bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessing formal accountability for public policies: the case of health policy in Spain
Authors: Pérez Durán Ixchel
Published: June 2015

The aim of this study is to present a framework for analyzing and assessing accountability for public policies. First, I suggest two dimensions for analyzing accountability for policies (the informative/justifying dimension, and the evaluative/sanctioning dimension), applied to the implementation phase of the policy and, in particular, to three central elements that make up this phase (the actors responsible, the resources, and the policy results). Second, I suggest assessing accountability for a public policy starting from the degree of formalization and, specifically, from compliance with four characteristics of its regulatory framework: specific, binding, public and autonomous character. Third, I develop an empirical application of this proposal to the analysis of health policy in Spain, whose decentralized design, where regional governments are responsible for its implementation, allows us to analyze the differences in the levels of accountability for this policy across regions.

Points for practitioners

This study identifies and limits the components that can be incorporated into the analysis of accountability for public policies by providing an analytical framework that can be used to measure and compare levels of accountability for different kinds of policies (e.g. health, education, pensions) in different contexts (e.g. countries, regions, local governments). In order to test the validity of the proposal developed here, this article presents an empirical application to the analysis of health policy in Spain, whose decentralized design allows us to analyze the differences in accountability across regional governments.
Influence of micro and nanofillers on mechanical properties of pultruded unidirectional glass fiber reinforced epoxy composite systems
Authors: Manjunath M , Renukappa NM , Suresha B
Published: June 2015

This paper reports, fabrication and characterization of unidirectional glass fiber reinforced epoxy composite filled with nano-size alumina, silica and micron-size alumina trihydrate fillers using pultrusion technique. Tensile, flexural and impact strengths were determined to evaluate the effectiveness of fillers on the mechanical properties. Results show that the micro and nanofillers act as secondary reinforcement. The tensile, flexural and impact strengths of 10 wt% (combined alumina, silica and alumina trihydrate)-filled glass fiber reinforced epoxy composite improved by 9, 20 and 28%, respectively, as compared to the unfilled and alumina/silica-filled glass fiber reinforced epoxy composites. The enhanced performance of micro and nanofillers-filled glass fiber reinforced epoxy composites is due to better adhesion and good dispersion of particulates in the epoxy matrix providing increased surface area for strong interfacial interaction and better load transfer. The improved mechanical properties indicate that the unidirectional glass fiber reinforced epoxy with combined micro- and nanofillers-filled composite is a good candidate for structural application.
Impact behavior of different cross-ply laminated carbon fiber-reinforced silicon carbide composites under the low velocity
Authors: Mei Hui , Han Daoyang , Farhan Shameel , Cheng Laifei , Xu Hongrui , Liu Yongsheng
Published: June 2015

Carbon fiber-reinforced silicon carbide composites (C/SiC) were fabricated by a chemical vapor infiltration process using various ply orientations of 2D carbon fabric in the preform. The effect of ply angles (0°/90°, 45°/−45°, and 0°/45°/90°/−45°) on the low-velocity impact damage of the C/SiC composites was investigated externally and internally. Different depths of pits were formed in the impacted side with fibers sheared off, whereas fiber bundles breakage and matrix cracking appeared on the back side. The sample with 0°/90° ply angles experienced a serious fiber fracture and stratification damage, while the other two samples only showed a slight stratification. The samples with 0°/45°/90°/−45° and 0°/90° ply angles had nearly the same strength loss rate, which was smaller than that of the sample with 45°/−45° ply angle. In 45°/−45°, the ply angle had a major influence on the residual strength as the fibers were at 45° to the loading direction. Comparison of compression strength of the samples before and after impact test showed that the quasi-isotropic laminate improved the impact damage resistance due to the prevention of the devastating crack extension.
Catheter specimen urines: are they worth culturing?
Authors: Khalsa Kamaljit , Deshpande Ashutosh , Whitehead Sarah
Published: June 2015

Urinary tract infections are the most commonly acquired bacterial infections, but the significance of growths from catheter-related specimens, particularly heavy mixed growths, is uncertain and can pose a dilemma for the clinical laboratory responsible for processing and authorising reports, as well as a diagnostic dilemma for clinicians. Furthermore, inappropriate processing and reporting of samples may lead to inappropriate treatment of patients, which can result in adverse effects as well as increased laboratory and clinical costs. This short communication summarises recent evidence and guidelines on the matter.
Energy‐Dense Formulae May Slow Gastric Emptying in the Critically Ill
Authors: Kar Palash , Plummer Mark P. , Chapman Marianne J. , Cousins Caroline E. , Lange Kylie , Horowitz Michael , Jones Karen L. , Deane Adam M.
Published: June 2015

Background: Enteral feed intolerance occurs frequently in critically ill patients and can be associated with adverse outcomes. “Energy‐dense formulae” (ie, >1 kcal/mL) are often prescribed to critically ill patients to reduce administered volume and are presumed to maintain or increase calorie delivery. The aim of this study was to compare gastric emptying of standard and energy‐dense formulae in critically ill patients. Methods: In a retrospective comparison of 2 studies, data were analyzed from 2 groups of patients that received a radiolabeled 100‐mL “meal” containing either standard calories (1 kcal/mL) or concentrated calories (energy‐dense formulae; 2 kcal/mL). Gastric emptying was measured using a scintigraphic technique. Radioisotope data were collected for 4 hours and gastric emptying quantified. Data are presented as mean ± SE or median [interquartile range] as appropriate. Results: Forty patients were studied (n = 18, energy‐dense formulae; n = 22, standard). Groups were well matched in terms of demographics. However, patients in the energy‐dense formula group were studied earlier in their intensive care unit admission (P = .02) and had a greater proportion requiring inotropes (P = .002). A similar amount of calories emptied out of the stomach per unit time (P = .57), but in patients receiving energy‐dense formulae, a greater volume of meal was retained in the stomach (P = .045), consistent with slower gastric emptying. Conclusions: In critically ill patients, the administration of the same volume of a concentrated enteral nutrition formula may not result in the delivery of more calories to the small intestine over time because gastric emptying is slowed.
Pleural fat-forming variant of solitary fibrous tumor
Authors: Hui Cheryl LY , Asmat Atasha , Ali Akbar Fazuludeen , Rajapaksha Keerthi , Chau Cora Yuk-Ping , Ahmed Aneez Dokeu Basheer
Published: June 2015

The fat-forming variant of solitary fibrous tumor is rare. It occurs predominantly in the deep soft tissues of the retroperitoneum and thigh. We describe a case of fat-forming solitary fibrous tumor arising from the pleura, which was successfully treated using a video-assisted thoracoscopic approach. The patient remained free of recurrence 2 years after surgery and continues to be under long-term follow-up.
Management of partial anomalous pulmonary venous connection in single ventricle
Authors: Sugiura Junya , Sakurai Hajime , Nonaka Toshimichi , Sakurai Takahisa , Taneichi Tetsuyoshi , Otsuka Ryohei
Published: June 2015

We herein report a case of a hypoplastic left heart syndrome variant complicated with partial anomalous pulmonary venous connection to the left innominate vein. We left the vertical vein at the time of the bidirectional Glenn procedure, and ligated the vertical vein at the time of the total cavopulmonary connection procedure, without reconnecting the vertical vein to the left atrium. Because of the development of an interlobar vein draining from the left upper lung into the lower lung after the bidirectional Glenn procedure, the circulation of the left upper lung was preserved after the total cavopulmonary connection procedure.
Problematic Internet use among Spanish adolescents: The predictive role of Internet preference and family relationships
Authors: López de Ayala López María Cruz , Sendín Gutierrez José Carlos , García Jiménez Antonio
Published: June 2015

Inasmuch as adolescents are intensive Internet users, concern about the negative effects of Internet on their social wellbeing and their daily lives has also become a matter of social interest. Based on a representative sample of 2077 Spanish adolescents, this study analyses the influence on perceived discomfort from lack of online access and the negative consequences on daily lives as perceived by the adolescents themselves of two factors: on the one hand, preferences for online communication and, on the other, how they regard their family relationships, controlling other factors that the literature associates with problematic Internet use. The results of various logistic regression studies indicate that both factors influence the analysed indicators in distinctive ways and the implications are discussed.
Immunodetection and subcellular distribution of imidazoline receptor proteins with three antibodies in mouse and human brains: Effects of treatments with I1- and I2-imidazoline drugs
Authors: Keller Benjamin , García-Sevilla Jesús A
Published: June 2015

Various imidazoline receptor (IR) proteins have been proposed to mediate the effects of selective I1- and I2-IR drugs. However, the association of these IR-binding proteins with classic I1- and I2-radioligand binding sites remains somewhat controversial. In this study, three IR antibodies (anti-NISCH and anti-nischarin for I1-IRs; and anti-IRBP for I1/I2-IRs) were used to immunodetect, characterize and compare IR protein patterns in brain (mouse and human; total homogenate, subcellular fractionation, grey and white matter) and some cell systems (neurones, astrocytes, human platelets). Various immunoreactive IRs (specific molecular weight bands coincidently detected with the different antibodies) were related to I1-IR (167 kDa, 105/115 kDa and 85 kDa proteins) or I2-IR (66 kDa, 45 kDa and 30 kDa proteins) types. The biochemical characterization of cortical 167 kDa protein, localized in the membrane/cytosol but not in the nucleus, indicated that this I1-IR also forms part of higher order nischarin-related complexes. The contents of I1-IR (167 kDa, 105/115 kDa, and 85 kDa) proteins in mouse brain cortex were upregulated by treatment with I1-drugs (moxonidine, efaroxan) but not with I2-drugs (BU-224, LSL 61122). Conversely, the contents of I2-IR (66 kDa, 45 kDa and 30 kDa) proteins in mouse brain cortex were modulated by treatment with I2-drugs (decreases after BU-224 and LSL 61122, and increases after idazoxan) but not with I1-drugs (with the exception of moxonidine). These findings further indicate that brain immunoreactive IR proteins exist in multiple forms that can be grouped in the already known I1- and I2-IR types, which are expressed both in neurones and astrocytes.
Efficacy of drug treatment for acute mania differs across geographic regions: An individual patient data meta-analysis of placebo-controlled studies
Authors: Welten Carlijn CM , Koeter MWJ , Wohlfarth TD , Storosum JG , van den Brink W , Gispen-de Wied CC , Leufkens HGM , Denys DAJP
Published: June 2015

Given globalization trends in the conduct of clinical trials, the external validity of trial results across geographic regions is questioned. The objective of this study was to examine the efficacy of treatment in acute mania in bipolar disorder across regions and to explain potential differences by differences in patient characteristics. We performed a meta-analysis of individual patient data from 12 registration studies for the indication acute manic episode of bipolar disorder. Patients ( n = 3207) were classified into one of three geographic regions: Europe ( n = 981), USA ( n = 1270), and other regions ( n = 956). Primary outcome measures were mean symptom change score on the Young Mania Rating Scale (YMRS) from baseline to endpoint and responder status (50% improvement form baseline). Effect sizes were significantly smaller in the USA ( g = 0.203, 95% confidence interval (CI) 0.062–0.344; odds ratio (OR) 1.406, 95% CI 0.998–1.980) than in Europe ( g = 0.476, 95% CI 0.200–0.672; OR 2.380, 95% CI 1.682–3.368) or other regions ( g = 0.533, 95% CI 0.399–0.667; OR 2.300, 95% CI 1.800–2.941). Regional differences in age, gender, initial severity, body mass index, placebo response, discontinuation rate, and type of compound could not explain the geographic differences in effect. Less severe symptoms at baseline in the US patients did explain some of the difference in responder status between patients in Europe and the USA. These findings suggest that the results of studies involving patients with acute mania cannot be extrapolated across geographic regions. Similar findings have been identified in schizophrenia, contraceptive, and in cardiovascular trials. Therefore, this finding may indicate a more general problem regarding the generalizability of pharmacological trials over geographic regions.
Representative Bureaucracy and School Discipline
Authors: Roch Christine H. , Edwards Jason
Published: June 2015

This article examines whether the racial context within local communities influences the assignment of disciplinary policies in public schools. First, we consider whether different policies may be assigned to similar target groups across varying racial contexts. Then, we consider whether the racial context moderates the transition from passive representation to active representation among bureaucrats. We draw from two theories of intergroup relations—group contact theory and group threat theory—to help explain the passive-to-active representation link. Using a sample of Georgia public schools, we find that schools rely more on more punitive disciplinary measures in school districts characterized by greater segregation and that this occurs especially among schools with sizable African American student populations. We also find that active representation appears to occur more often in segregated environments, perhaps because of the greater salience of race within these communities.
Research on the shear failure load of composite pretightened tooth connections by the characteristic lengths
Authors: Zhao QiLin , Li Fei , Gao YiFeng , Xu LongXing , Zhang DongDong , Chen Haosen
Published: June 2015

In the conventional methods, the shear failure load of composite pretightened tooth connections is determined by experiment. To determine the shear failure load of the composite pretightened tooth connection without performing experiments, a method based on the characteristic lengths is presented in this paper. This method involves three steps: first, the characteristic lengths of the composite are determined; second, the stress distribution of the composite joint is analyzed by the use of a finite element method; finally, the failure load is predicted by the stress distribution of the characteristic length and failure criterion. The failure loads based on the characteristic lengths are validated by the test results for composite joints with different parameters. In comparison with the experimental data, this method provides higher magnitudes of failure load with a difference of <11% of the test value, except one with 11.6%. Good agreement was observed among the results of the present numerical method and the test. The method in the present work can be directly used in the design of pretightened tooth connections.
Prevalence and Correlates of Aggression and Hostility in Hospitalized Schizophrenic Patients
Authors: Knezevic Vladimir , Mitrovic Dragan , Drezgic-Vukic Svetlana , Knezevic Jelena , Ivezic Aleksandar , Siladji-Mladenovic Djendji , Golubovic Boris
Published: June 2015

This study is aimed at identifying the incidence as well as clinical and socio-demographic correlates of aggression in hospitalized schizophrenic patients. We prospectively recruited participants with Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.) diagnosis of schizophrenia presenting to the Clinic for Psychiatry during a 2-year period. We used the Modified Overt Aggression Scale to assess the aggression and Positive and Negative Syndrome Scale (PANSS) to assess the clinical characteristics of participants. One out of three patients with schizophrenia (31%) was aggressive and hostile at the time of presentation. Socio-demographic variables (such as gender, age, duration of illness, and number of hospitalizations) were poor predictors of aggression for schizophrenic patients. The level of aggression was not associated with the clinical characteristics in aggressive and hostile hospitalized schizophrenic patients. However, there was a weak negative association between the level of aggression and the PANSS Negative Scale ( p < .01). In conclusion, socio-demographic variables and clinical characteristics seem to be not such good predictors of aggressive behavior in hospitalized schizophrenic patients. Nevertheless, the results of our study contribute to the understanding of the prediction and treatment of aggression in a well-defined cohort of schizophrenic patients.
Interest Groups Vie for Public Support
Authors: Hinz Serena E.
Published: June 2015

Although affirmative action in college admissions has not been declared unconstitutional by the Supreme Court, the consideration of race in admissions has been banned in nine states—in six of them by public vote. This article analyzes the campaigns to ban affirmative action in California and Michigan as a battle between interest groups. The course of events in these states demonstrates that public opinion is a threat to the legality of affirmative action, should interest groups continue to take advantage of it by pursuing bans by state initiative.
Allergic Reactions in Hospitalized Patients With a Self-Reported Penicillin Allergy Who Receive a Cephalosporin or Meropenem
Authors: Crotty Danielle Joset , Chen Xian Jie Cindy , Scipione Marco R. , Dubrovskaya Yanina , Louie Eddie , Ladapo Joseph A. , Papadopoulos John
Published: June 2015

Background:

Cefepime and meropenem are used frequently in hospitalized patients for broad-spectrum empiric coverage, however, practitioners are often reluctant to prescribe these antibiotics for patients with a self-reported nonsevere, nontype I allergic reaction to penicillin.

Methods:

Retrospective review of electronic medical records of adults with a self-reported allergy to penicillin who received at least 1 dose of cefepime, ceftriaxone, cefoxitin, cephalexin, or meropenem to assess incidence and type of allergic reactions.

Results:

Of 175 patients included, 10 (6%) patients experienced an allergic reaction. The incidence for individual study drugs were cefepime 6% (6 of 96), meropenem 5% (3 of 56), cefoxitin 8% (1 of 13), ceftriaxone 0% (0 of 69), and cephalexin 0% (0 of 8). The majority of patients experienced a rash with or without pruritus and fever. Patients with a concomitant “sulfa” allergy (odds ratio [OR] 5.4, 95% confidence interval [CI] 1.4-21, P = .02) or ≥3 other drug allergies (OR 6.4, 95% CI 1.3-32, P = .025) were more likely to have an allergic reaction.

Conclusions:

In one of the largest retrospective reviews of hospitalized patients who received full dose therapy with cefepime, ceftriaxone, and meropenem, the incidence of allergic reactions was low and reactions were mild. Cefepime, ceftriaxone, and meropenem can be considered for use in patients with a self-reported nontype I penicillin allergy.
Experimental research on oblique cone die-less shear spinning
Authors: Han Zhiren , Xu Qiang , Jia Zhen , Li Xinbiao
Published: June 2015

In order to break through the limitation of traditional axisymmetric spinning, a discretization method is made to form an oblique cone by die-less shear spinning technique. Due to the characteristics of asymmetric spinning, the roller feed should harmonize with the spindle rotation, and the roller path is derived through a discretization method. The thickness variation of oblique cone in different directions is coincident with the sine relation in axisymmetric shear spinning. The surface quality, especially the surface smoothness (the distribution of arrises) and surface roughness of the spun part, is discussed by analyzing the roller motion and important spinning parameters, and a smaller axial feed rate f and a smaller angle increment Δ α can improve the surface quality.
A new control strategy of the filling phase for wet dual clutch transmission
Authors: Hao Hongtao , Lu Tongli , Zhang Jianwu , Zhou Bin
Published: June 2015

The traditional filling control strategy mainly relies on a large number of calibrations and is an open loop control. In order to avoid cumbersome calibrations and improve the control precision, a systematic approach of the filling control for wet dual clutch transmission is established in this paper. First, a model of the electro-hydraulic actuator for the wet dual clutch transmissions is presented and validated by the experiments. Then, an analytic solution method is developed for the filling control. To obtain the analytic solution of the filling pressure trajectory in the filling phase, the nonlinear mathematic model for wet clutches is transformed into a model in linear space by the feedback linearization, and then the optimal filling pressure trajectory is obtained based on Pontryagin’s Minimum Principle. Furthermore, to improve the control accuracy of a variable force solenoid, a closed loop control based on adaptive generalized predictive control algorithm is applied to the developed model of the electro-hydraulic actuator to track the optimal filling pressure trajectory. The simulation results indicate that the control strategy is effective for solving the filling control problem.
Influences of dehydration and rehydration on the lubrication properties of phospholipid polymer-grafted cross-linked polyethylene
Authors: Yarimitsu Seido , Moro Toru , Kyomoto Masayuki , Watanabe Kenichi , Tanaka Sakae , Ishihara Kazuhiko , Murakami Teruo
Published: June 2015

Surface modification by grafting of biocompatible phospholipid polymer onto the surface of artificial joint material has been proposed to reduce the risk of aseptic loosening and improve the durability. Poly(2-methacryloyloxyethyl phosphorylcholine) (PMPC)-grafted cross-linked polyethylene (CLPE) has shown promising results for reducing wear of CLPE. The main lubrication mechanism for the PMPC layer is considered to be the hydration lubrication. In this study, the lubrication properties of PMPC-grafted CLPE were evaluated in reciprocating friction test with rehydration process by unloading in various lubricants. The start-up friction of PMPC-grafted CLPE was reduced, and the damage of PMPC layer was suppressed by rehydration in water or hyaluronic acid solutions. In contrast, the start-up friction of PMPC-grafted CLPE increased in fetal bovine serum solution, and the damage for PMPC layer was quite noticeable. Interestingly, the start-up friction of PMPC-grafted CLPE was reduced in fetal bovine serum solution containing hyaluronic acid, and the damage of the PMPC layer was suppressed. These results indicate that the rehydration by unloading and hyaluronic acid are elemental in maximizing the lubrication effect of hydrated PMPC layer.
Association of the interleukin-6 polymorphisms with systemic lupus erythematosus: a meta-analysis
Authors: Cui Y X , Fu C W , Jiang F , Ye L X , Meng W
Published: June 2015

Background

Interleukin (IL)-6, an important proinflammatory cytokine, plays a potential pathological role in systemic lupus erythematosus (SLE). Studies on the relationship of IL-6 gene polymorphisms with SLE are inconclusive. The aim of this study was to estimate the relationship more precisely.

Methods

The databases of PubMed and Web of Science updated to 30 August 2014 were retrieved. Meta-analysis was conducted using allelic contrast, dominant, recessive and homozygote contrast models. Fifteen studies were included in this study and ethnicity-specific meta-analysis was performed on European, Iranian and Asian populations.

Results

Analysis for the IL-6-174 G/C polymorphism under all models except the homozygote contrast model indicated an association in the overall population (allelic contrast model: odds ratio (OR) 1.428, 95% confidence interval (CI) 1.124–1.812, dominant model: OR 1.382, 95% CI 1.037–1.842, recessive model: OR 1.610, 95% CI 1.158–2.240, homozygote contrast model: OR 1.759, 95% CI 0.989–3.127), as well as in European individuals under all four genetic models (allelic contrast model: OR 1.557, 95% CI 1.155–2.098, dominant model: OR 1.699, 95% CI 1.203–2.400, recessive model: OR 1.506, 95% CI 1.176–1.930, homozygote contrast model: OR 2.118, 95% CI 1.103–4.065). Analysis for the IL-6-572 G/C polymorphism indicated significant association in overall ethnicities under the recessive model (OR 1.491, 95% CI 1.104–2.014), but not under other models or in Asian individuals. In addition, significant association between the IL-6-174 G/C polymorphism and discoid skin lesions and antinuclear antibodies (ANAs) were found under the allelic contrast model and recessive model, respectively (discoid skin lesions: OR 2.271, 95% CI 1.053–4.895; ANAs: OR 2.244, 95% CI 1.141–4.416).

Conclusion

This meta-analysis provides evidence of the association between the IL-6 polymorphism and the risk of SLE, hinting that the IL-6-174 G/C and IL-6-572 G/C polymorphisms may play a role in SLE susceptibility.
Psychometric validation of the Brief Pain Inventory-Short Form in patients with systemic lupus erythematosus in the United States
Authors: Naegeli A N , Tomaszewski E L , Al Sawah S
Published: June 2015

This study evaluated the Brief Pain Inventory-Short Form (BPI-SF) in patients with moderate-to-severe systemic lupus erythematosus (SLE). Patients ≥18 years old who self-reported a physician diagnosis of SLE (confirmed by medical record review) and active SLE (Systemic Lupus Activity Questionnaire (SLAQ) score of ≥11) were included. The BPI-SF and Short Form Health Survey version 2 (SF-36v2) were administered electronically at baseline, week 2 and week 12. Psychometric properties of the BPI-SF were evaluated. Cronbach alphas were >0.9 for all BPI-SF items, domains and total score. Test-retest reliability correlations for responses between baseline and week 2 of the BPI-SF had intraclass correlation coefficients (ICCs) ≥0.5. The BPI-SF domains and total score were moderately positively correlated to the SLAQ score ( r ≥ 0.4), but negatively correlated to the SF-36v2 bodily pain domain ( r ≤ –0.6). The BPI-SF domains and total score were moderately negatively correlated to the SF-36v2 physical functioning domain and physical component summary ( r ≤ –0.4), with low correlations between the BPI-SF severity domain and SF-36v2 mental component summary ( r = −0.16). Assessment of pain, as measured by the BPI-SF, demonstrated validity and reliability in a sample of patients with moderate-to-severe SLE.
Two-stage phase II oncology designs using short-term endpoints for early stopping
Authors: Kunz Cornelia U , Wason James MS , Kieser Meinhard
Published: June 2015

Phase II oncology trials are conducted to evaluate whether the tumour activity of a new treatment is promising enough to warrant further investigation. The most commonly used approach in this context is a two-stage single-arm design with binary endpoint. As for all designs with interim analysis, its efficiency strongly depends on the relation between recruitment rate and follow-up time required to measure the patients’ outcomes. Usually, recruitment is postponed after the sample size of the first stage is achieved up until the outcomes of all patients are available. This may lead to a considerable increase of the trial length and with it to a delay in the drug development process. We propose a design where an intermediate endpoint is used in the interim analysis to decide whether or not the study is continued with a second stage. Optimal and minimax versions of this design are derived. The characteristics of the proposed design in terms of type I error rate, power, maximum and expected sample size as well as trial duration are investigated. Guidance is given on how to select the most appropriate design. Application is illustrated by a phase II oncology trial in patients with advanced angiosarcoma, which motivated this research.
Bayesian multivariate augmented Beta rectangular regression models for patient-reported outcomes and survival data
Authors: Wang Jue , Luo Sheng
Published: June 2015

Many longitudinal studies (e.g. observational studies and randomized clinical trials) have collected multiple rating scales at each visit in the form of patient-reported outcomes (PROs) in the close unit interval [0 ,1]. We propose a joint modeling framework to address the issues from the following data features: (1) multiple correlated PROs; (2) the presence of the boundary values of zeros and ones; (3) extreme outliers and heavy tails; (4) the PRO-dependent terminal events such as death and dropout. Our modeling framework consists of a multivariate augmented mixed-effects sub-model based on Beta rectangular distributions for the multiple longitudinal outcomes and a Cox model for the terminal events. The simulation studies suggest that in the presence of outliers, heavy tails, and dependent terminal event, our proposed models provide more accurate parameter estimates than the joint model based on Beta distributions. The proposed models are applied to the motivating Long-term Study-1 (LS-1 study, n = 1741) of Parkinson’s disease patients.
What ethics for case managers? Literature review and discussion
Authors: Corvol Aline , Moutel Grégoire , Somme Dominique
Published: June 2015

Background:

Little is known about case managers’ ethical issues and professional values.

Objectives:

This article presents an overview of ethical issues in case managers’ current practice. Findings are examined in the light of nursing ethics, social work ethics and principle-based biomedical ethics.

Research design:

A systematic literature review was performed to identify and analyse empirical studies concerning ethical issues in case management programmes. It was completed by systematic content analysis of case managers’ national codes of ethics.

Findings:

Only nine empirical studies were identified, eight of them from North America. The main dilemmas were how to balance system goals against the client’s interest and client protection against autonomy. Professional codes of ethics shared important similarities, but offered different responses to these two dilemmas.

Discussion:

We discuss the respective roles of professional and organizational ethics. Further lines of research are suggested.
Implementing iPads in the Inclusive Classroom Setting
Authors: Maich Kimberly , Hall Carmen
Published: June 2015

This column provides practical suggestions to help guide teachers in utilizing classroom sets of iPads. Following a brief introduction to tablet technology in inclusive classrooms and the origin of these recommendations from a case study focus group, important elements of setting up classroom iPad use, from finding funding to teaching apps, are explained in practical terms.
An Early Assessment of Accountable Care Organizations’ Efforts to Engage Patients and Their Families
Authors: Shortell Stephen M. , Sehgal Neil J. , Bibi Salma , Ramsay Patricia P. , Neuhauser Linda , Colla Carrie H. , Lewis Valerie A.
Published: June 2015

Accountable care organizations (ACOs) have incentives to meet quality and cost targets to share in any resulting savings. Achieving these goals will require ACOs to engage more actively with patients and their families. The extent to which ACOs do so is currently unknown. Using mixed methods, including a national survey, phone interviews, and site-visits, we examine the extent to which ACOs actively engage patients and their families, explore challenges involved, and consider approaches for dealing with those challenges. Results indicate that greater ACO use of patient activation and engagement (PAE) activities at the point-of-care may be related to positive perceptions among ACO leaders of the impact of PAE investments on ACO costs, quality, and outcomes of care. We identify a number of important practices associated with greater PAE, including high-level leadership commitment, goal-setting supported by adequate resources, extensive provider training, use of interdisciplinary care teams, and frequent monitoring and reporting on progress.
Optimal design of a circular corrugated diaphragm using the homogenization approach
Authors: Andrianov Igor V , Diskovsky Alexander A , Syerko Elena
Published: June 2015

Axisymmetric deformation of a circular corrugated diaphragm is defined by the equations formulated in terms of projections of displacements on the axes of the principal plane equidistant from the tops of corrugations. The optimal design problem is considered basing on the homogenization of these equations. As a result, a diaphragm consisting of a flat central part and a corrugated part with variable amplitude is obtained.
Proposals to improve the durability assessment after ageing tests for wood-based sandwich panels
Authors: Estrada-Martínez Salvador , Mollón Victoria , Bonhomme Jorge
Published: June 2015

This work deals with the durability assessment, after ageing, of wood-based sandwich panels, carried out according to the European guideline ETAG 016, Annex C7 Climatic testing cycles. ETAG 016-2 is a guideline to assess the wood-based sandwich panels for roofs. It has tests and criteria for evaluating the results of these tests. As regards durability and performance under the weather, it proposes to choose one of three different climatic cycles. The choice depends on the material of the core. Each climate cycle has assessment criteria to measure whether the cycle has been successfully overcome or not. This assessment is related to the standard EN 14509, paragraph 5.2.3.1 that contains the same climatic test cycles. In this work we subjected several types of non-metallic sandwich panels to this test and criteria. Then, a critical review of these acceptance criteria was done. As a result, some recommendations are proposed regarding the acceptance criteria and testing procedure.
Benevolent racism? The impact of target race on ambivalent sexism
Authors: McMahon Jean M. , Kahn Kimberly Barsamian
Published: June 2015

Two studies investigated whether benevolent sexism is differentially applied based on a woman’s race. Study 1 demonstrated that participants expressed more benevolent sexism to White females than Black females when given no other information besides race. Study 2 introduced positive (chaste) and negative (promiscuous) sexually subtyped behaviors in addition to female race. Under these conditions, participants directed more benevolent sexism at chaste Black women rather than chaste White women, consistent with shifting standards theory. Despite receiving more benevolent sexism, chaste Black women did not receive more positive evaluations overall. Across both studies, expressions of hostile sexism did not differ by race. Results suggest that race may function as a subtype to elicit benevolent sexism contingent on behavior. Black women who follow traditional gender norms may be overcompensated for their conformity with benevolent sexism, but not receive more positive benefits.
Don’t bring me down: Divergent effects of being the target of empathy versus perspective-taking on minority group members’ perceptions of their group’s social standing
Authors: Vorauer Jacquie D. , Quesnel Matthew
Published: June 2015

This experiment examined how being the target of one of two commonly recommended strategies for improving intergroup relations—empathy or perspective-taking—affects minority group members’ sense of their group’s power and status in society. The main hypothesis was that the distinct status hierarchies implied by each of these mindsets would be communicated across face-to-face intergroup exchanges. Specifically, because empathy targets are typically in lower power positions whereas perspective-taking targets are typically in higher power positions, minority group members who were targets of a dominant group member’s empathy were expected to come away with a reduced sense of their group’s social standing relative to those who were targets of a dominant group member’s perspective-taking. Results were consistent with this prediction and further suggested that the mindset effect was partially mediated by a tendency for dominant group members’ efforts to empathize with minority targets to foster heightened imbalance in the levels of various power-relevant behaviors exhibited by each person.
Health performance and cost management model for sustainable healthy buildings
Authors: Na Youngju , Palikhe Shraddha , Lim Chaeyeon , Kim Sunkuk
Published: June 2015

The construction industry is a flourishing business. Demand for ‘sustainable healthy buildings’ is rapidly increasing with the growing population. As the population increases, problems associated with health impacts of a building would also increase. Addressing the health problems of buildings could require raising of construction cost. In order to maintain a reasonable cost, a construction project might possibly have to compromise health performance and cost, which thus illustrates the major dilemmas being faced in the construction industry. Proper building health management is obligatory to reduce and control health problems and to maintain comfort levels throughout a building’s life cycle. To achieve this, a health performance evaluation model has been proposed to measure the level of health performance throughout a building’s life cycle. However, detail solutions of cost issues are not within scope of this paper. The objective of this paper is to propose a health performance and cost management model to achieve satisfactory health performance level within the project budget. The main significance of this model is to establish a decision-making process for decision-makers to improve and identify problems that could affect the health performance of a building throughout a building’s life cycle, thus allowing stakeholders to resolve shortcomings and to apply advanced solutions for building upgrade.
A low-order adaptive engine model for SI–HCCI mode transition control applications with cam switching strategies
Authors: Gorzelic Patrick , Shingne Prasad , Martz Jason , Stefanopoulou Anna , Sterniak Jeff , Jiang Li
Published: June 2015

This article presents a low-order engine model to support model-based control development for mode transitions between spark ignition (SI) and homogeneous charge compression ignition (HCCI) combustion modes in gasoline engines. The modeling methodology focuses on cam switching mode transition strategies wherein the mode is abruptly changed between SI and recompression HCCI via a switch of the cam lift and phasing. The model is parameterized to a wide range of steady-state data which are selected to include conditions pertinent to cam switching mode transitions. An additional HCCI combustion model parameter is augmented and tuned based on transient data from SI to HCCI mode transitions where the conditions can be significantly outside any contained in the baseline steady-state parameterization. An adaptation routine is given which allows transient data be assimilated in online operation to update the augmented parameter and improve SI–HCCI transition predictions. With the baseline steady-state parameterization and augmented mode transition parameter, the model is shown to reproduce both steady-state data and transient performance output time histories from SI–HCCI transitions with considerable accuracy.
Influence of the in-cylinder gas density and fuel injection pressure on the combustion characteristics in a large-bore diesel engine
Authors: Imperato Matteo , Kaario Ossi , Sarjovaara Teemu , Larmi Martti
Published: June 2015

Engine research is going toward higher specific power and downsizing. This topic is of increasing interest in compression-ignition engines, due to high output demand and more restrictive legislation. This study focuses on the influence of in-cylinder gas density and fuel injection pressure on the combustion and performance in a large-bore medium speed research engine. From a baseline setup close to a commercial engine, the specific power density was augmented by higher in-cylinder pressure ranging from 200 to 300 bar. This corresponds to gas density between 65 and 90 kg/m3 at top dead center. In addition, fuel injection pressure was varied between 1500 and 2400 bar. Based on the literature, this is the first study to report engine operation with 300 bar cylinder pressure. The results show that ignition delay is significantly reduced by increasing the injection pressure, while gas density has only a moderate effect. In addition, specific nitrogen oxides increase strongly with higher injection pressure but only moderately with higher gas density. Running with high gas density permits to improve the engine fuel economy. The test outcomes also show that the combustion duration can be decreased by increasing the in-cylinder density.
Self-censorship for democrats
Authors: Festenstein Matthew
Published: June 2015

On the face of it, self-censorship is profoundly subversive of democracy, particularly in its talk-centric forms, and undermines the culture of openness and publicity on which it relies. This paper has two purposes. The first is to develop a conception of self-censorship that allows us to capture what is distinctive about the concept from a political perspective and which allows us to understand the democratic anxiety about self-censorship: if it is not obvious that biting our tongues is always wrong, we need a fuller account of the moral sensibility that finds it so troubling and this is elaborated here. The second is to develop an argument to the effect that this sensibility should not have the last, or only, word, but instead that self-censorship should be viewed as an ‘ordinary vice’ of democratic societies. The grounds for tolerating it rest on the democratic values that critics believe it threatens.
A Randomized Controlled Study to Determine the Efficacy of Garlic Compounds in Patients With Hematological Malignancies at Risk for Chemotherapy-Related Febrile Neutropenia
Authors: Gatt Moshe E. , Strahilevitz Jacob , Sharon Nir , Lavie David , Goldschmidt Neta , Kalish Yossef , Gural Alexander , Paltiel Ora B.
Published: June 2015

Background. Patients receiving chemotherapy for hematological malignancies are at high risk for febrile neutropenia (FN). Garlic extracts (GEs) are natural food substances showing antimicrobial effects in vivo. Objectives. We explored whether adding GE may be efficacious in reducing the risk or severity of infections. Design. This was a placebo-controlled double-blind randomized study. Results. Of 95 patients randomized to receive GE or placebo following chemotherapy, a febrile episode was documented in 50% of patients receiving GE and 63.3% receiving placebo ( P = .89). There was a higher risk of developing a third and fourth febrile episode in the GE group ( P = .01). However, among those at a lower risk for FN, those receiving GE developed fewer FN episodes ( P = .075), especially those with severe neutropenia ( P = .05). Major adverse events were distributed equally, but nonadherence was more common in the GE than in the placebo group: 19.5% versus 4%, respectively ( P = .05). Conclusions. GE was safe and did not reduce FN risk in the entire cohort, but yet appeared to exert a protective effect in the lower-risk subgroup. We do not recommend the use of GE for FN prevention in higher-risk patients. A larger-scale clinical trial for the lower-risk subgroup of patients is advocated. (This trial was registered at www.clinicaltrials.gov as NCT00247039.)
Competitive assessments of pulmonary embolism: Noninvasiveness versus the golden standard
Authors: Ma Yuxia , Yan Shi , Zhou Lin , Yuan Dong-Tang
Published: June 2015

Diagnosis of suspected pulmonary embolism (PE) is crucial as undiagnosed and over-diagnosis can both lead to serious consequences. Contemporary diagnostic approach of PE is a sequential combination assessment beginning with clinical assessment, validated with D-dimer measurement and confirmed with pulmonary angiography or imaging. Since the invasive pulmonary angiography is risky and costly, imaging is a warranted tool in the diagnosis procedure. CT pulmonary angiography is a less-invasive method with general availability, studies provide favorable evidences for CT pulmonary angiography as a stand-alone test for excluding PE, and it has become the first choice of tests in emergency department for suspected PE in most centers. Ventilation/perfusion single-photon emission CT signifies a new era in nuclear medicine. It has excellent sensitivity and specificity, fast procedure, low radiation exposure, few complications and contradictions. Besides, MR angiography is another possible and promising approach for diagnosis of suspected PE with much safer contrast agents than CT and no ionizing radiation. With wide availability and less invasive effects, imaging becomes a firsthand tool to obtain optimal accuracy in the diagnosis work up in clinic nowadays. This review summarizes the current methods in diagnosing PE and the update of imaging assessments of the disease.
Sesamin enhances nitric oxide bioactivity in aortas of spontaneously hypertensive rats
Authors: Kong Xiang , Li Wei , Guo Li-qun , Zhang Jun-xiu , Chen Xiang-pan , Liu Wei-yong , Yang Jie-ren
Published: June 2015

Background:

The blood pressure lowering effect of sesamin has been demonstrated to be associated with the increase in vascular nitric oxide (NO) biological activity by our previous studies and others. The present study was designed to explore the underlying mechanisms involved in the effect of sesamin on aortic NO bioactivity in spontaneously hypertensive rats (SHRs).

Methods:

Sesamin was orally administered for 8 consecutive weeks in SHRs. Systolic blood pressure (SBP) was measured using the tail-cuff method. The aortas were isolated and in vitro vascular reactivity studies were performed. Superoxide anion production in carotid arteries was assessed by dihydroethidium fluorescence staining. The protein expression of endothelial nitric oxide synthase (eNOS), phosphorylated eNOS (P-eNOS), dihydrofolate reductase (DHFR), nicotinamide adenine dinucleotide phosphate oxidase subunit p47phox, and copper, zinc superoxide dismutase (Cu/Zn-SOD) in aortas was detected by Western blotting. The dimeric form of eNOS in aortas was determined by low-temperature sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). Aortic level of nitrotyrosine and activities of antioxidant enzymes, namely, total SOD (T-SOD), glutathione peroxidase (GPx) and catalase were also detected.

Results:

In SHRs, sesamin treatment reduced SBP, improved vascular relaxation induced by acetylcholine and enhanced aortic NO bioactivity. Sesamin treatment enhanced NO biosynthesis in SHR aortas was due to upregulated P-eNOS and suppressed eNOS uncoupling, and the latter effect might be attributed to decreased nitrotyrosine and upregulated DHFR. Sesamin also reduced the NO oxidative inactivation and decreased the superoxide anion production through downregulation of p47phox and amelioration of eNOS uncoupling. In addition, sesamin treatment did not alter the levels of GPx and catalase activity but obviously reduced the compensatory elevated T-SOD activity and Cu/Zn-SOD protein expression.

Conclusion:

Chronic treatment with sesamin could reduce hypertension and improve endothelial dysfunction through enhancement of NO bioactivity in SHR aortas.