bluuebunny/crossref_metadata_2025 huggingface dataset:
Erythromycin vs Metoclopramide for Facilitating Gastric Emptying and Tolerance to Intragastric Nutrition in Critically Ill Patients
Authors: MacLaren Robert , Kiser Tyree H. , Fish Douglas N. , Wischmeyer Paul E.
Published: July 2008

Background: The purpose of this study is to evaluate erythromycin vs metoclopramide for facilitating gastric emptying and tolerance to intragastric enteral nutrition (EN). Methods: Twenty critically ill patients with a gastric residual >150 mL while receiving EN were randomized to receive 4 intravenous doses of erythromycin 250 mg or metoclopramide 10 mg, each administered every 6 hours. Acetaminophen 975 mg was administered enterally at baseline and after the fourth dose. Acetaminophen peak plasma concentration (Cmax), concentration at 60 minutes (C60), time to Cmax (Tmax), and area under the concentration‐time curve from 0 to 60 minutes (AUC0‐60) were determined. Residual volumes and feeding rates were recorded. Results: Compared with baseline, erythromycin increased Cmax (9.5 ± 6.1 mg/L to 17.7 ± 11.9 mg/L, P < .01), C60 (5.4 ± 3.5 mg/L to 12.9 ± 7.6 mg/L, P< .01), and AUC0‐60 (3.5 ± 3.0 mg·h/L to 12.5± 8.7 mg·h/L, P < .01), while metoclopramide increased only AUC0‐60 (4.4 ± 2.8 mg·h/L to 9.5± 3.8 mg·hr/L, P < .05). Neither agent significantly reduced Tmax. Both erythromycin and metoclopramide reduced residual volumes (122 ± 48 mL to 36 ± 48 mL, P < .01, and 103± 88 mL to 21 ± 23 mL, P < .05, respectively) and allowed increased feeding rates (17 ± 23 mL/h to 45 ± 21 mL/h, P < .05, and 14 ± 17 mL/h to 44 ± 22 mL/h, P < .05, respectively). Conclusions: Both agents facilitate tolerance to intragastric EN, but erythromycin may be more effective than metoclopramide for enhancing gastric motility.
Differential Effects of Luminal Arginine and Glutamine on Metalloproteinase Production in the Postischemic Gut
Authors: Robinson Emily K. , Kelly Daniel P. , Mercer David W. , Kozar Rosemary A.
Published: July 2008

Background: Matrix metalloproteinases (MMPs) are a group of endopeptidases induced under inflammatory conditions in the intestine which possess the capacity to degrade components of the extracellular matrix. We have previously demonstrated that MMP‐2 expression correlates with increased inducible nitric oxide synthase (iNOS) production in the stomach and that iNOS is upregulated in the postischemic gut by the luminal nutrient arginine and repressed by luminal glutamine. We therefore hypothesized that arginine would enhance expression of MMP‐2 in the postischemic gut. Methods: Jejunal sacs were created in rats at laparotomy and filled with either 60 mM glutamine, arginine, or magnesium sulfate (osmotic control) followed by 60 minutes of superior mesenteric artery occlusion (SMAO) and 6 hours of reperfusion and compared with shams. Jejunum was harvested, and membrane type‐1 matrix metalloproteinase (MT1‐MMP), MMP‐2, and iNOS protein expression was determined by Western analysis and MMP‐9 production by gelatin zymography. Results: MMP‐2, MT1‐MMP, MMP‐9, and iNOS were all increased after SMAO compared with shams. Arginine maintained while glutamine inhibited the increase in iNOS, MT1‐MMP, and MMP‐2 expression in the postischemic gut. Pretreatment of the arginine group with a selective iNOS inhibitor blunted the induction of MMP‐2 in the postischemic gut. There was no differential modulation of MMP‐9 by the luminal nutrients. Conclusions: The arginine‐induced upregulation of iNOS may contribute to increased activity of MT1‐MMP and MMP‐2. The mechanism for this differential regulation by arginine warrants further investigation.
Glutamine Induces Heat Shock Protein Expression Via O‐Glycosylation and Phosphorylation of HSF‐1 and Sp1
Authors: Singleton Kristen D. , Wischmeyer Paul E.
Published: July 2008

Background: Glutamine (GLN) improves outcome in experimental and clinical states of illness and injury. The authors hypothesized GLN‐mediated enhancement of O‐glycosylation and subsequent phosphorylation of key transcription factors in the HSP70 pathway would lead to increased HSP70 expression following experimental sepsis. Methods: Mice underwent cecal ligation and puncture (CLP)–induced sepsis and were treated with GLN (0.75 g/kg) or a saline placebo 30 minutes after CLP. A separate group of mice was treated with mithramycin, an Sp1 inhibitor. Lung tissue was harvested at 1, 2, 6, and 24 hours after CLP and was analyzed for HSF‐1 and Sp1 O‐GlcNAc modification, α‐p‐threonine modification, and HSP70. Results: GLN increased O‐GlcNAc modification of HSF‐1 and Sp1 at 1 and 2 hours after sepsis (P < .001 vs saline). Samples immunoprecipitated for Sp1 and probed for subsequent phosphorylation showed a significant increase in nuclear α‐p‐threonine‐modified Sp1 at 2 and 6 hours after sepsis (P < .001 vs saline). GLN increased phosphorylated nuclear HSF‐1 at 1 and 2 hours after CLP (P < .001). Finally, GLN treatment increased HSP70 4‐fold (P < .01), but when treated with mithramycin, this increase was attenuated at 2, 6, and 24 hours (P< .001 vs no mithramycin treatment). Conclusions: These results indicate that GLN induces HSF‐1 and Sp1, which is known to lead to their nuclear translocation. The molecular mechanism of GLN‐mediated HSP70 expression appears to be dependent on O‐GlcNAc pathway activation and subsequent O‐glycosylation and phosphorylation of key transcription factors required for HSP70 induction.
Necessity of Testing Combustibles under Well-developed Fires
Authors: Chow W.K.
Published: July 2008

Flashover might occur rapidly as a consequence of an arson fire in a small enclosure such as a retail shop in the Far East. Testing the products, especially those made of new synthetic materials modified with additives, in well-developed fires after flashover is necessary. This refers to both full-scale burning tests on the product and bench-scale tests under higher radiative heat fluxes. Starting a room fire test with a small fire source as in the room calorimeter and stopping it upon reaching flashover would only give the `flashover propensity.' This is good enough only for designing fire safety provisions under accidental fires. Information on the heat release rate, burning duration, smoke generation rate and the toxicity of real-scale fires cannot be determined. In this article, the necessity of testing combustibles under post-flashover conditions in fire hazard assessment is pointed out. Several arrangements in retail shops are described to support the argument. Equations in the literature on estimating the maximum heat release rates for well-developed fires in those small spaces are assessed.
Predicting the Alignment of Ferromagnetic Particles in a Thermoplastic Matrix
Authors: Streilen David , Yarlagadda Shridhar , Gillespie John W.
Published: June 2008

This study investigates the use of an external magnetic field to cause the magnetic and physical alignment of ferromagnetic particles in a thermoplastic polymer matrix. The composite selected provides the best alignment involving rare-earth ferromagnetic particles in a polystyrene matrix. The rare-earth particles are able to be effectively aligned due to their high magnetic and physical anisotropy. The time-to align the particles ranged from <5 s at 498 K to approximately 60 s at 398 K. Composites with weight percents ranging from 5 to 25% are studied. A model is developed in order to predict the alignment, and is validated against experimental data. This model predicts the time-to-align based on magnetic torque balancing that would cause alignment with the viscous drag that acts to slow the particle rotation. It is found that the model describing the polymer as a Newtonian fluid follows the same trends and form as the experimental data. Potential sources of differences that prevents close fit to the data are attributed to particle interactions, sample variations, and especially the shear thinning behavior of polystyrene.
Thermomechanical Simulation of Infrared Heating Diaphragm Forming Process for Thermoplastic Parts
Authors: Labeas G.N. , Watiti V.B. , Katsiropoulos Ch. V.
Published: June 2008

An innovative methodology for the thermomechanical simulation of the infrared heating diaphragm forming (DF) process is proposed. In the first section of the paper, the heat transfer mechanisms between the infrared (IR) heating lamps and the thermoplastic plate are simulated, and the effect of the various preheating parameters on the heating time and temperature distribution is investigated. In the second section, the mechanical deformation of the thermoplastic component is simulated to enable prediction of heat losses due to the plate contact with the mold. Based on the developed simulation methodology, the main process parameters — e.g., the number, location, and power of IR lamps for optimal preheating; the heat losses during plate deformation; and the minimum required mold temperature throughout the forming phase — are derived for five different thicknesses. The optimization results show that the forming parameters considered influence the heating of the plate in a complex and interactive way; in addition, it is found that with increasing plate thickness, the heating time required to reach the desired temperature also increases.
Bernstein and poetics revisited: voice, globalization and education
Authors: Blommaert Jan
Published: June 2008

This article engages in a theory of linguistic inequality under conditions of globalization. Starting from a development of the notion of voice as the capacity to make sense, and a development of the organized and patterned `poetic' structure of actual discourse, it analyses data from police interviews with immigrants, witness statements in the South African Truth and Reconciliation Commission, and data from classroom learning environments in South Africa and Belgium. Throughout these analyses, we see that detailed attention to poetic patterning is required in order to reconstruct the voice articulated by people whose voice's would otherwise not be heard. This insight has a bearing on our understanding of competence, and issues of competence become more and more pressing in globalizing contexts.
Why we must attack Iraq: Bush's reasoning practices and argumentation system
Authors: Chang Gordon C. , Mehan Hugh B.
Published: June 2008

This three-part article describes the reasoning practices and argumentation system deployed by the Bush administration to build a case for the war on Iraq initiated in 2003. First, it analyzes the elaborate description of Saddam Hussein's evil character presented by the Bush administration and the political implications that followed from it. Then, it analyzes the methods by which these understandings were utilized to argue that Saddam Hussein's regime (1) possessed weapons of mass destruction and (2) had collaborative relationships with terrorists, including al-Qaeda. Last, it explains how the Bush administration creatively used event-sequencing strategies and syntactical formations to help forward their accusations in public against opponents who argued that the Bush administration had lacked evidence for its claims. The overall analysis demonstrates that an argumentation system was built through a dialectical process whereby one way of speaking, thinking, and acting helped to legitimize and `afford' subsequent ones.
The intertextual origins of public opinion: constructing Ebonics in the New York Times
Authors: Sclafani Jennifer
Published: June 2008

In this article, I revisit the 1996 Oakland School Board (OSB) resolution on Ebonics and perform a discourse analysis of the NeW York Times coverage of the decision. Using the framework of intertextuality, I consider how reported speech allows authors to appropriate authority and construct various stances toward the OSB decision. I discuss how other framing devices work in tandem with intertextuality to discursively construct ideologies of Ebonics. I also analyze how language from early articles is incorporated in subsequent news items, and emphasize the need to consider both discursive reproduction processes and cognitive processes of reception when using intertextual analysis to understand the origin of language ideologies. I suggest that this approach to media discourse analysis can be utilized by linguists who wish to actively shape attitudes toward stigmatized language varieties.
Conceptualizations to Advance Born Global Definition
Authors: Gabrielsson Mika , Kirpalani V H Manek , Dimitratos Pavlos , Solberg Carl Arthur , Zucchella Antonella
Published: June 2008

The ‘Born Globals’ (BGs) have now been studied for over a decade and yet the conceptualizations and theory development are at an initial phase. This article was written to clarify the definition of a BG firm, and focus on its characteristics. BGs deviate considerably when contrasted with traditional internationalizing Small to Medium-Sized Enterprises (SMEs). Most importantly their vision is global, they have global products which are of unique and specialized nature, and they have accelerated internationalization capability from inception.
Drivers of Organizational Commitment among Managers of Industrial Organizations
Authors: Mohapatra Mamta , Sharma Baldev R.
Published: June 2008

On the basis of an in-depth analysis of the responses of managers of two organizations from the same industry, one from the public sector and the other from the private sector, the authors identified the determinants of managerial organizational commitment. Thereafter, a comparison has been made of the factors thus identified with those found through other studies on the subject to demonstrate the relevance, nature and extent of the relationship between organizational commitment and its drivers. As a departure from the conventional approach, the authors have attempted to develop an unbiased model for testing the relationship between variables as would emerge from the data suo motto. In the present day dynamic scenario of increased mobility, high employee turnover and a volatile talent market, the authors contend that it is necessary to identify organization-specific drivers of organizational commitment and to formulate commitment-inducing HR policies and practices.
An Analysis of Efficiency–Profitability Relationship in Indian Public Sector Banks
Authors: Kumar Sunil
Published: June 2008

Based on cross-sectional data for 27 banks, this article has endeavoured to explore the relationship between Technical Efficiency (TE) and profitability in the Indian public sector banking industry. The technique of Data Envelopment Analysis (DEA) has been utilized to compute the TE score for each bank in the year 2005. The mean level of TE for the industry is found to be 88.5 per cent. This implies that public sector banks can produce 1.13 times as much output from the same inputs, if they operate at ‘efficiency frontier’. In 20 inefficient banks, the technical inefficiency ranges from 2.6 per cent to 36.8 per cent. Also, the banks affiliated with ‘State Bank of India Group’ outperform the banks belonging to the ‘Nationalized Banks Group’ in terms of operating efficiency. An analysis of efficiency–profitability matrix based on the efficiency scores and Return on Assets (ROA) reveals that 13 banks that fall in the ‘lucky’ and ‘underdog’ quadrants have the TE score below the industry average. The resource utilization process in these banks features the presence of considerable wastage of resources. The ‘ace’ quadrant contains 9 banks which are flagship units in the industry in terms of both efficiency and profitability. Both Andhra Bank and Corporation Bank appear as an ideal benchmark for the laggards on the efficiency and profitability dimensions of performance evaluation.
Contradictions and Confusions in Development Work
Authors: Arvidson Malin
Published: June 2008

Ambiguous practices and identities of NGOs have become a source of increasing concern for all involved in development intervention. But apart from pointing at dishonest marketing and unfortunate unintended consequences of donors' support, how can we under-stand these ambiguities? Based on an ethnographic study of local Bangladeshi NGOs, the article explores actions and behaviour of grassroots NGO staff. The article shows how, equipped with an ideal image of the altruistic development worker, the staff's encounter with reality provides them with contradictory and confusing messages as to who they should be and how they should act, resulting in disillusion and moral discord. The analysis examines concepts such as altruism, alienation, goal ambiguity, moral selving and moral discord, with an aim to expand our understanding of some moral dilemmas of development practice, its sources and unpredictable outcomes.
Exploring an Inquiry-Based Stance for Planning and Instruction in General Music Education
Authors: Scott Sheila J.
Published: July 2008

Through the experiences of Joan, we see how music teachers might re-envision instruction with attention to an inquiry-based approach for education. Within this context, students actively construct musical meanings themselves, rather than acquiring those meanings by taking part in musical activities constructed by teachers. An example of this approach is provided in the unit “Sound Escapes,” wherein teacher and students explore their musical environment from the stance of inquiry. Although the academic terminology around inquiry-based learning may be new, music teachers already incorporate the educational principles underlying these strategies by engaging students in their learning through questioning and problem solving. Through this unit, we see how teachers might encourage students' inquiries in music around a schoolwide inquiry project. These ideas are also appropriate for an inquiry stance to planning and instruction within a music program where connections are not related to schoolwide events as they are in the example depicted.
The Use of Student-Written Cases in Music Teacher Education
Authors: Hourigan Ryan
Published: July 2008

The purpose of this study was to examine the use of student-written cases as part of an instrumental music methods course. Research questions included the following: (a) What are the positive and negative issues associated with student-written cases? (b) What are preservice music teachers' perceptions as to the value of case writing as part of an instrumental music methods class? Five preservice instrumental music students who were enrolled in music teacher education at a large midwestern university agreed to participate in this study. A qualitative comparable case study design was used in this investigation. Student-written cases, the researcher's feedback, and interviews with the participants served as data for this study. Positive issues included student reflection and the building of music teacher identity through revisions and feedback. Negative issues included lack of time, the need for discussion of cases, and the need for peer feedback. Participants expressed that case writing was a valuable activity.
Sources of Pedagogical Content Knowledge
Authors: Haston Warren , Leon-Guerrero Amanda
Published: July 2008

The purpose of the study was to better understand what influences preservice instrumental music teachers' acquisition of pedagogical content knowledge (PCK). Research questions were as follows: (a) Are there identifiable applications of PCK in the preservice teachers' interactions with students? (b) To what source—apprenticeship of observation, methods classes, cooperating teachers, or intuition—do preservice teachers attribute these applications of PCK? Video recordings of preservice teachers conducting a rehearsal were collected and analyzed for events that demonstrated PCK. Exemplary excerpts were selected and reviewed with each participant. Interviews revealed a substantial amount of identifiable PCK. Apprenticeship of observation, methods courses, and cooperating teacher were each cited by 2 participants as their primary source of PCK. One participant cited intuition and methods courses equally. Determining where preservice teachers go to access PCK is the first step in redesigning college methods courses to better account for previously learned PCK.
Deep-Vein Thrombosis in the Elderly
Authors: Piazza Gregory , Seddighzadeh Ali , Goldhaber Samuel Z.
Published: July 2008

Venous thromboembolism, including deep-vein thrombosis and pulmonary embolism, is a major source of morbidity and mortality among elderly patients. To improve our understanding of elderly patients with deep-vein thrombosis, we compared 1932 patients with deep-vein thrombosis aged 70 years or older with 2554 nonelderly patients in a prospective registry of consecutive ultrasound-confirmed deep-vein thrombosis patients. The mean age of elderly patients was 78.9 ± 6.1 years compared with 51.8 ± 12.9 years in nonelderly ( P < .0001). Elderly patients were more likely to have prior recent hospitalization (49.2% vs 44.7%, P = .03), congestive heart failure (20.5% vs 9.9%, P < .0001), chronic obstructive pulmonary disease (18.2% vs 11.7%, P < .0001), and recent immobilization (50.5% vs 39.6%, P < .0001) than the nonelderly patients. Elderly patients were less likely to present with typical deep-vein thrombosis symptoms of extremity discomfort (44.4% vs 60.6%, P < .0001) and difficulty ambulating (8.4% vs 11.2%, P = .002). Only 41% of elderly patients subsequently diagnosed with deep-vein thrombosis had received any venous thromboembolism prophylaxis. In conclusion, elderly patients with deep-vein thrombosis represent a particularly vulnerable population with numerous comorbid conditions. Diagnosis can present a challenge because typical deep-vein thrombosis symptoms may be absent. Fewer than 50% of elderly patients with deep-vein thrombosis had received any venous thromboembolism prophylaxis.
Multisector Longitudinal Administrative Databases
Authors: Jonson-Reid Melissa , Drake Brett
Published: July 2008

This article describes the need for and the practicality and utility of longitudinal, multisector, and multilevel administrative data to address key issues in child maltreatment prevention and intervention. The goal is not to alert the reader to a new technology, but rather to clarify its potential and overview the process of creating such a database. Changes in technology, including data storage, computational speed, transfer systems, and software advances have made the creation of truly advanced multisector databases vastly easier than was the case even 10 years ago. We argue that this meshes well with the emerging recognition that practice and policy should be evidence based. We are entering a time when child welfare policy can now be informed by a much more complete understanding of who we serve, how they are served over time, what other social service systems they encounter, and what outcomes they commonly experience.
School District Fragmentation and Racial Residential Segregation
Authors: Bischoff Kendra
Published: July 2008

Fragmentation, or the proliferation of independent jurisdictions, is a key feature of the political structure in many metropolitan areas in the United States. This article engages sorting theories to investigate racial segregation as one potential negative consequence of school district fragmentation in metropolitan areas. The main results suggest that fragmentation does increase multiracial segregation between districts. Using a decomposable segregation measure, the author also finds that fragmentation has a negative impact on segregation within districts and no significant effect on tract-level segregation. Additionally, the results suggest that the causes of segregation may differ for various race/ethnic groups. I argue here that segregation between political units may in fact be more appropriate than segregation between smaller units, such as census tracts, if one believes that the negative consequences of segregation stem from access to and social interactions within public institutions.
Crush Initiators for Increased Energy Absorption in Composite Sandwich Structures
Authors: Stapleton Scott E. , Adams Daniel O.
Published: June 2008

Sandwich composites loaded in edgewise compression often display low energy absorbing failures due to facesheet debonding and/or buckling-type failure modes. Although crush initiators have been used to trigger progressive crushing in monolithic composites, little research has been performed to investigate the use of crush initiators with sandwich composites. In this investigation, fixture-based crush initiators were evaluated for producing progressive crushing failures and high levels of energy absorption under dynamic edgewise compression loading. Four different sandwich configurations were investigated, fabricated using woven or random mat carbon/epoxy facesheets with foam or balsa wood cores. Results show that the effectiveness of crush initiators is highly dependant upon both the facesheet and core materials used in the sandwich construction. Additionally, the initiation of progressive crushing of a sandwich composite appears to be dependent on the stiffness and strength properties of both the facesheets and core as well as the strength of the facesheet/core interfaces. These findings suggest that a sandwich composite may be designed for enhanced energy absorption through the proper selection of facesheet and core materials and geometries such that high-energy absorbing failure progressions are produced, especially with the application of a crush initiator.
Risk-based regulatory system and its effective use in health and social care
Authors: Adil Mahmood
Published: July 2008

The regulatory landscape of the health and adult social care system in England is constantly changing. The establishment of a new regulator, the Care Quality Commission (CQC), will help to integrate the regulation of the health and adult social care sector together and strengthen the safety and quality assurance for patients and service users. It will have the challenge of regulating a much bigger sector and wider variety of organizations than its predecessor bodies — i.e. Healthcare Commission, Commission for Social Care Inspection and Mental Health Act Commission. An effective and efficient regulatory approach is needed by the new regulator to achieve the objectives, without increasing the regulatory burden on the services. A risk-based regulatory approach may help to deal with those challenges by proactively identifying and assessing any key risks to the quality and safety of these services. There are a number of perceived benefits of adapting such a risk-based approach by the regulator, both in terms of effectiveness and efficiency, as experienced by many other regulators in the UK and abroad.
The Ghost is Back, Again
Authors: Yair Gad , Soyer Michaela
Published: July 2008

This paper proposes to re-read Marx's oeuvre through the cultural narrative of the Golem. It suggests that this narrative reappeared in the writings of Karl Marx throughout his career. There are three typical parts in this narrative: (a) the will of men to be empowered; (b) the use of a non-human material instrument to garner this power; culminating in (c) the instrument developing an autonomous spirit, which fatefully makes it turn against its master, leading to personal alienation and social destruction. This paper shows that the three-part composition of the Golem reappears in Marx's writings while focusing on four major topics: the dialectical analysis of history; the historical development of capitalism and its expected eventual demise; the theory of alienation; and his conception of the fetishism of machines, money, and commodities.
A Comparison of Measured and Simulated Air Pressure Conditions of a Detached House in a Cold Climate
Authors: Jokisalo Juha , Kalamees Targo , Kurnitski Jarek , Eskola Lari , Jokiranta Kai , Vinha Juha
Published: July 2008

This study discusses the evaluation exercise of a multi-zone infiltration model of an existing two-storey detached house in the cold Finnish climate. This study is performed by comparing the simulated and measured pressure conditions of the building during a 3-week test period in the heating season. The simulations are carried out using a dynamic simulation tool, IDA-ICE, which combines whole-building energy simulation and infiltration modeling. The initial data of the building model are obtained with extensive field measurements, including measurements of the airtightness and air leakage distribution of the envelope and performance of the ventilation system. The study shows that the model is realistically able to predict the air pressure conditions of a detached house in a cold climate and it is suitable for detailed infiltration and energy analyses. The model allows the prediction of the effects of leakage distribution, airflows between rooms and floors, building leakage rate, pressure conditions, and climate on infiltration and energy use.
Modeling and Database Development of Conductive and Apparent Thermal Conductivity of Moist Insulation Materials
Authors: Mar Jonathan D. , Litovsky Efim , Kleiman Jacob
Published: July 2008

Computer simulation and modeling of coupled heat and moisture transfer are becoming increasingly significant for accurate calculations of heat and moisture transfer. However, to solve their equations, the true component, λ, of apparent thermal conductivity, λapp, as a function of temperature, moisture content, and material structure is required. An approach to the development of a comprehensive database for λ is discussed. Its key feature is demonstrated by the development of a theoretical model for λ and λ app of two common building insulation materials — expanded polystyrene insulation and highly porous calcium silicate — for a wide range of temperature and moisture conditions.
Integrated Methodology for Evaluation of Energy Performance of the Building Enclosures — Part 1: Test Program Development
Authors: Bomberg Mark , Thorsell Thomas
Published: July 2008

As a result of increased concern with energy consumption in the industrial world, it is only natural to look towards the building sector to seek significant improvements to meet expectations of the society. After all, the building sector consumes more energy than the transportation sector. Yet, the procedures that are used to define the thermal performance of, for example a wall, are typically based on the tests performed on dry materials, without consideration of air and moisture movements. In other words, these tests represent arbitrary rating conditions because we know that the energy performance of materials and building assemblies are affected by moisture and air flows. It is believed that to improve their energy performance one must have more precise means of evaluation of their field performance that would also include the consideration of air and moisture transfer conditions. In the first part of this article a background for the evaluation of thermal performance by traditional testing with calibrated boxes shows that use of these tests is limited. The average heat flow that they measure is sufficient to rate the wall assemblies but insufficient to calculate its thermal performance under field conditions. To include the effect of climate on thermal performance one must use computer models that are capable of simultaneous calculations of heat, air, and moisture transfer. Effectively, to characterize energy performance of the building enclosure one must simultaneously use assembly testing and modeling, i.e., an integrated methodology. In the second part of the article, this integrated testing and modeling methodology is applied to a few selected residential and commercial walls to highlight the magnitude of air flow effects on the steady-state thermal resistance. The integrated methodology proposed by Syracuse University includes several other aspects of hygrothermal performance evaluations. Those aspects will be addressed in later parts of this article series.
CNS Hodgkin lymphoma
Authors: Gerstner Elizabeth R , Abrey Lauren E , Schiff David , Ferreri Andrés J. M , Lister Andrew , Montoto Silvia , Tsang Richard , Thiel Eckhard , Graus Francesc , Behringer Dirk , Illerhaus Gerald , Weaver Susan , Wen Patrick , Voloschin Alfredo , Harris Nancy Lee , Batchelor Tracy T
Published: June 2008

Central nervous system (CNS) involvement by Hodgkin lymphoma (HL) is rare. As a result, there is limited guidance for clinicians on how to manage these patients. Detailed information was collected on 16 patients, the largest number to date, with meningeal or parenchymal CNS-HL confirmed by histopathology (15) or CSF (1). Eight patients presented with CNS-HL at diagnosis, 2 of whom had isolated CNS disease, while 8 patients developed CNS-HL at relapse. Patients received a range of treatments including surgery or radiation alone, radiation with chemotherapy, or chemotherapy alone. Median overall survival for all 16 patients was 60.9 months from first diagnosis of HL (systemic or CNS) and 43.8 months from diagnosis of CNS-HL. Although a majority of patients have died, long-term survival is possible in patients who achieve a complete response to treatment, particularly those who present with CNS involvement or involvement of the CNS is the sole site of relapsed disease.
Imaging of the hypoxia-inducible factor pathway: insights into oxygen sensing
Authors: Berchner-Pfannschmidt U. , Frede S. , Wotzlaw C. , Fandrey J.
Published: June 2008

The transcription factor complex hypoxia-inducible factor (HIF)-1 controls the expression of most genes involved in adaptation to hypoxic conditions. HIF-1 is a heterodimer composed of oxygen-labile HIF-α and constitutively expressed HIF-β subunits. The oxygen-dependent regulation of HIF-α is a multistep process that includes degradation under normoxia but stabilisation, translocation into the nucleus and activation under hypoxic conditions.

The present paper summarises the contributions of optical methods to the understanding of oxygen-dependent regulation of the HIF-1 pathway. The tissue- and cell-specific distribution of HIF-α was visualised immunohistochemically and by immunofluorescence. Transcriptional activity of HIF-1 was monitored using green fluorescent protein as a reporter under control of hypoxia response elements in living cells, spheroids and tumour tissues in living mice. With cyan and yellow variants of green fluorescent protein fused to HIF subunits and regulatory proteins, subcellular distribution, migration and interaction were imagedin vivoby means of fluorescence recovery after photo-bleaching and fluorescence resonance energy transfer. Noninvasive imaging of these cellular and molecular processes by laser scanning microscopy complementsex vivomolecular biology assays and provides an additional spatial and temporal dimension to the understanding of the HIF-1 pathway.
Possible role of imatinib in clinical pulmonary veno-occlusive disease: Fig. 1—
Authors: Overbeek M. J. , van Nieuw Amerongen G. P. , Boonstra A. , Smit E. F. , Vonk-Noordegraaf A.
Published: June 2008

The platelet-derived growth factor receptor inhibitor imatinib has demonstrated clinical and haemodynamical improvement in both animal models of pulmonary hypertension (PH) and patients with PH. It has been suggested that anti-proliferative effects on pulmonary vascular smooth muscle cells are responsible for these beneficial effects.

The current study describes a patient with pulmonary arterial hypertension associated with a suspected pulmonary veno-occlusive disease.

Treatment with imatinib resulted in rapid clinical improvement and decrease of ground-glass opacities and lobular septal thickening on high-resolution computed tomography.

Based on these findings and onin vitroeffects of imatinib on permeability of the endothelium, the authors hypothesise that the rapid clinical outcome is partly due to effects of imatinib on vascular integrity.
The aftermath of the Merck's HIV vaccine trial
Authors: Iaccino Enrico , Schiavone Marco , Fiume Giuseppe , Quinto Ileana , Scala Giuseppe
Published: July 2008

The recently released results of the Merck's Phase IIb "test-of concept" vaccine trials have shown no protection from HIV-1 infection in the vaccinated group compared with a control group vaccinated with placebo. The study was designed to test the Merck's MRKAd5 trivalent candidate vaccine. The vaccine formulation was expected to stimulate a HIV-specific T cell immune response and to either prevent infection, or to reduce the levels of the viral load in vaccinated subjects. Upon the first evaluation of the interim data, the independent Data and Safety Monitoring Board (DSMB) underscored no protection from HIV-1 infection in the vaccine-inoculated volunteers compared with the control group; accordingly, the vaccine trial was stopped. This disappointing outcome warrants a critical analysis of the current vaccine studies and calls for a renewed effort toward a rational design of novel immunogens to be tested in large primate trials.
Signaling through ephrin-A ligand leads to activation of Src-family kinases, Akt phosphorylation, and inhibition of antigen receptor-induced apoptosis
Authors: Holen Halvor L , Shadidi Mohsen , Narvhus Kristina , Kjøsnes Oddveig , Tierens Anne , Aasheim Hans-Christian
Published: July 2008

Eph receptor tyrosine kinases and ephrins play important roles in diverse biological processes such as migration, adhesion, and angiogenesis. Forward and reverse signaling has been reported in receptor- and ligand-bearing cells. The ligands can be divided into the transmembrane ephrin-B family and the GPI-anchored ephrin-A family. Here, we show expression of ephrin-A ligands on CD4+ T cells cultured in medium with human serum and the T cell line Jurkat TAg and on cells isolated from patients with T cell lymphomas and T cell leukemias. Functional role and identification of proteins involved in ephrin-A signaling were investigated here in the T cell line Jurkat TAg. Signaling through ephrin-A induces phosphorylation of several proteins, including the Src kinases Lck and Fyn. In addition, PI-3K is activated, shown by induced phosphorylation of the Akt kinase. An ephrin-A signaling complex could be isolated, containing several phosphorylated proteins including Lck and Fyn. Interestingly, we show that signaling through ephrin-A in Jurkat TAg cells, initiated by interaction with the EphA2 receptor, leads to inhibition of activation-induced cell death. To conclude, ephrin-A signaling in Jurkat TAg cells leads to induced phosphorylation of several proteins including Lck, Fyn, and Akt. A consequence of ephrin-A signaling is inhibition of antigen receptor-induced apoptosis.
Disability rights and mental health in the UK: recent
developments of the Disability Discrimination Act
Authors: Sayce Liz , Boardman Jed
Published: June 2008

The Disability Discrimination Act, passed by Parliament in 1995 and amended
in 2001 and 2005, covers people in Britain with physical or mental
impairments that have a substantial and long-term adverse effect on their
ability to carry out normal day-to-day activities. The Act has been
important in setting a framework for good practice and it can stimulate more
systemic change through formal investigations of organisations or whole
sectors, and through the Disability Equality Duty, in force since December
2006. The Disability Discrimination Act has implications for people working
in mental health services when they are considering employment and
educational opportunities for service users, and when they are considering
how to redress systemic disadvantage, including inequalities in physical
health.
Neuropathica diabolica
Authors: Bourke Julius , Turner Benjamin
Published: June 2008

In 1951 Asher described chronic factitious disorder characterised by dramatic presentations, histories and recurrent admissions. Asher initially described three types of presentation – acute abdominal (laparotamophilia migrans), haemorrhagic (haemorrhagia histrionica) and neurological (neuropathica diabolica). Factitious disorder is now included in both DSM–IV and ICD–10. Numerous case reports exist but the evidence base for effective management strategies remains relatively sparse. It is an uncommon disorder most often encountered in liaison psychiatry that remains difficult to manage and characteristically stimulates strong countertransference reactions in the teams involved. Psychiatric involvement remains vital in such cases although poor engagement is often a significant obstruction. As an illustration, we present a vignette based on case of a previously unreported variant of the neurological category involving Guillain-Barré syndrome.
Inflammation and its relevance to psychiatry
Authors: Cavanagh Jonathan , Mathias Christopher
Published: June 2008

Depression is increasingly recognised as a major public health problem
worldwide. The heterogeneity of this condition implies that there may be
several neurobiological pathways to depression. This article attempts to
explore a pathway that links depression with the inflammatory response.
Associations linking inflammation and chronic immune activation with
depression have been noted, particularly in the context of (a) medical
disorders with inflammatory pathophysiology and (b) immunotherapy for cancer
and hepatitis C. Acute coronary syndrome is given as an example of how the
inflammatory process might result in depression, and potential mechanisms
are discussed. These include: direct action of pro-inflammatory cytokines on
the serotonin system, with specific reference to the serotonin transporter;
action of cytokines on the hypothalamic–pituitary–adrenal axis; and effects
of pro-inflammatory cytokines on neurogenesis in the hippocampus. Reference
is made to the potential anti-inflammatory effects of antidepressant drugs
and antidepressant effects of anti-inflammatory treatments.
Improving mental healthcare for ethnic minorities
Authors: McKenzie Kwame
Published: June 2008

Multicultural societies offer a significant challenge to mental health services. Different groups have different rates of illness, illness models, ideas of what a suitable pathway of care is and what suitable care looks like. Trying to set up services to meet all these needs can be difficult. There may need to be modifications in clinical practice, service configuration and the way services are commissioned. Ethnic minority communities face complex problems and, consequently, strategies to deal with them can be complex, requiring support from the non-statutory sector, social services and other branches of medicine. Service development often needs research, staff training, race-equality schemes and sufficient funding to make change possible. I offer here a scheme for considering how to think through service development in this area as well as introducing the government strategy, Delivering Race Equality.
Recovery and the medical model
Authors: Mountain Deborah , Shah Premal J.
Published: June 2008

The recovery approach is much in vogue, initiated by the user movement and
embraced by politicians. Users and politicians have a variety of opinions
about how it fits with professional psychiatric practice – some view
recovery and professional practice as compatible, others view them as
mutually exclusive, naming professional practice the ‘medical model’. This
editorial explores the relationship between the medical model and the
recovery approach. We argue that both have multiple points of similarity,
and that applying the medical model to the recovery approach has the
potential to significantly influence psychiatric practice.
Rural mental health
Authors: Nicholson Laura Anne
Published: June 2008

A significant proportion of people live and work in rural areas, and rural mental health is important wherever psychiatry is practised. There are inherent difficulties in conducting rural research, due in part to the lack of an agreed definition of rurality. Mental health is probably better in rural areas, with the exception of suicide, which remains highest in male rural residents. A number of aspects of rural life (such as the rural community, social networks, problems with access, and social exclusion) may all have particular implications for people with mental health problems. Further issues such as the effect of rural culture on help-seeking for mental illness, anonymity in small rural communities and stigma may further affect the recognition, treatment and maintenance of mental health problems for people in rural areas. Providing mental health services to remote and rural locations may be challenging.
Big boys do cry
Authors: Smith Michael J.
Published: June 2008

Do men comprise a minority group whose distress would be better understood
by positing a new ‘male depressive syndrome’? Or have gender differences
been overemphasised for political reasons that are clinically unhelpful? An
unedifying list of mistaken categories of depression advocates caution.
Is there a science of recovery and does it
matter?
Authors: Holloway Frank
Published: June 2008

In this issue of APT Mountain & Shah seek to reconcile
the currently fashionable ‘recovery’ paradigm of mental healthcare with the
distinctly unfashionable ‘medical model’ of psychiatric practice. I argue
that their article raises more questions than it answers – not least whether
the recovery concept is amenable to empirical analysis.
Mental state decoding v. mental state reasoning as a mediator between cognitive and social function in psychosis
Authors: McGlade Nicola , Behan Caragh , Hayden Judy , O'Donoghue Therese , Peel Rosie , Haq Farhan , Gill Michael , Corvin Aiden , O'Callaghan Eadbhard , Donohoe Gary
Published: July 2008

Theory of mind deficits in schizophrenia have been parsed into mental state reasoning and mental state decoding components. We report that mental state decoding as measured by the ‘Eyes task’ better predicted social function than mental state reasoning as measured by the ‘Hinting task’ in 73 out-patients with chronic schizophrenia. Mental state decoding task performance also partly mediated the influence of basic neuropsychological performance on social function. We discuss these findings in terms of the accumulating evidence that mental state decoding has particular relevance for understanding deficits in social function in schizophrenia
Wake-up call for British psychiatry
Authors: Craddock Nick , Antebi Danny , Attenburrow Mary-Jane , Bailey Anthony , Carson Alan , Cowen Phil , Craddock Bridget , Eagles John , Ebmeier Klaus , Farmer Anne , Fazel Seena , Ferrier Nicol , Geddes John , Goodwin Guy , Harrison Paul , Hawton Keith , Hunter Stephen , Jacoby Robin , Jones Ian , Keedwell Paul , Kerr Mike , Mackin Paul , McGuffin Peter , MacIntyre Donald J. , McConville Pauline , Mountain Deborah , O'Donovan Michael C. , Owen Michael J. , Oyebode Femi , Phillips Mary , Price Jonathan , Shah Prem , Smith Danny J. , Walters James , Woodruff Peter , Young Allan , Zammit Stan
Published: July 2008

The recent drive within the UK National Health Service to improve psychosocial care for people with mental illness is both understandable and welcome: evidence-based psychological and social interventions are extremely important in managing psychiatric illness. Nevertheless, the accompanying downgrading of medical aspects of care has resulted in services that often are better suited to offering non-specific psychosocial support, rather than thorough, broad-based diagnostic assessment leading to specific treatments to optimise well-being and functioning. In part, these changes have been politically driven, but they could not have occurred without the collusion, or at least the acquiescence, of psychiatrists. This creeping devaluation of medicine disadvantages patients and is very damaging to both the standing and the understanding of psychiatry in the minds of the public, fellow professionals and the medical students who will be responsible for the specialty's future. On the 200th birthday of psychiatry, it is fitting to reconsider the specialty's core values and renew efforts to use psychiatric skills for the maximum benefit of patients