science assumptions underpinning the overwhelming dominance of the quantitative‐experimental approach in cognitive behavioural psychotherapy. Such a critically evaluative and pluralistic stance would arguably distinguish senior practitioners in terms of them being able to make broad rather than narrow appraisals of the evidence base for their practice. A recognition of the relevance of paradigmatic and epistemological pluralism in cognitive behavioural work would, it is argued, confer considerable advantages on our practice communities and clients. A range of emerging implications for cognitive behavioural education, practice and relational ethics are described and discussed.
Efficacy of a 0.0584% hydrocortisone aceponate spray in the management of canine atopic dermatitis: a randomised, double blind, placebo‐controlled trial
Authors: Nuttall Tim , Mueller Ralf , Bensignor Emmanuel , Verde Maite , Noli Chiara , Schmidt Vanessa , Rème Christophe
Published: April 2009

This study evaluated a 0.0584% hydrocortisone aceponate (HCA) spray (Cortavance®; Virbac SA, Carros, France) in canine atopic dermatitis (AD). Initially, dogs with a canine AD extent and severity index (CADESI‐03) ≥ 50 were randomly allocated to receive HCA (n = 15) or placebo (n = 13) (two sprays from 10 cm away to treat an area of 100 cm2) once daily for 28 days. Twenty‐one of the dogs then received HCA spray once daily, reducing to every other day or twice weekly over 42 days if improvement was maintained. CADESI, pruritus (14 cm visual‐analogue‐scale) and owner satisfaction (5‐point scale) were recorded every 14 days. Haematology, biochemistry and adrenocorticotrophic hormone stimulation were performed at baseline, d28 and d70 (HCA n = 9; placebo n = 7). Intention‐to‐treat data were analysed. HCA spray significantly decreased CADESI (–61.4% versus –13.4%, P = 0.0069) and pruritus (–38.8% versus +57.6%, P = 0.0015) at d28 compared to placebo. Scores were significantly decreased at d14 (CADESI –50.5%, P < 0.0021) and d28 (CADESI P < 0.0001; pruritus P = 0.018) compared to baseline following HCA but not placebo. At d28 11 of 15 and 7 of 15 HCA dogs had ≥ 50% reductions in CADESI and pruritus compared to 3 of 13 (P = 0.02) and 1 of 13 (P = 0.04) placebo dogs. Owner satisfaction scores were significantly higher in the HCA group (d28 P = 0.0001). Daily 3 of the 21 dogs required daily maintenance therapy, 7 every other day, 6 twice weekly and 5 dogs required additional therapy. Coat length did not influence the results. No adverse effects or changes to blood parameters were noted. HCA spray proved safe and effective up to 70 days. It is not, however, licensed for long‐term treatment.
Three microsporidian pathogens infecting Lymantria dispar larvae do not differ in their success in horizontal transmission
Authors: Goertz D. , Hoch G.
Published: April 2009

We quantified horizontal transmission of three microsporidian pathogens, Endoreticulatus schubergi, Nosema lymantriae and Vairimorpha disparis that infect Lymantria dispar larvae in an experiment using caged, potted oak plants. Despite marked differences in the modes of spore release from infectious hosts, no significant differences in the transmission success to uninfected, susceptible test hosts were ascertained between the tested microsporidian species. The density of initially inoculated larvae and the exposure period, on the other hand, did influence the number of infected test larvae. Depending on the density of inoculated larvae (10%, 30% or 50%), between 0% and 26% of the test larvae became infected with one of the three tested microsporidian pathogens after an exposure period of 6 days. When the exposure period was 12 days, between 11% and 76% of the test larvae became infected.
Reliability reconsidered: Cronbach's alpha and paediatric assessment in occupational therapy
Authors: Spiliotopoulou Georgia
Published: April 2009

Background/aim: Using reliable outcome measures is a necessity for the occupational therapy profession in enabling valid assessments of clients. Although Cronbach's alpha is the most widely applied index of internal consistency reliability, there are misconceptions about its use and interpretation. This paper aims to guide assessment developers in paediatric occupational therapy, as well as practitioners who are evaluating outcome measures in using and interpreting the Cronbach's alpha estimates appropriately. This will enable them to decide on the tools’ clinical value and incorporate them into their practice with children.

Method: Previously published papers reporting on internal consistency issues of outcome measures in paediatric occupational therapy were searched through the Allied and Complementary Medicine database. These papers were used as a basis to discuss possible reasons for reporting of low internal consistency.

Results: The analysis demonstrates that Cronbach's alpha reports are not always interpreted in a sound way. The paper emphasises that one should be cautious about judging estimates of internal consistency. Low size of the coefficient alpha might not always indicate problems with the construction of the tool; whereas large sizes do not always suggest adequate reliability. Instead, these reports might be related to the data characteristics of the construct.

Conclusion: In judging an outcome measure's internal consistency, researchers and practitioners in occupational therapy should report and consider the nature of data, the scale's length and width, the linearity and the normality of response distribution, the central response tendency, the sample response variability and the sample size.
The significance of measurement of serum unbound bilirubin concentrations in high‐risk infants
Authors: Lee Yong‐Kye , Daito Yasuyo , Katayama Yoshinori , Minami Hirotaka , Negishi Hirokuni
Published: April 2009

Background:  In the management of neonatal hyperbilirubinemia, total bilirubin (TB) concentration is not specific enough to predict the brain damage caused by bilirubin toxicity. Unbound bilirubin (UB) easily passes the blood–brain barrier and causes neurotoxicity. We aimed to evaluate whether serum UB concentration would be a useful predictor of bilirubin encephalopathy in high‐risk infants.

Methods:  We measured the serum TB and UB concentrations of 388 newborn infants treated with phototherapy or exchange transfusion for their hyperbilirubinemia at Takatsuki General Hospital between January 2002 and October 2003. Peak serum TB and UB levels and UB/TB ratios were studied on each birthweight group: below 1500 g (very low birthweight), 1500 g–2499 g (low birthweight), above 2500 g (normal birthweight); and several clinical factors influencing hyperbilirubinemia were also studied.

Results:  Peak serum TB and UB levels increased with increasing birthweight, while UB/TB ratios decreased. The very low birthweight group showed higher UB levels and UB/TB ratios despite lower TB levels in intraventricular hemorrhage or severe infection compared to those in the others. The low birthweight and normal birthweight groups showed higher TB and UB levels in cases of hemolytic disease of the newborn compared to non‐hemolytic disease of the newborn cases. Eight of 44 cases showed high UB levels accompanied by abnormal auditory brainstem responses, one of whom subsequently developed ataxic cerebral palsy with hearing loss, whereas the other seven showed transient abnormalities of auditory brainstem responses by the treatment of exchange transfusion or phototherapy.

Conclusion:  The UB measurement was considered to be significant for the assessment of the risk of bilirubin neurotoxicity and the appropriate intervention for hyperbilirubinemia in high‐risk infants.
Association of a single nucleotide polymorphism in the constitutive androstane receptor gene with bone mineral density
Authors: Urano Tomohiko , Usui Takahiko , Shiraki Masataka , Ouchi Yasuyoshi , Inoue Satoshi
Published: April 2009

Background:  Nuclear receptors play an important role in bone metabolism. In bone cells, the vitamin D receptor (VDR) and the steroid and xenobiotic receptor (SXR) are activated by vitamin D and vitamin K2, respectively. VDR and SXR are the NR1I subfamily members of nuclear receptors. We speculated that the constitutive androstane receptor (CAR), the third member of the NR1I subfamily, also could be implicated in the regulation of bone metabolism. Therefore, we analyzed expression of CAR mRNA in osteoblasts and then examined association of a single nucleotide polymorphism (SNP) in the human CAR gene at intron 2 (IVS2–99C>T, rs2502815) with bone mineral density (BMD).

Methods:  Expression levels of CAR mRNA were analyzed during the culture course of rat primary osteoblasts. Association of an SNP in the CAR gene with BMD was examined in 548 healthy Japanese postmenopausal women.

Results:  CAR mRNA increased at day 16 and then increased during culture of rat primary osteoblasts. The increase of CAR mRNA was parallel with the increase of alkaline phosphatase expression, a differentiation marker of osteoblasts. As a result of association study of an SNP in the CAR gene at intron 2, subjects with the CC genotype (n = 208) had significantly higher BMD than subjects with the TT or CT genotype (n = 340) (lumbar spine BMD, P = 0.0185; total body BMD, P = 0.0416).

Conclusion:  CAR mRNA was expressed and regulated in primary osteoblasts. A genetic variation at the CAR gene locus is associated with BMD, suggesting an involvement of the CAR gene in bone metabolism.
Phenotypical aspects of maturity‐onset diabetes of the young (MODY diabetes) in comparison with Type 2 diabetes mellitus (T2DM) in children and adolescents: experience from a large multicentre database
Authors: Schober E. , Rami B. , Grabert M. , Thon A. , Kapellen Th. , Reinehr Th. , Holl R. W.
Published: April 2009

Aims  To analyse and compare clinical characteristics in young patients with maturity‐onset diabetes of the young (MODY) and Type 2 diabetes mellitus (T2DM).

Methods  We conducted an observational investigation using the DPV‐Wiss database containing clinical data on 40 757 diabetic patients < 20 years of age from Germany and Austria.

Results  Three hundred and thirty‐nine cases were clinically categorized as MODY (0.83%); 562 patients were diagnosed as T2DM (1.4%). In 20% of cases, the diagnosis of MODY was based on clinical findings only. Of the 272 subjects where genetic testing was available, 3% did not carry mutations in the three examined MODY genes. Glucokinase‐MODY was commoner than HNF1A‐MODY and HNF4A‐MODY. Age at diagnosis was younger in MODY patients. The body mass index of T2DM was significantly higher compared with all MODY subgroups. Macrovascular risk factors such as dyslipidaemia and hypertension were commoner in T2DM, but 23% of MODY patients had dyslipidaemia and 10% hypertension. Glycaemic control was within the therapeutic target (HbA1c < 7.5%) in 86% of MODY and 70% of T2DM patients.

Conclusions  The prevalence of MODY in children and adolescents in Germany and Austria is lower than that of T2DM in this age group. Dyslipidaemia and hypertension are less frequent in MODY compared with T2DM patients, but do occur.
Multilevel Regression Mixture Analysis
Authors: Muthén Bengt , Asparouhov Tihomir
Published: April 2009

A two-level regression mixture model is discussed and contrasted with the conventional two-level regression model. Simulated and real data shed light on the modelling alternatives. The real data analyses investigate gender differences in mathematics achievement from the US National Education Longitudinal Survey. The two-level regression mixture analyses show that unobserved heterogeneity should not be presupposed to exist only at level 2 at the expense of level 1. Both the simulated and the real data analyses show that level 1 heterogeneity in the form of latent classes can be mistaken for level 2 heterogeneity in the form of the random effects that are used in conventional two-level regression analysis. Because of this, mixture models have an important role to play in multilevel regression analyses. Mixture models allow heterogeneity to be investigated more fully, more correctly attributing different portions of the heterogeneity to the different levels.
Central retinal artery occlusion: timing and mode of presentation
Authors: Rudkin A. K , Lee A. W. , Chen C. S.
Published: April 2009

Background and purpose:  Central retinal artery occlusion (CRAO) is a sudden, frequently irreversible, monocular vision loss, analogous to acute cerebral ischaemia. Thrombolysis may improve visual outcomes, but it is unclear what the acceptable timing of administration should be. We aim to ascertain, through audit, the timing and mode of presentation of individuals with potentially thrombolysable CRAOs.

Methods:  A retrospective audit of patients with acute thromboembolic CRAO.

Results:  Thirty‐one patients were identified. Mean time from onset of vision loss to presentation was 31 ± 65 h. Eighteen patients (58%) presented within 20 h of vision loss, and the majority presented first to a general practitioner. Fifteen patients (48%) were reviewed by an in‐hospital ophthalmologist within 20 h of vision loss. The mean delay from the referring source to assessment by an in‐hospital ophthalmologist was 5.2 h (median 3.3 h, range 50 min to 24 h). This delay was, on average, shorter for patients referred directly to an ophthalmology clinic.

Conclusions:  Just under half (48%) of our cohort of CRAO patients were reviewed by an in‐hospital ophthalmologist within the 20‐h therapeutic time window for thrombolytic therapy and thus could qualify for inclusion in a randomized controlled trial according to EAGLE inclusion criteria. If thrombolysis is proven to be a feasible and safe treatment in CRAO then public awareness should be raised of the symptoms and an efficient direct referral pathway to an in‐hospital ophthalmologist established to aid treatment delivery.
Spontaneous release of acetylcholine from autonomic nerves in the bladder
Authors: Zagorodnyuk VP , Gregory S , Costa M , Brookes SJH , Tramontana M , Giuliani S , Maggi CA
Published: April 2009

Background and purpose:  Bladder contractility is regulated by intrinsic myogenic mechanisms interacting with autonomic nerves. In this study, we have investigated the physiological role of spontaneous release of acetylcholine in guinea pig and rat bladders.

Experimental approach:  Conventional isotonic or pressure transducers were used to record contractile activity of guinea pig and rat bladders.

Key results:  Hyoscine (3 µmol·L−1), but not tetrodotoxin (TTX, 1 µmol·L−1), reduced basal tension, distension‐evoked contractile activity and physostigmine (1 µmol·L−1)‐evoked contractions of the whole guinea pig bladder and muscle strips in vitro. ω‐Conotoxin GVIA (0.3 µmol·L−1) did not affect physostigmine‐induced contractions when given either alone or in combination with ω‐agatoxin IVA (0.1 µmol·L−1) and SNX 482 (0.3 µmol·L−1). After 5 days in organotypic culture, when extrinsic nerves had significantly degenerated, the ability of physostigmine to induce contractions was reduced in the dorso‐medial strips, but not in lateral strips (which have around 15 times more intramural neurones). Most muscle strips from adult rats lacked intramural neurones. After 5 days in culture, physostigmine‐induced or electrical field stimulation‐induced contractions of the rat bladder strips were greatly reduced. In anaesthetized rats, topical application of physostigmine (5–500 nmol) on the bladder produced a TTX‐resistant tonic contraction that was abolished by atropine (4.4 µmol·kg−1 i.v.).

Conclusions and implications:  The data indicate that there is spontaneous TTX‐resistant release of acetylcholine from autonomic cholinergic extrinsic and intrinsic nerves, which significantly affects bladder contractility. This release is resistant to blockade of N, P/Q and R type Ca2+ channels.

British Journal of Pharmacology (2009) 157, 607–619; doi:10.1111/j.1476‐5381.2009.00166.x; published online 3 April 2009
Peripheral endocannabinoid dysregulation in obesity: relation to intestinal motility and energy processing induced by food deprivation and re‐feeding
Authors: Izzo Angelo A , Piscitelli Fabiana , Capasso Raffaele , Aviello Gabriella , Romano Barbara , Borrelli Francesca , Petrosino Stefania , Di Marzo Vincenzo
Published: April 2009

Background and purpose:  Endocannabinoids in tissues controlling energy homeostasis are altered in obesity, thus contributing to metabolic disorders. Here we evaluate endocannabinoid dysregulation in the small intestine of mice with diet‐induced obesity (DIO) and in peripheral tissues of Zucker and lean rats following food deprivation and re‐feeding.

Experimental approach:  Intestinal transit, evaluated using rhodamine‐B‐labelled dextran, and small intestinal endocannabinoid levels, measured by liquid chromatography mass spectrometry, were measured in mice fed normal or high‐fat diets (HFDs). Endocannabinoid levels were measured also in various tissues of lean and Zucker rats fed ad libitum or following overnight food deprivation with and without subsequent re‐feeding.

Key results:  After 8 weeks of HFD, baseline intestinal transit was increased in DIO mice and enhanced by cannabinoid CB1 receptor antagonism less efficaciously than in lean mice. Small intestinal anandamide and 2‐arachidonoylglycerol levels were reduced and increased respectively. In Zucker rats, endocannabinoids levels were higher in the pancreas, liver and duodenum, and lower in the subcutaneous adipose tissue. Food deprivation increased endocannabinoid levels in the duodenum and liver of both rat strains, in the pancreas of lean rats and in adipose tissues of Zucker rats.

Conclusions and implications:  Reduced anandamide levels might account for increased intestinal motility in DIO mice. Regulation of endocannabinoid levels in rat peripheral tissues, induced by food deprivation and re‐feeding, might participate in food intake and energy processing and was altered in Zucker rats. These data, together with previous observations, provide further evidence for dysregulation of peripheral endocannabinoids in obesity.
An imbalance in C/EBPs and increased mitochondrial activity in asthmatic airway smooth muscle cells: novel targets in asthma therapy?
Authors: Roth Michael , Black Judith L
Published: April 2009

The asthma prevalence was increasing over the past two decades worldwide. Allergic asthma, caused by inhaled allergens of different origin or by food, is mediated by inflammatory mechanisms. The action of non‐allergic asthma, induced by cold air, humidity, temperature or exercise, is not well understood. Asthma affects up to 15% of the population and is treated with anti‐inflammatory and muscle relaxing drugs which allow symptom control. Asthma was first defined as a malfunction of the airway smooth muscle, later as an imbalanced immune response of the lung. Recent studies placed the airway smooth muscle again into the focus. Here we summarize the molecular biological basis of the deregulated function of the human airway smooth muscle cell as a cause or important contributor to the pathology of asthma. In the asthmatic human airway smooth muscle cells, there is: (i) a deregulation of cell differentiation due to low levels of maturation‐regulating transcription factors such as CCAAT/enhancer binding proteins and peroxisome proliferator‐activated receptors, thereby reducing the cells threshold to proliferate and to secrete pro‐inflammatory cytokines under certain conditions; (ii) a higher basal energy turnover that is due to increased number and activity of mitochondria; and (iii) a modified feedback mechanism between cells and the extracellular matrix they are embedded in. All these cellular pathologies are linked to each other and to the innate immune response of the lung, but the sequence of events is unclear and needs further investigation. However, these findings may present the basis for the development of novel curative asthma drugs.
The Study of Terrorism After 11 September 2001: Problems, Challenges and Future Developments
Authors: Jackson Richard
Published: April 2009

Terrorism studies is one of the fastest-growing areas of social scientific research in the English-speaking world. This article examines some of the main challenges, problems and future developments facing the wider terrorism studies field through a review of seven recently published books. It argues that while a great deal of the current research is characterised by a persistent set of weaknesses, an increasing number of theoretically rigorous and critically oriented studies that challenge established views suggest genuine reasons for optimism about the future of terrorism research.
Four Perspectives on Terrorism: Where They Stand Depends on Where You Sit
Authors: Butko Thomas J.
Published: April 2009

The general assumption is that there is one objective and universally applicable conceptualization of ‘terrorism’. This position is especially prominent in the United States and other Western countries after the terrorist attacks of 9/11. Yet, despite such a view, it is possible to distinguish four specific perspectives or paradigms on terrorism: standard/mainstream, radical, relativist and constructivist. While the standard/mainstream approach remains dominant among academics, intelligence analysts and policy makers, the other positions have exhibited their own adherents. In the end, it will be argued that the constructivist perspective is the most accurate. Since ‘terrorism’ remains too contentious and disputed a term to achieve universal consensus, the constructivist approach has been the most effective in stressing the decisive role that parochial state and national interests perform in any conceptualization of ‘terrorism’, especially the strategic and security concerns of the dominant or hegemonic power(s) within the international system.
Gender, Violence and Global Politics: Contemporary Debates in Feminist Security Studies
Authors: Shepherd Laura J.
Published: April 2009

In this essay I develop a critique of the war/peace dichotomy that is foundational to conventional approaches to IR through a review of three recent publications in the field of feminist security studies. These texts are Cynthia Enloe's (2007) Globalization and Militarism, David Roberts' (2008) Human Insecurity, and Mothers, Monsters, Whores: Women's Violence in Global Politics by Laura Sjoberg and Caron Gentry (2008). Drawing on the insights of these books, I ask first how violence is understood in global politics, with specific reference to the gendered disciplinary blindnesses that frequently characterise mainstream approaches. Second, I demonstrate how a focus on war and peace can neglect to take into account the politics of everyday violence: the violences of the in-between times that international politics recognises neither as ‘war’ nor ‘peace’ and the violences inherent to times of peace that are overlooked in the study of war. Finally, I argue that feminist security studies offers an important corrective to the foundational assumptions of IR, which themselves can perpetuate the very instances of violence that they seek to redress. If we accept the core insights of feminist security studies – the centrality of the human subject; the importance of particular configurations of masculinity and femininity; and the gendered conceptual framework that underpins the discipline of IR – we are encouraged to envisage a rather different politics of the global.
Implant–Bone Interface Stress Distribution in Immediately Loaded Implants of Different Diameters: A Three‐Dimensional Finite Element Analysis
Authors: Ding Xi , Zhu Xing‐Hao , Liao Sheng‐Hui , Zhang Xiu‐Hua , Chen Hong
Published: April 2009

Purpose: To establish a 3D finite element model of a mandible with dental implants for immediate loading and to analyze stress distribution in bone around implants of different diameters.

Materials and Methods: Three mandible models, embedded with thread implants (ITI, Straumann, Switzerland) with diameters of 3.3, 4.1, and 4.8 mm, respectively, were developed using CT scanning and self‐developed Universal Surgical Integration System software. The von Mises stress and strain of the implant–bone interface were calculated with the ANSYS software when implants were loaded with 150 N vertical or buccolingual forces.

Results: When the implants were loaded with vertical force, the von Mises stress concentrated on the mesial and distal surfaces of cortical bone around the neck of implants, with peak values of 25.0, 17.6 and 11.6 MPa for 3.3, 4.1, and 4.8 mm diameters, respectively, while the maximum strains (5854, 4903, 4344 μɛ) were located on the buccal cancellous bone around the implant bottom and threads of implants. The stress and strain were significantly lower (p < 0.05) with the increased diameter of implant. When the implants were loaded with buccolingual force, the peak von Mises stress values occurred on the buccal surface of cortical bone around the implant neck, with values of 131.1, 78.7, and 68.1 MPa for 3.3, 4.1, and 4.8 mm diameters, respectively, while the maximum strains occurred on the buccal surface of cancellous bone adjacent to the implant neck, with peak values of 14,218, 12,706, and 11,504 μm, respectively. The stress of the 4.1‐mm diameter implants was significantly lower (p < 0.05) than those of 3.3‐mm diameter implants, but not statistically different from that of the 4.8 mm implant.

Conclusions: With an increase of implant diameter, stress and strain on the implant–bone interfaces significantly decreased, especially when the diameter increased from 3.3 to 4.1 mm. It appears that dental implants of 10 mm in length for immediate loading should be at least 4.1 mm in diameter, and uniaxial loading to dental implants should be avoided or minimized.
An Approach to Define Clinical Significance in Prosthodontics
Authors: John Mike T. , Reißmann Daniel R. , Szentpétery András , Steele James
Published: April 2009

Purpose: The concept of the minimal important difference (MID) of an oral health‐related quality of life (OHRQoL) questionnaire has been proposed to refer to the smallest OHRQoL score difference considered to be clinically important in oral health. This study determined the MID for the 49‐item Oral Health Impact Profile (OHIP) in prosthodontic patients. This could serve as a patient‐based approach to define clinical significance for prosthodontic interventions.

Materials and Methods: A consecutive sample of 224 adult patients completed the OHIP questionnaires twice before treatment was performed and 4 to 6 weeks after prosthodontic treatment was finished. At follow‐up patients were asked about their overall impression of the treatment (global transition; answer categories “improved a lot,”“improved a little,”“stayed the same,”“worsened a little,” and “worsened a lot”).

Results: The median of baseline and follow‐up differences in OHIP (change scores) was computed for subjects (N = 47) reporting a “little improvement.” This figure was considered the MID for the OHIP, and it was found to be 6 OHIP units (95% confidence interval: 2 to 9).

Conclusion: The MID of the OHIP is an important benchmark to assess individual and group treatment effects in prosthodontics and could be used to approach what is clinically significant in terms of patient‐based outcomes.
Packed blood cells stored in AS‐5 become proinflammatory during storage
Authors: McFaul Steve J. , Corley Jason B. , Mester Craig W. , Nath Jayasree
Published: April 2009

BACKGROUND: Studies have shown that packed blood cells (PBCs) stored in AS‐1 (Adsol, Baxter) and AS‐3 (Nutricel, Medsep Corp.) accumulate proinflammatory substances, which may contribute to increased complications from allogeneic blood transfusion. This study assessed whether supernates from PBCs stored in AS‐5 (Optisol, Terumo Corp.) prime neutrophils (PMNs), activate platelets (PLTs), and accumulate proinflammatory cytokines and PMN granule constituents.

STUDY DESIGN AND METHODS: PBC units were prepared in AS‐5 from nonleukoreduced (NLR) and leukoreduced (LR) whole‐blood units and stored at 4°C. Supernates from samples of PBCs collected at various storage times were analyzed by multiplex enzyme‐linked immunosorbent assay for proinflammatory cytokines and myeloperoxidase (MPO) and were incubated with type‐matched blood, which was assessed by flow cytometry for expression of CD11b on PMNs, CD62P on PLTs, and formation of PMN‐PLT aggregates.

RESULTS: Supernates from NLR PBCs stored for at least 14 days elevated CD11b expression on PMNs and the number of PMN‐PLT aggregates compared to supernates from collection day PBCs. The magnitude of these effects correlated with storage age. Supernates from LR PBCs did not elicit these responses. Expression of CD62P on PLTs was not affected by supernates from either NLR or LR PBCs. Levels of interleukin (IL)‐1β, IL‐6, IL‐8, IL‐18, NAP‐2, MCP‐1, RANTES, and MPO were elevated in supernates from 28‐ and 42‐day NLR units. Tumor necrosis factor α and MIP‐1α did not increase, and cytokine levels in LR PBC units did not increase.

CONCLUSION: Units of NLR PBCs stored in AS‐5 become increasingly proinflammatory as a function of storage time. Leukoreduction prevents this change.
Clinical significance of serologic markers related to red blood cell autoantibodies production after red blood cell transfusion—severe autoimmune hemolytic anemia occurring after transfusion and alloimmunization: successful treatment with rituximab
Authors: Sigler Erica , Shvidel Lev , Yahalom Vered , Berrebi Alain , Shtalrid Mordechai
Published: April 2009

BACKGROUND: The association of autoantibody formation with blood transfusion was previously noted. Severe autoimmune hemolytic anemia (AIHA) diagnosed after red blood cell (RBC) transfusion determined us to undertake this study and investigate the incidence and clinical significance of autoantibodies occurring after transfusion by a retrospective review of blood bank and medical records.

STUDY DESIGN AND METHODS: We report a lymphoma patient who developed severe autohemolysis after blood transfusion and alloantibody production. The hemolysis was refractory to steroids and chemotherapy and ceased after rituximab. We also retrospectively assessed the blood bank records for a 2‐year period to identify the patients who developed autoantibodies after blood transfusion and examined laboratory, clinical features, and outcome.

RESULTS: From January 2005 through December 2006, 375 direct antiglobulin tests (DATs) and 3409 indirect antiglobulin tests (IATs) were found to be positive. Thirty‐eight patients with positive DATs and IATs had demonstrable RBC warm‐type autoantibodies occurring after blood transfusion; 27 of them had also one or more alloantibodies. Clinical and laboratory signs of hemolysis were absent in all patients (except the case reported). In another 5 patients alloantibodies were retrieved from RBC eluate and serum without evidence of autoantibodies; therefore, a delayed serologic transfusion reaction was diagnosed.

CONCLUSION: RBC autoantibodies are quite commonly found after blood transfusion. Nevertheless, clinically significant AIHA is a rare but at times a life‐threatening phenomenon. We describe a first case of successful treatment with rituximab of refractory posttransfusion AIHA. Rituximab must be further evaluated for this indication.
Oral squamous cell carcinoma: overview of current understanding of aetiopathogenesis and clinical implications
Authors: Scully C , Bagan JV
Published: April 2009

MEDLINE contains well over 14 000 papers revealed by a search using keywords ‘oral squamous cell cancer’ or ‘oral squamous cell carcinoma’, over 27 000 using ‘oral carcinoma’ and over 48 000 using the keywords ‘oral cancer’. It is difficult to see how clinicians could keep abreast of such a subject. This paper attempts to help by providing an overview of the aetiopathogenesis of oral squamous cell carcinoma (OSCC), discussing changes in epidemiology and increasing awareness of the wide range of risk factors, emphasising the genetic background to cancer susceptibility and the genetic changes associated with progression to OSCC and highlighting clinical implications.
Neuroprotective Effects of Diazepam, Carbamazepine, Phenytoin and Ketamine after Pilocarpine‐induced Status Epilepticus
Authors: Cunha Alexandra Olimpio Siqueira , Mortari Márcia Renata , Liberato José Luiz , Dos Santos Wagner Ferreira
Published: April 2009

Abstract:  Cell damage and spatial localization deficits are often reported as long‐term consequences of pilocarpine‐induced status epilepticus. In this study, we investigated the neuroprotective effects of repeated drug administration after long‐lasting status epilepticus. Groups of six to eight Wistar rats received microinjections of pilocarpine (2.4 mg/µl, 1 µl) in the right dorsal hippocampus to induce a status epilepticus, which was attenuated by thiopental injection (35 mg/kg, i.p.) 3 hrs after onset. Treatments consisted of i.p. administration of diazepam, ketamine, carbamazepine, or phenytoin at 4, 28, 52, and 76 hr after the onset of status epilepticus. Two days after the treatments, rats were tested in the Morris water maze and 1 week after the cognitive tests, their brains were submitted to histology to perform haematoxylin and eosin staining and glial fibrillary acidic protein (GFAP) immunofluorescence detection. Post‐status epilepticus rats exhibited extensive gliosis and cell loss in the hippocampal CA1, CA3 (70% cell loss for both areas) and dentate gyrus (60%). Administration of all drugs reduced cell loss in the hippocampus, with best effects observed in brains slices of diazepam‐treated animals, which showed less than 30% of loss in the three areas and decreased GFAP immunolabelling. Treatments improved spatial navigation during training trials and probe trial, with exception of ketamine. Interestingly, in the probe trial, only diazepam‐treated animals showed preference for the goal quadrant. Our data point to significant neuroprotective effects of repeated administration of diazepam against status epilepticus‐induced cell damage and cognitive disturbances.
Heat and Moisture Transport Through the Micro-Climate Air Annulus of the Clothing-Skin System Under Periodic Motion
Authors: Ghaddar N. , Ghali K. , Jaroudi E.
Published: April 2009

A dynamic thermal model is developed using the 2D cylinder model of Ghaddar et al [1] of ventilated fabric-skin system where a microclimate air annulus separates an outer cylindrical fabric boundary and an inner human body solid boundary for closed and open apertures. The cylinder model solves for the radial, and angular flow rates in the microclimate air annulus domain where the inner cylinder is oscillating within an outer fixed cylinder of porous fabric boundary. The 2-D cylinder model is further developed in the radial and angular directions to incorporate the heat and moisture transport from the inner cylinder when the fabric touches the skin boundary at repetitive finite intervals during the motion cycle. The touch model is based on a lumped fabric transient approach based on the fabric dry and evaporative resistances at the localized touch regions at the top and bottom of points of the cylinder. The film coefficients at the inner cylinder are needed for the model simulation. Experiments are conducted in an environmental chamber under controlled conditions to measure the mass transfer coefficient at the skin to the air annulus separating the wet skin and the fabric in the cylindrical geometry. In addition, experiments have also been conducted at ventilation frequencies of 30, 40, and 60 rpm to measure the sensible heat loss from the inner cylinder to validate the predictions of sensible and latent heat losses of the 2-D ventilation model for the two cases when fabric is in contact with the skin surface and when no contact is present for close aperture. The model prediction of time-averaged steady-periodic sensible heat loss agreed well with the experimentally measured values. A parametric study is performed to predict sensible and latent heat losses from the system by ventilation at different frequencies, fabric skin contact times during the motion cycle measured by a dimensionless amplitude parameter (ζ = amplitude/mean annular spacing). The rate of heat loss increases with increased ventilation frequency at fixed ζ. The latent heat loss in the contact region increases by almost 40% due to increase in fabric temperature during contact. The sensible heat loss decreases between 3% at f = 60 rpm, and 5% at f = 25 rpm in the contact region due to higher air temperature and lack of heat loss by radiation during the contact between fabric and skin.
Numerical Simulation of Reacting Flows in Radiant Porous Burners
Authors: Tong Timothy W. , Abou-Ellail Mohsen M. M. , Li Yuan , Beshay Karam R.
Published: April 2009

The present paper presents, numerical computations for flow, heat transfer and chemical reactions in an axisymmetric inert porous burner. The porous media re-radiate the heat absorbed from the gaseous combustion products by convection and conduction. In the present work, the porous burner species mass fraction source terms are computed from an ‘extended’ reaction mechanism, controlled by chemical kinetics of elementary reactions. The porous burner has mingled zones of porous/nonporous reacting flow, i.e. the porosity is not uniform over the entire domain. Therefore, it has to be included inside the partial derivatives of the transport governing equations. Finite-difference equations are obtained by formal integration over control volumes surrounding each grid node. Up-wind differencing is used to insure that the influence coefficients are always positive to reflect the real effect of neighboring nodes on a typical central node. Finite-difference equations are solved, iteratively, for U, V, p’ (pressure correction), enthalpy and species mass fractions, utilizing a fine grid of (80×60) nodes. The eighty grid nodes in the axial direction are needed to resolve the detailed structure of the thin reaction zone inside the porous media. The radial grid is extended inside the annular solid wall of the porous burner, to compute the wall temperature. The porous burner uses a premixed CH4-air mixture, while its radiating characteristics are computed numerically, using a four-flux radiation model. Sixteen species are included, namely CH4, CH3, CH2, CH, CH2O, CHO, CO, CO2, O2, O, OH, H2, H, H2O, H2O, H2O2, involving 49 chemical reaction equations. It was found that 1000 iterations are sufficient for complete conversion of the computed results with errors less than 0.1%. The computed temperature profiles of the gas and the solid show that, heat is conducted from downstream to the upstream of the reaction zone. Most stable species, such as H2O, CO2, H2, keep increasing inside the reaction zone staying appreciable in the combustion products. However, unstable products, such as HO2, H2O2 and CH3, first increase in the preheating region of the reaction zone, they are then consumed fast in the post-reaction zone of the porous burner. Therefore, it appears that their important function is only to help the chemical reactions continue to their inevitable completion of the more stable combustion products.
Variable Test Furnace Cooling
Authors: Bussman Wesley R. , Baukal Charles E. , French Kenneth W.
Published: April 2009

Testing burners in the process industries requires controlling both the furnace temperature and the firing rate independently. This has commonly been done by varying the amount of insulation inside a test furnace. This paper discusses using a bayonet heat exchanger system to vary the furnace temperature at a fixed firing rate. The heat transfer inside the furnace to the heat exchanger system is considered.
Evaluation of General Correlations for Heat Transfer During Boiling of Saturated Liquids in Tubes and Annuli
Authors: Shah M. Mohammed
Published: April 2009

Six of the most verified correlations for boiling heat transfer were compared to data for horizontal and vertical tubes and annuli. The correlations evaluated were: Chen (1966), Shah (1982), Gungor and Winterton (1986), Liu & Winterton (1991), Kandlikar (1990), and Steiner and Taborek (1992). The database used to evaluate these correlations included 29 fluids: water, refrigerants, cryogens, organic and inorganic chemicals. The data cover reduced pressures from 0.005 to 0.783, mass flux from 28 to 11071 kg/m2s, vapor quality from 0 to 0.95, and boiling number from 0.000026 to 0.00742. The correlations of Shah and Gungor & Winterton gave the best agreement with data with a mean deviation of about 17.5%, only a couple of data sets showing large deviations. The paper presents and discusses the results of this study. Included are tables giving the range of dimensional and non-dimensional parameters covered by each experimental study.
Heat Transfer Performance of a Porous Metal Foam/Phase Change Material System: Part 1 — Freezing
Authors: Siahpush A. S. , O’Brien J. E. , Williams B.
Published: April 2009

A detailed experimental study has been performed to evaluate the heat transfer performance of a solid/liquid phase-change thermal energy storage system that includes porous metal foam. The phase-change material (PCM) and metal foam were contained in a vertically oriented test cylinder that is cooled at its outside boundary, resulting in radially inward freezing. As the PCM freezes, the solid/liquid interface moves inward from the surface of the test cylinder, and a thermal resistance layer is built up, resulting in a reduced heat transfer rate between the system to be cooled and the PCM. The porous material used in this research was intended to minimize the insulating effect of this thermal resistance layer. In the freezing case study, a one-dimensional mathematical model was developed, which considered heat conduction as the only mode of heat transfer. The effective thermal conductivity of the porous media saturated with solid eicosane was predicted utilizing several models and compared with the measured effective thermal conductivity. The results of this study are discussed in terms of the effectiveness of the metal foam as a heat transfer enhancement device.
Conjugate Heat Transfer in an Optical Fiber Coating Process
Authors: Yoo Sang-Yeoun , Jaluria Yogesh
Published: April 2009

The optical fiber coating process in an axi-symmetric applicator and die system was simulated in this study. Various thermal conditions and process variables are investigated. Ultra-violet (UV) curable acrylates are used for the coating material, whose properties are highly dependent on temperature. Conjugate heat transfer is considered at the moving fiber surface since the fiber constantly exchanges energy with the contacting fluid. The temperature level in the applicator and die is found to increase with fiber speed, the increase being the highest in the die whose wall temperature is kept fixed. This high temperature rise is primarily due to the tremendous viscous dissipation within the fluid, especially in the die. It is important to avoid high temperatures in the fluid because the polymer starts to crosslink and degrade. The fiber temperature at the entrance was also found to be of substantial importance. This work can be used to improve the quality of the coating, particularly its uniformity, and the production rate.
Flow Boiling in Microchannels
Authors: Peters Kathleen H. , Kulacki Francis A.
Published: April 2009

Experiments are reported on convective boiling of water in a system of parallel micro-channels with a constant wall heat flux and highly sub-cooled inlet flow. The test section comprises a nickel plate containing ∼388 micro-channels along the center-plane with a mean hydraulic diameter of 145 μm with and a mean separation of 35 μm. The data set spans wall heat fluxes from 94 to 152 kW/m2, 8 < G < 24 kg/m2-s, and 2 < Re < 40. These parameters produce Weber, capillary and boiling numbers one to two orders of magnitude below those of the current published database. Overall heat transfer coefficients in flow boiling are estimated in the range 65 to 325 kW/m2-K. The present experiments more nearly emulate conditions for practical micro-channel heat exchangers compared to those of reported studies using artificially induced two-phase flows and either one or several micro-channels.
Multi-Hole Film Cooling With Integrally Woven SiC-SiC Ceramic Wall Panels
Authors: Mehta Jayesh M. , Shouse Dale , Neuroth Craig , Marshall Dave , Cox Brian
Published: April 2009

This paper presents numerical analyses of coupled heat transfer for multi-hole cooling of an integrally woven ceramic matrix composite, suitable for use in a combustor liner. The results indicate potential benefit in expanding the current design space for the combustor liners to include shallow film injection angles, very small diameter film holes, and a film injection scheme that features opposing cooling jets. These features can be conveniently produced in integrally woven SiC-SiC ceramic composite panels to yield film effectivenesses that are significantly higher than the current technology that is based on super alloy panels. This has the potential for significant cooling air saving that can be re-introduced in the combustor dome region and result in lower NOx emissions.
Spiral-Plate Heat Exchanger Effectiveness With Equal Capacitance Rates
Authors: Burmeister Louis C.
Published: April 2009

A formula is derived for the dependence of heat exchanger effectiveness on the number of transfer units for a spiral-plate heat exchanger with equal capacitance rates. The difference-differential equations that describe the temperature distributions of the two counter-flowing fluids, neglecting thermal radiation, are solved symbolically to close approximation. Provision is made for offset inlet and exit of the hot and cold fluids at the outer periphery and for large heat transfer coefficients in entrance regions. The peak effectiveness and the number of transfer units at which it occurs are predicted.
Brownian-Motion-Based Convective-Conductive Model for the Thermal Conductivity of Nanofluids
Authors: Prasher Ravi
Published: April 2009

The research community has been perplexed for the past five years with the unusually high effective thermal conductivity of nanofluids. Although various mechanisms and models have been proposed in the literature to explain the high conductivity of these nanofluids, no concrete conclusions have been reached. Through an order-of-magnitude analysis of various possible mechanisms, we show that convection caused by the Brownian movement of these nanoparticles is primarily responsible for the enhancement in the thermal conductivity of such colloidal nanofluids. We also introduce a convective-conductive model which accurately captures the effects of particle size, choice of base liquid, thermal interfacial resistance between the particles and liquid, temperature, etc. This model is a combination of the Maxwell-Garnett (MG) conduction model and the convection caused by the Brownian movement of the nanoparticles, and reduces to the MG model for large particle sizes.