bluuebunny/crossref_metadata_2025 huggingface dataset:
Numerical modelling of oblique shock and detonation waves induced in a wedged channel
Authors: Fan H Y , Lu F K
Published: August 2008

A computational study of wedge-induced oblique shock and detonation wave phenomena in the flow of a combustible mixture over a wedged channel is presented with the purpose of understanding the fundamental gasdynamics of the waves and their interactions. A two-dimensional, time accurate, finite-volume-based method was used to perform the computations, and a five-species, two-step chemical reaction is assumed for a stoichiometric hydrogen—air mixture. The combustion channel is made of a wedged section followed by a constant area section. The simulation was performed with wedges of up to 20° semi-angle and Mach numbers from 1.25 to 6, with other inflow parameters fixed. Within the computational domain either propagating or standing shock and detonation wave configurations were obtained depending on the flow Mach number and the wedge semi-angle. Four flow modes, namely, a propagating detonation wave, a standing detonation wave, a propagating shock wave, and a standing shock wave mode were identified. The two detonation-based modes were emphasized. Detonation initiation, propagation, and the induced wave interactions of these modes were investigated. The shock-based modes were also studied briefly. Phenomena explored included overall wave structures, detonation initiation arising from shock coalescence, location of initiation, and double detonation initiation. The physical mechanisms of these phenomena were analysed.
Unsteady aerodynamic effects experienced by aerofoils during acceleration and retardation
Authors: Roohani H , Skews B W
Published: August 2008

This investigation focuses on the aerodynamic effects caused by acceleration and retardation. It shows that, when an object is accelerated in a compressible fluid, the aerodynamic forces and moments experienced by the object at any instantaneous Mach number are different to those, experienced at the same Mach number, when the object moves at constant velocity. A supersonic biconvex aerofoil was chosen, with Fluent as the computational fluid dynamic (CFD) software. Constant velocity (steady state) simulations were conducted at Mach numbers ranging from 0.1 to 1.6 for the aerofoil. The aerofoil was then accelerated at 1041 m/s2 (106 g) and 86.77 m/s2 (8.845 g), starting at Mach 0.1, and decelerated at −1041 and −86.77 m/s2, starting at Mach 1.6, through the same range of Mach numbers using time-dependent (unsteady) simulations. Significant differences were shown between the steady and the unsteady cases with the greatest differences observed in the transonic region. In this region, for each specific Mach number, acceleration-dependant variations in the position of the shock wave on the upper surface of the aerofoil were also observed. This was used to explain the great differences in the aerodynamic forces and moments between the steady and the unsteady cases in the transonic region.
Interaction between laser-induced plasma and shock wave over a blunt body in a supersonic flow
Authors: Sakai T , Sekiya Y , Mori K , Sasoh A
Published: August 2008

The interaction of the laser-induced plasma produced by a pulse laser energy deposition with the shock wave over a blunt body in a freestream Mach number of 3 is studied numerically and experimentally. The unsteady flow phenomena during the interaction are analysed by the comparison of the flow structures between experiment and calculation to understand the effect of the energy deposition on the reduction of the pressure on the wall of the blunt body. The stagnation point pressure on the centre-line of the blunt body is compared between experiment and calculation to confirm the qualitative feature of the unsteady flowfields so analysed. The present result shows that the unsteady flow phenomena are consistent with the time variation of the stagnation point pressure, and that the time variation of the pressure is in a good agreement between experiment and calculation. The drag averaged over an interaction time is evaluated based on the calculated data.
Fluorescence imaging and streakline visualization of hypersonic flow over rapid prototype wind-tunnel models
Authors: Danehy P M , Alderfer D W , Inman J A , Berger K T , Buck G M , Schwartz R J
Published: August 2008

The use of planar laser-induced fluorescence (PLIF) of nitric oxide (NO) was inves-tigated for use in visualizing wake flowfields downstream of rapid prototyping models in a hypersonic wind tunnel. The re-entry models for use in this study were fabricated using a stereo-lithography apparatus. These models were produced in one day or less, which is a significant time savings compared with the manufacture of ceramic or metal models. The models were tested in the NASA Langley Research Center 31-Inch Mach 10 Air Tunnel. Pure NO was either seeded through tubes plumbed into the model or via a tube attached to the strut holding the model, which provided localized addition of NO into the model's wake through a porous metal cylinder attached to the end of the tube. Various entry capsule model types and configurations and NO-seeding methods were used, including a new streamwise visualization method based on PLIF. Virtual diagnostics interface technology, developed at NASA Langley Research Center, was used to visualize the datasets in post-processing. The use of calibration ‘dotcards’ was investigated to correct for camera perspective and lens distortions in the PLIF images.
Industrial applications of shock waves
Authors: Jagadeesh G
Published: August 2008

Shock waves have been traditionally considered to be an integral part of flow field features in the area of high-speed aerodynamics. Physically the propagation of shock waves in any media is invariably associated with instantaneous increase in pressure and temperature behind the shockwave. The capability of shock waves to generate non-linear pressure and temperature spikes in the medium of propagation finds very interesting applications in variety of areas such as medicine, biological sciences, material processing, manufacturing, and microelectronic industries. This paper reviews four new industrial applications of shock waves that have been developed in the Shock Waves Laboratory (SWL), Department of Aerospace Engineering, IISc, Bangalore. They are shock wave assisted (a) cell transformation, (b) preservative injection into Bamboos, (c) sandal oil extraction, and (d) removal of micron size dust from silicon wafer surfaces. The shock waves generated in an underwater shock wave generator are exploited in successfully injecting the desired deoxyribonucleic acid into Escherichia coli and Agrobacterium cells. The vertical shock wave reactor is applicable in successfully injecting the water-soluble chemical preservative (copper—chrome—arsenic) to samples of bamboo. The exposure of sandalwood samples to shock wave loading in the horizontal diaphragmless shock tube resulted in the drastic reduction (40 per cent) of time required for oil extraction. Further, a new shock wave assisted technique for micron-size dust removal from silicon wafer surfaces has been developed in collaboration with the Interdisciplinary Shock Wave Research Center, Tohoku University, Sendai, Japan. The strong vortex field generated behind the Mach reflection of a shock wave has been used to remove micron size dust particles from the surface of silicon wafers. The salient features of these new industrial applications of shock waves are described in this paper along with some important results.
Three-dimensional contour bumps for transonic wing drag reduction
Authors: Qin N , Wong W S , Le Moigne A
Published: August 2008

Two-dimensional and three-dimensional contour bumps are designed and optimized for substantial wave drag reduction for an un-swept natural laminar flow (NLF) wing (RAE5243 aerofoil section) at transonic speeds. An NLF aerofoil wing is chosen in this study, as shock control is more crucial for such wings due to the requirement of favourable pressure gradients on a substantial part of the wing. For the validation purpose and to focus on the wave drag issues, the boundary layer is assumed to be fully turbulent from the leading edge. Key bump geometrical parameters including the maximum height, the length, and the crest position have been chosen for the parameterization of the two-dimensional and three-dimensional shock control bumps. For the three-dimensional bumps, an array of the contour bumps is installed spanwise on the transonic wing and their width and spanwise spacing are chosen as additional design parameters. Both the two-dimensional and the three-dimensional bump shapes are optimized using a discrete adjoint-based optimization method. The performance of the three-dimensional contour bumps are compared in detail with the similarly optimized two-dimensional bumps both at and around the design point. The results show that, for the NLF wing studied, the optimized three-dimensional bumps are as effective as the optimized two-dimensional bump in terms of total drag reduction at the given design point, despite the significant difference in their geometrical shapes. More importantly, in terms of the operational range for varying lift conditions for practical applications, the three-dimensional bumps outperform the two-dimensional bump by a substantial margin.
Group II introns in Eubacteria and Archaea: ORF-less introns and new varieties
Authors: Simon Dawn M. , Clarke Nicholas A.C. , McNeil Bonnie A. , Johnson Ian , Pantuso Davin , Dai Lixin , Chai Dinggeng , Zimmerly Steven
Published: August 2008

Group II introns are a major class of ribozymes found in bacteria, mitochondria, and plastids. Many introns contain reverse transcriptase open reading frames (ORFs) that confer mobility to the introns and allow them to persist as selfish DNAs. Here, we report an updated compilation of group II introns in Eubacteria and Archaea comprising 234 introns. One new phylogenetic class is identified, as well as several specialized lineages. In addition, we undertake a detailed search for ORF-less group II introns in bacterial genomes in order to find undiscovered introns that either entirely lack an ORF or encode a novel ORF. Unlike organellar group II introns, we find only a handful of ORF-less introns in bacteria, suggesting that if a substantial number exist, they must be divergent from known introns. Together, these results highlight the retroelement character of bacterial group II introns, and suggest that their long-term survival is dependent upon retromobility.
Upf1 potentially serves as a RING-related E3 ubiquitin ligase via its association with Upf3 in yeast
Authors: Takahashi Shinya , Araki Yasuhiro , Ohya Yuriko , Sakuno Takeshi , Hoshino Shin-Ichi , Kontani Kenji , Nishina Hiroshi , Katada Toshiaki
Published: August 2008

Three Upf proteins are essential to the nonsense-mediated mRNA decay (NMD) pathway. Although these proteins assemble on polysomes for recognition of aberrant mRNAs containing premature termination codons, the significance of this assembly remains to be elucidated. The Cys- and His-rich repeated N terminus (CH domain) of Upf1 has been implicated in its binding to Upf2. Here, we show that CH domain also plays a RING-related role for Upf1 to exhibit E3 ubiquitin ligase activity in yeast. Despite the sequence divergence from typical E3-RING fingers, the CH domain of yeast Upf1 specifically and directly interacted with the yeast E2 Ubc3. Interestingly, Upf1 served as a substrate for the in vitro self-ubiquitination, and the modification required its association with Upf3 rather than Upf2. Substitution of the coordinated Cys and His residues in the CH domain impaired not only self-ubiquitination of Upf1 but also rapid decay of aberrant mRNAs. These results suggest that Upf1 may serve as an E3 ubiquitin ligase upon its association with Upf3 and play an important role in signaling to the NMD pathway.
Potent activation of FGF-2 IRES-dependent mechanism of translation during brain development
Authors: Audigier Sylvie , Guiramand Janique , Prado-Lourenco Leonel , Conte Caroline , Gonzalez-Herrera Irma Gabriela , Cohen-Solal Catherine , Récasens Max , Prats Anne-Catherine
Published: August 2008

Fibroblast growth factor-2 (FGF-2) plays a fundamental role in brain functions. This role may be partly achieved through the control of its expression at the translational level via an internal ribosome entry site (IRES)-dependent mechanism. Transgenic mice expressing a bicistronic mRNA allowed us to study in vivo and ex vivo where this translational mechanism operates. Along brain development, we identified a stringent spatiotemporal regulation of FGF-2 IRES activity showing a peak at post-natal day 7 in most brain regions, which is concomitant with neuronal maturation. At adult age, this activity remained relatively high in forebrain regions. By the enrichment of this activity in forebrain synaptoneurosomes and by the use of primary cultures of cortical neurons or cocultures with astrocytes, we showed that this activity is indeed localized in neurons, is dependent on their maturation, and correlates with endogenous FGF-2 protein expression. In addition, this activity was regulated by astrocyte factors, including FGF-2, and spontaneous electrical activity. Thus, neuronal IRES-driven translation of the FGF-2 mRNA may be involved in synapse formation and maturation.
Pueri, Iuvenes , and Viri : Age and Utility In the Gregorian Reform
Authors: Cushing Kathleen G.
Published: August 2008

This article explores the role played by ideas about age and appropriate behavior for different stages of life in shaping the eleventh-century ecclesiastical reformers' vision for an ordered Christian society—notable at a time when the role of the Church and especially the papacy as both the definer and enforcer of utilitas was increasingly emphasized. By focusing on how some influential reformers and writers characterized youth, adulthood, and that shadowy stage between them, the iuventus, this article examines the extent to which the reformers not only drew upon the language of age and life stages but also combined them with ideas of suitability and utility in a powerful rhetoric that reinforced their scheme of social definition.
Catholics and the Italian Revolutionary Left of the 1960s
Authors: Drake Richard
Published: August 2008

Radical left-wing Catholics played an important role in Italy's extra-parliamentary revolutionary movement of the 1960s, which took as its starting point the need to fill the void created by the growing moderation of the official Communist party. For guidance in opposing the American-dominated capitalist status quo in Italy, Catholics looked to activist intellectuals, such as the priests Lorenzo Milani at home and Camilo Torres abroad. The vital Catholic component in Lotta Continua, the foremost extraparliamentary left group of the period, illustrates the practical consequences, at their most extreme, of the Catholic-Marxist dialogue in Italy.
Suffering for Jesus: Penitential Practices at Fort St. Joseph (Niles, Michigan) During the French Regime
Authors: Brandão José António , Nassaney Michael Shakir
Published: August 2008

Scholarship on New France often emphasizes the factors that motivated the establishment of the colony, including the desire to promulgate the spread of Catholicism to Native peoples. However, the place of religion in the lives of the French inhabitants in the far-flung outposts in the North American interior is difficult to assess. Recent excavations at Fort St. Joseph, an eighteenth-century mission-garrison-trading post complex in the western Great Lakes, uncovered an unusual religious artifact tentatively identified as a cilice, an instrument of self-mortification used by the devout for a variety of penitential purposes. The authors seek to verify that identification, describe the various uses of the cilice in Catholic penitential practice, and draw some tentative conclusions about what the use of a cilice suggests about religious life at the fort on the edge of the French empire. Depending on who might have used it, the cilice reflects an enduring and vibrant French Catholic faith on the frontier, or the adoption by Native peoples of that same faith.
The Army Learns to Luau: Imperial Hospitality and Military Photography in Hawai‘i
Authors: Imada Adria L.
Published: August 2008

Circulating in the contemporary global cultural marketplace, the tourist luau is an iconic form of commodified hospitality and leisure, readily available in embodied and mediated forms. This article traces the emergence of the luau as a material practice and discursive formation during the “mili-touristic” economy of World War II Hawai‘i in films shot by US military units. US combat photography units staged ethnographic performances of hula and luaus, transforming the luau from a privileged experience for a select few to a mass mediated event. These filmic performances produced scripts of imperial hospitality: imagined and enacted scripts in which Islanders and soldiers play roles as host and guest, respectively. Military luaus rendered uneven colonial relationships as mutual and consensual encounters between white soldiers and Native women. Through the exercise of biopower, military cameras did not merely discipline Hawaiian populations, but also integrated colonial subjects and regulated Hawaiian sexuality. These gendered scripts continue to secure Hawai‘i as a rest and relaxation capital for US military personnel.
Interdisciplinarity and Pacific Studies: Roots and Routes
Authors: Whimp Graeme
Published: August 2008

This paper discusses the approaches generally grouped under the heading of “interdisciplinarity.” There is no intention to arrive at a perfect, authoritative definition of interdisciplinarity, but rather to assess the contribution those approaches might make. The essay begins by briefly covering some generalizations about Pacific knowledges and considers the European academic framework before and during the emergence of disciplines. It then outlines that emergence, reviews a range of ideas about the nature of interdisciplinarity and related methodologies, and examines the relationship between interdisciplinarity and area studies. Finally the paper attempts to establish the specific identity of one Pacific studies program, that of Victoria University of Wellington, considering some possible obstacles and impediments to its development, and presenting some suggestions for possible program orientation and content.
Alternative Market Values?: Interventions into Auctions in Aotearoa/New Zealand
Authors: Geismar Haidy
Published: August 2008

This article discusses the auction market for certain kinds of taonga Māori (Māori treasures or cultural property). The social, political, and economic tensions that emerge from the national regulation of the auction market for Māori artifacts are framed by the complex political dynamic in Aotearoa / New Zealand of biculturalism: a Treaty-based political contract between Māori (indigenous people of Aotearoa) and Pākehā (settlers in colonial New Zealand, primarily of European descent), subject to continual negotiation. The antiquities market, which includes Māori artifacts, is carefully regulated by the government in keeping with (ever-shifting) understandings of Crown sovereignty over national cultural heritage. Interventions by Māori activists and curators complicate this notion of sovereignty and assert a primacy of indigenous title. I argue that these idiosyncratic interventions, within the political context of biculturalism, alter the very form of the market, undermining perceived dichotomies between taonga and commodity, indigenous and market values. Eventual auction results reflect a synthesis of complex intercultural negotiation and opposition between activists, dealers, auctioneers, and collectors. The case studies here raise important issues around the relationship among value, social and political relations, and the form and substance of the marketplace.
Medical and Support Service Utilization in a Medical Program Targeting Marginalized HIV-infected Individuals
Authors: Cunningham Chinazo O. , Sanchez John-Paul , Li Xuan , Heller Daliah , Sohler Nancy L.
Published: August 2008

Background . One strategy to facilitate HIV health care services utilization is to incorporate support services with medical services. We developed a program that delivers HIV medical care and support services to marginalized people, and evaluated the association between support and medical services utilization.
Methods . We extracted data on 218 newly enrolled program participants 3 months prior to through 6 months after program enrollment, and analyzed associations between support and medical services.
Results . Case management visits (AOR=1.95, 95% CI 1.04–3.67) and group visits (AOR=2.59, 95% CI 1.30–5.16) were associated with greater odds of quarterly medical visits. Outreach visits were associated with greater odds of having a medical visit in a traditional medical setting (AOR=2.31, 95% CI 1.15–4.67).
Conclusion . Case management, support groups, and outreach were associated with HIV medical visits. Further research exploring how integration of support services into HIV medical programs can improve health care delivery is crucial for health policy and program development.
Factors Associated with Zidovudine Receipt and Prenatal Care among HIV-Infected Pregnant Women in New Jersey
Authors: Abatemarco Diane J. , Catov Janet M. , Cross Helene , Delnevo Cristine , Hausman Alice
Published: August 2008

Despite reductions in perinatal HIV transmission, cases continue to occur. To determine factors associated with zidovudine (ZDV) receipt among HIV-infected pregnant women we merged three data sets for women in New Jersey in 1995–1997, identifying 395 HIV-infected pregnant women. Half received two arms of ZDV prophylaxis. Attendance at five or more prenatal visits was the strongest independent factor related to ZDV receipt (OR 6.37, 95% CI 3.84, 10.57). Half (49.0%) had limited prenatal care. AIDS diagnosis, race/ethnicity, and drug use were also independently related to ZDV receipt. Post hoc analysis revealed that being unmarried, Black, multiparous, having no insurance, and illegal drug use were associated with limited prenatal care. Although the U.S. has seen reductions in HIV perinatal transmission, our research showed that HIV-infected women who did not get prenatal care were less likely to receive two arms of ZDV prophylaxis. A wide public health net that brings all women into care is necessary to reduce perinatal transmission further.
HIV Prevention for Black Women: Structural Barriers and Opportunities
Authors: Newman Peter A. , Williams Charmaine C. , Massaquoi Notisha , Brown Marsha , Logie Carmen
Published: August 2008

Black women bear a disproportionate burden of HIV/AIDS in North America. The purpose of this investigation was to explore Black Canadian women’s perspectives on HIV risk and prevention. Four 90-minute focus groups (n = 26) and six key informant interviews were conducted in Toronto with Black women of African and Caribbean descent and low socioeconomic status. Data analysis revealed a number of potent barriers to existing HIV preventive interventions: stigma, cultural disconnections, lack of engagement of Black religious institutions, and multiple intersecting forms of discrimination. Recommended HIV prevention opportunities included the Black church, mainstreaming, health care providers, and ethno-specific agencies. HIV prevention strategies for North American Black women, rather than focusing on HIV and individual risk behaviors, may benefit from a primary focus on social and structural factors (e.g., promoting gender equality, economic opportunity, women-controlled prevention technologies and combating racism in health care) thereby integrating HIV prevention into the larger context of community health and survival.
The Promise Clinic: A Service Learning Approach to Increasing Access to Health Care
Authors: Jimenez Manuel , Tan-Billet Jennifer , Babineau John , Jimenez Jennifer Endres , Billet Todd , Flash Charlene , Levin Steven , West Bernadette , Tallia Alfred
Published: August 2008

The goal of the Promise Clinic (a project of an academic medical center and a local social services group) is to increase access to primary care for an underserved population while addressing deficiencies in medical education. Students manage common primary care problems, creating access for this mostly uninsured population.
Poverty and Sexual Concurrency: A Case Study of STI Risk
Authors: Tsui Emma K. , Leonard Lori , Lenoir Chavonne , Ellen Jonathan M.
Published: August 2008

This paper is about sexual concurrency, or maintaining multiple sexual partnerships that overlap in time. Sexual concurrency is a concept that is used in the field of public health to explain the spread of sexually transmitted diseases. Sexual concurrency has also been proposed as a site of intervention to reduce sexually transmitted infection (STI) rates, particularly among those populations who carry the heaviest STI burden: adolescents and African Americans. In this paper, we use ethnographic data collected from a group of African American adolescents living in Baltimore to examine the socially produced configurations of risks and relationships that are obscured by the term sexual concurrency . The data we present show the limits of this concept, and suggest that structural reforms, including improvements to education, drug treatment, and work opportunities, are necessary to reduce racial disparities in STI rates.
Dietary Intake of Homeless Women Residing at a Transitional Living Center
Authors: Davis Lisa R. , Holleman Warren L. , Weller Nancy F. , Jadhav Monika
Published: August 2008

Women who are homeless experience health problems due to many factors, including poor nutrition. This paper describes a nutritional assessment of women who are homeless living at a transitional living center in an urban setting. A rapid food screener was used to assess fat, fruit and vegetable, and fiber intake, and focus group analysis was used to assess nutritional attitudes and dietary behaviors. We found that the dietary intake of shelter residents does not meet the USDA recommendations in several key areas. We also found that shelter residents considered shelter cafeteria food to be inadequate in terms of taste, nutritional quality, and choices, and they believed the shelter diet contributed to chronic diseases and their symptoms. We conclude that addressing these barriers to good nutrition may help people who are homeless prevent and manage chronic illness.
The Experience of Stigma among Black Mental Health Consumers
Authors: Alvidrez Jennifer , Snowden Lonnie R. , Kaiser Dawn M.
Published: August 2008

Little is known about how stigma affects Black people receiving mental health treatment. For a project to develop a consumer-based stigma intervention, qualitative interviews were conducted with public-sector Black mental health consumers (N=34). Primary themes from the interviews regarding stigma concerns, experiences, and coping strategies were examined. Concerns about stigma prompted most consumers initially to avoid or delay treatment; once in treatment, consumers commonly faced stigmatizing reactions from others. Consumers identified numerous strategies to deal with stigma, including seeking support from accepting members of their existing social networks, and viewing their own health as more important than the reaction of others. These consumer perspectives may be valuable to Black individuals who are contemplating seeking mental health treatment.
A Systematic Review of COPC: Evidence for Effectiveness
Authors: Gavagan Thomas
Published: August 2008

Purpose . This systematic review was conducted to assess the evidence for effectiveness of the community oriented primary care (COPC) model and discuss alternative approaches to community medicine practice and education.
Methods . A literature search for all articles referring to COPC was conducted. Articles were categorized by type, and the extent of the use of elements of the COPC model, and the level of community involvement.
Results . The majority of articles on COPC (60% of those reviewed) describe the general theory or educational use of the methodology. Many published studies are project descriptions not utilizing the complete model as initially described. Few of project descriptions include all elements of COPC or document community participation. Evidence for or against the effectiveness of the COPC model in improving community health outcomes (using the Strength of Recommendation Taxonomy (SORT) classification system as evidence) was found to be limited.
Conclusions . Most publications related to COPC do not use the complete COPC model as originally described and evidence for its effectiveness is lacking. Further research with evaluation of community health outcomes and community participation is needed. Diverse models of community health intervention can be considered for training and collaborative practice with underserved populations.
Diabetes Mellitus Medication Assistance Program: Relationship of Effectiveness to Adherence
Authors: Horswell Ronald L. , Wascom Charles K. , Cerise Frederick P. , Besse Jay A. , Johnson Jolene K.
Published: August 2008

This retrospective study examines the effect of a medication assistance program (MAP) on HbA1c levels in an uninsured, low-income, type 2 diabetes population. It also examines the degree to which improvement in HbA1c level varied with adherence to medication regimens among those patients using the MAP. The MAP was found to have a mean effect of −0.60% on HbA1c levels. However, MAP users differed in how strictly they adhered to medication regimens, as measured by number of refill opportunities taken. The MAP’s effect on HbA1c varied monotonically with adherence level, with greater adherence leading to greater HbA1c improvement. Never refilling the prescription (complete nonadherence) led to no change in HbA1c, while complete adherence led to an estimated −0.88% improvement in HbA1c. Further study is needed to investigate factors related to non-adherence within medication assistance programs and the effect of such programs on other patient outcomes.
The Association between Perceived Discrimination and Underutilization of Needed Medical and Mental Health Care in a Multi-Ethnic Community Sample
Authors: Burgess Diana J. , Ding Yingmei , Hargreaves Margaret , van Ryn Michelle , Phelan Sean
Published: August 2008

This study examines the association between perceived discrimination and underutilization of needed medical and mental health care, in a representative, multi-ethnic community sample. Data were derived from a cross sectional survey of 10,098 White, U.S.-born Black, African-born Black, American Indian, Hispanic, and Southeast Asian adults in Hennepin County, Minnesota. Even after controlling for socio-demographic characteristics, health care access, and physical and mental health, perceived discrimination was associated with underutilization of medical care among Whites, U.S.-born Blacks, and American Indians and was associated with underutilization of mental health care among Whites, U.S.-born Blacks, Southeast Asians, and American Indians. Correlates of different types of discrimination (major, everyday, health care) on underutilization of care varied among ethnic groups. The higher prevalence of discrimination among racial and ethnic minorities may contribute to their underutilization of health care services. Future research is needed to understand the impacts of different types of discrimination on different groups.
“The Salt in a Merchant’s Letter”: The Culture of Julfan Correspondence in the Indian Ocean and the Mediterranean
Authors: Aslanian Sebouh
Published: August 2008

This article draws on archival sources in London, Venice, Isfahan, and elsewhere in examining the role of information and commercial correspondence in the long-distance trading community of Armenian merchants from New Julfa, Isfahan. The article focuses on commercial letters written by Julfan merchants working in the Indian Ocean and Mediterranean regions. It argues that information sharing was important not only for the daily commercial affairs of merchants but also for maintaining the integrity of the Julfan trade network. The article examines the stylistic properties of Julfan mercantile correspondence as well as the logistical problems of circulating letters across vast spaces through a courier network that glued the trade settlements of the Julfan network to its nodal center at New Julfa, Isfahan.
Cellular Mechanism of Decreased Bone in Brtl Mouse Model of OI: Imbalance of Decreased Osteoblast Function and Increased Osteoclasts and Their Precursors
Authors: Uveges Thomas E , Collin-Osdoby Patricia , Cabral Wayne A , Ledgard Felicia , Goldberg Leah , Bergwitz Clemens , Forlino Antonella , Osdoby Philip , Gronowicz Gloria A , Marini Joan C
Published: August 2008

The Brtl mouse, a knock-in model for moderately severe osteogenesis imperfecta (OI), has a G349C substitution in half of type I collagen α1(I) chains. We studied the cellular contribution to Brtl bone properties. Brtl cortical and trabecular bone are reduced before and after puberty, with BV/TV decreased 40–45%. Brtl ObS/BS is comparable to wildtype, and Brtl and wildtype marrow generate equivalent number of colony-forming units (CFUs) at both ages. However, OcS/BS is increased in Brtl at both ages (36–45%), as are TRACP+ cell numbers (57–47%). After puberty, Brtl ObS/BS decreases comparably to wildtype mice, but osteoblast matrix production (MAR) decreases to one half of wildtype values. In contrast, Brtl OcS falls only moderately (∼16%), and Brtl TRACP staining remains significantly elevated compared with wildtype. Consequently, Brtl BFR decreases from normal at 2 mo to one half of wildtype values at 6 mo. Immunohistochemistry and real-time RT-PCR show increased RANK, RANKL, and osteoprotegerin (OPG) levels in Brtl, although a normal RANKL/OPG ratio is maintained. TRACP+ precursors are markedly elevated in Brtl marrow cultures and form more osteoclasts, suggesting that osteoclast increases arise from more RANK-expressing precursors. We conclude that osteoblasts and osteoclasts are unsynchronized in Brtl bone. This cellular imbalance results in declining BFR as Brtl ages, consistent with reduced femoral geometry. The disparity in cellular number and function results from poorly functioning osteoblasts in addition to increased RANK-expressing precursors that respond to normal RANKL/OPG ratios to generate more bone-resorbing osteoclasts. Interruption of the stimulus that increases osteoclast precursors may lead to novel OI therapies.
Postpubertal Architectural Developmental Patterns Differ Between the L3 Vertebra and Proximal Tibia in Three Inbred Strains of Mice
Authors: Buie Helen R , Moore Christopher P , Boyd Steven K
Published: August 2008

An understanding of normal microarchitectural bone development patterns of common murine models is needed. Longitudinal, structural, and mineralization trends were evaluated by in vivo μCT over 12 time points from 6–48 wk of age at the vertebra and tibia of C3H/HeN, C57BL/6, and BALB/C mice. Longitudinal growth occurred rapidly until 8–10 wk, slowed as the growth plate bridged, and fused at 8–10 mo. Structural augmentation occurred through formation of trabeculae at the growth plate and thickening of existing ones. In the vertebrae, BV/TV increased rapidly until 12 wk in all strains. Between 12 and 32 wk, the architecture was stable with BV/TV deviating <1.1%, 1.6%, and 3.4% for the C57BL/6, BALB/C, and C3H/HeN mice. In contrast, the tibial architecture changed continuously but more moderately for BV/TV and TbTh compared with the vertebra and with comparable or larger changes for TbN and TbSp. Age-related trabecular deterioration (decreased BV/TV and TbN; increased TbSp and structure model index) was evident at both sites at 32 wk. In all strains, the cortex continued to develop after trabecular values peaked. The temporal plateau of BMD was variable across mouse strains and site, whereas tissue mineral density was attained at ∼6 mo for all sites and strains. Geometric changes at the tibial diaphysis occurred rapidly until 8–10 wk, providing the C57BL/6 mice and C3H/HeN mice with the highest torsional and compressive rigidity, respectively. In summary, key skeletal development milestones were identified, and architectural topology at the vertebra was found to be more stable than at the tibia.
New Automated Multiplex Assay for Bone Turnover Markers in Osteoporosis
Authors: Claudon Aurélie , Vergnaud Philippe , Valverde Cécile , Mayr Anita , Klause Ursula , Garnero Patrick
Published: August 2008

Background: Serum C-terminal cross-linked telopeptide of type I collagen (CTX-I), N-terminal propeptide of type I collagen (PINP), and osteocalcin (OC) are among the most sensitive bone turnover markers for evaluating osteoporosis. Each marker is currently measured individually by manual or automated immunoassays that are time consuming and require substantial sample volume. We evaluated the performance characteristics of a novel, fully automated, protein-array chip system that allows the simultaneous measurement of CTX-I, PINP, OC, and intact parathyroid hormone (PTH) in 20 μL of serum.

Methods: We measured CTX-I, PINP, OC, and PTH using multiplex and corresponding automated single assays in 157 healthy premenopausal women, 74 healthy men, and 56 postmenopausal osteoporotic women before and 6 months after treatment with oral ibandronate (150 mg/month).

Results: Within- and between-run CVs of the multiplex assay were similar to those of single measurement assays (<10% for all markers), whereas the limit of quantification was lower, except for OC. Multiplex values highly correlated (r > 0.93, P < 0.0001 for all markers) with the corresponding single assays, and measured concentrations were comparable. After 6 months of ibandronate, CTX-I, PINP, and OC decreased by a median of 48%, 63%, and 52%, respectively (P < 0.0001 for all 3 markers), magnitudes similar to those of the corresponding single assays.

Conclusions: The automated protein-array chip demonstrated similar analytical precision, improved analytical sensitivity, and comparable measured concentrations to those of single assays. The multiplex assay should be useful for assessing bone metabolism in large clinical studies, particularly when sample volume is limited.
Key Issues in the Developing Synergism between Cardiovascular Imaging and Biomarkers
Authors: Jaffe Allan S
Published: August 2008

Background: Sophisticated methods of cardiac imaging have the potential to revolutionize the care of patients with cardiovascular disease. The benefits of these state-of-the art imaging techniques can be enhanced by their use in combination with new cardiac biomarkers. This review addresses potentially useful interactions between imaging and biomarkers.

Content: Areas were defined in which the combined use of novel imaging techniques and biomarkers would be most beneficial. This review addresses multiple cardiovascular conditions for which the useful aspects of imaging and biomarkers are likely to be positively synergistic, including acute and chronic ischemic heart disease, heart failure, myocarditis, hypertension, and atherosclerosis.

Conclusions: The synergistic use of imaging techniques and biomarkers will enhance the investigation of many key issues and questions and will be an important resource in the future.
Clinical Evaluation of Bionime Rightest GM310 Biosensors with a Simplified Electrode Fabrication for Alternative-Site Blood Glucose Tests
Authors: Wu Ming-Hsun , Fang Mei-Yen , Jen Lin-Ni , Hsiao Hung-Chan , Müller Andreas , Hsu Cheng-Teng
Published: August 2008

Background: Most processes for fabricating biosensors applied to screen-printed carbon electrodes (SPCEs) are complex. This study presents a novel one-step process for manufacturing electrodes for injection-molding biosensors.

Methods: During the sensor-fabrication process, barrel-plated gold electrodes were inserted into an injection-molded base. The electrode directly touched the electrical contact of a meter. We analyzed technical measurements for this biosensor, including tests of the measurement range, within-run imprecision, and between-meter imprecision. In clinical trials, experienced technicians tested 3 alternative sites (fingertip, palm, and arm). The results were simultaneously compared with plasma values obtained with the hexokinase method on the Olympus AU640 instrument. Analytical results were evaluated according to International Standards Organization 15197 (ISO 15197:2003) criteria and by Clarke error grid analysis (EGA), and CVs were calculated to evaluate within-run imprecision.

Results: The glucose measurement range was 0.6– 33.3 mmol/L (y = 0.96x + 0.07 mmol/L; r2 = 0.9977). The CVs in the within-run imprecision test were 1.7%–3.5%, and the overall CV was 2.1%, indicating good reproducibility of results. The Student t-tests of mean values from 5 meters revealed statistically insignificant differences (P > 0.05). In clinical trials, the agreement of the Rightest GM310 meter results with those of a laboratory method complied with ISO 15197:2003 criteria. In the EGA, 100% of the values were within the acceptable zones (A + B), and the proportion of values within zone A exceeded 95%.

Conclusions: The Bionime Rightest GM310 meter applied a simplified process for biosensor fabrication and displayed acceptable performance for monitoring glucose concentrations at alternative test sites.
From Suspicion of Physical Child Abuse to Reporting: Primary Care Clinician Decision-Making
Authors: Flaherty Emalee G. , Sege Robert D. , Griffith John , Price Lori Lyn , Wasserman Richard , Slora Eric , Dhepyasuwan Niramol , Harris Donna , Norton David , Angelilli Mary Lu , Abney Dianna , Binns Helen J.
Published: August 2008

OBJECTIVES. The goals were to determine how frequently primary care clinicians reported suspected physical child abuse, the levels of suspicion associated with reporting, and what factors influenced reporting to child protective services.

METHODS. In this prospective observational study, 434 clinicians collected data on 15003 child injury visits, including information about the injury, child, family, likelihood that the injury was caused by child abuse (5-point scale), and whether the injury was reported to child protective services. Data on 327 clinicians indicating some suspicion of child abuse for 1683 injuries were analyzed.

RESULTS. Clinicians reported 95 (6%) of the 1683 patients to child protective services. Clinicians did not report 27% of injuries considered likely or very likely caused by child abuse and 76% of injuries considered possibly caused by child abuse. Reporting rates were increased if the clinician perceived the injury to be inconsistent with the history and if the patient was referred to the clinician for suspected child abuse. Patients who had an injury that was not a laceration, who had >1 family risk factor, who had a serious injury, who had a child risk factor other than an inconsistent injury, who were black, or who were unfamiliar to the clinician were more likely to be reported. Clinicians who had not reported all suspicious injuries during their career or who had lost families as patients because of previous reports were more likely to report suspicious injuries.

CONCLUSIONS. Clinicians had some degree of suspicion that ∼10% of the injuries they evaluated were caused by child abuse. Clinicians did not report all suspicious injuries to child protective services, even if the level of suspicion was high (likely or very likely caused by child abuse). Child, family, and injury characteristics and clinician previous experiences influenced decisions to report.
Translating Child Abuse Research Into Action
Authors: Flaherty Emalee G. , Sege Robert D. , Hurley Tammy Piazza
Published: August 2008

The Child Abuse Recognition Experience Study revealed that primary care clinicians did not always follow the legal mandate to report suspected child abuse to child protective services. National child abuse experts representing different disciplines met in a 2-day conference in January 2007 to discuss and develop new strategies that would address the barriers to reporting suspected child abuse and improve the protection of children. This article describes the rationale, structure, and goals of the conference.
Understanding Roles and Improving Reporting and Response Relationships Across Professional Boundaries
Authors: Goad John
Published: August 2008

Child abuse is underreported. The author, a child protective service professional with extensive field and management experience, provides his perspective on some of the barriers that inhibit an effective response to reporting and collaboration between the professionals evaluating and investigating possible child abuse. Then presented are his ideas for improving the collaboration, including recommendations for changes in training, child protective service procedures, child protective service staffing, confidentiality requirements, and the adoption of a Child Advocacy Center (CAC) model. Pediatrics 2008;122:S6–S9
Child Abuse Recognition and Reporting: Supports and Resources for Changing the Paradigm
Authors: Berkowitz Carol D.
Published: August 2008

As shown previously in the Child Abuse Recognition Experience Study (CARES), primary care providers reported that they decided not to report a substantial proportion of injuries that they suspected might have resulted from abuse. The most serious cases result in death. This article provides detailed reports of 2 illustrative cases from the author's experience as a member of a multidisciplinary child fatality review team and discusses several alternative legal mechanisms for improving mandated reporting. Regional centers of excellence in child protection may be an effective way of improving child protection; current proposals to establish such centers are reviewed.
Professional Education in Child Abuse and Neglect
Authors: Christian Cindy W.
Published: August 2008

Physicians have reported feeling that they were not adequately trained to identify and report child abuse. This article reviews the current state of medical education and residency training and the needs of physicians in practice and proposes changes and additions that can be made to improve the ability and confidence of physicians who are faced with the responsibility of keeping children safe.
Strategies for Saving and Improving Children's Lives
Authors: Flaherty Emalee G. , Sege Robert D. , Hurley Tammy Piazza , Baker Alison
Published: August 2008

At the Child Abuse Recognition, Research, and Education Translation (CARRET) Conference, national child abuse experts representing different disciplines discussed and developed new strategies that would address the barriers to reporting suspected child abuse and improve the protection of children. This article describes the experts' analysis of the barriers to and strategies for improving the outcome for abused children, in addition to the steps planned to facilitate continued action.
Doing the Right Thing: A Primary Care Pediatrician's Perspective on Child Abuse Reporting
Authors: McCarthy Claire
Published: August 2008

The Child Abuse Recognition Experience Study (CARES) demonstrated that primary care physicians and nurse practitioners who treat injured children find the decision of whether to report suspected abuse difficult. This commentary briefly summarizes and responds to the papers presented at the Child Abuse Recognition, Research, and Education Translation (CARRET) Conference. The commentator traces her own changing views of child protective services as she became more involved in a multidisciplinary assessment team. Pediatricians are called on to advocate for more effective collaborations to better protect vulnerable maltreated children.