bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring User Experience While Playing Educational Games
Authors: Zaharias Panagiotis , Gatzoulis Christos , Chrysanthou Yiorgos
Published: February 2013

The concept and methods of user experience (UX) are gaining momentum in the game industry. Designers and educational practitioners aim to provide rich and effective user experience through serious educational games. Nevertheless several phenomena that delineate the complex issue of UX in serious gaming remain unexplored. This empirical study sheds light on temporality of UX and attractiveness of serious games. More specifically it explores a) how pragmatic and hedonic UX quality affects attractiveness in a serious game and b) investigates differences between anticipated and episodic UX so as to capture how the UX develops over time. Key findings are presented and discussed.
World of Race War
Authors: Weiss Alfred , Tettegah Sharon
Published: February 2013

Stereotypical portrayals of race are common in many modern video games. However, research on games and game environments has often overlooked race as an important consideration when evaluating games for their educational potential. This is particularly true of the educational literature on online games, which has tended to emphasize virtual game spaces as intrinsically exemplary learning environments while deemphasizing the narrative content of the games themselves. This article addresses this oversight. Through a close reading of game communications and fan-created content, the authors examined how developer-produced racial narratives influence players’ experience of the game world. The authors find that players and player communities reproduce and reinforce narrow developer-produced interpretations of race during in-game interactions as well as in player forums and virtual communities beyond the confines of the game world. Because the game environment is not conducive to players’ critical examination of race, the authors conclude that the game does not intrinsically provide a means for players to engage critically with game content. They further conclude that as educational environments these games must be situated and contextualized within the ideologies and discourses of the physical world.
An Intelligent and Dynamic Decision Support System for Nonlinear Environments
Authors: Uma S. , Suganthi J.
Published: February 2013

Nonlinear time series systems are high dimensional and chaotic in nature. Since, the design of a dynamic and efficient decision making system is a challenging task, a Support Vector Machine (SVM) based model is proposed to predict the future event of a nonlinear time series environment. This model is a non-parametric model that uses the inherent structure of the data for forecasting. The Hybrid Dimensionality Reduction (HDR) and Extended Hybrid Dimensionality Reduction (EHDR) techniques are proposed to represent the time series data and to reduce the dimensionality and control noise besides subsequencing the time series data. The proposed SVM based model using EHDR is compared with the models using Symbolic Aggregate approXimation (SAX), HDR, SVM using Kernel Principal Component Analysis(KPCA) and SVM using varying tube size values for historical data on different financial instruments. The experimental results have proved that the prediction accuracy of the proposed model is better compared with other models taken for the experimentation.
Role Mining to Assist Authorization Governance
Authors: Hachana Safaà , Cuppens-Boulahia Nora , Cuppens Frédéric
Published: February 2013

The concept of role has revolutionized the access control systems by making them more efficient and by simplifying their management. Role mining is the discipline of automating the definition of roles in a given access control system. It is a vivid research area, which has attracted a growing interest in the last years. Research on role mining has produced several interesting contributions in this field, and has also raised several related issues toward leveraging them in actual enterprises. This paper is a comprehensive analysis of the main research directions around role mining and the future trends. The authors present the problem of role mining, the current achievements to solve it and the related open issues. With this objective, they define a complete and realistic business process for Role Mining, and the authors sequentially analyze the issues related to each step of the process by investigating the main contributions in the literature. They also point the unhandled issues and we highlight the future perspectives.
Effect of Bosentan on Exercise Capacity and Clinical Worsening in Patients with Dual down and Eisenmenger Syndrome
Authors: Serino Giorgio , Guazzi Marco , Micheletti Angelo , Lombardi Carlo , Danesi Rossella , Negura Diana , Carminati Mario , Chessa Massimo
Published: February 2013

This single-center, retrospective analysis evaluated long-term bosentan treatment in adult patients (n = 7) with both Down and Eisenmenger syndromes (DS-ES). Laboratory tests, 6-minute walk distance (6MWD), functional class, and Doppler echocardiography were assessed at baseline and during 2 years' follow-up. Improvements or maintenance of 6MWD were observed (68 m improvement from baseline at month 12) after bosentan initiation. 6MWD was maintained up to year 2. Overall, 6 patients experienced a significant improvement in functional class during 2 years' therapy ( P = 0.01). There were no significant changes in parameters measured by Doppler echocardiography. None of the patients required either hospitalization or additional pulmonary arterial hypertension (PAH) therapy because of PAH progression. Bosentan treatment was generally well tolerated; no liver function abnormalities or serious adverse drug reactions were noted. In this DS-ES cohort, bosentan seemed to be well tolerated and clinically effective.
A Population Based Study on the Prevalence of Cigarette Smoking and Smokers' Characteristics at Osogbo, Nigeria
Authors: Adepoju Ebenezer G , Olowookere Samuel A , Adeleke Najemdeen A , Afolabi Olusegun T , Olajide Folakemi O , Aluko Olufemi O
Published: February 2013

Background

Cigarette smoking has been linked to several cancers worldwide. The characteristics of smokers have not been well documented among Nigerians.

Objective

This study assessed the prevalence and characteristics of cigarette smokers among the residents of Osogbo, in southwestern Nigeria.

Method

The study, a population based cross-sectional study of randomly selected consenting adult residents of Osogbo, was conducted in September of 2011. Data was collected using a semi-structured interviewer administered questionnaire on cigarette smoking.

Results

A total of 759 respondents were interviewed. Mean age was 42.1 ± 12.5 years. There were 364 (48%) males and 395 (52%) females. About 22% had ever smoked while 8.7% were current smokers, smoking an average of 22.9 ± 10.1 cigarettes per day. Males constituted the majority of current smokers. Most smokers (71%) were introduced to smoking by friends and ill health was the most often reported reason for quitting.

Conclusion

Cigarette smoking is commonly practiced among males in the studied population and awareness creation and advocacy should be conducted throughout the city in order to inform current smokers about the hazards and cumulative effects inherent in smoking.
Derivations on Toeplitz Algebras
Authors: Didas Michael , Eschmeier Jörg
Published: February 2013

Let H2(Ω) be the Hardy space on a strictly pseudoconvex domain Ω ⊂ ℂn, and let A ⊂ L∞(∂Ω) denote the subalgebra of all L∞-functions ƒ with compact Hankel operator Hƒ. Given any closed subalgebra B ⊂ A containing C(Ω), we describe the first Hochschild cohomology group of the corresponding Toeplitz algebra 𝒯(B) ⊂ B(H2(Ω). In particular, we show that every derivation on 𝒯(A) is inner. These results are new even for n = 1, where it follows that every derivation on T(H∞ +C) is inner, while there are non-inner derivations on T(H∞ + C(∂ℝn)) over the unit ball Bn in dimension n > 1.
Subspace Trajectory Piecewise-Linear Model Order Reduction for Nonlinear Circuits
Authors: Pan Xiaoda , Zhu Hengliang , Yang Fan , Zeng Xuan
Published: February 2013

Despite the efficiency of trajectory piecewise-linear (TPWL) model order reduction (MOR) for nonlinear circuits, it needs large amount of expansion points for large-scale nonlinear circuits. This will inevitably increase the model size as well as the simulation time of the resulting reduced macromodels. In this paper, subspace TPWL-MOR approach is developed for the model order reduction of nonlinear circuits. By breaking the high-dimensional state space into several subspaces with much lower dimensions, the subspace TPWL-MOR has very promising advantages of reducing the number of expansion points as well as increasing the effective region of the reduced-order model in the state space. As a result, the model size and the accuracy of the TWPL model can be greatly improved. The numerical results have shown dramatic reduction in the model size as well as the improvement in accuracy by using the subspace TPWL-MOR compared with the conventional TPWL-MOR approach.
Employing Per-Component Time Step in DSMC Simulations of Disparate Mass and Cross-Section Gas Mixtures
Authors: Maltsev Roman V.
Published: February 2013

A new approach to simulation of stationary flows by Direct Simulation Monte Carlo method is proposed. The idea is to specify an individual time step for each component of a gas mixture. The approach consists of modifications mainly to collision phase simulation and recommendations on choosing time step ratios. It allows lowering the demands on the computational resources for cases of disparate collision diameters of molecules and/or disparate molecular masses. These are cases important e.g., in vacuum deposition technologies. Few tests of the new approach are made. Finally, the usage of new approach is demonstrated on a problem of silver nanocluster diffusion in argon carrier gas under conditions of silver deposition experiments.
Balanced Scorecard and IPA Enables Public Service in Township Management: Local Government Performance
Authors: Lin Wen-Cheng
Published: February 2013

Quality of township management is highly related to society, and it reflects the local government situation. However, past research seldom discusses the balanced

scorecard and Importance-performance analysis concepts of townships management, which is a driving factor in the enhancement enterprises and local government performance. This paper proposes the concepts of balanced scored to combine the analysis and integration of township resident surveys for Electronic Toll Collection (ETC) implementation. The implication of the existing perspective on management concept is that performance evaluation systems emerging in profit and non-profit enterprises are going to meet the needs of local governments in terms of townships that citizens’ satisfaction in Taiwan.
OCS photolytic isotope effects from first principles: sulfur and carbon isotopes, temperature dependence and implications for the stratosphere
Authors: Schmidt J. A. , Johnson M. S. , Hattori S. , Yoshida N. , Nanbu S. , Schinke R.
Published: February 2013

Abstract. The isotopic fractionation in OCS photolysis is studied theoretically from first principles. UV absorption cross sections for OCS, OC33S, OC34S, OC36S and O13CS are calculated using the time-depedent quantum mechanical formalism and a recently developed ab-initio description of the photodissociation of OCS which takes into account the lowest four singlet and lowest four triplet electronic states. The calculated isotopic fractionations as a function of wavelength are in good agreement with recent measurements by Hattori et al. (2011) and indicate that photolysis leads to only a small enrichment of 34S in the remaining OCS. The photodissociation dynamics provide strong evidence that the photolysis quantum yield is unity at all wavelengths for atmospheric UV excitation, for all isotopologues. A simple stratospheric model is constructed taking into account the main sink reactions of OCS and it is found that overall stratospheric removal slightly favors light OCS in constrast to the findings of Leung et al. (2002). These results show, based on isotopic considerations, that OCS is an acceptable source of background stratosperic sulfate aerosol in agreement with a recent model study of of Brühl et al. (2012). The 13C isotopic fractionation due to photolysis of OCS in the upper stratosphere is significant and will leave a clear signal in the remaining OCS making it a candidate for tracing using the ACE-FTS and MIPAS data sets.
Monthly measured primary and new productivities in the Ulleung Basin as a biological "hot spot" in the East/Japan Sea
Authors: Kwak J. H. , Lee S. H. , Park H. J. , Choy E. J. , Jeong H. D. , Kim K. R. , Kang C. K.
Published: February 2013

Abstract. The Ulleung Basin (UB), located in the southwestern part of the East/Japan Sea (EJS), is considered having an unusually high productivity for a~deep basin. Recently changes have been reported in physical, chemical, and in biological properties. Here we measured the primary and new productivities in the UB using a 13C-15N dual isotope tracer technique. Measurements took place every month for the first time throughout a year for a~better estimate of the annual primary production in the EJS. Temporal variations of temperature, salinity and density (σt) in the study area were highly seasonal as expected for an ocean in the temperate zone. Nutrient distributions reflected these seasonal fluctuations in the vertical structure of the water column. Diatoms were in general the most dominant phytoplankton ranging from 15.5 to 82.2% with an average of 42.0% (S.D. = ± 9.9%). Based on those average daily productivities from our monthly measurements, the annual primary, new, and regenerated production in the UB were 273.0 g C m−2 yr−1, 62.6 g N m−2 yr−1, and 48.7 g N m−2 yr−1, respectively. Our estimated high f-ratio (0.59) in the UB, indicated that the predominant nitrogen source for primary production was nitrate. This is comparable with the nitrogen source in a productive coastal-upwelling region. New carbon production by phytoplankton is estimated as 212.8 g C m−2 yr−1 (S.D. = ± 9.7 g C m−2 yr−1) which indicates that a large portion (78%) of total annual primary production might potentially be exported from the diatom-dominated euphotic zone to a deeper zone in the UB. Further intense integrated field observations will be necessary to improve our understanding of the current marine ecosystem in the UB as an important biological production area in the EJS.
Dansgaard–Oeschger events: bifurcation points in the climate system
Authors: Cimatoribus A. A. , Drijfhout S. S. , Livina V. , van der Schrier G.
Published: February 2013

Abstract. Dansgaard–Oeschger events are a prominent mode of variability in the records of the last glacial cycle. Various prototype models have been proposed to explain these rapid climate fluctuations, and no agreement has emerged on which may be the more correct for describing the palaeoclimatic signal. In this work, we assess the bimodality of the system, reconstructing the topology of the multi-dimensional attractor over which the climate system evolves. We use high-resolution ice core isotope data to investigate the statistical properties of the climate fluctuations in the period before the onset of the abrupt change. We show that Dansgaard–Oeschger events have weak early warning signals if the ensemble of events is considered. We find that the statistics are consistent with the switches between two different climate equilibrium states in response to a changing external forcing (e.g. solar, ice sheets), either forcing directly the transition or pacing it through stochastic resonance. These findings are most consistent with a model that associates Dansgaard–Oeschger with changing boundary conditions, and with the presence of a bifurcation point.
One-dimensional simulation of fire injection heights in contrasted meteorological scenarios with PRM and Meso-NH models
Authors: Strada S. , Freitas S. R. , Mari C. , Longo K. M. , Paugam R.
Published: February 2013

Abstract. Wild-fires release huge amounts of aerosol and hazardous trace gases in the atmosphere. The residence time and the dispersion of fire pollutants in the atmosphere can range from hours to days and from local to continental scales. These various scenarios highly depend on the injection height of smoke plumes. The altitude at which fire products are injected in the atmosphere is controlled by fire characteristics and meteorological conditions. Injection height however is still poorly accounted in chemistry transport models for which fires are sub-grid scale processes which need to be parametrised. Only recently, physically-based approaches for estimating the fire injection heights have been developed which consider both the convective updrafts induced by the release of fire sensible heat and the impact of background meteorological environment on the fire convection dynamics. In this work, two different models are used to simulate fire injection heights in contrasted meteorological scenarios: a Mediterranean arson fire and two Amazonian deforestation fires. A Eddy-Diffusivity/Mass-Flux approach, formerly developed to reproduce convective boundary layer in the non-hydrostatic meteorological model Meso-NH, is compared to the 1-D Plume Rise Model. For both models, radiosonde data and re-analyses from the European Center for Medium-Range Weather Forecasts (ECMWF) have been used as initial conditions to explore the sensitivity of the models responses to different meteorological forcings. The two models predict injection heights for the Mediterranean fire between 1.7 and 3.3 km with the Meso-NH/EDMF model systematically higher than the 1-D PRM model. Both models show a limited sensitivity to the meteorological forcings with a 20–30% difference in the injection height between radiosondes and ECMWF data for this case. Injection heights calculated for the two Amazonian fires ranges from 5 to 6.5 km for the 1-D PRM model and from 2 to 4 km for the Meso-NH/EDMF model. The difference of smoke plume heights between the two models can reach 3–4 km. A large difference is obtained for the windy-wet Amazonian fire by the 1-D PRM model with a injection height 1.5 km higher when ECMWF re-analyses are used compared to the run with the radiosonde forcing. For the Mediterranean case, both models forecast a plume injection height above the boundary layer, although there are evidences that this particular fire propagated near the surface, highlighting the current limitations of the two approaches.
Analyzing resilience of urban networks: a preliminary step towards more flood resilient cities
Authors: Lhomme S. , Serre D. , Diab Y. , Laganier R.
Published: February 2013

Abstract. In Europe, river floods have been increasing in frequency and severity. These circumstances require the management of flood risk by integrating new concepts like urban resilience. Nevertheless, urban resilience seems to have no accurate meanings. That is why researchers are primarily concerned with defining resilience. Nevertheless, focus on research object seems to be more important than focus on conceptual debate (Resilience of what? Rather than what is resilience?). Thus the methodology designed here is focused on urban considerations. In fact, a system approach emphasizes technical networks' importance concerning urban resilience. Principles and assumptions applied in this research finally lead to the analysis of how urban networks are able to face natural hazards. In this context, a Web-GIS has been developed for analyzing resistance capacity, absorption capacity and recovery capacity of different technical networks. A first application has been carried out on a French agglomeration in order to analyze road network absorption capacity. This application is very specific but, thanks to this example, it is already possible to highlight the methodology's usefulness.
Thermal conductivity of snow measured by three independent methods and anisotropy considerations
Authors: Riche F. , Schneebeli M.
Published: February 2013

Abstract. The thermal conductivity of snow determines the temperature gradient, and by this, it has a direct effect on the rate of snow metamorphism. It is therefore a key property of snow. However, thermal conductivities measured with the transient needle probe and the steady-state, heat flux plate differ. In addition, the anisotropy of thermal conductivity plays an important role in the accuracy of thermal conductivity measurements. In this study, we investigated three independent methods to measure snow thermal conductivity and its anisotropy: a needle probe with a long heating time, a guarded heat flux plate, and direct numerical simulation at the microstructural level of the pore and ice structure. The three methods were applied to identical snow samples. We analyzed the consistency and the difference between these methods. As already shown in former studies, we observed a distinct difference between the anisotropy of thermal conductivity in small rounded grains and in depth hoar. Indeed, the anisotropy between vertical and horizontal thermal conductivity components ranges between 0.5–2. This can cause a difference in thermal conductivity measurements carried out with needle probes of up to –25 % to +25 % if the thermal conductivity is calculated only from a horizontally inserted needle probe. Based on our measurements and the comparison of the three methods studied here, the direct numerical simulation is the most reliable method, as the tensorial components of the thermal conductivity can be calculated and the corresponding microstructure is precisely known.
Adverse Drug Reactions to Antiretroviral Therapy: Prospective Study in Children in Sikasso (Mali)
Authors: Oumar Aboubacar A. , Diallo Korotoumou , Dembélé Jean P. , Samaké Lassana , Sidibé Issa , Togo Boubacar , Sylla Mariam , Tounkara Anatole , Dao Sounkalo , Tulkens Paul M.
Published: February 2013

OBJECTIVES

Adverse events during antiretroviral treatment are frequent and various. Their diagnosis incurs some various difficulties according to the geographic context. Our aim was to describe the frequency, nature, and preventability of adverse drug reactions (ADRs) due to antiretroviral treatment in Malian outpatient children.

METHODS

The study was a 6-month (June 1 to November 30, 2010) prospective, observational study of 92 children admitted to a pediatric hospital in Sikasso, Mali. The patients were treated with a generic drug and/or drug combinations. Prior to treatment initiation, demographic characteristics, clinical history, and biologic parameters, including CD4 cell counts, were collected for each patient. The World Health Organization's adverse drug reactions classification was used to characterize the side effects. Adverse effects and toxicities were graded 1, 2, and 3. Analysis of data was performed using SPSS Version 17.0 software.

RESULTS

Ninety-two human immunodeficiency virus–infected children met the criteria of inclusion. After 24 weeks of treatment, we observed that 14.1% of children had at least one side effect during our study. Side effects were many and varied, with the most frequent being cutaneous rash, nausea, vomiting, and diarrhea (38.5%, 23.1%, 15.4%, and 15.4%, respectively). Side effects were grade 1 in most cases. One case of grade 2 and one case of grade 3 were observed with rash. We observed one case of grade 3 side effects during our study. The treatment regimen was changed in 15.2% of cases, including one case because of side effects.

CONCLUSION

ADRs are not rare in Mali, particularly in children. These ADRs have an impact on quality of life for patients. We recommend a pharmacovigilance system for sustainable management of side effects in patients infected with human immunodeficiency virus in Mali.
Special interest groups 1959 - 1980: Uneasy détente or collegial cold war?
Authors: La Barre Kathyrn
Published: February 2013

An exploration of the events leading to the leading to the formation of the ASIST Special Interest Group/ Classification Research (SIG/CR) - one of the first of the American Documentation Institute’s SIGs, with context about other SIGs that formed during this same period.
The principal affordance of publishing texts online: Possible implications for the bibliographic universe model
Authors: MacCall Steven L.
Published: February 2013

In this presentation, I argue for focusing the attention of classification theorists on the implications of what I argue to be the principal affordance of publishing texts online, in contrast to their publication on paper, and that is the capability for an author or creator to update an online text without the text having to be republished as a new physical edition. This affordance is a result of the possibilities provided for by a shift in the materiality of textual carrier from physical to digital. I examine the implications of this capability for the WEMI model and argue that its starting point in terms of online “things” in the bibliographic universe should be modeled more granularly.
Likeness and Likeliness: Exploring Multidimensional Classification for the Multiverse of Information
Authors: Van den Heuvel Charles , Smiraglia Richard P.
Published: February 2013

In previous studies grouped under the common denominator “Idea Collider,” the CERN Hadron-Collider was used as a metaphor to explore the meaning of breaking down existing structured and less-structured clusters of information into the finest particles to get a better understanding of the laws and nature of the universe of knowledge (Heuvel and Smiraglia, 2010). Moreover we compared past conceptualizations and visualizations of multidimensional classifications, in particular of faceted systems, and tried to assess their potential for future information retrieval (Heuvel 2011; Heuvel and Akdag Salah, 2011). Where most classification theories focused on knowledge integration in a single universe of knowledge, we outlined the framework of an elementary theory of knowledge interaction in a multiverse of knowledge (Smiraglia, Heuvel and Dousa 2011). We believe that similar to the real universe, not only matter, but also energy and gravitational forces are of importance for understanding the multiverse of information better. For that reason we want to elaborate on the question of how one perceives and interacts with knowledge production.
Detection of Introns in Eukaryotic Small Subunit Ribosomal RNA Gene Sequences
Authors: Bachar Dipankar , Guillou Laure , Christen Richard
Published: February 2013

The gene encoding SSU-rRNA sequences is the tool of choice for phylogenetic analyses and environmental biodiversity analyses of bacteria, Archaea but also unicellular Eukaryota. In Eukaryota, gene sequences may often be interrupted by long or several introns. Searching in GenBank release 188, we found descriptions of 3638 such sequences. Using a database of 180 000 SSU-rRNA sequences well annotated for taxonomy and a C++ program written for that purpose, we computed the presence of 18 691 introns (among which the 3638 described introns). Filtering on length and sequence quality, 3646 sequences were retained. These introns were clustered; clusters were analyzed for the presence of single or multiple clades at various levels of taxonomic depth, allowing future analyses of horizontal transfers. Various analyses of the results are provided as tabulated files as well as FASTA files of described or computed introns. Each sequence is annotated for cellular location (nuclear, chloroplast, and mitochondria), positions at which they were found in the SSU-rRNA sequences and taxonomy as provided by GenBank.
The Case for Early Diagnosis and Treatment In Relapsing Remitting Multiple Sclerosis
Authors: Rudick Richard A.
Published: February 2013

The emergence of partially effective disease-modifying drugs for patients with relapsing remitting multiple sclerosis (RR-MS) has raised important questions. Which patients with RR-MS should be started on disease-modifying drugs? Can some patients be observed without treatment? Treatment decisions are difficult in part because currently available drugs must be administered by injections, and the drugs are expensive. Emerging research findings support the view that most people diagnosed with RR-MS are at risk for irreversible brain tissue injury and resultant neurologic disability. Importantly, the pathologic process is active during the early stages in many RR-MS patients who appear clinically stable. These findings provide a rationale for proactively treating patients with RR-MS early in their disease course with disease-modifying drugs in order to suppress disease activity, minimize tissue injury, and prevent disability at a later stage. Evidence in support of this approach is reviewed in this report, as are practical issues related to the use of disease-modifying drugs in RR-MS patients.
The Evolution of Nursing Care in Multiple Sclerosis
Authors: Halper J
Published: February 2013

Multiple sclerosis (MS) is a chronic, frequently debilitating neurologic disease that affects young adults in the prime of their lives. Until recently, treatment focused on symptom management rather than on disease modification. Patients’ contacts with the health care system were limited to the diagnostic period, episodes of acute attacks, and periods of disease progression.

With the advent of disease-modifying agents, the focus of care in MS has changed from one of maintenance and crisis intervention to a more positive and proactive approach. The nurse working in the field of MS has emerged as an important member of the health care team, playing a vital role in the ongoing care of and interaction with patients and their families. Nursing care in MS is a collaborative effort whose goal is self-awareness and self-responsibility; its activities involve supporting a great deal of self-care by patients, families, and care partners.

The nurse working with MS patients is a care provider, facilitator, advocate, educator, counselor, and innovator. The challenges of the disease require many creative interventions in a wide variety of settings. The list of care needs is long and complex. Interventions range from instruction in the use of medications, both oral and injectable, to bowel and bladder management strategies, to the improvement of mobility. The dynamic nature of the disease, along with its psychosocial, economic, and physical implications, calls for ongoing skill development and up-to-date information on the part of the nurse interested in MS care.
Reduction of Relapses in Multiple Sclerosis after Anti-Alpha4 Integrin Antibody (Natalizumab)
Authors: Minagar A , Sheremata WA , Vollmer TL , Willmer-Hulme AJ , Koller M
Published: February 2013

Anti-alpha4 integrin antibody, natalizumab (Antegren), is a monoclonal antibody to a4b1 integrin adhesion molecules expressed on activated monocytes and CD4 cells. A 1-year followup of 28 patients with relapsing multiple sclerosis, randomized to 3 groups in a double-blind pharmacokinetic study, are presented. One group received placebo, a second group low doses (0.01–0.3 mg/kg) of natalizumab, and a third group high doses (1–3 mg/kg) of natalizumab. The observed reduction of relapses in all natalizumab-treated patients with multiple sclerosis suggests a potential range of doses to induce stabilization of the disease.
Impact of a Comprehensive Long-Term Care Program on Caregivers and Persons with Multiple Sclerosis
Authors: Guagenti-Tax EM , DiLorenzo TA , Tenteromano L , LaRocca NG , Smith CR
Published: February 2013

The goal of this project was to evaluate a comprehensive model of long-term care in multiple sclerosis (MS). This model consisted of workshops designed to assist participants cope with caregiving demands; medical day care to provide rehabilitation and group therapy; home visits by a psychotherapist or nurse to assist with practical and psychological issues; and case management and liaison services.

Thirty patient-caregiver units receiving treatment were compared with 29 control subjects, with data being collected on 3 occasions over a 2-year period. Repeated measures analysis of variance found that physical functioning declined for MS subjects as indicated by Kurtzke score, Incapacity Status Scale score, and number of hospitalizations. The experimental group reported an increase in perceived cognitive deficits and decreased anxiety. Control subjects reported a greater decline in perceived health than experimental subjects as assessed by the SF-36 general health subscale. All caregivers reported increased overcommitment. Caregivers of controls reported significant decreases in perceived health and that health problems and caregiving activities interfered with social activities. Persons with MS in both groups reported increased satisfaction with caregiver help, while control subjects reported greater satisfaction with the timeliness of help received.

These results provide valuable information about effective ways to use and integrate community resources in the provision of long-term care for persons with MS.
Drug-Induced Dysphagia
Authors: Balzer KM
Published: February 2013

Dysphagia is commonly defined as difficulty swallowing. Although the disorder can have several causes, the patient's medication is often overlooked as a source of the problem. This type of dysphagia, one of the most readily corrected, is known as drug-induced dysphagia. A thorough literature search was undertaken to determine the potential for drug-induced dysphagia.

Drug-induced dysphagia can be classified into one of three categories: dysphagia as a side effect, dysphagia as a complication of therapeutic action, and medication-induced esophageal injury. Examples of medications in each category are provided based on therapeutic classification. Specifically, the role of dysphagia in multiple sclerosis and the agents that have been linked with dysphagia are discussed.

The most valuable method of preventing drug-induced dysphagia is obtaining a thorough and accurate medication history from each patient. Other prevention strategies and compensatory techniques are also explored.
Use of MRI Technology in Determining Prognosis and Tracking Therapeutic Benefit in Multiple Sclerosis
Authors: Vollmer Timothy
Published: February 2013

Over the past decade, magnetic resonance imaging (MRI) has been increasingly used as a tool to facilitate the diagnosis of multiple sclerosis (MS). Because of the relative insensitivity of commonly used clinical assessment measures, however, clinicians are exploring ways in which MRI can be used to determine a patient's prognosis and track progression of the disease. This article discusses the MRI findings that may be useful in evaluating disease progression in MS; results of recent clinical trials of MS treatment agents that have employed MRI; and potential applications for MRI in clinical practice.
A Fundamentally New View of Multiple Sclerosis
Authors: Ransohoff Richard
Published: February 2013

The last decade has been an era of unprecedented progress in our understanding of multiple sclerosis (MS). MS is now considered a destructive process of the central nervous system, initiated by inflammatory demyelination but including prominent axonal pathology. This new knowledge has been acquired from new imaging techniques and traditional histopathologic study. New mechanisms of myelin destruction have been uncovered, and hypothetical new therapies for MS include neuroprotectants. Serial gadolinium-enhanced magnetic resonance imaging (MRI) scans reveal MS as a continuously active process. Brain and spinal cord atrophy, defined by MRI, correlate closely with clinical state. MR imaging techniques therefore are considered the standard tools for monitoring disease activity and severity. These efforts have produced improved therapy for patients with MS. Two classes of agents, interferon beta and glatiramer acetate, have been approved by the US Food and Drug Administration for use. A major challenge for clinicians is to provide early diagnosis and determine appropriate treatment. New neuroprotective and anti-inflammatory drugs are on the horizon.
Editorial: Brain Plasticity: Has It a Role in Reducing Disability Related to Demyelinating Disease?
Authors: Cramer Steven C.
Published: February 2013

Patients with multiple sclerosis (MS) and other demyelinating conditions often show improvement from disease-related neurologic deficits. A number of factors have been proposed as contributing to this recovery. One possible mechanism that has received limited attention in the past is cortical plasticity, a process of active remodeling by which surviving resources are reorganized to maximize clinical status. Pilot studies of brain mapping in patients with MS and myelitis suggest that several motor cortex regions are organized differently than in healthy controls. Further studies are needed to evaluate the role of cortical plasticity in reducing disability among patients with MS. If further evidence supports a role for cortical remodeling in recovery from MS attacks, then treatments targeting the processes underlying cortical plasticity, such as growth factors currently being evaluated in stroke models, may represent new therapeutic avenues for patients with demyelinating disease.
Registry of Multiple Sclerosis Treatment and Care (MSTRAC) Patient and Physician Characteristics
Authors: Lacy Joseph R. , Stuart William H. , Jacobs Lawrence D. , Vartanian Timothy , Phillips J. Theodore , Greenstein Jeffrey I. ,   the MSTRAC Investigators Group
Published: February 2013

The registry of Multiple Sclerosis Treatment and Care (MSTRAC) is an ongoing US research project that was initiated in April 1998. This article reports the characteristics of 2,590 relapsing multiple sclerosis (MS) patients and 483 physicians enrolled as of July 31, 1999. The mean age of the MSTRAC patients was 44 years; 92% were white; and 83% were women. The majority had some college education, and 50% were employed. Eighty-one percent of patients had relapsing-remitting MS, 17% had secondary progressive MS with relapses, and 3% had progressive relapsing MS. Mean age at symptom onset was 34 years, and mean duration of illness was nine years; mean time between disease onset and diagnosis was two years. Most patients (84%) experienced either no or slow disability progression that varied significantly by the type of relapsing MS (P < .001). MSTRAC physicians had practiced medicine for a mean of 15 years and had spent 84% of their time in patient care. Physicians were distributed across the United States and saw their MS patients in various settings.
Understanding Fluctuations of Multiple Sclerosis across the Menstrual Cycle
Authors: Houtchens Maria K. , Gregori Ninel , Rose John W.
Published: February 2013

This preliminary study offers a novel questionnaire/temperature chart tool to prospectively evaluate monthly neurologic changes in multiple sclerosis (MS) patients, correlate these changes with the menstrual cycle, and distinguish them from symptoms of premenstrual syndrome (PMS). The study volunteers from the MS Clinic at the University of Utah were five menstruating women with relapsing-remitting disease. They received neither estrogen replacement therapy nor oral contraceptives. Each patient received a Modified Vanderbilt University PMS questionnaire and temperature charts. They recorded basal body temperature daily and graded physical and emotional symptoms during three consecutive menstrual cycles.

At the conclusion of the study, the investigators identified four different responses based on their review of the temperature charts and questionnaires. One response was a consistent increase in neurologic symptoms during the late luteal period, while another response was an absence of such an increase in symptoms. They also identified a PMS response, as well as chronic, severely depressed mood. The Modified Vanderbilt University PMS questionnaire and the temperature chart allow correlation of neurologic symptoms and the menstrual cycle. The investigators feel that the questionnaire/temperature chart combination (reproduced in this article) has the potential to be a valuable tool for prospective, long-term clinical evaluation of female MS patients.
Charge‐Compensated Compound Defects in Ga‐containing Thermoelectric Skutterudites
Authors: Qiu Yuting , Xi Lili , Shi Xun , Qiu Pengfei , Zhang Wenqing , Chen Lidong , Salvador James R. , Cho Jung Y. , Yang Jihui , Chien Yuan‐chun , Chen Sinn‐wen , Tang Yinglu , Snyder G. Jeffrey
Published: February 2013

Heavy doping changes an intrinsic semiconductor into a metallic conductor by the introduction of impurity states. However, Ga impurities in thermoelectric skutterudite CoSb3 with lattice voids provides an example to the contrary. Because of dual‐site occupancy of the single Ga impurity charge‐compensated compound defects are formed. By combining first‐principle calculations and experiments, we show that Ga atoms occupy both the void and Sb sites in CoSb3 and couple with each other. The donated electrons from the void‐filling Ga (GaVF) saturate the dangling bonds from the Sb‐substitutional Ga (GaSb). The stabilization of Ga impurity as a compound defect extends the region of skutterudite phase stability toward Ga0.15Co4Sb11.95 whereas the solid–solution region in other directions of the ternary phase diagram is much smaller. A proposed ternary phase diagram for Ga‐Co‐Sb is given. This compensated defect complex leads to a nearly intrinsic semiconductor with heavy Ga doping in CoSb3 and a much reduced lattice thermal conductivity (κL) which can also be attributed to the effective scattering of both the low‐ and high‐frequency lattice phonons by the dual‐site occupant Ga impurities. Such a system maintains a low carrier concentration and therefore high thermopower, and the thermoelectric figure of merit quickly increases to 0.7 at a Ga doping content as low as 0.1 per Co4Sb12 and low carrier concentrations on the order of 1019 cm−3.
Layered Gradient Nonwovens of In Situ Crosslinked Electrospun Collagenous Nanofibers Used as Modular Scaffold Systems for Soft Tissue Regeneration
Authors: Angarano Marco , Schulz Simon , Fabritius Martin , Vogt Robert , Steinberg Thorsten , Tomakidi Pascal , Friedrich Christian , Mülhaupt Rolf
Published: February 2013

In a versatile modular scaffold system, gradient nonwovens of in situ crosslinked gelatin nanofibers (CGN), fabricated by reactive electrospinning, are laminated with perforated layers and nonwovens of thermoplastic non‐crosslinked biodegradable polyesters. The addition of glyoxal to a gelatin solution in a non‐toxic solvent mixture consisting of acetic acid, ethyl acetate, and water (5:3:2 w/w/w) enables the in situ crosslinking of gelatin nanofibers during electrospinning. The use of this fluorine‐free crosslinking system eliminates the need of post‐treatment crosslinking and purification steps typical for conventional CGN scaffolds. The slowly progressing crosslinking of the dissolved gelatin in the presence of glyoxal increases the viscosity of the gelatin solution during electrospinning so that the average diameter of the crosslinked gelatin nanofibers gradually increases from 90 to 680 nm. During the subsequent lamination process, alternating layers of CGN and polycaprolactone (PCL) nonwovens, produced by 3D microextrusion of micrometer‐sized PCL fibers, are bonded together upon heating above the PCL melting temperature. In contrast to the water‐soluble gelatin nanofibers and the comparatively weak CGN, the CGN/PCL/CGN layered biocomposites are water‐resistant and very robust. In such modular scaffold systems, strength, biodegradation rate, and biological functions can be controlled by varying the type, composition, fiber diameter, porosity, number, and sequence of the individual layers. The CGN/PCL multilayer biocomposites can be cut into any desired scaffold shape and attached to tissue by surgical sutures in order to suit the needs of individual patients.
Molecular or Nanoscale Structures? The Deciding Factor of Surface Properties on Functionalized Poly(3,4‐ethylenedioxythiophene) Nanorod Arrays
Authors: Lin Hsing‐An , Luo Shyh‐Chyang , Zhu Bo , Chen Chi , Yamashita Yoshiro , Yu Hsiao‐hua
Published: February 2013

Nanostructures of poly(3,4‐ethylenedioxythiophene) (PEDOT) are assembled by using an anodic aluminum oxide template directly fabricated on gold‐coated silicon wafers. Inside these templates, PEDOT and hydroxy functionalized PEDOT form tubes. On the other hand, alkyl‐ and perfluoro‐functionalized PEDOTs assembled as nanorods. This approach allows a platform to understand the molecular and nanostructural effect on the surface wettability of these materials. In the water/air interface, the contact angle of water droplet (CAwater) for the smooth alkyl‐functionalized PEDOT films increases when alkyl chain gets longer. In contrast, the contact angle reachs saturation at 130° with alkyl chain longer than ethyl in assembled nanorod arrays. It remains the same even in the case of perfluoro‐functionalized PEDOT. Moreover, ethyl‐functionalized PEDOT (PEDOT‐C2) nanorods displays superoleophilicity and the oil deoplet cannot stay on the film in water. Based on the wettability studies, it is concluded that the nanostructures contribute predominantly for the surface wettability of these nanomaterials when the length of alkyl chain crosses certain threshold.
Aqueous Two‐Phase System Patterning of Microbubbles: Localized Induction of Apoptosis in Sonoporated Cells
Authors: Frampton John P. , Fan Zhenzhen , Simon Arlyne , Chen Di , Deng Cheri X. , Takayama Shuichi
Published: February 2013

Ultrasound‐driven microbubbles produce mechanical forces that can disrupt cell membranes (sonoporation). However, it is difficult to control microbubble location with respect to cells. This lack of control leads to low sonoporation efficiencies and variable outcomes. In this study, aqueous two‐phase system (ATPS) droplets are used to localize microbubbles in select micro‐regions at the surface of living cells. This is achieved by stably partitioning microbubbles in dextran (DEX) droplets, deposited on living adherent cells in medium containing polyethylene glycol (PEG). The interfacial energy at the PEG‐DEX interface overcomes microbubble buoyancy and prevents microbubbles from floating away from the cells. Spreading of the small DEX droplets retains microbubbles at the cell surface in defined lateral positions without the need for antibody or cell‐binding ligand conjugation. The patterned microbubbles are activated on a cell monolayer exposed to a broadly applied ultrasound field (center frequency 1.25 MHz, active element diameter 0.6 cm, pulse duration 8 μs or 30 s). This system enables efficient testing of different ultrasound conditions for their effects on sonoporation‐mediated membrane disruption and cell viability. Regions of cells without patterned microbubbles show no injury or membrane disruption. In microbubble patterned regions, 8 μs ultrasound pulses (0.2‐0.6 MPa) produce cell death that is primarily apoptotic. Ultrasound‐induced apoptosis increases with higher extracellular calcium concentrations, with cells displaying all of the hallmarks of apoptosis including annexinV labeling, loss of mitochondrial membrane potential, caspase activation and changes in nuclear morphology.