bluuebunny/crossref_metadata_2025 huggingface dataset:
Telemedicine in Leading US Neurology Departments
Authors: George Benjamin P. , Scoglio Nicholas J. , Reminick Jason I. , Rajan Balaraman , Beck Christopher A. , Seidmann Abraham , Biglan Kevin M. , Dorsey E. Ray
Published: July 2012

Objective: To determine the current practice and plans for telemedicine at leading US neurology departments. Design and Setting: An electronic survey was sent to department chairs, administrators, or faculty involved in telemedicine at 47 neurology departments representing the top 50 hospitals as ranked by U.S. News and World Report. Main Outcome Measures: Current use, size, scope, reimbursement, and perceived quality of telemedicine services. Results: A total of 32 individuals from 30 departments responded (64% response rate). The primary respondents were neurology faculty (66%) and department chairs (22%). Of the responding departments, 60% (18 of 30) currently provide telemedicine and most (n = 12) had initiated services within the last 2 years. Two thirds of those not providing telemedicine plan to do so within a year. Departments provide services to patients in state, out of state, and internationally, but only 6 departments had more than 50 consultations in the last year. The principal applications were stroke (n = 14), movement disorders (n = 4), and neurocritical care (n = 3). Most departments (n = 12) received external funding for telemedicine services, but few departments (n = 3) received payment from insurers (eg, Medicare, Medicaid). Reimbursement (n = 21) was the most frequently identified barrier to implementing telemedicine services. The majority of respondents (n = 20) find telemedicine to be equivalent to in-person care. Conclusions: Over 85% of leading US neurology departments currently use or plan to implement telemedicine within the next year. Addressing reimbursement may allow for its broader application.
Sepsis
Authors: Karnatovskaia Lioudmila V. , Festic Emir
Published: July 2012

Sepsis represents a major challenge in medicine. It begins as a systemic response to infection that can affect virtually any organ system, including the central and peripheral nervous systems. Akin to management of stroke, early recognition and treatment of sepsis are just as crucial to a successful outcome. Sepsis can precipitate myasthenic crisis and lead to encephalopathy and critical illness neuropathy. Stroke and traumatic brain injury can predispose a patient to develop sepsis, whereas Guillain-Barré syndrome is similarly not uncommon following infection. This review article will first describe the essential principles of sepsis recognition, pathophysiology, and management and will then briefly cover the neurologic aspects associated with sepsis. Vigilant awareness of the clinical features of sepsis and timeliness of intervention can help clinicians prevent progression of this disease to a multisystem organ failure, which can be difficult to reverse even after the original source of infection is under control.
Prospects for treating osteoarthritis: enzyme–protein interactions regulating matrix metalloproteinase activity
Authors: Meszaros Evan , Malemud Charles J.
Published: July 2012

Primary osteoarthritis (OA) is a musculoskeletal disorder of unknown etiology. OA is characterized by an imbalance between anabolism and catabolism in, and altered homeostasis of articular cartilage. Matrix metalloproteinases (MMPs) and a disintegrin and metalloproteinase with thrombospondin motif are upregulated in OA joints. Extracellular matrix (ECM) proteins are critical for resistance to compressive forces and for maintaining the tensile properties of the tissue. Tissue inhibitor of metalloproteinases (TIMPs) is the endogenous inhibitor of MMPs, but in OA, TIMPs do not effectively neutralize MMP activity. Upregulation of MMP gene expression occurs in OA in a milieu of proinflammatory cytokines such as interleukin (IL)-1, IL-6 and tumor necrosis factor α. Presently, the medical therapy of OA includes mainly nonsteroidal anti-inflammatory drugs and corticosteroids which dampen pain and inflammation but appear to have little effect on restoring joint function. Experimental interventions to restore the imbalance between anabolism and catabolism include small molecule inhibitors of MMP subtypes or inhibitors of the interaction between IL-1 and its receptor. Although these agents have some positive effects on reducing MMP subtype activity they have little efficacy at the clinical level. MMP-9 is one MMP subtype implicated in the degradation of articular cartilage ECM proteins. MMP-9 was found in OA synovial fluid as a complex with neutrophil gelatinase-associated lipocalin (NGAL) which protected MMP-9 from autodegradation. Suppressing NGAL synthesis or promoting NGAL degradation may result in reducing the activity of MMP-9. We also propose initiating a search for enzyme–protein interactions to dampen other MMP subtype activity which could suppress ECM protein breakdown.
Long-acting basal insulin analogs: latest developments and clinical usefulness
Authors: Mavrogiannaki Anastasia N. , Migdalis Ilias N.
Published: July 2012

All patients with type 1 diabetes mellitus need insulin treatment permanently, and many patients with type 2 diabetes will require insulin therapy. Basal insulin analogs are increasingly used in the treatment of diabetes, with the aim of offering a better replication of the pattern of basal endogenous secretion of insulin. Their flatter pharmacodynamic profile, with a much lower peak of action, their slow and continuous absorption into the systemic circulation, and prolonged duration, more closely duplicate the endogenous insulin secretion leading to physiological basal glycemic control and affording more flexible treatment with fewer hypoglycemia episodes. The basal analogs represent the most significant advances in ‘basal insulin’ supplementation, and can be used in different insulin regimens achieving the same clinical effectiveness over conventional insulins, with benefits in terms of hypoglycemia and less weight gain, and may be an option for patients with problematic hypoglycemia despite optimization of conventional insulin therapy. At present, there are no data on micro- or macrovascular endpoints, and indeed it is unlikely that these will become available, at least in the foreseeable future. The evidence for basal insulin analogs affecting the risk of cancer is limited, and overriding diabetes indications rather than putative cancer concerns should remain the principal consideration when selecting therapy in patients with diabetes.
Role of SHP2 phosphatase in KIT-induced transformation: identification of SHP2 as a druggable target in diseases involving oncogenic KIT
Authors: Mali Raghuveer Singh , Ma Peilin , Zeng Li-Fan , Martin Holly , Ramdas Baskar , He Yantao , Sims Emily , Nabinger Sarah , Ghosh Joydeep , Sharma Namit , Munugalavadla Veerendra , Chatterjee Anindya , Li Shuo , Sandusky George , Craig Andrew W. , Bunting Kevin D. , Feng Gen-Sheng , Chan Rebecca J. , Zhang Zhong-Yin , Kapur Reuben
Published: July 2012

Intracellular mechanism(s) that contribute to promiscuous signaling via oncogenic KIT in systemic mastocytosis and acute myelogenous leukemia are poorly understood. We show that SHP2 phosphatase is essential for oncogenic KIT-induced growth and survival in vitro and myeloproliferative disease (MPD) in vivo. Genetic disruption of SHP2 or treatment of oncogene-bearing cells with a novel SHP2 inhibitor alone or in combination with the PI3K inhibitor corrects MPD by disrupting a protein complex involving p85α, SHP2, and Gab2. Importantly, a single tyrosine at position 719 in oncogenic KIT is sufficient to develop MPD by recruiting p85α, SHP2, and Gab2 complex to oncogenic KIT. Our results demonstrate that SHP2 phosphatase is a druggable target that cooperates with lipid kinases in inducing MPD.
Elevating body temperature enhances hematopoiesis and neutrophil recovery after total body irradiation in an IL-1–, IL-17–, and G-CSF–dependent manner
Authors: Capitano Maegan L. , Nemeth Michael J. , Mace Thomas A. , Salisbury-Ruf Christi , Segal Brahm H. , McCarthy Philip L. , Repasky Elizabeth A.
Published: July 2012

Neutropenia is a common side effect of cytotoxic chemotherapy and radiation, increasing the risk of infection in these patients. Here we examined the impact of body temperature on neutrophil recovery in the blood and bone marrow after total body irradiation (TBI). Mice were exposed to either 3 or 6 Gy TBI followed by a mild heat treatment that temporarily raised core body temperature to approximately 39.5°C. Neutrophil recovery was then compared with control mice that received either TBI alone heat treatment alone. Mice that received both TBI and heat treatment exhibited a significant increase in the rate of neutrophil recovery in the blood and an increase in the number of marrow hematopoietic stem cells and neutrophil progenitors compared with that seen in mice that received either TBI or heat alone. The combination treatment also increased G-CSF concentrations in the serum, bone marrow, and intestinal tissue and IL-17, IL-1β, and IL-1α concentrations in the intestinal tissue after TBI. Neutralizing G-CSF or inhibiting IL-17 or IL-1 signaling significantly blocked the thermally mediated increase in neutrophil numbers. These findings suggest that a physiologically relevant increase in body temperature can accelerate recovery from neutropenia after TBI through a G-CSF–, IL-17–, and IL-1–dependent mechanism.
Levels and values of circulating endothelial progenitor cells, soluble angiogenic factors, and mononuclear cell apoptosis in liver cirrhosis patients
Authors: Chen Chih-Hung , Chang Li-Teh , Tung Wei-Chih , Chen Yung-Lung , Chang Chia-Lo , Leu Steve , Sun Cheuk-Kwan , Tsai Tzu-Hsien , Tsai I-Ting , Chang Hsueh-Wen , Yip Hon-Kan
Published: July 2012

Background

The roles of circulating endothelial progenitor cell (EPC) and mononuclear cell apoptosis (MCA) in liver cirrhosis (LC) patients are unknown. Moreover, vascular endothelial growth factor (VEGF) and stromal cell-derived factor (SDF)-1α are powerful endogenous substances enhancing EPC migration into circulation. We assessed the level and function of EPCs [CD31/CD34 (E1), KDR/CD34 (E2), CXCR4/CD34 (E3)], levels of MCA, VEGF and SDF-1α in circulation of LC patients.

Methods

Blood sample was prospectively collected once for assessing EPC level and function, MCA, and plasma levels of VEGF and SDF-1α using flow cytometry and enzyme-linked immunosorbent assay (ELISA), respectively, in 78 LC patients and 25 age- and gender-matched healthy controls.

Results

Number of EPCs (E1, E2, E3) was lower (all p < 0.0001), whereas SDF-1α level and MCA were higher (p < 0.001) in study patients compared with healthy controls. Number of EPCs (E2, E3) was higher but MCA was lower (all p < 0.05) in Child's class A compared with Child's class B and C patients, although no difference in VEGF and SDF-1α levels were noted among these patients. Chronic hepatitis B and esophageal varices bleeding were independently, whereas chronic hepatitis C, elevated aspartate aminotransferase (AST), and decompensated LC were inversely and independently correlated with circulating EPC level (all p < 0.03). Additionally, angiogenesis and transwell migratory ability of EPCs were reduced in LC patients than in controls (all p < 0.001).

Conclusion

The results of this study demonstrated that level, angiogenic capacity, and function of circulating EPCs were significantly reduced, whereas plasma levels of SDF-1α and circulating MCA were substantially enhanced in cirrhotic patients.
What do peer support workers do? A job description
Authors: Jacobson Nora , Trojanowski Lucy , Dewa Carolyn S
Published: July 2012

Background

The extant literature suggests that poorly defined job roles make it difficult for peer support workers to be successful, and hinder their integration into multi-disciplinary workplace teams. This article uses data gathered as part of a participatory evaluation of a peer support program at a psychiatric tertiary care facility to specify the work that peers do.

Methods

Data were gathered through interviews, focus groups, and activity logs and were analyzed using a modified grounded theory approach.

Results

Peers engage in direct work with clients and in indirect work that supports their work with clients. The main types of direct work are advocacy, connecting to resources, experiential sharing, building community, relationship building, group facilitation, skill building/mentoring/goal setting, and socialization/self-esteem building. The main types of indirect work are group planning and development, administration, team communication, supervision/training, receiving support, education/awareness building, and information gathering and verification. In addition, peers also do work aimed at building relationships with staff and work aimed at legitimizing the peer role. Experience, approach, presence, role modeling, collaboration, challenge, and compromise can be seen as the tangible enactments of peers’ philosophy of work.

Conclusions

Candidates for positions as peer support workers require more than experience with mental health and/or addiction problems. The job description provided in this article may not be appropriate for all settings, but it will contribute to a better understanding of the peer support worker position, the skills required, and the types of expectations that could define successful fulfillment of the role.
Overlapping effector interfaces define the multiple functions of the HIV-1 Nef polyproline helix
Authors: Kuo Lillian S , Baugh Laura L , Denial Sarah J , Watkins Richard L , Liu Mingjie , Garcia J Victor , Foster John L
Published: July 2012

Background

HIV-1 Nef is a multifunctional protein required for full pathogenicity of the virus. As Nef has no known enzymatic activity, it necessarily functions through protein-protein interaction interfaces. A critical Nef protein interaction interface is centered on its polyproline segment (P69VRPQVPLRP78) which contains the helical SH3 domain binding protein motif, PXXPXR. We hypothesized that any Nef-SH3 domain interactions would be lost upon mutation of the prolines or arginine of PXXPXR. Further, mutation of the non-motif “X” residues, (Q73, V74, and L75) would give altered patterns of inhibition for different Nef/SH3 domain protein interactions.

Results

We found that mutations of either of the prolines or the arginine of PXXPXR are defective for Nef-Hck binding, Nef/activated PAK2 complex formation and enhancement of virion infectivity (EVI). Mutation of the non-motif “X” residues (Q, V and L) gave similar patterns of inhibition for Nef/activated PAK2 complex formation and EVI which were distinct from the pattern for Hck binding. These results implicate an SH3 domain containing protein other than Hck for Nef/activated PAK2 complex formation and EVI. We have also mutated Nef residues at the N-and C-terminal ends of the polyproline segment to explore interactions outside of PXXPXR. We discovered a new locus GFP/F (G67, F68, P69and F90) that is required for Nef/activated PAK2 complex formation and EVI.

MHC Class I (MHCI) downregulation was only partially inhibited by mutating the PXXPXR motif residues, but was fully inhibited by mutating the C-terminal P78. Further, we observed that MHCI downregulation strictly requires G67and F68. Our mutational analysis confirms the recently reported structure of the complex between Nef, AP-1 μ1 and the cytoplasmic tail of MHCI, but does not support involvement of an SH3 domain protein in MHCI downregulation.

Conclusion

Nef has evolved to be dependent on interactions with multiple SH3 domain proteins. To the N- and C- terminal sides of the polyproline helix are multifunctional protein interaction sites. The polyproline segment is also adapted to downregulate MHCI with a non-canonical binding surface. Our results demonstrate that Nef polyproline helix is highly adapted to directly interact with multiple host cell proteins.
Structural distinctions in BMPs underlie divergent signaling in spinal neurons
Authors: Perron Jeanette C , Dodd Jane
Published: July 2012

Background

In dorsal spinal neurons and monocytes, bone morphogenetic protein (BMP)7 activates distinct transduction pathways, one leading to inductive specification and the other to axon orientation and chemotaxis. BMP7-evoked induction, also stimulated by the closely related BMP6, acts through a Smad cascade, leading to nuclear signaling, and is not BMPR subunit selective. Orientation is evoked by BMP7, but not by BMP6, through PI3K-dependent cytoskeletal activation mediated by the type II BMPRs, ActRIIA and BMPRII and is independent of the Smad cascade. The responses can be stimulated concurrently and suggest that BMP7, but not BMP6, can selectively activate BMPR subunits that engage the divergent paths. Although structural and biochemical analyses of selected BMP/BMPR interfaces have identified key regions of interaction, how these translate into function by related BMPs is poorly understood. To determine the mechanisms underlying the distinct activities of BMP7 and the disparate properties of BMP7 and BMP6 in spinal cord development, we have performed a family-wide structure/function analysis of BMPs and used the information to predict and test sites within BMPs that may control agonist properties, in particular the ability of a BMP to orient axons, through interactions with BMPRs.

Results

We demonstrate that whereas all BMPs can induce dorsal neurons, there is selectivity in the ability also to orient axons or evoke growth cone collapse. The degree to which a BMP orients is not predictable by overall protein similarity with other BMPs but comparison of sequences of potent and weakly orienting BMPs with that of the non-orienting BMP6 revealed three candidate positions within the BMPs at which the amino acid residues may confer or obstruct orienting ability. Residue swapping analysis has identified one residue, Gln

48
in BMP6, that blocks axon orienting ability. Replacing Gln

48
with any of the amino acids present at the equivalent residue position in the orienting subset of BMPs confers orienting activity on BMP6. Conversely, swapping Gln

48
into BMP7 reduces orienting ability. The inductive capacity of the BMPs was unchanged by these residue swaps.

Conclusions

The results suggest that the presence of the Gln

48
residue in BMP6 is structurally inhibitory for BMP/BMPR interactions that result in the activation of intracellular signaling, leading to axon orientation. Moreover, since residue 48 in BMP7 and the corresponding residue in BMP2 are important for type II BMPR binding, our results provide a basis for a mechanistic understanding of the diverse activities of BMPs in spinal cord development.
The Rice Oligonucleotide Array Database: an atlas of rice gene expression
Authors: Cao Peijian , Jung Ki-Hong , Choi Daeseok , Hwang Daehee , Zhu Jun , Ronald Pamela C
Published: July 2012

Background

Microarray technologies facilitate high-throughput gene expression analysis. However, the diversity of platforms for rice gene expression analysis hinders efficient analysis. Tools to broadly integrate microarray data from different platforms are needed.

Results

In this study, we developed the Rice Oligonucleotide Array Database (ROAD,http://www.ricearray.org) to explore gene expression across 1,867 publicly available rice microarray hybridizations. The ROAD’s user-friendly web interface and variety of visualization tools facilitate the extraction of gene expression profiles using gene and microarray element identifications. The ROAD supports meta-analysis of genes expressed in different tissues and at developmental stages. Co-expression analysis tool provides information on co-regulation between genes under general, abiotic and biotic stress conditions. Additionally, functional analysis tools, such as Gene Ontology and KEGG (Kyoto Encyclopedia of Genes and Genomes) Orthology, are embedded in the ROAD. These tools facilitate the identification of meaningful biological patterns in a list of query genes.

Conclusions

The Rice Oligonucleotide Array Database provides comprehensive gene expression profiles for all rice genes, and will be a useful resource for researchers of rice and other grass species.
Proposal for a Novel Methodology to Screen And Score Cost Versus Survival for Anticancer Drugs in Metastatic Disease: Could Cost Weigh in Evaluation?
Authors: Guirgis Helmy M.
Published: July 2012

Methodology with limits on cost per day of survival was proposed to evaluate anticancer drugs used in first-line therapy for metastatic disease. Cost versus survival varied with the number of cycles.
Cost Effectiveness of Integrated Medicine in Patients With Cancer Receiving Anticancer Chemotherapy
Authors: Coriat Romain , Boudou-Rouquette Pascaline , Durand Jean-Philippe , Forgeot d'Arc Priscille , Martin Idalie , Mir Olivier , Ropert Stanislas , Alexandre Jérôme , Goldwasser François
Published: July 2012

The hospital-home monitoring program is a cost-effective strategy for offering ambulatory chemotherapy treatment to patients with cancer and has become the authors' standard procedure for ambulatory chemotherapy.
Barriers to the Use of Personalized Medicine in Breast Cancer
Authors: Weldon Christine B. , Trosman Julia R. , Gradishar William J. , Benson Al B. , Schink Julian C.
Published: July 2012

Poorly coordinated diagnostic testing and the current oncology reimbursement model are barriers to the use of genomic and molecular diagnostic tests in cancer care.
Clock accuracy and precision evolve as a consequence of selection for adult emergence in a narrow window of time in fruit flies Drosophila melanogaster
Authors: Kannan Nisha N. , Vaze Koustubh M. , Sharma Vijay Kumar
Published: July 2012

Although circadian clocks are believed to have evolved under the action of periodic selection pressures (selection on phasing) present in the geophysical environment, there is very little rigorous and systematic empirical evidence to support this. In the present study, we examined the effect of selection for adult emergence in a narrow window of time on the circadian rhythms of fruit flies Drosophila melanogaster. Selection was imposed in every generation by choosing flies that emerged during a one hour window of time close to the emergence peak of baseline/control flies under 12:12 h (hour) light/dark (LD) cycles. To study the effect of selection on circadian clocks we estimated several quantifiable features that reflect inter- and intra-individual variance in adult emergence and locomotor activity rhythms. The results showed that with increasing generations incidence of adult emergence and activity of adult flies during the one hour selection window increased gradually in the selected populations. Flies from the selected populations were more homogenous in their clock period, were more coherent in their phase of entrainment, and displayed enhanced accuracy and precision in their emergence and activity rhythms compared to controls. These results thus suggest that circadian clocks in fruit flies D. melanogaster evolve enhanced accuracy and precision when subjected to selection for emergence in a narrow window of time.
Locomotion analysis identifies roles of mechanosensory neurons in governing locomotion dynamics of C. elegans
Authors: Cohen Emiliano , Yemini Eviatar , Schafer William , Feitelson Dror G. , Treinin Millet
Published: July 2012

The simple and well-characterized nervous system of C. elegans facilitates analysis of mechanisms controlling behavior. Locomotion is a major behavioral output governed by multiple external and internal signals. Here we examine the roles of low- and high-threshold mechanosensors in locomotion, using high-resolution and detailed analysis of locomotion and its dynamics. This analysis reveals a new role for touch receptor neurons in suppressing an intrinsic direction bias of locomotion. We also examine the response to noxious mechanical stimuli, showing a response entailing several locomotion properties and lasting several minutes. Effects on different locomotion properties have different half-lives and depend on different partly overlapping sets of sensory neurons. PVD and FLP, high-threshold mechanosensors, play a major role in some of these responses. Overall, our results demonstrate the power of detailed, prolonged, and high-resolution analysis of locomotion and locomotion dynamics in enabling better understanding of gene and neuron function.
Mineral and bone disorders in chronic kidney disease: new insights into mechanism and management
Authors: Lewis Robert
Published: July 2012

Chronic kidney disease (CKD) is now recognized as a major public health issue. One consequence of this condition is disturbance of mineral and bone homeostasis. Bone disease (renal osteodystrophy) as a consequence of CKD has long been recognized. However, it is now appreciated that the mineral and bone disturbances of CKD (and perhaps treatment of them) lead to vascular calcification, which is a cause of significant morbidity. In recognition of the widespread nature of the condition, the term CKD-mineral bone disorder (CKD-MBD) is now in general use to describe the biochemical, skeletal and vascular changes that occur in CKD. The pathogenesis of CKD-MBD is incompletely understood but has recently been redefined with the emergence of fibroblast growth factor 23 (FGF-23) as a major influence on control of vitamin D and parathyroid hormone. This review describes the classification of CKD and current understanding of the mechanisms underlying CKD-MBD (incorporating FGF-23). It describes and evaluates the means of identifying CKD-MBD in the clinical setting and the interventions available for treatment. It then reviews current clinical guidelines for the use of biochemical markers in clinical decision-making. In acknowledgement of the paucity of evidence upon which these guidelines are based, areas where clinical research might be directed in the future will be identified.
Ethicists conscientiously objecting: an ontological dejustification
Authors: Kekewich Michael A , Foreman Thomas C
Published: July 2012

Much has been written about the rights of health-care professionals to conscientiously object. Ironically, there has been no formal discussion as to whether clinical ethicists have the same right. Given that ethicists routinely deal with the same situations and questions that other health-care professionals find morally discomforting, the question as to whether they have the same right is a critical one. We conclude that ethicists should not have the same right to conscientious objection. The role of an ethicist is to competently manage those situations and cases that cause moral discomfort and confusion. By conscientiously objecting, an ethicist would be failing to fulfil their primary function. The same cannot be said as forcefully about other professionals who object. Moreover, ethicists retain the right to conscientious objection to the joining of the discipline in the first place, and also retain the right to exit if they so choose.
Dilemmas of ethics committees’ effectiveness: a management and team theory contribution
Authors: Shetach Ana
Published: July 2012

This paper attempts to draw on management theory and practice and, more specifically, on know-how from the study of teamwork, to seek insights into enhancing the effectiveness of hospital ethics committees and clinical ethics committees (CECs), with the aim of contributing to heath-care organizations’ effective and efficient decision-making and operation. Based on an analysis of the obstacles that stand in the way of ethics committees’ (ECs’) efficient functioning, five specific conditions for EC success are brought forth. A couple of practical tools for their attainment are proposed. The article suggests that the construction of those committees, as well as the working procedures that may render them effective, should be flexible and made adaptable to the specific assignment or case, which is dealt with by that committee, at the time; and that the optimal set of procedures to adopt, throughout the working sessions of ECs, are those which will gear the committee with the means to contribute to the eventual materializing and finalization of a quality and practical set of decisions; for the benefit of patients, their families, health-care organizations and the community, alike.
What German experts expect from individualized medicine: problems of uncertainty and future complication in physician–patient interaction
Authors: Heßling Arndt , Schicktanz Silke
Published: July 2012

‘Individualized medicine’ is an emerging paradigm in clinical life science research. We conducted a socio-empirical interview study in a leading German clinical research group, aiming at implementing ‘individualized medicine’ of colorectal cancer. The goal was to investigate moral and social issues related to physician–patient interaction and clinical care, and to identify the points raised, supported and rejected by the physicians and researchers. Up to now there has been only limited insight into how experts dedicated to individualized medicine view its problems. Interviews with researchers and clinicians ( n= 19) were based on a prestructured questionnaire. The content analysis revealed a broad spectrum of opinions. Major findings were (a) disappointments with the limits of the current therapy regimen and clinical practice; (b) problematic impacts on physician–patient relationship; and (c) an informed consent procedure which is mainly based on paternalistic assumptions. According to our analysis, major problems will be uncertainties related to the biomarker's sensitivity and specificity, and the identification of ‘non-responders’. However, the findings also indicate that experts expect evidence-based medicine to replace decisions based on gut feeling or hierarchical structures.
Safety and efficacy of oral ivabradine as a heart rate-reducing agent in patients undergoing CT coronary angiography
Authors: Adile K K , Kapoor A , Jain S K , Gupta A , Kumar S , Tewari S , Garg N , Goel P K
Published: July 2012

Objective: To investigate the role of oral ivabradine as a heart rate reducing agent in patients undergoing CT coronary angiography (CTCA). Despite the routine use of β-blockers prior to CTCA studies, it is not uncommon to have patients with heart rates persistently above the target range of 65 bpm. Ivabradine is a selective inhibitor of the If current, which primarily contributes to sinus node pacemaker activity, and has no significant direct cardiovascular effects such as reduction of blood pressure, cardiac contractility or impairment of cardiac conduction.

Methods: We investigated 100 consecutive patients who had been referred for CTCA for the evaluation of suspected coronary artery disease (CAD). Patients were randomised to receive either of the following two pre-medication protocols: oral metorprolol or oral ivabradine.

Results: Ivabradine was significantly more effective than metorprolol in lowering the heart rate; the mean percentage reduction in heart rate with ivabradine vs metorpolol was 23.89+6.95% vs 15.20+4.50%, respectively (p=0.0001). Metoprolol significantly lowered both systolic and diastolic blood pressure while ivabradine did not. The requirement of additional doses to achieve a target heart rate of <65 beats per min was also significantly more frequent with metoprolol.

Conclusion: Ivabradine is a potentially attractive alternative to currently used drugs for reduction of heart rate in patients undergoing CTCA.
Interobserver variation in clinical target volume and organs at risk segmentation in post-parotidectomy radiotherapy: can segmentation protocols help?
Authors: Mukesh M , Benson R , Jena R , Hoole A , Roques T , Scrase C , Martin C , Whitfield G A , Gemmill J , Jefferies S
Published: July 2012

Objective: A study of interobserver variation in the segmentation of the post-operative clinical target volume (CTV) and organs at risk (OARs) for parotid tumours was undertaken. The segmentation exercise was performed as a baseline, and repeated after 3 months using a segmentation protocol to assess whether CTV conformity improved.

Methods: Four head and neck oncologists independently segmented CTVs and OARs (contralateral parotid, spinal cord and brain stem) on CT data sets of five patients post parotidectomy. For each CTV or OAR delineation, total volume was calculated. The conformity level (CL) between different clinicians' outlines was measured using a validated outline analysis tool. The data for CTVs were reaanalysed after using the cochlear sparing therapy and conventional radiation segmentation protocol.

Results: Significant differences in CTV morphology were observed at baseline, yielding a mean CL of 30% (range 25–39%). The CL improved after using the segmentation protocol with a mean CL of 54% (range 50–65%). For OARs, the mean CL was 60% (range 53–68%) for the contralateral parotid gland, 23% (range 13–27%) for the brain stem and 25% (range 22–31%) for the spinal cord.

Conclusions: There was low conformity for CTVs and OARs between different clinicians. The CL for CTVs improved with use of a segmentation protocol, but the CLs remained lower than expected. This study supports the need for clear guidelines for segmentation of target and OARs to compare and interpret the results of head and neck cancer radiation studies.
A Semi-Analytical Approach to Predict Ground Vibration by Identification of Soil Properties and Train-Transit Loads
Authors: Lee Joo-Ho , Lee Jong-Jae , Choi Jun-Seong , Yun Chung-Bang
Published: July 2012

Train-induced ground vibration problems have become an important subject, as the number of the high speed railroad construction projects rapidly increases worldwide. Various numerical approaches have been proposed and used for the prediction of the train-induced ground vibration. However, the estimation performance has not been satisfactory due to the difficulty in modeling the train-transit loads on railroad structures and the structure-soil interaction system, which are essential for the accurate prediction of ground vibration. In this study, a new semi-analytical method was proposed for the prediction of ground vibration and the evaluation of environmental vibration levels with simple measurements of the ground vibration on the surface. The proposed method does not need any analytical model for inputting the train load. Instead, it identifies the effective train loads acting on the railroad track structure based on the measured ground responses at several locations and the numerical model of the structure-soil interaction system through the identification of the properties of the soil layers. Then, the effective train load is utilized as an input to the structure-soil interaction problem to predict the ground vibrations and the environmental vibration levels of the structures. A finite and infinite element model was utilized to solve the wave propagation problem in the soil medium in the frequency domain. Field validations were carried out at a site where Korea high-speed trains run over an elevated bridge structure. The predicted ground accelerations were found to be in good agreement with the measured data.
A Piezoelectric Film Type Scour Monitoring System for Bridge Pier
Authors: Wang Chung-Yue , Wang Hao-Lin , Ho Chun-Che
Published: July 2012

An upgraded piezoelectric film type real-time scour monitoring sensor installed along the bridge pier is presented. The core idea of developing this scouring sensing system is based on the physical characteristic that output voltage can be generated as the piezoelectric film is deformed by the flowing media. Therefore, a sensing device can be constructed by mounting piezoelectric thin films along the rod at a fixed distance and inserting them into a guide rail beside the bridge pier. The piezoelectric film embedded in the soil of the riverbed is undisturbed and the output voltage is much smaller than the one disturbed by the water current. From the output signals of all the piezoelectric sensors with known locations along the depth of the pier foundation, one can trace the variation of the soil/water interface before, during and after a flood. Compared with other types of scouring sensors, this piezoelectric type scouring sensor is durable, sensitive, and cost effective and works in real-time without the need for power. In this paper, a signal processing technique and performance tests in laboratory of this novel piezoelectric film type scouring device are introduced first. The installation and performance of the system in the field is also addressed.
Estimate of CLD increase laminated plate and shell low-velocity impact strength
Authors: Luo Guangmin
Published: July 2012

FRP laminated structures enjoy the advantages of a low mass and high specific strength. However, the utilization of laminated forming methods causes these structures to become susceptible to phenomena such as delamination and fiber breakage, which lead to strength deficiencies, when they sustain low-velocity impact. In light of this, increasing the low-velocity impact strength of FRP laminated structures has been a major direction. This study utilizes Constrained Layered Damping (CLD) to enhance the low-velocity impact strength of FRP laminated structures, and assesses the efficiency of attaching CLD to laminated materials in increasing low-velocity impact strength. The results provide a reference for the design and construction of relevant structures in the future. Low-velocity impact failure in FRP laminated structures commonly includes fiber breakage and delamination. Delamination is particularly apparent when laminated curved shells bear external loading. We will attach CLD to the rear of FRP laminated structures to appropriately absorb impact energy, increasing the low-velocity impact strength of the structures. Results showed that the existence of CLD effectively delayed the occurrence of delamination, increasing the post-failure strength of laminated structures and alleviating structural failure. Finally, the energy perspective is used to assess the efficiency of increasing the low-velocity impact strength of FRP structures after attaching CLD.
Social Category Diversity Promotes Premeeting Elaboration: The Role of Relationship Focus
Authors: Loyd Denise Lewin , Wang Cynthia S. , Phillips Katherine W. , Lount Robert B.
Published: July 2012

A purported downside of social category diversity is decreased relationship focus (i.e., one’s focus on establishing a positive social bond with a coworker). However, we argue that this lack of relationship focus serves as a central mechanism that improves information processing even prior to interaction and, ultimately, decision-making performance in diverse settings. We introduce the construct of premeeting elaboration (i.e., the extent to which individuals consider their own and others’ perspectives in the anticipation of an interaction) and explore its link with social category diversity and relationship focus. Experiments 1 and 2 demonstrate that when disagreement occurs, social category diversity increases premeeting elaboration, with relationship focus as a central causal mechanism. Experiment 3 shows that premeeting elaboration has important implications for performance: disagreeing dyads with social category diversity elaborate more prior to meeting and, as a result, perform better on a decision-making task than those with social category homogeneity. We discuss the value of studying early-stage interaction and propose a reconsideration of the “downside” of social category diversity.
PERSPECTIVE—The Myth of Firm Performance
Authors: Miller C. Chet , Washburn Nathan T. , Glick William H.
Published: July 2012

Firm performance is one of the most prominent concepts in organizational research. Despite its importance, and despite the many developmental critiques that have appeared over the years, performance continues to be a difficult concept to apply in a scientifically rigorous way. After surfacing three potentially viable approaches for conceptualizing performance, we find that most studies are internally inconsistent in their use of these approaches, a situation that creates substantial difficulty in effectively interpreting research. The primary source of inconsistency lies in the use of a generalized abstract conceptualization of performance in theory building (the latent multidimensional approach) coupled with the adoption of one or two narrow aspects of performance in the empirical work (the separate constructs approach). Follow-up analyses designed to determine the best path for resolving these mismatches indicate that our field’s heavy use of abstract performance in theorizing is not scientifically grounded and should be replaced with more specific aspects of performance to match existing practices in empirical work. Although this change would profoundly affect the field and would be resisted by many, it offers a concrete path away from indefensible practices. We offer several explanations for current practices but emphasize forces related to institutional theory. From an institutional perspective, it appears that firm performance is treated in a general fashion in many areas of our academic lives because it has been embraced as an instrument of legitimacy rather than as a scientific tool that facilitates dialogue and the accumulation of knowledge. We recommend and begin a conversation designed to highlight the long-run dangers of focusing our attention on an abstract concept of performance and suggest a set of specific steps that could help to move all of us in a new direction as we attempt to enhance the scientific rigor of our field.
“We Want Respect”: Adults with Intellectual and Developmental Disabilities Address Respect in Research
Authors: McDonald Katherine Elizabeth
Published: July 2012

Respect is central to ethical guidelines for research. The scientific community has long debated, and at times disagreed on, how to demonstrate respect in research with adults with intellectual and developmental disabilities. To illuminate the voices of those most affected, the author studies the views of adults with intellectual and developmental disabilities on respect in research. Findings are consistent with disability rights' ideas and indicate that adults with intellectual and developmental disabilities have much to contribute to the discussion, that they value participating, and that they agree with calls to focus on human rights and dignity. Notably, participants spoke at lengths about the nature of interactions between researchers and participants. Implications are discussed, including how to infuse research standards with community-supported values and preferences.
Sleep and Daytime Functioning: A Short-term Longitudinal Study of Three Preschool-age Comparison Groups
Authors: Anders Thomas , Iosif Ana-Maria , Schwichtenberg A. J , Tang Karen , Goodlin-Jones Beth
Published: July 2012

This study examined sleep, sleepiness, and daytime performance in 68 children with autism, 57 children with intellectual disability (ID), and 69 typically developing preschool children. Children in the autism and ID groups had poorer daytime performance and behaviors than the typically developing children. Children in the ID group also were significantly sleepier than children in both the autism and typically developing groups. These significant differences persisted over 6 months. Actigraph-defined sleep behaviors and problems did not relate to daytime sleepiness or daytime performance and behaviors for the children with autism or the typically developing group. For the ID group, longer night awakenings and lower sleep efficiency predicted more daytime sleepiness. For each group, parent-report sleep problems were associated with more daytime sleepiness and more behavior problems.
Health Care of Latino Children with Autism and Other Developmental Disabilities: Quality of Provider Interaction Mediates Utilization
Authors: Parish Susan , Magaña Sandra , Rose Roderick , Timberlake Maria , Swaine Jamie G
Published: July 2012

This study examines access to, utilization of, and quality of health care for Latino children with autism and other developmental disabilities. We analyze data from the National Survey of Children with Special Health Care Needs (N  =  4,414 children with autism and other developmental disabilities). Compared with White children, Latino children with autism and other developmental disabilities had a consistent pattern of worse health care access, utilization, and quality. We then test mediation models to determine if health care quality mediates the relationship between ethnicity and health care utilization disparities. Three of four quality indicators (provider does not spend enough time with child, provider is not culturally sensitive, and provider does not make parent feel like a partner) were significant mediators. These analyses suggest that interventions targeted at improving providers' cultural sensitivity and behavior during the clinical encounter may reduce disparities in the health care utilization of Latino children with autism and other developmental disabilities.
Tweeting About Testing: Do Low‐Income, Parenting Adolescents And Young Adults Use New Media Technologies To Communicate About Sexual Health?
Authors: Divecha Zai , Divney Anna , Ickovics Jeannette , Kershaw Trace
Published: July 2012

CONTEXT

Little research exists about adolescents’ and young adults’ use of new media technologies to communicate about sexual health. Understanding how young people at high risk for STDs use these technologies can inform media‐based interventions.

METHODS

Between October 2010 and March 2011, a sample of 94 low‐income, parenting adolescents and young adults recruited at clinics in Connecticut completed an audio computer‐assisted self‐interview about their use of media technologies, communication with friends about sexual health and willingness to use media technologies for such communication. Descriptive statistics were calculated; characteristics of those willing and those unwilling to communicate were compared in chi‐square, t and Mann–Whitney tests.

RESULTS

Ninety‐three percent of participants had mobile phones; 71% used Facebook regularly. Participants discussed sexual health more often with close friends than with casual friends, and preferred to have such conversations in person (71% with close friends and 68% with casual friends), over the phone (52% and 45%) or via text message (30% and 28%), rather than through social networking sites (0–9% and 2–7%). Fewer than one‐third reported being willing to share sexual health information with friends through a specific new media technology. Those who were willing were predominantly black (59%); of those who were unwilling, 51% were Latino. Condom self‐efficacy, STD knowledge and number of Facebook friends were greater among those who were willing than among those who were unwilling.

CONCLUSIONS

For conversations about sexual health, young urban parents prefer private forms of ‐communi‐cation; thus, social networking sites may not aid STD interventions.
Multicomponent Systems Pricing: Rational Inattention and Downward Rigidities
Authors: Ray Sourav , Wood Charles A. , Messinger Paul R.
Published: July 2012

The authors examine the relative magnitude of price reductions for product systems and their constituent components (e.g., cameras, computers, monitors, lenses) and hypothesize that these price reductions systematically vary across different types of systems. The authors offer rational inattention as an explanation and document patterns of downward rigidity in online prices of computers and cameras that are consistent with this view. Their basic argument is that under certain circumstances, it is rational for consumers to ignore small price changes. This results in some price rigidity because firms would see no demand effect for small reductions. The authors suggest that this inattention systematically varies across different types of multicomponent systems, leading to specific hypotheses about sellers’ pricing behavior. They first check the validity of their theoretical arguments using data from two surveys of consumers and managers. They then examine 669,557 daily price listings for 1052 high-end cameras and computers from 102 online vendors and find evidence consistent with their predictions. Using publicly available web traffic data, the authors also find that their predicted pricing behavior is aligned with better traffic response for the firm.