bluuebunny/crossref_metadata_2025 huggingface dataset:
Procter & Gamble, mass media, and the making of American life
Authors: McGuigan Lee
Published: April 2015

Owing to its unmatched sponsorship of commercial broadcasting and the ubiquity of its homemaking goods, Procter & Gamble (P&G) has had a profound impact on culture and society in the United States. From a critical political economy approach, this article documents P&G’s historical contributions to the commercial system of broadcasting in the United States. At the nexus of entertainment, industry, and domesticity, P&G provides a unique case study for probing the political economy of capitalism in the United States, with particular emphasis on commodity consumption and the reproduction of labor power in the home. It is argued that the significance of P&G has less to do with direct message effects, and more to do with the institutional formation of broadcasting as both an advertiser-supported industry and a daily ritual commanding human resources of time and attention.
Direction-dependence analysis
Authors: Wiedermann Wolfgang , von Eye Alexander
Published: April 2015

The concept of direction dependence has attracted growing attention due to its potential to help decide which of two competing linear regression models ( X → Y or Y → X) is more likely to reflect the correct causal flow. Several tests have been proposed to evaluate hypotheses compatible with direction dependence. In this issue, Thoemmes (2015) reports results of an empirical evaluation of direction-dependence tests using real-world data sets with known causal ordering and concludes that the tests (known to perform excellent in simulation studies) perform poorly in the real-world setting. The present article aims at answering the question how this is possible. First, we review potential conceptual issues associated with Thoemmes’ (2015) approach. We argue that direction dependence is best conceptualized as a confirmatory approach to test focused directional theories. Thoemmes’ (2015) evaluation is based on an exploratory use of direction dependence. It implicitly follows the tradition of causal search algorithms. Second, we discuss potential statistical issues associated with Thoemmes’ (2015) selection schemes used to decide whether a variable pair is suitable for direction-dependence analysis. Based on these issues, new tests of direction dependence as well as new guidelines for confirmatory direction-dependence analysis are proposed. An empirical example is given to illustrate the application of these guidelines.
Generalized reciprocal collision avoidance
Authors: Bareiss Daman , van den Berg Jur
Published: April 2015

Reciprocal collision avoidance has become a popular area of research over recent years. Approaches have been developed for a variety of dynamic systems ranging from single integrators to car-like, differential-drive, and arbitrary, linear equations of motion. In this paper, we present two contributions. First, we provide a unification of these previous approaches under a single, generalized representation using control obstacles. In particular, we show how velocity obstacles, acceleration velocity obstacles, continuous control obstacles, and LQR-obstacles are special instances of our generalized framework. Secondly, we present an extension of control obstacles to general reciprocal collision avoidance for non-linear, non-homogeneous systems where the robots may have different state spaces and different non-linear equations of motion from one another. Previous approaches to reciprocal collision avoidance could not be applied to such systems, as they use a relative formulation of the equations of motion and can, therefore, only apply to homogeneous, linear systems where all robots have the same linear equations of motion. Our approach allows for general mobile robots to independently select new control inputs while avoiding collisions with each other. We implemented our approach in simulation for a variety of mobile robots with non-linear equations of motion: differential-drive, differential-drive with a trailer, car-like, and hovercrafts. We also performed physical experiments with a combination of differential-drive, differential-drive with a trailer, and car-like robots. Our results show that our approach is capable of letting a non-homogeneous group of robots with non-linear equations of motion safely avoid collisions at real-time computation rates.
Alcohol use amongst older adults: Knowledge and beliefs of occupational therapists working in physical health care settings
Authors: Maclean Fiona , Gill Jan , O’May Fiona , Breckenridge Jenna
Published: April 2015

Introduction

There is little discussion in the United Kingdom occupational therapy literature surrounding the topic of older people and alcohol, despite the growing prevalence of alcohol-related health problems in older adults resulting from an ageing population and changing patterns of consumption. Occupational therapists in physical health care settings are likely to work with older people whose drinking pattern may not be alcohol dependent, but may put their physical or psychological health at risk.

Method

A survey methodology was employed using open and closed questions, recruiting occupational therapists (band 5 to 9) ( n = 122) working with older people (65+ years) in physical health care settings across all, except one, National Health Service Regional Health Boards in Scotland.

Results

Responses highlight gaps in occupational therapists’ knowledge around alternative ‘safe limits’ of alcohol intake for older people. Belief in professional role was evident, but the perception was that this was not supported by undergraduate education. Occupation focused theory and assessment were not prioritized when considering alcohol in the older adult.

Conclusion

This study has highlighted a need to develop pre- and post-qualification education for occupational therapists, to enhance understanding of theory, assessment and knowledge of alcohol with older adults in physical health care settings.
Association of Equipment Worn and Concussion Injury Rates in National Collegiate Athletic Association Football Practices
Authors: Kerr Zachary Y. , Hayden Ross , Dompier Thomas P. , Cohen Randy
Published: April 2015

Background:

The epidemiology of football-related concussions has been extensively examined. However, although football players experience more at-risk exposure time during practices than competitions, there is a dearth of literature examining the nature of the activities or equipment worn during practice. In particular, varying levels of equipment worn during practices may place players at varying levels of risk for concussion.

Purpose:

To describe the epidemiology of NCAA men’s football concussions that occurred during practices from the 2004-2005 to 2008-2009 academic years by amount of equipment worn.

Study Design:

Descriptive epidemiology study.

Methods:

Men’s collegiate football data from the National Collegiate Athletic Association Injury Surveillance System (NCAA ISS) during the 5-year study period were analyzed. Injury rates and injury rate ratios (RRs) were reported with 95% confidence intervals.

Results:

During the study period, 795 concussions were reported during practices, resulting in an injury rate of 0.39 per 1000 athlete-exposures (AEs) (95% CI, 0.36-0.42). Among NCAA divisions, Division III had the highest concussion rate (0.54/1000 AEs), followed by Division I (0.34/1000 AEs) and Division II (0.24/1000 AEs) (all P values for RRs comparing divisions <.001). Most concussions in practice occurred when players were fully padded (69.9%), followed by wearing shells (23.5%) and helmets only (1.9%). The practice concussion rate was higher in fully padded practices (0.66/1000 AEs) compared with practices when shells were worn (0.33/1000 AEs; RR = 1.99 [95% CI, 1.69-2.35]; P < .001) and practices when only helmets were worn (0.03/1000 AEs; RR = 22.39 [95% CI, 13.41-37.39]; P < .001). The practice concussion rate of the preseason (0.76/1000 AEs) was higher than that of the regular season (0.18/1000 AEs; RR = 4.14 [95% CI, 3.55-4.83]; P < .001) and that of postseason (0.25/1000 AEs; RR = 3.02 [95% CI, 1.95-4.67]; P < .001). The types of practice with the highest concussion rate were scrimmages (1.55/1000 AEs). Although only 3 concussions were sustained during scrimmage practices in which players wore shells, the concussion rate (2.84/1000 AEs) was higher than all other reported rates.

Conclusion:

Practice concussion rates are highest during fully padded practices, preseason practices, and scrimmages, suggesting that the nature, focus, and intensity of football practices affect concussion risk. In addition, coaching staff should continue to closely monitor player safety during scrimmages. Meanwhile, future surveillance should examine whether removing scrimmages, particularly those that are not fully padded, will meaningfully reduce the incidence and rate of concussions.
An Evaluation of Second Step
Authors: Sullivan Terri N. , Sutherland Kevin S. , Farrell Albert D. , Taylor Katherine A.
Published: April 2015

The impact of a school-based violence prevention program, Second Step, on peer victimization and aggression, and emotion regulation was evaluated among 457 sixth graders. A cluster-randomized trial was conducted with classrooms randomly assigned to intervention ( n = 14) or control ( n = 14) conditions. A repeated measures analysis of covariance on each measure was conducted using random effects. Several intervention effects were moderated by gender and disability status. Teacher-rated relational victimization at posttest decreased for students with disabilities in intervention but not control classrooms. Students without disabilities in intervention classrooms reported greater decreases from pretest to 6-month follow-up in overt aggression. Boys in the intervention classrooms had smaller increases in teacher-rated overt aggression at posttest than boys in control classrooms. Girls in intervention classrooms reported greater decreases from pretest to 6-month follow-up in relational aggression than girls in control classrooms. Study implications and directions for future research are discussed.
Parents’ Experiences as Predictors of State Accountability Measures of Schools’ Facilitation of Parent Involvement
Authors: Elbaum Batya , Blatz Erin T. , Rodriguez Raymond J.
Published: April 2015

The aim of this study was to ascertain which dimensions of parents’ experiences with schools are most strongly associated with parents’ perceptions that schools are or are not facilitating parent involvement as mandated by the federal accountability system under the Individuals With Disabilities Education Act (IDEA). Participants were 92 parents of students with disabilities from 18 schools in 8 school districts in a large southeastern state. Parents completed the quantitative measure used by their state to report on schools’ parent engagement efforts; they then described their experiences collaborating with their child’s school. Data from the qualitative analysis of parents’ comments were transformed into quantitative variables used to predict success, defined as meeting the state’s standard on the quantitative measure of schools’ facilitation of parent involvement. Results suggested that schools prioritize responsive communication with parents and careful monitoring of students’ progress to improve collaborative relationships with parents of students with disabilities.
The Sound of Intellect
Authors: Schroeder Juliana , Epley Nicholas
Published: April 2015

A person’s mental capacities, such as intellect, cannot be observed directly and so are instead inferred from indirect cues. We predicted that a person’s intellect would be conveyed most strongly through a cue closely tied to actual thinking: his or her voice. Hypothetical employers (Experiments 1–3b) and professional recruiters (Experiment 4) watched, listened to, or read job candidates’ pitches about why they should be hired. These evaluators rated a candidate as more competent, thoughtful, and intelligent when they heard a pitch rather than read it and, as a result, had a more favorable impression of the candidate and were more interested in hiring the candidate. Adding voice to written pitches, by having trained actors (Experiment 3a) or untrained adults (Experiment 3b) read them, produced the same results. Adding visual cues to audio pitches did not alter evaluations of the candidates. For conveying one’s intellect, it is important that one’s voice, quite literally, be heard.
Analgesic use of inhaled methoxyflurane
Authors: Dayan AD
Published: April 2015

Methoxyflurane is a volatile, halogenated analgesic, self-administered in a controlled low dose from the Penthrox® inhaler for short-term pain relief. It was formerly used in significantly higher doses to produce anaesthesia, when it caused a specific type of dose-related renal tubular damage. The pathogenesis of the renal damage and clinical use of methoxyflurane are discussed here with evidence that a low but effective analgesic dose is not associated with the risk of renal adverse effects. The maximum dose employed to produce analgesia is limited to methoxyflurane 6 mL/day and 15 mL/week, producing a minimum alveolar concentration (MAC) of 0.59 MAC-hours. Renal damage is due to the metabolism of methoxyflurane and release of fluoride ions. Exposure of humans to methoxyflurane ≤2.0 MAC-hours, resulting in serum fluoride ≤40 µmol/L, has not been associated with renal tubular toxicity. The safety margin of analgesic use of methoxyflurane in the Penthrox® inhaler is at least 2.7- to 8-fold, based on methoxyflurane MAC-hours or serum fluoride level, with clinical experience suggesting it is higher. It is concluded from clinical experience in emergency medicine, surgical procedures and various experimental and laboratory investigations that the analgesic use of methoxyflurane in subanaesthetic doses in the Penthrox inhaler does not carry a risk of nephrotoxicity.
Radioprotection of 1,2-dimethylhydrazine-initiated colon cancer in rats using low-dose γ rays by modulating multidrug resistance-1, cytokeratin 20, and β-catenin expression
Authors: Nabil HM , Hassan BN , Tohamy AA , Waaer HF , Abdel Moneim AE
Published: April 2015

Ionizing radiation is a widely used therapy for solid tumors. However, high-dose ionizing radiation causes apoptosis, transforms normal cells into tumor cells, and impairs immune functions, leading to the defects in the removal of damaged or tumor cells. In contrast, low-dose radiation has been reported to exert various beneficial effects in cells. This experimental study investigated the effect of γ rays at low dose on the development of colorectal tumor in a 1,2-dimethylhydrazine (DMH)-induced colon cancer. Colorectal tumor model was induced in Wistar rats by subcutaneous injection of DMH (20 mg/kg) once a week for 15 weeks. Starting from zero day of DMH injection, a single low dose of whole-body γ irradiation of 0.5 Gy/week was applied to the rats. A significant reduction in lipid peroxidation, nitric oxide, and elevation in the glutathione content and antioxidant enzyme activity (superoxide dismutase and catalase) were observed after γ irradiation comparing with DMH group. Moreover, γ ray reduced the expressions of multidrug resistance 1 (MDR1), β-catenin, and cytokeratin 20 (CK20) those increased in DMH-treated rats. However, survivin did not change with γ ray treatment. A histopathological examination of the DMH-injected rats revealed ulcerative colitis, dysplasia, anaplasia, and hyperchromasia. An improvement in the histopathological picture was seen in the colon of rats exposed to γ rays. In conclusion, the present results showed that low-dose γ ray significantly inhibited DMH-induced colon carcinogenesis in rats by modulating CK20, MDR1, and β-catenin expression but not survivin expression.
EU posted work and transnational action in the German meat industry
Authors: Wagner Ines
Published: April 2015

This article traces the course of a transnational action in the German meat industry involving an alliance of transnational posted workers, a local civil society organization and the trade union NGG (Gewerkschaft Nahrung-Genuss-Gaststätten). As labour’s channels of influence have broken down and posting of low-wage workers has intensified, trade unionists have responded by building coalitions with societal actors. The case illustrates a complementary approach to studying how resistance unfolds in transnational workplaces under conditions in which traditional avenues for protest are blocked or marginalized.
Austerity, personalization and the degradation of voluntary sector employment conditions
Authors: Cunningham Ian
Published: April 2015

This qualitative study of two social care organizations, explores how public sector austerity and policies to personalize social care services through introducing individual budgets in the UK combine to reshape employment conditions. It further explores how these new market relations impact on staff morale and commitment. The individual case summaries reveal a remarkable degree of similarity in terms of employment outcomes, with social care workers experiencing an erosion of the standard employment relationship. Workers experience greater insecurity in areas of pay and conditions, working time, training and development, career prospects, along with work intensification. Worker morale appeared vulnerable as employees struggled to cope with worsening working conditions, but also expressed concerns with quality of care in an era of austerity.
A Tale of Two Transitions
Authors: Pellegrino Lauren , Hoggan Chad
Published: April 2015

Surprisingly few empirical studies examine the experience of veterans as they transition into community college. Using Schlossberg’s transition model and 4S framework—situation, self, supports, and strategies—this article portrays a subset of findings from a qualitative study involving recent military veterans transitioning into community college. Findings comprise biographical vignettes of two female veterans entering their first year of community college. Although the findings align with some existing research, this study illustrates the complex and nuanced issues that veteran students face, including strained finances and lack of familiarity with college structure. For female veterans, these issues are often further complicated by circumstances such as motherhood and marriage.
Virtual Mentoring of Preservice Teachers
Authors: Reese Jill
Published: April 2015

The purpose of the study was to describe music teachers’ perceptions of the benefits and challenges they experienced as virtual mentors of preservice music teachers. Each mentor was assigned a cohort of preservice teachers who were enrolled in an elementary general music methods course. Cohorts observed their mentor’s teaching via Skype. Mentors watched video of their cohort field teaching. After each experience, mentors met their cohorts via Skype for feedback and reflection. Data included mentors’ written reflections and interviews. Virtual experiences were valuable but different from traditional mentoring experiences. Benefits were similar to those identified by traditional mentors. Use of technology alleviated some challenges associated with face-to-face mentoring. Challenges of virtual mentoring related to limits of current technology. Music teacher educators, administrators, and policymakers should consider findings when making decisions about technology-based professional development experiences and teacher evaluation programs.
Using a 3D Immersive Virtual Environment System to Enhance Social Understanding and Social Skills for Children With Autism Spectrum Disorders
Authors: Cheng Yufang , Huang Cheng-Li , Yang Chung-Sung
Published: April 2015

Children with autism spectrum disorders (ASDs) have a severe deficiency in social understanding and skills. The present study utilized single-subject design ( N = 3) with multiple probes to investigate the effectiveness of a three-dimensional social understanding system with a head-mounted display to improve social understanding and skills in three children with ASD. We tested the proposed system based on immersive virtual environments. The target behaviors of non-verbal communication, social initiations, and social cognition for each participant and the impact of using immersive digital equipment with this population were examined simultaneously. A preliminary empirical study for three participants diagnosed with ASD was conducted over a 6-week period. The findings indicate that participants’ targeted behaviors improved from baseline to intervention through maintenance following their use of the system. These suggest that the system may present an effective learning environment for the promotion of social understanding and skills in children with ASD.
What is Russia’s real homicide rate? Statistical reconstruction and the ‘decivilizing process’
Authors: Lysova Alexandra , Shchitov Nikolay
Published: April 2015

This article examines a paradox that relates to the issue of homicide in Russia. On the one hand, official police statistics demonstrate a rapid decline in the homicide rate in Russia in the 2000s, which is consistent with the stable economic growth (in particular after the financial crisis of 1998) and a stable political environment during the presidency of Vladimir Putin. On the other hand, other conditions and processes (e.g. rampant corruption, predatory policing, political repressions, state violence against businesses, rising xenophobia and apathy) point to what Norbert Elias terms a ‘decivilizing process’, which is expected to be associated with a less precipitous decline in homicide or stable homicide rate in this period. In fact, newly available homicide estimates suggest that the homicide rate was higher than and did not decline at a pace suggested by the official police and mortality sources in the 2000s. Hence, this article has two main objectives. First, it discusses issues around homicide statistics in Russia and argues that the newly available homicide estimates represent the more accurate statistics. Second, it explores decivilizing process theory as a potential framework for explaining a high and steady homicide rate in Russia in the 2000s.
Molecular dynamics simulation of defected carbon nanotubes
Authors: Rafiee Roham , Mahdavi Mohammad
Published: April 2015

The influence of vacancy defects on the Young’s modulus of carbon nanotubes (CNTs) is studied. Firstly, the Young’s moduli of nondefected CNTs are predicted using two different nonlinear force fields. The stress–strain curves of CNTs are obtained up to the failure points and corresponding Young’s modulus and failure strain are reported. Then, the influence of CNTs diameter, chirality, and length on the results is extensively analyzed. Secondly, the influence of vacancy defects on the Young’s modulus of CNT is evaluated using molecular dynamics simulation. Both numbers and locations of defects are treated as random parameters. Therefore, stochastic modeling procedure is employed. The Young’s modulus of defected CNTs are obtained and compared with nondefected ones. The obtained results are compared with available date in literature. It is revealed that nanoscale continuum modeling which is used as a compromise in modeling of nanostructure underestimates the reduction level in the Young’s modulus of defected CNTs. A linear reduction trend is observed for the Young’s modulus of defected CNTs with respect to the number of vacancy defects. Moreover, the locations of defects play an important role in defining the degree to which the Young’s modulus decreases.
Junior doctor dementia champions in a district general hospital (innovative practice)
Authors: Wilkinson Iain , Coates Anna , Merrick Sophie , Lee Chooi
Published: April 2015

Dementia is a common condition in the UK with around 25% of patients in acute hospitals having dementia. In the UK, there is national guidance on the assessment of cognitive impairment in acute hospitals. This article is a qualitative study of junior doctors' experiences as part of a dementia and delirium team involved in changing the care of patients with dementia in a hospital in the UK. It draws on data from a focus group and follow-up questionnaire in two hospital trusts. We examine what drives doctors to become involved in such projects and the effects of this experience upon them. We suggest a typology for getting junior doctors involved in projects generating change when working with patients with dementia. Being more actively involved in caring for and developing services for patients with dementia may represent the crossing of an educational threshold for these junior doctors.
Individual variations in ankle brachial index measurement among Turkish adults
Authors: Demir Orhan , Tasci Ilker , Acikel Cengizhan , Saglam Kenan , Gezer Mustafa , Acar Ramazan , Yildiz Birol , Bulucu Fatih , Kabul Hasan Kutsi , Dogan Mustafa Inanc , Koc Bayram
Published: April 2015

Purpose

Variability of ankle brachial index (ABI) measured by the same observer in the same individual on three different occasions was examined.

Basic methods

A single morning ABI was initially determined (measurement 1) with handheld Doppler device. One to four weeks apart, another morning (measurement 2) and afternoon (measurement 3) ABI was measured on the same day.

Principal findings

A total of 161 adults were enrolled. Mean ABI was similar among the three measurements. ABI differed more than ≥0.15 in 15 individuals between measurement 1 and 3, in 10 subjects between measurement 1 and 2, and in 12 individuals between measurement 2 and 3. Intra-group correlation coefficients of reproducibility of ABI were 0.808 for single measurements (coefficient of the values lacking association with each other), and 0.927 for average measurements (coefficient of the values that were associated with each other).

Conclusions

Although reproducibility of ABI values was found satisfactory, up to 12% of participants displayed more than 0.15 alternations between measurements, either on the same day or more than a week apart.
Interprofessional student-run primary health care clinics
Authors: Weidmann Anita E. , Pammett Robert , Landry Eric , Jorgenson Derek
Published: April 2015

Introduction:

Interprofessional student-run primary health care clinics have been a flagship model of health professional education in Canada for many years. The purpose of this study was to determine if there is support for implementing this educational model in the United Kingdom and to highlight the implications for pharmacy education in Scotland.

Method:

A cross-sectional postal survey of 3000 randomly selected citizens of Aberdeen city and shire, Scotland, aged 18 years and older.

Results:

Of the 824 questionnaires that were returned (response rate 27.5%), more than half of the respondents (62.4%; n = 514) would consider accessing health care from a student-led, walk-in service. The range of services they expect to see includes general health checks (60%; n = 494), help for sexually transmitted diseases (57.5%; n = 474), weight management (56.8%; n = 468), smoking cessation (54.4%; n = 448) and drug misuse services (47.2%; n = 387). Concerns raised pertained to student ability, suitability for children and accessibility. Many comments pertained to the improvement of the current system by offering after-hours care.

Discussion:

The positive response from the general public towards an interprofessional student-run primary health care clinic in Aberdeen suggests that this Canadian model of interdisciplinary health professional education would likely be a successful addition to the pharmacy curriculum in Scotland.
A calibrated measuring tape accurately predicts tidal volumes from ulna length
Authors: Rivers Jon , Brown Jules , Dolphin Kirsty , Squire Yolande
Published: April 2015

Background

Low tidal volume ventilation improves outcomes in acute respiratory distress syndrome. Calculation of this volume requires knowledge of a patient’s gender, and height, which may not be available in emergency admissions, and the subsequent application of a nomogram. The objective of this study was to test the accuracy of a calibrated measuring tape that reads in mL of tidal volume when the ulna is measured.

Methods

The measuring tape was used to obtain an estimate of a subject’s tidal volume from their ulna length, and standing height was then measured (reference method).

Result

A total of 100 healthy volunteers were included. Mean tidal volume was 450 mL for males and 372 mL for females when calculated from the height. Comparing tidal volumes from the tape with those from the reference method, Bland Altman analysis showed a bias of −10 mL (limits of agreement (2SD) −74 mL to 54 mL) for males and a bias of −36 mL (limits of agreement (2SD) −88 mL to 16 mL) for females. Predicted mean tidal volumes were 5.7 mL/kg (95% CI: 5.1–6.3 mL/kg) for males and 5.8 mL/kg (95% CI: 5.3–6.2 mL/kg) for females.

Conclusions

Usage of a calibrated measuring tape produced accurate estimates of tidal volumes required for lung protective ventilation in healthy volunteers.
Housing Choices and Care Home Design for People With Dementia
Authors: Hadjri Karim , Rooney Cliona , Faith Verity
Published: April 2015

This article reviews the current state of housing for people with dementia by exploring housing choices available to this group, and identifying potential issues with design of care homes. Older people who wish to age in place are faced with the challenge of adapting their domestic environment to ensure independence, accessibility, and social connectivity. This is even more challenging for people with dementia who continue to live at home, given the risks of self-harm and getting lost. More imaginative and inclusive forms of collective housing are needed. For people with dementia, a move to a new environment is often a stressful experience that causes shock, withdrawal, and anger. Hence, more research is needed to develop more fitting long-term housing options for people with dementia. This article presents a brief review on housing choices and housing design for people with dementia. Interviews with managers of 22 care homes were conducted to explore housing choices and design issues. Results show that the main housing choices available to people with dementia offer different levels of care. The choice of care homes relates to the atmosphere of a home as some occupants favor a homely or relaxing environment and others prefer dynamic settings. A combination of appropriate level of care, a good atmosphere, and design quality within the care home are elements that lead to a more enabling environment. Design of a successful caring environment also requires appropriate care and a positive therapeutic and domestic-looking environment.
Communication failures during clinical handovers lead to a poor patient outcome: Lessons from a case report
Authors: Manias Elizabeth , Geddes Fiona , Watson Bernadette , Jones Dorothy , Della Phillip
Published: April 2015

In the emergency department, communication failures occur in clinical handover due to the urgent, changing and unpredictable nature of care provision. We present a case report of a female patient who was assaulted, and identify how various factors interacted to produce communication failures at multiple clinical handovers, leading to a poor patient outcome. Several handovers created many communication failures at diverse time points. The bedside medical handover produced misunderstandings during verbal exchange of information between emergency department consultants and junior doctors, and there was miscommunication involving plastic registrars. There was a failure in adequately informing the general practitioner and the patient relating to follow-up care after discharge. Deficiencies of communication occurred with conveying changes in an investigative report. Communication could be improved by dividing the conduct of handover in a quiet room and at the bedside, ensuring multiple sources of information are used and encouraging role-modelling behaviours for junior clinicians.
Cellulitis in Obesity
Authors: Theofiles Meghan , Maxson Julie , Herges Lori , Marcelin Alberto , Angstman Kurt B.
Published: April 2015

Purpose: Cellulitis in obese patients is associated with increased rates of treatment failure compared to those with normal body mass index (BMI); however, patients have not been extensively studied in the outpatient environment or stratified based on range of obesity and associated risk factors. This study looked at antibiotic dosing and treatment failure in the obese population from the primary care perspective and accounts for BMI range, weight, comorbid diabetes, and tobacco use. Methods: This study was a retrospective chart review of 637 adult primary care patients designed to evaluate rates of treatment failure of outpatient cellulitis among patients of varying BMI. Treatment failure was defined as ( a) hospital admission for intravenous antibiotics, ( b) prolonged antibiotic course, or ( c) requiring a different antibiotic after initial course. Results: Adverse outcomes were not statistically significant between normal BMI and those with BMI ≥40 kg/m2. A subset of patients with a BMI ≥50 kg/m2 was noted to have approximately twice the rate of adverse outcomes as the normal BMI group. While controlling for age, gender, race, diagnosis of diabetes mellitus, and tobacco use, a BMI of ≥50 kg/m2 and a weight ≥120 kg was associated with adverse outcomes with an odds ratio of 2.440 (95% CI, 1.260-4.724; P = .008) and 2.246 (95% CI, 1.154-4.369; P = .017), respectively. Conclusions: Patients with cellulitis weighing >120kg or with a BMI ≥50 kg/m2 were at greatest risk for treatment failure in the outpatient setting, even when controlling for comorbid diabetes and tobacco use. As morbid obesity continues to become more prevalent, it becomes imperative that primary care physicians have better antibiotic dosing guidelines to account for the physiologic effects of obesity to minimize the risk of increased morbidity, health care costs, and antibiotic resistance.
Rest
Authors: Asp Margareta
Published: April 2015

Rest is a health-related phenomenon. Researchers have explored the phenomenon of rest, but further concept development is recommended. The aim of my study was to develop and describe a concept of rest, from interviews with a total of 63 participants about their lived experiences of rest. I performed the developing process in two stages: first with descriptive phenomenology and second with a hermeneutic approach. The concept of rest is comprised of the essences of both rest and “non-rest,” and there is a current movement between these two conditions in peoples’ lives. The essence of rest is being in harmony in motivation, feeling, and action. The essence of non-rest is being in disharmony in motivation, feeling, and action. The essences reveal some meaning constituents. Health care professionals and researchers can use the concept as a frame of reference in health care praxis and in applied research.
DNA-functionalized silicon nitride nanopores for sequence-specific recognition of DNA biosensor
Authors: Tan Shengwei , Wang Lei , Yu Jingjing , Hou Chuanrong , Jiang Rui , Li Yanping , Liu Quanjun
Published: April 2015

Nanopores have been proven to be novel and versatile single-molecule sensors for individual unlabeled biopolymer detection and characterization. In the present study, a relatively large silicon nitride (Si3N4) nanopore with a diameter of approximately 60 nm was fabricated successfully using a focused Ga ion beam (FIB). We demonstrated a simple ex situ silanization procedure to control the size and functionality of solid-state nanopores. The presented results show that by varying the silanization time, it is possible to adjust the efficiency of probe molecule attachment, thus shrinking the pore to the chosen size, while introducing selective sensing probes. The functionalization of nanopores was verified by analysis of field-emission scanning electron microscopy (FESEM), energy-dispersive X-ray spectroscopy (EDS), and electrical measurements. Based on this study, we envision that the functionalized silicon nitride nanopores with the DNA probe might provide a biosensing platform for the detection and discrimination of a short single-stranded DNA oligomer of unknown sequences in the future.
An international multicenter retrospective study of Pseudomonas aeruginosa nosocomial pneumonia: impact of multidrug resistance
Authors: Micek Scott T , Wunderink Richard G , Kollef Marin H , Chen Catherine , Rello Jordi , Chastre Jean , Antonelli Massimo , Welte Tobias , Clair Bernard , Ostermann Helmut , Calbo Esther , Torres Antoni , Menichetti Francesco , Schramm Garrett E , Menon Vandana
Published: April 2015

Introduction

Pseudomonas aeruginosanosocomial pneumonia (Pa-NP) is associated with considerable morbidity, prolonged hospitalization, increased costs, and mortality.

Methods

We conducted a retrospective cohort study of adult patients withPa-NP to determine 1) risk factors for multidrug-resistant (MDR) strains and 2) whether MDR increases the risk for hospital death. Twelve hospitals in 5 countries (United States, n = 3; France, n = 2; Germany, n = 2; Italy, n = 2; and Spain, n = 3) participated. We compared characteristics of patients who had MDR strains to those who did not and derived regression models to identify predictors of MDR and hospital mortality.

Results

Of 740 patients withPa-NP, 226 patients (30.5%) were infected with MDR strains. In multivariable analyses, independent predictors of multidrug-resistance included decreasing age (adjusted odds ratio [AOR] 0.91, 95% confidence interval [CI] 0.96-0.98), diabetes mellitus (AOR 1.90, 95% CI 1.21-3.00) and ICU admission (AOR 1.73, 95% CI 1.06-2.81). Multidrug-resistance, heart failure, increasing age, mechanical ventilation, and bacteremia were independently associated with in-hospital mortality in the Cox Proportional Hazards Model analysis.

Conclusions

Among patients withPa-NP the presence of infection with a MDR strain is associated with increased in-hospital mortality. Identification of patients at risk of MDRPa-NP could facilitate appropriate empiric antibiotic decisions that in turn could lead to improved hospital survival.
A reservation-based call admission control scheme and system modeling in 4G vehicular networks
Authors: Halabian Hassan , Rengaraju Perumalraja , Lung Chung-Horng , Lambadaris Ioannis
Published: April 2015

In 4G cellular networks, call admission control (CAC) has a direct impact on quality of service (QoS) for individual connections and overall system efficiency. Reservation-based CAC schemes have been previously proposed for cellular networks where a certain amount of system bandwidth is reserved for high-priority calls, e.g., hand-off calls and real-time new calls. Traditional reservation-based schemes are not efficient for 4G vehicular networks, as the reserved bandwidth may not be utilized effectively in low hand-off rates. We propose a channel borrowing approach in which new best effort (BE) calls can borrow the reserved bandwidth for high-priority calls. Later, if a hand-off call arrives and all the channels are busy, it will pre-empt the service of a borrower BE call if there exists any. The pre-empted BE calls are kept in a queue and resume their service whenever a channel becomes available. The analytical model for this scheme is a mixed loss-queueing system for which it is difficult to calculate call blocking probability (CBP) and call dropping probability (CDP). Our focus in this paper is on the system modeling and performance evaluation of the proposed scheme. We present two system models that approximate the operation of the proposed scheme. For these models, we derive the CBP and CDP analytically. It is shown that our analytical results are very close to the ones obtained from simulations. Furthermore, it is observed that our channel borrowing approach decreases the CBP considerably while increases the CDP slightly over a large range of hand-off rates.
Association of glutathione S-transferase (GSTM1 and GSTT1) genes with chronic myeloid leukemia
Authors: Kassogue Yaya , Dehbi Hind , Quachouh Meryem , Quessar Asma , Benchekroun Said , Nadifi Sellama
Published: April 2015

Chronic myeloid leukemia (CML), as most of cancers results from a complex interaction between genetic or non genetic factors. Exposures to xenobiotics endogenous or exogenous associated with a reduced individual ability in detoxifying activity, constitutes a risk of developing cancer. It is known that polymorphism of glutathione S-transferases (GSTs) genes affects the detoxification of xenobiotics. Thus, we conducted a case-control study in which 92 patients (Mean age ± SD, 40.62 ± 12.7 years) with CML and 93 healthy unrelated controls (Mean age ± SD, 41.38 ± 13.4 years) have participated.GSTM1andGSTT1genotypes were determined by multiplex polymerase chain reaction. Logistic regression was used to assess the possible link betweenGSTM1andGSTT1null genotypes and CML as well as between combined genotypes and CML.GSTM1null genotype frequency was slightly higher in patients than control (48.9% vs. 40.9%) but, it was not associated with CML (OR 95% CI, 1.4, 0.78-2.48; p = 0.271). Moreover,GSTT1null genotype frequency showed a similar trend between patients and control (17.4% vs. 9.7%; OR 95% CI, 1.97, 0.82-4.71; p = 0.13). Surprisingly,GSTT1null genotype was significantly associated with the risk of CML in males (OR 95% CI, 5, 1.25-20.1; p = 0.023). The combinedGSTM1present/GSTT1null genotype was found to have a limited effect against the risk of CML (OR 95% CI, 0.3, 0.08-0.99; p = 0.049). Our findings have shown thatGSTT1null genotype might be a risk factor of CML in males. While,GSTT1present genotype might be considered as protective against CML. However, further studies with a large sample size are needed to confirm our findings.
Taxane-cisplatin-fluorouracil as induction chemotherapy for advanced head and neck cancer: a meta-analysis of the 5-year efficacy and safety
Authors: Qian Xu , Ma Chenming , Hoffmann Thomas K , Kaufmann Andreas M , Albers Andreas E
Published: April 2015

Background

The objective of this study was to compare the efficacy and safety of taxane (docetaxel or paclitaxel), cisplatin, and fluorouracil (Tax-PF) with cisplatin plus fluorouracil (PF) regimen by a meta-analysis of data retrieved from the literature.

Methods

Seven randomized clinical trials were identified, which included patients with advanced head and neck cancer who underwent induction chemotherapy with either a Tax-PF or PF protocol. The outcomes included the 3-year and 5-year overall survival (OS) and progression-free survival (PFS), overall response rate (ORR) and different types of adverse events.

Results

The 3-year OS rate (HR: 1.14; 95% CI: 1.03 to 1.25; P = 0.008), 3-year PFS rate (HR: 1.24; 95% CI: 1.08 to 1.43; P = 0.002), 5-year OS rate (HR: 1.30; 95% CI, 1.09 to 1.55;P = 0.003), 5-year PFS rate (HR: 1.39; 95% CI, 1.14 to 1.70; P = 0.001) and ORR to chemotherapy (OR 1.66; 95% CI, 1.35 to 2.05; P < 0.001) of the patients in the Tax-PF group were statistically superior to those in the PF group. In terms of toxicities, the incidence of febrile neutropenia (OR 2.36; 95% CI, 1.62 to 3.46; P < 0.001), alopecia (OR 8.22; 95% CI, 3.99 to 16.92; P < 0.001), diarrhea (OR 1.57; 95% CI, 1.05 to 2.36; P = 0.03) and leukopenia (OR 2.79; 95% CI, 1.86 to 4.21; P < 0.001) was higher in the Tax-PF group.

Conclusion

The Tax-PF induction chemotherapy improved PFS and OS, and the ORR was better as compared to PF-based therapy regimens at the cost of a higher incidence of adverse events.
Proprotein convertase FURIN regulates T cell receptor-induced transactivation
Authors: Ortutay Zsuzsanna , Oksanen Anna , Aittomäki Saara , Ortutay Csaba , Pesu Marko
Published: April 2015

Antigen emergence rapidly stimulates T cells, which leads to changes in cytokine production, cell proliferation, and differentiation. Some of the key molecules involved in these events, such as TGF-β1 and NOTCH1, are synthesized initially as inactive precursors and are proteolytically activated during T cell activation. PCSKs regulate proprotein maturation by catalyzing the proteolytic cleavage of their substrates. The prototype PCSK FURIN is induced upon TCR activation, and its expression in T cells is critical for the maintenance of peripheral immune tolerance. In this study, we tested the hypothesis that FURIN regulates T cell activation. Our data demonstrate that IL-2 is increased initially in FURIN-deficient mouse CD4+ T cells, but the TCR-induced IL-2 mRNA expression is not sustained in the absence of FURIN. Accordingly, the inhibition of FURIN in human Jurkat T cell lines also results in a decrease in IL-2 production, whereas the overexpression of WT FURIN is associated with elevated IL-2 levels. In Jurkat cells, FURIN is dispensable for immediate TCR signaling steps, such as ERK, ZAP70, or LAT phosphorylation. However, with the use of gene reporter assays, we demonstrate that FURIN regulates the AP-1, NFAT, and NF-κB transcription factors. Finally, by performing a transcription factor-binding site enrichment analysis on FURIN-dependent transcriptomes, we identify the FURIN-regulated transcription factors in mouse CD4+ T cell subsets. Collectively, our work confirms the hypothesis that the TCR-regulated protease FURIN plays an important role in T cell activation and that it can specifically modulate TCR-activated transactivation.
The transmembrane protein Crumbs displays complex dynamics during follicular morphogenesis and is regulated competitively by Moesin and aPKC
Authors: Sherrard Kristin M. , Fehon Richard G.
Published: April 2015

The transmembrane protein Crumbs (Crb) functions in apical polarity and epithelial integrity. To better understand its role in epithelial morphogenesis, we examined Crb localization and dynamics in the late follicular epithelium of Drosophila. Crb was unexpectedly dynamic during middle-to-late stages of egg chamber development, being lost from the marginal zone (MZ) in stage 9 before abruptly returning at the end of stage 10b, then undergoing a pulse of endocytosis in stage 12. The reappearance of MZ Crb is necessary to maintain an intact adherens junction and MZ. Although Crb has been proposed to interact through its juxtamembrane domain with Moesin (Moe), a FERM domain protein that regulates the cortical actin cytoskeleton, the functional significance of this interaction is poorly understood. We found that whereas the Crb juxtamembrane domain was not required for adherens junction integrity, it was necessary for MZ localization of Moe, aPKC and F-actin. Furthermore, Moe and aPKC functioned antagonistically, suggesting that Moe limits Crb levels by reducing its interactions with the apical Par network. Additionally, Moe mutant cells lost Crb from the apical membrane and accumulated excess Crb at the MZ, suggesting that Moe regulates Crb distribution at the membrane. Together, these studies reveal reciprocal interactions between Crb, Moe and aPKC during cellular morphogenesis.
Synthesis of Garnet-type Li7La3Zr2O12 by Coprecipitation Method
Authors: Hamao Naoki , Akimoto Junji
Published: April 2015

A tetragonal garnet-type Li7La3Zr2O12 sample was synthesized by the coprecipitation method for the first time. The particle morphology of the Li7La3Zr2O12 sample prepared by the coprecipitation method was elliptical shape and the primary grain size was smaller than the Li7La3Zr2O12 sample prepared by the conventional solid-state method. The result of the particle size distribution measurement shows that the average secondary particle size was approximately 9.66 µm, even after calcination at 950 °C with a relatively narrow distribution.