bluuebunny/crossref_metadata_2025 huggingface dataset:
Beyond metatheory?
Authors: Reus-Smit Christian
Published: September 2013

Metatheory is out of fashion. If theory has a purpose, we are told, that purpose is the generation of practically relevant knowledge. Metatheoretical inquiry and debate contribute little to such knowledge and are best bracketed, left aside for the philosophers. This article challenges this all-too-common line of reasoning. First, one can bracket metatheoretical inquiry, but this does not free one’s work, theoretical or otherwise, of metatheoretical assumptions. Second, our metatheoretical assumptions affect the kind of practically relevant knowledge we can produce. If our goal is the generation of such knowledge, understanding how our metatheoretical assumptions enable or constrain this objective is essential. Today, the most sustained articulation of the ‘bracket metatheory thesis’ is provided by analytical eclecticists, who call on the field to leave behind metatheoretical debate, concentrate on concrete puzzles and problematics, and draw selectively on insights from diverse research traditions to fashion middle-range theoretical explanations. Yet by forgoing metatheoretical reflection, analytical eclecticists fail to see how their project is deeply structured by epistemological and ontological assumptions, making it an exclusively empirical-theoretic project with distinctive ontological content. This metatheoretical framing significantly impedes the kind of practically relevant knowledge eclecticist research can generate. Practical knowledge, as both Aristotle and Kant understood, is knowledge that can address basic questions of political action — how should I, we, or they act? Empirical-theoretic insights alone cannot provide such knowledge; it has to be integrated with normative forms of reasoning. As presently conceived, however, analytical eclecticism cannot accommodate such reasoning. If the generation of practical knowledge is one of the field’s ambitions, greater metatheoretical reflection and a more expansive and ambitious form of eclecticism are required.
International theory in a post-paradigmatic era: From substantive wagers to scientific ontologies
Authors: Jackson Patrick Thaddeus , Nexon Daniel H.
Published: September 2013

Concerns about the end of International Relations theory pivot around at least three different issues: the fading of the ‘paradigm wars’ associated with the 1990s and early 2000s; the general lack of any sort of ‘great debate’ sufficient to occupy the attention of large portions of the field; and claims about the vibrancy of middle-range theorizing. None of these are terribly helpful when it comes to assessing the health of International Relations theory. We argue that international theory involves scientific ontologies of world politics: topographies of entities, processes, mechanisms, and how they relate to one another. Understood this way, the state of International Relations theory looks strong: there is arguably more out there than ever before. Ironically, this cornucopia helps explain concerns regarding the end of International Relations theory. In the absence of a ‘great debate,’ let alone ways of organizing contemporary International Relations theory, this diversity descends into cacophony. We submit that three major clusters of international theory are emerging: choice-theoretic, experience-near, and social-relational. These clusters map onto two major axes of contention: (1) the degree that actors should be treated as autonomous from their environment; and (2) the importance of thickly contextual analysis. These disputes are both field-wide and high-stakes, even if we do not always recognize them as such.
The end of International Relations theory?
Authors: Dunne Tim , Hansen Lene , Wight Colin
Published: September 2013

With a view to providing contextual background for the Special Issue, this opening article analyses several dimensions of ‘The end of International Relations theory?’ It opens with a consideration of the status of different types of theory. Thereafter, we look at the proliferation of theories that has taken place since the emergence of the third/fourth debate. The coexistence and competition between an ever-greater number of theories begs the question: what kind of theoretical pluralism should IR scholars embrace? We offer a particular account of theoretical engagement that is preferable to the alternatives currently being practised: integrative pluralism. The article ends on a cautiously optimistic note: given the disciplinary competition that now exists in relation to explaining and understanding global social forces, International Relations may find resilience because it has become theory-led, theory-literate and theory-concerned.
Development of a new model to engage patients and clinicians in setting research priorities
Authors: Pollock Alex , George Bridget St , Fenton Mark , Crowe Sally , Firkins Lester
Published: September 2013

Objectives

Equitable involvement of patients and clinicians in setting research and funding priorities is ethically desirable and can improve the quality, relevance and implementation of research. Survey methods used in previous priority setting projects to gather treatment uncertainties may not be sufficient to facilitate responses from patients and their lay carers for some health care topics. We aimed to develop a new model to engage patients and clinicians in setting research priorities relating to life after stroke, and to explore the use of this model within a James Lind Alliance (JLA) priority setting project.

Methods

We developed a model to facilitate involvement through targeted engagement and assisted involvement (FREE TEA model). We implemented both standard surveys and the FREE TEA model to gather research priorities (treatment uncertainties) from people affected by stroke living in Scotland. We explored and configured the number of treatment uncertainties elicited from different groups by the two approaches.

Results

We gathered 516 treatment uncertainties from stroke survivors, carers and health professionals. We achieved approximately equal numbers of contributions; 281 (54%) from stroke survivors/carers; 235 (46%) from health professionals. For stroke survivors and carers, 98 (35%) treatment uncertainties were elicited from the standard survey and 183 (65%) at FREE TEA face-to-face visits. This contrasted with the health professionals for whom 198 (84%) were elicited from the standard survey and only 37 (16%) from FREE TEA visits.

Conclusions

The FREE TEA model has implications for future priority setting projects and user-involvement relating to populations of people with complex health needs. Our results imply that reliance on standard surveys may result in poor and unrepresentative involvement of patients, thereby favouring the views of health professionals.
Genre organization in specialized discourse: Disciplinary variation across university textbooks
Authors: Parodi Giovanni
Published: September 2013

Not many studies have focused on the analysis of the rhetorical organization of a genre and the respective frequency of occurrence of moves and steps as they occur in a corpus across disciplines – particularly, with a complementary qualitative-quantitative approach. This article aims to become a step in helping to fill this gap in research on Spanish. In this way, the textbook genre, the occurrence of its rhetorical macro-moves, moves and steps and disciplinarity are the central focus of this study. More specifically, in this article we seek to determine and to compare the frequency of occurrence of macro-moves, moves and steps in a corpus of 126 university textbooks across the academic discourse of four disciplines. We distinguish the major areas of knowledge (Basic Sciences and Engineering and Social Sciences and Humanities) as well as the specific disciplines (Social Work, Psychology, Industrial Chemistry and Construction Engineering). The main findings show there are differences between the occurrence of some discourse moves and steps across the texts of disciplines under study, which reveals a distinctive feature in the didactic component of textbooks. So we can infer that knowledge construction process through this genre is not carried out in the same way and that disciplinarity plays an important role in the diversifying organizational discourse patterns detected.
On the future of anthropology: Fundraising, the job market and the corporate turn
Authors: Duranti Alessandro
Published: September 2013

Building on the author’s participant observation in academic leadership roles over the last two decades, this article reviews four areas of engagement for anthropology within the larger context of US higher education: a) fundraising; b) training and placing of students; c) the so-called ‘corporate turn’ and its alleged effects on current evaluation measures; and d) the popularity of anthropology among college students in the context of a highly self-critical discourse among professional anthropologists and a challenging academic job market. On the basis of the data presented, I argue that (1) fundraising activities are nothing new in anthropology and might play a role in continuing to support a holistic view of anthropology, (2) programs in anthropology should embrace rather than be skeptical of the potential for the employment of anthropologists in other fields or non-academic professions, (3) being students of society, anthropologists should be more engaged in the running of the university including its financial aspects and should teach their students to be more entrepreneurial, and (4) the applied and public aspects of anthropological research should be foregrounded and rewarded.
Technological indeterminacy: Medium, threat, temporality
Authors: de Abreu Maria José A
Published: September 2013

For some time now technological determinism, a theory that, broadly speaking, explains the relation between technology and humans in terms of historical causation, has been the target of intense criticism. In this article, I reassess a few of these criticisms in light of what I consider constitutes a new temporal sensibility. Rather than explained in causational terms, I characterize this sensibility as a tendency to place causes in the future. Placing causes in the future means a conversion of technological determinism into an instance of indeterminacy. This then allows religious groups, political actors and global media corporations to act while an imminent future effects the present. Referencing the journalistic mediations by global news broadcasting corporations of events such as the 2011 Arab Spring uprisings or Pastor Terry Jones’s threat to burn copies of the Quran on the anniversary of the 9/11 attacks, this study focuses on the temporal medium of threat to offer an alternative epistemology on time and mediation in politics, religion and media.
Contact modeling and inverse dynamics identification of the handspring front somersault in pike position
Authors: Dziewiecki Krzysztof , Blajer Wojciech , Mazur Zenon , Czaplicki Adam
Published: September 2013

Handspring front somersaults are explosive and exciting events consisting of several distinct ballistic motion and support phases, in which the gymnast contacts the springboard/mat and the table, respectively, with his feet and hands. The purpose of this article is to develop an effective formulation for the inverse dynamics simulation of all the vaults that are suitable for analyses in two dimensions. A planar model of a jumper composed of 16 rigid segments connected by 15 hinge joints is used in the computations. The determinate inverse dynamics formulation, developed in Cartesian coordinates of the segments, allows for the explicit estimation of the resultant muscle torques in the joints and external reactions (up to three components) during the analyzed vaults. By using a projection method, the analysis is then confined to the lower limbs. A computational scheme for the indeterminate inverse dynamics is proposed to distribute the previously assessed net torques in the limbs into the respective muscle forces based on static optimization solution. The reaction forces in the lower limb joints are finally determined following the projection-based formulation. Some numerical results of the inverse dynamics simulation of the handspring front somersault in pike position are reported.
An aikidōka’s contribution to the teaching of qualitative inquiry
Authors: Noy Chaim
Published: September 2013

Teaching qualitative research methods on the one hand, and Martial Arts, on the other, seem to have only little in common: one is academic, and one is not; one is essentially somatic and kinesthetic, and the one is not. Yet during two decades of teaching and practicing both I repeatedly noticed a fruitful interaction between these ‘arts’, which I experienced as exciting embodied insights that shed light on both spheres. In this article I wish to ‘translate’ three concepts used in martial arts pedagogy, specifically in Aikidō, to the teaching of qualitative methods and methodology.
Vacability and sociability as touristic attraction
Authors: Blichfeldt Bodil S , Mikkelsen Marie
Published: September 2013

Researchers sometimes portray the tourist as someone who travels the world searching for authentic experiences and scorns both ‘being a tourist’ and other tourists. However, in drawing on two studies of seemingly mundane kinds of holidays, this article points to two under-researched dimensions. The first dimension is ‘sociability’ and relates to the skill or tendency of being social during the holidays. This dimension covers tourists’ searches for meaningful social interactions with other tourists and how some tourists, instead of scorning other tourists, actively and deliberately go on holiday in order to ‘be’ with other tourists. The second dimension is labelled ‘vacability’ and is defined as the quest to truly ‘vacare’ and to the tourists’ ability to be vacant. This dimension relates to some tourists’ wish to be ‘freed from experiences’ during the holidays and how the choice of a seemingly mundane type of holiday may prove superior in making the tourist able to indulge in vacability.
Practitioner perspectives on risk: Using governmentality to understand contemporary probation practice
Authors: Hardy Mark
Published: September 2013

This article reports findings from a study investigating if, how and why concerns regarding risk are impacting on probation work in England and Wales from the practitioner perspective. It begins with a review of key debates regarding how ‘the rise of risk’ has come about and with what effects. I then briefly explain what the study entailed – its aims and objectives, methods and theoretical framework (governmentality). Findings from the study are then presented. These are at odds with the ‘critical consensus’ that risk has dramatically altered the nature of practice. The article concludes with discussion of the implications of these findings for ongoing debates regarding the significance of risk in probation practice.
Gene Expression Profile and Functional Analysis of Alzheimer’s Disease
Authors: Chen Fei , Guan Qiang , Nie Zhi-Yu , Jin Ling-Jing
Published: September 2013

Background:

Alzheimer’s disease (AD) is a complex neurodegenerative disorder with largely unknown genetic mechanisms. Identifying altered neuronal gene expression in brain regions differentially affected by AD may provide the diagnostic or therapeutic targets of AD.

Methods:

The gene expression profile of AD was analyzed with bioinformatics. Function analysis was performed with Database for Annotation, Visualization and Integrated Discovery (DAVID), and TransFind was used to predict the possible transcriptional regulators in AD. Finally, connectivity map (cMap) database was used to explore small molecules targeted for AD.

Results:

The AD gene signatures associated with 6 different brain regions were identified. Functional analysis revealed that biological processes involved with metabolism, protein ubiquitination, and vasculature development were found dysregulated, and synaptic signaling pathways were found perturbated in AD. The WT1 was identified as an important transcriptional regulator in AD, and cMap database predicted that small molecules, such as histone deacetylase (HDAC) inhibitor, may be candidate drugs in the treatment of AD.

Conclusion:

According to our in silico analysis, Wilms' tumor suppressor may play regulatory roles in AD development and progress. The HDAC inhibitor could possibly be used to treat AD.
Needs of People With Dementia in Long-Term Care
Authors: Cadieux Marie-Andrée , Garcia Linda J. , Patrick Jonathan
Published: September 2013

With the aging of the population and the projected increase of dementia in the coming years, it is crucial that we understand the needs of people with dementia (PWD) in order to provide appropriate care. The aim of this study is to determine, using the best evidence possible, the care needs of PWD living in long-term care (LTC). A total of 68 studies, published between January 2000 and September 2010, were identified from six databases. From the selected studies, 19 needs of PWD were identified. The existing evidence suggests that psychosocial needs such as the need to engage in daily individualized activities and care must not be ignored in LTC. This review aims to provide a clearer picture of the needs of this growing patient population.
Caregivers of Patients With Dementia in Chinese Mainland
Authors: Liu Jia , Wang Lu-Ning
Published: September 2013

Objective:

We aimed to systematically search and summary the publications from 1990 to 2012 on Chinese dementia caregivers to understand the development in this field.

Methods:

We searched Pubmed and Chinese medical databases for all the original publications on the dementia caregivers in Chinese mainland until December 31st, 2012.

Results:

126 papers involved 117 studies with 11178 participants were analyzed. The earliest study on Chinese caregivers with dementia patients was published in 1990. Most studies (92%) were reported in Chinese. 85% of studies were published between 2006 and 2012, while 42% were carried out in the most developed regions.

Conclusions:

In spite of the late start, the number of publications on Chinese dementia caregivers has rapidly increased since 2006. However, the quality of studies is still need to improve in sample size, intervention and outcome design. More attentions, policies and funds should be given to support the future study in dementia caregivers.
HDAC inhibition suppresses bladder cancer cell adhesion to collagen under flow conditions
Authors: Juengel Eva , Santos Sascha Meyer dos , Schneider Tanja , Makarević Jasmina , Hudak Lukasz , Bartsch Georg , Haferkamp Axel , Wiesner Christoph , Blaheta Roman A
Published: September 2013

The influence of the histone deacetylase (HDAC)-inhibitor, valproic acid (VPA), on bladder cancer cell adhesion in vitro was investigated in this paper. TCCSUP and RT-112 bladder cancer cells were treated with VPA (0.5 or 1 mM) twice or thrice weekly for 14 days. Controls remained untreated. Tumour cell interaction with immobilized collagen was evaluated by a flow-based adhesion assay using a shear force of 2 or 4 dyne/cm2. The effects of VPA on the integrin adhesion receptors α3, α5, β1, β3 and β4 were assessed by flow cytometry to determine integrin surface expression and by western blotting to determine the cytoplasmic integrin level. VPA of 0.5 mM and 1 mM significantly prevented binding of both RT-112 and TCCSUP cells to collagen, compared with the untreated controls. Adhesion was reduced to a higher extent when RT-112 (subjected to 2 dyne/cm2) or TCCSUP (subjected to 2 or 4 dyne/cm2) tumour cells were treated with VPA three times a week, compared to the two times a week protocol. VPA caused a significant up-regulation of the integrin α3, α5, β1, β3 and β4 subtypes on the TCCSUP cell surface membrane. In RT-112 cells, only integrin α5 was elevated on the cell surface following VPA exposure. Western blotting revealed an up-regulation of α3, α5, β3 and β4 integrins and down-regulation of the integrin β1 protein by VPA in TCCSUP. VPA also up-regulated α5 and down-regulated β1 integrin in RT-112 cells, but also reduced α3 and β3 in TCCSUP. VPA exerted adhesion-blocking properties on bladder cancer cells under physiologic flow conditions. The effects were accompanied by distinct modifications of the integrin expression profile, which differ depending on the cell lines used. Application of VPA might be an innovative option to prevent bladder cancer dissemination.
Salvianolic acid B inhibits hepatic stellate cell activation through transforming growth factor beta-1 signal transduction pathwayin vivoandin vitro
Authors: Tao Yan-Yan , Wang Qing-Lan , Shen Li , Fu Wen-Wei , Liu Cheng-Hai
Published: September 2013

Salvianolic acid B (Sal B) is a major water soluble component extracted from Radix Salviae miltiorrhizae, a traditional Chinese herb widely used for treating cardiovascular and hepatic diseases. Sal B has been reported to inhibit transforming growth factor (TGF)-β1-stimulated hepatic stellate cells (HSCs) activation and collagen type I expression. In this study, we further investigated the mechanisms of Sal B on liver fibrosis relating to TGF-β/Smads signalling pathway, especially to TGF-β1 receptors. Liver fibrosis model was induced by intraperitoneal injection of dimethylnitrosamine (DMN) for four weeks. Rats were randomly divided into three groups: normal, model, and Sal B groups. Rats in Sal B group were treated by oral administration of Sal B for four weeks from the first day of DMN exposure. Hydroxyproline (Hyp) content in liver tissue was assayed using Jamall's method and collagen deposition was visualized using Sirius red staining. HSCs were isolated from normal rats, and were cultured primarily in uncoated plastics. At day 4 after isolation, cells were stimulated with 2.5 ng/mL TGF-β1, and treated with 1 and 10 µmol/L Sal B and 10 µmol/L SB-431542 (TβR-I inhibitor) for 24 h, respectively. Cell proliferation was examined with 5-ethynyl-2'-deoxyuridine assay. The expressions of alpha smooth muscle actin (α-SMA) and Smad3 were assayed by immunofluorescent stain and Western blotting. The expression of TβR-I was analysed by Western blotting and real-time polymerase chain reaction. The activity of TβR-I kinase was measured by ADP-Glo kinase assay. The results showed that Sal B could inhibit collagen deposition and reduce Hyp content significantly, and decrease expressions of TGF-β1 and TβR-I in fibrotic liver in vivo. Also, Sal B decreased the expressions of α-SMA and TβR-I, inhibited Smad3 nuclear translocation and down-regulated TβR-I kinase activity in vitro. These findings suggested that Sal B could prevent HSCs activation through TGF-β signalling pathway, i.e. inhibiting TGF-β1 expression, activity of TβR-I kinase and Smads phosphorylation.
Evaluation of therapeutic efficacy of Majoon Suranjan, a Unani formulation, in the treatment of rheumatoid arthritis: an experimental study
Authors: Subramaneyaan Mythily , Yasmeen Shagufta , Ahmed Rafat S , Arora Vinod K , Tripathi Asok K , Banerjee Basu D
Published: September 2013

Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disorder. Allopathic treatments for RA have various side-effects and limitations. Majoon Suranjan (MS) is a polyherbal Unani formulation used to treat RA. Although it is widely used, evidence-based toxicity and efficacy data are not available. The present study was designed to assess the safety and therapeutic efficacy of MS in experimental animals. Acute (14 days) and long-term (90 days) toxicity studies were carried out at three doses of MS, i.e. 440, 880 and 1760 mg/kg body weight in male and female Wistar rats. Arthritis was induced in male rats by immunization with bovine collagen type II and they were treated with vehicle, methotrexate (0.25 mg/kg body weight, intraperitoneal once weekly) and MS (880 mg/kg body weight, orally, daily) for 20 days. Serum rheumatoid factor, anticyclic citrullinated peptide antibody, antinuclear antibody and C-reactive protein (CRP) were estimated. None of the rats exhibited overt toxicity or mortality and MS was found to be safe at the tested doses. No abnormal findings were observed in haematological and biochemical parameters, necropsy and histopathology at therapeutic effective dose. MS significantly inhibited the footpad swelling in arthritic rats while serum autoantibodies and CRP levels were significantly decreased. The present study demonstrates that at therapeutic doses, the Unani medicine, MS is relatively safe. Furthermore, MS was found to be effective in decreasing the biomarkers of RA, thus providing scientific evidence in support of its traditional use in the treatment of RA.
Intermedin1–53 attenuates vascular smooth muscle cell calcification by inhibiting endoplasmic reticulum stress via cyclic adenosine monophosphate/protein kinase A pathway
Authors: Chang Jin-Rui , Duan Xiao-Hui , Zhang Bao-Hong , Teng Xu , Zhou Ye-Bo , Liu Yue , Yu Yan-Rong , Zhu Yi , Tang Chao-Shu , Qi Yong-Fen
Published: September 2013

We previously reported that endoplasmic reticulum (ER) stress-mediated apoptosis participated in vascular calcification. Importantly, a novel paracrine/autocrine peptide intermedin1–53 (IMD1–53) in the vasculature inhibited vascular calcification in rats. But the mechanisms needed to be fully elucidated. Vascular smooth muscle cells (VSMCs) calcification was induced by CaCl2 and β-glycerophosphate. Tunicamycin (Tm) or dithiothreitol (DTT) was used to induce ER stress. We found that IMD1–53 (10−7 mol/L) treatment significantly alleviated the protein expression of ER stress hallmarks activating transcription factor 4 (ATF4), ATF6, glucose-regulated protein 78 (GRP78) and GRP94 induced by Tm or DTT. ER stress occurred in early and late calcification of VSMCs but was inhibited by IMD1–53. These inhibitory effects of IMD1–53 were abolished by treatment with the protein kinase A (PKA) inhibitor H89. Pretreatment with IMD1–53 decreased the number of apoptotic VSMCs and downregulated protein expression of cleaved caspase 12 and C/EBP homologous protein (CHOP) in calcified VSMCs. Concurrently, IMD1–53 restored the loss of VSMC lineage markers and ameliorated calcium deposition and alkaline phosphatase activity in calcified VSMCs as well. The observation was further verified by Alizarin Red S staining, which showed that IMD1–53 reduced positive red nodules among calcified VSMCs. In conclusion, IMD1–53 attenuated VSMC calcification by inhibiting ER stress through cAMP/PKA signalling.
Lower Extremity Amputations
Authors: Shah Samir K. , Bena James F. , Allemang Matthew T. , Kelso Rebecca , Clair Daniel G. , Vargas Lina , Kashyap Vikram S.
Published: September 2013

Background:

Tissue loss or gangrene in the setting of lower extremity peripheral artery disease (PAD) may result in amputation. Previous studies have demonstrated elevated mortality rates after major transtibial and transfemoral amputation. Also, amputation of 1 leg may be associated with subsequent major amputation of the contralateral leg. The aim of our study was to identify patient variables associated with mortality and contralateral amputation.

Methods:

We reviewed the medical records of patients who underwent transfemoral or transtibial amputation secondary to PAD from 2004 to 2009. A total of 454 consecutive major amputations were performed on 391 patients, with 63 of these having a subsequent contralateral amputation. Standard demographic information, comorbidities, prior vascular interventions, and relevant procedural information were extracted from patient records. Kaplan-Meier estimates of survival were calculated. Cox proportional hazard models were used to estimate the risk of death and contralateral amputation. Multivariate Cox proportional hazards models were fit for all variables shown to be marginally associated in the univariate model.

Results:

In 391 amputees, the mean age was 67.3 years, 63% were male and 62% were caucasian. Patients had high rates of diabetes (63%), hypertension (83%), renal insufficiency (35%), hyperlipidemia (51%), and prior ipsilateral vascular intervention (75%). Seventy percent of patients had below-knee amputations. Perioperative mortality was 9.2% (n = 36). Survival at 12 and 24 months was 70% (95% confidence interval [CI], 65%-74%) and 60% (95% CI, 55%-65%), respectively. Multivariate analysis demonstrated that several independent factors were detrimental to survival including chronic obstructive pulmonary disease (hazard ratio [HR] 1.82, P = .002), dialysis dependence (HR 2.50, P < .001), high cardiac risk (HR 2.20, P < .001), and guillotine amputation (HR 2.49, P = .004). Dialysis (HR 2.42, P = .002) and revision of the index ipsilateral amputation to a higher level (HR 2.02, P = .014) were associated with a subsequent contralateral amputation.

Conclusions:

Patients with advanced PAD that require lower extremity amputation have diminished survival and significant contralateral amputation rates. Elderly patients on dialysis are particularly prone to dying or losing the other leg after a major amputation. These data support strategies to enhance limb preservation and optimize medical comorbidities in these patients.
Resilience in Everyday Operations
Authors: Rankin Amy , Lundberg Jonas , Woltjer Rogier , Rollenhagen Carl , Hollnagel Erik
Published: September 2013

Managing complexity and uncertainty in high-risk sociotechnical systems requires people to continuously adapt. Designing resilient systems that support adaptive behavior requires a deepened understanding of the context in which adaptations take place, of conditions and enablers to implement these adaptations, and of their effects on the overall system. Also, it requires a focus on how people actually perform, not how they are presumed to perform according to textbook situations. In this paper, a framework to analyze adaptive behavior in everyday situations in which systems are working near the margins of safety is presented. Further, the variety space diagram has been developed as a means to illustrate how system variability, disturbances, and constraints affect work performance. The examples that underlie the framework and the diagram are derived from nine focus groups with representatives working with safety-related issues in different work domains, including health care, nuclear power, transportation, and emergency services.
Imperfect gold standards for biomarker evaluation
Authors: Waikar Sushrut S , Betensky Rebecca A , Emerson Sarah C , Bonventre Joseph V
Published: September 2013

Background

Serum creatinine has been used as the diagnostic test for acute kidney injury (AKI) for decades despite having imperfect sensitivity and specificity. Novel tubular injury biomarkers may revolutionize the diagnosis of AKI; however, even if a novel tubular injury biomarker is 100% sensitive and 100% specific, it may appear inaccurate when using serum creatinine as the gold standard.

Conclusions

In general, the apparent diagnostic performance of a biomarker depends not only on its ability to detect injury but also on disease prevalence and the sensitivity and specificity of the imperfect gold standard. Apparent errors in diagnosis using a new biomarker may be a reflection of errors in the imperfect gold standard itself rather than poor performance of the biomarker.
New insights into breadth-first search edge ordering of regular networks for terminal-pair reliability analysis
Authors: Pan Zhusheng , Mo Yuchang , Xing Liudong , Han Jianmin
Published: September 2013

In the binary decision diagram–based terminal-pair network reliability analysis, the size of binary decision diagram heavily depends on the chosen edge ordering. From a theoretical point of view, finding the best ordering is an intractable task. Therefore, heuristics have been used to obtain reasonably good orderings. Among them, the breadth-first search heuristic typically outperforms other heuristics by generating smaller binary decision diagram and thus has been widely used for terminal-pair network reliability analysis. However, the performance of breadth-first search is still only vaguely understood; not much formal work has been done. In this work, we investigate the selection of high-performance root node of breadth-first search ordering for both lattice networks and de Bruijn networks. Empirical study shows that using the two terminal nodes in the terminal-pair network reliability analysis as the root node of the breadth-first search heuristic can have poor performance, and the high-performance root nodes are not randomly distributed. The relationship between the distribution pattern of high-performance root nodes and the rearrangement of successors is also studied. Given that there is often a variation of several orders of magnitude between the sizes of binary decision diagram built using different root nodes for the same network, the application of our results can dramatically reduce the running time and memory usage and make the binary decision diagram–based reliability analysis of large-scale regular networks possible.
Estimation and inference in sets of Weibull samples
Authors: McCool John I
Published: September 2013

Menon’s method of estimation of the Weibull parameters is extended to the analysis of multiple samples of a common size. A methodology is developed for testing the equality of shape parameters among the populations from which the samples are drawn. When the shape parameters are judged to be equal, point and interval estimates of the common shape parameter are constructed. An analysis of variance approach is shown to be valid for testing the equality of scale parameters when a common shape parameter is hypothesized. A post hoc multiple comparison test is developed for assessing which scale parameters differ. Confidence intervals on a percentile may be set for any of the sample populations using the estimated common shape parameter. Tables of the percentage points of the distributions needed for testing hypotheses and constructing interval estimates were obtained by Monte Carlo sampling and are given for a useful range of sample sizes and number of samples. The result is a comprehensive, easily computed, method of analyzing uncensored sets of Weibull data such as occurs when the flexural strength of brittle materials is observed under different conditions of formulation, finishing or test environment. An example analysis of data of this type is included.
The combination of umeclidinium bromide and vilanterol in the management of chronic obstructive pulmonary disease: current evidence and future prospects
Authors: Feldman Gregory J. , Edin Anton
Published: September 2013

The defining feature of chronic obstructive pulmonary disease (COPD) is progressive airflow limitation that causes air trapping and hyperinflation. The increasing hyperinflation results in dyspnea along with associated inability to engage in the activities of daily living. The American Thoracic Society (ATS), European Respiratory Society (ERS) and Global Initiative for Chronic Obstructive Lung Disease (GOLD) treatment guidelines all place bronchodilators as the foundation of pharmacological management of COPD. In patients with moderate-to-very-severe respiratory impairment, adding regular treatment with one or more long-acting bronchodilators is recommended [long-acting β2-agonists (LABAs) or long-acting muscarinic antagonists (LAMAs)]. A growing body of evidence shows that LAMA and LABA co-administration is more effective than either drug class alone in managing stable COPD to improve lung function, symptoms and health status. Recently, new drug applications (NDAs) for a fixed-dose combination (FDC) of umeclidinium (UMEC), a LAMA, and vilanterol (VI), a LABA, at UMEC/VI doses of 125/25 and 62.5/25 µg have been submitted by sponsors to the US Food and Drug Administration (FDA) and to the European Medicines Agency (EMA). Thus, UMEC/VI has become the first FDC LAMA/LABA product that has reached a regulatory approval stage. Other LAMA/LABA once-daily combinations coming through development include FDCs of tiotropium and olodaterol, glycopyrronium and indacaterol, and twice-daily aclidinium and formoterol. The aim of this review is to explore currently available data for once-daily UMEC/VI in the context of the evolving standards of COPD management.
A Case of Hypokalemic Paralysis in a Patient With Neurogenic Diabetes Insipidus
Authors: Nguyen Frederic N. , Kar Jitesh K. , Verduzco-Gutierrez Monica , Zakaria Asma
Published: September 2013

Acute hypokalemic paralysis is characterized by muscle weakness or paralysis secondary to low serum potassium levels. Neurogenic diabetes insipidus (DI) is a condition where the patient excretes large volume of dilute urine due to low levels of antidiuretic hormone. Here, we describe a patient with neurogenic DI who developed hypokalemic paralysis without a prior history of periodic paralysis. A 30-year-old right-handed Hispanic male was admitted for refractory seizures and acute DI after developing a dental abscess. He had a history of pituitary adenoma resection at the age of 13 with subsequent pan-hypopituitarism and was noncompliant with hormonal supplementation. On hospital day 3, he developed sudden onset of quadriplegia with motor strength of 0 of 5 in the upper extremities bilaterally and 1 of 5 in both lower extremities with absent deep tendon reflexes. His routine laboratory studies revealed severe hypokalemia of 1.6 mEq/dL. Nerve Conduction Study (NCS) revealed absent compound motor action potentials (CMAPs) with normal sensory potentials. Electromyography (EMG) did not reveal any abnormal insertional or spontaneous activity. He regained full strength within 36 hours following aggressive correction of the hypokalemia. Repeat NCS showed return of CMAPs in all nerves tested and EMG revealed normal motor units and normal recruitment without myotonic discharges. In patients with central DI with polyuria, hypokalemia can result in sudden paralysis. Hypokalemic paralysis remains an important differential in an acute case of paralysis and early recognition and appropriate management is key.
Leadership Coaching in an Induction Program for Novice Principals
Authors: Lochmiller Chad R.
Published: September 2013

This article presents results from a study of leadership coaches who worked with novice principals in a university-based induction program for a 3-year period. The qualitative case study describes how the support the coaches provided to the novice principals changed over time. The study reveals that coaches adapted their leadership coaching practice in response to the principal’s needs and shifted their coaching strategies as a result. The article concludes with a discussion of the findings in relation to existing research on leadership coaching for K-12 school leaders and offers suggestions for future research.
Squires
Authors: Weber J. Mark , Moore Celia
Published: September 2013

Drawing on several theoretical traditions in the social sciences, we offer a theory of the social facilitation of charismatic leadership by introducing the concept of squires. Squires are key followers who serve four social facilitation functions: liberating and legitimizing, modeling, buffering, and interpreting and translating. Liberating and legitimizing builds on social conformity research. Modeling is based in the social learning and social influence literatures. Buffering, and interpreting and translating, draw on insights from the psychology of power and organizational theory. These functions help resolve two central charismatic leadership paradoxes: (a) the need to be different from followers, though followers prefer to be led by leaders who are like them, and (b) the need to be personally inspiring to followers while being socially distant from them. In specifying squires’ functions, we also address three weaknesses in conceptions of followership and contribute to understandings of how charismatic leadership emerges, works, and endures.
Silica-based mesoporous nanoparticles for controlled drug delivery
Authors: Kwon Sooyeon , Singh Rajendra K , Perez Roman A , Abou Neel Ensanya A , Kim Hae-Won , Chrzanowski Wojciech
Published: September 2013

Drug molecules with lack of specificity and solubility lead patients to take high doses of the drug to achieve sufficient therapeutic effects. This is a leading cause of adverse drug reactions, particularly for drugs with narrow therapeutic window or cytotoxic chemotherapeutics. To address these problems, there are various functional biocompatible drug carriers available in the market, which can deliver therapeutic agents to the target site in a controlled manner. Among the carriers developed thus far, mesoporous materials emerged as a promising candidate that can deliver a variety of drug molecules in a controllable and sustainable manner. In particular, mesoporous silica nanoparticles are widely used as a delivery reagent because silica possesses favourable chemical properties, thermal stability and biocompatibility. Currently, sol-gel-derived mesoporous silica nanoparticles in soft conditions are of main interest due to simplicity in production and modification and the capacity to maintain function of bioactive agents. The unique mesoporous structure of silica facilitates effective loading of drugs and their subsequent controlled release. The properties of mesopores, including pore size and porosity as well as the surface properties, can be altered depending on additives used to fabricate mesoporous silica nanoparticles. Active surface enables functionalisation to modify surface properties and link therapeutic molecules. The tuneable mesopore structure and modifiable surface of mesoporous silica nanoparticle allow incorporation of various classes of drug molecules and controlled delivery to the target sites. This review aims to present the state of knowledge of currently available drug delivery system and identify properties of an ideal drug carrier for specific application, focusing on mesoporous silica nanoparticles.
Associations between different measures of anticholinergic drug exposure and Barthel Index in older hospitalized patients
Authors: Bostock Clare V , Soiza Roy L , Mangoni Arduino A
Published: September 2013

Objective:

To compare associations between four measures of anticholinergic exposure (anticholinergic risk scale, ARS; anticholinergic drug burden, DBAC; number and use versus no use of anticholinergic drugs), Barthel Index (BI, physical function) and Abbreviated Mental Test (AMT, cognitive function) on admission in older hospitalized patients.

Methods:

Prospective observational study of a consecutive series of 271 older patients (age 83 ± 7 years) from community-dwelling and institutionalized settings, admitted to an acute geriatric admission unit between 28 September 2011 and 18 December 2011. The main outcome measures were BI quartiles (primary outcome) and AMT (secondary outcome) on admission.

Results:

Anticholinergic prevalence was 47%. Multinomial logistic regression showed higher DBAC was associated with a greater risk of being in the lower BI quartiles versus highest BI quartile (Q4). This risk was significant for Q3 ( p = 0.04) and Q2 ( p = 0.02) but not for Q1 ( p = 0.06). A greater number of anticholinergic drugs was associated with a higher risk of being in Q2 ( p = 0.02). This risk was not significant for either Q3 ( p = 0.10) or Q1 ( p = 0.06). No significant associations were observed either with use of anticholinergic medication or with ARS and BI quartiles. AMT did not show independent associations with any of the four measures of anticholinergic exposure.

Conclusion:

In older hospitalized patients, DBAC and some crude measures of anticholinergic exposure, but not ARS, showed independent associations with lower BI, but not AMT. These results highlight differences between various measures of anticholinergic drug exposure when studying their associations with functional status.
Pharmacists’ journey to clinical pharmacy practice in Ethiopia: Key informants’ perspective
Authors: Mekonnen Alemayehu B , Yesuf Elias A , Odegard Peggy S , Wega Sultan S
Published: September 2013

Objective:

Clinical pharmacy practice has developed internationally to expand the role of a pharmacist well beyond the traditional roles of compounding and supplying drugs to roles more directly in caring for patients and providing medication consultation to staff. This area of practice is at the infant stage in Ethiopia. The aim of this study was to explore key informants’ perspective in the implementation of clinical pharmacy practice in Jimma University Specialized Hospital, Ethiopia.

Method:

A qualitative study was conducted through in-depth interviews with the heads of departments (internal medicine, paediatrics, surgery, nurse, pharmacy, medical director, administration) and pharmacy student representatives. Qualitative data analysis was done after audiotapes were transcribed verbatim and notes were compiled.

Results:

All of the respondents interviewed express diverse and conflicting perspectives on pharmacists’ role, varying from a health-care professional to a business man. Despite this, the current pace of change worldwide takes the professions’ mission to that of a provider of clinical pharmacy services. The data ascertained the change in pharmacy practice, and integrating clinical pharmacy services within the health-care system should be seen as a must. Pharmacists should delineate from a business perspective and focus on widening the scope of the profession of pharmacy and should come close to the patient to serve directly.

Conclusions:

Although the perception of people on traditional roles of pharmacists was weak, there were promising steps in developing clinical pharmacy practice within the health-care system. Moreover, the results of this study revealed a high demand for this service among health-care providers.
Mitigation of hot cracking of alloy 52M overlay on cast stainless steel CF8A
Authors: Shih Y-J
Published: September 2013

Effects of ER308L buffer layer and welding parameter slope down time on the hot cracking susceptibility of alloy 52M overlay on CF8A base metal were studied. The results indicated that Si segregation was a critical factor affecting Alloy 52M hot cracking. Applying ER308L buffer layers between CF8A and Alloy 52M can reduce the dilution of Alloy 52M weld beads and minimise the contribution of Si from CF8A into Alloy 52M, thereby alleviating Si segregation and the hot cracking susceptibility of Alloy 52M. When the Si content in the grain boundary region was lower than 0·81 wt-%, the hot cracking in the weld bead could be mitigated completely. In many cases, crater cracks occurred in the end crater of the weld bead. Increasing the number of ER308L buffer layers and extending the slope down time could reduce crater crack susceptibility. However, the Si content in the grain boundary region should be controlled to be lower than 0·63 wt-% to prevent crater cracking.
Measuring laser weldability of aluminium alloys using controlled restraint weldability test
Authors: Coniglio N , Patry M
Published: September 2013

Al–Mg–Si alloys are known to be highly susceptible to solidification cracking. Weldability results of laminated AA6061-T6 plates are presented in this paper when welded in full penetration keyhole mode using a 1030 nm, 10 kW Yb:YAG disk laser welding source with different welding conditions. Making use of the controlled restraint weldability (CRW) cracking test, a boundary has been established between crack and no crack conditions for different preloads. The originality of the CRW test is the cross-shaped test coupon that partitions the pre-stress unequally along the welding path. The CRW is proven capable of ranking the solidification cracking behaviour of weld metals deposited under different welding conditions.