bluuebunny/crossref_metadata_2025 huggingface dataset:
Hurricanes Katrina and Rita and the Department of Veterans Affairs: A Conceptual Model for Understanding the Evacuation of Nursing Homes
Authors: Dobalian Aram , Claver Maria , Fickel Jacqueline J.
Published: March 2010

Background: Hurricanes Katrina and Rita exposed significant flaws in US preparedness for catastrophic events and the nation’s capacity to respond to them. These flaws were especially evident in the affected disaster areas’ nursing homes, which house a particularly vulnerable population of frail older adults. Although evacuation of a healthcare facility is a key preparedness activity, there is limited research on factors that lead to effective evacuation. Objective: Our review of the literature on evacuation is focused on developing a conceptual framework to study future evacuations rather than as a comprehensive assessment of prior work. Methods: This paper summarizes what is known thus far about disaster response activities of nursing homes following natural and human-caused disasters, describes a conceptual model to guide future inquiry regarding this topic, and suggests future areas of research to further understand the decision-making process of nursing home facilitators regarding evacuating nursing home residents. To demonstrate the utility of the conceptual model and to provide guidance about effective practices and procedures, this paper focuses on the responses of Veterans Health Administration (VHA) nursing homes to the 2 hurricanes. Results: Quarantelli’s conceptual framework, as modified by Perry and Mushkatel, is useful in guiding the development of central hypotheses related to the decision-making that occurred in VA nursing homes and other healthcare facilities following Hurricanes Katrina and Rita. However, we define evacuation somewhat differently to account for the fact that evacuation may, in some instances, be permanent. Thus, we propose modifying this framework to improve its applicability beyond preventive evacuation. Conclusions: We need to better understand how disaster plans can be adapted to meet the needs of frail elders and other residents in nursing homes. Moreover, we must address identified gaps in the scientific literature with respect to health outcomes by tracking outcomes over time. Information on health outcomes would allow administrators and others to more appropriately weigh the balance of risks and benefits associated with evacuation. Without this understanding of the relationship between evacuation and health outcomes, it is not possible to develop effective response plans that are tailored to meet the needs of nursing home residents.
Hyponatremia, Natriuretic Peptides, and Outcomes in Acutely Decompensated Heart Failure
Authors: Mohammed Asim A. , van Kimmenade Roland R.J. , Richards Mark , Bayes-Genis Antoni , Pinto Yigal , Moore Stephanie A. , Januzzi James L.
Published: March 2010

Background—

Hyponatremia is a well-known predictor of mortality in patients with acutely decompensated heart failure. Associations between hyponatremia and other prognostic variables in acutely decompensated heart failure, such as amino-terminal pro-B type natriuretic peptide remain unclear.

Methods and Results—

Six hundred twenty-eight patients presenting to the emergency department with acutely decompensated heart failure were studied. All were hospitalized. Serum sodium (Na) concentration at presentation was examined as a function of mortality at 1 year, alone and relative to other predictors of death. Hyponatremia (Na ≤135 mmol/L) was diagnosed in 24%(n=149) patients. Compared with those without hyponatremia, those affected were less likely to be male or to have hypertension or coronary artery disease but were more likely to have severe symptoms, to be anemic, and to have higher amino-terminal pro-B-type natriuretic peptide (NT-proBNP) concentrations (all
P
≤0.05). When examined as a function of Na deciles (ranging from Na <132 mmol/L to Na ≤142 mmol/L), a U-shaped association was found between Na level and 1-year mortality. In multivariate Cox proportional hazards analysis, hyponatremia was an independent predictor of 1-year mortality (hazards ratio=1.72; 95% CI=1.22 to 2.37;
P
=0.001) as was an NT-proBNP concentration above the median value of 4690 pg/mL (hazards ratio=1.49; 95% CI=1.10 to 2.00;
P
=0.009). Those with hyponatremia and more elevated NT-proBNP were more likely to develop worsening renal function during their hospitalization and had highest rates of 1-year death. Notably, however, hyponatremia predicted only 1-year mortality in those with an elevated NT-proBNP.

Conclusion—

Hyponatremia is associated with adverse outcome in patients with acutely decompensated heart failure; however, the prognostic value of low Na is mainly evident in those with more pronounced elevation of NT-proBNP concentrations.
Periadventitial Rapamycin-Eluting Microbeads Promote Vein Graft Disease in Long-Term Pig Vein-Into-Artery Interposition Grafts
Authors: Rajathurai Thirumaran , Rizvi S. Imran , Lin Hua , Angelini Gianni D. , Newby Andrew C. , Murphy Gavin J.
Published: March 2010

Background—

Neointima formation and atherosclerosis compromise long-term graft patency in aortocoronary and peripheral vein bypass grafts. We investigated the short- and long-term effects of periadventitial application of a sustained-release formulation of rapamycin on experimental pig vein grafts with similar dimensions and kinetics to human saphenous vein bypass grafts.

Methods and Results—

Periadventitial application of rapamycin-eluting polyvinyl alcohol microspheres (60 μg � cm
−2
) to porcine saphenous vein-to-carotid artery interposition grafts inhibited vein graft positive and vascular smooth muscle cell proliferation in 1-week grafts. It also decreased neointima formation and wall thickening in 4-week vein grafts compared with controls. The inhibition of vein graft thickening was not sustained; however, a catch-up phenomenon was observed, and there was no therapeutic benefit evident in 12-week grafts. Increasing the dose of rapamycin to 120 μg � cm
−2
was associated with significant local toxicity manifest by high rates of graft rupture (25%), inhibition of adventitial neoangiogenesis, and a paradoxical acceleration of vein graft disease as evidenced by increased vascular smooth muscle cell proliferation.

Conclusions—

Local toxicity and poor long-term efficacy limits the clinical applicability of locally applied, sustained rapamycin release in vein graft disease.
Incidence, Predictors, and Prognostic Implications of Hospitalization for Late Bleeding After Percutaneous Coronary Intervention for Patients Older Than 65 Years
Authors: Ko Dennis T. , Yun Lingsong , Wijeysundera Harindra C. , Jackevicius Cynthia A. , Rao Sunil V. , Austin Peter C. , Marquis Jean-François , Tu Jack V.
Published: March 2010

Background—

Previous data on bleeding after percutaneous coronary intervention (PCI) have been obtained primarily from randomized trials that focused on in-hospital bleeding. The incidence of late bleeding after PCI, its independent predictors, and its prognostic importance in clinical practice has not been fully addressed.

Methods and Results—

We evaluated 22 798 patients aged >65 years who underwent PCI from December 1, 2003, to March 31, 2007, in Ontario, Canada. Cox proportional hazard models were used to determine factors associated with late bleeding, which was defined as hospitalization for bleeding after discharge from the index PCI, and to estimate risk of death or myocardial infarction associated with late bleeding. We found that 2.5% of patients were hospitalized for bleeding in the year after PCI, with 56% of bleeding episodes due to gastrointestinal bleed. The most significant predictor of late bleeding was warfarin use after PCI (hazard ratio [HR], 3.12). Other significant predictors included age (HR, 1.41 per 10 years), male sex (HR, 1.24), cancer (HR, 1.80), previous bleeding (HR, 2.42), chronic kidney disease (HR, 1.93), and nonsteroidal antiinflammatory drug use (HR, 1.73). After adjusting for baseline covariates, hospitalization for a bleeding episode was associated with a significantly increased 1-year hazard of death or myocardial infarction (HR, 2.39; 95% CI, 1.93 to 2.97) and death (HR, 3.38; 95% CI, 2.60 to 4.40).

Conclusions—

Hospitalization for late bleeding after PCI is associated with substantially increased risk of death and myocardial infarction. The use of triple therapy (ie, aspirin, thienopyridine, and warfarin) is associated with the highest risk of late bleeding.
Monitoring Drought over the Conterminous United States Using MODIS and NCEP Reanalysis-2 Data
Authors: Yao Yunjun , Liang Shunlin , Qin Qiming , Wang Kaicun
Published: March 2010

Monitoring land surface drought using remote sensing data is a challenge, although a few methods are available. Evapotranspiration (ET) is a valuable indicator linked to land drought status and plays an important role in surface drought detection at continental and global scales. In this study, the evaporative drought index (EDI), based on the estimated actual ET and potential ET (PET), is described to characterize the surface drought conditions. Daily actual ET at 4-km resolution for April–September 2003–05 across the continental United States is estimated using a simple improved ET model with input solar radiation acquired by Moderate-Resolution Imaging Spectroradiometer (MODIS) at a spatial resolution of 4 km and input meteorological parameters from NCEP Reanalysis-2 data at a spatial resolution of 32 km. The PET is also calculated using some of these data. The estimated actual ET has been rigorously validated with ground-measured ET at six Enhanced Facility sites in the Southern Great Plains (SGP) of the Atmosphere Radiation Measurement Program (ARM) and four AmeriFlux sites. The validation results show that the bias varies from −11.35 to 27.62 W m−2 and the correlation coefficient varies from 0.65 to 0.86. The monthly composites of EDI at 4-km resolution during April–September 2003–05 are found to be in good agreement with the Palmer Z index anomalies, but the advantage of EDI is its finer spatial resolution. The EDI described in this paper incorporates information about energy fluxes in response to soil moisture stress without requiring too many meteorological input parameters, and performs well in assessing drought at continental scales.
Employing Cluster Analysis to Detect Significant Cloud 3D RT Effect Indicators
Authors: Foster Michael J. , Veron Dana E.
Published: March 2010

Three-dimensional cloud field morphology contributes to scene-averaged cloud reflectivity, but climate models do not currently incorporate methods of identifying situations where this contribution is substantial. This work represents an effort to identify atmospheric conditions conducive to the formation of cloud field configurations that significantly affect shortwave radiative fluxes. Once identified, these characteristics may form the basis of a parameterization that accounts for radiative impact of complex cloud fields. A k-means clustering algorithm is applied to observed cloud properties taken from the Atmospheric Radiation Measurement Program tropical western Pacific sites to identify specific cloud regimes. Results from a stand-alone stochastic model, which statistically represents shortwave radiative transfer through broken cloud fields, are compared with those of a plane-parallel model. The aggregate scenes in each regime are examined to measure the bias in shortwave flux calculations due to neglected cloud field morphology. The results from the model comparison and cluster analysis suggest that cloud fraction, vertical wind shear, and spacing between cloudy layers are all important indicators of complex cloud field geometry and that these criteria are most often met in cloud regimes characterized by moderate to strong convection. The cluster criteria are applied to output from the Community Climate System Model (version 3.0) and it is found that the presence of persistent high cirrus cloud in model simulations inhibits identification of specific cloud regimes.
A Classical-Theory-Based Parameterization of Heterogeneous Ice Nucleation by Mineral Dust, Soot, and Biological Particles in a Global Climate Model
Authors: Hoose Corinna , Kristjánsson Jón Egill , Chen Jen-Ping , Hazra Anupam
Published: March 2010

An ice nucleation parameterization based on classical nucleation theory, with aerosol-specific parameters derived from experiments, has been implemented into a global climate model—the Community Atmosphere Model (CAM)-Oslo. The parameterization treats immersion, contact, and deposition nucleation by mineral dust, soot, bacteria, fungal spores, and pollen in mixed-phase clouds at temperatures between 0° and −38°C. Immersion freezing is considered for insoluble particles that are activated to cloud droplets, and deposition and contact nucleation are only allowed for uncoated, unactivated aerosols. Immersion freezing by mineral dust is found to be the dominant ice formation process, followed by immersion and contact freezing by soot. The simulated biological aerosol contribution to global atmospheric ice formation is marginal, even with high estimates of their ice nucleation activity, because the number concentration of ice nucleation active biological particles in the atmosphere is low compared to other ice nucleating aerosols. Because of the dominance of mineral dust, the simulated ice nuclei concentrations at temperatures below −20°C are found to correlate with coarse-mode aerosol particle concentrations. The ice nuclei (IN) concentrations in the model agree well overall with in situ continuous flow diffusion chamber measurements. At individual locations, the model exhibits a stronger temperature dependence on IN concentrations than what is observed. The simulated IN composition (77% mineral dust, 23% soot, and 10−5% biological particles) lies in the range of observed ice nuclei and ice crystal residue compositions.
Optimal Tropical Sea Surface Temperature Forcing of North American Drought
Authors: Shin Sang-Ik , Sardeshmukh Prashant D. , Webb Robert S.
Published: March 2010

The optimal anomalous sea surface temperature (SST) pattern for forcing North American drought is identified through atmospheric general circulation model integrations in which the response of the Palmer drought severity index (PDSI) is determined for each of 43 prescribed localized SST anomaly “patches” in a regular array over the tropical oceans. The robustness and relevance of the optimal pattern are established through the consistency of results obtained using two different models, and also by the good correspondence of the projection time series of historical tropical SST anomaly fields on the optimal pattern with the time series of the simulated PDSI in separate model integrations with prescribed time-varying observed global SST fields for 1920–2005. It is noteworthy that this optimal drought forcing pattern differs markedly in the Pacific Ocean from the dominant SST pattern associated with El Niño–Southern Oscillation (ENSO), and also shows a large sensitivity of North American drought to Indian and Atlantic Ocean SSTs.
Wind Modifications to Density-Driven Flows in Semienclosed, Rotating Basins
Authors: Reyes-Hernández Cristóbal , Valle-Levinson Arnoldo
Published: March 2010

An analytical two-dimensional model is used to describe wind-induced modifications to density-driven flows in a semienclosed rotating basin. Wind stress variations produce enhancement, inversion, or damping of density-driven flows by altering the barotropic and baroclinic pressure gradients and by momentum transfer from wind drag. The vertical structure of wind-induced flows depends on αH, the nondimensional surface trapping layer, where α is the inverse of the Ekman layer depth d and H is the maximum water depth. For αH > 5 wind-driven flow structures are similar to the Ekman spiral; for αH < 2 wind-driven flows are unidirectional with depth. The relative importance of density to wind forcing is evaluated with the Wedderburn number W = τ−1ρH2D, which depends on water density ρ, mean depth H, a proxy of the baroclinic pressure gradient D, and wind stress τ. Because D depends on α and therefore on the eddy viscosity of water Az, wind speed and Az both modify W. Moreover, wind direction alters W by modifying the pressure gradient through the sea surface slope. The effect of Az is also evaluated with the Ekman number E = Az/fH2, where f is the Coriolis parameter. The alterations of the density-driven flow by the wind-driven flow are explored in the E and W parameter space through examination of the lateral structure of the resulting exchange flows. Seaward winds and positive transverse winds (to the right facing up basin in the Northern Hemisphere) result in vertically sheared flow structures for most of the E versus W space. In contrast, landward winds and negative transverse winds (to the left facing up basin) result in unidirectional landward flows for most of the E versus W space. When compared to observed and numerically simulated flow structures, the results from the analytical model compare favorably in regard to the main features.
Stochastic Dynamics of Sea Surface Height Variability
Authors: Sura Philip , Gille Sarah T.
Published: March 2010

Sea surface height anomalies measured by the Ocean Topography Experiment (TOPEX)/Poseidon satellite altimeter indicate high values of skewness and kurtosis. Except in a few regions, including the Gulf Stream, the Kuroshio Extension, and the Agulhas Retroflection, that display bimodal patterns of sea surface height variability, kurtosis is uniformly greater than 1.5 times the squared skewness minus an adjustment constant. This relationship differs substantially from what standard Gaussian or double-exponential noise would produce. However, it can be explained by a simple theory in which the noise is assumed to be multiplicative, meaning that a larger background state implies larger random noise elements. The existence of multiplicative noise can be anticipated from the equations of motion, if ocean dynamics are split into a slowly decorrelating deterministic component and a rapidly decorrelating contribution that is approximated as noise. Such a model raises the possibility of predicting the probabilities of extreme sea surface height anomalies from first physical principles and may provide a useful null hypothesis for non-Gaussian sea surface height variability.
Analysis of Bottom-Track and Compass Error in a Self-Contained Acoustic Doppler Diver Navigation Console
Authors: Hench James L. , Rosman Johanna H.
Published: March 2010

The Cobra-Tac (Teledyne RD Instruments) is a self-contained diver navigation system based on acoustic Doppler velocity log (DVL) technology that uses dead reckoning to compute displacements from a known starting point. The navigational accuracy of the system was evaluated using a series of field tests with known solutions. Initial test data had an obvious directional bias in the navigation measurements, with positional errors as large as 5% of the track length. An analysis of this error showed that the DVL speed measurements were extremely accurate and that most of the position error could be explained by heading-dependent compass error. Compass error versus heading curves were different depending on whether a given route was mapped in a clockwise or counterclockwise direction, and further testing indicated that this was due to a combination of local magnetic field anomalies at the test site and instrument tilt. A postprocessing correction procedure, based on a one-cycle compass error model, was derived that significantly improves Cobra-Tac position estimates. After correction, position errors were well within manufacturer specifications. Further tests using new firmware that permitted in situ underwater compass calibration gave position errors of less than 1% of the track length. This level of accuracy should be sufficient for a wide range of scientific applications. Collectively, the test results and analyses indicate that Cobra-Tac can give very accurate navigation results, but the accuracy depends strongly on compass calibration and diver skill with the system.
Using TIGGE Data to Diagnose Initial Perturbations and Their Growth for Tropical Cyclone Ensemble Forecasts
Authors: Yamaguchi Munehiko , Majumdar Sharanya J.
Published: March 2010

Ensemble initial perturbations around Typhoon Sinlaku (2008) produced by ECMWF, NCEP, and the Japan Meteorological Agency (JMA) ensembles are compared using The Observing System Research and Predictability Experiment (THORPEX) Interactive Grand Global Ensemble (TIGGE) data, and the dynamical mechanisms of perturbation growth associated with the tropical cyclone (TC) motion are investigated for the ECMWF and NCEP ensembles. In the comparison, it is found that the vertical and horizontal distributions of initial perturbations as well as the amplitude are quite different among the three NWP centers before, during, and after the recurvature of Sinlaku. In addition, it turns out that those variations cause a difference in the TC motion not only at the initial time but also during the subsequent forecast period. The ECMWF ensemble exhibits relatively large perturbation growth, which results from 1) the baroclinic energy conversion in a vortex, 2) the baroclinic energy conversion associated with the midlatitude waves, and 3) the barotropic energy conversion in a vortex. Those features are less distinctive in the NCEP ensemble. A statistical verification shows that the ensemble spread of TC track predictions in NCEP (ECMWF) is larger than ECMWF (NCEP) for 1- (3-) day forecasts on average. It can be inferred that while the ECMWF ensemble starts from a relatively small amplitude of initial perturbations, the growth of the perturbations helps to amplify the ensemble spread of tracks. On the other hand, a relatively large amplitude of initial perturbations seems to play a role in producing the ensemble spread of tracks in the NCEP ensemble.
Stochastic Integration for the Heterogeneous Correlation Modeling Using a Diffusion Equation
Authors: Pannekoucke Olivier , Vezard Laurent
Published: March 2010

In this note, a stochastic integration scheme is proposed as an alternative to a deterministic integration scheme, usually employed for the diffusion operator in data assimilation. The stochastic integration scheme is no more than a simple interpolation of the initial condition in lieu of the deterministic integration. Furthermore, this also presents a potential in high performance computing. For the classic preconditioned minimizing problem, the stochastic integration is employed to implement the square root of the background error covariance matrix, while its adjoint is obtained from the adjoint code of the square root code. In a first part, the stochastic integration method and its weak convergence are detailed. Then the practical use of this approach in data assimilation is described. It is illustrated in a 1D test bed, where it is shown to run smoothly for background error covariance modeling, with nearest-neighbor interpolations, and O(100) particles.
The Effects of Walking and Cycling Computer Workstations on Keyboard and Mouse Performance
Authors: Straker Leon , Levine James , Campbell Amity
Published: March 2010

Objective: This study aimed to determine the effects of active workstation designs on speed and error during typing, mouse pointing, and combined type and mouse-use tasks. Background: Office ergonomics has focused on musculoskeletal disorder prevention; however, increasing computer-based work also increases health risks associated with inactivity. Workstations allowing computer users to walk or cycle while performing computer tasks have been shown to demand sufficient energy expenditure to result in significant health benefits. However the performance effects of being active while using a computer have not been documented. Method: Thirty office workers (16 female, 15 touch typists) performed standardized computer tasks in six workstation conditions: sitting, standing, walking at 1.6 km/h and 3.2 km/h, and cycling at 5 and 30 watts. Performance, perceived performance, and heart rate were measured. Results: Computer task performance was lower when walking and slightly lower when cycling, compared with chair sitting. Standing performance was not different from sitting performance. Mouse performance was more affected than typing performance. Performance decrements were equal for females and males and for touch typists and nontouch typists. Conclusion: Performance decrements maybe related to both biomechanical and cognitive processes. Active workstations may be less suitable for mouse-intensive work and susceptible users. Application: Although active workstations may result in some decrement in performance, their ability to increase daily energy expenditure may make them a feasible solution for workplace inactivity.
Noise Absorption Modeling of Rib Knitted Fabrics
Authors: Mozhdeh Ghahremani Honarvar  , Ali Asghar Asgharian Jeddi  , Amani Tehran M.
Published: March 2010

In recent years, textile goods have come to be widely used as soundproofing, because of their two important advantages, low production costs and light density, in relation to other soundproofing materials. These intrinsic parameters are very important in some industries such as the automobile and aircraft industry. Although, previously, nonwovens had a wide application as soundproofing among textiles, it seems that weft knitted fabrics can also be a suitable substitute due to their pleasant appearance in comparison to nonwoven fabrics. In this paper, by incorporating two theoretical models presented for nonwoven and plain knitted fabrics, a suitable theoretical model is obtained for calculating the sound absorption coefficient of weft knitted fabrics with complex structures and, finally, the results of a theoretical model are compared with experimental results.
Use of 3D Angle-Interlock Woven Fabric for Seamless Female Body Armor: Part 1: Ballistic Evaluation
Authors: Xiaogang Chen  , Dan Yang
Published: March 2010

In contrast to making male body armor, manufacturers of body armor encounter problems in design and manufacture of female body armor because of the curvaceous body shape of females. The traditional cut-and-sew method could be used to form the dome shape to accommodate the bust area but it gives rise to weakness at the seams against projectile impact. Fabric folding has been another way to form the domes but it also leads to reduced impact performance and wearing discomfort. In this paper, angle-interlock woven fabrics are proposed as an alternative to the conventional plain woven fabrics in making female body armor due to their advantages in moldability without the need of cutting or folding and ease in manufacture. However, it is vital that the angle-interlock fabrics satisfy the ballistic requirements before being employed for the body armor application. Part Ι of this paper reports on an investigation on the ballistic performance of angle-interlock fabrics. It has been found that the angle-interlock fabric is not less than the conventional fabric constructions used for body armor against ballistic impact. Based on the employment of the angle-interlock fabric, Part ΙΙ presents the mathematical modeling of molding of angle-interlock fabrics to form the front panel of female body armor, which would lead to quick creation of female body armor based on the input of the body and bust sizes.
Simulation of the Distribution of State of Cure for Multi-stage Curing Processes
Authors: Warley Russell L.
Published: March 2010

The selection of a curing process for a molded elastomeric component is frequently carried out with consideration given to the elastomer compound characteristics, the geometry of the component, the molding equipment available, and the resulting cost of the process. In this work the effect of multi-stage cure processes on the distribution of state of cure in a component is examined. Cure processes that include elastomer preheat, press cures, oven bake steps, and cool down cycles are considered. The focus is to discern the effect of the molding process on the distribution of the state of cure within the component for processes that yield a technologically acceptable state of cure. The results are analyzed in terms of providing guidance toward optimization of state of cure distributions via practical molding process variables.
Polyurethane–Polystyrene Simultaneous Interpenetrating Networks from Modified Castor Oil
Authors: Valero Manuel F.
Published: March 2010

A series of simultaneous interpenetrating polymer networks (SINs) based on pentaerythritol modified castor oil polyurethane and polystyrene were studied. Miscibility, phase continuity and phase separation are studied by dynamic mechanical thermal analysis (DMTA). The patterns of extent of the phase separation and the characteristics of the interpenetration reached as a function of the components were deduced. The modulus-composition relationship has been analyzed for the synthesized SINs using theoretical equations based on mechanical models. Most of these models assume perfect adhesion between the homogeneous isotropic phases and the inclusions in the matrix are spherical. The IPNs follow the Budiansky model, which predicts a phase inversion at intermediate compositions.
Race/Ethnicity, Social Support, and Associations With Diabetes Self-Care and Clinical Outcomes in NHANES
Authors: Rees Courtney A. , Karter Andrew J. , Young Bessie A.
Published: March 2010

Purpose

The purpose of this study was to evaluate how social support and race/ethnicity were associated with diabetes self-care behaviors and clinical outcomes.

Methods

Using the cross-sectional 2005-2006 National Health and Nutrition Examination Survey (NHANES), the authors examined white, black, and Latino respondents who self-reported a diabetes diagnosis (n = 450), estimating the associations of social support on diabetes outcomes. The primary exposure was a social support index (0-5), which assessed the number of sources of support in one’s life. Outcomes were self-care behaviors (controlling weight, exercising, controlling fat/caloric intake, checking feet, and self-monitoring blood glucose) and intermediate clinical outcomes (hemoglobin A1C, diastolic blood pressure, and low-density lipoprotein [LDL]).

Results

There were no differences in social support by race/ethnicity. The authors observed several significant race/ethnicity by social support interactions in adjusted models, controlling for age, gender, education, self-reported health, depression, functional disability, insurance status, and insulin use. Among blacks, social support was associated with controlling weight (odds ratio [OR] = 1.55, P = .03), exercising (OR = 1.38, P = .03), controlling fat/ calories (OR = 1.84, P = .03), and lower diastolic blood pressure (β = -3.07, P = .02). Among whites, social support was associated with lower LDL (β = -9.45, P = .01). No significant effects were noted for Latinos.

Conclusions

The relationship of social support with diabetes management differed by race/ethnicity, with the strongest findings among blacks. Social support may be influential for maintaining self-care behaviors among blacks and controlling lipid levels among whites.
An atypical case of successful resuscitation of an accidental profound hypothermia patient, occurring in a temperate climate
Authors: Coleman E. , Doddakula K. , Meeke R. , Marshall C. , Jahangir S. , Hinchion J.
Published: March 2010

Cases of accidental profound hypothermia occur most frequently in cold, northern climates. We describe an atypical case, occurring in a temperate climate, where a hypothermic cardiac—arrested patient was successfully resuscitated using extracorporeal circulation (ECC).
Effects of Prolonged Formalin Fixation on the Immunohistochemical Detection of Infectious Agents in Formalin-Fixed, Paraffin-Embedded Tissues
Authors: Webster J. D. , Miller M. A. , DuSold D. , Ramos-Vara J.
Published: March 2010

Immunohistochemistry is commonly used to detect and characterize infectious agents in diagnostic pathology. The principal advantage of immunohistochemistry over other antigen detection techniques is the ability to identify antigen within the context of histologic lesions. Although epitope masking attributed to formalin fixation, especially prolonged fixation, has been considered a limiting factor in diagnostic immunohistochemistry, only a few studies have evaluated the immunohistochemical detection of infectious agents following prolonged formalin fixation. Therefore, the goal of this study was to evaluate the effects of prolonged formalin fixation on the immunohistochemical detection of 21 infectious agents. Tissue slices about 5 mm thick were fixed in 10% neutral-buffered formalin, processed, and paraffin embedded at day 1 or 2 and then at approximately weekly intervals. Three pathologists graded immunoreactivity according to a four-tier grading system: negative, weak, moderate, strong. Canine parvoviral immunoreactivity was markedly decreased following 2, 7, and 10 weeks of fixation in myocardium, small intestine, and spleen, respectively. Bovine respiratory syncytial virus immunoreactivity was markedly decreased following 7 weeks of fixation. Bartonella henselae had an abrupt loss of immunoreactivity following 9 weeks of fixation. Despite variation among time points, immunoreactivity remained moderate to strong throughout the study period for the other 18 antigens. These results suggest that prolonged formalin fixation of up to 7 weeks generally does not limit immunohistochemical detection of infectious agents. However, the effects of prolonged fixation depend on the targeted antigen and the selected antibody. The results of this study further validate the utility and reliability of immunohistochemistry in diagnostic pathology.
Against Tyranny
Authors: Scammell Michael
Published: March 2010

Michael Scammell on the birth of Index on Censorship Lisa Goldman on a drama of censorship An extract from Gurpreet Kaur Bhatti’s new satire
Kremlin.Com
Authors: Soldatov Andrei
Published: March 2010

Standards of journalism in Russia have not benefited from news websites. The authorities have a new channel to push the party line, says Andrei Soldatov
Cyber Wars
Authors: Deibert Ron , Rohozinski Rafal
Published: March 2010

Citizens, states and corporations are battling for online space. What happened to the dream of global communication? Ron Deibert and Rafal Rohozinski report
Television Premier
Authors: D’Eramo Giulio
Published: March 2010

Documentary maker Erik Gandini tells Giulio D'Eramo why appearance matters more than truth in Italy
Out of Sight, Out of Mind
Authors: McNamee Joe
Published: March 2010

Blocking websites that show images of child abuse does not solve the problem: it’s a smokescreen for political failure, says Joe McNamee
Freedom Is Not a Luxury
Authors: Scammell Michael
Published: March 2010

Michael Scammell, founding editor of Index on Censorship, recalls the role of Stephen Spender in the birth of the magazine
Meditation Research: The State of the Art in Correctional Settings
Authors: Himelstein Samuel
Published: March 2010

There is research that serves as evidence in favor of meditation-based programs as rehabilitative for incarcerated populations. This article reviews empirical research regarding the effects of meditation-based programs in correctional populations. Three meditation-based interventions have been shown to represent the majority of empirical research and are reviewed in this article: Transcendental Meditation, mindfulness-based stress reduction, and 10-day Vipassana retreats. Selected dissertation research is reviewed as well. Overall, research suggests three areas in which meditation-based programs provide sufficient treatment to criminal offenders: the enhancement of psychological well-being, a decrease in substance use, and a decrease in recidivism. This suggests that meditation-based programs may be proper treatment programs and support rehabilitation for correctional populations.
Long-Term Durability of Autologous Chondrocyte Implantation
Authors: Moseley J. Bruce , Anderson Allen F. , Browne Jon E. , Mandelbaum Bert R. , Micheli Lyle J. , Fu Freddie , Erggelet Christoph
Published: March 2010

Background

Autologous chondrocyte implantation for full-thickness lesions of the distal femur has demonstrated good short- to midterm clinical improvement. However, long-term durability (>5 years) of autologous chondrocyte implantation has not been evaluated in US patients to date.

Hypothesis

Patients who improve from baseline to early follow-up will sustain improvement at later follow-up.

Study Design

Case series, Level of evidence, 4.

Methods

Cartilage Repair Registry patients with full-thickness distal femur lesions who were treated with autologous chondrocyte implantation before December 31, 1996 and had modified overall Cincinnati scores at baseline and 1- to 5-year follow-up scores were re-evaluated at 6- to 10-year follow-up. Autologous chondrocyte implantation durability was determined by comparing early (1-5 years) to long-term (6-10 years) outcomes. Adverse events and treatment failures were recorded.

Results

Seventy-two patients met eligibility criteria (at baseline: mean age, 37 years; mean lesion size, 5.2 cm2; and overall condition score, 3.4 points [poor]). Eighty-seven percent of patients (47 of 54) who improved at the earlier follow-up period sustained a mean improvement in overall condition score of 3.8 points from baseline to the later follow-up period (P < .001). From baseline to 10-year follow-up (mean follow-up, 9.2 years), 69% improved, 17% failed, and 12.5% reported no change from baseline. Most failures (75% [9 of 12]) occurred at a mean follow-up of 2.5 years. Thirty patients (42%) had 42 operations after autologous chondrocyte implantation; 24 operations (57%) occurred in patients who met the study definition of failure.

Conclusion

Treatment with autologous chondrocyte implantation for large, symptomatic, full-thickness lesions of the distal femur can result in early improvement that is sustained at longer follow-up (up to 10 years) in the majority of patients.
The Human Figure Drawing as Related to Attention-Deficit Hyperactivity Disorder (ADHD)
Authors: Perets-Dubrovsky Sharon , Kaveh Michelle , Deutsh-Castel Tsofia , Cohen Ayala , Tirosh Emanuel
Published: March 2010

To assess the reliability and validity of the human figure drawing test among children with attention-deficit hyperactivity disorder (ADHD) and/or learning disability, boys (n = 136) between the ages of 8 and 10 years, with either or both ADHD and learning disability, were included. Two drawings were used: person and house, tree and person. The drawings were analyzed using the Koppitz emotional and developmental scales. Conners teacher and parent rating scales and the Matching Familiar Figure Test were administered. High intertest reliability for the emotional scale and a significant negative correlation between the 2 scales were found. The reported anxiety and learning were significantly correlated with the cognitive score. A combination of cognitive and emotional items resulted in 67% correct classification of ADHD and learning disability. This test can be used as part of the assessment of ADHD/learning disability.
A Novel Presentation of Inappropriate Antidiuretic Hormone Secretion in Leigh Syndrome With the Myoclonic Epilepsy and Ragged Red Fibers, Mitochondrial DNA 8344A>G Mutation
Authors: Swiderska Nina , Appleton Richard , Morris Andrew , Isherwood David , Selby Andrew
Published: March 2010

A 17-month-old infant presented with a 2-week history of lethargy, anorexia, and an abnormal respiratory pattern on a previous 4-month history of hypotonia and gross motor delay, suggesting a clinical phenotype of Leigh syndrome. The patient experienced no epileptic seizures. Biochemical investigations were normal other than showing evidence of inappropriate secretion of antidiuretic hormone, and cerebral magnetic resonance imaging (MRI) showed symmetrical lesions in the cervical cord and lower brain stem. Initial screening investigations for a mitochondrial cytopathy were negative. Muscle histochemistry demonstrated reduced staining of cytochrome c oxidase but no ragged red fibers. Blood and muscle-derived DNA demonstrated a high level (92% and 82%, respectively) of the m.8344A>G mutation seen in patients with the mitochondrial cytopathy, ‘‘myoclonic epilepsy with ragged red fibers on muscle biopsy.’’ This infant’s early presentation including inappropriate antidiuretic secretion due to presumed renal salt loss and rapid course appears to be unique to this mutation.
Diffusion Tensor Imaging Analysis of Frontal Lobes in Pediatric Traumatic Brain Injury
Authors: Oni Margaret B. , Wilde Elisabeth A. , Bigler Erin D. , McCauley Stephen R. , Wu Trevor C. , Yallampalli Ragini , Chu Zili , Li Xiaoqi , Hunter Jill V. , Vasquez Ana C. , Levin Harvey S.
Published: March 2010

This study examined the use of diffusion tensor imaging in detecting white matter changes in the frontal lobes following pediatric traumatic brain injury. A total of 46 children (ages 8-16 years) with moderate to severe traumatic brain injury and 47 children with orthopedic injury underwent 1.5 Tesla magnetic resonance imaging (MRI) at 3 months postinjury. Conventional MRI studies were obtained along with diffusion tensor imaging. Diffusion tensor imaging metrics, including fractional anisotropy, apparent diffusion coefficient, and radial diffusivity, were compared between the groups. Significant group differences were identified, implicating frontal white matter alterations in the injury group that were predictive of later Glasgow Outcome Scale ratings; however, focal lesions were not related to the Glasgow Outcome Scale ratings. Injury severity was also significantly associated with diffusion tensor imaging metrics. Diffusion tensor imaging holds great promise as an index of white matter integrity in traumatic brain injury and as a potential biomarker reflective of outcome.
Regions, networks and innovative performance: The case of knowledge-intensive industries in Norway
Authors: Isaksen Arne , Onsager Knut
Published: March 2010

Many recent studies maintain that regional characteristics influence the innovative performances, innovation processes and innovation patterns of firms. Based on a representative sample of knowledge-intensive firms in Norway, this paper analyses the innovation output, innovation partners, knowledge sources, and localization of sources and partners for knowledge-intensive firms in three types of region: large urban regions, small urban regions and rural areas.The empirical results contradict some of the assumptions of the literature dealing with agglomeration economies, regional clusters, and so on. We find, for example, that the firms’ innovation partners and knowledge sources are quite similar irrespective of location. This may indicate that the relevant innovation systems in knowledge-intensive industries in Norway are sectoral and national rather than regional. The paper also finds that the small urban regions and the rural regions have a higher share of innovating, knowledge-intensive firms than the large urban regions, which may partly be explained by a much higher rate of public funding of innovation activity in the first two regional types. However, the large urban regions have higher new firm formation rates and more radically innovating firms than the other two types of region. The paper discusses to what extent the concept of open innovation may contribute to explaining the empirical results, because firms in large urban regions can rely more on open innovation than firms in other regions.
Moments, Mixed Methods, and Paradigm Dialogs
Authors: Denzin Norman K.
Published: March 2010

I reread the 50-year-old history of the qualitative inquiry that calls for triangulation and mixed methods. I briefly visit the disputes within the mixed methods community asking how did we get to where we are today, the period of mixed-multiple-methods advocacy, and Teddlie and Tashakkori’s third methodological moment.
Evaluation of a low, weight-based dose of rasburicase in adult patients for the treatment or prophylaxis of tumor lysis syndrome
Authors: Knoebel Randall W , Lo Mimi , Crank Christopher W
Published: March 2010

Purpose: Rasburicase is a recombinant urate oxidase enzyme generally reserved for the treatment or prevention of hyperuricemia in patients that are at high risk of developing tumor lysis syndrome (TLS). The primary objective of this study is to evaluate and characterize the outcomes of patients receiving low dose rasburicase for treatment or prophylaxis of hyperuricemia secondary to TLS.

Patients/Methods: A retrospective chart review between April 1, 2007 and September 31, 2008 was completed. All adult patients who received a dose of 0.05mg/kg with either a leukemia or lymphoma diagnosis in addition to at least two TLS risk factors: WBC ≥ 50 × 109/L, LDH 2 × ULN, uric acid ≥ 8 mg/dl, SCr ≥ 1.5 mg/dl were included. Forty-eight patients received rasburicase for prophylaxis (n = 18) or treatment (n = 30) of TLS.

Results: Forty patients achieved and maintained a uric acid less than 8 mg/dL, 24 h after receipt of a single dose of rasburicase without the requirement for renal replacement therapy. A statistically significant decrease in UA was achieved in all patients when compared to baseline (p < 0.001). Cost analysis revealed a $ 1.96 million (96%) direct cost savings for the 48 patients in this study when compared to the cost of manufacturer’s dosing recommendation.

Conclusions: Low dose rasburicase was efficacious and cost effective for both prophylaxis and treatment of TLS. Administration of a single dose of 0.05mg/kg of rasburicase was sufficient in correcting uric acid levels for most patients.
Lack of Association Between a 3’UTR VNTR Polymorphism of Dopamine Transporter Gene (SLC6A3) and ADHD in a Brazilian Sample of Adult Patients
Authors: Aparecida da Silva Maria , Cordeiro Quirino , Louzã Mario , Vallada Homero
Published: March 2010

Objective: To investigate a possible association between a 3’UTR VNTR polymorphism of the dopamine transporter gene (SLC6A3) and ADHD in a Brazilian sample of adult patients. Method: Study Case-control with 102 ADHD adult outpatients ( DSM-IV criteria) and 479 healthy controls. The primers’ sequence used were: 3’UTR-Forward: 5’ TGT GGT GAT GGG AAC GGC CTG AG 3’ and 3’UTR-Reverse: 5’ CTT CCT GGA GGT CAC GGC TCA AGG 3’. Alleles of the 3’UTR were coded according to their number of repeats: 6- repeat 320 bp (allele 6), 8- repeat 400 bp (allele 8), 9- repeat 440 bp (allele 9), 10- repeat 480 bp (allele 10), and 11- repeat 520 bp (allele 11). Results: There were no allelic (χ2 = 2.67, 5df, p = .75) and genotypic (χ2 = 7.20, 1df, p = .61) association between adult ADHD and VNTR 3’UTR polymorphism of SLC6A3. Conclusion: Our findings do not support SLC6A3 as marker genetic susceptibility factor in adult ADHD. More comprehensive polymorphism coverage within the SLC6A3 region should be conducted in larger samples, including comparisons in clinical subgroups, and in samples with different ethnic backgrounds. (J. of Att. Dis. 2011; 15(4) 305-309)
Indole-3-Carbinol Inhibits Nasopharyngeal Carcinoma
Authors: Zhu Wei , Li Wenxue , Yang Guangyu , Zhang Quanxin , Li Ming , Yang Xingfen
Published: March 2010

This study explored the effects of indole-3-carbinol on the proliferation of human nasopharyngeal carcinoma, both in vitro and in vivo, and the underlying mechanisms in inducing apoptosis of CNE1 cells. Proliferation, apoptosis, malondialdehyde, superoxide dismutase, glutathione peroxidase, expressions of caspase-9, and caspase-3 in human nasopharyngeal carcinoma cells CNE1 were examined. Indole-3-carbinol suppressed proliferation, induced apoptosis, decreased malondialdehyde level, increased the activity of superoxide dismutase and glutathione peroxidase, and up-regulated the expression of active fragments of caspase-9 and caspase-3 both in vitro and in vivo. It was concluded that indole-3-carbinol could inhibit proliferation and induce apoptosis of CNE1 cells and inhibit tumor growth in mice. Increased activity of superoxide dismutase and glutathione peroxidase and activated expression of caspase-9 and caspase-3 were also observed in indole-3-carbinol–treated tumors or tumor cells, suggesting that stress- and apoptosis-related molecules are involved in the indole-3-carbinol–induced apoptosis and inhibition of tumor growth.