bluuebunny/crossref_metadata_2025 huggingface dataset:
Maximising the utilisation of micro-generation using a multi-state optimal power flow
Authors: Pudjianto Danny , Strbac Goran
Published: November 2012

This article investigates the use of a multi-state optimal power flow algorithm that simultaneously optimises the capacity utilisation of micro-generators to produce electricity in combination with the provision of spinning/standing reserve. The optimisation will consider various market data including energy and reserve markets, operating cost and technical characteristics of micro-generators, network constraints to optimise the dispatch and allocation of reserves. Two operating states are considered: (a) one base case where the reserve contracts are allocated to micro-generators but have not been exercised and (b) another state where all scheduled reserve is utilised. The optimal power flow algorithm will ensure that in both states, the system can be operated securely and no network operating limits/constraints are violated. We demonstrate the feasibility of the proposed optimal power flow through a number of case studies on a low-voltage system. The studies demonstrate that micro-generators are capable to contribute to both local and system support services, particularly, in the forms of reserve and voltage control while simultaneously optimising the portfolio of energy production in order to maximise the benefits for the owners of micro-generators and improve the efficiency of the overall system.
Dignity in care in the clinical setting
Authors: Lin Yea-Pyng , Watson Roger , Tsai Yun-Fang
Published: November 2012

This review aimed to explore nursing literature and research on dignity in care of inpatients and to evaluate how the care patients received in the hospital setting was related to perceived feelings of being dignified or undignified. Studies conducted between 2000 and 2010 were considered, using Cumulative Index to Nursing and Allied Health Literature and MEDLINE, and the search terms ‘patient dignity’, ‘dignity in care’, ‘human dignity and nursing’ and ‘dignity and nursing ethics’. Findings revealed, from the perspectives of nurses and patients, that dignity in care in the hospital setting is seen to be influenced by physical environment, staff attitude and behaviour, organisational culture and patient independence. This review can help nurses to better understand dignity in care, and for policy makers, there are implications about determining the physical environment, staff attitude and behaviour and organisational culture needed to promote patient dignity in nursing. By identifying the most important factors from patients’ and nurses’ perspectives that contribute to dignity in care, nursing interventions, such as campaigns and education in clinical practice, can be developed.
Tier 2 Team Processes and Decision-Making in a Comprehensive Three-Tiered Model
Authors: Pool Juli L. , Carter Deborah Russell , Johnson Evelyn S.
Published: November 2012

Three-tiered models of academic and behavioral support are being increasingly adopted across the nation, and with that adoption has come an increasing message that designing and implementing effective practices alone is not enough. Systems are needed to help staff to collectively implement best practices. These systems, as well as effective processes for collecting and using data for decision-making, are necessary at each tier. This article outlines the systems considerations and decision-making processes for Tier 2 adopted by one elementary school in the implementation of a combined response to intervention (RTI) and school-wide positive behavior support (SWPBS) model.
Desmoplastic Medulloblastoma Arising From an Ovarian Teratoma
Authors: Wey Shiuan-Li , Chen Chi-Kuan , Chen Tze-Chien , Chen Tung-Ying
Published: November 2012

The primary neuroectodermal tumor of the ovary is extremely rare, and it manifests in 3 forms: differentiated, primitive, and anaplastic. The medulloblastoma belongs to the subgroup of primitive neuroectodermal tumor of the ovary. Only 3 cases of ovarian medulloblastoma have been reported in the literature, and all of them are presented without information about the specific pathological subtype. We present the fourth case of a 26-year-old woman who presented with abdominal fullness for months. Ultrasound exam showed a right adnexal mass with cystic feature and foci solid components. A partial oophorectomy was performed, and the mass was a desmoplastic medulloblastoma arising from an ovarian teratoma.
Microscopic Kaposiform Hemangioendothelioma With Extensive Lymphangiomatosis
Authors: Low Irene C. , Yang Rita Y.-T. , Symmans Pennie J.
Published: November 2012

Kaposiform hemangioendothelioma (KHE) is presently classified as a vascular neoplasm of intermediate malignant potential. The clinical course of large, deep-seated tumors is frequently complicated by consumptive coagulopathy and life-threatening hemorrhage, while superficial tumors tend to behave in an indolent manner, with no known reports of distant metastasis. We describe an unusual example of KHE occurring as an incidental microscopic finding, within a background of extensive lymphangioma-like changes. The patient underwent 4 intralesional excisions over a period of 6 years, and the Kaposiform component accounts for less than 5% of the overall tissue excised. The patient remains clinically well with residual disease 5 years after conservative surgery, and there has been no evidence of regional or distant metastasis. Based on existing literature, it appears doubtful that KHE has any metastatic potential at all, which calls into question the appropriateness of its place in the spectrum of malignant vascular neoplasms.
Wave propagation in micropolar thermoelastic layer with two temperatures
Authors: Kumar Rajneesh , Kaur Mandeep , Rajvanshi Satish
Published: November 2012

The propagation of waves in micropolar thermoelastic homogeneous plate with two temperatures subjected to stress free thermally insulated and isothermal conditions is investigated. The secular equations for both symmetric and skew-symmetric wave mode of propagation have been derived. Helmholtz decomposition technique has been used to simplify mathematical model and frequency equations for different mechanical conditions. The regions of secular equations are obtained and some special cases such as thin plate and short wavelength waves of the secular equations are also discussed. The phase velocity and attenuation coefficient are computed numerically and depicted graphically. The amplitudes of stress components and thermodynamic temperature distribution for the symmetric and skew-symmetric wave modes are computed analytically and presented graphically. Results of some earlier workers have been deduced as particular cases.
Fault diagnosis of rolling bearings based on Marginal Fisher analysis
Authors: Jiang Li , Shi Tielin , Xuan Jianping
Published: November 2012

Feature extraction plays an important role in fault diagnosis. It is critical to extract the representative features for improving the classification performance. An intelligent fault diagnosis method based on Marginal Fisher analysis (MFA) is put forward and applied to rolling bearings. The high-dimensional features in time-domain, frequency-domain and wavelet-domain are extracted from the raw vibration signals to obtain rich faulty information. Subsequently, MFA excavates the underlying low-dimensional fault characteristics embedded in the high-dimensional feature space by preserving local manifold structure. Thus, the optimal low-dimensional features are obtained to characterize the various fault conditions of rolling bearings and finally fed into the simplest k-nearest neighbor classifier to recognize different fault categories. The diagnosis results validate the feasibility and effectiveness of the proposed fault diagnosis method, compared with the other three similar approaches.
Longitudinal vibration analysis for microbars based on strain gradient elasticity theory
Authors: Akgöz Bekir , Civalek Ömer
Published: November 2012

The longitudinal free vibration problem of a micro-scaled bar is formulated using the strain gradient elasticity theory. The equation of motion together with initial conditions, classical and non-classical corresponding boundary conditions for a micro-scaled elastic bar is derived via Hamilton’s principle. The resulting higher-order equation is solved for clamped-clamped and clamped-free boundary conditions. Effects of the additional length scale parameters on the frequencies are investigated. It is observed that size effect is more significant when the ratio of the microbar diameter to the additional length scale parameter is small. It is also observed that the difference between natural frequencies predicted by current and classical models becomes more prominent for both lower values of slenderness ratio of the microbar and for higher modes.
Conceptual, Methodological, and Ethical Problems in Communicating Uncertainty in Clinical Evidence
Authors: Han Paul K. J.
Published: November 2012

The communication of uncertainty in clinical evidence is an important endeavor that poses difficult conceptual, methodological, and ethical problems. Conceptual problems include logical paradoxes in the meaning of probability and “ambiguity”—second-order uncertainty arising from the lack of reliability, credibility, or adequacy of probability information. Methodological problems include questions about optimal methods for representing fundamental uncertainties and for communicating these uncertainties in clinical practice. Ethical problems include questions about whether communicating uncertainty enhances or diminishes patient autonomy and produces net benefits or harms. This article reviews the limited but growing literature on these problems and efforts to address them and identifies key areas of focus for future research. It is argued that the critical need moving forward is for greater conceptual clarity and consistent representational methods that make the meaning of various uncertainties understandable, and for clinical interventions to support patients in coping with uncertainty in decision making.
Turnout and Incumbency in Local Elections
Authors: Trounstine Jessica
Published: November 2012

It is well established that incumbents win reelection at high rates. But we know less about the ways in which institutional variation affects the incumbency advantage. Using data from more than 4,000 cities, evidence in this article indicates that institutions generating low-participation environments increase the proportion of city council incumbents who run for reelection and the proportion who win. These low-turnout environments are shown to have spending patterns that benefit particular subgroups in the population who have good reason to participate even when the costs are high.
Festival and the Laughter of Being
Authors: McHugh Kevin E. , Fletchall Ann M.
Published: November 2012

We present a performance in festival laughter that unfolds in three movements. Movement I traces the emergence and proliferation of Renaissance “faires” in America as spectacle, a Rabelaisian landscape of pleasure and excess that speaks to nostalgia and escape as cultural elixirs. In Movement II, we sketch the history of festival and wink to Ren Fest as contemporary expression of the carnivalesque, sanitized remnants of transgression and subversion that marked premodern carnivals and festivals. This catapults us to the third, and culminating, movement—an eruption in festival laughter that reverberates and shakes high-minded seriousness, leaving in its wake questions of being qua becoming. Our entanglement in laughter moves in streams of anti- or nonrepresentational thought, most notably that of Georges Bataille. Laughter is spontaneous, a contagion that “communicates” that we beings called human are thoroughly relational, most united in “senseless” detachment. We end the performance with a coda, sounding eruptions of laughter as moments of the unexpected, moments of vitality, moments of communitas ripe with possibility.
Exercise in the community for people with multiple sclerosis — a follow-up of people with minimal gait impairment
Authors: Garrett Maria , Hogan Neasa , Larkin Aidan , Saunders Jean , Jakeman Philip , Coote Susan
Published: November 2012

Background:

Although there are many studies evaluating exercise interventions, few studies have evaluated the effect at follow-up.

Objectives:

This paper presents follow-up data for participants who completed the exercise interventions in a large randomised controlled trial.

Methods:

One hundred twenty-one people with multiple sclerosis (MS) with minimal gait impairment who completed 10 weeks of community-based exercise interventions were evaluated by a blinded assessor 12 weeks after the intervention. The primary outcome measure was the Multiple Sclerosis Impact Scale-29 version 2 (MSIS-29,v2) physical component. Other outcomes were the MSIS-29 psychological component, the Modified Fatigue Impact Scale (MFIS) and the 6-minute walk test (6MWT) distance.

Results:

The positive effect on the physical impact of MS was not maintained from baseline to follow-up (−1.6, 95% CI −0.8, 4.0, p=0.189). The psychological impact and the impact of fatigue remained significantly improved (−3.5, 95% CI −6.1, −1.0, p = 0.006 and −4.68, 95% CI −6.9, −2.5, p < 0.001, respectively). There was no time effect for the 6MWT ( f = 1.76, p = 0.179) although the trend suggests reversal of the benefits gained from the physiotherapist (PT)- and fitness instructor (FI)-led intervention.

Conclusion:

The maintained benefit on the psychological impact of MS and fatigue may have important personal and socioeconomic consequences; however, it is important to find ways to maintain the physical benefits of exercise over the long term.
Maternal intolerance of uncertainty, anxiety, and adherence with food challenge referrals
Authors: Herbert Linda J , Dahlquist Lynnda M , Bollinger Mary E
Published: November 2012

Anxiety regarding food challenges may serve an important role in parents’ decisions to adhere to their child’s food challenge referrals. This study examined the role of intolerance of uncertainty in food challenge referral adherence by assessing state/trait anxiety among mothers whose children were referred for a food challenge. Mothers whose children passed a food challenge reported significant decreases in anxiety regarding allergic reactions, but intolerance of uncertainty did not predict adherence. Trust in the physician was a primary reason mothers attended the food challenge, suggesting that physicians should consider the impact of the physician–patient relationship when treating these families.
Thriving in the shadow of the 2008 Sichuan Earthquake: Two studies on resilience in adolescents
Authors: Gan Yiqun , Xie Xiaofei , Wang Ting , Rodriguez Marcus A , Tang Catherine S
Published: November 2012

The objective of the current study was to explore the relationship between resilience and psychological adjustment in Chinese adolescents who experienced the 2008 Sichuan earthquake. Study 1 compared the scores and factor structures on the Resilience Scale for Chinese Adolescents for 1436 adolescents, who were divided into a high-adversity group and a low-adversity group. The results showed that resilience following exposure to an earthquake included cognitive and emotive components. In Study 2, 311 Chinese adolescents who resided in the most severely affected areas were surveyed at 15 months (T1) and 20 months (T2) following the earthquake. The results revealed that resilience mediated the relationship between positive future expectations at T1 and adjustment at T2.
Subsidence damage assessment of a Gothic church using differential interferometry and field data
Authors: Tomás Roberto , García-Barba Javier , Cano Miguel , Sanabria Margarita P , Ivorra Salvador , Duro Javier , Herrera Gerardo
Published: November 2012

The Santas Justa and Rufina Gothic church (fourteenth century) has suffered several physical, mechanical, chemical, and biochemical types of pathologies along its history: rock alveolization, efflorescence, biological activity, and capillary ascent of groundwater. However, during the last two decades, a new phenomenon has seriously affected the church: ground subsidence caused by aquifer overexploitation. Subsidence is a process that affects the whole Vega Baja of the Segura River basin and consists of gradual sinking in the ground surface caused by soil consolidation due to a pore pressure decrease. This phenomenon has been studied by differential synthetic aperture radar interferometry techniques, which illustrate settlements up to 100 mm for the 1993–2009 period for the whole Orihuela city. Although no differential synthetic aperture radar interferometry information is available for the church due to the loss of interferometric coherence, the spatial analysis of nearby deformation combined with fieldwork has advanced the current understanding on the mechanisms that affect the Santas Justa and Rufina church. These results show the potential interest and the limitations of using this remote sensing technique as a complementary tool for the forensic analysis of building structures.
Classed Femininity, Performativity, and Camp in British Structured Reality Programming
Authors: Woods Faye
Published: November 2012

This article explores the representations and tonal qualities of British “structured reality” programming. Focusing on The Only Way Is Essex and Made in Chelsea, it investigates their glocalizing of the model established by MTV’s Laguna Beach and The Hills. It argues that while they blur boundaries between docusoap, drama, and soap opera, the British programs also recognize and foreground issues of construction for their reality TV-literate youth audience. It suggests the programs play a key role in their respective channel identities and the ideologies of British youth television, connecting to larger issues of class, gender, and taste. This is articulated through their regional and classed femininities, with the article exploring how the programs draw on classed ideologies surrounding “natural” and “excessive” femininities and of the role of this in their engagement with construction and camp play. This play contributes to the tonal shift offered by the British programs, mixing the melodrama of the MTV programs with a knowing, at times comic edge that can tip into mockery. In doing so, the programs offer their audience a combination of performative self-awareness and emotional realism that situates them clearly within British youth television.
Political Conditions and the Electoral Effects of Redistricting
Authors: McKee Seth C.
Published: November 2012

Redistricting can have considerable electoral consequences because it undermines the incumbency advantage. Numerous voters are drawn into districts with a different incumbent seeking reelection. With regard to vote choice, these redrawn constituents rely more on their partisanship and prevailing political conditions because they lack familiarity with their new representative. Macropartisanship, the aggregate party identification of the electorate, is an excellent barometer of the political climate and hence the partisan direction guiding voters. Because redrawn constituents have at best a tenuous bond with their new incumbent, partisan tides have more influence on their vote choice. Analyses of the 1992 and 2002 U.S. House elections show that higher district percentages of redrawn constituents significantly reduced the vote shares of southern Democratic representatives in 1992 and Democratic incumbents regardless of region in 2002. Given the stated behavioral implications associated with redistricting, these findings speak to the political conditions occurring at the time of these respective elections: a Republican realignment picking up steam in the South in 1992 and a short-term national GOP tide in the first post-9/11 midterm.
Object Relations Treatment of a Woman With Borderline Personality Disorder From a Mahlerian Perspective
Authors: Giugliano John R.
Published: November 2012

This article presents the treatment of a female patient with borderline personality disorder which draws on the principles of Margret Mahler’s object relations theory. Common characteristics of this disorder include fear of abandonment, unstable relationships, lack of identity, impulsiveness, pervasive emptiness, excessive anger, and the inability to regulate emotions. These symptoms are rooted in the dynamic, ambivalent, and prevailing struggle between the merger and individualization during the rapprochement subphase. Psychotherapy that utilizes transference within the treatment helps the patient to increase awareness of how she participates in a dyadic relationship based on early internalizations. The unconscious reenactment of early object relations is understood by uncovering defenses (splitting, projection, and projective identification) that play out in the therapist/patient relationship. This offers the patient the opportunity to integrate parts of the self and other, and hold ambivalent feelings without splitting or distorting. Consequently the therapeutic relationship is the vehicle for change.
Preparation and characterization of black shale–reinforced ethylene propylene diene monomer nanocomposites
Authors: El-Nashar Doaa E , Khalaf Aman I , Temraz Mostafa G
Published: November 2012

Organophilic kaolinitic black shale was prepared through incorporation of cetyl trimethyl ammonium bromide (CTAB C16) as surfactant with natural kaolinitic black shale. It was characterized by X-ray diffraction, Fourier transform infrared spectroscopy, and transmission electron microscopy. The acrylic acid modifying agent can be utilized to improve the distribution of the organophilic kaolinitic black shale in the rubber matrix. The ethylene propylene diene monomer was mixed with different concentrations of modified organophilic kaolinitic black shale. The dispersion of the modified organophilic kaolinitic black shale was characterized by scanning electron microscopy and X-ray diffraction, which confirmed the formation of exfoliated nanocomposites at lower clay content. The elastomeric compound was filled with kaolinitic black shale and then it was analyzed by undergoing the physicomechanical properties and thermal gravimetric analysis. The nanocomposites showed remarkable improvements in tensile strength, elongation at break, Young’s modulus, and hardness. In addition, increase in thermal stability due to the presence of modified organophilic kaolinitic black shale was observed.
Harnessing the Undiscovered Resource of Student Research Projects
Authors: Grahe Jon E. , Reifman Alan , Hermann Anthony D. , Walker Marie , Oleson Kathryn C. , Nario-Redmond Michelle , Wiebe Richard P.
Published: November 2012

This article suggests that undergraduate research can help advance the science of psychology. We introduce a hypothetical “question-list paradigm” as a mechanism to do this. Each year, thousands of undergraduate projects are completed as part of the educational experience. Although many of these studies may not contain sufficient contributions for publication, they provide a good test of the replicability of established findings across populations at different institutions and geographic locations. Thus, these projects could meet the needs of recent calls for increased replications of psychological studies while simultaneously benefiting the student researchers, their instructors, and the field in general.
A Vast Graveyard of Undead Theories
Authors: Ferguson Christopher J. , Heene Moritz
Published: November 2012

Publication bias remains a controversial issue in psychological science. The tendency of psychological science to avoid publishing null results produces a situation that limits the replicability assumption of science, as replication cannot be meaningful without the potential acknowledgment of failed replications. We argue that the field often constructs arguments to block the publication and interpretation of null results and that null results may be further extinguished through questionable researcher practices. Given that science is dependent on the process of falsification, we argue that these problems reduce psychological science’s capability to have a proper mechanism for theory falsification, thus resulting in the promulgation of numerous “undead” theories that are ideologically popular but have little basis in fact.
An Agenda for Purely Confirmatory Research
Authors: Wagenmakers Eric-Jan , Wetzels Ruud , Borsboom Denny , van der Maas Han L. J. , Kievit Rogier A.
Published: November 2012

The veracity of substantive research claims hinges on the way experimental data are collected and analyzed. In this article, we discuss an uncomfortable fact that threatens the core of psychology’s academic enterprise: almost without exception, psychologists do not commit themselves to a method of data analysis before they see the actual data. It then becomes tempting to fine tune the analysis to the data in order to obtain a desired result—a procedure that invalidates the interpretation of the common statistical tests. The extent of the fine tuning varies widely across experiments and experimenters but is almost impossible for reviewers and readers to gauge. To remedy the situation, we propose that researchers preregister their studies and indicate in advance the analyses they intend to conduct. Only these analyses deserve the label “confirmatory,” and only for these analyses are the common statistical tests valid. Other analyses can be carried out but these should be labeled “exploratory.” We illustrate our proposal with a confirmatory replication attempt of a study on extrasensory perception.
It Does Not Follow
Authors: Simonsohn Uri
Published: November 2012

Francis (2012a, 2012b, 2012c, 2012d, 2012e, in press) attacks individual papers through critiques that apply faulty logic to analyses ironically biased by cherry picking. However well intentioned, the critiques are probably counterproductive to their stipulated goal and certainly unfair to the targeted authors.
Management of asthma during pregnancy
Authors: Maselli Diego J. , Adams Sandra G. , Peters Jay I. , Levine Stephanie M.
Published: November 2012

Asthma is an inflammatory lung condition that is the most common chronic disease affecting pregnancy. The changes in pulmonary physiology during pregnancy include increased minute ventilation, decreased functional residual capacity, increased mucus production, and airway mucosa hyperemia and edema. Pregnancy is also associated with a physiological suppression of the immune system. Many studies have described the heterogeneous immune system response in women with asthma during pregnancy, which partly explains why asthma has been shown to worsen, improve, or remain stable in equal proportions of women during pregnancy. Asthma may be associated with poor maternal and fetal outcomes. However, better maternal and fetal outcomes are observed with better asthma control. Asthma controller medications are generally thought to be safe during pregnancy, but limited data are available for some of the medicines. Newer medications like omalizumab open avenues for the treatment of asthma, but also pose a challenge, as there is limited experience with their use. Therefore, a multidisciplinary approach, including obstetricians, asthma specialists, and pediatricians should collaborate with the patient to carefully weigh the risks and benefits to determine an optimal management plan for each individual patient. The aim of this review article is to summarize the most recent literature about the immunological changes that occur during pregnancy, physiological and clinical implications of asthma on pregnancy, and asthma management and medication use in pregnant women.
Combination therapy with losartan/hydrochlorothiazide for blood pressure reduction and goal attainment in a real-world clinical setting in Japan
Authors: Suzuki Hiromichi , Shimada Yukio , Fujiwara Kenji
Published: November 2012

Objective:

When physicians prescribe a new antihypertensive drug, they do not know the extent of the drug’s effect on lowering blood pressure. To resolve this dilemma, a Web-based program was constructed for real-time entry and analysis of treatment. This observational study evaluated the efficacy of losartan/hydrochlorothiazide (Lo/HCTZ) in lowering blood pressure (BP) and achieving BP target values.

Methods:

Physicians prescribed Lo/HCTZ for patients with hypertension who failed to achieve target BP values of < 140/90 mmHg and < 130/80 mmHg in patients with diabetes or chronic kidney disease, respectively, with antihypertensive drugs including an angiotensin receptor blocker.

Results:

From December 2006 to December 2009, the data of 88,254 patients were entered into this database, and the data of 24,825 subjects were analyzed. At the first visit, a total of 88,254 patients received a first prescription of Lo/HCTZ daily. Among these, at the end of the present analysis, 24,825 (28%) outpatients had a follow-up visit at 1 month and 20,726 (23%) outpatients had a follow-up visit at 6 months. The prevalence of hypertensive patients achieving systolic blood pressure (SBP) control (< 140 mmHg) increased over time from 6.9% to 54.3% in females and 6.1% to 52.3% in males ( p < 0.05). At the start of the study, the levels of SBP were significantly highest in the eldest patients (≥ 75 years) followed by the group of 65–75 years and lowest in the youngest patients (≤ 64 years). However, at the end of the study, there were no differences in levels of SBP among the three groups.

Conclusions:

This Web-based system may provide useful information when a new drug is first released into the market. Treatment with Lo/HCTZ enabled a substantial proportion of hypertensive patients to achieve the recommended goal of < 140/90 mmHg.
Emotional Coregulation in Close Relationships
Authors: Butler Emily A. , Randall Ashley K.
Published: November 2012

Coregulation refers to the process by which relationship partners form a dyadic emotional system involving an oscillating pattern of affective arousal and dampening that dynamically maintains an optimal emotional state. Coregulation may represent an important form of interpersonal emotion regulation, but confusion exists in the literature due to a lack of precision in the usage of the term. We propose an operational definition for coregulation as a bidirectional linkage of oscillating emotional channels between partners, which contributes to emotional stability for both partners. We propose several distinctions and raise unanswered questions that will need to be addressed in order to understand the relevance of coregulation for well-being in adulthood.
Split dose and MiraLAX-based purgatives to enhance bowel preparation quality becoming common recommendations in the US
Authors: Hillyer Grace Clarke , Lebwohl Benjamin , Basch Corey H. , Basch Charles E. , Kastrinos Fay , Insel Beverly J. , Neugut Alfred I.
Published: November 2012

Objectives:

Rates of suboptimal bowel preparation up to 30% have been reported. Liberalized precolonoscopy diet, split dose purgative, and the use of MiraLAX-based bowel preparation (MBBP) prior to colonoscopy are recently developed measures to improve bowel preparation quality but little is known about the utilization prevalence of these measures. We examined the patterns of utilization of these newer approaches to improve precolonoscopy bowel preparation quality among American gastroenterologists.

Methods:

Surveys were distributed to a random sample of members of the American College of Gastroenterologists. Participants were queried regarding demographics, practice characteristics, and bowel preparation recommendations including recommendations for liberal dietary restrictions, split dose purgative, and the use of MBBP. Approaches were evaluated individually and in combination.

Results:

Of the 999 eligible participants, 288 responded; 15.2% recommended a liberal diet, 60.0% split dose purgative, and 37.4% MBBP. Diet recommendations varied geographically with gastroenterologists in the West more likely to recommend a restrictive diet (odds ratio [OR] 2.98, 95% confidence interval [CI] 1.16–7.67) and physicians in the Northeast more likely to recommend a liberal diet more likely. Older physicians more often recommended split dosing (OR 1.04, 95% CI 1.04–2.97). Use of MBBP was more common in suburban settings (OR 2.14, 95% CI 1.23–3.73). Evidence suggests that physicians in private practice were more likely to prescribe split dosing ( p = 0.03) and less often recommended MBBP ( p = 0.02). Likelihood of prescribing MBBP increased as weekly volume of colonoscopy increased ( p = 0.03).

Conclusions:

To enhance bowel preparation quality American gastroenterologists commonly use purgative split dosing. The use of MBBP is becoming more prevalent while a liberalized diet is infrequently recommended. Utilization of these newer approaches to improve bowel preparation quality varies by physician and practice characteristics. Further evaluation of the patterns of usage of these measures is indicated.
Clinical diagnosis of bilateral vestibular loss: three simple bedside tests
Authors: Petersen Jens A. , Straumann Dominik , Weber Konrad P.
Published: November 2012

Bilateral vestibular loss (BVL) may present with or without vertigo and hearing loss. Amongst the causes of BVL are vestibulotoxic antibiotics, autoimmune ear diseases, Menière’s disease and meningitis. Clinical diagnosis of BVL is based on the result of three simple bedside tests: a positive head impulse test, reduced dynamic visual acuity and a positive Romberg test on foam rubber. With these signs, diagnosis of severe BVL is usually straightforward to establish.
The Effectiveness of Pharmacist Interventions on Asthma Management
Authors: Adunlin Georges , Mahdavian Soheyla
Published: November 2012

Background. In recent years, pharmacists have become more active in patient care and can demonstrate a positive impact on the outcomes of drug therapy in asthma patients. Objective. The primary objective of this systematic review was to assess the impact of asthma improvement strategies used by pharmacists. The secondary objective was to ascertain if these strategies improve the control and other direct outcomes for patients with asthma compared with no intervention. Methods. Electronic databases were searched from January 2006 to February 2012. Data abstracted from publications included publication details, participants/setting, intervention study design, outcome measures, and key findings. Results. Forty-seven studies were initially identified; 8 matched our inclusion criteria. Four were US studies and 4 were Canadian. Published studies provided evidence of the clinical effectiveness of pharmacy services in asthma interventions. The role of pharmacists in disease diagnosis, access to private area for consultation, time, and staff support were highlighted as the key barriers to asthma intervention. Reimbursement for consulting services provided a unique opportunity for pharmacists to provide direct patient care. Conclusion. The review demonstrated the contribution of pharmacy-based services to the monitoring, counseling, and educating in asthma care. The evidence supports the wider provision of asthma intervention through pharmacy services. Well-designed studies on the effectiveness of pharmacists’ interventions to improve outcomes of patients with asthma need to be performed. In addition, further research is needed regarding the contribution of pharmacy services to disease detection as part of local public health strategies.
Primary Care Physicians’ Concerns May Affect Adolescents’ Access to Intrauterine Contraception
Authors: Rubin Susan E , Campos Giselle , Markens Susan
Published: November 2012

Purpose: Although the intrauterine device (IUD) may be safely used in adolescents, few US adolescents use IUDs. Increasing IUD use in adolescents can decrease pregnancy rates. Primary care providers’ clinical practices many be one of the many barriers to increasing adolescents access to IUDs. We explored primary care physicians’ (PCPs) approaches to contraception counseling with adolescents, focusing on their views about who would be appropriate IUD candidates. Methods: Phone interviews were conducted with 28 urban family physicians, pediatricians, and obstetrician-gynecologists. Using standard qualitative techniques, we developed coding template and applied codes. Results: Most respondents have a patient-centered general contraceptive counseling approach. However, when considering IUDs many PCPs describe more paternalistic counseling. For example, although many respondents believe adolescents’ primary concern is pregnancy prevention, many PCPs prioritize sexually transmitted infection (STI) prevention and thus would not offer an IUD. Attributes PCPs associate with an appropriate IUD candidate include responsibility, reliability, maturity, and monogamy. Conclusion: Our findings suggest that when considering IUDs for adolescents some PCPs’ subjective assessment of adolescent sexual behavior, attitudes about STI risk factors and use of overly restrictive IUD eligibility criteria impede adolescent’s IUD access. Education around best practices may be insufficient to counterbalance attitudes concerning adolescent sexuality and STI risk; there is also a need to identify and discuss PCPs potential biases or assumptions affecting contraception counseling.
Utilization of Sonography Compared With Magnetic Resonance Imaging in Determining the Cross-Sectional Area of the Median Nerve in a Sample of Working Macaca fascicularis
Authors: Volz Kevin R. , Evans Kevin D , Fout Larry Tyler , Hutmire Cristina , Sommerich Carolyn M. , Buford John A
Published: November 2012

A preclinical study of 15 Macaca fascicularis monkeys was conducted to determine (1) the ability of detecting median mononeuropathy (MMN) within the median nerve after a work intervention and (2) the relationship between the layers of the median nerve during an acute inflammatory process by using sonography in conjunction with magnetic resonance imaging (MRI). Cross-sectional areas (CSAs) were imaged using MRI and sonography proximal to the carpal tunnel inlet (defined by the most distal portion of the radius) and further distal into the carpal tunnel (defined by the most proximal portion of the pisiform) at the prework exposure stage. CSAs measured on the outer edge of the median nerve were obtained from both modalities, at both anatomical locations. An intermodality t test demonstrated no statistical differences between the two sets of measurements (radius, P ≤ .15; pisiform, P ≤ .46). At the postwork exposure stage, sonographic measurements were obtained on the outer and inner borders of the median nerve at both anatomical levels. A two-tailed t test showed statistically significant differences within the carpal tunnel comparing pre- and postwork CSA measurements (radius, P ≤ .01; pisiform, P ≤ .297). The epineurial layer area was then determined as the difference between outer-border and inner-border CSAs. Pearson correlations between the epineurial layer and overall median nerve CSA within the carpal tunnel demonstrated a strong positive correlation that was statistically significant ( r = 0.97; P ≤ .01) after postwork exposure. Possible factors contributing to this acute phase of MMN could be hyperemia within the layers of the nerve and the development of Renault bodies. This work would need to be translated to human studies for further confirmation of the anatomic and clinical significance of this effect.
The Approved Miracle of Saint Elizabeth Ann Seton
Authors: Boursiquot Marie-Alberte , Reddoch Shirley E.
Published: November 2012

Saint Elizabeth Ann Seton (1774–1821) was a convert to Roman Catholicism and foundress of the Sisters of Charity, the first sisterhood native to the United States. She is also the first person born in the United States to be canonized a saint. The second of three cures attributed to the intercession of Mother Seton was of Anne Theresa O'Neill. Anne was born at Baltimore in 1947 and, at the age of four, was diagnosed with acute lymphocytic leukemia at St. Agnes Hospital, Baltimore, Maryland. At the time, acute leukemia, like other aggressive malignancies, was considered a fatal disease without any treatment that assured a cure. In essence, no effective therapy for disease control and sustained remission existed. Anne's cure, which was considered acceptable by the Sacred Congregation of Rights in 1959, would contribute directly toward Mother Seton's beatification and ultimate canonization on September 14, 1975, outside Saint Peter's Basilica in Rome by Pope Paul VI. Ms. O'Neill attended both the beatification as a thirteen-year-old girl and the canonization ceremony at age twenty-seven, as a mother of several children and accompanied by her mother and husband.
Misleading Leadership: The Deliberate Deception of Recommendation 5.5
Authors: Nichols Arland K.
Published: November 2012

On August 1, 2011, the Department of Health and Human Services accepted the Institute of Medicine's recommendation that all Food and Drug Administration—approved contraceptives and sterilization procedures be made available to women without incurring out-of-pocket costs. The Institute of Medicine and the Department of Health and Human Services have deliberately misled the American people by claiming that this mandate would not include abortifacient drugs, that conscientious objection would be honored, and that this provision is essential to preserving the health of women. The author rebuts each of these claims by appeal to the scientific, medical, legal, and political facts surrounding these claims. In doing so, he argues that the recommendations include at least three abortion-inducing contraceptive methods. Likewise, he illustrates that the current administration has shown no will to protect the inviolable right of conscience of both individuals and institutions. Finally, he draws the reader's attention to the known deleterious side effects of oral contraception, emphasizing that these recommendations ultimately encourage women to use drugs that put them at a greater risk of harm. The author concludes that the Institute of Medicine and the Department of Health and Human Services have neglected their responsibility to American women and have misled and deceived the American people.

As the Patient Protection and Affordable Care Act was nearing passage, Senator Barbara Mikulski (D-Maryland) secured an amendment—the “Mikulski Women's Preventive Health Care Amendment”—that gave the Department of Health and Human Services (HHS) the authority to delineate preventive care uniquely necessary for women. 1 The secretary of HHS, Kathleen Sebelius, tasked the Institute of Medicine (IOM) with undertaking a systematic review of those preventive services that should be covered, without payment, for all women. On July 19, 2011, the IOM submitted a 210-page report recommending eight preventive services. 2 Seven of these recommendations involve important screening, counseling, and testing for common health risks facing women. Recommendation 5.5, unfortunately, was a recommendation of a different kind. It stated, “Women will have access to all Food and Drug Administration (FDA)—approved contraceptive methods, sterilization procedures, and patient education and counseling. These recommendations do not include abortifacient drugs.” On August 1, 2011, in a quietly made announcement in the corner of the HHS website, the federal government accepted the IOM recommendations wholesale. 3
Effects of solidification rate on segregation and fluid flow tendency in mushy zone of directionally solidified superalloy Inconel 718
Authors: Wang L , Liu L , Dong J X , Xie X S
Published: November 2012

The microstructure and composition of the interdendritic liquid along the mushy zone of superalloy Inconel 718 that was directionally solidified at various solidification rates between 2 and 100 μm s−1 have been investigated by SEM and EDAX techniques. The interdendritic liquid segregation profiles along the mushy zone are presented. The liquid density difference and Rayleigh number in the interdendritic liquid were calculated and analysed as well. It was found that when the solidification rates increased in the range 10–70 μm s−1, segregation of Nb decreased, but segregation of Mo was most serious at 20 μm s−1. The liquid density difference increased the most for rates from 20 to 40 μm s−1 as temperature decreased. The maximum relative Rayleigh number was highest at 10°C below the liquidus temperature at 20 μm s−1, which indicated the conditions where fluid flow most easily occurred for Inconel 718. The relative Rayleigh number synthetically considers the factors affecting fluid flow and can give a reasonable prediction for fluid flow tendency.
Mg bearing coating of resin sand–PTSA moulds to control graphite degeneration in surface layer of ductile iron castings
Authors: Ivan N , Chisamera M , Riposan I
Published: November 2012

The relative performance of coatings for furan resin sand (FRS)–P-toluol sulphonic acid (PTSA) mould (FRS–PTSA), compared with no S, Novolak resin sand coated mould (NRS) was evaluated to determine the occurrence of a degenerated graphite surface layer. The FRS–PTSA moulds evidently incited graphite degeneration in the surface layer, as its thickness increased up to 10 times that with NRS moulds. Applying a mould coating containing S aggravated graphite degeneration. Conversely a desulphurising coating could protect the nodular graphite and limit the surface layer thickness. Independently of the S source at the metal/mould interface, sulphur affected graphite degeneration drastically. The coatings incorporating desulphurisation materials, [MgO; (CaO+MgO+Talc); Mg–FeSi] protected the iron from graphite degeneration, with the average layer thickness decreasing from 3·8 to 4·2: a factor of 7–10 reduction in FRS–PTSA moulds. If the first two coatings acted mainly as desulphurisers, the Mg–FeSi coating had an additional role to desulphurisation and provided Mg for the molten iron, to restore some nodularising potential. It is important to combine desulphurisation with supplementary Mg to remove migrating S and restore lost Mg. This complex behaviour could be realised by the application of coatings with active Mg from fine sized Mg–FeSi.
Mineralogy and magmatic affinity of the Jasra intrusive complex, Shillong Plateau, India
Authors: Melluso L. , Srivastava R. K. , Petrone C. M. , Guarino V. , Sinha A. K.
Published: November 2012

The rocks of the Jasra intrusive complex (Shillong Plateau, northeastern India) include phlogopite clinopyroxenites (with olivine or perovskite relics), alkali gabbros/monzodiorites, syenites and nepheline syenites. They have a potassic affinity (Na2O/K2O ∼1), and their mineralogy is dominated by clinopyroxene with which phlogopite, olivine, amphibole, feldspars, feldspathoids, oxides, orthopyroxenes, perovskite, titanite and other accessory phases are variably associated. The Jasra intrusive rocks are cumulates derived from at least two distinct magmatic liquids. The potassic affinity of the Jasra rocks differs from the nearby Sung Valley ijolitic-carbonatitic complex and from the ultrapotassic lamproitic rocks of the Damodar Valley, which are of approximately the same age. This suggests major variability in the mantle sources of small-volume alkaline volcanism in the Early Cretaceous of northeastern India.
Aluminium-bearing strunzite derived from jahnsite at the Hagendorf-Süd pegmatite, Germany
Authors: Grey I. E. , Macrae C. M. , Keck E. , Birch W. D.
Published: November 2012

Aluminium-bearing strunzite, [Mn0.65Fe0.26Zn0.08Mg0.01]2+[Fe1.50Al0.50]3+(PO4)2(OH)2·6H2O, occurs as fibrous aggregates in a crystallographically oriented association with jahnsite on altered zwieselite samples from the phosphate pegmatite at Hagendorf Süd, Bavaria, Germany. Synchrotron X-ray data were collected from a 3 μm diameter fibre and refined in space group P to R1 = 0.054 for 1484 observed reflections. The refinement confirmed the results of chemical analyses which showed that one quarter of the trivalent iron in the strunzite crystals is replaced by aluminium. The paragenesis revealed by scanning electron microscopy, in combination with chemical analyses and a crystal-chemical comparison of the strunzite and jahnsite structures, are consistent with strunzite being formed from jahnsite by selective leaching of (100) metal—phosphate layers containing large divalent Ca and Mn atoms.