bluuebunny/crossref_metadata_2025 huggingface dataset:
Expression of Aurora B and alternative variant forms in hepatocellular carcinoma and adjacent tissue
Authors: Yasen Mahmut , Mizushima Hiroshi , Mogushi Kaoru , Obulhasim Gulanbar , Miyaguchi Ken , Inoue Kazuhiko , Nakahara Izumi , Ohta Tsutomu , Aihara Arihiro , Tanaka Shinji , Arii Shigeki , Tanaka Hiroshi
Published: January 2009

Surgical resection is the effective treatment modality for hepatocellular carcinoma (HCC); however, rapid recurrence of the tumors are frequently observed even after apparently curative resection. The recurrence and prognostic assessment of patients with HCC after resection is an important clinical issue. We recently reported that aberrant expression of Aurora B is observed in primary HCC, and that it can be a predictive factor for HCC recurrence exceeding Milan criteria after curative hepatectomy. In this study we investigated the expression of the newly observed Aurora B splicing variant forms in HCC, and their roles in hepatocarcinogenisis. The expression of Aurora B and splicing variant forms were screened in 125 HCC patients (94 chronic hepatitis with cirrhosis background liver specimens), 18 metastatic liver cancer patients and 16 normal liver specimens by cDNA microarray, reverse transcription – polymerase chain reaction (RT–PCR) and Real time quentitative Reverse Transcription PCR (qRT‐PCR). The results showed that expression of Aurora B splicing variant 2 (AURKB‐Sv2) variant form was absent in normal liver and was higher in metastatic liver cancer than HCC. This aberrant expression was associated with the advanced stages of HCC (P < 0.01), correlated with a poor outcome (P = 0.008) and short disease‐free period (P = 0.018). Furthermore, AURKB‐Sv2 variant form is associated with a higher level of serum α‐fetoprotein, protein induced by vitamin K absence or antagonist‐II (PIVKAII), tumor capsular invasion, multiple tumor formation and at an age younger than those with other variant forms (P < 0.05). The results thus suggest that AURKB‐Sv2 variant form is more significantly associated with the advanced stages of HCC than others and is a marker of poor prognosis. Founded in the tumor capsular invasion and multiple tumor regions, suggests that this might play a role in enhancing multiple malignant tumor formation and recurrence of HCC in hepatocarcinogenesis. This is the first study to report clinicopathological significance of aberrant expression of AURKB‐Sv2 variant form in hepatocellular carcinoma. (Cancer Sci 2009; 100: 472–480)
The relationships between abundance, range size and niche breadth in Central European tree species
Authors: Köckemann Benjamin , Buschmann Holger , Leuschner Christoph
Published: January 2009

Aim  Range size and niche breadth have been found to be positively related to abundance in many plant and animal groups. We tested these two relationships for the tree species flora of Central Europe; that is, for all 25 species that have their distribution centre in this region.

Location  Eurasia, with a focus on Central Europe.

Methods  We devised an abundance and niche variable classification system to transform the existing literature data into a semi‐quantitative assessment of abundance and niche breadth (in terms of soil chemical and physical variables, and temperature) for each of the 25 tree species. Regression analyses between abundance, range size and niche breadth were conducted for the entire species sample and for subsets of species defined by their ecology or phylogeny.

Results  The relationship between abundance in the distribution centre and range size was weak for the Central European tree species. However, significant abundance–range size relationships were found for phylogenetically or ecologically more homogenous species groups (for example for trees of the order Rosales and for mid‐successional tree species). Realized niche breadth was positively related to range size in the case of temperature, but not for soil‐related variables. No relationship existed between niche breadth and abundance in the distribution centre.

Main conclusions  We hypothesize that the weak relationship between abundance and range size is primarily a consequence of substantial ecological and phylogenetic heterogeneity within this rather species‐poor assemblage. The positive relationship between realized temperature niche breadth and range size emphasizes the strong influence of climatic variables on plant distribution patterns over continental or global scales.
Complement Inhibitor C4b‐Binding Protein in Primary Sjögren’s Syndrome and its Association With Other Disease Markers
Authors: Zadura A. Foltyn , Theander E. , Blom A. M. , Trouw L. A.
Published: January 2009

A subgroup of patients suffering from primary Sjögren’s syndrome (pSS) display unexplained low levels of complement components C3 and/or C4 which is associated with increased risk of non‐Hodgkin’s lymphoma. C4b‐binding protein (C4BP) is a major fluid‐phase complement inhibitor which can influence C4 and C3 levels. Therefore we analysed C4BP levels in the sera of patients with pSS to better understand the disturbances in complement in pSS. Associations with other disease markers were also investigated to define a possible role of C4BP as marker of high‐risk disease course. Plasma levels of C4BP were analysed in pSS patients (n = 86) and in controls (n = 68) by ELISA. C4BP levels from 49 patients were correlated to disease activity markers and autoantibody profiles. We found that total C4BP plasma levels were significantly higher in pSS patients compared with controls. C4BP levels correlated to the acute phase response, to levels of C4 and C3 as well as to the CD4+/CD8+ T‐cell ratio. C4BP levels were inversely related to IgG levels, extent of autoantibody production and global disease activity. C3dg levels, a marker of complement activation, displayed a negative correlation to C4 levels but interestingly not to C4BP levels. In conclusion, C4BP levels are increased in patients suffering from pSS proportional to their acute phase response. However, in the most active cases, with the most widespread autoantibody production, C4BP levels were decreased in parallel with levels of C3 and C4 and CD4+ T cells, suggesting that disturbed complement regulation may contribute to pathogenicity in pSS.
A Reply to Dembic: On an End to the Beginning of Misunderstanding the Immune Response
Authors: Cohn M.
Published: January 2009

We all agree that dealing with the complexity and volume of the data necessitates the use of computer modelling. This in turn requires a heuristic conceptual framework to guide this modelling. The first attempt to do this by Cohn has been criticized by Dembic as being severely lacking. This commentary deals with his criticism of the framework to show why Cohn’s postulates, in fact, remain unchallenged.
Gastrointestinal stromal tumor in the duodenum exhibiting hemangiopericytoma‐like histological pattern
Authors: Takahashi Yoshihisa , Shimizu Seiichiro , Sakurai Shinji , Kumagai Arisa , Mori Shigeo , Fukusato Toshio
Published: January 2009

Reported herein is a gastrointestinal stromal tumor (GIST) that exhibited a hemangiopericytoma (HPC)‐like histological pattern. Such a morphological variant of GIST has not been described previously. A 57‐year‐old woman presented with bloody stools. On upper digestive tract endoscopy a submucosal tumor of diameter 2 cm was detected at the duodenal bulb, and enucleated. Grossly, the tumor was well‐circumscribed, grayish to whitish, and solid, and its central portion was ulcerated. Histology indicated round to fusiform tumor cells that had proliferated around branching vessels that had a staghorn configuration. Immunohistochemistry showed that the tumor cells were diffusely positive for vimentin and KIT; partially positive for CD34 and muscle actin; and negative for α‐smooth muscle actin. On mutation analysis a 42 bp deletion was found from codons 560 to 573 of exon 11 of the KIT gene, which is a mutational hot spot of GIST. In diagnosis of gastrointestinal tract tumors with an HPC‐like histological pattern, pathologists should consider the possibility of GIST.
Parathyroid carcinoma with anaplastic feature: Association of a p53 gene mutation with anaplastic transformation
Authors: Tamura Gen , Miyoshi Hiroaki , Ogata Shin‐ya , Sasou Shun‐ichi , Kudoh Shun , Kikuchi Jun , Yanagawa Naoki , Motoyama Teiichi
Published: January 2009

Parathyroid carcinoma is a rare neoplasm that accounts for only 1–3% of cases of primary hyperparathyroidism. Parathyroid carcinoma is a well‐differentiated tumor that is sometimes difficult to differentiate histopathologically from its benign counterpart, parathyroid adenoma. The molecular mechanism of parathyroid carcinogenesis remains unknown, and investigators have reported that abnormalities of the p53 gene do not play a significant role in parathyroid carcinogenesis, unlike in other human malignancies. The present report describes parathyroid carcinoma with anaplastic transformation of differentiated parathyroid carcinoma in a patient with primary hyperparathyroidism. Nuclear accumulation of p53 protein was found in anaplastic carcinoma cells but not in differentiated carcinoma cells. Polymerase chain reaction–single‐strand conformation polymorphism followed by direct sequencing showed that anaplastic carcinoma cells carried a missense mutation at codon 248 (CGG to CAG) of the p53 gene, while the remaining differentiated carcinoma cells had the wild‐type p53 gene. These findings suggest that the p53 gene mutation is associated with anaplastic transformation of parathyroid carcinoma.
Primary osteosarcoma of the breast
Authors: Murakami Shigeki , Isozaki Hiroshi , Shou Tatsuo , Sakai Kunihiko , Yamamoto Yasuhisa , Oomori Masako , Toyoda Hiroshi
Published: January 2009

Presented herein is a case of primary pure osteosarcoma of the breast. A 59‐year‐old woman noticed a left breast tumor. Mammography showed a cluster of crushed stone‐like calcifications, which gave the tumor a raw cotton‐like appearance. Malignancy was suspected on fine‐needle aspiration cytology of the tumor. An excisional biopsy was performed. The tumor was 2.0 × 2.4 cm in size. Histopathologically the tumor was composed of diffuse atypical cells with mitosis and a lot of bone. Atypical cells were thought to be neoplastic osteoblasts. Multinucleated osteoclastic cells were interspersed with osteoblasts. Spindle cells were found at the verge of the tumor. A few entrapped tubular structures were seen. Immunohistochemistry indicated that neoplastic osteoblastic cells of the tumor were stained positively for vimentin, but negatively for epithelial markers; which suggested that the tumor cell elements originated from epithelial cells. This tumor was diagnosed as primary extraskeletal osteosarcoma. Partial resection was additionally performed around the excisional biopsy without dissection of the axillary lymph nodes. Bone radionuclide scan after operation showed no abnormal uptake. At 5 years after surgery no recurrence was seen.
Appreciating history: The Australian experience of direct‐entry mental health nursing education in universities
Authors: Happell Brenda
Published: January 2009

More than two decades since the introduction of comprehensive nursing education in Australia, the controversy regarding the type of undergraduate education that would best serve the needs of the mental health nursing profession continues. The ensuing debate tends to be based on a comparison between the current model of comprehensive education in the universities and the specialist mental health nursing programs that previously operated within the hospital system. The previous existence of a tertiary‐based direct‐entry mental health nursing program in Victoria is generally not recognized. The paper provides a brief overview of mental health nursing education from a historical perspective emphasizing the period following the commencement of the transfer of the nursing education. Articulating the Victorian experience of specialist undergraduate mental health nursing education within universities is essential as discussions about the most appropriate educational preparation for mental health nursing continues.
Sociology and nursing: Role performance in a psychiatric setting
Authors: Handsley Stephen , Stocks Susan
Published: January 2009

The role of sociology in nursing continues to cast new light on many aspects of health and illness. Over the last 20 years, nursing practice has seen sociological theory become a valuable clinical tool, both in the diagnosis and prognosis of a wide range of illnesses and long‐term conditions. Nevertheless, of these, the sociological examination of mental health problems and its impact upon nursing practitioners has received little coverage, simply because, as a discipline, mental health nursing has historically been wedded to a biomedical model, one which continues to embrace psychiatry/psychology as the driving force in the diagnosis and treatment of psychopathology. Adopting a sociological approach, this paper brings to light previously unexplored insights into the way nurses interact with patients experiencing mental health problems. Drawing on social interactionist methodology, this paper considers depression and other mental health problems in relation to current psychiatric nursing practice. Specifically, the paper focuses on aspects of role performance and interpersonal care in a psychiatric setting, and the impact the individual role may have on the wider aspects of institutional and official practices. The paper concludes by making a number of recommendations/observations for nursing practice.
Bachelor of Nursing students' beliefs about prognosis and outcomes for people with schizophrenia: A longitudinal study
Authors: McCann Terence V. , Lu Sai , Deegan Joanna
Published: January 2009

Many nursing students have unfavourable attitudes towards people with mental illness. This study aimed to examine if Australian Bachelor of Nursing students' beliefs about prognosis and long‐term outcomes for people with schizophrenia changed through their course. The Attitudes and Beliefs about Mental Health Problems: Professional and Public Views questionnaire, which included a vignette about a person with schizophrenia, was used with a convenience sample of students. An interrupted time series approach to data collection was used, with data collected three times between 2005 and 2007. A university ethics committee approved the study. Data were analysed using SPSS version 15. Overall, the students recognized the person's need for professional help. By third year, students were more pessimistic about prognosis if the person did not receive professional help than in their earlier years of study. By third year, students also rated the long‐term outcome to be ‘creative or artistic’ more favourably than in earlier years. The findings showed no significant differences in perceived overall negative and positive long‐term outcomes across the three data collection points. The findings reinforce the need for theoretical and clinical education in mental health to be included and progressively increased in all years of study if attitudes are to be improved.
RELATIONSHIP BETWEEN BUSINESS DEFINITION AND CORPORATE GROWTH: THE EFFECT OF FUNCTIONAL ALIGNMENT
Authors: Wakabayashi Koji
Published: January 2009

Abstract.  In previous research, the hypothesis drawn from Theodore Levitt's idea that companies could continuously grow by ‘functional’ business definitions was statistically proved with 50 Japanese electric/electronics companies. The current research tests the hypothesis that in the case where the functions in corporate business definitions, divisional business definitions and products and services are all aligned, it will ultimately bring continuous growth to the company, through case studies and content analysis of four companies with highly functional corporate business definitions. As a result, it is proved that the company that successfully aligns the functions on every level continuously grows at a higher rate than the others.
The stabilization technology of superfine liposome
Authors: Matsuo Masaki , Hisamitsu Issei , Sumida Yasushi
Published: January 2009

Generally, hydrophilic surfactants are added to make a small particle size liposome. However, there is a problem that a small particle size liposome causes a decrease of its capacity in the internal water phase, and it cannot function well enough as a capsule. Therefore we investigated the effect of various surfactants and lipids on superfine liposome. Firstly, we examined some hydrophilic surfactants which have different molecular structures to minimize the liposomes. PEG‐25 phytostanol ether was most effective to make particle size small among non‐ionic hydrophilic surfactants. However, as the particle size got smaller, its capacity in the internal water phase decreased, being transformed into the micelles. Secondly, we tried to increase the capacity of the internal water phase by adding the combined lipid into the liposome membrane. It was indicated that phytosterol had the potential to increase remarkably the internal water phase. As a result, we found that it's possible to make a liposome of a small particle size having a large capacity in the internal water phase by using both PEG‐25 phytostanol ether and phytosterol. Furthermore, the superiority of the liposome which consisted of the above ingredients in electrolyte‐resistance was confirmed.
Vol. 42, No. 1, pp.22‐29, 2008 White blood cell fractions, oxidation index and level of stress in acne patients and healthy volunteers
Authors: Takahashi M. , Tan M. , Kimura S. , Ikeno H.
Published: January 2009

In recent years, a lot of people have suffered physical and mental stress. It makes sympathetic nerves dominant, and autonomic nerves unbalanced. Disruption of the balance in autonomic nerves leads to the increase of granulocyte, and causes various undesirable physical conditions. We investigated the relationship between stress and acne in order to confirm the influence of stress on skin conditions. The degree of subjective stress, and the ratio of neutrophils or lymphocytes in leukocytes were measured in acne patients and healthy volunteers. As it is suggested that the increase of the neutrophil ratio by stress makes reactive oxygen, and raises the degree of oxidation in the blood, we also measured the antioxidant action and the degree of oxidative stress by FRAS4. Additionally, the lifestyle characteristics in each group was investigated in order to confirm the relationship with stress by a questionnaire survey. According to the results of the questionnaire survey, acne patients find themselves readily suffering from acne anytime. Compared with healthy volunteers, acne patients have more undesirable lifestyles and higher stress degrees than healthy volunteers. Further, the Biological Antioxidant Potential (BAP), an antioxidant index measured in acne patients, was significantly lower (P < 0.0001) than that of healthy volunteers. The acne patients had a higher ratio of neutrophils and a lower ratio of lymphocytes compared to the healthy volunteers. Among the acne patients, the neutrophil ratio was higher in those with high stress (P < 0.05). These results suggest that acne patients easily feel higher stress against various loads, and the stress leads to the increase in the neutrophil ratio and the oxidation degree, which exacerbates the acne lesions.

Keywords: acne, stress, autonomic nerve, sympathetic nerve, white blood cell, neutrophil, lymphocyte, oxidation, life style, skin
Vol. 42, No. 1, pp.30‐35, 2008 A high‐speed mixer enabling particle design
Authors: Shundo A.
Published: January 2009

When fluid is mixed by a rotor and small vessel that has a narrow clearance between its wall and the rotor with the upper part covered by an endplate, the processing fluid becomes a high‐speed thin‐film spin flow. This flow possibly allows the peripheral speed to be over 30 m/s, which was unable to be obtained by a conventional high‐speed mixer. As a result, the processing fluid obtains more and homogenous energy. In an actual experiment, we compared a high‐speed thin‐film spin mixer with a conventional high‐speed mixer upon an emulsification experiment with soybean oil. The experiment proved that the former mixer could control the particle size distribution. It also proved that the same result could be obtained by continuous operation as by batch operation. In conclusion, the high‐speed thin‐film spin mixer can control particle size distribution with a high efficiency.

Keywords: thin‐film spin, fluid, mixer, particle size distribution, emulsification, continuous processing, batch operation
An Outreach Intervention Increases Bone Densitometry Testing in Older Women
Authors: Denberg Thomas D. , Myers Beth A. , Lin Chen‐Tan , Libby Anne M. , Min Sung‐Joon , McDermott Michael T. , Steiner John F.
Published: January 2009

OBJECTIVES: To evaluate the performance of a patient recall intervention that relies on an outreach coordinator with a bachelor's degree to prompt women by mail and telephone about their eligibility for bone densitometry (dual‐energy X‐ray absorptiometry (DXA)) screening and allow them to schedule an examination without a medical provider visit ahead of time.

DESIGN: Observational.

SETTING: Academic general internal medicine practice.

INTERVENTION: Mail‐ and telephone‐based patient recall for DXA.

PARTICIPANTS: Five hundred sixty‐four women aged 65 to 79 at average risk for osteoporosis without a history of DXA.

MEASUREMENTS: Rates of DXA completion and the change in proportion of screened women during a 7‐month intervention period, case finding for clinically significant bone loss, frequency of appropriate clinical follow‐up, DXA no‐show rates compared with usual care, and clinician satisfaction.

RESULTS: Through patient recall, rates of DXA screening rose significantly (P<.001), and the proportion of the eligible clinic population screened increased 13%. Thirty percent of patients had clinically significant bone loss, with almost all of these receiving follow‐up. DXA no‐show rates were comparable with usual care, and provider acceptance was high.

CONCLUSION: A patient recall intervention substantially increased DXA screening, allowing pharmacological therapy to be started much earlier in some women with significant bone loss. It imposed minimal burden on providers and enhanced patient convenience. This type of program may have utility for additional preventive services.
Predictors of Mortality in Home‐Dwelling Patients with Cardiovascular Disease Aged 75 and Older
Authors: Strandberg Timo E. , Pitkala Kaisu H. , Tilvis Reijo S.
Published: January 2009

OBJECTIVES: To compare the predictive value of biomarkers commonly measured in older patients with cardiovascular disease (CVD) with an indicator of cognitive function.

DESIGN: Prospective cohort study.

SETTING: Helsinki, Finland.

PARTICIPANTS: Three hundred ninety‐eight home‐dwelling older persons (261 women, mean age 80) with stable CVD and without a diagnosis of clinical dementia.

MEASUREMENTS: Simple laboratory and clinical measurements (including the Mini Mental State Examination (MMSE, maximum score 30 points) and New York Heart Association (NYHA) classification) were used to predict mortality. A MMSE score between 18 and 24 points was considered to indicate cognitive impairment.

RESULTS: At baseline, median MMSE score was 27 (interquartile range 25–28), with 59 individuals having a score below 24 points. During a mean follow‐up of 6.0 years, 129 participants died. In the fully adjusted Cox proportional hazards model, low MMSE score was the strongest predictor of mortality, with a relative hazard of 2.38 (95% confidence interval=1.52–3.74; P<.001). Of the various clinical and laboratory variables, only creatinine, C‐reactive protein, and history of congestive heart failure were significant independent predictors, whereas conventional risk factors were not.

CONCLUSION: Only a few clinical variables independently predicted 6‐year mortality in older home‐living patients with CVD. The strongest predictor was impaired cognitive function assessed using MMSE.
Fabrication of SiOC Ceramic Microparts and Patterned Structures from Polysiloxanes via Liquid Cast and Pyrolysis
Authors: Liu Xiang , Li Ya‐Li , Hou Feng
Published: January 2009

SiOC ceramic microparts and patterned microstructures are fabricated from their metal masters using polysiloxanes as a precursor, which consists of polyhydromethylsiloxane (PHMS) and 1,3,5,7‐tetramethyl‐1,3,5,7‐tetravinylcyclotetrasiloxane (D4Vi), via mold transfer, liquid cast, crosslink, and pyrolysis. The mixed liquid of PHMS and D4V was cast with the polydimethylsiloxane (PDMS) negative molds transferred from the masters and solidified via hydrosilylation of PHMS and D4Vi under controlled heating. Because both the precursors and mold materials are polysiloxanes, their chemical similarities ensure the excellent contact between the two phases that allows for the precise duplication of the master microstructures into the polysiloxanes. Strategies were developed for the use of a two‐step controlled heating method and the use of polysiloxane as a support in the processes of demolding, crosslinking, and pyrolysis in order to ensure the bonding qualities of both the crosslinked bodies and the pyrolyzed microstructures. Through this route, we obtained dense and crack‐free SiOC ceramic microngears and arrayed holes of well‐duplicated microstructures with a resolution down to the submicrometers. Moreover, the polysiloxanes allow the direct imprints with the metal masters to form inversed microstructures of SiOC ceramics, as demonstrated by the formation of microchannels and various motifs of SiOC ceramics from their metal counterparts.
Optimization of the Kinematics Available in the Polishing Process of Ceramic Tiles by Computational Simulations
Authors: Sousa Fábio J. P. , Aurich Jan C. , Weingaertner Walter L. , Alarcon Orestes E.
Published: January 2009

This work investigated the influence of the kinematics involved in the polishing process of stoneware tiles over the spatial distribution of abrasive contacts. The basic intention was to delimit the best combinations of both forward and transverse oscillation motions that would result in a uniform polishing effect over the tile surface. Such uniformity was quantitatively represented by the variance of the distribution of polishing time. By means of computational algorithms, a wide range of both forward speed and oscillation frequency were simulated in order to obtain the corresponding distributions of polishing time. The results highlight the importance of adopting good kinematics to avoid excessive polishing gradients. Thus, a large number of kinematic conditions could be potentially recommended, whereas many others were found to be primarily inadequate. In view of this, the simulations carried out herein can be suggested as a useful guide for future phenomenological investigations, and also as a useful tool for polishing industries.
Correlation of Plasma and Peritoneal Diasylate Clomipramine Concentration with Hemodynamic Recovery after Intralipid Infusion in Rabbits
Authors: Harvey Martyn , Cave Grant , Hoggett Kerry
Published: January 2009

Objectives:  Drug sequestration to an expanded plasma lipid phase has been proposed as a potential mechanism of action for lipid emulsions in lipophilic cardiotoxin overdose. The authors set out to document plasma and peritoneal diasylate clomipramine concentration after resuscitation with lipid emulsion in a rabbit model of clomipramine‐induced hypotension.

Methods:  Twenty sedated mechanically ventilated New Zealand White rabbits were allocated to receive either 12 mL/kg 20% Intralipid or 12 mL/kg saline solution, following clomipramine infusion to 50% baseline mean arterial pressure (MAP). Hemodynamic parameters and serum clomipramine concentration were determined to 59 minutes. Peritoneal dialysis with 20% Intralipid or saline solution was evaluated for clomipramine concentration.

Results:  Mean arterial pressure was greater in lipid‐treated animals as assessed by repeated‐measures analysis of variance (F[1,14] = 6.84; p = 0.020). Lipid infusion was associated with elevated plasma clomipramine concentration and reduced initial volume of distribution (Vd; 5.7 [±1.6] L/kg lipid vs. 15.9 [±7.2] L/kg saline; p = 0.0001). Peritoneal diasylate clomipramine concentration was greater in lipid‐treated animals (366.2 [±186.2] μg/L lipid vs. 37.7 [±13.8] μg/L saline; p = 0.002).

Conclusions:  Amelioration of clomipramine‐induced hypotension with lipid infusion is associated with reduced initial Vd and elevated plasma clomipramine concentration consistent with intravascular drug–lipid sequestration. Concomitant peritoneal dialysis with lipid emulsion enhances clomipramine extraction.
The Centers for Medicare and Medicaid Services (CMS) Community‐Acquired Pneumonia Core Measures Lead to Unnecessary Antibiotic Administration by Emergency Physicians
Authors: Nicks Bret A. , Manthey David E. , Fitch Michael T.
Published: January 2009

Objectives:  The objectives were to assess emergency physician (EP) understanding of the Centers for Medicare and Medicaid Services (CMS) core measures for community‐acquired pneumonia (CAP) guidelines and to determine their self‐reported effect on antibiotic prescribing patterns.

Methods:  A convenience sample of EPs from five medical centers in North Carolina was anonymously surveyed via a Web‐based instrument. Participants indicated their level of understanding of the CMS CAP guidelines and the effects on their prescribing patterns for antibiotics.

Results:  A total of 121 EPs completed the study instrument (81%). All respondents were aware of the CMS CAP guidelines. Of these, 95% (95% confidence interval [CI] = 92% to 98%) correctly understood the time‐based guidelines for antibiotic administration, although 24% (95% CI = 17% to 31%) incorrectly identified the onset of this time period. Nearly all physicians (96%; 95% CI = 93% to 99%) reported institutional commitment to meet these core measures, and 84% (95% CI = 78% to 90%) stated that they had a department‐based CAP protocol. More than half of the respondents (55%; 95% CI = 47% to 70%) reported prescribing antibiotics to patients they did not believe had pneumonia in an effort to comply with the CMS guidelines, and 42% (95% CI = 34% to 50%) of these stated that they did so more than three times per month. Only 40% (95% CI = 32% to 48%) of respondents indicated a belief that the guidelines improve patient care. Of those, this was believed to occur by increasing pneumonia awareness (60%; 95% CI = 52% to 68%) and improving hospital processes when pneumonia is suspected (86%; 95% CI = 80% to 92%).

Conclusions:  Emergency physicians demonstrate awareness of the current CMS CAP guidelines. Most physicians surveyed reported the presence of institutional protocols to increase compliance. More than half of EPs reported that they feel the guidelines led to unnecessary antibiotic usage for patients who are not suspected to have pneumonia. Only 40% of EPs believe that CAP awareness and expedient care resulting from these guidelines has improved overall pneumonia‐related patient care. Outcome‐based data for non–intensive care unit CAP patients are lacking, and EPs report that they prescribe antibiotics when they may not be necessary to comply with existing guidelines.
Getting Noticed, Showing‐Off, Being Overheard: Amateurs, Authors and Artists Inventing and Reinventing Themselves in Online Communities
Authors: FAULKNER SUSAN , MELICAN JAY
Published: January 2009

This paper reports early findings of an ethnographically‐inspired research project focused on individuals who are actively engaged in the creation and online distribution of original media — on blogs, vlogs, and social networking sites — and on the collectives that form around “user‐generated content.” In this paper, we profile a small number of creative individuals producing original content in four very different cultural contexts: a children's book author in Los Angeles, a pair of video bloggers in New York, an ex‐pat journalist and social commentator in Dubai, and a cosmetics expert sharing advice with an online community in Seoul, South Korea. We explore what motivates each “lead user” to create; we examine how they imagine themselves as authors and artists, and how they imagine (and interact with) their readers and viewers. In addition, we explain how the insights they provide into an emerging form of online authorship are relevant to Intel Corporation's Digital Home Group.
Ethnography as Design Provocation
Authors: BUUR JACOB , SITORUS LARISA
Published: January 2009

In this paper, we present our experience in sharing ethnographic material with engineers that have a very different perception of technology and the role of its users. Rather than convey findings' in a rational argument, we have experimented with formats where the role of the ethnography is to provoke engineers to reframe their perception of new designs. Based on four design encounters (workshops) from two different design projects completed in industry, this paper looks at the ways in which the ethnographic material provokes design. We use video transcripts and conversation analysis to learn more about this mechanism of provocation.
Giving Voice to Print Production Facility Workers: Representing actual work practices in the streamlining of a labor intensive production print job
Authors: MARY NATHANIEL MARTIN , SPRAGUE ANN , WALL PATRICIA , WATTS‐PEROTTI JENNIFER
Published: January 2009

This paper presents findings from an ethnographic study of digital production printing with a focus on a complex, labor‐intensive production print job. The goal of the study was to inform the development of tools, processes and technologies to improve the efficiency of this kind of job within the print production facility. By documenting how work was done from the perspective of the people who did the work, our study ensured that the voices and perspectives of the workers were formally represented in the process of improving and streamlining the tools and print production facility workflows.
ENGAGED CLIENTS: STORIES OF COLLABORATION
Authors: Anderson‐Kempe Elizabeth
Published: January 2009

Three client‐consultant pairs discuss highlights of their collaboration with an emphasis on the outcomes of that collaboration — whether a product or a service brought to market, a methods innovation, or a shift in business strategy. Instead of telling seamless success stories, each team focuses on the challenges of collaboration and specific approaches to addressing these challenges. By listening to stories of collaboration challenges, ethnographers are exposed to practical ideas that they can apply to their own practice of ethnography in a business context.
Enabling our voices to be heard
Authors: RADKA RICH
Published: January 2009

Identifying differences in how ethnography is practiced in academia and in business is the key to successfully developing ethnography further as a business discipline. In the following paper, I propose that the key difference between the practice of ethnography in academia versus business is the purpose of the ethnography, and that all other questions we struggle with in the transition from academia to industry clearly flow from this difference in purpose. Addressing this difference honestly is the key to being heard correctly, even to being heard at all. By describing how business disciplines are conceptually structured and by exemplifying analogous disciplines, I will provide thoughts on how we might shift the way we think and talk about business ethnography. I believe this shift will enable us to find common ground with other disciplines, be recognized for delivering clear value to the businesses we work for, and create opportunities for making positive contributions to society at large. Finally, I will conclude by summarizing the organizing principle of this chapter of the proceedings, and will briefly introduce the section's seven papers.
Not Lost in Translation: Maximizing Impact in Marketing Ethnography through Bivocality
Authors: MAISH AMY , WESOLKOWSKA MAGDA
Published: January 2009

The bivocal approach is a systematic research and strategy framework that leverages marketing professionals' and social scientists' unique perspectives in order to develop brand, consumer and cultural insights relevant to the business challenge. Thus allowing all voices to be heard equally and clearly: that of the social scientist and the marketing professional, that of culture, consumer and brand It results in an explanation for the forces at play on the brand or business questions and acts as a cultural GPS for the brand The explanatory nature and consistent connection between brand consumer and culture allow for a highly grounded, and we would assert, more powerfully informed set of actions, including, when, how, and why brands/products are used or could be used by consumers.
Predictors of pregnancy outcome in essential thrombocythemia: a single institution study of 63 pregnancies
Authors: Gangat Naseema , Wolanskyj Alexandra P. , Schwager Susan , Tefferi Ayalew
Published: January 2009

An increased risk of pregnancy complications was recently reported in JAK2V617F‐positive essential thrombocythemia (ET). In the current study of 63 pregnancies among 36 women with ET, we sought to appraise this association and identify other predictors of outcome. Overall outcome included 38 (60%) births and 20 (35%) first trimester spontaneous abortions. Among 36 first pregnancies, 22 (61%) resulted in live birth. Twelve of the 14 pregnancy losses occurred during the first trimester. Rate of pregnancy loss was 21% among 24 patients receiving aspirin therapy during the first trimester vs. 75% among 12 patients not receiving such treatment (P = 0.002). Pregnancy outcome was not influenced by platelet count, leukocyte count or presence of JAK2V617F; four pregnancy losses each were documented in 10 mutated and 10 unmutated patients. Among 17 second pregnancies, 12 (71%) resulted in live birth; these included eight from nine patients with successful and four from eight with unsuccessful first pregnancies (P = 0.07). Maternal complications were infrequent (11%): pre‐eclampsia (n = 1), hematoma after Cesarean‐section (n = 2) and post‐partum hemorrhage (n = 1). This study suggests a salutary role for aspirin therapy in pregnant women with ET. Furthermore, the occurrence of a miscarriage in ET might be a marker for a similar event during subsequent pregnancies.
Combined Gemcitabine and Carboplatin Therapy for Carcinomas in Dogs
Authors: Dominguez P.A. , Dervisis N.G. , Cadile C.D. , Sarbu L. , Kitchell B.E.
Published: January 2009

Background: Response and adverse reactions to combined gemcitabine (GEM) and carboplatin (CARBO) therapy in dogs with carcinomas are not documented.

Hypothesis: GEM and CARBO are safe for the treatment of dogs with carcinomas.

Animals: Thirty‐seven dogs with histologically or cytologically confirmed carcinomas.

Methods: Prospective clinical trial. Dogs were treated with GEM (2 mg/kg, 20–30‐minute infusion IV) on Days 1 and 8 and 4 hours later, CARBO (10 mg/kg IV) on Day 1. The cycle was repeated on Day 22.

Results: Thirty‐seven dogs (29 with measurable tumor) received a median of 2 cycles (range 0.5–6) for a total of 101 cycles administered. Twelve dogs (32%) developed neutropenia (3 Grade 3, and 5 Grade 4) and 9 (24%) thrombocytopenia (2 Grade 3, and 1 Grade 4). Dogs >20 kg were twice as likely to develop thrombocytopenia (P= .023). Twenty‐seven dogs (73%) had evidence of gastrointestinal (GI) toxicosis, but most signs were of mild to moderate severity and self‐limiting. One dog died of treatment‐related complications. Overall tumor response rate was 13%. One dog with metastatic prostatic carcinoma achieved a complete remission and 1 dog with intestinal adenocarcinoma and 1 with tonsillar squamous cell carcinoma achieved partial remission. Twelve dogs achieved stable disease for a median of 72 days.

Conclusion and Clinical Importance: GEM and CARBO combination causes mild to moderate hematologic and GI toxicosis in dogs with carcinoma. Response rate in this study was modest, and optimization of dosing of this combination is required.
Coupling between mechanical and neural behaviour in the human first dorsal interosseous muscle
Authors: Hudson Anna L. , Taylor Janet L. , Gandevia Simon C. , Butler Jane E.
Published: January 2009

The neural drive to a muscle and its biomechanical properties determine the force at a joint. These factors may be centrally linked. We studied the relationship between the ability of first dorsal interosseous muscle (FDI) to generate index flexion force around the metacarpophalangeal joint and the neural drive it receives in a voluntary contraction. The role of FDI was assessed in two thumb postures, thumb ‘down’ (thumb abducted) and thumb ‘up’ (thumb extended), and at different thumb carpometacarpal angles. These postures were designed to change acutely the flexion moment arm for FDI. The flexion twitch force evoked by supramaximal stimulation of the ulnar nerve was measured in the two postures and the change in moment arm was assessed by ultrasonography. Subjects also made voluntary flexion contractions of the index finger of ∼5 N in both postures during which neural drive to FDI and the long finger flexor muscles was measured using surface EMG. Recordings of FDI EMG were normalized to the maximal M wave. Five of the 15 subjects also had a radial nerve block to eliminate any co‐contraction of the extensor muscles, and extensor muscle EMG was monitored in subjects without radial nerve block. Compared to thumb up, flexion twitch force was ∼60% greater, and the flexion moment arm was ∼50% greater with the thumb down. There was minimal effect of altered carpometacarpal angle on flexion twitch force for either thumb posture. During voluntary flexion contractions, normalized FDI EMG was ∼28% greater with thumb down, compared to thumb up, with no consistent change in neural drive to the long flexors. Hence, the contribution of FDI to index finger flexion can be altered by changes in thumb position. This is linked to changes in neural drive to FDI such that neural drive increases when the mechanical contribution increases, and provides a central mechanism to produce efficient voluntary movements.
Relative Contributions of Inelastic and Elastic Diffuse Phonon Scattering to Thermal Boundary Conductance Across Solid Interfaces
Authors: Hopkins Patrick E. , Norris Pamela M.
Published: January 2009

The accuracy of predictions of phonon thermal boundary conductance using traditional models such as the diffuse mismatch model (DMM) varies depending on the types of material comprising the interface. The DMM assumes that phonons, undergoing diffuse scattering events, are elastically scattered, which drives the energy conductance across the interface. It has been shown that at relatively high temperatures (i.e., above the Debye temperature) previously ignored inelastic scattering events can contribute substantially to interfacial transport. In this case, the predictions from the DMM become highly inaccurate. In this paper, the effects of inelastic scattering on thermal boundary conductance at metal/dielectric interfaces are studied. Experimental transient thermoreflectance data showing inelastic trends are reviewed and compared to traditional models. Using the physical assumptions in the traditional models and experimental data, the relative contributions of inelastic and elastic scattering to thermal boundary conductance are inferred.
Combustion and Emission Performance of a Hog Fuel Fluidized Bed Boiler With Addition of Tire Derived Fuel
Authors: Duo Wenli , Karidio Ibrahim , Cross Larry , Ericksen Bob
Published: January 2009

Salt-laden hog fuel (wood waste) is burnt in a fluidized bed boiler converted from a travelling grate boiler to generate steam for a specialty paper mill. The converted boiler has a design capacity of 156 t/h of steam from hog and actual generation has varied from 76 to 107% of the design capacity. The conversion has resulted in more stable operation, more complete combustion, less ash production, reduced boiler maintenance, and lower fossil fuel consumption. Tire derived fuel (TDF) is used as a supplementary fuel. With an energy content of 33 GJ/t for TDF, as compared to 8 GJ/t for wet hog, addition of 2–5% TDF by weight increased the bed temperature by an average of 55°C, stabilized and improved the combustion of low quality hog and high moisture content sludge. The impact of TDF addition was studied in detail. Stack emissions were tested and bottom and fly ash samples were analyzed. Although TDF contains 1% zinc and 5 to 7% steel wire, addition of TDF did not affect total particulate emissions from the boiler. SO2 emissions were increased due to the high sulfur content of TDF (1.6%). A good correlation was obtained from the test results, showing that the addition of TDF resulted in a reduction in both the total formation and the stack emissions of dioxins and furans.
In-Situ Hydrocarbon Capture and Reduction of Emissions of Dioxins by Porous Bed Material Under Fluidized Bed Incineration Conditions
Authors: Shimizu Tadaaki , Franke Hans-Ju¨rgen , Hori Satoko , Takano Yasuo , Yamagiwa Kazuaki , Tanaka Masato
Published: January 2009

This work is intended to reduce emissions of dioxins and unburned gas from fluidized bed waste incinerators. Combustion of plastic pellets was conducted using a bench-scale bubbling fluidized bed combustor. Porous alumina was used as a bed material instead of conventional bed material (sand). First, we evaluated the effect of bed material on capture of volatile matter in the bed in a nitrogen atmosphere. Porous alumina captured volatile matter while sand did not. Feeding gas asymmetrically to enhance internal circulation of solids in the bed increased volatile capture efficiency of the porous alumina bed, whereas no improvement was found for the sand bed. Next, we performed combustion of plastic pellets by air. Emission of unburned gas was lower for the porous alumina bed than for the sand bed under a uniform gas feed condition. This is attributable to volatile matter capture by bed material that lengthens residence time of volatile matter in the combustor. However, non-uniform air feed for internal circulation was ineffective for suppressing unburned gas emissions. This may be caused by formation of an oxygen-deficient zone in the combustor. Finally, dioxin emissions were measured during PVC pellet combustion in a uniformly fluidized bed. The porous alumina bed was more effective for dioxin emission suppression than the sand bed.