bluuebunny/crossref_metadata_2025 huggingface dataset:
CPAP of 4 cm H2O Has No Short-Term Benefit at Term in Infants with BPD
Authors: Sandberg Kenneth L. , Hjalmarson Ola
Published: August 2012

Background: Lung development and function is compromised at term in infants with bronchopulmonary dysplasia (BPD), characterized by reduced functional residual capacity (FRC) and impaired gas-mixing efficiency in distal airways. Objective: To determine whether continuous positive airway pressure (CPAP) improves FRC, ventilation, distal airway function, and gas exchange in spontaneously breathing infants with BPD. Design/Methods: Twenty-one infants with BPD (median birth weight 0.72 kg (range 0.50–1.27) and median gestational age 26 weeks (range 23–28)) were studied before and after CPAP of 4 cm H2O was applied by a facemask system. A multiple-breath nitrogen washout method was used to assess FRC, ventilation, and gas-mixing efficiency. Moment analysis and lung clearance index was calculated from the nitrogen-decay curve for assessment of gas-mixing efficiency. Transcutaneous (Tc) PO2/PCO2 was monitored during stable infant conditions before each washout test. Results: When CPAP was raised from 0 to 4 cm H2O, FRC increased significantly together with a significant increase in moment ratios (M1/M₀ and M2/M₀). Tc PO2 decreased significantly and the breathing pattern changed, with significantly reduced respiratory rate, minute ventilation, and alveolar ventilation. There was also an increase in tidal volume and dead space. Conclusions: CPAP of 4 cm H2O applied with a facemask at term to infants with BPD did not improve ventilation, gas-mixing efficiency in distal airways, or oxygenation despite an increase in FRC. We speculate that instead of promoting recruitment of unventilated lung volumes, increasing the end-expiratory pressure in infants with BPD may lead to an overexpansion of already ventilated parts of the lung, causing further compromise of lung function.
Enamel Pits in Hamster Molars, Formed by a Single High Fluoride Dose, Are Associated with a Perturbation of Transitional Stage Ameloblasts
Authors: Lyaruu D.M. , Vermeulen L. , Stienen N. , Bervoets T.J.M. , DenBesten P.K. , Bronckers A.L.J.J.
Published: August 2012

Excessive intake of fluoride (F) by young children results in the formation of enamel subsurface porosities and pits, called enamel fluorosis. In this study, we used a single high dose of F administered to hamster pups to determine the stage of ameloblasts most affected by F and whether pit formation was related to F-related sub-ameloblastic cyst formation. Hamster pups received a single subcutaneous injection of either 20 mg or 40 mg NaF/kg body weight, were sacrificed 24 h later, and the number of cysts formed in the first molars were counted. Other pups were sacrificed 8 days after F injection, when the first molars had just erupted, to score for enamel defects. All F-injected pups formed enamel defects in the upper half of the cusps in a dose-dependent way. After injection of 20 mg NaF/kg, an average of 2.5 white spots per molar was found but no pits. At 40 mg NaF/kg, almost 4.5 spots per molar were counted as well as 2 pits per molar. The defects in erupted enamel were located in the upper half of the cusps, sites where cysts had formed at the transition stage of ameloblast differentiation. These results suggest that transitional ameloblasts, located between secretory- and maturation-stage ameloblasts, are most sensitive to the effects of a single high dose of F. F-induced cysts formed earlier at the pre-secretory stage were not correlated to either white spots or enamel pits, suggesting that damaged ameloblasts overlying a F-induced cyst regenerate and continue to form enamel.
Treatment with a Novel Hypoxia-Inducible Factor Hydroxylase Inhibitor (TRC160334) Ameliorates Ischemic Acute Kidney Injury
Authors: Jamadarkhana Prashant , Chaudhary Anita , Chhipa Laxmikant , Dubey Amita , Mohanan Anookh , Gupta Rameshchandra , Deshpande Shailesh
Published: August 2012

Background: Hypoxia-inducible factor (HIF) transcriptional system plays a central role in cellular adaptation to low oxygen levels. Preconditional activation of HIF and/or expression of its individual target gene products leading to cytoprotection have been well established in hypoxic/ischemic renal injury. Increasing evidence indicate HIF activation is involved in hypoxic/ischemic postconditioning of heart, brain and kidney. Very few studies evaluated the potential benefits of postischemia HIF activation in renal injury employing a pharmacological agent. We hypothesized that postischemia augmentation of HIF activation with a pharmacological agent would protect renal ischemia/reperfusion injury. For this, TRC160334, a novel HIF hydroxylase inhibitor, was used. Methods: TRC160334, a novel HIF hydroxylase inhibitor, was synthesized. Ability of TRC160334 for stabilization of HIF-α and consequent HIF activation was evaluated in Hep3B cells. Efficacy of TRC160334 was evaluated in a rat model of ischemia/reperfusion-induced AKI. Two different treatment protocols were employed, one involved treatment with TRC160334 before onset of ischemia, the other involved treatment after the reperfusion of kidneys. Results: TRC160334 treatment results in stabilization of HIF-α leading to HIF activation in Hep3B cells. Significant reduction in renal injury was observed by both treatment protocols and remarkable reduction in serum creatinine (23 and 71% at 24 and 48 h, respectively, p < 0.01) was observed with TRC160334 treatment applied after reperfusion. Urine output was significantly improved up to 24 h by both treatment protocols. Conclusion: The data presented here provide pharmacologic evidence for postischemia augmentation of HIF activation by TRC160334 as a promising and clinically feasible strategy for the treatment of renal ischemia/reperfusion injury.
Growth Hormone-Releasing Effects of Whole Body Vibration Alone or Combined with Squatting plus External Load in Severely Obese Female Subjects
Authors: Giunta Marialuisa , Cardinale Marco , Agosti Fiorenza , Patrizi Alessandra , Compri Emanuele , Rigamonti Antonello E. , Sartorio Alessandro
Published: August 2012

Background: Whole body vibration (WBV) has been reported to exert growth hormone(GH)-releasing effects in healthy subjects. Despite the potential of WBV to positively affect body composition changes via lipolytic effects, few studies have been performed in obese subjects to date. Methods: This study evaluated the acute effects of WBV alone or in combination with squatting plus external load (WBV+S) on serum GH levels and blood lactate concentrations in 7 severely obese women (age 22 ± 5 years; BMI 39.9 ± 2.9 kg/m2). Results: WBV and WBV+S determined a significant GH increase (mean GH peaks 5.1 ± 1.9 ng/ml, p < 0.001 vs. basal, and 6.5 ± 3.7 ng/ml, p < 0.001 vs. basal, respectively), GH peaks occurring immediately after both exercise sessions. No significant differences were observed between GH peaks and GH net incremental area under the curve (nAUC) after both conditions (p = 0.39 and p = 0.53, respectively), the whole pattern of GH responsiveness being comparable among all the subjects. Lactate concentrations increased after both conditions (mean lactate peaks 2.0 ± 0.5 mmol/l, p < 0.05 vs. basal, and 4.5 ± 2.0 mmol/l, p < 0.001 vs. basal, respectively). The lactate response was significantly higher after WBV+S than after WBV (p < 0.05). Baseline GH and GH peak values positively correlated to baseline lactate and lactate peak concentrations in both conditions (R2 = 0.64, p < 0.001, and R2 = 0.52, p < 0.05, respectively). Conclusions: WBV alone stimulates GH release and lactate production in severely obese female subjects, with no additive effect when combined with squatting plus external load. Further additional studies are required to verify the chronic effects of WBV exercise on the GH/IGF-1 system, which could represent a potentially effective approach for weight management in obese subjects.
Interleukin-27 Receptor Limits Atherosclerosis in
Ldlr
−/−
Mice
Authors: Koltsova Ekaterina K. , Kim Gisen , Lloyd Kathleen M. , Saris Christiaan J.M. , von Vietinghoff Sibylle , Kronenberg Mitchell , Ley Klaus
Published: August 2012

Rationale:

Atherosclerosis is a chronic inflammatory disease of the arterial wall. Several proinflammatory cytokines are known to promote atherosclerosis, but less is known about the physiological role of anti-inflammatory cytokines. Interleukin (IL)-27 is a recently discovered member of the IL-6/IL-12 family. The IL-27 receptor is composed of IL-27 receptor A (WSX-1) and gp130 and is required for all established IL-27 signaling pathways. The expression of the IL-27 subunit Ebi3 is elevated in human atheromas, yet its function in atherosclerosis remains unknown.

Objective:

The aim of this study was to test the role of IL-27 receptor signaling in immune cells in atherosclerosis development.

Methods and Results:

Atherosclerosis-prone
Ldlr
−/−
mice transplanted with
Il27ra
−/−
bone marrow and fed Western diet for 16 weeks developed significantly larger atherosclerotic lesions in aortic roots, aortic arches, and abdominal aortas. Augmented disease correlated with increased accumulation of CD45
+
leukocytes and CD4
+
T cells in the aorta, which produced increased amounts of IL-17A and tumor necrosis factor. Several chemokines, including CCL2, were upregulated in the aortas of
Ldlr
−/−
mice receiving
Il27ra
−/−
bone marrow, resulting in accumulation of CD11b
+
and CD11c
+
macrophages and dendritic cells in atherosclerotic aortas.

Conclusions:

The absence of anti-inflammatory IL-27 signaling skews immune responses toward T-helper 17, resulting in increased production of IL-17A and tumor necrosis factor, which in turn enhances chemokine expression and drives the accumulation of proatherogenic myeloid cells in atherosclerotic aortas. These findings establish a novel antiatherogenic role for IL-27 receptor signaling, which acts to suppress the production of proinflammatory cytokines and chemokines and to curb the recruitment of inflammatory myeloid cells into atherosclerotic aortas.
Renal Liver-Type Fatty Acid Binding Protein Attenuates Angiotensin II–Induced Renal Injury
Authors: Ichikawa Daisuke , Kamijo-Ikemori Atsuko , Sugaya Takeshi , Yasuda Takashi , Hoshino Seiko , Igarashi-Migitaka Jyunko , Hirata Kazuaki , Kimura Kenjiro
Published: August 2012

To investigate the role of human liver-type fatty acid binding protein (hL-FABP) in angiotensin (Ang) II–induced renal injury, Ang II was infused systemically into hL-FABP chromosomal transgenic (Tg) and wild-type (WT) mice (Tg-Ang II and WT-Ang II) for 28 days. Control mice were injected with saline only (Tg-control and WT-control). hL-FABP was expressed in proximal tubules of Tg mice. After a high-dose injection of Ang II, renal gene and protein expressions of hL-FABP in Tg-Ang II mice increased significantly compared with Tg-control mice. Urinary excretion of L-FABP was significantly greater in Tg-Ang II than in Tg-control mice. Blood pressure levels in both groups increased to a similar extent. Upregulation of monocyte chemoattractant protein 1 expression, macrophage infiltration in the interstitium, tubulointerstitial damage, and depositions of type I and III collagens were observed in both Tg-Ang II and WT-Ang II mice. However, these effects were less pronounced in Tg-Ang II compared with WT-Ang II mice. The level of renal N-(hexanoyl)lysine, an oxidative stress marker, was significantly higher in WT-Ang II than in Tg-Ang II mice. In conclusion, renal hL-FABP reduced oxidative stress in Ang II–induced renal injury and attenuated tubulointerstitial damage.
Mail Art: A Bridge to Freedom
Authors: Padín Clemente
Published: August 2012

The testimony of a personal participation in the mail art network is presented together with and the characteristics of mail art, that emphasizes communication over market interests during the period of dictatorship in Latin America. The relationship with artists from Eastern Europe and colleagues from Latin America is the main focus concerning the friendship with Robert Rehfeldt, Guilhermo Deisler, Klaus Groh.
“Something Unnameable in Common”: Translocal Collaboration at the Beau Geste Press
Authors: Gilbert Zanna
Published: August 2012

This article traces the roots and development of the Beau Geste Press, which developed extensive international networks through its publishing activity in the 1970s. The article suggests that these links developed because an idea of “openness” was applied to artistic practices, resulting in a shared aesthetic language that enabled cross-border collaboration. I propose the term “translocal” as a way of understanding how artists in different contexts communicated and attempted to build a system parallel to the art world.
Artistic Networks: From Effect to Affect and its Translation
Authors: Alarcón Paulina Varas
Published: August 2012

This article identifies what the recognition of forms of collaboration in the mail art network suggests to us today about a distribution of experiences. This was not fixed only in objects, but in exchanges of moments, affections, preoccupations, political positions and collective desires, that were anticipated as episodes of correspondence through a “Collectionism of place” and an estrangement of what circulates. The action of receiving remains implicit the act of sending, and also considers the translation of object or letter received as crucial. For any cultural exchange, translation is vital to activate the content and its significance in the new scenario where the contents of the letter are displayed.
Media Art in Argentina: Ideology and Critique “Después Del Pop”
Authors: Benezra Karen
Published: August 2012

This article examines the rise and reception of conceptual art in Argentina. Against dominant readings of the 1960s' and 70s' visual avant-gardes in Latin America, I reconsider the stakes of art's so-called “dematerialization” and its unique claim on ideology critique in the work of the Grupo Arte de los Medios [Media Art Group], a collective of young artists led by the philosopher and literary critic Oscar Masotta. Arguing for a re-historicization of the 1960s avant-garde as one that emerges as a self-reflexive reaction to the novel articulation of late capitalism in Argentina, I trace a critical continuity between the Grupo Arte de los Medios and the avant-gardist claims on the fusion of art and militant politics among its immediate successors. I suggest that the Argentinean avant-garde defined its radical political stance through a reflection on the immanent relation of structural cause to symbolic form, probing and pointing to the limits of the operation of estrangement.
A Learning Architecture
Authors: Scanlan Martin
Published: August 2012

Purpose: The field of socially just educational leadership focuses on reducing inequities within schools. The purpose of this article is to illustrate how one strand of social learning theory, communities of practice, can serve as a powerful tool for analyzing learning within a school ostensibly pursuing social justice. The author employs a core dimension of the theory of communities of practice, “learning architecture,” as a conceptual framework to analyze one such school. Research Design: For the case study presented here, data were collected in the form of interviews with teachers, administrators, support staff, and volunteers and board members ( N = 21), field observations, and archival documents in an elementary school over the course of a school year. Findings: Members within a school community belong to multiple, overlapping, and interacting “communities of practice,” groupings of individuals who share common interests, practices, and purposes. The learning architecture illuminates design features that affect learning within and across these communities of practice. These features both facilitate and frustrate the efforts of individual teachers, administrators, support staff, and volunteers and board members to pursue social justice. Conclusions: This research suggests that the theory of communities of practice, and in particular the learning architecture therein, can be a valuable analytical tool within the field of socially just educational leadership, providing a perspective on how individuals within school communities learn to better serve traditionally marginalized students, along with the interconnections, depth, and edges to this learning.
Rethinking Instructional Leadership, a Review
Authors: Neumerski Christine M.
Published: August 2012

Purpose: The purpose of this article is to uncover what scholars know and do not know about instructional leadership, paying particular attention to what they have learned about how this work is done and where knowledge falls short. The author takes a first step at integrating three distinct literatures: (a) the traditional instructional leadership literature (centered primarily on the principal), (b) the teacher instructional leadership literature, and (c) the coach instructional leadership literature. Research Design: The author utilizes a distributed lens to examine the principal, teacher leader, and coach instructional leadership literatures. This lens illuminates what scholars know about instructional leaders in interaction with one another, their followers, and particular contexts as they work toward the improvement of teaching and learning. The author proposes that analyzing these three literatures together may allow scholars to apply findings from one research area to another, as well as to generate new knowledge around how leaders improve instruction. Conclusions: An integrated, comprehensive understanding of what scholars do and do not know about instructional leadership can begin to shape future studies that will address existing shortcomings around the “how” of leadership that emerge across these literatures.
The Effect of Chair Designs on Sitting Pressure Distribution and Tissue Perfusion
Authors: Makhsous Mohsen , Lin Fang , Hanawalt David , Kruger Shannon Lynn , LaMantia Angie
Published: August 2012

Objective:

The aim of this study was to investigate the effect of five chair designs on interface pressure distribution and tissue perfusion in the buttock-thigh region.

Background:

Prolonged sitting has been found to contribute to the symptoms of work-related low back pain. Studies have found that chair design affects users’ sitting posture and comfort. As sitting applies pressure to the user, it is necessary to investigate how chair design affects sitting pressure and tissue perfusion during sitting.

Method:

We tested five chair designs (Suspension A, Suspension B, Foam A, Foam B, and bicompliant) on 15 young, healthy females. Sitting interface pressure and buttock-thigh tissue perfusion (in terms of transcutaneous partial pressure of oxygen and carbon dioxide, tcPO2 and tcPCO2, respectively) were measured during 10-min sitting on each chair.

Results:

We found that chair design significantly affected the distribution of the sitting pressure ( p < .001) and buttock-thigh tissue perfusion ( p < .023). Average pressure and total contact area were found highest in both foam designs, and the average pressure was the lowest in one of the suspension designs. Across all tested chair designs, the anterior portion of the seat sustained the lowest contact pressure. It was also found that tcPO2 was the lowest ( p < .003) and tcPCO2 was the highest ( p < .001) in tissue around ischial tuberosity for all chair designs.

Conclusion:

Chair design and materials of the seat significantly affect the sitting interface pressure distribution and tissue perfusion in sitting area. Further evaluation of these outcomes may provide useful information to correlate chair design with sitting comfort.
Population, labour and living standards in early modern Ceylon: An empirical contribution to the divergence debate
Authors: de Zwart Pim
Published: August 2012

In the light of the great divergence debate, the economic history of Asian countries has attracted increased attention in the past decade. This article brings early modern Ceylon (present-day Sri Lanka) into the discourse, providing new quantitative evidence on wages, prices, demography and occupations from the Dutch East India Company archives. It is shown that throughout the eighteenth century, Ceylonese living standards were around subsistence level, lower than in Europe, and, until 1760, China. This can to some extent be attributed to population growth, driven by high birth rates rather than high life expectancies. The occupational structure in the maritime provinces of Ceylon shows that almost one-third of the labour force laboured outside agriculture in 1684, which does not compare favourably with England and Holland. These tentative figures suggest that Ceylon already lagged behind north- western Europe before 1800.
Sending out the spears: Zeliangrong movement, Naga Club and a nation in the making
Authors: Thomas John
Published: August 2012

In the 1920s and 30s, the Naga areas comprising Naga Hills and the adjoining Naga inhabited hill tracts of Manipur witnessed two important initiatives which were to become integral to the imagining and making of a Naga nation: the movement among the Rongmeis, Liangmeis and Zemes under the leadership of Jadonang and later Gaidinliu—popularly known as the Zeliangrong movement—and the programmes and activities of the Naga Club. Both the Zeliangrong movement and the Naga Club had a history and trajectory of their own but at the same time, faced with situations that seemed to threaten their way of life, they envisioned and anticipated a moment when Nagas would be united as a single political entity independent from the kingdoms of the plains and other external political authorities. This article looks closely at these initiatives, their shared and particular histories, how they made sense of and negotiated with their existing reality, and finally the visions they had of their anticipated Naga nation. The article concludes by briefly looking at how and why the Naga national movement, in the later decades of twentieth century, came to privilege one initiative over the other.
Improved viscoelastic model for laminate composite under static and dynamic loadings
Authors: Berthe J , Brieu M , Deletombe E
Published: August 2012

Organic matrix composite materials are rate-dependent. Approaches exist for static and for dynamic cases but not for both. In the present study, a viscoelastic spectral model, classically used for low strain rates, was successfully identified on dynamic test data as being suitable for high strain rates. The associated identified model was no longer available for low strain rates. An improved formulation of the model was devised, to be representative for both high and low strain rates. Results exhibited the desired rate dependence and good agreement with experimental data.
Damage characterisation on PP-hemp/aluminium fibre–metal laminates using acoustic emission
Authors: Santulli C , Kuan Hoo Tien , Sarasini F , De Rosa IM , Cantwell WJ
Published: August 2012

In this work, type 2024-O aluminium from ALCOA with a nominal thickness of 0.5 mm was stacked on both sides of a hemp polypropylene composite with stacking sequence 1Al/10PP/1H/10PP/1Al. Tensile and planar indentation loading of the fibre–metal laminates so obtained have been followed in real time using acoustic emission monitoring and related to damage characterisation obtained by scanning electron microscopy. The results confirm that natural fibre-based fibre–metal laminates may have significant potential in engineering, whenever an easier recyclability is desirable, although the properties of hemp fibre composite core are likely to affect their performance during loading, especially at stress levels exceeding their elastic limit. Acoustic emission analysis, based on the study of counts, amplitude and duration, confirms that hemp fibre fracture plays a significant role during tensile loading, whilst, during indentation, collapse is originated by the star-shaped cracking of aluminium sheets. The possible improvement of interface strength, with respect to the simple film stacking process adopted for composite manufacturing, would need attention in future work.
Ten Years Later
Authors: Conway Colleen M.
Published: August 2012

The purpose of this inquiry was to examine the current reflections of experienced teachers on their past perceptions of preservice music teacher preparation as documented in the author’s previous research. Research questions included the following: (a) How would participants describe their reactions to a present-day examination of 1999 or 2000 data (journals, individual and focus group interviews, and two questionnaires) and 2002 study findings? (b) How had their perceptions regarding preservice music teacher preparation changed since 1999-2000? and (c) On the basis of their recent work with preservice interns and student teachers, what could these experienced teachers say about preservice music teacher preparation today? Data collected in 2010 included participant journals and individual interviews. Findings categories include (a) general agreement with 2002 study findings regarding best and worst facets of preservice preparation, (b) experience is the best teacher, (c) teacher education is doing the best it can do, (d) preservice students will get out of teacher education what they put into it, and (e) specific suggestions for teacher education provided by participants.
Distinguishing Autonomous and Directive Forms of Goal Support
Authors: Koestner Richard , Powers Theodore A. , Carbonneau Noémie , Milyavskaya Marina , Chua Sook Ning
Published: August 2012

Three studies examined the relations of autonomy support and directive support to goal progress over 3 months. Autonomy support was defined in terms of empathic perspective-taking, whereas directive support was defined in terms of the provision of positive guidance. Results from Study 1 revealed that autonomy support between romantic partners was significantly positively related to goal progress over 3 months, and that the beneficial effect of autonomy support was mediated by enhanced autonomous goal motivation. Study 2 involved female friend dyads and extended the goal progress results to include both self-reports and reports by peers. Study 3 showed that autonomy support similarly promoted progress at vicarious goals. Across three studies, autonomy support was also significantly associated with improved relationship quality and subjective well-being. Directive support was marginally associated with better goal progress across the three studies and unrelated to relationship quality or well-being.
Navigating Political Hazard Risks and Legal System Quality
Authors: Khoury Theodore A. , Junkunc Marc , Mingo Santiago
Published: August 2012

With emphasis on a venture’s institutional environment and its stage of development, the authors develop theory to explain how the quality of a nation’s legal system and the level of political hazards affect venture capital (VC) investment strategies in developing countries. The data set consists of 433 VC investment transaction rounds occurring in 13 Latin American countries over the period 1995 to 2003. Different from previous research on the likelihood of investment occurrence, the authors consider the size of an investment transaction as a dependent variable. The authors find a negative relationship between investment size and the political hazards risk and that larger investments are associated with ventures operating in lower quality legal systems. The authors also propose the moderating role of these institutional dimensions in the relationship between a venture’s stage of development and investment size. Findings indicate that in lower quality legal systems, conventional VC-staging strategies are not apparent, where middle and later stage ventures receive the largest investments, but with improvements to the legal system, increasingly larger investments go to early stage ventures. Regarding the stage interaction with political hazards, the authors find that the positive relationship between the venture’s stage of development and investment size weakens as the level of political hazards increases, and when political hazards are high, conventional VC-staging similarly does not occur. In uncovering the unique impact of these institutional dimensions with respect to developing country entrepreneurship, these findings shed light on the acute challenges faced by developing country ventures seeking VC funding at varying stages of development.
Instructional Practices in the Middle Grades
Authors: Teague Ginger M. , Anfara Vincent A. , Wilson Nicole L. , Gaines Cherie B. , Beavers Jennifer L.
Published: August 2012

Deciding which instructional strategies to employ is a complex issue faced daily by middle school teachers. Although a wealth of literature on developmentally appropriate and responsive middle school instructional practices is available, the extent to which these strategies are employed is often unknown. Thus, the purpose of this study was to explore the instructional practices being utilized in core academic subjects in middle schools in a southeastern state. Using a mixed methods case study design, teachers’ espoused beliefs about instruction and instructional practices were explored through a questionnaire and interviews and their actual practices were observed during classroom instruction. Findings revealed a disconnect between teachers’ espoused beliefs and actual practices. One third of participating teachers indicated that the strategy employed most often in their classrooms is that of authentic inquiry, but there was little evidence of this in classroom observations. Instead, 78.3% of observations involved teacher-directed instruction or student seatwork supported by the teacher. Implications for school administrators are also discussed.
Methods to Assess Cost-Effectiveness and Value of Further Research When Data Are Sparse
Authors: Soares Marta O. , Dumville Jo C. , Ashby Rebecca L. , Iglesias Cynthia P. , Bojke Laura , Adderley Una , McGinnis Elizabeth , Stubbs Nikki , Torgerson David J. , Claxton Karl , Cullum Nicky
Published: August 2012

Health care resources are scarce, and decisions have to be made about how to allocate funds. Often, these decisions are based on sparse or imperfect evidence. One such example is negative-pressure wound therapy (NPWT), which is a widely used treatment for severe pressure ulcers; however, there is currently no robust evidence that it is effective or cost-effective. This work considers the decision to adopt NPWT given a range of alternative treatments, using a decision analytic modeling approach. Literature searches were conducted to identify existing evidence on model parameters. Given the limited evidence base, a second source of evidence, beliefs elicited from experts, was used. Judgments from experts on relevant (uncertain) quantities were obtained through a formal elicitation exercise. Additionally, data derived from a pilot trial were also used to inform the model. The 3 sources of evidence were collated, and the impact of each on cost-effectiveness was evaluated. An analysis of the value of further information indicated that a randomized controlled trial may be worthwhile in reducing decision uncertainty, where from a set of alternative designs, a 3-arm trial with longer follow-up was estimated to be the most efficient. The analyses presented demonstrate how allocation decisions about medical technologies can be explicitly informed when data are sparse and how this kind of analyses can be used to guide future research prioritization, not only indicating whether further research is worthwhile but what type of research is needed and how it should be designed.
Interpreting Patient Decisional Conflict Scores
Authors: Knops Anouk M. , Goossens Astrid , Ubbink Dirk T. , Legemate Dink A. , Stalpers Lukas J. , Bossuyt Patrick M.
Published: August 2012

Background. Patient decision aids facilitate treatment decisions. They are often evaluated in terms of their effect on decisional conflict, as measured by the Decisional Conflict Scale (DCS). It is unclear to what extent lower DCS scores are accompanied by observable patient behavior or emotions. Objective. To help interpret DCS scores. Design. In a Dutch university hospital, statements on behaviors or emotions during decision making were collected from asymptomatic aneurysm patients and healthy employees. Subsequently, they rated the intensity of decisional conflict that each statement expresses on a 1 to 10 scale. Selected statements were prospectively tested in aneurysm patients and cancer patients facing treatment dilemmas. Measurements. Associations between patients’ DCS scores and reported behavior and emotions were analyzed using logistic regression analysis. Results. Participants provided 363 statements on behaviors and emotions during decision making, of which 28 were mentioned more than 4 times. Nine forms of behavior and emotions were selected as they were graded with the least variable median ratings of intensity of decisional conflict. Among 100 patients facing a treatment dilemma, each point increase in DCS lowered their odds for “immediately making the decision” (odds ratio [OR], 0.96; 95% confidence interval [CI], 0.93–0.98), whereas the odds of “fretting regularly” (OR, 1.05; 95% CI, 1.02–1.08) and “feeling nervous when thinking of the decision” (OR, 1.04; 95% CI, 1.01–1.06) where higher. Conclusions. A decrease in decisional conflict scores leads to less decision postponing behavior, fretting, and nervousness. Research should focus on which DCS scores are needed to make deliberate decisions and which scores hinder patients in decision making.
The Choice of a Noninformative Prior on Between-Study Variance Strongly Affects Predictions of Future Treatment Effect
Authors: Gajic-Veljanoski Olga , Cheung Angela M. , Bayoumi Ahmed M. , Tomlinson George
Published: August 2012

Purpose. Bayesian random-effects meta-analyses require the analyst to specify the prior distribution for between-study variance of the treatment effect. We assessed the sensitivity of prediction and other outputs of the meta-analysis to the choice of this prior. Methods. We reanalyzed 7 published meta-analyses (5–14 trials) with rare (event rates <5%), moderate (15%–50%), and frequent binary outcomes (>50%). We examined 10 noninformative priors: inverse gamma on between-study variance ( τ2), 2 uniforms on each of the between-study standard deviation ( τ) and τ2, uniform shrinkage on τ2, DuMouchel shrinkage on τ, half-normal on τ2, and half-normal priors on τ with large and small variances. For each analysis, we calculated the posterior distributions for τ, the population treatment effect in current studies, and the predicted treatment effect in a future study. We assessed goodness of fit using total residual deviance, the deviance information criterion, and predictive deviance (by cross-validations). Results. According to total residual deviance, the best-fitting priors were uniform on τ2. According to predictive deviance, half-normal on τ2 and the shrinkage priors were optimal. Across analyses with the 10 priors, there were no important differences in the posteriors for the population treatment effect, but there were substantial differences in the posteriors for τ and predictions. The priors that fitted best according to predictive deviance resulted in less uncertainty around predictions of future treatment effect. Conclusions. In this sample of Bayesian meta-analyses with binary outcomes, the choice of noninformative prior for between-study variance affected model fit and the predictions of future treatment effect. When the predictive distribution is of interest, we highly recommend examination of multiple prior distributions for between-study variance, especially the half-normal on τ2 and the shrinkage priors.
Retraction of Supraspinatus Muscle and Tendon as Predictors of Success of Rotator Cuff Repair
Authors: Meyer Dominik C. , Wieser Karl , Farshad Mazda , Gerber Christian
Published: August 2012

Background:

The structural failure rate of rotator cuff repair can exceed 50%. Important predictors for repair failure are preoperative fatty muscle infiltration and myotendinous retraction.

Purpose:

To quantitatively assess the prognostic value of preoperative retraction of both the supraspinatus muscle and tendon for the outcome of supraspinatus repair.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

In 33 shoulders with complete supraspinatus tendon ruptures subjected to arthroscopic repair, magnetic resonance imaging (MRI) scans taken preoperatively and after a mean follow-up of 24 months were studied. The exact position of the lateral extension of the supraspinatus muscle and of the tendon end was evaluated and correlated with the preoperative stage of fatty infiltration (Goutallier) and the failure rate of tendon repair.

Results:

The mean lengthening of the muscle and tendon end was −3 mm and 4 mm in the failed repairs (n = 19) and 14 mm and 8 mm in the successful repairs (n = 14). If the supraspinatus had preoperative Goutallier stages 2 to 3 and a tendon length of less than 15 mm, the failure rate was 92%, but if the tendon length was greater than 15 mm, the failure rate was only 33%. With Goutallier stages 0 to 1, the corresponding failure rates were 57% and 25%, respectively.

Conclusion:

Rotator cuff repair lengthens the tendon, even if the repair fails. The possibility to lengthen the myotendinous unit is related to the preoperative length of the tendon. The combination of Goutallier grading and preoperative tendon length appears to be a more powerful predictor for the reparability of a tendon tear than Goutallier grading alone.
Holding Back the Sea
Authors: Mitsova Diana , Esnard Ann-Margaret
Published: August 2012

“Holding back the sea” is a predicament that is complicated by coastal development trends, eroding shore zones, and changing environmental conditions such as sea level rise. Planners are important players in shaping adaptive responses and identifying and prioritizing appropriate land-use planning strategies. This article provides an overview of existing regulatory provisions, studies, and planning efforts, as well as approaches and strategies to managing erosion of “high wave energy” and “low-to-medium wave energy” shorelines. The article also highlights the multiple sectors and stakeholders involved, and the need for continued research geared at evaluating the viability and feasibility of natural approaches such as living shorelines.
Virtual Sales Associates for Mature Consumers
Authors: Shim Soo In , Kwon Wi-Suk , Chattaraman Veena , Gilbert Juan E.
Published: August 2012

This study examines whether social presence through a virtual sales associate (VSA) affects mature consumers’ perceptions of technical and social supports from an apparel retail website and whether these perceptions influence consumers’ attitudes and patronage intentions toward the website. Sixty mature consumers participated in a laboratory experiment and completed a shopping task on a mock apparel website with or without a VSA. Results revealed that participants in the VSA (vs. no-VSA) condition perceived significantly greater social support; however, no significant difference existed in perceived technical support between the two conditions. This study also revealed that mature consumers’ perceived social support and ease of use of the retail website positively influenced their attitude toward the retail website, which in turn led to their website patronage intentions. Theoretical and managerial implications are discussed with respect to the potential of VSAs in enhancing the e-tail service quality for mature consumers.
A Comparison of Objective Biomarkers With a Subjective Health Status Measure Among Children in the Philippines
Authors: Butrick Elizabeth , Peabody John W. , Solon Orville , DeSalvo Karen B. , Quimbo Stella A.
Published: August 2012

Large health surveys use subjective (self-reported) and objective (biomarkers) measures to assess heath status. However, the linkage or disparity of these measures has not been systematically studied in developing countries.

Method:

Using data from the Philippine Quality Improvement Demonstration Study, QIDS, this study evaluated the associations between General Self-Reported Health Status (GSRH) and height, weight, hemoglobin, red blood cell folate, C-reactive protein, and blood lead levels. The authors modeled each biomarker as a function of GSRH controlling for socioeconomic status and selection effects. Changes in biomarkers and GSRH in children who had previously been hospitalized were also examined.

Results:

GSRH independently predicted hemoglobin, C-reactive protein, stunting, and wasting. GSRH did not vary significantly with folate deficiency and blood lead levels.

Conclusions:

In addition to being a measure of overall child health status, GSRH may be a useful and inexpensive screening tool for identifying children that need further health testing.
Health-Related Quality of Life in Old Age
Authors: Nilsson Jan , Rana A. K. M. Masud , Luong Duong Huy , Winblad Bengt , Kabir Zarina Nahar
Published: August 2012

This study compares health-related quality of life (HRQoL) and its determinants among older people (≥60 years) in rural Bangladesh and Vietnam. Cross-sectional studies among older people were conducted in Bangladesh (n = 1031) and Vietnam (n = 870). Data on HRQoL were collected using an instrument that includes 24 items distributed into 6 dimensions. Older people in Vietnam reported more favorable HRQoL outcomes than those in Bangladesh, reporting better HRQoL on physical, psychological, social, and financial dimensions. Hierarchical linear regression analyses show that advanced age, being a woman, belonging to a poor household, and reporting poor health were significantly associated with lower HRQoL scores in both Bangladesh and Vietnam. In Bangladesh, being illiterate was additionally associated with lower HRQoL scores. The results of this explorative study underline the importance of a cross-cultural understanding of HRQoL of older people and the influence of the socioecological context.
Colorectal Cancer Screening
Authors: Foo Aaron S. C. , Thia Joshua J. P. , Ng Zhi Peng , Fong Ngan Phoon , Koh Gerald C. H.
Published: August 2012

To assess the awareness and acceptability of colorectal cancer (CRC) screening in noncompliant Singaporeans and to determine if their barriers can be overcome by education. A questionnaire developed from thematic analysis of open-ended interviews with 72 subjects was administered to 580 residents in a local high-rise housing estate. Participants aware of CRC screening were assessed for barriers and acceptability of CRC screening. All participants were subsequently educated about CRC screening and reassessed for barriers and acceptance. Those keen for fecal occult blood testing (FOBT) were offered FOBT kits and followed up. CRC screening awareness was poor. Having no symptoms was the most common barrier. More barriers to FOBT than to colonoscopy were reduced with education. After education, acceptability toward FOBT increased but rejection rates rose even higher. FOBT is probably Singapore’s most acceptable screening modality. Education is limited by barriers, which need to be overcome by alternative measures.
Consensus Statement
Authors: Chan Siew Pheng , Chui William C. , Lo Kwok Wing , Huang Kuo-Chin , Leyesa Normita D. , Lin Wen-Yuan , Mirasol Roberto C. , Robles Yolanda R. , Tey Beng Hea , Paraidathathu Thomas
Published: August 2012

Background and aim

The increasing prevalence of overweight and obesity worldwide demands increased efforts in the prevention and management of obesity. This article aims to present consensus statements promoting appropriate consumer education and communication programs for weight-loss agents in Asia.

Methods

Panel members from various disciplines developed consensus statements based on an expert meeting on the benefits of consumer education and communication programs for over-the-counter weight-loss agents. Key opinion leaders discussed relevant data that served as the basis of the recommendations.

Results

Obesity is a growing epidemic in Asia, turning the region into a potential market for weight-loss products and services. Current trends in direct-to-consumer advertising demonstrate the pervasiveness of false representations lacking adequate substantiation. Relevant issues and recommendations were established.

Conclusions

Public education on weight management is a shared responsibility; there is a need to raise public awareness of obesity and its health-related consequences. Advertising guidelines should ensure responsible direct-to-consumer advertising of weight-loss agents.
Anticipatory Loss and Early Mastectomy for Young Female BRCA1/2 Mutation Carriers
Authors: Hoskins Lindsey M. , Greene Mark H.
Published: August 2012

Young women who carry BRCA1/2 mutations face difficult decisions in managing their hereditary breast/ovarian cancer risk. Through this National Cancer Institute study, we sought to understand the process by which some young women choose risk-reducing bilateral mastectomy (RRBM) instead of alternative risk-management options. Data indicate that electing to undergo RRBM, although difficult, is experienced as a way to sidestep potentially devastating outcomes, such as stressful and costly high-risk screening, chemotherapy or radiation, or putting loved ones through the challenges of a cancer diagnosis. The decision to pursue RRBM is often the product of screening fatigue, encouragement from loved ones, and/or a sense of urgency to put one’s high-risk period behind one. By understanding how young carriers make decisions about surgical risk reduction, providers can better guide, counsel, and support patients in the important tasks surrounding this life-changing medical decision, thereby helping to increase the duration and quality of their lives.
Preparing Heart and Mind Following Prenatal Diagnosis of Complex Congenital Heart Defect
Authors: McKechnie Anne Chevalier , Pridham Karen
Published: August 2012

Drawing on attachment and caregiving theory and the concept of motivation, the purpose of this descriptive study was to examine parents’ retrospective accounts of their prenatal experiences after receiving the diagnosis of a fetal heart defect. These parents constituted a subgroup of participants in a larger longitudinal study of parenting an infant with a complex congenital heart defect. Data were derived from 14 semistructured interviews with 13 mothers and 3 fathers in the home or hospital setting. A directed content analysis yielded a central category of preparing heart and mind for infant caregiving. Preparing heart and mind is a preliminary caregiving goal within the caregiving system that generates intentions and expectations indicative of specific caregiving motivations to relate to the baby, handle circumstances practically, and manage infant medical care. A theoretical model illustrates the prenatal process these parents engaged in to provide care to their infants with life-threatening medical conditions.
An elastoplastic damage-induced anisotropic constitutive model at finite strains
Authors: Ganjiani M , Naghdabadi R , Asghari M
Published: August 2012

In this paper, a hyperelastic plastic damage-induced anisotropic constitutive model is proposed based on the logarithmic strain in finite deformations. The evolution equations are written in terms of the material time derivative of the stress tensor conjugate to the logarithmic strain. The dissipation inequality is considered in the intermediate configuration with some appropriate internal variables. The Helmholtz free energy is considered as combination of three parts including elastic, plastic and damage. The exponential isotropic plasticity hardening and linear isotropic damage hardening are considered. For taking into account the unilateral effect in the damage growing, a modified stress tensor is considered. A return mapping two-step operator split algorithm, elastic predictor and plastic-damage corrector, is adopted for the integration of the evolution equations. To present some numerical results, the proposed constitutive model has been implemented into a finite element implicit code. For validating the model and also showing its capabilities, several benchmark examples are solved. In these examples, the deterioration in the material properties due to the propagation of the damage is well simulated.