bluuebunny/crossref_metadata_2025 huggingface dataset:
Preventing Influenza: Vaccine Systems and Practices in the Southeast
Authors: Gazmararian Julie A. , Orenstein Walter A. , Wortley Pascale , Buehler James W. , Elon Lisa , Koplan Jeffrey P. , Schild Laura , Dixon Tonya , Weiss Paul , Stephens David S. ,   State Working Group
Published: July 2017

Objectives.

The purpose of this study was to determine from state and local health departments: ( 1) how they purchase, distribute, and fund influenza vaccine; ( 2) whether they experienced a shortage in 2003/04; ( 3) how the shortages were handled; and ( 4) how they prepared for distribution in 2004/05.

Methods.

A web-based survey was completed from June to August 2004 in eight Southeastern states.

Results.

Data were obtained from each state and 222 local health departments. Major differences between and within states were found with regard to purchasing, distributing, and funding influenza vaccine. Although the majority of health departments experienced periods of shortages in 2003/2004, surpluses of vaccine remained at the end of the season. There was little evidence of interaction between the public and private sectors to share vaccine resources in response to shortages. Tracking systems for redistribution of vaccine or follow-up were often not in place. Entering the 2004/05 season, 25% of states and 11% of counties were not developing any special procedures to deal with shortages beyond what was in place earlier.

Conclusions.

Better systems and funding are needed, especially for adult influenza vaccine delivery and for redistribution of influenza vaccine in response to shortages.
Replicating Success: Developing a Standard FETP Curriculum
Authors: Traicoff Denise A. , Walke Henry T. , Jones Donna S. , Gogstad Eric K. , Imtiaz Rubina , White Mark E.
Published: July 2017

Field epidemiology training programs have been successful models to address a country's needs for a skilled public health workforce, partly due to their responsiveness to the countries' unique needs. The Centers for Disease Control and Prevention has partnered with ministries of health to strengthen their workforce through customized competency-based training programs. While desirable, emphasis on program flexibility can result in redundancy and inconsistency. To address this challenge, the ADDIE model (analysis, design, development, implementation, and evaluation) of instructional design was used by a cross-functional team to guide completion of a standard curriculum based on 15 competencies. The standard curriculum has supported the development and expansion of programs while still allowing for adaptation. This article describes the process that was used to develop the curriculum, which, together with needs assessment and evaluation, is crucial for successful training programs.
From Competencies to Capacity: Assessing the National Epidemiology Workforce
Authors: Lichtveld Maureen , Boulton Matthew , Lemmings Jennifer , Gale James
Published: July 2017

Objectives.

We determined the competency of the public health epidemiology workforce within state health agencies based on the Centers for Disease Control and Prevention/Council of State and Territorial Epidemiologists Competencies for Applied Epidemiologists in Governmental Public Health Agencies (AECs).

Methods.

The competence level of current state health agency staff and the need for additional training was assessed against 30 mid-level AECs. Respondents used a five-point Likert scale—ranging from “strongly agree” to “strongly disagree”—to designate whether staff was competent in certain areas or whether additional training was needed for each of the competencies.

Results.

Most states indicated their epidemiology workforce was competent in most of the AECs subject areas. Subject areas with the greatest number of states reporting competency (82%) are creating and managing databases and applying privacy laws. However, at least one-third of the states reported a need for additional training in all competencies assessed. The greatest reported needs were for additional training in surveillance system evaluation and use of knowledge of environmental and behavioral science in epidemiology practice.

Conclusions.

The results indicate that most epidemiologists mastered the traditional discipline-specific competencies. However, it is unclear how this level of competency was achieved and what strategies are in place to sustain and strengthen it. The results indicate that epidemiologists have lower levels of competence in the nontraditional epidemiologic fields of knowledge. Future steps to ensure a well-qualified epidemiology workforce include assessing the full AECs in a subgroup of Tier 2 epidemiologists and implementing competencies in academic curricula to sustain reported competency achievements.
Epidemiology Competencies and Preventive Medicine Residencies: Do They Mix and Map?
Authors: Boulton Matthew L. , Montgomery JoLynn P. , Beck Angela
Published: July 2017

Objectives.

This article maps the program requirements of the University of Michigan preventive medicine residency (PMR) to the newly established Centers for Disease Control and Prevention/Council of State and Territorial Epidemiologists Competencies for Applied Epidemiologists in Governmental Public Health Agencies (AECs) to determine the feasibility and utility of using these competencies to assess the training of physician epidemiologists.

Methods.

The academic and practicum requirements of the PMR are mapped against the 38 AECs for Tier 2, or mid-level epidemiologists. The process of mapping was done by reviewing academic course syllabi/content and practicum tasks to determine how closely they aligned with the AECs. This process allowed us to identify competencies that are relative training strengths and weaknesses of the residency.

Results.

Overall, the current program requirements of the PMR generally satisfy the AECs, although one competency was not met in either the academic or practicum year, and another was only met in a single, required academic course. The areas in which AECs were fulfilled by many activities in the residency were in domain 1 (assessment and analysis) and domain 2 (basic public health sciences). The areas in which competencies were met by few activities were primarily in domain 6 (financial and operational planning and management) and domain 7 (leadership and systems thinking).

Conclusions.

We found that the process of mapping an academically rigorous epidemiology training program (the PMR) to the AEC was feasible and useful. It permitted us to identify training strengths and gaps in our program and consider modifications that will strengthen the level of competency of our physician graduates.
Two Tuberculosis Genotyping Clusters, One Preventable Outbreak
Authors: Buff Ann M. , Sosa Lynn E. , Hoopes Andrea J. , Buxton-Morris Deborah , Condren Thomas B. , Hadler James L. , Haddad Maryam B. , Moonan Patrick K. , Lobato Mark N.
Published: July 2017

In 2006, eight community tuberculosis (TB) cases and a ninth incarceration-related case were identified during an outbreak investigation, which included genotyping of all Mycobacterium tuberculosis isolates. In 1996, the source patient had pulmonary TB but completed only two weeks of treatment. From February 2005 to May 2006, the source patient lived in four different locations while contagious. The outbreak cases had matching isolate spoligotypes; however, the mycobacterial interspersed repetitive unit (MIRU) patterns from isolates from two secondary cases differed by one tandem repeat at a single MIRU locus. The source patient's isolates showed a mixed mycobacterial population with both MIRU patterns. Traditional and molecular epidemiologic methods linked eight secondary TB cases to a single source patient whose incomplete initial treatment, incarceration, delayed diagnosis, and housing instability resulted in extensive transmission. Adequate treatment of the source patient's initial TB or early diagnosis of recurrent TB could have prevented this outbreak.
Health and Economic Burden of Traumatic Brain Injury: Missouri, 2001–2005
Authors: Kayani Noaman A. , Homan Sherri , Yun Shumei , Zhu Bao Ping
Published: July 2017

Objective.

We examined the financial and social costs resulting from traumatic brain injury (TBI) in Missouri.

Methods.

We computed mortality rates from death certificates, the direct cost of TBI from hospital and emergency department (ED) visit charges, the social cost in terms of years of potential life lost (YPLL) using an abridged Missouri life table, and the indirect financial cost in terms of lost productivity due to premature death for all TBI and four major causes of TBI in Missouri.

Results.

During 2001–2005, a mean of 1,358 lives were lost due to TBI in Missouri. Four major causes—unintentional falls, motor vehicle traffic crashes, motorcycle crashes, and firearms—accounted for 88% of all TBI deaths. We estimated the annual direct medical cost of TBI at $95 million, or about $1.67 million per 100,000 Missourians. This cost increased by about 60% between 2001 and 2005. The four major causes of TBI accounted for 68% of all direct medical costs of TBI. We estimated the cost per hospitalization and ED visit at $6,948 and the indirect social cost at 48,501 YPLL. During this period, the mean age of TBI fatality was 44 years. We determined the lost productivity due to TBI mortality—$1.1 billion, or about $18.8 million per 100,000 Missourians—to be three times as high for males as for females.

Conclusions.

The types of costs covered in this study underestimated the total cost of TBI in Missouri, as we did not include outpatient care, rehabilitation, and drug costs. Nevertheless, we found the health and economic burden from medical care and mortality related to TBI to be substantial in Missouri.
Pediatricians and Screening for Obesity with Body Mass Index: Does Level of Training Matter?
Authors: Hillman Jennifer B. , Corathers Sarah D. , Wilson Stephen E.
Published: July 2017

Objectives.

Pediatric obesity is increasing at epidemic rates in industrialized nations. It is recommended that pediatricians screen all children annually with the use of body mass index (BMI). However, it is unclear whether this recommendation is followed. This study sought to ( 1) determine the proportion of children screened for obesity with BMI, and ( 2) test whether attending physicians are more likely than resident physicians to document and plot BMI.

Methods.

We conducted a systematic review of medical records in an urban academic pediatric practice. Participants were children aged 5 to 11 years presenting for health care in 2004. We measured the proportion of subjects with documented and plotted BMI and compared results for attending and resident physicians. We used logistic regression analysis to determine factors associated with documentation of BMI.

Results.

Of 397 medical records reviewed, 59.7% contained the 2000 Centers for Disease Control and Prevention growth curve with BMI for age; 5.5% documented BMI, and 4.3% plotted BMI. Resident physicians were more likely to document (13.0% vs. 3.0%, p=0.0008) and plot (9.0% vs. 2.7%, p=0.0260) BMI compared with attending physicians. Children with a BMI ≥95% for age were more likely to have their BMI documented (odds ratio [OR] = 10.7, 95% confidence interval [CI] 3.7, 31.5) and plotted (OR=7.1, 95% CI 2.3, 21.6).

Conclusion.

We found the use of BMI to screen for childhood obesity very poor in this academic pediatric practice. Resident physicians were more likely to document and plot BMI than attending physicians.
Advancing Novel HIV Prevention Intervention Research with MSM—Meeting Report
Authors: Grossman Cynthia I. , Forsyth Andrew , Purcell David W. , Allison Susannah , Toledo Carlos , Gordon Christopher M.
Published: July 2017

HIV continues to exact an enormous toll on society and to disproportionately affect gay and bisexual men and other men who have sex with men (MSM). Innovative prevention interventions are needed to reverse this trend. In August 2009, the U.S. National Institute of Mental Health and the Centers for Disease Control and Prevention convened a meeting of scientists, community representatives, advocates, and federal partners to discuss innovative prevention-intervention science. The meeting was structured to maximize discussion of (7) healthy sex interventions, (2) community and structural interventions, (3) integrated biomedical and behavioral interventions, and (4) interventions to improve uptake of HIV testing. Presentations and discussion focused on research gaps in designing risk-reducing and sexual health-promoting interventions for MSM, including interventions to address mental health, substance use, disclosure, and stigma. This article summarizes the meeting proceedings, highlights key points, and outlines future directions.
Seroprevalence of Hepatitis A Virus Antibodies in the U.S.: Results from the National Health and Nutrition Examination Survey
Authors: Klevens R. Monina , Kruszon-Moran Deanna , Wasley Annemarie , Gallagher Kathleen , McQuillan Geraldine M. , Kuhnert Wendi , Teshale Eyasu H. , Drobeniuc Jan , Bell Beth P.
Published: July 2017

Objectives.

We described seroprevalence of antibody to hepatitis A virus (anti-HAV) in the United States during 1999–2006 and compared it with seroprevalence before the availability of vaccine.

Methods.

We analyzed data from the 1988–1994 and 1999–2006 National Health and Nutrition Examination Survey (NHANES) to obtain estimates of anti-HAV seroprevalence for the U.S. household population. We grouped region of residence based on the 1999 Advisory Committee on Immunization Practices recommendations into 17 states with any recommendation (vaccinating) and 33 states without any recommendation (non-vaccinating).

Results.

During 1999–2006, the overall seroprevalence of anti-HAV was 34.9% (95% confidence interval [CI] 33.1, 36.7). During 1999–2006, U.S.-born children living in vaccinating states (33.8%, 95% CI 26.2, 42.2) had a higher seroprevalence than children in non-vaccinating states (11.0%, 95% CI 9.4, 12.8; p<0.001). Seroprevalence among children increased from 8.0% (95% CI 6.3, 10.1) during 1988–1994 to 20.2% (95% CI 16.0, 24.8) during 1999–2006 ( p<0.001). For U.S.-born children aged 6–19 years, the strongest factor associated with seroprevalence was residence in vaccinating states. Among U.S.-born adults aged >19 years, the overall age-adjusted seroprevalence of anti-HAV was 29.9% (95% CI 28.3, 31.5) during 1999–2006, which was not significantly different from the seroprevalence during 1988–1994 (32.2%, 95% CI 30.1, 34.4).

Conclusions.

Increases in seroprevalence among children in vaccinating states suggest a positive effect of the 1999 vaccination recommendations.
Protecting Newborns by Immunizing Family Members in a Hospital-Based Vaccine Clinic: A Successful Tdap Cocooning Program during the 2010 California Pertussis Epidemic
Authors: Rosenblum Elizabeth , McBane Sarah , Wang Wendy , Sawyer Mark
Published: July 2017

Objective.

Infants are at greatest risk for mortality from pertussis infection. Since 2005, the Advisory Committee on Immunization Practices has recommended a cocooning strategy of vaccinating all close contacts of infants with tetanus, diptheria, and acellular pertussis (Tdap) vaccine to reduce the risk of transmitting pertussis. Difficulties in establishing a complete cocoon have been reported in the literature. We determined whether families of newborns could be fully immunized against pertussis, thereby providing a complete cocoon of protection.

Methods.

Tdap vaccine was offered during visiting hours to contacts aged 7 years and older and to postpartum patients who had not received Tdap vaccine during pregnancy. We then conducted retrospective phone interviews with randomly selected mothers (or other family members) to assess vaccination rates. We compared household vaccination rates during intervention and control periods and the demographic factors associated with Tdap vaccination of all members within the households.

Results.

During the intervention period, 243 postpartum patients and 1,287 other family members of newborns were immunized, with 84.8% of all family members receiving Tdap vaccination. Seventy-six percent of households reported a complete cocoon. In the control group, 52.2% of all family members received Tdap vaccination, and 29.3% of households had a complete cocoon. In the control group, fewer family members completed Tdap vaccination in the larger households than in the smaller households ( p=0.008).

Conclusion.

A cocooning strategy can be successfully implemented, such that the majority of newborns leave the hospital with their families fully immunized against pertussis.
Disparities in Current Cigarette Smoking Prevalence by Type of Disability, 2009–2011
Authors: Courtney-Long Elizabeth , Stevens Alissa , Caraballo Ralph , Ramon Ismaila , Armour Brian S.
Published: July 2017

Objectives.

Smoking, the leading cause of disease and death in the United States, has been linked to a number of health conditions including cancer and cardiovascular disease. While people with a disability have been shown to be more likely to report smoking, little is known about the prevalence of smoking by type of disability, particularly for adults younger than 50 years of age.

Methods.

We used data from the 2009–2011 National Health Interview Survey to estimate the prevalence of smoking by type of disability and to examine the association of functional disability type and smoking among adults aged 18–49 years.

Results.

Adults with a disability were more likely than adults without a disability to be current smokers (38.8% vs. 20.7%, p<0.001). Among adults with disabilities, the prevalence of smoking ranged from 32.4% (self-care difficulty) to 43.8% (cognitive limitation). When controlling for sociodemographic characteristics, having a disability was associated with statistically significantly higher odds of current smoking (adjusted odds ratio = 1.57, 95% confidence interval 1.40, 1.77).

Conclusions.

The prevalence of current smoking for adults was higher for every functional disability type than for adults without a disability. By understanding the association between smoking and disability type among adults younger than 50 years of age, resources for cessation services can be better targeted during the ages when increased time for health improvement can occur.
The Psychological Effects of Chronic Violence on Children Living in South African Townships
Authors: Govender K. , Killian B.J.
Published: July 2017

This paper focuses on adolescent youth living in the townships of the Midlands region of KwaZulu- Natal. The subject sample has lived within violence stricken communities for most of their lives. It was assumed that all participants were also victims of poverty and social discrimination. Four different communities, with varying profiles of political and criminal violence, combined with varied access to resources were selected. A life events scale, a symptom checklist and a coping scale were used to ascertain the degree of psychological distress. The results indicated that a number of individual and community variables are likely intervening variables. This led to the development of an interactionist model, which indicates that a number of mediating and/ or moderating variables operate which enhance resilience or alternatively place an individual at greater risk for the development of psychopathology. Other probable mediating variables, not fully investigated in this study but suggested in recent literature, are discussed. These include cognitive attribution, meaning of the violence to the individual and the community as well as the nature of the enemy. The need for greater focus on factors which facilitate coping both at community and individual level are discussed.
A Cross-Cultural Study into Loneliness Amongst University Students
Authors: Le Roux Anda , Connors John
Published: July 2017

The main aim of this research was to determine whether two groups of students from different cultural backgrounds differed as far as their experience of loneliness was concerned. The researchers also wanted to determine whether the groups differed in their experience of loneliness for gender, age, domestic circumstances and socio-economic status. The two groups were formed as follows: Information was gathered from senior students of the Charles Sturt University in Wagga Wagga (N=189); data were also obtained from the students of the University of the Free State in Bloemfontein, South Africa, by distributing questionnaires amongst second- and third year students (N=104). The data were analysed by using t-tests for independent samples. The results indicated firstly that students from the Charles Sturt University in New South Wales were significantly more lonely than students from the University of the Free State. Furthermore, it was found that female Australian students were significantly more lonely than female students from South Africa, and that there were no age differences for the two groups. It was also found that domestic circumstances play an important role in the experience of loneliness, since Australian students who grew up in happy parental homes were significantly more lonely than their South African counterparts.
Personality and Behaviour Associated with Excessive Dependence on Exercise: Some Reflections from Research
Authors: Basson C.J.
Published: July 2017

This paper examines possible links between negative addiction to running and personality variables. More specifically, it addresses the question of why only certain runners become addicted to running and whether there is a unique interaction between personality variables and specific reinforcing aspects of running. Drawing on the results of four studies conducted in an ongoing research programme at the University of Natal, Pietermaritzburg, significant trends that have emerged with regard to the personality attributes of addicted runners are highlighted and explained. In particular, the studies provide preliminary supportive evidence for personality differences between extremely dependent and non-dependent groups of runners. It appears that excessive dependence on running is associated with generally rigid, inflexible personality patterns rather than specific personality pathology. The findings further suggest an association between negative addiction to running and interpersonal difficulties. Using Theodore Millon's Biosocial learning theory of personality as the conceptual framework for interpreting these results, this paper offers explanations of how the identified personality pattern of highly dependent runners interacts with the contextual and physiological variables elicited by running to maintain addictive behaviour. Finally, this paper suggests a number of directions for future research into excessive exercise dependence.
Career Psychology in South Africa: Moral Perspectives on Present and Future Directions
Authors: Watson Mark B. , Stead Graham B.
Published: July 2017

This article provides a framework for a moral consideration of career research and practice in South Africa. The status quo of South African career research and practice is overviewed and some initial questions are suggested in terms of the present and future direction of career psychology in South Africa.
Rereading the evidence of the earliest Christian communities in East Asia during and prior to the Táng Period
Authors: Morris James H.
Published: July 2017

The history of the church of the East in East Asia is one in which it is often difficult to divide fact and fiction. This is the result of an over-reliance on late 19th- and early 20th-century Orientalist scholarship, which sought to show the all-encompassing influence of Christianity in global history, and is often repeated in modern works without critical attention. In this article, I explore claims that Christianity arrived in Korea and Japan prior to the 9th century. I offer a critical assessment of these claims in order to suggest that they do not have an historical basis. Similarly, I seek to question what evidence we have to suggest that Christianity was present in pre-Táng dynasty China. I seek to illustrate that reliance on early scholarship has resulted in a number of fictional claims, which either cannot be maintained or require more research. The article seeks to act as a starting point for greater criticism of a number of assumptions made by scholars of early East Asian Christianity, historians and missiologists alike.
Gastric Acid Secretion and Vitamin B 12 Absorption After Vertical Ronx‐en‐Y Gastric Bypass for Morbid Obesity
Authors: Sax Harry C.
Published: July 2017

It is difficult to imagine that the morbidly obese patient suffers from nutritional deficiencies. Nonetheless, severe obesity can lead to hepatic steatosis and cirrhosis, which may significantly alter protein synthesis and immune response. Early surgical therapy for morbidly obese patients involved creating a short gut by performing a jejunoileal bypass. Many of these patients developed malabsorption and blind‐loop syndrome, with significant metabolic abnormalities, and some died.1 Recently, the vertical‐banded gastric bypass has been shown to be effective in morbidly obese patients, not only by reducing the volume of food eaten, but also by discouraging the consumption of concentrated sweets by causing dumping. A small upper‐gastric pouch is created that is completely excluded from the distal stomach and duodenum. A Roux‐en‐Y limb of jejunum is then anastomosed to this pouch to restore intestinal continuity.2 Although weight loss is significant, many of these patients develop pernicious anemia. It is unclear whether this is caused by a lack of intrinsic factor from the stomach itself, inasmuch as the large parietal cell mass remains intact, or by hypoacidity of the proximal pouch. Pernicious anemia is seen in other states of hypoacidity, which are recreated by these small pouches.

Ten patients who had undergone vertical Roux‐en‐Y gastric bypass were compared with 15 healthy volunteers. Gastric tubes were positioned in the stomach or proximal pouch to assess acid production. The patients underwent a Schilling test using either free or food‐bound 57Co‐labeled cyanocobalamin (Vitamin B12). Twenty‐four hours later, urine was collected, and the percentage of labeled B12 that was detected represented gastrointestinal tract absorption.

Acid secretion from the proximal gastric pouch was markedly less than the acid output in the total stomach of age‐matched hospital controls (0 ± 0 vs 5 ± 0.7 mEq/h; p <.001). This may explain the incidental fmding of few anastomotic gastrojejunal ulcers. Crystalline Vitamin B12 absorption was normal in both groups, suggesting that intrinsic factor continued to be produced and bound with the B12 in the jejunum before its absorption. However, when food‐bound Vitamin B12 was given, uptake was significantly decreased in the bypass patients (0.8% ± 0.2% vs 3.7% ± 0.5%; p <.01).
Does Player Mobility Lead to Higher Earnings? Evidence from the Nhl
Authors: Vincent Claude , Eastman Byron
Published: July 2017

A superficial examination of NHL earnings data shows that players who have changed teams earn more, on average, than players who have not. Extensive media coverage of player movement at trading and free agency deadlines has generated the perception that players on the move are consistently moving to higher salaries. Using career data for players in the National Hockey League, we estimate an earnings function and find, perhaps surprisingly, that the cumulative effect of moving on earnings is negative. Players who have changed teams many times during their careers earn less than those who remained with the same team throughout their career. We show that the negative impact of moving holds for free agents and highly talented players only if they move often.
Academic Success and the Transfer of Community College Credits in the Principles of Economics
Authors: Grimes Paul W. , Rezek Jon P. , Campbell Randall C.
Published: July 2017

A growing number of today's college students attend local 2-year community colleges. Many of these students will ultimately transfer to major universities in pursuit of the traditional Bachelors degree. The question of whether such transfer credits adequately prepare students for future academic endeavors is important for educators interested in preparing successful students and maintaining the quality of their institution. In this paper, we examine whether students who transfer credits earned for the traditional Principles of Economics course sequence achieve the same levels of academic success, measured in terms of GPA, as students taking the sequence at a major state university. The model indicates that community college transfer students perform poorly relative to native students in terms of cumulative GPA. This result is driven by a self-selection process whereby the more academically challenged students are those who choose to transfer credit from 2-year schools. The results of our model are used to develop a grade equivalency measure between the university and 2-year schools. Using this measure we are able to reject the hypothesis that grades are equivalent between 2- and 4-year institutions. Finally, we find that grades in the Principles of Economics sequence are strong predictors of overall academic success.
Benefits from Collecting Checks Electronically
Authors: Humphrey David B.
Published: July 2017

The Uniform Commercial Code has long required the physical check to be presented to banks for payment. This was before electronic methods were invented. This process was disrupted during September 11, 2001 and legislation was passed permitting the presentment of a digital image of a check in lieu of the original item. The efficiency gains were large–totaling over $3 billion in 2010.
Measuring The Sorting and Incentive Effects of Tournament Prizes
Authors: Davies Tim , Stoian Adrian
Published: July 2017

Prizes and ability influence both choices of tournaments and effort exerted during a tournament. The number of participants close in ability to an individual also impacts his effort. These are two of the novelties of our model with which we quantify the sorting and incentive effects of tournament prizes using unique data of road running race results. We show that the sorting and incentive effects are inter-related and that the impact of prizes is heterogeneous across runners in the same race. The study sheds light on the nature of other economically significant tournaments where data is less available.
Failure Mode Dependent Strength Criteria for Composite Laminates
Authors: Echaabi Jamal , Trochu Francois
Published: July 2017

Failure of composite laminates reinforced with continuous fibres is not fully understood. The complexity of failure behaviors for these materials depends mainly on the large number of possible failure modes. In this work, some failure criteria that incorporate or predict failure modes will first be discussed. Then a formulation taking into account failure modes will be presented. It is based on the dual kriging approach described previously [3,4,5], but includes a new feature: the kriging of derivatives. The introduction of derivatives in kriging allows control of the local shape of the failure envelope as a function of the main failure modes. The method is applied to two types of composite materials: a unidirectional composite and a graphite-epoxy laminate. The effect of failure modes on the shape of the failure envelope is explained, and the results obtained by this approach are compared to those of other criteria. The method provides a general tool to model the failure envelope of composite materials. However, in order to use its full potential, a more fundamental experimental investigation must be performed on the failure phenomena of composite laminates.
Shape Control of Intelligent Composite Stiffened Structures Using Piezoelectric Materials-A Finite Element Approach
Authors: Goswami Sanjib , Kant Tarun
Published: July 2017

A finite element procedure is adopted for the analysis of composite stiffened structures with piezoelectric materials attached to it either at the top or bottom surfaces or inside the substrate as a composite layer. In the large space structures made of strong and light weight materials, the necessity of using self controlling strategies becomes important day by day for deformation control and suppression of undesired oscillation, specially for the unmanned space vehicles in the outer space. As the importance of stiffened composite configuration in aerospace structures has already been established for their optimum use of materials with high strength to weight ratio, a study of electromechanical interaction problem with these structures become necessary. Analysis of composite stiffened plates with piezoelectric sensors/actuators attached to it has been carried out for the first time. Static analysis of intelligent structures, i.e., structures integrated with distributed actuators and sensors, is presented in this work. The distributed sensors and actuator layers, made of piezoelectric materials, are perfectly bonded to the structures. The substrate is a laminated composite stiffened plate made of graphite/epoxy materials. To validate the present procedure, several experimental and analytical examples already solved by the previous researchers, have been compared. Finally, some new results for the stiffened composite plates, hitherto not published, have been included for future research.
The Aerodynamics of Cooling of Blown Film Bubbles
Authors: Sidiropoulos V. , Wood P. E. , Vlachopoulos J.
Published: July 2017

Numerical simulation ofturbulent flow ofjet impinging at various angles on blown film bubbles has been performed. The air flow from various types of air rings has been studied. The streamline pattern for external cooling as well as heat transfer coefficients have been detennined from the solution of the differential equations for the conservation of mass, momentum and energy of the air jets studied. The turbulent flow has been calculated using the renormalization group (RNG) k-E model. Venturi effect (local creation of low pressure due to high speed flow at narrow passages) has been studied.
Governance standards
Authors: Mitchell Jonathan I. , Izad Shenas Seyed Abdolmotalleb , Kuziemsky Craig
Published: July 2017

Reducing the rate of adverse events and preventable harm associated with healthcare delivery is a policy priority across healthcare systems internationally. Care transitions or handovers in clinical care introduce risk to patients that can lead to adverse events. Building on the literature showing the impact of governing boards on the quality and safety of healthcare services, this study builds a predictive model between governance and safety at care transitions. Analysis was based on 490 Canadian healthcare organizations across six sectors of care. Organizational compliance with the Accreditation Canada Governance Standards was shown to be a predictor of organizational performance with the Medication Reconciliation Required Organizational Practice. Results indicate that among a comprehensive set of governance standards, a set of 11 central governance elements predict organizational medication reconciliation practice. Implications for healthcare leaders are discussed including the role of organizational leadership in medication reconciliation practices. The importance of a governance process cycle that encompasses board prioritization of desired goals, monitoring of performance regularly, and communicating results with stakeholders is shown.
Molecular Microencapsulation: Paclitaxel Formations in Aqueous Medium Using Hydrophobized Poly(L-Lysine Citramide Imide)
Authors: Poujol S. , Pinguet F. , Bressole F. , Boustta M. , Vert M.
Published: July 2017

Hydrophobized polyelectrolytes are able to aggregate in aqueous media and to form lipophilic microdomains which are much more stable than micelles made of amphiphilic diblock copolymers. Solubilization of paclitaxel in water by molecular encapsulation was attempted in the hydrophobic pockets present in the aggregates of hydrophobized poly(l-lysine citramide imide) polymers, PLCAixRy, where x = percentage in imide groups and y = percentage in alkyl substituents per lysine citramide repeat unit. A comparison was made of the physical entrapment and the solubilization of paclitaxel in PLCAi27C1234, PLCAC1275, PLCAi13C730, PLCAC12100 aggregates and in the usual allergic Cremophor® present in the Taxol® commercial formulation. PLCAixRy polymers solubilized paclitaxel in the selected aqueous medium proportionally to the polymer concentration. For comparable amounts in weight, the polymers were two to six times less efficient than Cremophor® in terms of equivalent mass of solubilizing species. A comparison between PLCAi13C730 and PLCAixC12y polymers suggested that dodecyl hydrophobizing groups were more efficient than heptyl ones in promoting the physical entrapment of paclitaxel. The antitumoral activity of the polymer-solubilized paclitaxel was tested in vitro against an ovarian carcinoma cell line (A2780). The C12 systems showed cytotoxicity, the IC50 values were statistically comparable in the 6.5-10.5 μg/L range. However, the amounts of drug incorporated in the polymer aggregates at the tested concentrations were still too low for clinical use. Improvements are expected from PLCA polymers with longer alkyl chains, greater hydrophobicity and higher concentrations.
Physico-Chemical and Biological Properties of Monofunctional Hydroxy Teriminating Poly(N-Vinylpyrrolidone) Conjugated Superoxide Dismutase
Authors: Caliceti Paolo , Schiavon Oddone , Morpurgo Margherita , Veronese Francesco M. , Sartore Luciana , Ranucci Elisabetta , Ferruti Paolo
Published: July 2017

Monofunctional hydroxy-terminated poly( N-vinylpyrrolidone) was obtained by radical polymerization in the presence of isopropoxyethanol for protein surface modification. Superoxide dismutase was modified to various degrees by reaction with PVP-OH activated by 4-nitrophenyl chloroformate with high retention of enzymatic activity. All the polymer-enzyme conjugates showed increased body residence time after intravenous injection in rats with respect to the native enzyme. The residence time depended upon the number of bound polymer chains. PVP was found to affect the pharmacokinetic properties of the enzyme after subcutaneous, intramuscular and intraperitoneal administration. The antigenicity of superoxide dismutase was reduced to one third following modification, while its immunogenicity after intravenous, subcutaneous and intraperitoneal injection totally disappeared. The conjugates exhibited increased solubility in organic solvents and increased stability towards thermal denaturation, whereas changes in the structural properties were observed by circular dichroism measurements.
Lamb Pregastric Esterase Catalyzed Hydrolysis of 4-Nitrophenyl-Acetate and -Dodecanoate: pH, Temperature and Bile Salt Effects
Authors: O'Connor Charmian J. , Barton Richard H. , Lai Douglas T.
Published: July 2017

Two fractions, F2 and F3, eluted by ion exchange chromatography of the commercial extract of lamb pregastric enzyme have esterase activity against 4-nitrophenylacetate, PNPA. Preheat treatment of fraction F3 at pH 7.2, 50°C for 15 min effectively removes its lipase activity against tributyrin while leaving the esterase component relatively unaffected. The esterase components in fractions F2 and F3 and the lipase component in fraction F3 have K m values against PNPA equal to 0.96, 2.1 and 2.7 mM, respectively. When 4-nitrophenyldecanoate, PNPDe, was used as substrate, the maximum activity was reached at its critical micelle concentration, 1.6 μM, for catalysis by all three enzymes. The reactivity is dependent upon pH and p K values of 6.7 and 8.4, 6.7 and 7.5, and 7.3 were determined from the lipase and esterase components in fraction F3, and the fraction F2 esterase, respectively. The dependence upon temperature of the activities of the esterase components against PNPA were determined within the range 25-47.5°C and Arrhenius parameters have been calculated. The presence of sodium taurocholate affected the activity of each enzyme to a small and differing extent.
Synthesis, Characterization, and in Vitro Biodegradation of Poly(Ethylene Glycol) Modified Poly[5N-(2-Hydroxyethyl-L-Glutamine]
Authors: De Marre Anne , Hoste Karry , Bruneel Dorine , Schacht Etienne , De Schryver Frans
Published: July 2017

The synthesis and in vitro biodegradation of poly(ethylene glycol) modified poly[N-2-hydroxyethyl)L-glutamine] are described. Poly(ethylene glycol) (PEG) with terminal amino endgroup was coupled onto 4-nitrophenyl chloroformate activated poly[N-2-hydroxyethyl-L-glutamineI (PHEG). The influence of the degree of substitution and the molecular weight of PEG side groups on the degradability of the PHEG backbone exposed to isolated rat liver lysosomal enzymes was determined. These data indicate that substitution of PHEG with PEG side-chains only slightly alters the degradability of the carrier. The PEG-grafted polymers showed potential tensioactive properties. DSC analysis demonstrated phase separation of the PEG side-groups in solid state.
Peripheral Nerve Reconstruction with Bioabsorbable Polyphosphazene Conduits
Authors: Aldini N. Nicoli , Fini M. , Rocca M. , Martini L. , Giardino R. , Caliceti P. , Veronese F. M. , Lora S. , Maltarello M. C.
Published: July 2017

Tubes of poly[bis(ethylalanato)phosphazene], obtained by evaporating the polymer around a 1.3 mm diameter capillary, were evaluated as guides for nerve regeneration in an experimental animal model. In six Wistar rats, under general anesthesia and with microsurgical technique, the ischiatic nerve was bilaterally isolated. On the right side, a segment was removed to create a defect of 10 mm, that was repaired with the conduit; on the left side the defect was repaired with harvested nerve segment from the right side. Controls at 30, 90, 180 days showed slow and gradual absorption of the conduit without signs of local or general toxicity. Nerve fiber regeneration in the conduits was not significantly different from that obtained with autologous grafts. Polyphosphazene conduits may be considered effective as a guide for nerve regeneration mainly in the perspective of using the polymer matrix as a carrier for neurite-promoting factors.
Surface Coating of Liposomes with Hydrophobized Polysaccharides
Authors: Kang Eui-Chul , Aklyoshi Kazunari , Sunamoto Junzo
Published: July 2017

Coating the outermost surface of a liposomal membrane with several different hydrophobized polysaccharides was investigated by fluorescence depolarization, gel chromatography, and dynamic light scattering methods. The binding of cholesterol-bearing pullulan to the liposomal surface was biphasic. The first process was finished within minutes while the subsequent slow stages took over several hours. The binding isotherms followed Langmuir-type adsorption. The binding constant (K) increased with increases in the substitution degree of the cholesteryl moiety and the molecular weight of the pullulan derivatives used, while the maximum amount of the polysaccharide coating (qs) was almost the same. The apparent liposome size increased by 20-30 nm upon coating. Chemical structure of the parent polysaccharide had only a slight effect on the binding constant, while the structures of the hydrophobic moiety had a significant effect on the coating behavior of the liposomes. In the case of dodecyl diglyceryl group-bearing pullulan, both K and qs were smaller than those of other cholesterol-bearing polysaccharides. The addition of hexadecyl-bearing pullulan to the liposome induced aggregation of the liposomes. The cholesteryl moiety is an excellent hydrophobic anchor for polysaccharide coating liposomal surfaces compared with simple monoalkyl or dialkyl chains.
New Multifunctional Polymeric Materials for the Treatment of Chronic Uremia
Authors: Solaro Roberto , Dossi Eleftheria , Chiellini Emo , Mazzanti Giuseppe
Published: July 2017

The preparation and characterization of polymeric materials attained by synthetic or semisynthetic procedures is reported. These include radical copolymerization of acryloyl and methacryloyl monomers and modification of oligo- and polysaccharides. All the polymeric materials are characterized by hydrogel-like properties which are tunable by pH; the maximum swelling occurred under alkaline conditions. This behavior, combined with their capability to take up urea, ammonia and sodium and potassium ions, makes them good candidates for the removal of uremic toxins from patients affected by chronic uremia. The results of the in vitro evaluation of the efficacy of these materials to interact with the reported metabolites, including water, were analyzed in view of predicting their in vivo responses.
Synthesis and Hydrolysis of Polyurethanes Containing Ibuprofen Pendent Groups
Authors: Davaran S. , Entezami A.
Published: July 2017

New biodegradable polyurethanes and polyetherurethanes having hydrolytically labile ibuprofen groups as a therapeutic agent were prepared by reacting 1,6-hexamethylenediisocyanate (HDI), ethylene glycol with ibuprofen monoglyceride as a chain extender. The polyetherurethanes containing ibuprofen pendent groups were prepared by reacting poly(ethylene glycol) with an excess of HDI to obtain a prepolymer which was reacted with ibuprofen monoglyceride low molecular weight diol. The structure of the polymers was confirmed by FTIR and 1H NMR spectroscopy. The hydrolysis of the polymers was carried out in dialysis bags containing aqueous buffer solution (pH 8) at 370C. UV spectroscopy was used to show that ibuprofen was released by hydrolysis of the ester bond between the drug and polyurethane monoglyceride segments. The polyurethane-drug conjugates have longer duration of activity, due to slow release of ibuprofen.
Nonradioisotope Assay to Examine Adaptability of Nonnatural Amino Acids to the Active Center of Ribosomal a Site
Authors: Ito Yoshihiro , Teramoto Naozumi , Kawai Tetsuya , Imanishi Yukio , Ueda Mitsuyoshi , Tanaka Atsuo
Published: July 2017

A puromycin analog was synthesized and used for assessing the adaptability of the nonnatural amino acid to the active center of reticulocytic ribosome by competitive protein synthesis inhibition using a nonradioisotope procedure. Adaptability of benzyl L-glutamate was assessed by the amino acid-coupled puromycin analog. The puromycin analog inhibited in vitro protein synthesis by the ribosome indicating that chemical modification of side groups by benzyl group did not significantly affect the adaptability of amino acids.
Calf Pregastric Esterase Catalyzed Hydrolysis of 4-Nitrophenylalkanoates: pH and Temperature Effects
Authors: O'Connor Charmian J. , Lai Douglas T. , Sun Cynthia Q.
Published: July 2017

A commercial extract from the tongue and epiglottal region of suckling calf was partially purified to yield a calf pregastric enzyme with esterase activity against 4-nitrophenylalkanoate esters (C2-C12) at 370C, pH 7.2. The Km against 4-nitrophenylacetate was 0.023 mM, however, when 4-nitro-phenyldodecanoate was used as the substrate, the Km was 1.06 AM. The maximum activity was achieved at ca. 1.6 AM, which is similar to its critical micelle concentration. The reactivity is dependent upon pH. A pK of 7.23 which was obtained in the pH range 5.5-9.0 is indicative of a single ionizable residue. The activity dependence upon temperature of the partially purified enzyme was determined within the range of 25°C to 48°C and Eyring parameters were calculated.