bluuebunny/crossref_metadata_2025 huggingface dataset:
The effects of lower-extremity muscle fatigue on the vertical ground reaction force: A meta-analysis
Authors: Zadpoor Amir Abbas , Nikooyan Ali Asadi
Published: May 2012

There is currently no consensus in the literature on whether the magnitude of the ground reaction force or loading rate decreases or increases with muscle fatigue. In this article, the effects of lower extremity muscle fatigue on the magnitude of the ground reaction force and loading rate during running and drop landing are examined. Through a systematic search of the literature, 24 articles are identified that satisfy the inclusion criteria and study the relationship between fatigue and the ground reaction force variables during running, single-leg drop landing, and bilateral drop landing. The articles are categorized based on the type of locomotion they study. To determine whether or not the ground reaction force peaks/loading rate are markedly affected by fatigue, meta-analyses are conducted both separately for each type of locomotion and for an aggregate of all studies. The results of the meta-analyses show that the ground reaction force active peak significantly decreases for the following study groups: aggregate of all included studies, studies of drop landing (both single-leg and bilateral), and studies of bilateral landing only. The ground reaction force active peak did not significantly change in running and single-leg drop landing. The effects of muscle fatigue on the magnitude of the ground reaction force impact peak and loading rate was always insignificant.
Regional cartilage properties of three quadruped tibiofemoral joints used in musculoskeletal research studies
Authors: McLure Stewart W D , Fisher John , Conaghan Philip G , Williams Sophie
Published: May 2012

Quadruped joints are commonly used in musculoskeletal studies as a surrogate for human joints despite inherent differences in tissue properties. Although concerns exist regarding model validity, relatively few studies comparing the mechanical properties of quadruped tissue exist. This study aimed to characterise the regional intrinsic mechanical properties and thickness of tibiofemoral cartilage from three quadrupeds used in modern musculoskeletal research. Osteochondral plugs were removed from the major weight-bearing regions of porcine (6 months), bovine (18–24 months) and ovine (≈5 years) tibiofemoral joints. The equilibrium elastic modulus and permeability of the cartilage were derived by combining the creep indention deformation results and calculated tissue thickness within an in-silica model. Results showed significant interspecies and regional variation in cartilage thickness. Cartilage was thickest on porcine femoral condyles whereas ovine cartilage was consistently thinner across all sites. Furthermore, porcine tissue had a significantly lower equilibrium elastic modulus and significantly higher permeability than ovine cartilage. The results highlight the importance of considering the interspecies and regional variation in quadruped tissue properties when selecting animal joints for musculoskeletal investigations.
Strengths and weaknesses of the Information Technology curriculum in Library and Information Science graduate programs
Authors: Singh Vandana , Mehra Bharat
Published: May 2012

This research highlights the status of the information technology (IT) skills and competencies being taught at LIS schools in the United States. Results list specific IT topics that the library schools are teaching and the ones that are missing from the curriculum. Based on a literature review these skills are then juxtaposed with the expectations of the employers as well as the graduates of these programs. This research was conducted in multiple steps, starting from extensive literature review, secondary data collection regarding courses from top LIS schools’ websites, identifying and creating an IT competency list, content analysis on the course names and descriptions in relation to IT competencies and recommendations for further improvement. In conclusion, some potential courses consisting of the lacking IT skills are proposed as a recommendation.
Inducing involuntary musical imagery: An experimental study
Authors: Liikkanen Lassi A.
Published: May 2012

It is still a mystery why we sometimes experience the repetition of memories in our minds. This phenomenon seems to be particularly prominent in music. We believe that present lack of knowledge relates to the lack of methods available for the study of this topic. To improve the understanding of involuntary musical imagery (INMI), this paper proposes a novel method to induce it in experimental settings. We report three experiments that were conducted to evaluate two research questions related to INMI: Can it be experimentally induced, and if so, which factors influence its emergence? Investigation particularly focused on how recent activation of musical memory might predict INMI. The questions were tested in single-trial experiments conducted over the internet. The experiments utilized a cued-recall method to induce INMI and delayed self-reports. Among a large sample of people, the prevalence of the phenomenon was considerable. When the familiarity with the stimuli was controlled for, inducing INMI experimentally succeeded in over 50% of participants. It was found that music rehearsal in the near past was a more important predictor for INMI than very recent activation of musical memories. This suggests that recent activation is a facilitating but not a necessary condition for INMI. Overall, induction of INMI is possible, and several ways to improve the method are proposed.
Journey as Destination
Authors: O’Grady Caroline P. , Skinner W. J. Wayne
Published: May 2012

We conducted a study offering peer support and education to members of families affected by concurrent disorders (CD). This article is an analysis of the qualitative data from a mixed methods study. Using constructivist grounded theory, we analyzed semistructured interviews with participants, with half attending a 12-week support group and reading weekly workbook assignments, and the others receiving the workbook only and being interviewed 3 months later. We developed a model that describes family journeys into, through, and beyond CD, involving three phases connected by two transitional constructs. Preoccupation with the unresolved CD of an ill family member characterized the journey into and through illness, the first two phases, whereas renewal characterized the passage from illness to journeying on toward recovery. Participants had strong comments about health care providers and the service system, and spoke of the need for self-care, empowerment, support, and inclusion.
Grief Experiences of 3 Caregiving Wives of Veterans With Dementia
Authors: Ford James L. , Linde Brittany D. , Gigliotti Christina , Kim Kye Y.
Published: May 2012

Three wives share their experiences of caregiving for husbands with dementia. The 3 husbands, aged 51, 71, and 84, developed dementia following years of devoted military service. To present lived experiences of caregiving wives’, meanings attributed to caregiving are investigated, variations in caregiving and grieving experiences are explored, and therapeutic implications are offered. Through case study approach and with issues of caregiver grief considered, we introduce life course and ambiguous loss theoretical perspectives. Emergent qualitative themes and quantitative inventory ratings indicate significant differences in caregiver grief response depend on care-recipient age. Practice implications and directions for future care recipient, age-related research are presented.
Bacteria-inspired underactuated mobile robot based on a biological fluctuation
Authors: Nurzaman Surya G , Matsumoto Yoshio , Nakamura Yutaka , Shirai Kazumichi , Ishiguro Hiroshi
Published: May 2012

Interpretation of the living organism’s ability to utilize noise from engineering point of view may be beneficial for realizing a simple, yet adaptive, robotic system. This paper presents a bacteria-inspired mobile robot, with a 1-DOF motor and a single sensor. Even with such limitations, the underactuated mobile robot is able to navigate toward a gradient-inducing goal in a two-dimensional space by properly utilizing environmental noise that directly affects its motion. The way the robot utilizes this external noise to control its navigation behavior is interpreted based on biological fluctuation: a simple perspective commonly used to describe how living beings utilize internally generated biological noises.
Clinical Experience With Low-Dose Continuous Infusion of Furosemide in Acute Heart Failure
Authors: Ng Tien M. H. , Hshieh Shenche , Chan Cynthia Y. , Elkayam Uri
Published: May 2012

Introduction:

Clinical data are scarce for furosemide administered as a low-dose (<160 mg/24 hours) continuous intravenous infusion in acute heart failure (HF). Our purpose was to evaluate the efficacy and safety of low-dose continuous infusion of furosemide on diuretic response, renal function, and patient outcomes.

Methods:

A retrospective study of patients with acute HF who received furosemide administered as a continuous infusion after initial therapy with intermittent boluses (usually 40-80 mg every 12 hours). End points included mean hourly urine output, incidence of acute renal injury, and outcome disparities of patients who developed acute renal injury. Comparison of patients with preserved and reduced left ventricular ejection fraction (LVEF) was also performed.

Results:

The study included 150 patients (age 57 ± 13 years, male gender 61%, admission weight 87 ± 32 kg, LVEF 37 ± 15%, 28% preserved LVEF). Mean initial and maximum furosemide doses were 5.1 ± 1.1 mg/h and 6.2 ± 2.2 mg/h, respectively. Mean duration of therapy was 51.4 ± 67.5 hours. Continuous infusion of furosemide was associated with a significant increase in mean hourly urine output compared to baseline (150 ± 77 mL/h vs 116 ± 69 mL/h, P < .001). Acute renal injury developed in 19% of patients, with 70% of those occurring within the first 48 hours of therapy. Mean serum creatinine (baseline 1.55 ± 1.50 mg/dL vs at discharge 1.64 ± 1.61 mg/dL, P = .20) and estimated glomerular filtration rate (baseline 67 ± 39 mL/min vs at discharge 67 ± 43 mL/min, P = .89) did not significantly change over the course of the hospitalization. Development of acute renal injury was associated with poorer outcomes, higher furosemide dose, and longer duration of furosemide therapy. Diuretic response and safety were not different between patients with preserved or reduced LVEF.

Conclusions:

In patients with acute HF, furosemide administered as a low-dose continuous infusion was effective in achieving diuresis and was not associated with a detectable effect on renal function. This diuretic approach appeared to be similarly effective and safe in patients with preserved LVEF.
Pharmacological Prophylaxis of Venous Thromboembolism During Acute Phase of Spontaneous Intracerebral Hemorrhage
Authors: Masotti Luca , Godoy Daniel Agustin , Napoli Mario Di , Rabinstein Alejandro A. , Paciaroni Maurizio , Ageno Walter
Published: May 2012

Spontaneous intracerebral hemorrhage (sICH) represents a devastating clinical event with high mortality and morbidity rates. Only few patients with sICH are treated with neurosurgical evacuation of the hematoma, and the majority of them need only a good conservative medical approach. The goal of medical treatment is to avoid secondary neurological and systemic complications. Venous thromboembolism (VTE) represents one of the most feared complications of sICH, and it is a potential cause of death. The balance between the benefit of VTE prevention and the risk of hematoma enlargement and/or rebleeding with the use of pharmacologic thromboprophylaxis remains controversial because of the lack of consistent evidences in the literature. The efficacy of mechanical prophylaxis is also uncertain. Consequently, until now there are no clear guidelines and scientific evidences available for physicians in this field. The aim of this review is to analyze the available literature and guidelines about pharmacological VTE prophylaxis in patients with nonsurgical sICH.
Quantifying the Dynamic Effects of Service Recovery on Customer Satisfaction
Authors: Fang Zheng , Luo Xueming , Jiang Minghua
Published: May 2012

This study examines two issues which have challenged prior experimental or survey research: (1) whether the time-varying effects of service recovery on customer satisfaction may follow a long decay or short decay and (2) why and what service recovery efforts have a higher and quicker buildup, with respect to the significance and timing of recovering customer satisfaction losses due to service failures. The authors do so with a real-world data set from China’s mobile phone markets. The authors developed multivariate time-series model to simulate the dynamic service recovery process and implemented Bayesian estimation to resolve overparameterization problem. The empirical results surprisingly reveal that apology-based service recovery efforts are the least effective in salvaging customer satisfaction, with the shortest decay and lowest buildup intensity. In contrast, quality improvement is the most effective, with the highest buildup and longest decay but slowest buildup toward the peak impact point. Compensation has moderate and stable impact overtime. Communications' impact on customer satisfaction builds up the quickest, though with mild endurance and magnitude. Also, the decomposition models enable managers to monitor how many percentages of customer satisfaction gains are originated from which types of service rescue efforts.
Type III hemifacial microsomia in a kitten
Authors: Talbot Jessica J , Voss Katja , Beatty Julia , Barrs Vanessa R
Published: May 2012

The case described herein presented with craniofacial malformations resembling hemifacial microsomia (HFM), a congenital disorder described in humans. To our knowledge, this is the first reported case of HFM in a domestic cat.
The earliest narratives were musical
Authors: Dissanayake Ellen
Published: May 2012

In a baby’s first months of life, adults direct a lot of ‘talk’ at them, to which they respond with obvious delight. Baby talk can be regarded as narrative (or proto-narrative), though of a very peculiar kind, since its recipients don’t understand a word of what is said to them. What then do babies respond to? And why do we talk to babies? The importance of these early narratives, both phylogenetically (as they evolved in our species), and ontogenetically (as they develop in each individual person), has interesting implications for the way that narratives have been used historically and culturally – in theory as well as practice.
Aspects of second-language transfer in the oral production of Egyptian and Palestinian heritage speakers
Authors: Albirini Abdulkafi , Benmamoun Elabbas
Published: May 2012

The nature and extent of the impact of language transfer in majority–minority language contexts have been widely debated in both second- and heritage-language acquisition. This study examines four linguistic areas in three oral narratives collected from Egyptian and Palestinian heritage speakers in the United States (namely, plural and dual morphology, possessive constructions, and restrictive relative clauses), with a special focus on how the second language (English) influences the structure and use of these areas in connected discourse. In addition, the study examines the relationship between second-language transfer and the incompleteness and attrition of heritage Arabic. The findings show that heritage speakers have various gaps in their knowledge of the examined areas, particularly in forms and patterns that diverge from their counterparts in their dominant L2. The results also suggest that transfer effects are restricted to specific forms that are marked (e.g. broken plurals), infrequent (duals), or characterized by processing difficulty (as seems to be the case with the dependencies in the relative clauses). Moreover, transfer effects are intimately related to both the attrition and incomplete acquisition of the speakers’ knowledge of the four areas under study. The implications of the study for heritage language research are discussed.
Characterization of low- and high-temperature oxidation processes under non-premixed diesel-engine-like conditions
Authors: Weclas Miroslaw , Cypris Jochen
Published: May 2012

Low- and high-temperature oxidation processes, including thermal auto-ignition under diesel-engine-like conditions (non-premixed mixtures), have been investigated. A special combustion chamber, characterized by constant volume and adiabatic conditions, has been used as an engine simulator. The investigated processes are very complex in nature, and depend significantly on the temperature and pressure. There are five characteristic regions of the process characterized by different delay times, reaction rates and number of recognizable oxidation reactions: region 1 corresponds to processes occurring at low initial pressures over a wide range of initial temperatures; region 2 corresponds to low initial temperatures over a wide range of initial pressures; region 3 corresponds to middle pressures and higher temperatures; region 4 corresponds to middle temperatures and higher pressures; and region 5 corresponds to high initial pressures and high temperatures. by analogy to a negative temperature coefficient (as discussed in the literature), a positive pressure coefficient has been introduced here. This indicates that in the selected range of pressures, the delay time of low-temperature oxidation processes is the shortest, and the rate of these reactions is the highest. Further increases in the pressure behind the positive pressure coefficient range increase the delay time and decrease the reaction rate. The positive pressure coefficient has been observed at lower temperatures (mostly corresponding to cool-flame reactions and transitions to blue flames). Generally, the ignition delay time reduces with increasing chamber temperature and pressure.
Imaginative geography, neoliberal globalization, and colonial distinctions: docile and dangerous bodies in medical transcription ‘outsourcing’
Authors: Prasad Amit , Prasad Srirupa
Published: May 2012

Information Technology (IT) ‘outsourcing,’ of which medical transcription in India is a part, has received relatively little attention from geographers. Most often, it has been bracketed more broadly within IT and its role in transforming transnational space-time configurations has been analyzed. IT outsourcing, more specifically, medical transcription outsourcing, which is the focus of this article, is not only marked by tensions, hierarchies, and ambivalences, it also reflects an emergent ‘imaginative geography’ of neoliberal globalization. This imaginative geography, as we argue in this article, is deceptively ambiguous because of its ambivalent articulation. Medical transcription outsourcing, for example, seems to operate on two contradictory registers, particularly in the United States and some European nations from where outsourcing to countries such as India is taking place. There is an acknowledgement and even celebration of the ‘flattening’ and inter-connectedness of different parts of the world, even while there is widespread criticism and fear of these transnational activities, as well as that of the non-western people engaged in them. The criticism and fear are often articulated in relation to instances of data theft. Nevertheless, a closer look shows that there is something more going on. We argue that such discursive constructions exemplify an imaginative geography that is rooted in an ambivalent desire for a reformed and recognizable ‘other’ who could be ‘best global citizens.’ This ambivalence undergirds a forked biopolitical strategy, which seeks to make the neoliberal worker docile and yet continually marks him/her as dangerous. We call this biopolitical strategy colonial governmentality to signify its forked operation as an art of government that seeks to define agenda/non-agenda (and not population or people), but continually draws upon colonial distinctions and practices.
Ship electric propulsion with a sensorless permanent magnet synchronous motor: A simulation study
Authors: Li Zhixiong , Yan Xinping , Peng Zhongxiao
Published: May 2012

New general ships powered by electric propulsion always operate at low motor speeds. Popular sensorless vector control methods, including open loop and closed loop methods, are not reliable in this application. This is because the magnitude of back-electromotive force voltage is very small in the low speed region, and the performance of these methods is therefore significantly degraded. To overcome this problem, a high-frequency injection method is introduced in the control of the ship electric propulsion system. The injected periodic signal creates a high-frequency revolving field to act as a carrier. Then the desired information about the position angle of the motor can be retrieved. A simulation model of a ship electric propulsion system is established in Matlab/Simulink. The test results show that the newly proposed control system works stably with various ship operating conditions and robustly against speed variations. Its estimated position error is less than 0.3 rad. Moreover, the proposed sensorless vector control approach has been compared with the closed-loop-based model reference adaptive system. The comparison has demonstrated that the dynamic characteristics of the proposed control system are superior to the latter.
Societal Development Through Human Resource Development
Authors: Kim Namhee
Published: May 2012

The Problem.

Recently, human resource development (HRD) scholars and practitioners have reported the usefulness and effectiveness of an HRD framework to address emerging problems and issues to bring about meaningful and lasting change for the public good at multiple levels. However, basic expectations inherent in traditional HRD theory and practice that pursue organizational interests often do not fit numerous projects and programs designed for community development, nation building, or international development.

The Solution.

To understand the use of HRD for the purpose of societal development (SD), this article presents typical contextual characteristics of HRD in a community, a nation, and the world, along with the key change agents, such as governments, nongovernmental organizations (NGOs), and international agencies.

The Stakeholders.

This article is addressed to the many HRD practitioners who work for SD without broader scope of theoretical background by providing principles, concepts, and methods that are currently used or have potential for advancing the practice.
HRD for Societal Development
Authors: Wang Jia
Published: May 2012

The Problem.

Human resource development (HRD) in developing countries has scopes and applications beyond economic interests; it often involves addressing social issues. Furthermore, the continuing trend of population growth in the developing world, coupled with limited or unavailable resources and infrastructure, has created additional challenges. As a result, HRD practitioners in the developing world must become more innovative change agents.

The Solution.

This article introduces the concept of “social entrepreneurship” into HRD and urges HRD practitioners to partner with social entrepreneurs in their mission of promoting community and national development. Specifically, I draw details from four well-known case examples in two emerging economics—India and China—to demonstrate how social entrepreneurs have used HRD and organization development strategies to address societal problems in these two countries.

The Stakeholders.

Findings of this research will not only benefit HRD professionals and social entrepreneurs but also other stakeholders including central and local government agencies, policy makers, local communities, local business organizations, and the individuals directly affected by societal change.
Capacity Building for Societal Development
Authors: McLean Gary N. , Kuo Min-Hsin (Christine) , Budhwani Nadir N. , Yamnill Siriporn , Virakul Busaya
Published: May 2012

The Problem.

Traditionally, the core of human resource development (HRD) has focused on corporate settings and emerged primarily in the United States.

The Solution.

As the concept has evolved and moved around the world in response to factors supporting globalization, and as academics and practitioners have argued about its definition, HRD has begun to be applied much more broadly, including with geographically dispersed communities and nations. This article presents case studies in which HRD principles and theories have been used for societal development—the general improvement of the welfare of people usually outside of the workplace, primarily in communities. At least one of the coauthors, and usually two or more, have been either involved in or reported on all of the cases included.

The Stakeholders.

It is critical for HRD academics and practitioners to understand this evolving, broad-based perspective of HRD and participate in its practice, theory development, and research.
Development of a National HRD Strategy Model
Authors: Alagaraja Meera , Wang Jia
Published: May 2012

National human resource development (NHRD) literature describes the importance of developing human resources at the national level and presents several models. These models are primarily concerned with the national contexts of developing and underdeveloped countries. In contrast, the NHRD models in the non-HRD literature focus primarily on developed countries. Both types of models describe NHRD strategies with little analytical attention to the larger societal context, which the authors argue has a deep influence on the trajectory of NHRD practices in developing countries. The authors traced the evolution of NHRD strategies through an in-depth analysis of two emerging economies—India and China. Through comparative analysis, this study identifies similarities and differences in the emergence of NHRD strategy and develops a model that provides an enriched perspective on the dynamic process of NHRD strategy development.
India’s Reproductive Assembly Line
Authors: Rudrappa Sharmila
Published: May 2012

Why do working class women in India choose to become surrogate mothers? Sociologist Sharmila Rudrappa explains that these decisions make sense when contexualized within larger changes in the economy, the appallingly low wages these women command for their labor, and the lack of meaningful work.
How Rachel Carson and Michael Harrington Changed the World
Authors: Dreier Peter
Published: May 2012

The 50th anniversary of two pathbreaking books—Rachel Carson’s Silent Spring and Michael Harrington’s The Other America—that helped change public opinion and public policy about the environment and poverty is discussed. Peter Dreier looks into what contemporary academics, including sociologists, can learn from the lives and careers of these two influential public intellectuals.
Ballroom Bodies
Authors: Marion Jonathan S.
Published: May 2012

Accompanying Julia A. Ericksen’s feature on dance, Jonathan S. Marion provides photos and commentary to enchance our understanding of the body work of ballroom.
Mounting Opposition to Vivisection
Authors: Goodman Justin R. , Borch Casey A. , Cherry Elizabeth
Published: May 2012

Justin R. Goodman, Casey A. Borch, and Elizabeth Cherry discuss public attitudes toward animal testing and its growing opposition.
An adaptive design to bridge the gap between Phase 2b/3 microbicide effectiveness trials and evidence required for licensure
Authors: Taylor Douglas J , Grobler Anneke , Abdool Karim Salim S
Published: May 2012

Background

Vaginally and rectally applied microbicides are being developed to help prevent sexual acquisition of HIV. Due to the lack of surrogate outcomes, the path toward licensure typically moves directly from expanded safety studies to expensive Phase 2b/3 trials with rare incident infection outcomes. The need to confirm an initial trial’s significant finding can lead to serious delays in implementing essential programs to reduce the spread of HIV.

Purpose

To propose an adaptive design where a Phase 2b/3 study powered to detect a clinically meaningful effect with evidence of one trial (observing one-sided p < 0.025) is allowed to expand by a prespecified, feasible amount if interim data suggest the chance of further achieving a more robust evidence threshold ( p < 0.001, potentially sufficient for licensure from a single trial) is promising.

Methods

As an example, prespecified conditional power criteria are used to determine whether a 90-event trial with 90% power to detect a 50% reduction in risk should be expanded to 130 events. Asymptotic results and simulations are used to assess false-positive error rates and other operating characteristics of the design.

Results

False-positive error rates can be controlled at the desired 0.025 and 0.001 levels with appropriate choice of critical values or expansion criteria. The chance of achieving robust evidence can approach that of a 130-event trial with traditional stopping boundaries (controlling a = 0.001) but with substantially lower expected size for plausible effectiveness levels.

Limitations

Conditional power calculations assume the interim estimate of effect is an unbiased estimate for the remainder of the trial, an assumption which may not hold if product adherence varies over time. Observing a measure of effect with p < 0.001 may not be sufficient for licensure. A decision to expand the trial would be informative to investigators regarding the interim effect size.

Conclusions

A moderate increase in trial size can make the difference between a study with good power to detect a clinically meaningful effect and one which may reasonably obtain the robust evidence required for regulatory bodies and public health programs to consider making a new microbicide available to persons at risk of HIV infection. The proposed design allows for this possibility while not requiring investigators to make an up-front commitment to a prohibitively large trial.
Towards an understanding of judicial denunciation: Relating theory to practice by comparing the perceptions of English and Danish lower court judges when sentencing minor theft offenders
Authors: Lowenstein Max
Published: May 2012

The influence of judicial denunciation during sentence summation and how this equates with wider criminal justice attempts to change offending behaviour through re-education and re-moralization appears to be important. However, there is no coherent academic agreement as to what judicial denunciation means and how this may relate to its interpretation and application by judges in practice. Through a small comparison of judicial perceptions in two distinct legal cultures there were common hints provided as to what denunciation may mean when applied to theft offenders. However, the limited data gathered were insufficient to develop a firm link to any one specific sentencing principle, policy or social theory. It would appear that if we are to better understand judicial denunciation during sentence summation we must master both the plurality of theoretical understandings and philosophical thoughts available and gather significantly more qualitative data in order to test what judicial denunciation may mean. The comparison of England and Denmark was only a slight nudge in the right direction, but it remains an attempt nonetheless to keep the ball rolling and inspire future academic enquiry into this important research area.
A proposal for a computer-based framework of support for public health in the management of biological incidents: the Czech Republic experience
Authors: Bureš Vladimír , Otčenášková Tereza , Čech Pavel , Antoš Karel
Published: May 2012

Aims:

Biological incidents jeopardising public health require decision-making that consists of one dominant feature: complexity. Therefore, public health decision-makers necessitate appropriate support.

Methods:

Based on the analogy with business intelligence (BI) principles, the contextual analysis of the environment and available data resources, and conceptual modelling within systems and knowledge engineering, this paper proposes a general framework for computer-based decision support in the case of a biological incident. At the outset, the analysis of potential inputs to the framework is conducted and several resources such as demographic information, strategic documents, environmental characteristics, agent descriptors and surveillance systems are considered.

Results:

Consequently, three prototypes were developed, tested and evaluated by a group of experts. Their selection was based on the overall framework scheme. Subsequently, an ontology prototype linked with an inference engine, multi-agent-based model focusing on the simulation of an environment, and expert-system prototypes were created.

Conclusions:

All prototypes proved to be utilisable support tools for decision-making in the field of public health. Nevertheless, the research revealed further issues and challenges that might be investigated by both public health focused researchers and practitioners.
Clinical Characteristics and Thrombolytic Outcomes of Infective Endocarditis-Associated Stroke
Authors: Walker Kevin A. , Sampson Jacinda B. , Skalabrin Elaine J. , Majersik Jennifer J.
Published: May 2012

Objective: Our aim was to describe the clinical features of infective endocarditis (IE) in the acute stroke setting and outcomes following thrombolytic therapy. Methods: This is a single-center, retrospective, descriptive case series of IE-related stroke (IES). Infective endocarditis diagnosis was based on the modified Duke criteria. Results: From 2001 to 2007, 18 patients with acute stroke had definite or possible IE. Presenting stroke subtypes were: 11 ischemic stroke; 2 intracerebral hemorrhage; and 5 with a combination of ischemia and subarachnoid hemorrhage. On presentation, 6 had objective fever and 5 had subjective fever, 8 had heart murmur, and 3 had classic IE stigmata. The most common laboratory abnormalities were leukocytosis (n = 11) and anemia (n = 10). Sixteen patients had valvular vegetations on echocardiogram; 6 of 8 patients had vegetations visualized on transesophageal echocardiogram that were not detected by transthoracic echocardiogram. Two of the 3 patients with valve replacements had vegetations only on their native valves. Of 11 patients with pure ischemic stroke, 4 received thrombolytics and had hemorrhagic conversion. Overall mortality of IES was 56% (10 of 18). Mortality in pure ischemic IES patients was 29% (2 of 7, median National Institute of Health Stroke Scale [NIHSS] 13) in those not receiving thrombolytics and 75% (3 of 4, median NIHSS 14) in those receiving thrombolytics. Conclusions: Though diagnosis of IE in the acute stroke setting is difficult, features of the history, examination, and laboratory data may raise concern for IE. In this case series, thrombolytics in patients with IE-associated stroke were associated with very poor outcomes.
The Safety of Lacosamide for Treatment of Seizures and Seizure Prophylaxis in Adult Hospitalized Patients
Authors: Luk Marilyn E. , Tatum William O. , Patel Alden V. , Nau Karen M. , Freeman William D.
Published: May 2012

Background: Lacosamide (LCM) is a newer antiepileptic drug (AED) with favorable properties for hospitalized patients including intravenous formulation, minimal hepatic metabolism, and no adverse respiratory effects. We sought to determine the safety profile of LCM in hospitalized patients. Methods: We performed a retrospective medical record review of patients who received LCM between July 1, 2009, and January 31, 2010, at Mayo Clinic Hospital. Data included demographics, LCM dosing, concomitant AED therapy, documented seizure activity, hemodynamic variables, electrocardiogram (ECG), and laboratory data. Adverse drug reaction and drug–drug interactions were reviewed. Results: Thirty-two patients were identified. No major hypotension or serious cardiac arrhythmias occurred. Heart rate increased, however, in seizure group compared with the prophylaxis group 2 hours postdrug infusion (median heart rate = 86 vs 164). The ECGs demonstrated a mean PR interval prolongation of about 6 milliseconds (ms) after LCM initiation (mean PR 185.5 ms, compared with baseline ECG mean of 179.3 ms). Laboratory data revealed no clinically significant changes 24 hours after LCM initiation. Three patients developed adverse events (9.4%): One with altered mental state and exceptionally prolonged ECG PR interval (212 vs 178 ms baseline); One with unexplained thrombocytopenia; and a third patient with dizziness, all of which resolved after drug discontinuation. Conclusion: The LCM demonstrated ECG PR prolongation as previously reported without systemic hypotension, with no discernable drug–drug interactions in hospitalized patients. About 9% of patients had transient adverse drug reactions after LCM, namely alteration in mental state, unexplained thrombocytopenia, and dizziness, which stopped after discontinuation of the drug.
1 and 1 is 11
Authors: Rapport Richard , Howe John , Hare Kathy , Ellenbogen Richard G.
Published: May 2012

Contemporary departments in academic medical centers face challenging obstructions to the sometimes conflicted missions of education, research, and patient care. While the ward demands of patients and families have remained stable or increased, the availability of both attending faculty and residents has often decreased due to the requirements of relative value unit production and trainee duty hour limitations. The Department of Neurological Surgery at the University of Washington has evolved a novel solution to provide senior level attending coverage and bedside mentoring to help fill these gaps.
Examining Mechanisms of Personality Maturation
Authors: Specht Jule , Egloff Boris , Schmukle Stefan C.
Published: May 2012

Individuals are expected to mature with increasing age, but it is not yet fully understood which factors contribute to this maturation process. Using data of a representative sample of Germans ( N = 14,718) who gave information about their Big Five personality traits twice over a period of 4 years, the authors identified satisfaction with life, which was reported yearly, as an important variable for explaining mechanisms and interindividual differences in personality maturation. Dual latent change models suggest that more satisfied (compared to less satisfied) individuals experience more positive changes in Emotional Stability, Agreeableness, and Conscientiousness and that positive changes in life satisfaction are associated with positive changes in personality. Furthermore, maturation processes were examined for individuals who faced a social role transition, namely, marriage, birth of a child, or entering the job market. Again, differential effects highlight the importance of life satisfaction for personality maturation.
HIV Screening of Patients Presenting for Routine Medical Care in a Primary Care Setting
Authors: Anim Mamle , Markert Ronald J. , Okoye Nkeiruka E. , Sabbagh Wissam
Published: May 2012

Background: HIV screening is recommended for all patients between the ages of 13 and 64 years. Objective: To increase the rate of HIV screening in a primary care setting by routinely offering HIV screening to all patients. Methods: All patients seen over a 3-month period in the authors’ clinic were offered HIV screening by a medical assistant. Results: During the 3-month study period, 17% of patients offered HIV testing accepted screening, a large increase from the less than 1% rate of an earlier time period. Conclusion: HIV screening can be increased by routinely offering the test to all patients in the office. Use of trained health care professionals other than physicians may increase the number of patients screened.
Critical role of P1-Runx1 in mouse basophil development
Authors: Mukai Kaori , BenBarak Maya J. , Tachibana Masashi , Nishida Keigo , Karasuyama Hajime , Taniuchi Ichiro , Galli Stephen J.
Published: May 2012

Runx1 P1N/P1N mice are deficient in the transcription factor distal promoter-derived Runt-related transcription factor 1 (P1-Runx1) and have a > 90% reduction in the numbers of basophils in the BM, spleen, and blood. In contrast, Runx1P1N/P1N mice have normal numbers of the other granulocytes (neutrophils and eosinophils). Although basophils and mast cells share some common features, Runx1P1N/P1N mice have normal numbers of mast cells in multiple tissues. Runx1P1N/P1N mice fail to develop a basophil-dependent reaction, IgE-mediated chronic allergic inflammation of the skin, but respond normally when tested for IgE- and mast cell–dependent passive cutaneous anaphylaxis in vivo or IgE-dependent mast cell degranulation in vitro. These results demonstrate that Runx1P1N/P1N mice exhibit markedly impaired function of basophils, but not mast cells. Infection with the parasite Strongyloides venezuelensis and injections of IL-3, each of which induces marked basophilia in wild-type mice, also induce modest expansions of the very small populations of basophils in Runx1P1N/P1N mice. Finally, Runx1P1N/P1N mice have normal numbers of the granulocyte progenitor cells, SN-Flk2+/−, which can give rise to all granulocytes, but exhibit a > 95% reduction in basophil progenitors. The results of the present study suggest that P1-Runx1 is critical for a stage of basophil development between SN-Flk2+/− cells and basophil progenitors.
Induction of activin B by inflammatory stimuli up-regulates expression of the iron-regulatory peptide hepcidin through Smad1/5/8 signaling
Authors: Besson-Fournier Céline , Latour Chloé , Kautz Léon , Bertrand Jessica , Ganz Tomas , Roth Marie-Paule , Coppin Hélène
Published: May 2012

Anemia is very common in patients suffering from infections or chronic inflammation and can add substantially to the morbidity of the underlying disease. It is mediated by excessive production of the iron-regulatory peptide hepcidin, but the signaling pathway responsible for hepcidin up-regulation in the inflammatory context is still not understood completely. In the present study, we show that activin B has an unexpected but crucial role in the induction of hepcidin by inflammation. There is a dramatic induction of Inhbb mRNA, encoding the activin βB-subunit, in the livers of mice challenged with lipopolysaccharide, slightly preceding an increase in Smad1/5/8 phosphorylation and Hamp mRNA. Activin B also induces Smad1/5/8 phosphorylation in human hepatoma–derived cells and, synergistically with IL-6 and STAT-3 signaling, up-regulates hepcidin expression markedly, an observation confirmed in mouse primary hepatocytes. Pretreatment with a bone morphogenic protein type I receptor inhibitor showed that the effect of activin B on hepcidin expression is entirely attributable to its effect on bone morphogenetic protein signaling, most likely via activin receptor-like kinase 3. Activin B is therefore a novel and specific target for the treatment of anemia of inflammation.
Long-term outcomes after autologous stem cell transplantation for patients with POEMS syndrome (osteosclerotic myeloma): a single-center experience
Authors: D'Souza Anita , Lacy Martha , Gertz Morie , Kumar Shaji , Buadi Francis , Hayman Suzanne , Dingli David , Zeldenrust Steven , Kyle Robert , Ansell Stephen , Inwards David , Johnston Patrick , Micallef Ivana , Porrata Luis , Litzow Mark , Gastineau Dennis , Hogan William , Dispenzieri Angela
Published: May 2012

The POEMS syndrome (polyradiculoneuropathy, organomegaly, multiple endocrinopathies, monoclonal protein, skin changes) is a rare disease associated with a plasma cell dyscrasia. Patients with disseminated POEMS can be treated with high-dose therapy and autologous stem cell transplantation (ASCT). While clinical improvement is nearly universal in these patients, the long-term outcomes after transplantation are unclear. We therefore assessed the long-term clinical outcomes of 59 POEMS patients treated with ASCT at our institution. With a median follow-up of 45 months, 14 patients have progressed with a progression-free survival of 98% and 75% at 1 and 5 years, respectively. Factors associated with progression have included an IgG-λ monoclonal component (hazard ratio [HR] 7.5; 95% confidence interval [CI], 2.3-28.3; P = .0008), fluorodeoxyglucose-avid lesions on baseline positron emission tomography (HR 6.4; 95% CI, 1.2-120; P = .03), lack of complete hematologic response (HR 5.4; 95% CI, 1.8-16.7; P = .003), and patients aged 50 years or younger at transplantation (HR 4.4; 95% CI, 1.3-20; P = .01). The most common progression events have been radiologic followed by rising VEGF. Symptomatic progression has been rare. Most patients could be salvaged with immunomodulatory drugs or radiation. The 5-year survival is 94%. Herein, we describe a system of monitoring response and progression among patients with POEMS after ASCT.
Treatment of erythropoietin deficiency in mice with systemically administered siRNA
Authors: Querbes William , Bogorad Roman L. , Moslehi Javid , Wong Jamie , Chan Amy Y. , Bulgakova Elena , Kuchimanchi Satya , Akinc Akin , Fitzgerald Kevin , Koteliansky Victor , Kaelin William G.
Published: May 2012

Anemia linked to a relative deficiency of renal erythropoietin production is a significant cause of morbidity and medical expenditures in the developed world. Recombinant erythropoietin is expensive and has been linked to excess cardiovascular events. Moreover, some patients become refractory to erythropoietin because of increased production of factors such as hepcidin. During fetal life, the liver, rather than the kidney, is the major source of erythropoietin. In the present study, we show that it is feasible to reactivate hepatic erythropoietin production and suppress hepcidin levels using systemically delivered siRNAs targeting the EglN prolyl hydroxylases specifically in the liver, leading to improved RBC production in models of anemia caused by either renal insufficiency or chronic inflammation with enhanced hepcidin production.