bluuebunny/crossref_metadata_2025 huggingface dataset:
Numerical Simulation of Multi-Point Capacitor Discharge Welding of AISI 304 Bars
Authors: Casalino G , Panella F
Published: July 2006

Capacitor discharge welding (CDW) is able to weld with cooling rates greater than 106 K/s which produce a very narrow heat-affected zone with no thermal deformations. The physics of the process consists in an accumulated high current, discharging through a transformer to the welding area and vaporizing a protrusion machined at the centre of one of the joint surfaces. The vaporization of the protrusion produces the heat required for welding.

In this paper the authors present a numerical investigation on the influence of CDW process parameters on AISI 304 welds. In order to improve the welding capability, some modifications of the welding surface profiles were proposed. In particular, two different contact geometries were proposed as alternatives to the single protrusion geometry. A numerical model investigated the effects of the geometry and the interactions between the electrical and mechanical parameters on the thermal cycle and distortions.

Since the welding surface profiles had more than one contact point, the authors named this process ‘multi-point capacitor discharge welding’.
Cost Allocation for Business Process Simulation Models
Authors: Barber K D , Dewhurst F , Pritchard M C
Published: July 2006

This paper considers how object costing can be incorporated into business process simulation models for decision support. Conventional and activity-based costing (ABC) methods are assessed in order to determine their suitability for business process simulation and decision support. An extension of ABC is proposed, in which costs are divided between resources rather than activities, and cost allocation rates are refreshed after each event so that emergent changes are taken into account. An application built into a simulation model of a UK SME is presented and illustrated through the evaluation of downsizing a sales department.
A tube with a rectangular cut-out. Part 1: Subject to pure bending
Authors: Vartdal B. J. , Al-Hassani S. T. S. , Burley S. J.
Published: July 2006

The response to pure bending of tubes with rectangular cut-outs is considered. Experiments on 1000-mm long, 100-mm diameter, and 2.55-mm wall thickness DIN 2391 ST NBK supported steel tubes are described. Such a thickness-to-diameter ratio is typical of structural columns, rather than shell structures. Tubes containing cut-outs with an axial dimension of up to 30 mm and a circumferential size of up to 180° were tested. It was found that plastic hinge mechanisms dominated the response when the cut-out was on the compressive side, whereas fracture behaviour dominated the response when the cut-out was on the tensile side. Finite element and semi-empirical analyses were carried out to predict the global load-deformation behaviour of the tubes. All analyses gave reasonable predictions of the experimental results for the majority of the cut-out parameters investigated. The aim of this study is to investigate the feasibility of using cut-outs to initiate and control the toppling of offshore jacket structures.
Extrinsic Carrier Photogeneration in Organic Pigments Based on Electric-Field Induced Fluorescence Quenching Measurements
Authors: Hiramoto Masahiro , Sakaue Yoshitaka , Yokoyama Masaaki
Published: July 2006

Extrinsic carrier photogeneration in perylene pigment was studied by means of the electric field-induced fluorescence quenching. Perylene pigment mixed with small amount of phthalocyanine exhibited the effective enhancement of carrier generation efficiency together with decreasing field-induced fluorescence quenching, contrary to the expectation that both should be enlarged owing to the competitive relation between carrier generation and carrier recombination entailing fluorescence. The model assuming the existence of another efficient channel to photogenerate geminate ion pairs through perylene/phthalocyanine molecular contacts, solved this intriguing result reasonably.
Dehydrooligopeptides. XVI. Convenient Syntheses of Two Kinds of Antrimycins Av and Dv Containing Dehydrovaline Residues
Authors: Nakamura Yutaka , Ito Akio , Shin Chung-gi
Published: July 2006

Eight kinds of peptide antibiotics, antrimycins (1), consist of four sorts of unusual α-amino acids, that is, hydroxymethylserine, (2S,3S)-2,3-diaminobutanoic acid, (S)-2,3,4,5-tetrahydro-3-pyridazinecarboxylic acid, and dehydrovaline (ΔVal) or (E)-dehydroisoleucine (ΔIle) from the N-terminus of 1. The practical syntheses of the three segments containing these four acids, and all of the protected 1 by the usual fragment condensations of the three segments were accomplished. Moreover, after mild deprotection of the protecting groups, the two kinds of 1, antrimycins Av and Dv comprising Ala5–ΔVal6 and Leu5–ΔVal6 segments respectively, were synthesized.
Synthesis and NMR Studies of RGDSPASS-Containing Cystine Peptides
Authors: Yamamoto Yasuo , Sofuku Shosuke
Published: July 2006

Three types of Arg–Gly–Asp–Ser–Pro–Ala–Ser–Ser (RGDSPASS)-containing cystine peptides, FR-1, FR-2, and FR-3, were designed and synthesized. These cyclic peptides exhibited high activities as a platelet aggregation inhibitor. Using rabbit platelet-rich plasma, the IC50 values of FR-1, FR-2, and FR-3 were found to be 67, 280, and 135 μM, respectively. In each peptide, the position of the Pro residue was either i + 1 or i + 2 in the turn, as observed by NMR (ROESY, NOESY, and H–D exchange of amide proton).
A Novel Method for the Preparation of Acid-Sensitive Epoxides from Olefins with the Combined Use of Molecular Oxygen and Aldoacetal Catalyzed by a Cobalt(II) Complex
Authors: Yorozu Kiyotaka , Takai Toshihiro , Yamada Tohru , Mukaiyama Teruaki
Published: July 2006

An efficient synthesis of acid-sensitive epoxides, such as chromene oxide or epoxide of γ,δ-unsaturated alcohol, was successfully achieved by the oxygenation of corresponding olefins with the combined use of an atmospheric pressure of molecular oxygen and aldoacetal catalyzed by a cobalt(II) complex coordinated with the 1,3-diketone ligand. The reactions proceeded under mild and neutral conditions, and the desired epoxides were obtained in good yields. Neither overoxidation nor decomposition of the formed epoxide was observed under the present reaction conditions. Furthermore, various silyl enol ethers and silyl ketene acetals, acid-sensitive compounds, were also smoothly monooxygenated into the corresponding α-hydroxy ketones and α-hydroxy carboxylic acid esters, respectively.
Thermal Decomposition of COS
Authors: Oya Masaaki , Shiina Hiroumi , Tsuchiya Kentaro , Matsui Hiroyuki
Published: July 2006

Thermal decomposition of COS was investigated by shock tubes between 1140—3230 K. The decay of COS and S was monitored by IR emissions and atomic resonance absorption spectrometry (ARAS) coupled with laser flash photolysis technique, respectively. The rate constants for the reactions COS + M → CO + S + M (1) and COS + S → CO + S2 (2) were determined as k1 = (4.07 ± 1.83) × 10−10exp (−257 ± 24kJ/RT), T: 1900—3230 K and k2 = (3.91 ± 1.18) × 10−11exp (−28.3 ± 0.9 kJ/RT) cm3 molecule−1 s−1, T: 1140—1680 K.
Repeated Use of the Catalyst in Ln(OTf)3-Catalyzed Aldol and Allylation Reactions
Authors: Kobayashi Shu , Hachiya Iwao , Yamanoi Yoshinori
Published: July 2006

The lanthanoide trifluoromethanesulfonate (lanthanoid triflate)-catalyzed aldol reactions of silyl enol ethers with aldehydes and allylation reactions of tetraallyltin with aldehydes proceeded smoothly in a water–ethanol–toluene system. The reactions proceeded much faster in the above solvent than in water–tetrahydrofuran. Repeated use of the catalyst in these reactions was realized by a very simple procedure.
Polarized Reflection Spectra of Perchlorate-Doped Oriented Polyacetylene
Authors: Miyamae Takayuki , Shimizu Masaaki , Tanaka Jiro
Published: July 2006

Polarized reflection spectra of a highly oriented new type polyacetylene doped with perchlorate are presented. From the reflection spectra, measured from far infrared to ultraviolet regions, the optical conductivity spectra are obtained by Kramers–Kronig analysis. Three stages of doping are recognized from a spectral analysis. (1) 0 < y < 0.02, where the charged soliton band is dominant; (2) 0.02 < y < 0.04, the spectra change completely and the polson band begins to grow; (3) 0.045 < y, the spectral characteristic of metallic phase appears. Three-dimensional interaction of the polson chain is found to be essential for appearance of metallic conductivity. The origin of metallic properties is discussed from the change of spectra at different dopant concentration. The effect of orientation of polyacetylene chain on the spectra is discussed.
Crystal Structures of trans-[CoCl2{(CH3)2PCH2CH2P(CH3)2}2]ClO4, trans(Cl,Cl)cis(P,P)-[CoCl2{NH2CH2CH2P(CH3)2}2]PF6·0.5CH3OH, and trans-[CoCl2(NH2CH2CH2NH2)2]NO3
Authors: Kita Masakazu , Kashiwabara Kazuo , Fujita Junnosuke , Tanaka Hitoshi , Ohba Shigeru
Published: July 2006

The crystal structures of trans-[CoCl2(dmpe)2]ClO4 (dmpe = 1,2-bis(dimethylphosphino)ethane) (1), trans(Cl,Cl)cis(P,P)-[CoCl2(edmp)2]PF6·0.5CH3OH (edmp = (2-aminoethyl)dimethylphosphine) (2) and trans-[CoCl2(en)2]NO3 (en = 1,2-ethanediamine) (3) were determined by the single-crystal X-ray diffraction method. Crystal data and final R values are: for 1, orthorhombic, Ccca, a = 15.192(3), b = 16.221(4), c = 18.129(3) Å, V = 4468(1) Å3, Dx = 1.58, Dm = 1.60 g cm−3, and Z = 8, and R = 0.041 for 2360 reflections; for 2, orthorhombic, C2221, a = 15.295(4), b = 18.583(5), c = 14.680(4) Å, V = 4172(2) Å3, Dx = 1.59, Dm = 1.63 g cm−3, and Z = 8, and R = 0.099 for 4626 reflections; for 3, monoclinic, P21/n, a = 6.348(1), b = 9.304(1), c = 9.853(1) Å, β = 101.79(1)°, V = 569.6(1) Å3, Dx = 1.82, Dm = 1.85 g cm−3, and Z = 2, and R = 0.043 for 1024 reflections. The Co–P bond distances (av 2.196(3) Å) in 2 is shorter by 0.063 Å than that (av 2.259(1) Å) in 1, while the Co–N bond distance (av 2.039(7) Å) in 2 is longer by 0.079 Å than that (av 1.960(3) Å) in 3, indicating the trans influence of the phosphino group. The metal-ligand bond distances were compared with those of the corresponding trans-dichloro complexes of Fe(II), Fe(III), Cr(III), and Rh(III).
Classification of XeII Lines
Authors: Tsuji Masaharu , Ishimi Hiroaki , Kaneko Nobuo , Nishimura Yukio
Published: July 2006

There are a number of unclassified XeII lines in the spectral table reported by Striganov and Sventitskii. Among them, electronic transitions of 52 XeII lines can be assigned with reference to the Moore’s atomic energy diagram. The table presented here complements the spectral table of Striganov and Sventitskii.
Modeling the “Pseudodeductible” in Insurance Claims Decisions
Authors: Braun Michael , Fader Peter S. , Bradlow Eric T. , Kunreuther Howard
Published: July 2006

In many different managerial contexts, consumers “leave money on the table” by, for example, their failure to claim rebates, use available coupons, and so on. This project focuses on a related problem faced by homeowners who may be reluctant to file insurance claims despite the fact their losses are covered. We model this consumer decision by introducing the concept of the “pseudodeductible,” a latent threshold above the policy deductible that governs the homeowner’s claim behavior. In addition, we show how the observed number of claims can be modeled as the output of three stochastic processes that are separately, and in conjunction, managerially relevant: the rate at which losses occur, the size of each loss, and the choice of the individual to file or not file a claim. By allowing for the possibility of pseudodeductibles, one can sort out (and make accurate inferences about) these three processes. We test this model using a proprietary data set provided by State Farm, the largest underwriter of personal lines insurance in the United States. Using mixtures of Dirichlet processes to capture heterogeneity and the interplay among the three processes, we uncover several relevant “stories” that underlie the frequency and severity of claims. For instance, some customers have a small number of losses, but all are filed as claims, whereas others may experience many more losses, but are more selective about which claims they file. These stories explain several observed phenomena regarding the claims decisions that insurance customers make, and have broad implications for customer lifetime value and market segmentation.
Smoking and reconstruction of the anterior cruciate ligament
Authors: Karim A. , Pandit H. , Murray J. , Wandless F. , Thomas N. P.
Published: July 2006

We sought to determine whether smoking affected the outcome of reconstruction of the anterior cruciate ligament. We analysed the results of 66 smokers (group 1 with a mean follow-up of 5.67 years (1.1 to 12.7)) and 238 non-smokers (group 2 with a mean follow-up of 6.61 years (1.2 to 11.5)), who were statistically similar in age, gender, graft type, fixation and associated meniscal and chondral pathology. The assessment was performed using the International Knee Documentation Committee form and serial cruciometer readings.

Poor outcomes were reported in group 1 for the mean subjective International Knee Documentation Committee score (p < 0.001), the frequency (p = 0.005) and intensity (p = 0.005) of pain, a side-to-side difference in knee laxity (p = 0.001) and the use of a four-strand hamstring graft (p = 0.015). Patients in group 1 were also less likely to return to their original level of pre-injury sport (p = 0.003) and had an overall worse final 7 International Knee Documentation Committee grade score (p = 0.007).

Despite the well-known negative effects of smoking on tissue healing, the association with an inferior outcome after reconstruction of the anterior cruciate ligament has not previously been described and should be included in the pre-operative counselling of patients undergoing the procedure.
The reliability and validity of the locognosia test after injuries to peripheral nerves in the hand
Authors: Jerosch-Herold C. , Rosén B. , Shepstone L.
Published: July 2006

Locognosia, the ability to localise touch, is one aspect of tactile spatial discrimination which relies on the integrity of peripheral end-organs as well as the somatosensory representation of the surface of the body in the brain. The test presented here is a standardised assessment which uses a protocol for testing locognosia in the zones of the hand supplied by the median and/or ulnar nerves.

The test-retest reliability and discriminant validity were investigated in 39 patients with injuries to the median or ulnar nerve. Intraclass correlation coefficients were used to calculate the test-retest reliability. Discriminant validity was assessed by comparing the injured with the unaffected hand.

Excellent test-retest reliability was demonstrated for the injuries to the median (intraclass correlation coefficient 0.924, 95% confidence interval 0.848 to 1.00) and the ulnar nerves (intraclass correlation coefficient 0.859, 95% confidence interval 0.693 to 1.00). The magnitude of the difference in scores between affected and unaffected hands showed good discriminant validity. For injuries to the median nerve the mean difference was 11.1 points (1 to 33; sd 7.4), which was statistically significant (p < 0.0001, paired t-test) and for those of the ulnar nerve it was 4.75 points (1 to 13.5; sd 3.16), which was also statistically significant (paired t-test, p < 0.0001).

The locognosia test has excellent test-retest reliability, is a valid test of tactile spatial discrimination and should be included in the evaluation of outcome after injury to peripheral nerves.
Two-stage revision of infected total knee replacements using articulating cement spacers and short-term antibiotic therapy
Authors: Hart W. J. , Jones R. S.
Published: July 2006

We present a series of 48 patients with infected total knee replacements managed by the use of articulating cement spacers and short-term parenteral antibiotic therapy in the postoperative period. All patients had microbiological and/or histological confirmation of infection at the first stage of their revision. They all underwent re-implantation and had a mean follow-up of 48.5 months (26 to 85).

Infection was successfully eradicated in 42 of the 48 patients (88%). Six had persistent infection which led to recurrence of symptoms and further surgery was successful in eliminating infection in four patients. These rates of success are similar to those of other comparable series. We conclude that protracted courses of intravenous antibiotic treatment may not be necessary in the management of the infected total knee replacement.

In addition, we analysed the microbiological, histological and serological results obtained at the time of re-implantation of the definitive prosthesis, but could not identify a single test which alone would accurately predict a successful outcome.
Rinsing morcellised bone grafts with bisphosphonate solution prevents their resorption
Authors: Kesteris U. , Aspenberg P.
Published: July 2006

During revision total hip replacement using morcellised compacted bone allograft, 16 patients were randomised to receive a graft which had been rinsed in either an ibandronate solution or in saline. Patients were assessed by dual energy x-ray absorptiometry after operation and at 3, 6, 12 and 24 months. A region of interest between the tip of the femoral stem and the distal plastic plug was chosen to measure the changes in bone density over time. The study was double-blinded. In all the control patients the bone density decreased during the first three months and then remained constant at this lower level. A large proportion of the mass of the bone graft was lost. In contrast, all patients with grafts treated with bisphosphonate showed a slight increase in bone density. The difference between the groups was highly significant at all points in time.

We conclude that rinsing the graft in a bisphosphonate solution prevents its resorption and may therefore reduce the risk of mechanical failure. The treatment is simple, inexpensive, and appears virtually free of risk.
A randomised study comparing resection of acetabular bone at resurfacing and total hip replacement
Authors: Vendittoli P.-A. , Lavigne M. , Girard J. , Roy A. G.
Published: July 2006

We have undertaken a prospective, randomised study to compare conservation of acetabular bone after total hip replacement and resurfacing arthroplasty of the hip. We randomly assigned 210 hips to one of the two treatment groups. Uncemented, press-fit acetabular components were used for both.

No significant difference was found in the mean diameter of acetabular implant inserted in the groups (54.74 mm for total hip replacement and 54.90 mm for resurfacing arthroplasty). In seven resurfacing procedures (6.8%), the surgeon used a larger size of component in order to match the corresponding diameter of the femoral component.

With resurfacing arthroplasty, conservation of bone is clearly advantageous on the femoral side. Our study has shown that, with a specific design of acetabular implant and by following a careful surgical technique, removal of bone on the acetabular side is comparable with that of total hip replacement.
Tourniquet use and its complications in Norway
Authors: Odinsson A. , Finsen V.
Published: July 2006

Over a two-year period, 265 Norwegian orthopaedic surgeons working at 71 institutions performed 63 484 operations under a tourniquet. Their replies to a questionnaire revealed that they mostly followed modern guidelines in their use of the tourniquet. Most felt that the tourniquet could be left on for two hours, and that it could be re-applied after 15 minutes. A total of 26 complications (one in 2442 operations) that might have been due to the tourniquet were reported, of which 15 were neurological. Three were in the upper limb (one in 6155 operations) and 12 in the lower limb (one in 3752 operations). Two were permanent (one in 31742 operations), but the remainder resolved within six months. One permanent and one transient complication occurred after tourniquet times of three hours. The incidence of tourniquet complications is still at least as high as that estimated in the 1970s.
A retrospective comparative study of bilateral total knee replacement staged at a one-week interval
Authors: Forster M. C. , Bauze A. J. , Bailie A. G. , Falworth M. S. , Oakeshott R. D.
Published: July 2006

The clinical results of bilateral total knee replacement staged at a one-week interval during a single hospital admission were compared with bilateral total knee replacements performed under the same anaesthetic and with bilateral total knee replacements performed during two separate admissions. The data were retrospectively reviewed. All operations had been performed by the same surgeon using the same design of prosthesis at a single institution.

The operative time and length of stay for the one-week staged group were comparable with those of the separate admission group but longer than for the patients treated under one anaesthetic. There was a low rate of complications and good clinical outcome in all groups at a mean follow-up of four years (1 to 7.2). The group staged at a one-week interval had the least blood loss (p = 0.004).

With appropriate patient selection, bilateral total knee replacement performed under a single anaesthetic, or staged at a one-week interval, is a safe and effective method to treat bilateral arthritis of the knee.
Serum aluminium and cobalt levels after ceramic-on-ceramic and metal-on-metal total hip replacement
Authors: Grübl A. , Weissinger M. , Brodner W. , Gleiss A. , Giurea A. , Gruber M. , Pöll G. , Meisinger V. , Gottsauner-Wolf F. , Kotz R.
Published: July 2006

In a randomised study, 28 patients with a mean age of 62.2 years (32 to 81) with osteoarthritis or avascular necrosis of the hip received either a ceramic-on-ceramic or a metal-on-metal total hip replacement. Apart from the liners the acetabular and femoral components were made of Ti-Al-Nb alloy. The serum aluminium and cobalt levels were measured before, and at one year after surgery.

The 15 patients in the ceramic-on-ceramic group had a median pre-operative aluminium level of 1.3 μg/l (0.25 to 8.4) and a cobalt level below the detection limit. At one year the aluminium level was 1.1 μg/l (0.25 to 2.3) and the cobalt level was 0.4 μg/l (0.15 to 0.7). The 13 patients in the metal-on-metal group had a median pre-operative aluminium level of 1.9 μg/l (0.25 to 4.4) and a cobalt level below the detection limit. At one year the median aluminium level was 0.9 μg/l (0.25 to 3.9) whereas the cobalt level was 1.4 μg/l (0.5 to 10.5). This increase in the cobalt level at one year was significant (p < 0.001).

Our findings indicate that ceramic-on-ceramic bearings do not cause elevated levels of serum aluminium in the first post-operative year.
Race/Ethnicity and Nativity Differences in Alcohol and Tobacco Use During Pregnancy
Authors: Perreira Krista M. , Cortes Kalena E.
Published: July 2006

Objectives. We examined race/ethnicity and nativity correlates of prenatal substance use.

Methods. Using data on a nationally representative cohort of pregnant women in US cities (N=4185), we evaluated the relative importance of socioeconomic status, paternal health behaviors, social support, and maternal stress and health history in explaining variations in prenatal substance use by race/ethnicity and nativity.

Results. Maternal stress and health history appeared to fully explain differences in alcohol use by nativity, but these and other factors could not explain differences in prenatal smoking. For all races/ethnicities, paternal health behaviors were most strongly associated with maternal substance use. Except among Black women, socioeconomic background bore little relation to prenatal substance use after adjustment for more proximal risk factors (e.g., paternal and maternal health behaviors). Social support was most protective among Hispanic women.

Conclusions. Foreign-born immigrant women are at equal risk of prenatal alcohol use compared with similarly situated US-born women and should not be overlooked in the design of interventions for at-risk women. Furthermore, the inclusion of fathers and the development of social support structures for at-risk women can strengthen interventions.
School-Based Health Centers and the Decline in Black Teen Fertility During the 1990s in Denver, Colorado
Authors: Ricketts Sue A. , Guernsey Bruce P.
Published: July 2006

Objectives. We examined the changes in Black adolescent fertility rates in high-school areas with school-based health centers and compared them over time with changes in rates in high-school areas without school-based health centers.

Methods. Fertility rates were estimated for high-school areas with and without school-based health centers with geocoded birth certificate and school enrollment data.

Results. A high adolescent fertility rate (165 births/1000) in 1992 among Black students in Denver high-school areas with school-based health centers declined to a low rate (38/1000) in 1997 that matched the rate of school areas that did not have school-based health centers. Rates declined for both types of areas over the study period, but the rate of decline in the areas with school-based health centers was significantly greater (77% vs 56%).

Conclusions. The rapid and significant decline in Black adolescent fertility in school areas with school-based health centers strongly suggests that attending to the health needs of students at risk of pregnancy resulted in a radically lowered risk of fertility. The decline is likely the result of strategies to identify, intervene, and follow-up on students engaging in behaviors that place them at risk for unintended pregnancy.
Trends in Hospitalization and Sociodemographic Factors in Diabetic and Nondiabetic Populations in Germany: National Health Survey, 1990–1992 and 1998
Authors: Icks Andrea , Haastert Burkhard , Rathmann Wolfgang , Rosenbauer Joachim , Giani Guido
Published: July 2006

Objectives. We examined time trends of hospitalization, a main outcome measure in health care, in the diabetic and nondiabetic populations in Germany and their associations with sociodemographic variables.

Methods. Using data from 2 national health surveys, we estimated hospital days per person-year in the diabetic and nondiabetic populations in 1998 (n=5422) and 1990–1992 (n=7363) in Germany. We used Poisson regression to estimate relative risks and interaction of secular time with age, gender, and educational level, considering the cluster sample design of the study.

Results. Hospital days per person-year decreased between 1990–1992 and 1998—from 3.59 (95% confidence interval [CI]=2.59, 4.97) to 3.14 (95% CI=2.16, 4.56) for the diabetic population and from 1.38 (95% CI=1.23, 1.55) to 1.33 (95% CI=1.17, 1.51) for the nondiabetic population—but the decrease was not statistically significant. In the diabetic population, the decrease tended to be more pronounced (interaction year × time not significant; P=.756). Also, there was a notable decrease in men and in the group aged 25 to 39 years, and a decrease in both high- and low-educational-level subjects.

Conclusions. There seems to have been a larger decrease in hospitalization in the diabetic population than in the nondiabetic population in Germany. An increase in social disparity in this health outcome measure in the diabetic population could not be confirmed.
Missed Opportunities for Type 2 Diabetes Mellitus Screening Among Women With a History of Gestational Diabetes Mellitus
Authors: Kim Catherine , Tabaei Bahman P. , Burke Ray , McEwen Laura N. , Lash Robert W. , Johnson Susan L. , Schwartz Kendra L. , Bernstein Steven J. , Herman William H.
Published: July 2006

Objectives. We sought to determine rates and factors associated with screening for type 2 diabetes mellitus (DM) in women with a history of gestational diabetes mellitus.

Methods. We retrospectively studied women with diagnosed gestational diabetes mellitus who delivered at a university-affiliated hospital (n=570). Data sources included medical and administrative record review. Main outcome measures were the frequency of any type of glucose testing at least 6 weeks after delivery and the frequency of recommended glucose testing. We assessed demographic data, past medical history, and prenatal and postpartum care characteristics.

Results. Rates of glucose testing after delivery were low. Any type of glucose testing was performed at least once after 38% of deliveries, and recommended glucose testing was performed at least once after 23% of deliveries. Among women with at least 1 visit to the health care system after delivery (n=447), 42% received any type of glucose test at least once, and 35% received a recommended glucose test at least once. Factors associated with testing were being married, having a visit with an endocrinologist after delivery, and having more visits after delivery.

Conclusions. These findings suggest that most women with gestational diabetes mellitus are not screened for type 2 DM after delivery. Opportunities for DM prevention and early treatment are being missed.
Meeting the Dietary Reference Intakes for Fiber: Sociodemographic Characteristics of Preschoolers With High Fiber Intakes
Authors: Kranz Sibylle
Published: July 2006

To better understand the public health impact of the National Academy of Sciences’ Dietary Reference Intakes (DRIs) for fiber in preschoolers, I analyzed data from the United States Department of Agriculture Continuing Survey of Food Intake in Individuals for 5437 preschoolers and examined sociodemographic predictors of meeting the DRIs. Overall, only 12% of the children met the DRIs.

Older children (age 4 and 5 years) were less likely than younger children, girls were less likely than boys, and children from medium-income families (those earning 186% to 350% of the poverty guidelines, with poverty set at 100%) were least likely to meet the DRIs. Low-income children participating in the Special Supplemental Nutrition Program for Women, Infants, and Children were twice as likely as nonparticipants to meet the DRIs. The public should be educated about the importance of increasing fiber density in the diet.
The Power of Policy: A Case Study of Healthy Eating Among Children
Authors: Cassady Diana , Vogt Rainbow , Oto-Kent Debbie , Mosley Ramona , Lincoln Richard
Published: July 2006

We used a case study approach to examine the nutritional effect of a policy to increase fruit and vegetable consumption in the Students Today Achieving Results for Tomorrow after-school program. The snack menu was changed in 44 after-school programs serving 8000 low-income and ethnically diverse elementary-school students. A comparison of previous and current snack menus identified a significant increase in fruit servings (83%) and no change in vegetable servings. We discuss the unintended consequences resulting from the menu changes.
Identification of American Indian and Alaska Native Veterans in Administrative Data of the Veterans Health Administration and the Indian Health Service
Authors: Kramer B. Josea , Wang Mingming , Hoang Tuyen , Harker Judith O. , Finke Bruce , Saliba Debra
Published: July 2006

We sought to determine the extent to which the Indian Health Service (IHS) identified enrollees who also use the Veterans Health Administration (VHA) as veterans. We used a bivariate analysis of administrative data from fiscal years 2002–2003 to study the target population. Of the 32259 IHS enrollees who received care as veterans in the VHA, only 44% were identified by IHS as veterans. IHS data underestimates the number of veterans, and both IHS and VHA need mechanisms to recognize mutual beneficiaries in order to facilitate better coordination of strategic planning and resource sharing among federal health care agencies.
Asthma and Enrollment in Special Education Among Urban Schoolchildren
Authors: Stingone Jeanette A. , Claudio Luz
Published: July 2006

Objectives. We assessed whether asthma is associated with urban children’s use of special education services.

Methods. We conducted a cross-sectional study in 24 randomly selected New York City public elementary schools using a parent-report questionnaire focusing on sociodemographic characteristics, special education enrollment, asthma diagnosis and symptoms, school absences, and use of health care services.

Results. Thirty-four percent of children enrolled in special education had been diagnosed with asthma, compared with 19% of children in the general student population. After control for sociodemographic factors, children with asthma were 60% more likely than children without asthma to be enrolled in special education (odds ratio [OR] = 1.62; 95% confidence interval [CI] = 1.22, 2.16). Asthmatic children in special education were significantly more likely to be from low-income families and to have been hospitalized in the previous 12 months than asthmatic children in general education.

Conclusions. Inadequate asthma control may contribute to a greater risk of asthmatic children residing in urban areas being placed in special education. School health programs should consider targeting low-income urban children with asthma at risk for enrollment in special education through increased asthma interventions and medical support services.
The Influence of Marital Status on Self-Report of Symptoms of Psychological Burnout among Nurses
Authors: Ifeagwazi Fr. Chuka Mike
Published: July 2006

This study investigated the influence of marital status on self-report of symptoms of psychological burnout among nurses. Ninety-one female nurses comprising 51 married nurses and 40 widowed nurses drawn from seven hospital units of the University of Nigeria Teaching Hospital Enugu participated in the study. They were individually administered the Nigerian adaptation of Maslach Burnout Inventory (MBI) (Ugwu, 1998) originally developed by Maslach and Jackson (1981). A one-way analysis of variance (ANOVA) was performed on the data to test the first research question of the study. In addition, a separate one-way analysis of variance and the Duncan Multiple Range Test were performed to test the second research question. Results showed that the widowed nurses reported significantly higher burn-out symptoms than the married nurses ( p < .001). The analysis of variance also indicated significant differences among the hospital units on the mean burnout symptoms reported by the nursing staff ( p < .001). Results of the Duncan Multiple Range Test revealed that nurses on the theatre unit had a mean burnout symptoms score that was significantly higher than nurses on the postnatal, casualty, labor, surgical and out-patient units. Nurses on the intensive care unit (ICU) had a mean burnout symptom score that was significantly higher than nurses on the postnatal unit. The results were explained within the framework of the protection/support hypothesis (Adler, 1953). It was suggested that the nursing staff should adopt adequate self-care measures such as having enough rest, vacation, and exercise to reduce the potential for burnout.
Mental Distress and Family Functioning in Bereaved Parents: Case Examples and Intervention Challenges
Authors: Lohan Janet A. , Murphy Shirley A.
Published: July 2006

Mental distress and family functioning are important adaptive challenges that affect bereaved parents differentially by gender. In this second of two articles, we provide insights into mental distress and family functioning and intervention challenges. The Olson Circumplex Model (Olson, 1985) was used to determine levels of family functioning for 30 couples with children living at home. Based on these results and mental distress scores, four couples were selected for in-depth analysis. Results showed that discrepancies within couples changed over time. It was concluded that both mental distress and family functioning should be addressed jointly in intervention planning.
National Trends in Sales and Price for Commercial Tobacco and Nicotine Products, 2018-2022
Authors: Ganz Ollie , LaVake Melanie , Hrywna Mary , King Jensen Jessica L. , Delnevo Cristine D.
Published: March 2024

This cross-sectional study explores recent trends in sales and price of tobacco and nicotine products in the US.
Charting the Path to Systemic Therapy De-escalation—Oligometastatic Kidney Cancer as a Paradigm
Authors: Tang Chad , Msaouel Pavlos
Published: March 2024

This Viewpoint discusses whether select patient populations may benefit from de-escalation rather than escalation of systemic therapy for kidney cancer.
Efficacy and Safety of Radiotherapy Plus Relugolix in Men With Localized or Advanced Prostate Cancer
Authors: Spratt Daniel E. , George Daniel J. , Shore Neal D. , Cookson Michael S. , Saltzstein Daniel R. , Tutrone Ronald , Bossi Alberto , Brown Bruce A. , Lu Sophia , Fallick Mark , Hanson Sarah , Tombal Bertrand F.
Published: March 2024

Importance

Combination androgen deprivation therapy (ADT) with radiotherapy is commonly used for patients with localized and advanced prostate cancer.

Objective

To assess the efficacy and safety of the oral gonadotropin-releasing hormone antagonist relugolix with radiotherapy for treating prostate cancer.

Design, Setting, and Participants

This multicenter post hoc analysis of patients with localized and advanced prostate cancer receiving radiotherapy in 2 randomized clinical trials (a phase 2 trial of relugolix vs degarelix, and a subset of the phase 3 HERO trial of relugolix vs leuprolide acetate) included men who were receiving radiotherapy and short-term (24 weeks) ADT (n = 103) from 2014 to 2015 and men receiving radiotherapy and longer-term (48 weeks) ADT (n = 157) from 2017 to 2019. The data were analyzed in November 2022.

Interventions

Patients receiving short-term ADT received relugolix, 120 mg, orally once daily (320-mg loading dose) or degarelix, 80 mg, 4-week depot (240-mg loading dose) for 24 weeks with 12 weeks of follow-up. Patients receiving longer-term ADT received relugolix, 120 mg, orally once daily (360-mg loading dose) or leuprolide acetate injections every 12 weeks for 48 weeks, with up to 90 days of follow-up.

Main Outcomes and Measures

Castration rate (testosterone level <50 ng/dL [to convert to nmol/L, multiply by 0.0347) at all scheduled visits between weeks 5 and 25 for patients receiving short-term ADT and weeks 5 and 49 for patients receiving longer-term ADT.

Results

Of 260 patients (38 Asian [14.6%], 23 Black or African American [8.8%], 21 Hispanic [8.1%], and 188 White [72.3%] individuals), 164 (63.1%) received relugolix. Relugolix achieved castration rates of 95% (95% CI, 87.1%-99.0%) and 97% (95% CI, 90.6%-99.0%) among patients receiving short-term and longer-term ADT, respectively. Twelve weeks post–short-term relugolix, 34 (52%) achieved testosterone levels to baseline or more than 280 ng/dL. Ninety days post longer-term ADT, mean (SD) testosterone levels were 310.5 (122.4) (106.7) ng/dL (relugolix; n = 15) vs 53.0 ng/dL (leuprolide acetate; n = 8) among the subset assessed for testosterone recovery. Castration resistance-free survival was not statistically different between the relugolix and leuprolide acetate cohorts (hazard ratio, 0.97; 95% CI, 0.35-2.72; P = .62). Adverse events grade 3 or greater for short-term or longer-term relugolix (headache, hypertension, and atrial fibrillation) were uncommon (less than 5%).

Conclusions and Relevance

The results of these 2 randomized clinical trials suggest that relugolix rapidly achieves sustained castration in patients with localized and advanced prostate cancer receiving radiotherapy. No new safety concerns were identified when relugolix was used with radiotherapy.
Multinational External Validation of Autonomous Retinopathy of Prematurity Screening
Authors: Coyner Aaron S. , Murickan Tom , Oh Minn A. , Young Benjamin K. , Ostmo Susan R. , Singh Praveer , Chan R. V. Paul , Moshfeghi Darius M. , Shah Parag K. , Venkatapathy Narendran , Chiang Michael F. , Kalpathy-Cramer Jayashree , Campbell J. Peter
Published: March 2024

Importance

Retinopathy of prematurity (ROP) is a leading cause of blindness in children, with significant disparities in outcomes between high-income and low-income countries, due in part to insufficient access to ROP screening.

Objective

To evaluate how well autonomous artificial intelligence (AI)–based ROP screening can detect more-than-mild ROP (mtmROP) and type 1 ROP.

Design, Setting, and Participants

This diagnostic study evaluated the performance of an AI algorithm, trained and calibrated using 2530 examinations from 843 infants in the Imaging and Informatics in Retinopathy of Prematurity (i-ROP) study, on 2 external datasets (6245 examinations from 1545 infants in the Stanford University Network for Diagnosis of ROP [SUNDROP] and 5635 examinations from 2699 infants in the Aravind Eye Care Systems [AECS] telemedicine programs). Data were taken from 11 and 48 neonatal care units in the US and India, respectively. Data were collected from January 2012 to July 2021, and data were analyzed from July to December 2023.

Exposures

An imaging processing pipeline was created using deep learning to autonomously identify mtmROP and type 1 ROP in eye examinations performed via telemedicine.

Main Outcomes and Measures

The area under the receiver operating characteristics curve (AUROC) as well as sensitivity and specificity for detection of mtmROP and type 1 ROP at the eye examination and patient levels.

Results

The prevalence of mtmROP and type 1 ROP were 5.9% (91 of 1545) and 1.2% (18 of 1545), respectively, in the SUNDROP dataset and 6.2% (168 of 2699) and 2.5% (68 of 2699) in the AECS dataset. Examination-level AUROCs for mtmROP and type 1 ROP were 0.896 and 0.985, respectively, in the SUNDROP dataset and 0.920 and 0.982 in the AECS dataset. At the cross-sectional examination level, mtmROP detection had high sensitivity (SUNDROP: mtmROP, 83.5%; 95% CI, 76.6-87.7; type 1 ROP, 82.2%; 95% CI, 81.2-83.1; AECS: mtmROP, 80.8%; 95% CI, 76.2-84.9; type 1 ROP, 87.8%; 95% CI, 86.8-88.7). At the patient level, all infants who developed type 1 ROP screened positive (SUNDROP: 100%; 95% CI, 81.4-100; AECS: 100%; 95% CI, 94.7-100) prior to diagnosis.

Conclusions and Relevance

Where and when ROP telemedicine programs can be implemented, autonomous ROP screening may be an effective force multiplier for secondary prevention of ROP.
Water-Free Cyclosporine Ophthalmic Solution vs Vehicle for Dry Eye Disease
Authors: Peng Rongmei , Jie Ying , Long Qin , Gong Lan , Zhu Lei , Zhong Xingwu , Zhao Shaozhen , Yan Xiaoming , Gu Hao , Wu Huping , Li Gang , Zhang Kaiyun , Krösser Sonja , Xu Ruxia , Hong Jing
Published: March 2024

Importance

Dry eye disease (DED) is a prevalent eye disorder. Cyclosporine is an effective immunomodulator that is widely used in DED; however, due to its highly hydrophobic nature, delivery of cyclosporine to the ocular surface is challenging.

Objective

To evaluate the efficacy and safety of SHR8028, a water-free cyclosporine ophthalmic solution, 0.1%, compared with vehicle in Chinese participants with DED.

Design, Setting, and Participants

This was a multicenter, double-blind, vehicle-controlled, phase 3 randomized clinical trial conducted from March 4, 2021, to July 22, 2022. Adult participants with moderate to severe DED were recruited from 12 hospitals in China. Study data were analyzed April 2, 2022, for the primary analysis.

Interventions

Following a 14-day run-in period with an artificial tear, participants were randomly assigned (1:1) to receive water-free cyclosporine or vehicle (1 eye drop in each eye twice daily). After a 29-day treatment, participants of both groups were given the option to receive water-free cyclosporine for an additional 12 weeks for longer-term safety assessment.

Main Outcomes and Measures

The primary end points were changes from baseline in total corneal fluorescein staining (tCFS) using the National Eye Institute scale and in dryness score on a visual analog scale at day 29.

Results

A total of 206 participants (mean [SD] age, 47.8 [14.2] years; 185 female [90%]) were enrolled, with 103 each in the cyclosporine group and the vehicle group. At day 29, the cyclosporine group experienced improved tCFS compared with vehicle (change [Δ] = −1.8; 95% CI, −2.7 to −1.0; P < .001), with a tCFS score decrease from baseline of −4.8 in the cyclosporine group and −3.0 in the vehicle group. Dryness score decreased from baseline in both groups (−19.2 vs −15.4; Δ = −3.8; 95% CI, −9.2 to 1.6; P = .17). During the 29-day treatment, treatment-related adverse events were reported in 15 participants (14.6%) in the cyclosporine group and 11 participants (10.7%) in the vehicle group.

Conclusions And Relevance

Results demonstrated superiority of a water-free cyclosporine, 0.1%, eye solution over vehicle in improving tCFS score at day 29 in Chinese participants with DED. However, dryness score (VAS) was not improved at day 29.

Trial Registration

ClinicalTrials.gov Identifier: NCT05841043
First density estimates for a recovering bobcat population in Ohio using DNA from scat
Authors: Dyck Marissa A. , Uhrig Genelle , Spear Stephen F. , Iosif Ruben , Popescu Viorel D.
Published: March 2024

The recovery of mammalian species in the US Midwest through natural recolonization constitutes a conservation success story, yet management remains challenging due to many unknowns related to population dynamics and numeric trends. Abundance is a critical parameter for management decisions, and estimating the density and abundance of elusive species, such as terrestrial carnivores, remains challenging despite recent technological advances. In this study, we evaluated density and abundance of a recovering carnivore species, the bobcat (Lynx rufus) in two areas of Ohio using non‐invasive DNA from scat. The target areas in eastern and southern Ohio have been shown to have uneven dynamics and recolonization success and we expected that this would be reflected in differences in density and abundance. We collected 298 bobcat scats between July 2018 and April 2019 on 150 km of repeated transects. Of these, 102 scats were successfully genotyped, and 55 individuals were identified (33 in eastern Ohio and 22 in southern Ohio). Using Spatially Explicit Capture–Recapture models, we estimated 18.9 ± 4.1 and 10.9 ± 2.7 bobcats/100 km2 in eastern and southern Ohio study areas, respectively. Our results support prior telemetry data which indicated that bobcats in eastern Ohio had smaller home‐ranges than bobcats in southern Ohio, and thus could support a higher density of individuals. The higher densities were similar to other eastern US populations and are much higher than other Midwestern recovering populations. Our results provide a snapshot of the population status and can be used to determine sustainable management strategies for Ohio's bobcat population.
Command filter‐based adaptive robust prescribed performance formation control for nonlinear multi‐agent systems
Authors: Cao Xuemei , Li Kewen , Li Yongming
Published: March 2024

This paper investigates an observer‐based adaptive robust fuzzy formation tracking control method for nonlinear multi‐agent systems (MAS) with input delay. The considered nonlinear MAS contains the unknown nonlinear functions, that is, unmeasured states. The fuzzy logic systems (FLS) are used to approximate the unknown nonlinear functions, and then a fuzzy adaptive state observer is designed to estimate the unmeasured states. The Pade approximation approach is introduced to solve the input delay issue. By combining command filtering and backstepping recursive control techniques, a robust adaptive prescribed performance formation output feedback tracking controller is designed. Moreover, the proposed controller can avoid the “explosion of complexity” and “singularity” problems in the backstepping design framework. Based on Lyapunov stability theory, it is proved that all signals in the closed‐loop system are semi‐globally uniformly ultimately bounded (SGUUB), and the formation tracking errors do not exceed the prescribed performance bounds. Finally, the feasibility of the proposed control approach can be further verified through numerical and practical examples.