bluuebunny/crossref_metadata_2025 huggingface dataset:
Log Gaussian Cox processes and spatially aggregated disease incidence data
Authors: Li Ye , Brown Patrick , Gesink Dionne C , Rue Håvard
Published: April 2012

This article presents a methodology for modeling aggregated disease incidence data with the spatially continuous log-Gaussian Cox process. Statistical models for spatially aggregated disease incidence data usually assign the same relative risk to all individuals in the same reporting region (census areas or postal regions). A further assumption that the relative risks in two regions are independent given their neighbor's risks (the Markov assumption) makes the commonly used Besag–York–Mollié model computationally simple. The continuous model proposed here uses a data augmentation step to sample from the posterior distribution of the exact locations at each step of an Markov chain Monte Carlo algorithm, and models the exact locations with an log-Gaussian Cox process. A simulation study shows the log-Gaussian Cox process model consistently outperforming the Besag–York–Mollié model. The method is illustrated by making inference on the spatial distribution of syphilis risk in North Carolina. The effect of several known social risk factors are estimated, and areas with risk well in excess of that expected given these risk factors are identified.
Modelling of mixed damage on fibre reinforced composite laminates subjected to low velocity impact
Authors: Sosa JL Curiel , Phaneendra S , Munoz JJ
Published: April 2012

This article presents a numerical technique for the computation of damage in fibre-reinforced laminated composites which is embedded into an explicit finite element method. The technique is composed of two main components. First, a novel characterisation of the directions in which the various modes of damage propagate, which produces an effective damage localisation. This is conducted taking into consideration the strain-rate dependence. Second, a new mapping between the strain and stress spaces for the computation of the damage surfaces whereby time-stepping convergence is enhanced. Additionally, new damage initiation criteria in terms of strain damage surfaces are presented. Details of the in-house code developed are presented as well as the programming features. The capabilities of the technique are shown by means of tests on single fibre-reinforced element and low velocity impact on the laminate. It is shown that delamination is located in the expected regions by gradual progression of internal damage variables.
The use of strain sensors in an experimental modal analysis of small and light structures with free–free boundary conditions
Authors: Rovšček Domen , Slavič Janko , Boltežar Miha
Published: April 2012

Small and light structures have distinctive features, which cause difficulties in the measurement of their modal parameters. The major issues are the mass, which is added to the measured structure by sensors, and the very high resonant frequencies. Those difficulties occur with a measurement of the excitation force. An innovative procedure for the experimental modal analysis of small and light structures was developed in this study. This procedure involves a measurement of the excitation force, which was performed by a piezo strain gauge that enables an analysis of the aforementioned structures with free–free support. The main advantage of this sensor in comparison with other devices used for force measurements is that it adds a very small mass to the measured structure (≈0.4 g) but at the same time enables an accurate measurement of the modal parameters in a wide frequency range (up to 20 kHz). This makes it suitable for a measurement of the frequency-response functions of light structures that have high resonant frequencies. Consequently, an experimental modal analysis can be performed. The presented approach was experimentally tested on a sample with small dimensions and mass. The results of the experiment (modal parameters) were compared with the results of the numerical model. The good agreement between the results indicates that this procedure can be used on other similar structures.
Natural frequency analysis of continuously graded carbon nanotube-reinforced cylindrical shells based on third-order shear deformation theory
Authors: Aragh B Sobhani , Farahani E Borzabadi , Barati AH Nasrollah
Published: April 2012

Based on the third-order shear deformation theory (TSDT), the investigation of the free vibration response of a continuously graded carbon nanotube-reinforced (CGCNTR) cylindrical shell is presented. The volume fractions of randomly oriented straight single-walled carbon nanotubes are assumed to be graded in the thickness direction. An embedded carbon nanotube in a polymer matrix and its surrounding inter-phase is replaced with an equivalent fiber for predicting the mechanical properties of the carbon nanotube/polymer composite. The Mori–Tanaka scheme as an accurate micromechanics model is used for estimating the homogenized material properties of nanocomposites reinforced with equivalent fibers. The equations of motion and the associated boundary conditions are derived using the Hamilton’s principle based on TSDT. The discretization of the system by means of the Generalized Differential Quadrature Method leads to a standard linear eigenvalue problem. Detailed parametric studies have been carried out to study the impacts of the various types of equivalent fiber distribution, different boundary conditions and geometrical parameters on the vibration characteristics of CGCNTR cylindrical shells. The interesting finding of the present study is that the graded CNT volume fractions with symmetric distribution through the shell thickness have high capabilities to reduce or increase the natural frequency in comparison with uniformly and asymmetric CNT distribution.
Dynamic stability of cantilever columns under a tip-concentrated subtangential follower force
Authors: Mutyalarao Mandarapu , Bharathi Dora , Rao Boggarapu Nageswara
Published: April 2012

The dynamic stability of a uniform cantilever column under a tip-concentrated subtangential follower force is examined. The governing two-point boundary value problem is converted to an initial value problem. A simple numerical iterative scheme is followed to generate a load versus frequency curve (eigencurve) in order to study the critical and post-critical behavior of the columns subjected to a tip-concentrated follower force. For the load rotation parameter greater than [Formula: see text], the coalesce frequency and the corresponding critical load are obtained. The deformed configurations of cantilever columns are generated for different load rotation parameters. The details of the critical load parameter, tip angle and tip coordinates of the columns for the specified load rotation parameter are presented. The critical load parameter increases with the load rotation parameter.
Symptom Dimensions of Disruptive Behavior Disorders in Adolescent Drivers
Authors: Garner Annie A. , Gentry Ashley , Welburn Sharon C. , Fine Philip R. , Franklin Crystal A. , Stavrinos Despina
Published: April 2012

Objective: Adolescents with disruptive behavior disorder, including ADHD, are more likely to engage in risky driving practices and, consequently, are more likely to be involved in a motor vehicle crash (MVC) than their non-ADHD peers. It is unclear whether symptoms of inattention, hyperactivity/impulsivity, or oppositional defiant disorder (ODD) increase risk of poor driving outcomes. Method: A total of 41 participants (16-19 years old) reported their ADHD and ODD symptoms and risky driving practices (errors and violations). History of citations and MVCs were acquired from state records. Relative predictive utility of symptom dimensions was assessed using multiple regressions. Results: Inattention solely predicted driving variables of interest: Greater levels of inattention were predictive of more citations, MVCs, and self-reported errors and violations. Conclusion: Findings suggest that symptoms of inattention play a primary role in driving-related problems among adolescents. Implications for future research and practice are discussed.
Language Profiles and Mental Health Problems in Children With Specific Language Impairment and Children With ADHD
Authors: Helland Wenche Andersen , Helland Turid , Heimann Mikael
Published: April 2012

Objective: This study aimed to explore whether children with specific language impairment (SLI) and children with ADHD can be differentiated from each other in terms of their language profiles, and also to investigate whether these two clinical groups differ regarding mental health problems. Method: A total of 59 children in the age range 6 to 12 years participated in the study. The parents completed the Children’s Communication Checklist–Second Edition and the Strengths and Difficulties Questionnaire. Results: Communication impairments were as prominent in the ADHD group as in the SLI group; however, the groups were separable from each other in terms of their language profiles. Furthermore, the ADHD group experienced significantly more mental health problems compared with the SLI group. Conclusion: Language should be assessed in children with ADHD and instruments sensitive to ADHD should be included when assessing children with SLI. Mental health should be an area of concern to be addressed in both groups.
Navigating Adolescence
Authors: Deane Harriet , Young Susan
Published: April 2012

Objective: The current study investigated the experience of girls growing up with cognitive and social disorders. Method: Eight adolescent girls participated in interviews that were transcribed and analyzed using Interpretative Phenomenological Analysis. Results: Four of the girls had a history of ADHD symptoms and conduct disorder problems (ADHD/CP), four did not. Three master themes emerged within the domain of “Coping Behaviors”: seeking social support, bravado, and avoidance. Three master themes emerged within the domain of “Barriers to Adaptive Functioning”: lack of support and guidance, poor negotiation of interpersonal conflict, and victimization. Although all participants experienced developmental barriers, the girls with ADHD/CP coped with these barriers in a less effective way. Conclusion: The study raises an important developmental concern, the seemingly ineffective coping strategies of ADHD/CP adolescents.
Atomoxetine for Treating ADHD Symptoms in Autism
Authors: Ghanizadeh Ahmad
Published: April 2012

Objective: This study systematically reviews the current literature on the administration of atomoxetine for treating children and adolescents with comorbidity on autism spectrum disorder (ASD) and ADHD. Method: PubMed/Medline and Google Scholar databases were electronically searched to find the published trials on atomoxetine and ASD. Results: Six articles reported the clinical trials of atomoxetine for treatment of ADHD symptoms in patients with autism or pervasive development disorders. Only one study that was placebo-controlled crossover pilot trial reported that it is effective. Atomoxetine may be effective in high-functioning patients with autism or patients with low severity. Those with high severity of ASD may be more vulnerable to the adverse effects of atomoxetine. Conclusion: There are not enough controlled clinical trials for showing the efficacy of atomoxetine for treatment of ADHD symptoms in autism. Although evidence suggests potential efficacy of atomoxetine, the current evidences are not conclusive.
Adolescent and Caregiver Reports of ADHD Symptoms Among Inner-City Youth
Authors: Hogue Aaron , Dauber Sarah , Lichvar Emily , Spiewak Gabi
Published: April 2012

Objective: This study investigated adolescent and caregiver reports of ADHD symptoms in a sample of clinically referred inner-city adolescents. Method: Participants (N = 168) included youth ages 12-18 (54% male, 98% ethnic minority) and their caregivers who each completed diagnostic interviews of ADHD symptoms and assessments of perceived need for ADHD treatment and correlated behavior problems. Results: Informants showed poor agreement on DSM-IV diagnostic categories and also dimensional scales, Inattention/Disorganization (I/D) and Hyperactivity/Impulsivity (H/I). Both caregiver and adolescent reports of I/D symptoms, but not H/I symptoms, were related to perceived need for ADHD treatment. Caregiver reports were linked to behavioral correlates typically associated with ADHD: I/D symptoms correlated with planning/organization and socioemotional deficits, and H/I symptoms correlated with externalizing and behavior regulation deficits. In contrast, adolescent reports of I/D were related to internalizing and externalizing problems, and their reports of H/I correlated with externalizing only. Few gender effects were found. Conclusion: Study results underscore the developmental salience of I/D symptoms and have implications for ADHD diagnosis and treatment planning for adolescents.
Perioperative Management of Peripheral Vascular Trauma
Authors: Stovall Robert T. , Pieracci Fredric M. , Johnson Jeffrey L.
Published: April 2012

Peripheral vascular trauma is not uncommon in the civilian setting, and it can be uniquely challenging because of the limited time during which intervention can salvage an ischemic extremity. Injuries can be from a blunt or penetrating mechanism, and these injuries can be isolated or can be in the setting of a complex multisystem trauma. The intent of this review is to discuss the perioperative management of peripheral vascular trauma with an emphasis of predicting, preventing, and managing common postoperative complications.
On the Role of Empathy in Customer-Employee Interactions
Authors: Wieseke Jan , Geigenmüller Anja , Kraus Florian
Published: April 2012

While the service literature repeatedly emphasizes the role of empathy in service interactions, studies on empathy in customer-employee interactions are nearly absent. This study defines and conceptualizes employee and customer empathy as multidimensional constructs and empirically investigates their impact on customer satisfaction and customer loyalty. A quantitative study based on dyadic data and a multilevel modeling approach finds support for two effects of empathy in service interactions. The study reveals that customer empathy strengthens the positive effect of employee empathy on customer satisfaction, leading to more “symbiotic interactions.” The findings also indicate that empathic customers are more likely to respond to a dissatisfying encounter with “forgiveness,” in the sense that customer empathy is able to mitigate negative effects of customer dissatisfaction on customer loyalty. From these empirical results, the authors derive several implications for service research and the management of service encounters. In particular, the present study provides a valuable basis for strategies of “interaction routing,” that is, matching customers and employees on the basis of their psychological profiles to create smooth and satisfying service interactions. The authors elaborate on approaches to implement this strategy in service organizations.
Effect of the vibration on friction and wear behavior between the carbon strip and copper contact wire pair
Authors: Yang HJ , Chen GX , Zhang SD , Zhang WH
Published: April 2012

This article reports an experimental study on the friction and wear behavior of carbon strip sliding against copper contact wire under strong electric current utilizing a high-speed block-on-ring tester. The dynamic mechanism of electric arc generation was investigated. Scanning electron microscopy was used to observe morphology of worn surfaces of the carbon strips. The results show that arc discharge has a certain correlation with low-frequency vibration of the carbon strip. The arc discharge frequency and the average single arc discharge energy initially decrease and then tend to stable with increasing normal load at different speeds. The wear rate increases first and then decreases and has the minimum when the load is equal to 100 N especially. Moreover, the wear rate steadily increases with increase in arc discharge energy and is almost directly proportional to arc discharge energy. Arc erosion was a dominant wear mechanism occurred in carbon strip sliding against copper contact wire at a low load, accompanying with adhesive wear and material transferring. However, mechanical wear was a main wear mechanism at a high load. Severe arc erosion weakened the conductivity of the carbon strip.
The effects of clinical interventions on health-related quality of life in multiple sclerosis: a meta-analysis
Authors: Kuspinar Ayse , Rodriguez Ana Maria , Mayo Nancy E
Published: April 2012

The objective is to estimate the extent to which existing health care interventions designed specifically to target health-related quality of life (HRQL) in persons with multiple sclerosis (MS) achieve this aim. The structured literature search was conducted using multiple electronic databases including Ovid MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature and the Cochrane Central Register of Controlled Trial, for the years 1960 to 2011. The methodological quality of selected randomized controlled trials (RCTs) was assessed using the Cochrane Collaboration’s recommended domain-based method. Effect size (ES) was used to measure the effect of each intervention on HRQL. The studies were combined using a random-effects model to account for inter-study variation. Heterogeneity was tested for using the I-test and publication bias was assessed using funnel plots and the Egger weighted regression statistic. Thirty-nine RCTs met the criteria, all with acceptable methodological quality. Six major types of interventions were identified through the search. The smallest effect was observed for self-management and complementary and alternative medicine (ES=0.2), followed by medication (ES=0.3) then cognitive training and exercise (ES=0.4), and psychological interventions to improve mood (ES=0.7). The magnitude of positive effect on HRQL varied between the different types of interventions. The extent to which interventions are able to improve HRQL depends on delivering a potent intervention to those persons who have the potential to benefit.
Time to get emotional: Phronetic reflections on the concept of trust in International Relations
Authors: Michel Torsten
Published: April 2012

This article will engage with the growing literature on the subject of trust in international politics by pointing out remaining problems and contradictions in recent critiques against the rationalist mainstream. Although it finds itself in agreement with these critiques it will argue that despite its more nuanced appreciation of trust, this critical scholarship does not quite succeed in either leaving the rationalist conceptions behind or in achieving a more substantial account of the concept of trust. In order to do so the article will first challenge the remaining methodological framework in which trust scholarship is couched. Second, the article will proceed to show how the emotive element in acts of trust can be highlighted when approached through a phronetic lens and how the introduction of emotion into trust scholarship in IR will allow a richer and thicker study of the phenomenon of trust in international politics. Centrally, the article will claim that any study of trust which ignores the elementary emotional component will remain incomplete.
Existential relatedness in light of eudemonic well-being and religious coping among middle-aged and older cardiac patients
Authors: Ai Amy Lee , Hopp Faith , Tice Terrence N. , Koenig Harold
Published: April 2012

This study examined the prediction of preoperative faith factors for perceived spiritual support, indicating existential relationship as a dimension of eudemonic well-being (EWB), at 30 months after cardiac surgery ( N=226). The study capitalized on data from preoperative surveys and the Society of Thoracic Surgeons’ National Database. Controlling for demographics, cardiac indices, and mental health, hierarchical regression showed that preoperative prayer coping, subjective religiousness, and internal control were positive predictors of spiritual support. Negative religious coping was a negative predictor. Internal control mediated the role of positive religious coping. Certain faith-based experiences may enhance aspects of EWB, but future research should investigate mechanisms.
Balancing motherhood and drug addiction: The transition to parenthood of addicted mothers
Authors: Silva Sofia A , Pires António P , Guerreiro Cristina , Cardoso Antónia
Published: April 2012

This is a study about balancing motherhood and drug addiction, during the transition to parenthood. Few studies have dealt with the parental experience of drug-addicted mothers. The participants included 24 drug-addicted mothers, on methadone, with ages 25–42 and with children 1–32 months of age. Semi-structured interviews were conducted and analyzed according to Grounded Theory. The mothers’ main concern was the ambivalence they felt towards pregnancy/motherhood and drug addiction, which was associated with strong feelings of guilt. Confronted with this ambivalence their maternal role becomes merely functional. They focus on providing the basic care to the child, but show little willingness to talk or play. Social support, especially from the partner seems to have a positive role.
Workplace psychological harassment in Canadian nurses: A descriptive study
Authors: Trépanier Sarah-Geneviève , Fernet Claude , Austin Stéphanie
Published: April 2012

This descriptive study investigated workplace psychological harassment in a sample of 1179 Canadian nurses. Two complementary types of assessment were used: exposure to negative behaviors and perceived victimization. Results revealed that exposure to negative behaviors was associated with certain sociodemographic variables (i.e. job status and the amount of overtime performed weekly), lower psychological health, and poorer functioning at work. Although many nurses reported being exposed to negative behaviors, few perceived these behaviors as psychological harassment per se. However, regardless of perceptions of victimization, exposure to negative behaviors was detrimental to nurses’ psychological health and functioning at work. Practical implications are discussed.
An investigation into neck injuries in simulated frontal impacts
Authors: Al-Shammari Naif , Neal-Sturgess Clive
Published: April 2012

Spinal injury is one of the most debilitating and costly injuries. It is a devastating condition that disrupts the life of the injured and their families. Vehicle crashes are the most common cause of fractures, soft tissue injuries and dislocations of the neck and cervical spine. Among vehicle crashes frontal impacts are the most frequent cause for head and neck injuries. Neck injuries are often caused due to unusual head motion. Improvement of the knowledge of the correlation between crash dynamics, human body behaviour and internal neck phenomena could contribute to the development of new protection systems for the neck. The most acceptable way to study the behaviour of the human body and internal interactions during car crashes is mathematical modeling as it is non-invasive and repeatable. In this work, computer simulations have been performed using a multibody dynamic model of the cervical and thoracic-lumbar spine, where rigid bodies are connected by articulated joints and spring-damper elements. The models were developed using the ‘Working Model 2D’ and were used to simulate frontal impacts in vehicles. The models were validated based on experimental data available in literature. The verified models were used to analyse the behaviour of the driver and vehicle kinematics and calculate the internal neck forces and motion. Principle virtual power of neck was applied at inter-vertebral levels for various impact speeds. Principle virtual power of neck was then correlated with real world crash data of neck injuries. It has been shown that principle virtual power of neck at each intervertebral level correlates well with the crash data and can be used as a predictor of neck injuries.
Vehicle strip element in the analysis of stiffened plate under realistic moving loading
Authors: Malic Neira Toric , Kozar Ivica
Published: April 2012

In this article, a new vehicle strip element is proposed for a vehicle–bridge interaction modelling. Finite strip method principle is applied on the vehicle dynamic system in order to model and couple vehicle with the structure, which is discretised with flat shell strip elements. Vehicle degrees of freedom are transformed and embedded into the structural ones, such that any new conditions or model changes can be easily integrated. Combined with the shell finite strip it enabled observing all degrees of freedom of the structure and the vehicle, reducing modelling and calculation time and effort in the same time. A full vertical vehicle model with nine degrees of freedom is adopted here. The bridge is modelled as a simply supported stiffened plate with use of a flat shell strip elements. The main benefit of the vehicle strip element is possibility to analyse vehicle–structure interaction in a greater detail. This resulted in more realistic and comprehensive analysis of a bridge under the moving loading. Such realistic examples of bridge analysis are rare in literature due to the large effort they require using standard finite elements. A parametric study is made to compare the vehicle models with different level of complexity and to enquire the relationship between model simplification and the reliability of results. In contrast to beam or plate models, application of the flat shell strip element enabled the analysis with the realistic bridge cross section.
Newsroom ethnography in a field perspective
Authors: Willig Ida
Published: April 2012

The reflexive sociology of Pierre Bourdieu offers a promising analytical framework for extending the insights offered by the classical tradition of ethnographic newsroom studies. On a methodological level, Bourdieu’s analytical framework has the potential to help us address one of the key questions in ethnographic research: how should we theorise and empirically investigate context? The question is, not least, practical in nature. When it comes to newsroom ethnography, one of the traditional problems concerns the ‘invisibility’ of certain structures such as the political economy of everyday news work which guides journalist practice. By employing the analytical concepts of ‘journalistic field’, ‘news habitus’ and ‘newsroom capital’, reflexive sociology offers a research strategy for simultaneously studying journalistic practices and the structures that enable and constrain them. A case study of Danish news values is used as a vehicle for presenting Bourdieu’s field theory, which is discussed in relation to newsroom studies more generally. It shows how the ‘context’, often missing in ethnographic studies, can be analysed using the framework of reflexive sociology.
A people thinning institution: Changing bodies and souls in a commercial weight-loss group
Authors: Darmon Muriel
Published: April 2012

Some institutions use people as the material for their action and have the project of transforming individuals. This article aims to show that a commercial weight-loss group, insofar as its explicit aim is to make members lose weight, is a genuine ‘people changing institution’, or more specifically a ‘people thinning institution’. Based on a 14-month ethnographic study of a commercial weight-loss group, this article analyses how such an organization operates. The article shows that it relies on specific modes of surveillance aimed at controlling the participants’ attitudes and behaviours, and insists on the role played by writing and written materials as key tools in enforcing body discipline. It also argues that the change at issue is class-oriented, and more precisely is one oriented towards the middle and upper regions of the social space. These findings have implications for research on institutions, socialization and individual change.
Locating law and governance on unstable ground: An ethnography of events after a disaster in Taiwan
Authors: Jung Shaw-wu
Published: April 2012

The publication of Malinowski’s fieldnotes sheds an interesting light on the relationship between field experience, literally speaking, and the writing of ethnography. Anthropological research is, in the final analysis, an endeavor to decode socio-cultural life, but in ethnographic practice it involves the discovery of codes embedded in the actual flow of everyday events and processes. In a field study in Dongshih, Taiwan, I encountered the complexity of lived experience in the wake of a massive earthquake. That particular complexity played out along the fine line between the legal and the illegal in people’s negotiation of everyday life, and it forced me to rethink my historical analysis of certain formal codes. During this crisis, the plight of one extended family with jointly owned land made manifest a whole range of unforeseen issues that prompted me to question various existing legal processes. Thus, the 9/21 earthquake of 1999 not only highlighted specific actions that challenged the legal system through social contestation, it also revealed underlying processes that regulate the complexity of social conduct.
Pathways to dementia diagnosis among South Asian Canadians
Authors: McCleary Lynn , Persaud Malini , Hum Susan , Pimlott Nicholas JG , Cohen Carole A , Koehn Sharon , Leung Karen K , Dalziel William B , Kozak Jean , Emerson Victor F , Silvius James L , Garcia Linda , Drummond Neil
Published: April 2012

Urban centers are increasingly ethnically diverse. However, some visible minorities are less likely than their majority counterparts to seek and receive services and treatment for dementia. This study explored experiences of South Asian Canadians, Canada’s largest visible minority group, prior to dementia diagnosis. Six persons with dementia and eight of their family carers described their early perceptions of dementia-related changes, actions taken, including help seeking and diagnosis, and affective responses. Early signs were attributed to aging or personality. Even after cognitive enhancers were prescribed, some respondents continued to believe that the dementia symptoms were ‘normal’. Family carers’ affective responses may be related to their attributions. Before seeking medical attention, family carers modified physical or social environments because of symptoms. Help seeking was delayed up to four years, even with significant dementia symptoms. Recognition of a health problem was influenced by safety concerns, emergence of new symptoms following trauma, and treatment for other health problems. For some, relatives living outside the home or outside Canada were instrumental in recognizing a problem and convincing family carers and persons with dementia to seek medical attention. The pathway to diagnosis might be easier with outreach to help South Asian immigrants differentiate between normal aging and dementia. Symptom recognition by physicians treating other acute conditions was a portal to dementia services for others. Screening and referral in acute care could result in earlier diagnosis and treatment.
Data Quality in HIV/AIDS Web-Based Surveys
Authors: Bauermeister Jose A. , Pingel Emily , Zimmerman Marc , Couper Mick , Carballo-Diéguez Alex , Strecher Victor J.
Published: April 2012

Invalid data may compromise data quality. We examined how decisions made to handle these data may affect the relationship between Internet use and HIV risk behaviors in a sample of young men who have sex with men (YMSM). We recorded 548 entries during the 3-month period and created six analytic groups (i.e., full sample, entries initially tagged as valid, suspicious entries, valid cases mislabeled as suspicious, fraudulent data, and total valid cases) using data quality decisions. We compared these groups on the sample’s composition and their bivariate relationships. Forty-one cases were marked as invalid, affecting the statistical precision of our estimates but not the relationships between variables. Sixty-two additional cases were flagged as suspicious entries and found to contribute to the sample’s diversity and observed relationships. Using our final analytic sample, we found that very conservative criteria regarding data exclusion may prevent researchers from observing true associations. We discuss the implications of data quality decisions and its implications for the design of future HIV/AIDS web surveys.
Lack of Effect of Coenzyme Q10 on Doxorubicin Cytotoxicity in Breast Cancer Cell Cultures
Authors: Greenlee Heather , Shaw Jacquelyn , Lau Ying-Ka Ingar , Naini Ali , Maurer Matthew
Published: April 2012

Background/hypotheses. Doxorubicin is a standard adjuvant therapy for early-stage breast cancer, and it significantly improves disease-free and overall survival. However, 3% to 20% of breast cancer patients develop chronic cardiomyopathic changes and congestive heart failure because of doxorubicin therapy. Doxorubicin-induced cardiotoxicity is thought to be due to the increased generation of reactive oxygen species within cardiac myocyte mitochondria. Coenzyme Q10 (CoQ10) is a lipid-soluble antioxidant that may protect against mitochondrial reactive oxygen species and thus prevent doxorubicin-induced cardiotoxicity. Despite the potential benefits of CoQ10 in preventing cardiotoxicity, it is not known if CoQ10 diminishes the antineoplastic effects of doxorubicin therapy. Study design. In vitro cell culture experiments. Methods. Breast cancer cell lines (MDA-MB-468 and BT549) were tested for their ability to uptake exogenous CoQ10 using high-performance liquid chromatography. Breast cancer cell lines were then treated with doxorubicin and a range of CoQ10 concentrations to determine the effect of CoQ10 on doxorubicin’s cytotoxicity. Results. This study demonstrated that intracellular and mitochondrial CoQ10 concentrations increased substantially as higher exogenous concentrations were administered to breast cancer cells. CoQ10 had no effect on the ability of doxorubicin to induce apoptosis or inhibit growth or colony formation in both the cell lines tested when applied over a wide dose range, which encompassed typical basal plasma levels and plasma levels above those typically achieved by supplemented patients. Conclusion. The clinical testing of CoQ10 as a supplement to prevent doxorubicin-induced cardiotoxicity requires confidence that it does not decrease the efficacy of chemotherapy. These results support the hypothesis that CoQ10 does not alter the antineoplastic properties of doxorubicin. Further in vivo studies, as well as combination chemotherapy studies, would be reassuring before a large-scale clinical testing of CoQ10 as a cardioprotective drug.
Evidence That Naturopathic Therapy Including Cordyceps sinensis Prolongs Survival of Patients With Hepatocellular Carcinoma
Authors: Niwa Yukie , Matsuura Hiroshi , Murakami Masato , Sato Junichi , Hirai Keiichi , Sumi Hajime
Published: April 2012

Hypothesis. Naturopathic treatment will benefit patients with hepatocellular carcinoma (HCC). Study design. Retrospective analysis of case series of HCC patients treated with naturopathic agents. Methods. HCC was diagnosed by dynamic computed tomography (CT) imaging and α-fetoprotein (AFP) or PIVKA II, or by histology. Tumor staging was determined by CT. A modified Childs–Pugh scoring was used to assess liver disease. Patients were treated with orally administered combinations of 12 naturopathic agents. Patients were monitored clinically and by CT tumor imaging, serial tumor markers, and liver function tests. Results. Patient characteristics: 101 patients with HCC (67 men and 34 women, age 67.2 ± 8.8 years) were treated for a median of 13.4 months (range 0.8-100.8). Of these 84% had cirrhosis, 63% had hepatitis C virus, 18% had hepatitis B virus, 1% had both, and 9% had metastatic disease. Median modified Childs–Pugh score was 6 (range 3-13). Barcelona Clinic Liver Cancer tumor stages of 0, A, B, C, and D were found in 36%, 25%, 20%, 14%, and 6%, respectively. Median AFP was 40 (range 0-311,000). Median PIVKA II was 59 (0–378,000). Previous treatment was included none (27%), resection with relapse (20%), transarterial chemoembolization (50%), radiofrequency ablation (28%), percutaneous ethanol injection therapy (15%), chemotherapy (14%). Outcomes: Initial treatment was with 2.6 ± 0.8 agents (range 2-4). Overall, patients were treated with 3.7 ± 1.2 agents (range 2-7). There was a significant correlation between number of agents administered and survival ( P < .0001). Patients treated with ≥4 agents survived significantly longer than patients treated with ≤3 agents (40.2 vs 6.4 months, P < .0001). This difference could not be attributed to statistically significant differences in severity of liver disease or tumor stage, delay in treatment, previous treatment, concurrent nondrug treatment, or censoring effects. The greatest effect was seen in patients treated with at least 4 agents that included Cordyceps sinensis. This prolonged survival was without toxic side effects and appeared to potentiate the survival benefit of conventional therapy. Conclusion. Treatment of HCC with a regimen of ≥4 agents prepared from natural products was associated with prolonged survival in a substantial portion of patients. The data provide level II evidence for the efficacy of naturopathic therapy in HCC.
Carotid–Cavernous Fistula Treatment With Ethylene Vinyl Alcohol (Onyx) Exclusively Through Anterior Venous Approach
Authors: Santos-Franco J. A. , Lee A. , Zenteno M. , Gil-Ortiz C. , Vega-Montesinos S.
Published: April 2012

The type of venous drainage of a direct carotid–cavernous fistula is an important issue to consider for the endovascular therapeutic decision. In case of an inadequate posterior drainage associated with a good anterior drainage, the facial vein is a useful alternative. The exclusive embolization with ethylene vinyl alcohol (EVOH Onyx), arterial and/or venous via the internal carotid artery (ICA) occlusion has been used successfully, in a few cases until now. Nevertheless, the use of this method through anterior transvenous approach has not been previously described. Presented here is the case of a 13-year-old female patient with left posttraumatic carotid–cavernous fistula, with predominant anterior drainage, as well as carrier of traumatic occlusion of the contralateral ICA. The treatment was by means of a transvenous approach with transient occlusion of the left ICA.
Strength
Authors: Keller Jennifer L. , Wang Joseph I. , Kang Jonathan Y. , Hanson Joseph A. , Kamath Priya , Swain Jennifer O. , Raymond Gerald V. , Zackowski Kathleen M.
Published: April 2012

Background. With progressive abnormalities in leg strength, tone, and sensation, adrenomyeloneuropathy (AMN) is a differential diagnosis for multiple sclerosis and hereditary spastic paraparesis. AMN pathology has been linked to weakness, making it a relevant model to evaluate the relationship between neurodegeneration and disability. Quantifying symptom severity in AMN is essential for treatment development in rehabilitative management. Objective. To identify deficits in body functions, activity, and participation of people with AMN and provide a practical framework for evaluating the severity of disability. Methods. Cohort analysis of 142 participants with AMN. Measures of body functions (leg strength, vibration sensation, range of motion, and spasticity), activity (walk velocity, standing balance, Timed Up and Go, and Sit-to-Stand Time), and participation (6-Minute Walk) are evaluated. Regression analyses identify relationships between the measures. A staging framework (mild, moderate, and severe) reflects the continuum of disability. Finally, an analysis of variance/Kruskal-Wallis was used for between-stage and sex differences among the variables. Results. Strength is the strongest correlate for the 5 measures of activity and participation. Staging based on weakness distinguishes 3 levels of severity along a continuum of disability. Differences between the sexes are more prevalent earlier in the continuum but show equally severe deficits in the last stage. Conclusions. In AMN, staging based on degrees of weakness provides a practical means to characterize the severity of common deficits in body functions as well as activity and participation at each stage, to direct the evaluation. Such information could help clinicians develop more effective rehabilitative techniques.
Exercise to Enhance Mobility and Prevent Falls After Stroke
Authors: Dean Catherine M. , Rissel Chris , Sherrington Catherine , Sharkey Michelle , Cumming Robert G. , Lord Stephen R. , Barker Ruth N. , Kirkham Catherine , O’Rourke Sandra
Published: April 2012

Background. Exercise interventions can enhance mobility after stroke as well as prevent falls in elderly persons. Objective. Investigate whether an exercise intervention can enhance mobility, prevent falls, and increase physical activity among community-dwelling people after stroke. Method. A randomized trial with blinding of physical outcome assessment was conducted through local stroke clubs. Both groups, on average 5.9 years poststroke, received exercise classes, advice, and a home program for 12 months. The experimental group (EG) program (n = 76) aimed to improve walking, prevent falls and increase physical activity. The control group (CG) program (n = 75) aimed to improve upper-limb and cognitive functions. The primary outcomes were walking capacity, walking speed measured before and after the intervention, and fall rates monitored monthly. Results. At 12 months, the EG walked 34 m further in 6 minutes (95% confidence interval [CI] = 19-50; P < .001) and 0.07 m/s faster over 10 m (95% CI = 0.01-0.14; P = .03) than the CG. The EG had 129 falls, and the CG had 133. There were no differences in proportion of fallers (relative risk = 1.22; 95% CI = 0.91-1.62; P = .19) or the rate of falls between groups (incidence rate ratio = 0.96; 95% CI = 0.59-1.51; P = .88). Conclusion. The experimental intervention delivered through stroke clubs enhanced aspects of mobility but had no effect on falls.
Numerical modeling and experimental investigations of thermal performance of reflective insulations
Authors: Saber Hamed H , Maref Wahid , Sherrer Gordon , Swinton Michael C
Published: April 2012

Reflective insulations are being used in attics, flat roof, and wall systems. Numerical modeling and experimental investigations were conducted to assess the thermal performance of assemblies with reflective insulations. In this article, the present model was used to verify the use of the ASTM C-518 test method for measuring the effective thermal resistances (R-values) of sample stacks comprising reflective insulations. Two tests were conducted on sample stacks using heat flow meter apparatus. The sample stack consists of two expanded polystyrene layers and a reflective insulation installed in between. The model predictions agreed with the measured heat fluxes within ±1%. The article also discusses the combined effect of heat transfer by convection and radiation in the airspace facing the reflective insulation, showing that the derived R-value from the test data resulted in underestimation of the effective R-value of the sample stack.
Ethical dilemmas in social work practice with disabled people
Authors: Wilkins David
Published: April 2012

This article discusses the use of restraint with disabled adults and children and uses a case study of one particular child to explore issues related to the use of restraint, including the consent of the person subjected to restraint, their human rights, and the balancing of these rights with the need to reduce the risk of harm. The case study involves a young woman who requested to be restrained in a particular way and the challenges this posed to the staff caring for her. The article concludes that in many complex situations there is no clearly right approach to take, and each situation involving restraint must be considered on an individual case-by-case basis.
Intellectual disability, consumerism and identity
Authors: McClimens Alex , Hyde Martin
Published: April 2012

Here we consider the consumer society as it currently exists in the UK and examine its relationship and relevance to the population of individuals with intellectual disability. We do this through a reading of the associated literature on theories of shopping and consumption which we then contrast with research evidence as it applies to the lives of people with intellectual disability. By brining together these two perspectives we hope to shine some light on ideas around identity and choice.

We then transfer these arguments to the health and social care sector. Here we ask whether an economic model which has been exposed as divisive and exclusionary should be used in the administration of social secutity benefits of the kind accesed by people with a range of disabilities.

We conclude that the unchallenged advance of marketisation within health and social care may benefit those who are financially able but for those who are economically disadvantaged the choices offered are illusory at best.
Aflibercept in wet age-related macular degeneration: a perspective review
Authors: Ohr Matthew , Kaiser Peter K.
Published: April 2012

In the treatment of neovascular age-related macular degeneration (AMD), vascular endothelial growth factor (VEGF) has emerged as a key target of therapy. Currently, patients with neovascular AMD are treated with monthly intravitreal injections of anti-VEGF medications. Aflibercept is a novel recombinant fusion protein engineered to bind all isoforms of VEGF-A, VEGF-B, and placental growth factor. It is the latest medication to receive US Federal Drug Administration (FDA) approval for the treatment of neovascular AMD. Theoretical models suggest this molecule may have a longer duration of action compared with current treatments. The results of the VEGF Trap-Eye: Investigation of Efficacy and Safety in wet Age-related Macular Degeneration studies (VIEW 1 and VIEW 2) support this by demonstrating that aflibercept, dosed every 2 months after a monthly loading dose for 3 months, was noninferior in the proportion of patients who maintained or improved vision at 52 weeks compared with monthly injections of ranibizumab. These results were maintained over the 2 years of the studies. Aflibercept (Eylea; Regeneron Pharmaceuticals, Inc., Tarrytown, NY, USA and Bayer, Basel, Switzerland) was approved by the FDA for the treatment of neovascular AMD on 18 November 2011.