bluuebunny/crossref_metadata_2025 huggingface dataset:
Interaction of dopamine transporter (DAT1) genotype and maltreatment for ADHD: a latent class analysis
Authors: Li James J. , Lee Steve S.
Published: May 2012

Background:  Although the association of the dopamine transporter (DAT1) gene and attention‐deficit/hyperactivity disorder (ADHD) has been widely studied, far less is known about its potential interaction with environmental risk factors. Given that maltreatment is a replicated risk factor for ADHD, we explored the interaction between DAT1 and maltreatment with ADHD symptoms defined dimensionally and using latent class analysis (LCA).

Method:  We tested the association of the 40 base‐pair variable number of tandem repeats polymorphism in DAT1, maltreatment, and their interaction in 2,488 boys and girls from the National Longitudinal Study of Adolescent Health.

Results:  In boys, ADHD symptoms were optimally defined by four classes (Combined, Hyperactive/Impulsive, Inattentive, and Normal), whereas in girls, ADHD symptoms were defined by three classes (Combined, Combined‐Mild, Normal). A significant DAT1 × maltreatment interaction revealed that maltreated girls homozygous for the 10‐repeat allele had more symptoms of ADHD, and were also 2.5 times more likely to be classified in the Combined ADHD group than in the Normal Group.

Conclusions:  The underlying structure of ADHD symptoms differed between boys and girls and DAT1 interacted with maltreatment to predict ADHD symptoms and ADHD status derived from LCA. Interactive exchanges between maltreatment and DAT1 for ADHD symptoms, and their implications for intervention, are discussed.
Childhood ADHD is strongly associated with a broad range of psychiatric disorders during adolescence: a population‐based birth cohort study
Authors: Yoshimasu Kouichi , Barbaresi William J. , Colligan Robert C. , Voigt Robert G. , Killian Jill M. , Weaver Amy L. , Katusic Slavica K.
Published: May 2012

Background:  To evaluate associations between attention‐deficit/hyperactivity disorder (ADHD) and comorbid psychiatric disorders using research‐identified incident cases of ADHD and population‐based controls.

Methods:  Subjects included a birth cohort of all children born 1976–1982 remaining in Rochester, MN after age five (n = 5,718). Among them we identified 379 ADHD incident cases and 758 age‐gender matched non‐ADHD controls, passively followed to age 19 years. All psychiatric diagnoses were identified and abstracted, but only those confirmed by qualified medical professionals were included in the analysis. For each psychiatric disorder, cumulative incidence rates for subjects with and without ADHD were estimated using the Kaplan–Meier method. Corresponding hazard ratios (HR) were estimated using Cox models adjusted for gender and mother’s age and education at the subject’s birth. The association between ADHD and the likelihood of having an internalizing or externalizing disorder was summarized by estimating odds ratios (OR).

Results:  Attention‐deficit/hyperactivity disorder was associated with a significantly increased risk of adjustment disorders (HR = 3.88), conduct/oppositional defiant disorder (HR = 9.54), mood disorders (HR = 3.67), anxiety disorders (HR = 2.94), tic disorders (HR = 6.53), eating disorders (HR = 5.68), personality disorders (HR = 5.80), and substance‐related disorders (HR = 4.03). When psychiatric comorbidities were classified on the internalization‐externalization dimension, ADHD was strongly associated with coexisting internalizing/externalizing (OR = 10.6), or externalizing‐only (OR = 10.0) disorders.

Conclusion:  This population‐based study confirms that children with ADHD are at significantly increased risk for a wide range of psychiatric disorders. Besides treating the ADHD, clinicians should identify and provide appropriate treatment for psychiatric comorbidities.
Application of char products improves urban soil quality
Authors: GHOSH S. , YEO D. , WILSON B. , OW L. F.
Published: May 2012

Urban soils are a key component of the urban ecosystem but little research has considered their quality and management. The use of char or partially combusted char products as a soil amendment is becoming popular worldwide because of perceived benefits to fertility and the potential for increasing carbon sequestration. In this study, we assessed the effect of applying coarse and fine char material on the quality of four different types of soil‐based root‐zone mixes typically used for turfgrass and general landscaping in Singapore: clay loam soil, approved soil mix (ASM, 3 soil:2 compost:1 sand), 50:50 (sand/soil) and 75:25 (sand/soil). Char briquettes made from sawdust were mixed thoroughly at rates of 25, 50 and 75% by volume with the soil mixes. Results showed that addition of char (both coarse and fine) significantly enhanced the carbon content of the mixes, with the largest increase being associated with the 50% and 75% additions. Soil nutrients (total N, extractable P, K, Ca and Mg) and mean weight diameter of aggregates were also significantly increased following the application of char. The clay loam and the 50:50 and 75:25 soil mixes were more responsive to the addition of char than was ASM.
Binding characteristics of [3H]‐JSM10292: a new cell membrane‐permeant non‐peptide bradykinin B2 receptor antagonist
Authors: Faussner A , Schüssler S , Feierler J , Bermudez M , Pfeifer J , Schnatbaum K , Tradler T , Jochum M , Wolber G , Gibson C
Published: May 2012

BACKGROUND AND PURPOSE A 3H‐labelled derivative of the novel small‐molecule bradykinin (BK) B2 receptor antagonist JSM10292 was used to directly study its binding properties to human and animal B2 receptors in intact cells and to closely define its binding site.

EXPERIMENTAL APPROACH Equilibrium binding, dissociation and competition studies with various B2 receptor ligands and [3H]‐JSM10292 were performed at 4°C and 37°C. The experiments were carried out using HEK293 cells stably (over)expressing wild‐type and mutant B2 receptors of human and animal origin.

KEY RESULTS [3H]‐JSM10292 bound to B2 receptors at 4°C and at 37°C with the same high affinity. Its dissociation strongly depended on the temperature and increased when unlabelled B2 receptor agonists or antagonists were added. [3H]‐JSM10292 is cell membrane‐permeant and thus also bound to intracellular, active B2 receptors, as indicated by the different ‘nonspecific’ binding in the presence of unlabelled JSM10292 or of membrane‐impermeant BK. Equilibrium binding curves with [3H]‐JSM10292 and competition experiments with unlabelled JSM10292 and [3H]‐BK showed a different affinity profile for the wild‐type B2 receptor in different species (man, cynomolgus, rabbit, mouse, rat, dog, pig, guinea pig). Characterization of B2 receptor mutants and species orthologues combined with homology modelling, using the CXCR4 as template, suggests that the binding site of JSM10292 is different from that of BK but overlaps with that of MEN16132, another small non‐peptide B2 receptor ligand.

CONCLUSIONS AND IMPLICATIONS [3H]‐JSM10292 is a novel, cell membrane‐permeant, high‐affinity B2 receptor antagonist that allows direct in detail studies of active, surface and intracellularly located wild‐type and mutant B2 receptors.
A Look at State‐Level Risk Assessment in the United States: Making Decisions in the Absence of Federal Risk Values
Authors: Effio Diana G. , Kroner Oliver , Maier Andrew , Hayes William , Willis Alison , Strawson Joan
Published: May 2012

State environmental agencies in the United States are charged with making risk management decisions that protect public health and the environment while managing limited technical, financial, and human resources. Meanwhile, the federal risk assessment community that provides risk assessment guidance to state agencies is challenged by the rapid growth of the global chemical inventory. When chemical toxicity profiles are unavailable on the U.S. Environmental Protection Agency's Integrated Risk Information System or other federal resources, each state agency must act independently to identify and select appropriate chemical risk values for application in human health risk assessment. This practice can lead to broad interstate variation in the toxicity values selected for any one chemical. Within this context, this article describes the decision‐making process and resources used by the federal government and individual U.S. states. The risk management of trichloroethylene (TCE) in the United States is presented as a case study to demonstrate the need for a collaborative approach among U.S. states toward identification and selection of chemical risk values while awaiting federal risk values to be set. The regulatory experience with TCE is contrasted with collaborative risk science models, such as the European Union's efforts in risk assessment harmonization. Finally, we introduce State Environmental Agency Risk Collaboration for Harmonization, a free online interactive tool designed to help to create a collaborative network among state agencies to provide a vehicle for efficiently sharing information and resources, and for the advancement of harmonization in risk values used among U.S. states when federal guidance is unavailable.
Spatial Pattern of P Waves in Paroxysmal Atrial Fibrillation Patients in Sinus Rhythm and Controls
Authors: GIACOPELLI DANIELE , BOURKE JOHN P. , MURRAY ALAN , LANGLEY PHILIP
Published: May 2012

Background:

Measuring body surface potentials in the assessment of the electrical activity of the heart is the most commonly used noninvasive method for diagnosing cardiac arrhythmias. Paroxysmal atrial fibrillation (PAF) patients have disturbed cardiac electrophysiology but the detailed characteristics of atrial activation on the body surface are unknown.

Methods:

P waves from 60 sites on the body surface were analyzed from 10 PAF patients in sinus rhythm (PAF group) and 10 healthy controls (HC group). Evolution of atrial depolarization was described qualitatively by maps of P‐wave amplitudes. P‐wave dipole evolution was described quantitatively by measuring the changing location (body site) and amplitude of the dipole positive and negative pole peaks.

Results:

Both groups exhibited similar dipolar structure with an area of positive and an area of negative potentials. Over the depolarization cycle, there were significant changes in the location of the dipole with the positive pole rotating anteriorly right to left by two electrode sites (10 cm) (P = 0.001). There were significant differences between groups with the positive pole in PAF offset to the right of the chest by 0.43 (0.38) strips compared to HC (P < 0.007). Compared to controls, the PAF group positive poles reached peak amplitude sooner (49 [11] ms vs 65 [14] ms, P = 0.012) and negative poles reached peak amplitude later (74 [13] ms vs 62 [8] ms, P = 0.019).

Conclusion:

Atrial depolarization is characterized by a single dipole with time‐varying amplitude and orientation with significant differences in dipole trajectory between patients with PAF and HCs. (PACE 2012;00:1–8)
Proportion of Patients with Implanted Permanent Pacemakers with Atrial Fibrillation Receiving Appropriate Medical Prophylaxis in North Wales
Authors: JONES MATTHEW , WILLIAMS EDGAR M.
Published: May 2012

Background:
Atrial fibrillation (AF) is associated with an increased long‐term risk of stroke, heart failure, and mortality. Previous studies have demonstrated the suboptimal use of anticoagulation therapy in patients with AF.

Methods:
A retrospective survey of patients (N = 1,113) fitted with dual‐chamber pacemakers found 71 patients (age 69 ± 35, mean ± standard deviation) with atrial tachycardia and AF (defined as >5 minutes per day). Their medical records and anticoagulation status were investigated and used to stratify each patient for stroke risk with the Birmingham 2009 schema (CHA2DS2‐VASc) and assessed to determine the rate of appropriate thromboembolism (TE) prophylaxis prescription.

Results:
The most common overall concomitant risk factor for stroke was hypertension (54%), followed by age ≥75 (51%), being female and previous stroke/transient ischemic attack/TE (39%). The average CHA2DS2‐VASc score was 3.7 ± 1.6. Fifty‐six percent of the patients were not receiving appropriate anticoagulation therapy.

Conclusion:
This study demonstrates an underutilization of the oral anticoagulant warfarin in patients with known AF and that the clinicians may not be regarding current stroke risk factors when adopting a thromboprophylaxis strategy. (PACE 2012; 35:935–942)
Low Defibrillation Threshold in a Patient with a Dual‐Coil Defibrillator Lead Implanted through a Persistent Left Superior Vena Cava
Authors: WILLIAMS, Jr. THOMAS A. , ABE OLUWOLE , MITRE CRISTINA A. , KASSOTIS JOHN
Published: May 2012

Several reports have described the successful insertion of implantable cardioverter defibrillator (ICD) in patients with a persistent left superior vena cava (PLSVC). The implanters have used various techniques to achieve appropriate lead placement. In our case, the use of a long sheath, guided by a deflectable catheter, not only facilitated proper implantation of the lead, but also provided a unique position of the dual‐coil lead. This resulted in a very low defibrillation threshold (DFT). We describe a case of a patient found to have a PLSVC at implant who after successful insertion of the ICD exhibited DFT ≤5 J. (PACE 2012; 35:e274–e275)
The 2011 Model of the Clinical Practice of Emergency Medicine
Authors:   2011 EM Model Review Task Force, Perina Debra G. , Brunett Chair Patrick , Caro David A. , Char Douglas M. , Chisholm Carey D. , Counselman Francis L. , Heidt Jonathan , Keim Samuel M. , John Ma O.
Published: May 2012

The 2011 Model of the Clinical Practice of Emergency Medicine.

ACADEMIC EMERGENCY MEDICINE 2012; 19:000–000 © 2012 by the Society for Academic Emergency Medicine
Tooth loss is associated with increased blood pressure in adults – a multidisciplinary population‐based study
Authors: Peres Marco A. , Tsakos Georgios , Barbato Paulo R. , Silva Diego A. S. , Peres Karen G.
Published: May 2012

Objectives

To investigate whether tooth loss is associated with increased blood pressure among adults after controlling for socioeconomic, health, and lifestyle confounders. We also assessed the interactions between tooth loss and smoking status and tooth loss and age on systolic blood pressure (SBP).

Material and Methods

A population‐based cross‐sectional study was carried out with 1720 adults from Florianópolis, Brazil. Data collection included blood pressure, anthropometric measures, and a questionnaire on socio‐demographics, self‐rated health, diabetes, self‐reported number of natural teeth, and dental prosthesis. We used linear multivariable regression models for the association of blood pressure with tooth loss adjusting for potential confounders.

Results

Edentulous subjects had a SBP 8.3 mmHg (95% CI 0.1; 16.7) higher than those with more than 10 teeth in both arches after adjustment for potential confounders. We found interaction between tooth loss and smoking status. Moderate/heavy smokers were associated with considerably higher SBP than light, former or non‐smokers among edentulous and also partly among dentate with less than 10 teeth in at least one arch, but there was no real association between smoking and SBP among those with 10 or more teeth in both arches.

Conclusions

Total tooth loss is associated with increased levels of SBP in this adult population.
Mobilized peripheral blood stem cells compared with bone marrow from HLA‐identical siblings for reduced‐intensity conditioning transplantation in acute myeloid leukemia in complete remission: a retrospective analysis from the Acute Leukemia Working Party of EBMT
Authors: Nagler Arnon , Labopin Myriam , Shimoni Avichai , Mufti Ghulam J. , Cornelissen Jan J. , Blaise Didier , Janssen Jeroen J. W. M. , Milpied Noel , Vindelov Lars , Petersen Eefke , Gribben John , Bacigalupo Andrea , Malm Claes , Niederwieser Dietger , Socié Gerard J. , Arnold Renate , Brown Paul , Goker Hakan , Rocha Vanderson , Mohty Mohamad ,   The ALWP‐EBMT
Published: May 2012

Reduced‐intensity conditioning (RIC)‐alloSCT is increasingly used for acute myelogenous leukemia. Limited data are available for the comparison of peripheral blood stem cells with bone marrow for RIC‐alloSCT. We used the European Group for Blood and Marrow Transplantation (EBMT) ALWP data to compare the outcome of mobilized peripheral blood stem cells (PBSC) (n = 1430) vs. bone marrow (BM) (n = 107) for acute myelogenous leukemia (AML) patients with complete remission that underwent RIC‐alloSCT from compatible sibling donors. The leukemia features, the disease status, and the time from diagnosis were similar between the two groups. Engraftment was achieved in 99% and 93% in the PBSC and BM groups, respectively (P < 0.0001). The day of engraftment was significantly earlier for the PBSC vs. the BM group, 15 (1–59) and 19 (5–69), respectively (P < 0.001). Acute GVHD, severe GVHD (grade III–IV) and chronic GVHD did not differ between the groups. leukemia‐free survival (LFS), relapse, and non‐relapsed mortality (NRM) were 51 ± 2%, 32 ± 1%, and 17 ± 1% vs. 50 ± 6%, 38 ± 6%, and 12 ± 3% for the PBSC and BM groups, respectively. Our results indicate faster engraftment, but no difference in GVHD, LFS, relapse, and NRM when comparing PBSC to BM grafts from sibling donors following RIC conditioning. This is the first study comparing PBSC to BM grafts in the RIC setting, analyzing a homogeneous population of patients with AML in remission. Whether PBSC should be preferred for advanced phases of the disease, where the outcome is dominated by relapse incidences, needs further investigation.
Pelagic larval duration of three amphidromous Sicydiinae gobies (Teleostei: Gobioidei) including widespread and endemic species
Authors: Taillebois Laura , Maeda Ken , Vigne Stéphane , Keith Philippe
Published: May 2012

Sicydiinae species have an amphidromous life cycle during which they undergo a pelagic larval phase allowing them to disperse through the ocean and to recruit in distant island rivers. Hypotheses for the differences observed in dispersal abilities between species include the variation in pelagic larval duration (PLD). However, the implication of the PLD as a proxy for explaining the dispersal ability of a species is not clear in the Sicydiinae subfamily. In this study, otolith microstructure of three Sicydiinae species was analysed. One of these species, Sicyopus zosterophorum, has a widespread distribution in the West Pacific area, whereas the other two species, Smilosicyopus chloe and Akihito vanuatu, are endemic to New Caledonia and to Vanuatu, respectively. Deposition of the daily growth increments on the otoliths of S. zosterophorum was validated using an alizarin complexone time marking technique. We estimated the PLD for the three species by counting the number of growth increments from the core to the metamorphosis check mark, and it was shorter than the one of previous studies on Sicydiinae species. The PLD of the widespread species, S. zosterophorum (54.6 ± 5.6 days), was similar to those of the endemic species, S. chloe (53.6 ± 5.7 days) and A. vanuatu (55.4 ± 7.5 days). Here, we show that in contrast to the most diverse Sicydiinae genus, Sicyopterus, the PLD could not explain endemism, and we must take into account other elements to explain the differences observed in the distribution range.
Precipitation timing and grazer performance in a tallgrass prairie
Authors: Craine Joseph M. , Towne E. Gene , Tolleson Doug , Nippert Jesse B.
Published: May 2012

Changes in precipitation amount and variability have the potential to alter the structure and function of grasslands, but we know little about how changes in the timing of precipitation might affect grasslands. Here, we analyze long‐term records from a tallgrass prairie to show that shifts in the timing of precipitation during the growing season have little effect on primary productivity or grass reproduction, but can greatly affect grazer performance. While greater late‐season precipitation increases the weight gain of adult and young bison, greater mid‐season precipitation decreases their weight gain. In addition, calving rates are lower after years with greater mid‐season precipitation and higher after years with greater late‐season precipitation. As well‐timed drought can actually increase grazer weight gain and reproduction, it will be necessary to generate predictions of within‐season distribution of precipitation to successfully forecast future grazer performance.
Exposing human epithelial cells to zoledronic acid can mediate osteonecrosis of jaw: an in vitro model
Authors: Saracino S. , Canuto R. A. , Maggiora M. , Oraldi M. , Scoletta M. , Ciuffreda L. , Vandone A. M. , Carossa S. , Mozzati M. , Muzio G.
Published: May 2012

J Oral Pathol Med (2012) 41: 788–792

Background:  Osteonecrosis of the jaw (ONJ) is a chronic complication of bisphosphonate therapy, mainly when intravenous, in cancer patients with bone metastases and myeloma. Its pathophysiology is not yet fully elucidated; in particular, the molecular/cellular events triggering ONJ remain unclear. This complication could result from the effect of bisphosphonates released from bone into the soft‐tissues, or from osteolysis induced by soft‐tissues directly exposed to bisphosphonates. This research investigated the possibility that ONJ may be evocated by changes induced in osteoblast activity by factors released by soft‐tissue cells exposed to zoledronic acid.

Methods:  An ‘in vitro’ model was used, in which human osteoblast‐like MG‐63 cells were grown in medium conditioned by human keratinocytes NCTC 2544, exposed or not to zoledronic acid (5 or 50 μM); 5 μM zoledronic acid was also directly administered to MG‐63 cells.

Results:  In NCTC 2544 cells, zoledronic acid decreased proliferation via decreased hydroxy‐3‐methyl‐glutaryl‐CoA reductase, suggesting that a decrease in healing capability can occur in case of injury. An increased pro‐inflammatory potential was also observed. Osteoblasts grown in medium conditioned in the presence of zoledronic acid showed decreased proliferation and osteogenic properties, and increased ability to induce osteoclast differentiation and inflammatory process. Zoledronic acid directly administered to MG‐63 modulated only some parameters and in a lesser extent.

Conclusions:  The research evidenced, for the first time, the direct involvement of epithelial cells in zoledronic acid‐triggered molecular mechanisms leading to osteonecrosis of the jaw, by modulating both osteoblast and osteoclast properties.
Phenotypic changes caused by melatonin increased sensitivity of prostate cancer cells to cytokine‐induced apoptosis
Authors: Rodriguez‐Garcia Aida , Mayo Juan C. , Hevia David , Quiros‐Gonzalez Isabel , Navarro Maria , Sainz Rosa M.
Published: May 2012

Abstract:  Melatonin has antiproliferative properties in prostate cancer cells. Melatonin reduces proliferation without increasing apoptosis, and it promotes cell differentiation into a neuroendocrine phenotype. Because neuroendocrine cells displayed an androgen‐independent growth and high resistance to radiotherapy and chemotherapy, the role of molecules that induce neuroendocrine differentiation was questioned in terms of their usefulness as oncostatic agents. By using human epithelial androgen‐dependent and androgen‐independent prostate cancer cells, the role of melatonin in drug‐induced apoptosis was studied after acute treatments. In addition to cytokines such as hrTNF‐alpha and TRAIL, chemotherapeutic compounds, including doxorubicin, docetaxel, or etoposide, were employed in combination with melatonin to promote cell death. Melatonin promotes cell toxicity caused by cytokines without influencing the actions of chemotherapeutic agents. In addition, antioxidant properties of melatonin were confirmed in prostate cancer cells. However, its ability to increase cell death caused by cytokines was independent of the redox changes. Finally, phenotypic changes caused by chronic treatment with the indole, that is, neuroendocrine differentiation, make cells significantly more sensitive to cytokines and slightly more sensitive to some chemotherapeutic compounds. Thus, melatonin is a good inhibitor of the proliferation of prostate cancer cells, promoting phenotypic changes that do not increase survival mechanisms and make cells more sensitive to cytokines such as TNF‐alpha or TRAIL.
Quality of Diabetes Mellitus Care by Rural Primary Care Physicians
Authors: Tonks Stephen A. , Makwana Sohil , Salanitro Amanda H. , Safford Monika M. , Houston Thomas K. , Allison Jeroan J. , Curry William , Estrada Carlos A.
Published: May 2012

Purpose: To explore the relationship between degree of rurality and glucose (hemoglobin A1c), blood pressure (BP), and lipid (LDL) control among patients with diabetes.

Methods: Descriptive study; 1,649 patients in 205 rural practices in the United States. Patients’ residence ZIP codes defined degree of rurality (Rural‐Urban Commuting Areas codes). Outcomes were measures of acceptable control (A1c < = 9%, BP < 140/90 mmHg, LDL < 130 mg/dL) and optimal control (A1c < 7%, BP < 130/80 mmHg, LDL < 100 mg/dL). Statistical significance was set at P < .008 (Bonferroni's correction).

Findings: Although the proportion of patients with reasonable A1c control worsened by increasing degree of rurality, the differences were not statistically significant (urban 90%, large rural 88%, small rural 85%, isolated rural 83%; P= .10); mean A1c values also increased by degree of rurality, although not statistically significant (urban 7.2 [SD 1.6], large rural 7.3 [SD 1.7], small rural 7.5 [SD 1.8], isolated rural 7.5 [SD 1.9]; P= .16). We observed no differences between degree of rural and reasonable BP or LDL control (P= .42, P= .23, respectively) or optimal A1c or BP control (P= .52, P= .65, respectively). Optimal and mean LDL values worsened as rurality increased (P= .08, P= .029, respectively).

Conclusions: In patients with diabetes who seek care in the rural Southern United States, we observed no relationship between degree of rurality of patients’ residence and traditional measures of quality of care. Further examination of the trends and explanatory factors for relative worsening of metabolic control by increasing degree of rurality is warranted.
A Comparative Study of Financial Data Sources for Critical Access Hospitals: Audited Financial Statements, the Medicare Cost Report, and the Internal Revenue Service Form 990
Authors: Ozmeral Alisha Bhadelia , Reiter Kristin L. , Holmes George M. , Pink George H.
Published: May 2012

Purpose: Medicare Cost Reports (MCR), Internal Revenue Service Form 990s (IRS 990), and Audited Financial Statements (AFS) vary in their content, detail, purpose, timeliness, and certification. The purpose of this study was to compare selected financial data elements and characterize the extent of differences in financial data and ratios across the MCR, IRS 990, and AFS for a sample of nonprofit Critical Access Hospitals (CAHs).

Methods: Line items from AFS of 47 CAHs were compared to data reported in the hospitals’ MCR and IRS 990s. Line items were based on 9 financial indicators commonly used to assess hospital financial performance.

Findings: Of the indicators examined, the equity financing ratio most frequently matched between the 3 reports, while salaries and benefits to total expenses and debt service coverage were often different. Variances were driven by differences in individual account balances used to construct the ratios. Relative to AFS, cash was frequently lower on the IRS 990 while marketable securities and unrestricted investments were often higher. Other revenue and net income were consistently lower on the MCR and IRS 990, and depreciation was often higher on the MCR. The majority of total assets and fund balance (equity) values matched across the 3 reports, suggesting differences in classification among detailed accounts were more common than variances between the component totals (total assets, total liabilities, and fund balance).

Conclusions: Health policy researchers should consider the impact of these variances on study results and consider ways to improve the availability and quality of financial accounting information.
Guideline Adherence in Cardiovascular Risk Assessment and Analysis in 15,000 Hypertensive German Patients in Real Life: Results of the Prospective 3A Registry
Authors: Dechend Ralf , Kaiser Edelgard , Derer Wolfgang , Deeg Evelin , Busjahn Andreas , Schmieder Roland E. , Zeymer Uwe
Published: May 2012

J Clin Hypertens (Greenwich). 2012;00:00–00. ©2012 Wiley Periodicals, Inc.

The benefit obtained from antihypertensive treatment is related more to overall cardiovascular risk reduction than to blood pressure levels. Accurate implementation of cardiovascular diagnostics is a key step toward assessment of cardiovascular risk. In the 3A Registry study, data about patient history, concomitant diseases, diagnostic procedures, and medications were prospectively collected. A total of 14,738 patients recruited by 899 physicians in 2008 and 2009 were analyzed. Assessment of cardiovascular risk factors and subclinical end‐organ damage (SOD) showed broad differences in the implementation of European Society of Hypertension/European Society of Cardiology recommendations. Electrocardiograms were available in 59% of patients, cholesterol in 71.4%, and glucose in 69.7%. Almost all patients (99.6%) had creatinine measurements performed and microalbuminuria was measured in 8.5%. Metabolic syndrome (MS) had been evaluated in 59.7%. Implementation of diagnostic guidelines was highest in hypertensive patients with diabetes, followed by patients with known cardiovascular disease and established chronic renal insufficiency. For hypertensive patients without known comorbidities, the authors estimated that up to 29% had missed SOD (detection rate <50%) and 13% missed MS due to incomplete assessment of risk factors. This large registry study shows that assessment for cardiovascular risk factors and SOD is incomplete. Major efforts are required to improve comprehensive hypertension management as recommended by current guidelines.
The relationship between medication-related problems and behavioural health condition among patients served by a health care for the homeless centre
Authors: Marks Samantha Armour , Moczygemba Leticia R. , Gatewood Sharon B.S. , Osborn Robert D. , Wallace Nancy , Lakhani Sultan , Matzke Gary R. , Goode Jean-Venable R.
Published: May 2012

Objectives

To evaluate the association between behavioural health conditions and the presence of a medication-related problem (MRP) and the association between the type of MRP and the presence of a dual diagnosis.

Methods

We used an existing database from a behavioural health clinic for homeless persons. Logistic regression was used to assess the relationship between the type of behavioural health condition and MRP presence, and whether the type of MRP varied with the presence of a dual diagnosis.

Key findings

A total of 426 patients were eligible. The majority were black (61%) and women (53%). Patients were 44.7 ± 10.2 years old, taking 3.4 ± 2.4 medications and had 2.3 ± 0.9 behavioural health conditions. The majority (53%) had a dual diagnosis, 44% had depression, 30% had a bipolar disorder, 26% had a personality disorder and 12% had an anxiety disorder. Bipolar [odds ratio (OR) 4.0, 95% confidence interval (CI) 1.8–8.9] and anxiety disorders (OR 3.1, CI 1.0–9.2) and a dual diagnosis (OR 2.1, CI 1.2–3.8) were independently associated with the presence of an MRP. Patients with a dual diagnosis were more likely to have ineffective drug therapy (OR 1.7, CI 1.1–2.8) and less likely to have an adverse effect (OR 0.5, CI 0.3–0.9).

Conclusions

Patients with bipolar or anxiety disorders and/or a dual diagnosis may benefit from a pharmacist intervention to address MRPs. Pharmacists can make recommendations to improve the effectiveness of patients' medication therapy and help to resolve adverse effects.
Animal Biowarfare Research: Historical Perspective and Potential Future Attacks
Authors: Yeh Jung‐Yong , Park Jee‐Yong , Cho Yun Sang , Cho In‐Soo
Published: May 2012

A biological attack on livestock or poultry could result in the loss of valuable animals, costs related to the containment of outbreaks and the disposal of carcasses, lost trade and other economic effects involving suppliers, transporters, distributors and restaurants; however, it is not possible to secure all livestock, and livestock are much less well guarded than human targets. Thus, the vulnerability of the livestock industry to the introduction of biological agents varies for the following reasons: (i) the majority of lethal and contagious biological agents are environmentally resilient, endemic in foreign countries and harmless to humans, making it easier for terrorists to acquire, handle and deploy these pathogens, (ii) with animals concentrated in fewer production facilities and frequently transported between these facilities, a single pathogen introduction could cause widespread infection and (iii) the extent of human travel around the globe makes it difficult to exclude exotic animal diseases as possible biological agents. Historically, many governments have developed and planned to use biological agents for direct attacks on livestock or poultry. In the past, developed nations have actively developed biological weapons to target animals. The potential spectrum of bioterrorism ranges from isolated acts against individuals by individuals to tactical and strategic military attacks and state‐sponsored international terrorism intended to cause mass casualties in animals, humans or both. This review provides an overview of the past development and use of biological weapons and describes potential future attacks.
Turbulent Convection From Deterministic Roughness Distributions With Varying Thermal Conductivities
Authors: Mart Steven R. , McClain Stephen T. , Wright Lesley M.
Published: May 2012

Many flows of engineering interest are bounded by surfaces that exhibit roughness with thermal conductivities much lower than common metals and alloys. Depending on the local roughness element convection coefficients, the low thermal conductivities of the roughness elements may create situations where temperature changes along the heights of the elements are important and must be considered in predicting the overall surface convection coefficient. The discrete-element model (DEM) for flows over rough surfaces was recently adapted to include the effects of internal conduction along the heights of ordered roughness elements. While the adapted DEM provided encouraging agreement with the available data, more data are required to validate the model. To further investigate the effects of roughness element thermal conductivity on convective heat transfer and to acquire more experimental data for DEM validation, four wind tunnel test plates were made. The test plates were constructed using Plexiglas and Mylar film with a gold deposition layer creating a constant flux boundary condition with steady state wind tunnel measurements. The four test plates were constructed with hexagonal distributions of hemispheres or cones made of either aluminum or ABS plastic. The plates with hemispherical elements had element diameters of 9.53 mm and a spacing-to-diameter ratio of 2.099. The plates with conical elements had base element diameters of 9.53 mm and a spacing-to-base-diameter ratio of 1.574. An infrared camera was used to measure the temperature of the heated plates in the Baylor Subsonic Wind Tunnel for free stream velocities ranging from 2.5 m/s to 35 m/s (resulting in Reynolds number values ranging from 90,000 to 1,400,000 based on the distance from the knife-edge to the center of the infrared camera image) in turbulent flow. At lower Reynolds numbers, the thermal conductivity of the roughness elements is a primary factor in determining the heat transfer enhancement of roughness distributions. At the higher Reynolds numbers investigated, the hemispherical distribution, which contained more sparsely spaced elements, did not exhibit a statistically significant difference in enhancement for the different thermal conductivity elements used. The results of the study indicate that the packing density of the elements and the enhancement on the floor of the roughness distribution compete with the roughness element thermal conductivity in determining the overall convection enhancement of rough surfaces.
Design Considerations for Axial Steam Turbine Rotor Inlet Cavity Volume and Length Scale
Authors: Barmpalias Konstantinos G. , Abhari Reza S. , Kalfas Anestis I. , Hirano Toshio , Shibukawa Naoki , Sasaki Takashi
Published: May 2012

In this paper we examine the interaction between the cavity and main flows of three different rotor cavities. For each of the three rotor cavities, the cavity inlets differ in their axial cavity lengths, which are modified by extending the upper casing stator platform. The three cavity volumes are comprised of a baseline case, along with a 14% and a 28% volume reduction relative to the baseline case. Measurements show that there is an increase in efficiency of 0.3% for the 14% cavity volume reduction case (relative to the baseline case), whereas a further volume reduction of 28% (relative to the baseline case) decreases the efficiency. Computational analysis highlights the breakup of a toroidal vortex within the cavity as the primary factor explaining the changes in efficiency. The dominant cavity vortex originally present in the baseline case firstly broken up into two smaller vortices for the 14% cavity volume reduction case and secondly, completely replaced with a strong radial jet for the 28% volume reduction case. From a design perspective, reducing the cavity volume by extending the upper casing stator platform yields improvements in efficiency provided that the cavity vortex is still present. The design considerations, analysis and the associated aerodynamics are discussed in detail within this paper.
Effects of Surface Geometry on Film Cooling Performance at Airfoil Trailing Edge
Authors: Murata Akira , Nishida Satomi , Saito Hiroshi , Iwamoto Kaoru , Okita Yoji , Nakamata Chiyuki
Published: May 2012

Cooling at the trailing edge of a gas turbine airfoil is one of the most difficult problems because of its thin shape, high thermal load from both surfaces, hard-to-cool geometry of narrow passages, and at the same time demand for structural strength. In this study, the heat transfer coefficient and film cooling effectiveness on the pressure-side cutback surface was measured by a transient infrared thermography method. Four different cutback geometries were examined: two smooth cutback surfaces with constant-width and converging lands (base and diffuser cases) and two roughened cutback surfaces with transverse ribs and spherical dimples. The Reynolds number of the main flow defined by the mean velocity and two times the channel height was 20,000, and the blowing ratio was varied among 0.5, 1.0, 1.5, and 2.0. The experimental results clearly showed spatial variation of the heat transfer coefficient and the film cooling effectiveness on the cutback and land top surfaces. The cutback surface results clearly showed periodically enhanced heat transfer due to the periodical surface geometry of ribs and dimples. Generally, the increase of the blowing ratio increased both the heat transfer coefficient and the film cooling effectiveness. Within the present experimental range, the dimple surface was a favorable cutback-surface geometry because it gave the enhanced heat transfer without deterioration of the high film cooling effectiveness.
Comparison Between Frequency Domain and Time Domain Riser Analysis
Authors: Cristina de Fernanda , Takafuji Moraes , Arruda Martins Clóvis de
Published: May 2012

In the optimization or parametric analyses of risers, several configurations must be analyzed. It is laborious to perform time domain solutions for the dynamic analysis, since they are time-consuming tasks. So, frequency domain solutions appear to be a possible alternative, mainly in the early stages of a riser design. However, frequency domain analysis is linear and requires that nonlinear effects are treated. The aim of this paper is to present a possible way to treat some of these nonlinearities, using an iterative process together with an analytical correction, and compare the results of a frequency domain analysis with the those of a full nonlinear analysis.
Non-Gaussian Wave Groups Generated in an Offshore Wave Basin
Authors: Cherneva Z. , Guedes Soares C.
Published: May 2012

The main goal of the present paper is to study the differences of the descriptors of the wave groups in the nonlinear case in comparison with the same parameters for a Gaussian process. The data analyzed are from a deep water basin of Marintek. They consist of sequence of five identical independent experimental runs of unidirectional waves measured at ten fixed points situated in different distances from the wave maker. Each series contain about 1800 waves. Thus the statistics collected from a given gauge comprise about 9000 waves combined in a number of wave groups. Because the series describe a process significantly different from the Gaussian one, an upper and lower envelopes are introduced as lines which connect the peaks of the crests and the lower points of the troughs respectively. Spline functions are applied to calculate these envelopes. Then, the mean high run and mean group length are estimated for different levels, their ensemble average over five experimental runs is found for every gauge and is compared with the results of the theory of Gaussian process. It is found that the values of the mean time intervals of the groups correlate with coefficient of kurtosis of the process. It is determined also that mean group length is shorter and the mean high run is larger for the nonlinear wave groups in comparison with the Gaussian wave groups. The modification of wave groups in space and time is investigated in the work as well. Wigner time-frequency spectrum with Choi-Williams kernel is applied to describe the process of entire modulation and demodulation of the groups. It is found that before formation of the high wave a wave down-shifting takes place. At this stage the local spectrum is relatively narrow and the group shrinks continuously. Close to the focus the time-frequency spectrum is very wide and the group has a triangle form. Further the high wave breaks and the wave group acquires the form of “three sisters.” The transform of the group continues by its disintegration, the local spectrum stands narrow and an up-shifting is observed.
Structure Synthesis of Single-Driven Metamorphic Mechanisms Based on the Augmented Assur Groups
Authors: Li Shujun , Dai Jian S.
Published: May 2012

This paper presents a new way of structure composition of single-driven metamorphic mechanisms to develop a systematic and modularized structure synthesis methodology of metamorphic mechanisms based on augmented Assur groups (AAGs). Planar metamorphic mechanisms can hence be constructed based on the developed AAGs by applying the structure composition rule of general planar mechanisms formed by Assur groups (AGs). First, the one-mobility AAGs are introduced based on class II and class III AGs; the structure formulation and composition methodology of planar metamorphic mechanisms are then proposed based on the AAGs, and the basic problems including mobility and synthesis of constrained metamorphic working mobility-configuration are investigated. This leads to the investigation of the degenerated equivalent AGs of AAGs in the metamorphic process and the corresponding kinematic characteristics, providing references for kinematic synthesis of metamorphic mechanisms. Further, a typical spatial metamorphic group is introduced based on the concept of AAGs, and the structure formation and composition of spatial metamorphic mechanisms are presented. Examples show that both planar and spatial metamorphic mechanisms can be constructed by utilizing the one-mobility blocks extended from the AGs.
Chitin-Induced Dimerization Activates a Plant Immune Receptor
Authors: Liu Tingting , Liu Zixu , Song Chuanjun , Hu Yunfei , Han Zhifu , She Ji , Fan Fangfang , Wang Jiawei , Jin Changwen , Chang Junbiao , Zhou Jian-Min , Chai Jijie
Published: May 2012

Dissecting Chitin Binding

The chitin in fungal cells walls serves as a trigger to initiate plant defenses against pathogenic fungi.
Arabidopsis
detects these signals through a cell surface chitin receptor whose intracellular kinase domain initiates a signaling cascade in response to chitin that activates the plant's response to infection.

Liu
et al.

(p.
1160
) have now solved the crystal structure of the
Arabidopsis
chitin receptor AtCERK1. The results show how chitin binds to the receptor and suggest that the biological response requires dimerisation of the receptor when it binds a chitin oligomer at least seven or eight subunits long.
Generic Indicators for Loss of Resilience Before a Tipping Point Leading to Population Collapse
Authors: Dai Lei , Vorselen Daan , Korolev Kirill S. , Gore Jeff
Published: May 2012

Predicting Catastrophic Collapse

It is very difficult to predict the behavior of complex systems near tipping points, where a small change in conditions can lead to a large shift in the state of the system. Theory predicts that some generic statistical indicators can signal the approach of such tipping points, such as slower recoveries from perturbations of the system—a phenomenon called critical slowing down. Working with laboratory yeast populations,

Dai
et al.

(p.
1175
) provide an experimental measure for critical slowing down before catastrophic population collapse. This type of approach should help when trying to predict catastrophic thresholds in other complex systems, ranging from ecosystem transition to climate change, and even to crashes of financial markets.
The Ultimate Genetic Test
Authors: Drmanac Radoje
Published: May 2012

Individual whole-genome sequencing has the potential to greatly improve disease prevention, diagnosis, and treatment.
How Do Stars Explode?
Authors: Bhattacharjee Yudhijit
Published: May 2012

Many details of what goes on inside a star when its fuel has been spent and it explodes into a giant fireball known as a supernova, as well as how that explosion unfolds, remain a mystery.
Enhanced Influenza Virus-Like Particle Vaccines Containing the Extracellular Domain of Matrix Protein 2 and a Toll-Like Receptor Ligand
Authors: Wang Bao-Zhong , Gill Harvinder S. , Kang Sang-Moo , Wang Li , Wang Ying-Chun , Vassilieva Elena V. , Compans Richard W.
Published: May 2012

The extracellular domain of matrix protein 2 (M2e) is conserved among influenza A viruses. The goal of this project is to develop enhanced influenza vaccines with broad protective efficacy using the M2e antigen. We designed a membrane-anchored fusion protein by replacing the hyperimmunogenic region ofSalmonella entericaserovar Typhimurium flagellin (FliC) with four repeats of M2e (4.M2e-tFliC) and fusing it to a membrane anchor from influenza virus hemagglutinin (HA). The fusion protein was incorporated into influenza virus M1-based virus-like particles (VLPs). These VLPs retained Toll-like receptor 5 (TLR5) agonist activity comparable to that of soluble FliC. Mice immunized with the VLPs by either intramuscular or intranasal immunization showed high levels of systemic M2-specific antibody responses compared to the responses to soluble 4.M2e protein. High mucosal antibody titers were also induced in intranasally immunized mice. All intranasally immunized mice survived lethal challenges with live virus, while intramuscularly immunized mice showed only partial protection, revealing better protection by the intranasal route. These results indicate that a combination of M2e antigens and TLR ligand adjuvants in VLPs has potential for development of a broadly protective influenza A virus vaccine.