bluuebunny/crossref_metadata_2025 huggingface dataset:
Questioning the value of screening for gonorrhoea in symptomless heterosexual men
Authors: Pittrof R , Hitchings S , FitzGerald M
Published: October 2009

These two papers discuss whether gonorrhoea screening of asymptomatic heterosexual men with no contact history should continue in UK genitourinary medicine clinics. Currently, most clinics routinely test all attenders. This requires an estimated 330,000 tests annually to detect 915 positives (1 in 361). The benefits to these patients are uncertain but the costs are huge and could fund currently unprovided services such as oral contraceptive provision or HIV testing before terminations of pregnancy. However stopping testing would deny individuals the reassurance they seek, prevent early detection of outbreaks and fail to detect carriers who go on to cause morbidity in their partners. On this view, the availability of non-invasive tests should be used to widen screening.
Assessment of cognitive abilities in multiethnic countries: The case of the Wolof and Mandinka in the Gambia
Authors: Jukes Matthew C. H. , Grigorenko Elena L.
Published: October 2009

Background

The use of cognitive tests is increasing in Africa but little is known about how such tests are affected by the great ethnic and linguistic diversity on the continent.

Aim

To assess ethnic and linguistic group differences in cognitive test performance in the West African country of the Gambia and to investigate the sources of these differences.

Samples

Study 1 included 579 participants aged 14–19 years from the Wolof and Mandinka ethnic groups of the Gambia. Study 2 included 41 participants aged 12–18 years from the two ethnic groups.

Methods

Study 1 assessed performance on six cognitive tests. Participants were also asked about their history of education, residence in the city, parental education, and family socio‐economic status. Study 2 assessed performance on two versions of the digit span test. Recall of the numbers 1–5 were compared with recall of numbers 1–9 for both the Wolof (who count in base 5) and the Mandinka (who count in base 10).

Results

Study 1 established that Wolof performance was lower than that of the Mandinka on five out of six cognitive tests. In four of these tests, group differences were partially mediated by participation in primary school and migration to the city. Group differences were substantial for the digit span test and were not attenuated by mediating variables. Study 2 found that digit span among the Wolof was shorter than that of the Mandinka for numbers 1–9 but not for numbers 1–5.

Conclusions

Several suggestions are made on how to consider the ethnicity, language, education, and residence (urban vs. rural) of groups when conducting comparative cognitive assessments or collecting normative data.
Understanding words, understanding numbers: An exploration of the mathematical profiles of poor comprehenders
Authors: Pimperton Hannah. , Nation Kate.
Published: October 2009

Background

Poor comprehenders are children who show significant deficits in their reading comprehension performance, despite average, or above‐average word reading ability. To date, there have been no in‐depth studies of the mathematical performance profiles of such children.

Aims

This study aimed to explore the mathematical profiles of poor comprehenders. Given that language impairment is associated with difficulties with mathematics, and that poor comprehenders tend to have oral language weaknesses, we hypothesized that poor comprehenders would show relative weaknesses in aspects of mathematical performance.

Sample

From a sample of 109 children aged 7–8 years, we selected 14 poor comprehenders and 14 controls with age‐appropriate reading comprehension ability. The groups were matched on non‐verbal ability, multiple measures of reading accuracy, and chronological age.

Methods

We compared the performance of the group of poor comprehenders with that of the matched controls on two standardized measures of mathematical ability, one measuring procedural arithmetic prowess and the other tapping higher‐level mathematical reasoning.

Results

Although there were no group differences in performance on the arithmetic measure, the poor comprehenders showed significantly lower scores than the controls on the mathematical reasoning task. The poor comprehenders exhibited impaired verbal ability relative to controls, with these differences in verbal ability associated with the group differences found on the test of mathematical reasoning.

Conclusions

Poor comprehenders' deficits are not limited to the domain of literacy; their underlying profile of impairments also seems to selectively impact on certain components of mathematical ability.
Physically active patients with coronary artery disease: A longitudinal investigation of the processes of exercise behaviour change
Authors: Kanning Martina
Published: October 2009

Objectives. Although regular exercise is important for patients with coronary artery disease (CAD), most CAD patients are not sufficiently active. The transtheoretical model offers a framework for the process of exercise behaviour change. But until today, it is not clear which processes of exercise behaviour change (POC) support CAD patients in maintaining exercise after discharge.

Design. A longitudinal study with baseline measure and 6‐month follow‐up has been conducted. German CAD patients were mailed at home after discharge. POC and exercise were self‐reported.

Methods. A total of 204 CAD patients were selected from five rehabilitation centres. A total of 108 CAD patients, which were in the post‐action stages, provided data at baseline and follow‐up. Two different analyses were carried out. Firstly, structural equation modelling with baseline data (N =147) was used to test the hierarchical order of the POC in experiential and behavioural processes. Secondly, cross‐lagged panel analysis was used to investigate whether POC lead to exercise or vice versa and which POC support CAD patients in maintaining exercise.

Results. Comparative analysis indicates that the two hierarchical‐factor model fits the data significantly better than the one hierarchical‐factor model (χ2diff (1)=19.04, p <.001), even though experiential and behavioural processes are highly correlated (r =.98, p <.001). Standardized effects of the antecedent cross‐lags are significant for consciousness raising (β=0.27), reinforcement management (β=0.28), self‐liberation (β=0.28), and stimulus control (β=0.33) indicating that these POC are predictive for CAD patients maintaining exercise.

Conclusion. Although some POC support the exercise behaviour change process and the hierarchical structure is apparent, it may be beneficial to adapt the POC to give a more precise understanding of the change processes.
Structural Correlates of Preterm Birth in the Adolescent Brain
Authors: Nagy Zoltan , Ashburner John , Andersson Jesper , Jbabdi Saad , Draganski Bogdan , Skare Stefan , Böhm Birgitta , Smedler Ann-Charlotte , Forssberg Hans , Lagercrantz Hugo
Published: October 2009

OBJECTIVE: The Stockholm Neonatal Project involves a prospective, cross-sectional, population-based, cohort monitored for 12 to 17 years after birth; it was started with the aim of investigating the long-term structural correlates of preterm birth and comparing findings with reports on similar cohorts.

METHODS: High-resolution anatomic and diffusion tensor imaging data measuring diffusion in 30 directions were collected by using a 1.5-T MRI scanner. A total of 143 adolescents (12.18–17.7 years of age) participated in the study, including 74 formerly preterm infants with birth weights of ≤1500 g (range: 645–1486 g) and 69 term control subjects. The 2 groups were well matched with respect to demographic and socioeconomic data. The anatomic MRI data were used for calculation of total brain volumes and voxelwise comparison of gray matter (GM) volumes. The diffusion tensor imaging data were used for voxelwise comparison of white matter (WM) microstructural integrity.

RESULTS: The formerly preterm individuals possessed 8.8% smaller GM volume and 9.4% smaller WM volume. The GM and WM volumes of individuals depended on gestational age and birth weight. The reduction in GM could be attributed bilaterally to the temporal lobes, central, prefrontal, orbitofrontal, and parietal cortices, caudate nuclei, hippocampi, and thalami. Lower fractional anisotropy was observed in the posterior corpus callosum, fornix, and external capsules.

CONCLUSIONS: Although preterm birth was found to be a risk factor regarding long-term structural brain development, the outcome was milder than in previous reports. This may be attributable to differences in social structure and neonatal care practices.
Using BMI to Determine Cardiovascular Risk in Childhood: How Do the BMI Cutoffs Fare?
Authors: Skinner Asheley Cockrell , Mayer Michelle L. , Flower Kori , Perrin Eliana M. , Weinberger Morris
Published: October 2009

OBJECTIVE: Although adverse health outcomes are increased among children with BMI above the 85th (overweight) and 95th (obese) percentiles, previous studies have not clearly defined the BMI percentile at which adverse health outcomes begin to increase. We examined whether the existing BMI percentile cutoffs are optimal for defining increased risk for dyslipidemia, dysglycemia, and hypertension.

METHODS: This was a cross-sectional analysis of the National Health and Nutrition Examination Survey from 2001 to 2006. Studied were 8216 children aged 6 to 17 years, representative of the US population. BMI was calculated by using measured height and weight and converted to percentiles for age in months and gender. Outcome measures (dyslipidemia, dysglycemia, and hypertension) were based on laboratory and physical examination results; these were analyzed as both continuous and categorical outcomes.

RESULTS: Significant increases for total cholesterol values and prevalence of abnormal cholesterol begin at the 80th percentile. Significant increases in glycohemoglobin values and prevalence of abnormal values begin at the 99th percentile. Consistent significant increases in the prevalence of high or borderline systolic blood pressure begin at the 90th percentile.

CONCLUSIONS: Intervening for overweight children and their health requires clinical interventions that target the right children. On the basis of our data, a judicious approach to screening could include consideration of lipid screening for children beginning at the 80th percentile but for dysglycemia at the 99th percentile. Current definitions of overweight and obese may be more useful for general recognition of potential health problems and discussions with parents and children about the need to address childhood obesity.
Contact damage of tetrahedral amorphous carbon thin films on silicon substrates
Authors: Borrero-López Oscar , Hoffman Mark , Bendavid Avi , Martin Phil J.
Published: October 2009

We have investigated the fracture behavior of tetrahedral amorphous carbon films, with thicknesses 0.15 (ultrathin), 0.5 (thin), and 1.2 (thick) microns on silicon substrates. To that end, the systems were progressively loaded into a nanoindenter using a spherical tip, and surface and cross sections were subsequently examined using a focused ion beam miller at different loads. A transition was found as a function of film thickness: for ultrathin and thin films, cracking (radial and lateral) initiated in the silicon substrate and followed a similar path in the films. Thicker films, on the other hand, provided a higher level of protection to the substrate, and cracking (lateral and radial at the interface) was constrained to the film. The damage modes and the transition obtained differ from those that occur in thick coatings. Lateral cracks are highly dangerous, leading to delamination of thick films and to spallation when thinner films are used. The results have implications concerning the mechanical reliability of microelectromechanical systems.
Influence of hydrogen on the tarnishing film-induced brittle cracking of brass
Authors: Zhang Cheng , Su Yan Jing , Qiao Li jie , Chu Wu yang
Published: October 2009

The effects of hydrogen-charging on tarnishing film-induced brittle cracking of brass were studied. The tarnishing film was generated on brass samples with various hydrogen concentrations in Mattsson’s solution, then removed from the solution, dried, and subjected to a slow loading rate (loading speed = 0.5 mm/min) in air. The results indicated that hydrogen caused the film-induced brittle cracking to be more difficult to occur and a considerably high concentration of hydrogen could inhibit completely the film-induced brittle cracking. Elastic modulus test results showed that elastic modulus of the brass substrate decreased and elastic modulus of the tarnishing film increased with increasing the hydrogen concentration. Hydrogen inhibiting the film-induced cracking can be ascribed to the fact that hydrogen changed the elastic modulus of substrate and film.
Elaboration and characterization of novel polyamide-12-layered titanoniobates nanocomposites
Authors: Chausson Sophie , Retoux Richard , Rueff Jean-Michel , Pluart Loïc LE , Madec Pierre-Jean , Jaffres Paul-Alain
Published: October 2009

This article describes the synthesis and the characterization of a polyamide-12 filled with a nanostructured organic/inorganic titanoniobate hybrid material. The pristine oxide KTiNbO5has been successfully organomodified byN-alkyl amines via an acido-basic reaction after a cationic exchange step as shown by x-ray diffraction. Transmission electron microscope study and scanning transmission electron microscope observations have been used to describe the change of morphology of the nanofillers before and after processing; the micronic aggregates were changed into single sheets and dispersed in the polymer. Thermomechanical properties of the composites have been determined, and their analyses with structure-properties models are consistent with the exfoliation of the organomodified titanoniobates.
Thermochemistry of glass forming Y-substituted Sr-analogues of titanite (SrTiSiO5)
Authors: Park Tae-Jin , Li Simon , Navrotsky Alexandra
Published: October 2009

Strontium titanium silicates are possible oxide forms for immobilization of short lived fission products in radioactive waste. Through beta decay, strontium decays to yttrium, and then to zirconium. Therefore, not only the stability of Sr-loaded waste forms, but also that of a potential decay product series with charge-balance in a naturally occurring mineral or a ceramic is of fundamental importance. Strontium titanosilicate (SrTiSiO5) is the Sr-analogue of titanite (CaTiSiO5). To incorporate the reaction 3Sr2+ = 2Y3+ + vacancy in the titanite composition, Y-substituted Sr-analogues of titanite, (Sr1–xY2/3x)TiSiO5 (x = 0, 0.25, 0.5, 0.75) were prepared by high temperature synthesis and were found to form glass upon cooling. The Y-end-member (Y2/3TiSiO5, x = 1) crystallized to a mixture of Y2TiSiO7, TiO2, and SiO2 upon quenching in air. The enthalpies of formation of Y-substituted Sr-titanite glasses were obtained from drop solution calorimetry in a molten lead borate (2PbO·B2O3) solvent at 702 °C. The enthalpies of formation from constituent oxides are exothermic but become less so with increasing Y content. The thermodynamic stability of the Y-substituted Sr-analogue of crystalline titanite may become marginal with increasing yttrium content.
Surface-effect territory in small volume creep deformation
Authors: Wang Fei , Huang Ping , Lu Tianjian
Published: October 2009

It is yet unclear how far surface effects can dominate small volume creep deformation in the surface layer of a metallic solid. We report experimental results of the apparent activation volume of single, ultrafine-grained, and nanocrystalline Cu over a range of nanoscale displacements. The dependence of the apparent activation volume on the depth and grain size was determined using nanoindentation creep tests. The surface-affected deformation regimen, within which interfacial diffusion between the nanoindenter tip and the sample totally dominates the creep behavior, was quantitatively determined to be below ∼12 nm. As the initial creep depth is increased, the dominant mechanism is shifted from interfacial diffusion to grain-boundary diffusion as the contribution of the surface effects gradually vanishes when the indenter penetrates deeper into the sample (i.e., further away from the external surface).
Inorganic islands on a highly stretchable polyimide substrate
Authors: Sun Jeong-Yun , Lu Nanshu , Yoon Juil , Oh Kyu-Hwan , Suo Zhigang , Vlassak Joost J.
Published: October 2009

For a flexible electronic device integrating inorganic materials on a polymer substrate, the polymer can deform substantially, but the inorganic materials usually fracture at small strains. This paper describes an approach to make such a device highly stretchable. A polyimide substrate is first coated with a thin layer of an elastomer, on top of which SiNxislands are fabricated. When the substrate is stretched to a large strain, the SiNxislands remain intact. Calculations confirm that the elastomer reduces the strain in the SiNxislands by orders of magnitude.
Microstructures and properties of direct laser sintered tungsten carbide (WC) particle reinforced Cu matrix composites with RE–Si–Fe addition: A comparative study
Authors: Gu Dongdong , Shen Yifu
Published: October 2009

The poor wettability between ceramics and metals is a main obstacle in obtaining high-performance metal-matrix composites (MMCs) parts using direct metal laser sintering (DMLS). Rare earth (RE) elements, due to their unique physical and chemical properties, have high potential for improving laser processability of MMCs. In this work, a comparative study was performed to investigate the influence of RE–Si–Fe addition on microstructural features and mechanical properties of DMLS processed tungsten carbide (WC) particle reinforced Cu MMCs parts. It showed that by adding 3 wt% RE–Si–Fe, the WC reinforcing particles were refined, the particle dispersion state was homogenized, and the particle/matrix interfacial compatibility was enhanced. The RE–Si–Fe-containing WC/Cu MMCs parts possessed significantly elevated mechanical properties, i.e., densification level of 95.7%, microhardness of 417.6 HV, fracture strength of 201.8 MPa, and friction coefficient of 0.8. The metallurgical functions of the RE–Si–Fe additive for the improvement of DMLS quality of MMCs parts were discussed.
Deformation-induced ambient temperature α-to-β phase transition and nanocrystallization in (α + β) titanium alloy
Authors: Han Yong , Zhuang Huaye , Lu Jian
Published: October 2009

Ambient temperature α-to-β phase transition and nanocrystallization in the aged Ti–25Nb–3Mo–3Zr–2Sn titanium alloy was achieved by surface mechanical attrition treatment (SMAT). The phase transition occurs at α/β interfaces and extends to α phase interiors with increasing strain. It is irreversible and diffusion controlled. The stress-induced increase of Gibbs energy and enrichment of Nb may cause a high order of lattice instability of the α phase adjacent to the α/β interfaces and compel the α phase to β phase. The presence of fine α needles in the aged alloy and the phase transition from α to β with increasing strain are viewed to play a crucial role in the subsequent nanostructuring.
Structural and photoluminescence properties of laser processed ZnO/carbon nanotube nanohybrids
Authors: Aïssa Brahim , Fauteux Christian , El Khakani My A. , Therriault Daniel
Published: October 2009

Zinc oxide (ZnO)/carbon-nanotubular-structures (CNTS) nanohybrids were grown using a three-step laser process. First, an ultraviolet (UV) laser (KrF) was used to deposit Co/Ni catalyst nanoparticles (NP) directly onto SiO2/Si substrates. Second, a random network of CNTS was grown onto these Co/Ni-catalyzed substrates by using the UV-laser ablation method. Finally, ZnO nanostructures were grown onto the CNTS template by means of the CO2 laser-induced chemical liquid deposition technique. While the laterally grown CNTS mainly consist of nanotube bundles featuring a high aspect ratio (diameter of ∼20 nm and length of up to several microns), the ZnO nanostructures were found to consist of various morphologies including nanorods, polypods, and nanoparticles with a size as small as 2 nm. The ZnO/CNTS nanohybrids were found to exhibit a polychromatic photoluminescent (PL) emission, at room temperature, comprising a narrow near-UV band centered around 390 nm, a broad visible to near infrared band (500–900 nm), and a relatively weak emission band centered around 1000 nm. These PL results are compared to those of individual components (CNTS and ZnO) and discussed in terms of carbon defect density and possible charge transfer between the ZnO nanocrystals and the carbon nanotubes.
Atomistic simulation of sliding of [1010] tilt grain boundaries in Mg
Authors: Zhang Hao
Published: October 2009

A series of molecular dynamics simulations was performed to study grain boundary sliding of three types of [101¯0] tilt grain boundaries in a magnesium bicrystal. In particular, a near Σ11 twin boundary, an asymmetric near Σ11 twin boundary, and a θ = 40.3° general [101¯0] tilt grain boundary were studied. Simulations showed that grain boundary sliding (a rigid motion of two grains relative to each other along boundary plane) did not occur over the stress range applied; instead, coupled shear motion (grain boundary sliding induced boundary migration) was dominant. Although the measured coupling coefficient, the ratio of boundary tangential displacement to boundary normal displacement, was in good agreement with theoretical prediction, the detailed shear behavior was different, depending on types of grain boundary, magnitude of applied shear stress, and temperature. It was also noted that grain boundary twining was the predominant mechanism that allowed the coupled shear motion to occur in hexagonal close-packed (HCP) magnesium.
A Simulation of the Comparative Long‐term Effectiveness of Liraglutide and Glimepiride Monotherapies in Patients with Type 2 Diabetes Mellitus
Authors: Sullivan Sean D. , Alfonso‐Cristancho Rafael , Conner Chris , Hammer Mette , Blonde Lawrence
Published: October 2009

Study Objective. To project and compare long‐term outcomes of morbidity and mortality, and costs of complications of type 2 diabetes mellitus from a randomized controlled trial of patients receiving liraglutide versus glimepiride monotherapy.

Design. Mathematic simulation using the validated Center for Outcomes Research (CORE) Diabetes Model, calibrated to baseline patient characteristics from a short‐term, randomized, controlled trial of liraglutide and glimepiride monotherapies (Liraglutide Effect and Action in Diabetes [LEAD]‐3 trial) and using data from long‐term outcomes studies.

Setting. Simulated routine clinical practice.

Patients. Seven hundred forty‐six patients with type 2 diabetes who participated in the LEAD‐3 trial, and three hypothetical cohorts of 5000 patients each that were based on the baseline characteristics of the patients in the LEAD‐3 trial. The patients in the LEAD‐3 trial were randomly assigned to monotherapy with liraglutide 1.2 mg/day (251 patients), liraglutide 1.8 mg/day (247 patients), or glimepiride 8 mg/day (248 patients).

Measurements and Main Results. The impact of the three treatments for type 2 diabetes on survival and cumulative incidence of cardiovascular, ocular, or renal events and costs were estimated at three time periods: 10, 20, and 30 years. Simulations predicted improved survival for liraglutide 1.8 and 1.2 mg at all three time points compared with glimepiride. Survival benefits were greatest after 30 years of follow‐up: 16.5%, 13.6%, and 7.3%, respectively. The frequency of nonfatal renal and ocular events was lower for both liraglutide doses than for glimepiride. The rate of neuropathies leading to first or recurrent amputation was higher for glimepiride compared with both liraglutide doses. The average cumulative cost/patient was higher for glimepiride compared with liraglutide 1.2 mg and liraglutide 1.8 mg.

Conclusion. With use of the CORE Diabetes Model and data from the LEAD‐3 trial, long‐term projected survival, diabetes complications, and costs favored liraglutide 1.2‐ and 1.8‐mg monotherapies compared with glimepiride in the treatment of type 2 diabetes.
Lack of Effect on Prematurity, Birth Weight, and Infant Growth from Exposure to Protease Inhibitors In Utero and After Birth
Authors: Carceller Ana , Ferreira Ema , Alloul Sophie , Lapointe Normand
Published: October 2009

Study Objective. To determine whether an association exists between exposure in utero and after birth to highly active antiretroviral therapy (HAART) containing protease inhibitors and prematurity, birth weight, and infant growth parameters.

Design. Retrospective cohort study.

Setting. Tertiary, university‐affiliated hospital in Montreal, Canada.

Patients. Cohort of 206 pairs of mothers who had human immunodeficiency virus (HIV) and had been treated with HAART between 1997 and 2005, of whom 176 had regimens containing protease inhibitors, and their infants, as well as a control group of 206 infants born to non‐HIV‐infected mothers and thus not exposed to HAART.

Measurements and Main Results. Demographic and clinical characteristics were retrieved from patients' medical records and the hospital's HIV database. Duration of HAART use, rates of prematurity and low birth weight, and infant growth parameters during the first 2 years of the child's life were evaluated. Median duration of HAART use for the women before delivery was 18 weeks (range 4–36 wks) and for infants, started within the first 8–12 hours of life, was 6 weeks (range 2–6 wks). In infants exposed to HAART, the 10.6% rate of prematurity (11.1% with and 7.1% without protease inhibitors) was not significantly higher than that in the control group (7.8%). Moreover, the 9.9% rate for small for gestational age (9.8% with and 10.3% without protease inhibitors) was also not significantly higher than that in the control group (5.3%). The 176 mothers and infants exposed to protease inhibitors had a median follow‐up of 5 years. Stillbirth or death was not observed. At delivery, the weight, length, and head circumference of the 176 infants exposed to protease inhibitors were similar to those of the control group. During the first 2 years of life, premature infants were in the lower percentiles of growth; however, they followed normal Centers for Disease Control and Prevention growth curves matched for age and sex.

Conclusion. Significantly higher rates of prematurity and low birth weight were not demonstrated in infants exposed in utero to HAART with protease inhibitors. Moreover, these children reached normal growth percentiles during the first 2 years of life.
Pharmacokinetic Outcomes of a Simplified, Weight‐Based, Extended‐Interval Gentamicin Dosing Protocol in Critically Ill Neonates
Authors: Hoff David S. , Wilcox Roger A. , Tollefson Lisa M. , Lipnik Polina G. , Commers Amy R. , Liu Meixia
Published: October 2009

Study Objective. To determine the pharmacokinetic outcomes of a simplified, weight‐based, extended‐interval gentamicin dosing protocol for critically ill neonates.

Design. Retrospective medical record review with pharmacokinetic analysis.

Setting. Two neonatal intensive care units in a pediatric tertiary care system.

Patients. Sequential sample of 644 critically ill neonates less than 7 days old without evidence of renal dysfunction who received gentamicin, dosed by using a simplified, weight‐based, extended‐interval dosing protocol, on the first day of life for suspected sepsis between February 2003 and January 2008, and who had subsequent gentamicin plasma concentrations measured during their first week of life.

Measurements and Main Results. Data were collected on birth weight, gestational age at birth, serum creatinine concentration during the first 10 days of life, medical conditions, and concomitant drugs. Gentamicin dosing and its pharmacokinetic parameters were noted for each patient. A mean dose of 3.96 mg/kg/dose of gentamicin was administered intravenously every 48 hours in neonates weighing less than 1250 g at birth and every 24 hours in those weighing 1250 g or more. If the neonate received concurrent indomethacin, however, gentamicin was given every 48 hours. Protocol success was defined as a peak gentamicin plasma concentration of 7–10 mg/L and a trough concentration less than 2 mg/L. Mean gentamicin peak and trough concentrations were 9.38 mg/L (95% confidence interval [CI] 9.24‐9.52 mg/L) and 1.00 mg/L (95% CI 0.96‐1.04 mg/L), respectively. With use of the protocol, 361 neonates (56.1%) achieved gentamicin peak plasma concentrations in the range defined as successful and 610 neonates (94.7%) achieved successful trough concentrations. The mean gentamicin apparent volume of distribution and half‐life were 0.48 L/kg (95% CI 0.47‐0.49 L/kg) and 8.31 hours (95% CI 8.09‐8.52 hrs), respectively.

Conclusion. This simplified, weight‐based, extended‐interval gentamicin dosing protocol for critically ill neonates was effective in achieving therapeutic peak plasma concentrations of gentamicin in most of the patients and, as a high proportion of patients had acceptable trough concentrations, may minimize the potential for toxicity.
Primary Antifungal Prophylaxis in Adult Hematopoietic Stem Cell Transplant Recipients: Current Therapeutic Concepts
Authors: McCoy Dorothy , DePestel Daryl D. , Carver Peggy L.
Published: October 2009

In recipients of hematopoietic stem cell transplants (HSCTs), the mortality associated with invasive fungal infections (IFIs) remains high, despite the introduction of broad‐spectrum antifungal agents over the past 2 decades. Preventing exposure to fungal pathogens in this population is impossible; therefore, clinicians have focused on prophylactic use of antifungal agents to prevent IFIs in high‐risk HSCT recipients. It is important to target antifungal prophylaxis by type of HSCT (autologous or allogeneic), local epidemiology, and risk factors for IFIs so that patients can receive the most appropriate agent while balancing costs and the risks of toxicity, and minimizing the development of resistance. To assist clinicians in weighing the pros and cons of currently available antifungal agents when choosing a suitable prophylactic regimen, we provide a review of several key prospective randomized trials that evaluated various antifungal agents for primary prophylaxis in adult HSCT recipients. In addition, we describe the epidemiology of and risk factors for IFIs in HSCT recipients, the difficulties in diagnosing IFIs, antifungal agents used for prophylaxis, and the goals of primary prophylaxis. Fluconazole remains the gold standard for primary prophylaxis in autologous HSCT recipients. For allogeneic HSCT recipients, the agent chosen for prophylaxis must be based on the patient's risk factors for IFIs. In low‐risk patients, fluconazole is an appropriate agent to use for primary prophylaxis immediately after transplantation. However, in allogeneic HSCT recipients who develop complications, such as graft failure, graft‐versus‐host disease, or cytomegalovirus infection, prophylaxis with a mould‐active agent should be used.
Management of Venous Thromboembolism and the Potential to Impact Overall Survival in Patients with Cancer
Authors: Saraiya Biren , Goodin Susan
Published: October 2009

The risk of venous thromboembolism (VTE) in patients with cancer is 6–12‐fold higher than in the general population, and VTE is the second leading cause of death in this population, after cancer itself. The etiology underlying the increased risk of VTE is multifactorial and complex, involving patient‐, tumor‐, and treatment‐related factors. In patients with cancer, cumulative results from studies in those with VTE versus without VTE suggest that anticoagulation therapy, particularly with low‐molecular‐weight heparins, prevents morbidity and may reduce mortality. Despite the availability of effective and safe therapeutic options, VTE is often underrecognized and suboptimally managed. Interventions such as assessing individual patient risk of VTE, providing VTE prophylaxis and/or prompt treatment, and adopting VTE guidelines are essential aspects of cancer‐related care. Aggressive VTE management and strategies are critical to improving survival in patients with cancer and VTE.
Use of Antidepressants for Management of Hot Flashes
Authors: Carroll Dana G. , Kelley Kristi W.
Published: October 2009

A growing body of evidence suggests that antidepressant therapies, particularly selective serotonin reuptake inhibitors and venlafaxine, are effective in the management of hot flash symptoms. Several of these agents have the support of the American College of Obstetricians and Gynecologists and the North American Menopause Society. To review the literature on antidepressants for the treatment of hot flashes in women, we searched the PubMed, International Pharmaceutical Abstracts, and MEDLINE databases from inception through May 2009. All publication types that included human participants and that were published in English were eligible for review. These articles, relevant abstracts, and additional references were used to collect pertinent data. Although initial small pilot trials were conducted solely in breast cancer survivors, additional studies have been conducted both in breast cancer survivors and in relatively healthy menopausal women. Data on the benefits with many of these agents are conflicting. Venlafaxine and paroxetine have been studied more extensively than any of the other antidepressants and are more consistent in effectively reducing the frequency and severity of hot flashes, based on these study results. Desvenlafaxine, sertraline, fluoxetine, and citalopram should be considered second‐ or third‐line options if patients fail therapy with or cannot tolerate venlafaxine or paroxetine, based on the current published data. Duloxetine, escitalopram, fluvoxamine, and mirtazapine should be reserved as last‐line therapy until more rigorous studies are conducted assessing their use in the management of hot flashes.
Key Articles and Guidelines in the Treatment of Venous Thromboembolism
Authors: Dobesh Paul P. , Wittkowsky Ann K. , Stacy Zachary , Dager William E. , Trujillo Toby C. , Gulseth Michael P. , Nutescu Edith , Vondracek Tom
Published: October 2009

Venous thromboembolism (VTE) is a significant medical diagnosis that affects millions of patients each year. Appropriate management of VTE can help treat the initial event as well as reduce the frequency of complications such as postthrombotic syndrome, pulmonary hypertension, and death. Due to increasing regulatory requirements, hospitals nationwide are developing necessary documentation of appropriate and safe use of anticoagulants for the management of VTE. It is essential that a wide range of clinicians have an understanding of what constitutes appropriate VTE treatment in various patient populations. With the existence of numerous pharmacologic agents, abundance of major clinical trials, and nationally recognized clinical guidelines, compiling the needed reference material to make evidence‐based decisions on appropriate VTE treatment can be difficult for clinicians. Therefore we have provided bibliographies of key articles and guidelines related to the treatment of VTE with a number of different strategies in a variety of special patient populations. It is our hope that this compilation will serve as a resource for pharmacists, physicians, nurses, residents, and students responsible for the care of patients with VTE.
Clinically Significant Adverse Events from a Drug Interaction Between Quetiapine and Atazanavir‐Ritonavir in Two Patients
Authors: Pollack Todd M. , McCoy Christopher , Stead Wendy
Published: October 2009

Clinicians caring for patients infected with the human immunodeficiency virus (HIV) and diagnosed with psychiatric comorbidities must be aware of potential drug‐drug interactions, particularly with protease inhibitor‐based antiretroviral therapy. Although possible interactions can be predicted based on a drug's pharmacokinetic parameters, the clinical significance is often unknown. We describe two patients who experienced serious quetiapine adverse effects potentially mediated through an interaction with ritonavir‐boosted atazanavir. The first patient was a 57‐year‐old man with HIV and bipolar disease who developed rapid and severe weight gain when quetiapine was added to a stable atazanavir‐ritonavir‐based antiretroviral regimen. After the patient discontinued both quetiapine and ritonavir, his weight returned to its baseline value. The second patient was a 32‐year‐old woman with HIV, anxiety disorder, and a history of intravenous drug abuse who developed increased sedation and mental confusion when an atazanavir‐ritonavir‐based antiretroviral regimen was added to her stable antianxiety drug regimen, which included quetiapine. Her symptoms resolved promptly after discontinuation of the quetiapine. Use of the Naranjo adverse drug reaction probability scale indicated that the adverse effects experienced by the two patients were possibly related and probably related, respectively, to an interaction between quetiapine and atazanavir‐ritonavir. Quetiapine is primarily metabolized by cytochrome P450 (CYP) 3A4, and ritonavir is a potent inhibitor of CYP3A4. Thus, it is reasonable to theorize that quetiapine concentrations will increase when these drugs are used concurrently, which would be the likely cause of the toxicities in these two patients. To our knowledge, these are the first published reports of a clinically significant interaction between atazanavir‐ritonavir and quetiapine. Clinicians should be aware of the potential for this interaction, and extreme caution should be used when prescribing quetiapine and other atypical antipsychotic agents in HIV‐positive patients who are receiving antiretroviral therapy.
Harm's Way: Language and the Contemporary Arts of War
Authors: Pratt Mary Louise
Published: October 2009

How does language operate as an instrument of warfare? Leaving behind the idea of violence as beyond words, this essay seeks out terms for a reflection on linguistic violence and the weaponization of language in warfare. Using theories of war and examples from current United States engagements in Afghanistan and Iraq, the essay examines language as an essential element of violent action and as military weaponry under such rubrics as psychological operations, interrogation, morale building, force multiplication, and cultural awareness. The essay reflects on the semantic work of making warfare and violence meaningful to those who sacrifice for them and on the language predicaments that states of war create and cannot solve.
Still Winter Falls
Authors: Favret Mary A.
Published: October 2009

This essay follows closely a long tradition of poets writing about war as winter, emphasizing its most dangerous characteristics: an impersonal force that can bring indiscriminate annihilation, freezing numbness or insensibility, and blank illegibility. These poems tell of modern total waravant la lettreand its capacity to destroy what we can feel or know of its work. Focusing primarily on eighteenth-century British poets (Pope, Thomson, Cowper, and Wordsworth) but turning as well to Homer and our contemporary poets, the essay considers the particular threats of war to poetic creation and the difficult, often desperate means by which poets resist those threats. Perhaps most ominous in these figurations are representations of war as still, inactive, and somehow outside the logic of historical eventfulness. Thus the poets meditate as well on the very possibility of historical narrative amid the violence of war.
“Is Your Journey Really Necessary?”: Going Nowhere in Late Modernist London
Authors: Mackay Marina
Published: October 2009

This essay discusses civilian relations to space in the Second World War, focusing on late modernist fiction about wartime London. In novels by Elizabeth Bowen, Henry Green, Patrick Hamilton, and James Hanley, the modernist city has ceased to be the site of expansive, cosmopolitan opportunity it was for writers of the 1920s: permitting civilian death on a massive scale, the city is newly imagined as an anteroom to a brutal common death. Enforced immobility and coerced collectivity find expression in a recursive, subjectivist form that mimics the claustrophobic entrapments these novels describe. A pervasive sense that the mere existence of other people jeopardized one's own points to the limits of familiar stories about civilian solidarity in wartime.
Enchantment, Disenchantment, War, Literature
Authors: Cole Sarah
Published: October 2009

This essay employs the notions of enchantment and disenchantment to develop a theory of literature and violence across the twentieth century. War and violence were imagined either as generative, providing the symbolic core for cultural self-definition, or as entirely unredeemable, as pointless attacks on human flesh. A wide-ranging language is provided for elucidating the relation of literature to war and violence, and T. S. Eliot's The Waste Land (1922) is considered as an example of the key motifs traversing and defining this history. The poem demonstrates that literary modernism, for all its tendency to encode, rescript, and miscegenate, was fully and intricately engaged with the polarization between transformative and useless violence.
Watching War
Authors: Mieszkowski Jan
Published: October 2009

Today we refer to the dissolution of the classical battlefield, since combat is now waged virtually, in information networks as well as on physical terrain. The thesis of this essay is that this transformation of warfare was set in motion in Europe at the turn of the nineteenth century. In the popular mythology of the Napoleonic era, world history is figured as a giant spectacle of clashing of armies whose mysteries can be discerned only by the emperor's all-seeing eye. In contrast, authors such as Rousseau, Stendhal, and Tolstoy propose that military events are best understood not through direct experience of the front lines but by reading about battles or imagining what they must be like. In the modern theater of war, the audience is enjoined to consult a medium that is no longer essentially visual.
Lines of Sight: Watching War in Jarhead and My War: Killing Time in Iraq
Authors: Peebles Stacey
Published: October 2009

Jarhead, Anthony Swofford's 2003 memoir of the Persian Gulf War, and My War: Killing Time in Iraq, Colby Buzzell's 2005 memoir of the Iraq War, emphasize the authors' voyeuristic delight in watching war movies before and during their military service. What follows their enthusiastic consumption of “military pornography,” however, is a crisis of nonidentification and a lingering uncertainty about the significance of war in their own lives. Swofford and Buzzell find that the gaze they initially wielded is turned on them, and in response Swofford roils with sexually coded anger and frustration while Buzzell chooses to amplify his exposure by starting a blog. The two memoirs, then, provide a compelling account of the relation between changing technologies of representation and the experience of postmodern war. These lines of sight, all targeting the spectacle of combat, reveal the contemporary intersections among war, media, and agency.
Mother of All Battles
Authors: Schroeder Steven
Published: October 2009

In the United States, the best-known antiwar speech of the past decade is not antiwar. Barack Obama's remarks, delivered at an antiwar rally in Chicago in October 2002, are about timing and the place of “reason” in war. At no time is war's place questioned: because it is necessary, it is, sometimes, inevitable. Combined with the entrenchment of war attributed to Heraclitus, this sets the stage for reflection on war here and now: it is about timing, about centering, about naming, about reasoning—about the politics of the cities we build and inhabit. The pervasiveness of the assumption that war is necessary calls attention to the question that guides this essay: whether and how we might cultivate judgment that is intuitively opposed to war rather than intuitively resigned to it. (SS)
“Amicus Curiae”: The Friend, the Enemy, and the Politics of Love
Authors: Baucom Ian
Published: October 2009

Let me take as my point of departure a question of genre, one raised in the realm of jurisprudence by the amicus brief—that is, the brief of the amicus curiae, or friend of the court: one who is not a party to a case but holds a pressing interest in it. I was drawn to the genre, most immediately, by a reading of the amicus briefs filed in the case of Lakhdar Boumediene et al. v. George W. Bush, which came before the United States Supreme Court on 5 December 2007 and raised the question of whether the detainees held at Guantánamo Bay, Cuba, possessed the habeas corpus rights guaranteed by the United States Constitution.
Melancholia's Meerkat: A Poetic Leap
Authors: Greene Jody
Published: October 2009

I think we learn to be worldly from grappling with, rather than generalizing from, the ordinary.

—Donna Haraway

The question that preoccupies me in the light of recent global violence is, Who counts as human? Whose lives count as lives? And, finally, What makes for a grievable life?

—Judith Butler

In a New York Times editorial piece published in May 2007 about the ongoing humanitarian crisis in Darfur, Nicholas Kristof lamented, not for the first time, that people “aren't moved by genocide.” “The human conscience just isn't pricked by mass suffering,” Kristof continues, and yet, as both anecdotal evidence and scientific research have repeatedly shown, “an individual child (or puppy) in distress causes our hearts to flutter.” He recounts a series of psychological and sociological experiments that have borne out what he calls “the limits of rationality,” including the fact that people who hear narratives or see images that “prime the emotions” by focusing on the plight of an individual suffering creature—say, a baby or “a soulful dog in peril”—respond more vigorously to that suffering than those who have had their “rational side” primed by performing math problems. Perhaps, Kristof proposes in disgust, what the Darfur situation needs in order to achieve the public recognition it deserves—let alone to effect actual change—is not statistics of mass genocide but a very photogenic, if appropriately sad-eyed, poster child, “a suffering puppy with big eyes and floppy ears.” “If President Bush and the global public alike are unmoved by the slaughter of hundreds of thousands of fellow humans,” he despairingly concludes, “maybe our last, best hope is that we can be galvanized by a puppy in distress.”
There Will Be No Bobby Sands in Guantánamo Bay
Authors: Anderson Patrick
Published: October 2009

In his recent film sicko, Michael Moore turns his attention to the crisis in medical care in the United States eventuated by the powerful and wealthy insurance and pharmaceutical companies that control how, when, and if patients experience the broad range of practices we call healing. Moore uses his familiar technique of visiting everyday people and recording their sometimes heartbreaking stories of illness, pitching these narratives against interviews with representatives from large corporations and government agencies.