bluuebunny/crossref_metadata_2025 huggingface dataset:
Health-Related Quality of Life and Mortality in a General and Elderly Population of Patients With Type 2 Diabetes (ZODIAC-18)
Authors: Landman Gijs W.D. , van Hateren Kornelis J.J. , Kleefstra Nanne , Groenier Klaas H. , Gans Rijk O.B. , Bilo Henk J.G.
Published: August 2010

OBJECTIVE

Diabetes negatively impacts the health-related quality of life (HRQOL) of patients with type 2 diabetes. An earlier analysis showed HRQOL to be associated with mortality, which suggests that measuring HRQOL could have clinical implications. We studied the association between HRQOL and total and cardiovascular mortality in patients with type 2 diabetes during long-term follow-up and specifically focused on old age and sex differences.

RESEARCH DESIGN AND METHODS

HRQOL was measured in a prospectively followed cohort of 1,353 patients with type 2 diabetes using the RAND-36. Cox proportional hazard models were used to measure the independent effect of baseline HRQOL on mortality.

RESULTS

During a mean follow-up of 9.6 years, 570 (42%) patients died, 280 of whom died of cardiovascular disease (49%). The Physical Component Score (PCS) and the Mental Component Score (MCS) were inversely associated with total mortality, with hazard ratios of 0.988 (95% CI 0.983–0.993) and 0.990 (95% CI 0.985–0.995), respectively. A 10-point-higher score on the PCS and MCS decreased the risk for total mortality by 11 and 10%, respectively. An inverse relationship with mortality was also seen for men, women, and for patients aged >75 years. Mental health was significantly related to mortality in men but not in women.

CONCLUSIONS

Lower physical and mental HRQOL was associated with a higher total mortality and cardiovascular mortality in patients with type 2 diabetes; this is also the case when studying men and women and the elderly separately. The dimension mental health, related to depression and anxiety, was only associated with mortality in men, not in women.
L-rhamnose and L-fucose suppress cancer growth in mice
Authors: Tomsik Pavel , Soukup Tomas , Cermakova Eva , Micuda Stanislav , Niang Mohamed , Sucha Lenka , Rezacova Martina
Published: August 2010

It is documented that deficient fucosylation may play an important role in the pathogenesis of cancer. Since the supplementation of L-fucose could restore fucosylation in both in vitro and in vivo conditions, our intent was to examine the effect of intraperitoneal administration of L-fucose and L-rhamnose (a similar deoxysaccharide) on tumour growth, mitotic activity and metastatic setting of a solid form of Ehrlich carcinoma as well as on the survival rate of tumour bearing mice. Both L-fucose and L-rhamnose exerted a significant suppressive effect on tumour growth (P<0.05). After 10 days of therapy, the greatest inhibition of tumour growth expressed as a percentage of controls was observed in L-rhamnose at a dose of 3 g/kg/day (by 62%) and L-fucose at a dose of 5 g/kg/day (by 47%). Moreover, the mitotic index decreased with increasing doses of L-fucose and L-rhamnose. Prolonged survival of tumour bearing mice was observed after 14 consecutive days of daily administering L-rhamnose. Its optimal dose was estimated to be 3.64 g/kg/day. L-Fucose, however, displayed only a slight effect on the survival of the mice. Our results suggest that L-fucose and especially L-rhamnose have anticancer potential. This study is the first to demonstrate the tumour-inhibitory effect of L-rhamnose.
Effects of winter survival training on selected motor indices
Authors: Tomczak Andrzej
Published: August 2010

Effects of winter survival training on selected motor indices

Study aim: To assess the effects of prolonged winter survival activities of moderate workouts on selected motor skills in male participants of survival instructor training course.

Material and methods: A group of 11 physical education students, participants of a survival course camp for instructors, aged 21 - 25 years, participated in the study. They were examined 3 times: before starting the course (Day 1), on the following morning - after a 12-h night training when the participants were deprived of sleep (Day 2) and 24 h later, after a 6-h sleep and survival activities lasting all day (Day 3). At the end of the course all the participants were assessed by a single 10-point scale. In the mornings of all 3 days the participants were subjected to the following tests: 15-m straight run, shuttle run 3×5 m, 15-slalom run, 15-m squat, computer-aided co-ordination test, maximum handgrip, 50%-handgrip and corrected 50% handgrip.

Results: Running velocity on Day 3 was significantly (p<0.05) decreased in relation to the previous days but a running performance index computed from the standardised values of all running tests did not decrease and on Day 2 was even significantly (p<0.05) higher than on Day 1. No significant between-day differences were found for the visual co-ordination test and for handgrip strength indices despite exhausting workloads applied.

Conclusions: Although the applied tests did no fully reflect the real performance of subjects under the winter survival conditions, it seems that engaging soldiers in consecutive military actions without an adequate recovery should be avoided whenever possible in order to improve the execution of strenuous tasks.
Histological Marker to Differentiate Organogenic Calli from Non Organogenic Calli of Gloriosa superba L.
Authors: Madhavan Manju , Joseph Joy P.
Published: August 2010

A histological study of the indirect organogenesis from internodal cultures of Gloriosa superba L. showed that the callus initiated from the subepidermal cells. The organogenic and non organogenic callii are the result of hormonal variation in the medium. In non organogenic callus cells redifferentiated into xylem elements   forming clusters of nest like structures. In organogenic callus, cells redifferen-tiated into nodules of meristemoids which further differentiated into shoot apical meristem.  Keywords: Histological marker, Gloriosa superba, Organogenic calli D.O.I. 10.3329/ptcb.v20i1.5957 Plant Tissue Cult. & Biotech. 20(1): 1-5, 2010 (June)
Micropropagation of Ophiorrhiza eriantha Wight. through Leaf Explant Cultures
Authors: Rani V. K. Jaimsha , Fijesh P. V. , Padikkala Jose
Published: August 2010

Leaf explants of Ophiorrhiza eriantha cultured in MS supplemented with the combination of NAA 4 mg/l  and BA 0.5 mg/l induced higher callus growth. The maximum number of shoots were produced from callus on the MS supplemented with BA 5 mg/l. The regenerated shoots were transferred into the auxin containing medium for rooting and IBA 3 mg/l supplemented medium produced maximum number of roots per shoot. Camptothecin (anticancer drug) was isolated from O. eriantha wild grown plant and in vitro regenerated plants, and was confirmed by LC-MS-MS. The camptothecin content in wild grown plant, callus and regenerated plants were quantified by HPLC system. Key words: Camptothecin, Leaf explants, Ophiorrhiza eriantha, Micropropagation                      D.O.I. 10.3329/ptcb.v20i1.5960 Plant Tissue Cult. & Biotech. 20(1): 13-20, 2010 (June)
Efficient Plant Regeneration from Shoot Apices of Pearl Millet (Pennisetum americanum (L.) Leeke)
Authors: Varalaxmi Y. , Vijayalakshmi A. , Kumar K. Ravi , Vijayalakshmi T. , Maheswari M.
Published: August 2010

An efficient and rapid regeneration protocol was developed from shoot tip explants of Pennisetum americanum (L.) Leeke variety WC-75. MS supplemented with low concentration of 2,4-D and Kn was most effective in producing embryogenic calli. Maximum regeneration potential of 40 shoots per calli were obtained when transferred to regeneration medium containing 1.0 mg/l Kn. Shoots developed were efficiently rooted within 15 days on the medium containing NAA. Over 90% of rooted plants were fertile after transfer to a net house. Key words: Pearl millet, Efficient, plant regeneration, Shoot apices D.O.I. 10.3329/ptcb.v20i1.5964 Plant Tissue Cult. & Biotech. 20(1): 47-53, 2010 (June)
Young and Burgess Type I Lateral Compression Pelvis Fractures: A Comparison of Anterior and Posterior Pelvic Ring Injuries
Authors: Lin Edward A. , Min William , Christoforou Dimitrios , Tejwani Nirmal C.
Published: August 2010

The goals of this study were to find associations between anterior and posterior ring injuries, provide a descriptive comparison of pelvic ring disruptions as assessed by plain radiography, and compare the value of computed tomography (CT) over plain radiography in evaluating anterior and posterior structures.

A retrospective review of radiographic reports and records identified 142 patients with pubic ramus fractures as observed by plain radiography. A statistical analysis was performed to test the associations between anterior ring injury as assessed by plain radiography and posterior ring injury as assessed by CT. Forty-five point five percent of patients with bilateral ramus fractures and 42.0% of patients with dual-ramus fractures had concomitant sacral fractures not observed on plain radiographs. These occult sacral fractures were found in only 11.1% of patients with inferior ramus fractures.

The type of pubic injury on plain radiographs may be predictive of posterior ring injury, and therefore may help determine injury energy and severity, determine the need for further imaging studies, and help guide clinical management. Although CT is highly sensitive in identifying both anterior and posterior pubic ring injuries, elderly patients with simple fractures of a single pubic ramus are less likely to suffer from pelvic instability and thus may not benefit from CT.
Outcomes and Practical Information for Patients Choosing Nonoperative Treatment for Distal Biceps Ruptures
Authors: Geaney Lauren E. , Brenneman David J. , Cote Mark P. , Arciero Robert A. , Mazzocca Augustus D.
Published: August 2010

The goal of this study was to evaluate the outcomes of patients selecting nonoperative treatment for distal biceps tendon ruptures to provide information to patients and caregivers to consider in decision making. Five men conservatively treated for distal biceps tendon rupture between November 2002 and December 2006 were compared to 5 age-matched controls treated operatively. Outcomes at 4.5 years included supination strength, range of motion, and American Shoulder and Elbow Surgeons (ASES) score. Two groups of 9 normal volunteers—1 young group averaging 30.7 years and 1 older group averaging 48.8 years—served as controls.

In nonoperative patients, elbow supination strength in the injured arm was 4.14 Nm (SD 0.94) and in the uninjured arm was 4.91 Nm (SD 0.65). In operative patients, supination strength was 4.25±1.08 Nm in the operatively repaired arm and 5.74±1.27 Nm in the uninjured arm. Age-matched normal patients had supination strength of 5.78±1.46 Nm in the dominant arm and 5.59±1.32 Nm in the nondominant arm. The ASES score averaged 89.57, with 3 patients reporting pain, compared to a score of 87.5 in the operative patients.

Patients choosing conservative treatment for distal biceps ruptures have residual pain and weakness approximately double that seen between normal dominant and non-dominant extremities.
Progression of Aggressive Metastatic Carcinosarcoma After Treatment of Epithelioid Osteosarcoma
Authors: Amanatullah Derek F. , Ngann Kuong K. , Borys Dariusz , Tamurian Robert M.
Published: August 2010

Osteosarcoma is the most common primary malignant osseous neoplasm, constituting approximately 35% of skeletal malignancies. The different subtypes of osteosarcoma are differentiated based on clinical, histologic, and radiographic data, as well as the variable amount of osteoid produced by malignant cells. The epithelioid osteosarcoma subtype accounts for only 5.7% of all osteosarcomas and portends an extremely poor prognosis. The 5-year survival rate for patients with epithelioid osteosarcoma treated with surgery (with or without chemotherapy) is 13.5%. This is in direct contrast to the >70% ten-year survival rate of conventional osteosarcoma treated with surgery and chemotherapy.

This article presents a fatal case of epithelioid osteosarcoma in an 11-year-old girl with right knee pain of 6 months' duration. Biopsy demonstrated morphologic findings consistent with high-grade osteosarcoma with epithelioid features. The epithelioid component was positive for vimentin and CD99; however, fluorescent in situ hybridization for the (11;22) translocation was negative. In this case, the epithelioid cells failed to respond to conventional or subsequent experimental chemotherapy for osteosarcoma and eventual metastasized to the lymph nodes and lungs despite multiple ablative surgeries. This case report supports the concept of carcinosarcoma with malignant cells lines arising from 2 different cellular lineages or a common cellular precursor. The epithelial component was more aggressive than the cells of mesenchymal origin, highlighting the need for continued research and a more favorable outcome for this rare subset of osteosarcoma.
Arthroscopic Treatment of Pigmented Villonodular Synovitis Involving Bilateral Shoulders
Authors: Koh Kyoung Hwan , Lim Kyung Sub , Yoo Jae Chul
Published: August 2010

Pigmented villonodular synovitis (PVNS) is a lesion of benign proliferative synovium that invades joint, tendon sheath, and bursa. It mainly occurs in 1 joint, the knee joint or hand, and multi-joint invasion is reported to be <1%. Rare cases have been reported of PVNS occurring in the shoulder joint. Generally, total synovectomy is a standard treatment of PVNS. However, complete synovectomy is sometimes impossible because of difficulty of visualization and access to the whole joint and subacromial space. Therefore, recurrence of the disease is always of concern.

This article presents a case of 64-year-old patient with pain and swelling of bilateral shoulder joints of 4 months' duration. Physical examination showed atrophy of the deltoid and infraspinatus and a mass-like protrusion on the anterior portion of left shoulder. Active forward elevation was limited to 30° on the right and 90° on the left. Overall synovial hyperplasia and nodular mass was observed on magnetic resonance imaging. Massive rotator cuff tear and invasion of the lesion toward the subacromial space and deltoid muscle was noted as well. Arthroscopic examination revealed a typical finding of PVNS: yellowish brown pigmentation over the overall joint capsule and subacromial space. Arthroscopic total synovectomy without rotator cuff repair was performed for both shoulders. Clinical outcomes showed good pain relief and no recurrence of the disease, although range of motion and muscle strength was not significantly improved, possibly due to accompanied massive rotator cuff tear. Arthroscopic total synovectomy in the treatment of PVNS of the shoulder joint is a minimally invasive and effective method, which makes it possible to access the whole joint space and subacromial space.
Paraplegia Caused By Posture During MRI in a Patient With Cervical Disk Herniation
Authors: Kato Yoshihiko , Nishida Norihiro , Taguchi Toshihiko
Published: August 2010

A 48-year-old man presented with numbness in the lower left extremity of 4 months' duration. One month earlier, he presented to an orthopedic clinic and magnetic resonance imaging (MRI) revealed cervical disk herniation. Because the pain did not subside, he visited the clinic again and MRI was performed. His neck was slightly extended and fixed to the headrest of the MRI instrument. Because of the posture of his cervical spine, he suffered severe pain in the scapular region during the MRI. After 15 minutes the pain was unbearable and the MRI examination was aborted. As the patient tried to descend from the MRI table, he was unable to move his bilateral lower extremities. No muscle contraction was observed in his lower limbs. Following MRI with flexion posture of the cervical spine, he was diagnosed with paraplegia caused by cervical disk herniation. Emergency surgery consisting of anterior decompression and fusion was performed. The patient showed good neurological recovery. Three weeks postoperatively, the patient could walk without assistance and he was discharged. The extension posture of the cervical spine during MRI was considered to be the cause of acute paraplegia in this patient. Care should be taken with the posture of the cervical spine, when performing MRI in patients with cervical disk herniation. Extended posture of the cervical spine during MRI may lead to acute neurological deterioration.
Induction of Th17 Cells in the Tumor Microenvironment Improves Survival in a Murine Model of Pancreatic Cancer
Authors: Gnerlich Jennifer L. , Mitchem Jonathan B. , Weir Joshua S. , Sankpal Narendra V. , Kashiwagi Hiroyuki , Belt Brian A. , Porembka Matthew R. , Herndon John M. , Eberlein Timothy J. , Goedegebuure Peter , Linehan David C.
Published: August 2010

An important mechanism by which pancreatic cancer avoids antitumor immunity is by recruiting regulatory T cells (Tregs) to the tumor microenvironment. Recent studies suggest that suppressor Tregs and effector Th17 cells share a common lineage and differentiate based on the presence of certain cytokines in the microenvironment. Because IL-6 in the presence of TGF-β has been shown to inhibit Treg development and induce Th17 cells, we hypothesized that altering the tumor cytokine environment could induce Th17 and reverse tumor-associated immune suppression. Pan02 murine pancreatic tumor cells that secrete TGF-β were transduced with the gene encoding IL-6. C57BL/6 mice were injected s.c. with wild-type (WT), empty vector (EV), or IL-6–transduced Pan02 cells (IL-6 Pan02) to investigate the impact of IL-6 secretion in the tumor microenvironment. Mice bearing IL-6 Pan02 tumors demonstrated significant delay in tumor growth and better overall median survival compared with mice bearing WT or EV Pan02 tumors. Immunohistochemical analysis demonstrated an increase in Th17 cells (CD4+IL-23R+ cells and CD4+IL-17+ cells) in tumors of the IL-6 Pan02 group compared with WT or EV Pan02 tumors. The upregulation of IL-17–secreting CD4+ tumor-infiltrating lymphocytes was substantiated at the cellular level by flow cytometry and ELISPOT assay and mRNA level for retinoic acid-related orphan receptor γt and IL-23R by RT-PCR. Thus, the addition of IL-6 to the tumor microenvironment skews the balance toward Th17 cells in a murine model of pancreatic cancer. The delayed tumor growth and improved survival suggests that induction of Th17 in the tumor microenvironment produces an antitumor effect.
A Versatile Role of Mammalian Target of Rapamycin in Human Dendritic Cell Function and Differentiation
Authors: Haidinger Michael , Poglitsch Marko , Geyeregger Rene , Kasturi Sudhir , Zeyda Maximilian , Zlabinger Gerhard J. , Pulendran Bali , Hörl Walter H. , Säemann Marcus D. , Weichhart Thomas
Published: August 2010

The mammalian target of rapamycin (mTOR) regulates cell growth and survival and exists as rapamycin-sensitive mTOR complex (mTORC) 1 and as rapamycin-insensitive mTORC2. Although mTOR is a well-known regulator of diverse immune cells, its detailed role in human dendritic cell (DC) function and differentiation is only incompletely understood. In this study, we demonstrate divergent roles of mTOR during activation and differentiation of myeloid DCs (mDCs) and monocyte-derived DCs (moDCs). Inhibition of mTORC1 in mDCs activated with TLR-dependent or -independent stimuli increased proinflammatory cytokines and NF-κB, whereas IL-10 and STAT3 were blocked. Rapamycin regulated the costimulatory/surface molecules CD86, programmed death ligand-1, and CD25 on mDCs and significantly increased the T cell allostimulatory potential of mDCs. In contrast, rapamycin suppressed immunostimulatory molecules and the allostimulatory potential of LPS-stimulated moDCs by an inability to augment NF-κB signaling. In differentiating moDCs, the PI3K/Akt-dependent mTOR pathway was constitutively activated by GM-CSF to induce DC differentiation in an mTORC1-dependent manner. Inhibition of mTORC1 or mTORC1/2 during moDC differentiation decreased moDC survival and markedly hampered its immunostimulatory phenotype. Analyzing the fate of DCs in vivo, we found that kidney transplant patients treated with rapamycin displayed an increased immunostimulatory potential of mDCs compared with patients treated with calcineurin inhibitors. Furthermore, rapamycin did not interfere with mDC differentiation in these patients. Collectively, mTOR exerts divergent immunoregulatory functions during DC activation and differentiation depending on the DC type that lead to opposing T cell responses, which might be of clinical importance in transplantation, cancer, and also for novel vaccination strategies.
Coevolution of Killer Cell Ig-Like Receptors with HLA-C To Become the Major Variable Regulators of Human NK Cells
Authors: Older Aguilar Anastazia M. , Guethlein Lisbeth A. , Adams Erin J. , Abi-Rached Laurent , Moesta Achim K. , Parham Peter
Published: August 2010

Interactions between HLA class I and killer cell Ig-like receptors (KIRs) diversify human NK cell responses. Dominant KIR ligands are the C1 and C2 epitopes of MHC-C, a young locus restricted to humans and great apes. C1- and C1-specific KIRs evolved first, being present in orangutan and functionally like their human counterparts. Orangutans lack C2 and C2-specific KIRs, but have a unique C1+C2-specific KIR that binds equally to C1 and C2. A receptor with this specificity likely provided the mechanism by which C2–KIR interaction evolved from C1–KIR while avoiding a nonfunctional intermediate, that is, either orphan receptor or ligand. Orangutan inhibitory MHC-C–reactive KIRs pair with activating receptors of identical avidity and specificity, contrasting with the selective attenuation of human activating KIRs. The orangutan C1-specific KIR reacts or cross-reacts with all four polymorphic epitopes (C1, C2, Bw4, and A3/11) recognized by human KIRs, revealing their structural commonality. Saturation mutagenesis at specificity-determining position 44 demonstrates that KIRs are inherently restricted to binding just these four epitopes, either individually or in combination. This restriction frees most HLA-A and HLA-B variants to be dedicated TCR ligands, not subject to conflicting pressures from the NK cell and T cell arms of the immune response.
The Detrimental Effects of IFN-α on Vasculogenesis in Lupus Are Mediated by Repression of IL-1 Pathways: Potential Role in Atherogenesis and Renal Vascular Rarefaction
Authors: Thacker Seth G. , Berthier Celine C. , Mattinzoli Deborah , Rastaldi Maria Pia , Kretzler Matthias , Kaplan Mariana J.
Published: August 2010

Systemic lupus erythematosus (SLE) is characterized by increased vascular risk due to premature atherosclerosis independent of traditional risk factors. We previously proposed that IFN-α plays a crucial role in premature vascular damage in SLE. IFN-α alters the balance between endothelial cell apoptosis and vascular repair mediated by endothelial progenitor cells (EPCs) and myeloid circulating angiogenic cells (CACs). In this study, we demonstrate that IFN-α promotes an antiangiogenic signature in SLE and control EPCs/CACs, characterized by transcriptional repression of IL-1α and β, IL-1R1, and vascular endothelial growth factor A, and upregulation of IL-1R antagonist and the decoy receptor IL-1R2. IL-1β promotes significant improvement in the functional capacity of lupus EPCs/CACs, therefore abrogating the deleterious effects of IFN-α. The beneficial effects from IL-1 are mediated, at least in part, by increases in EPC/CAC proliferation, by decreases in EPC/CAC apoptosis, and by preventing the skewing of CACs toward nonangiogenic pathways. IFN-α induces STAT2 and 6 phosphorylation in EPCs/CACs, and JAK inhibition abrogates the transcriptional antiangiogenic changes induced by IFN-α in these cells. Immunohistochemistry of renal biopsies from patients with lupus nephritis, but not anti-neutrophil cytoplasmic Ab-positive vasculitis, showed this pathway to be operational in vivo, with increased IL-1R antagonist, downregulation of vascular endothelial growth factor A, and glomerular and blood vessel decreased capillary density, compared with controls. Our study introduces a novel putative pathway by which type I IFNs may interfere with vascular repair in SLE through repression of IL-1–dependent pathways. This could promote atherosclerosis and loss of renal function in this disease.
Pastorale begeleiding van die geestelik verwonde persoon
Authors: Coetzer Wentzel
Published: August 2010

Pastoral counselling for spiritually wounded people On the one hand, religion could fulfil an edifying and enriching role; on the other, it could be destructive and devastating if it uses unethical, manipulating and controlling techniques and coercive measures to promote the goals of a leader or a system. Insecurity and doubt regarding a person�s own competence and worth flowing from painful events in the past tend to make people vulnerable. Often, spiritual wounds lead to a warped image of God; a warped self-identity as a Christian; intense pain in family relationships; overwhelming feelings of disillusionment; problems with personal borders; a lack of basic life skills; a lack of trust and purpose in life, as well as fluctuating phases of opposite emotions, like depression, anger and joy. Once denial has been overcome, counselling towards healing can start. Such counselling should primarily focus on joining a support group, spiritual healing, healing with regard to habits of thought, social recovery as well as physical healing.
Economic Analyses for the Evaluation of is Projects
Authors: Ulukan Ziya , Ucuncuoglu Can
Published: August 2010

Information system projects usually have numerous uncertainties and several conditions of risk that make their economic evaluation a challenging task. Each year, several information system projects are cancelled before completion as a result of budget overruns at a cost of several billions of dollars to industry. Although engineering economic analysis offers tools and techniques for evaluating risky projects, the tools are not enough to place information system projects on a safe budget/selection track. There is a need for an integrative economic analysis model that will account for the uncertainties in estimating project costs benefits and useful lives of uncertain and risky projects. The fuzzy set theory has the capability of representing vague data and allows mathematical operators and programming to be applied to the fuzzy domain. The theory is primarily concerned with quantifying the vagueness in human thoughts and perceptions. In this article, the economic evaluation of information system projects using fuzzy present value and fuzzy B/C ratio is analyzed. A numerical illustration is included to demonstrate the effectiveness of the proposed methods.
M-Learning (Mobile Learning) in Practice: A Training Experience with IT Professionals
Authors: Zanela Saccol Amarolinda , Reinhard Nicolau , Victória Barbosa Jorge Luis , Schlemmer Eliane
Published: August 2010

This paper presents the results of a study that addresses the following question: what are the real possibilities of m-learning (mobile learning) for the development of individual competences and also for collaboration in the organizational setting? The paper analyzes a real experience in m-learning for training IT professionals. For this purpose a mobile virtual learning environment called COMTEXT was developed and implemented, which was designed to support competence development for workers using PocketPCs. The participants of the training activity (13 professionals) evaluated the m-learning experience via a structured questionnaire; all the content and interactions within COMTEXT were analyzed via content analysis. The results generated important insights into the ergonomic, technological and pedagogical possibilities and limitations of mobile and wireless technologies for corporate training and also on methodologies and learning tools that can be applied to m-learning. As an exploratory study, it also indicates issues for further research on m-learning in the organizational context.
Agile Governance in Information and Communication Technologies: Shifting Paradigms
Authors: Oliveira Luna Alexandre José Henrique de , Pereira Costa Cleyverson , Perrelli de Moura Hermano , De Araújo Novaes Magdala , A. D. C. do Nascimento César
Published: August 2010

This paper presents the basis of the Agile Governance in Information and Communication Technology (ICT), which is based on Agile Software Engineering Methodologies principles and values. Its development was done through a systematic review process, supported by Bibliometrics and Scientometrics methods and techniques, where the Critical Success Factors (CSF) of ICT Governance projects and the principles of the Agile Manifesto were analyzed. Next, through an inductive approach, focused on the convergence between the concepts involved, it was analyzed how agile principles could help to minimize the gap between ICT and business. Evidences of their occurrence were taken through a Conceptual Survey Research. As a result, the foundations and concepts of Agile Governance in ICT were defined and, finally, the development of a reference model was proposed as a future work.
The Influence of Technology on the Performance of Brazilian Call Centers
Authors: Gião Paulo Roberto , Mendes Borini Felipe , De Miranda Oliveira Júnior Moacir
Published: August 2010

Call centers (CCs) show an evolution over the course of time. There is an intensive use of technology in CCs, although not always a positive side. The article is based on a survey carried out among the 103 Brazilian companies that have come (falta algum complemento, não conseguimos entender a frase) and call center services and seeks to verify the contribution of technology in four distinct dimensions: cost reduction, customer relations, communication channels and monitoring of employees. The theoretical framework is eclectic based on strategic considerations, details of the technical areas of telecommunications and information technology, marketing. It focus particularly in the area of customer relations and especially of various national and international studies that have been developed regarding service and customer satisfaction. The results show that heavy use of technology does not mean a general improvement in performance in all dimensions assessed and some dimensions choices to be made over others
The Knowledge Management for Best Practices Sharing in a Database at the Tribunal Regional Federal da Primeira Região
Authors: Mazo Santos de Miranda Márcia , Amadeu Dutra Moresi Eduardo
Published: August 2010

A quick, effective and powerful alternative for knowledge management is the systematic sharing of best practices. This study identified in the literature recommendations for structuring a best practices database and summarized the benefits of its deployment to the Tribunal Regional Federal da Primeira Região TRF - 1ª Região. A It was conducted a quantitative research was then carried out, with the distribuition of where questionnaires were distributed to federal judges of the TRF- 1ª Região, which was divided into 4 parts: magistrate profile, flow of knowledge / information, internal environment, organizational facilitator. As a result, we identified the need to have a best practices database in the Institution for the organizational knowledge identification, transfer and sharing. The conclusion presents recommendations for the development of the database and highlights its importance for knowledge management in an organization.
The Practice of Knowledge Management in a Rentail Familiar Company in Minas Gerais (MG): A Case Study
Authors: Norimar Pacheco Ramos Érica , Henrique Helal Diogo
Published: August 2010

The Family Companies have an important role in national economies and, specially in the Brazilian one. However its importance and feasibility are questioned. Good part of such questionings has a focus on the managerial limitations often observed in the management of Family Organizations. As a consequence the search for solutions under the managerial scope is an urgent issue for the survival of Family Companies. Within the myriad of current organizational strategies, knowledge management has emerged as an important competitive differential. Following this track, the objective of this article was to verify how knowledge management (KM) in a rentail Family Company in Minas Gerais (Brazil) occurs. A qualitative case study was carried through, based on data obtained from observations and interviews with managers. The results led to KM’s practices (JÓIA and OLIVEIRA, 2007): exchange of knowledge in meetings, study groups, incentive to innovation and dissemination of knowledge by personal contact. The conclusion highlighted how much the company’s environment favored KM’s practices due to the a favorable field for the development of innovation, creativity and sharing of implicit knowledge.
Poison Ivy, Poison Oak, and Poison Sumac
Authors: Weinberg Lauren , Malani Preeti N.
Published: May 2024

This JAMA Patient Page describes allergic skin reactions from contact with poison ivy, poison oak, and poison sumac plants, and how to treat rashes caused by these plants.
Hospice Readmission, Hospitalization, and Hospital Death Among Patients Discharged Alive from Hospice
Authors: Luth Elizabeth A. , Brennan Caitlin , Hurley Susan L. , Phongtankuel Veerawat , Prigerson Holly G. , Ryvicker Miriam , Shao Hui , Zhang Yongkang
Published: May 2024

Importance

Transitions in care settings following live discharge from hospice care are burdensome for patients and families. Factors contributing to risk of burdensome transitions following hospice discharge are understudied.

Objective

To identify factors associated with 2 burdensome transitions following hospice live discharge, as defined by the Centers for Medicare & Medicaid Services.

Design, Setting, and Participants

This population-based retrospective cohort study included a 20% random sample of Medicare fee-for-service beneficiaries using 2014 to 2019 Medicare claims data. Data were analyzed from April 22, 2023, to March 4, 2024.

Exposure

Live hospice discharge.

Main Outcomes and Measures

Multivariable logistic regression examined associations among patient, health care provision, and organizational characteristics with 2 burdensome transitions after live hospice discharge (outcomes): type 1, hospice discharge, hospitalization within 2 days, and hospice readmission within 2 days; and type 2, hospice discharge, hospitalization within 2 days, and hospital death.

Results

This study included 115 072 Medicare beneficiaries discharged alive from hospice (mean [SD] age, 84.4 [6.6] years; 71892 [62.5%] female; 5462 [4.8%] Hispanic, 9822 [8.5%] non-Hispanic Black, and 96 115 [83.5%] non-Hispanic White). Overall, 10 381 individuals (9.0%) experienced a type 1 burdensome transition and 3144 individuals (2.7%) experienced a type 2 burdensome transition. In adjusted models, factors associated with higher odds of burdensome transitions included identifying as non-Hispanic Black (type 1: adjusted odds ratio [aOR], 1.47; 95% CI, 1.36-1.58; type 2: aOR, 1.70; 95% CI, 1.51-1.90), hospice stays of 7 days or fewer (type 1: aOR, 1.13; 95% CI, 1.06-1.21; type 2: aOR, 1.71; 95% CI, 1.53-1.90), and care from a for-profit hospice (type 1: aOR, 1.78; 95% CI, 1.62-1.96; type 2: aOR, 1.32; 95% CI, 1.15-1.52). Nursing home residence (type 1: aOR, 0.66; 95% CI, 0.61-0.72; type 2: aOR, 0.47; 95% CI, 0.40-0.54) and hospice stays of 180 days or longer (type 1: aOR, 0.63; 95% CI, 0.59-0.68; type 2: aOR, 0.60; 95% CI, 0.52-0.69) were associated with lower odds of burdensome transitions.

Conclusion and Relevance

This retrospective cohort study of burdensome transitions following live hospice discharge found that non-Hispanic Black race, short hospice stays, and care from for-profit hospices were associated with higher odds of experiencing a burdensome transition. These findings suggest that changes to clinical practice and policy may reduce the risk of burdensome transitions, such as hospice discharge planning that is incentivized, systematically applied, and tailored to needs of patients at greater risk for burdensome transitions.
Calculation of Overall Hospital Quality Star Ratings With and Without Inclusion of the Peer Grouping Step
Authors: Gettel Cameron J. , Bagshaw Kyle , Qin Li , Lin Zhenqiu , Rothenberg Eve , Omotosho Prince , Goutos Demetri P. , Herrin Jeph , Suter Lisa G. , Schreiber Michelle , Fleisher Lee A. , Myers Raquel , Spivack Steven B. , Venkatesh Arjun K.
Published: May 2024

Importance

The Centers for Medicare & Medicaid Services (CMS) Overall Star Rating is widely used by patients and consumers, and there is continued stakeholder curiosity surrounding the inclusion of a peer grouping step, implemented to the 2021 Overall Star Rating methods.

Objective

To calculate hospital star rating scores with and without the peer grouping step, with the former approach stratifying hospitals into 3-, 4-, and 5-measure group peer groups based on the number of measure groups with at least 3 reported measures.

Design, Setting, and Participants

This cross-sectional study used Care Compare website data from January 2023 for 3076 hospitals that received a star rating in 2023. Data were analyzed from April 2023 to December 2023.

Exposure

Peer grouping vs no peer grouping.

Main Outcomes and Measures

The primary outcome was the distribution of star ratings, with 1 star being the lowest-performing hospitals and 5 stars, the highest. Analyses additionally identified the number of hospitals with a higher, lower, or identical star rating with the use of the peer grouping step compared with its nonuse, stratified by certain hospital characteristics.

Results

Among 3076 hospitals that received a star rating in 2023, most were nonspecialty (1994 hospitals [64.8%]), nonteaching (1807 hospitals [58.7%]), non–safety net (2326 hospitals [75.6%]), non–critical access (2826 hospitals [91.9%]) hospitals with fewer than 200 beds (1822 hospitals [59.2%]) and located in an urban geographic designations (1935 hospitals [62.9%]). The presence of the peer grouping step resulted in 585 hospitals (19.0%) being assigned a different star rating than if the peer grouping step was absent, including considerably more hospitals receiving a higher star rating (517 hospitals) rather than a lower (68 hospitals) star rating. Hospital characteristics associated with a higher star rating included urbanicity (351 hospitals [67.9%]), non–safety net status (414 hospitals [80.1%]), and fewer than 200 beds (287 hospitals [55.6%]). Collectively, the presence of the peer grouping step supports a like-to-like comparison among hospitals and supports the ability of patients to assess overall hospital quality.

Conclusions and Relevance

In this cross-sectional study, inclusion of the peer grouping in the CMS star rating method resulted in modest changes in hospital star ratings compared with application of the method without peer grouping. Given improvement in face validity and the close association between the current peer grouping approach and stakeholder needs for peer-comparison, the current CMS Overall Star Rating method allows for durable comparisons in hospital performance.
Perspectives on Referral Pathways for Timely Head and Neck Cancer Care
Authors: Batool Sana , Hansen Elisabeth E. , Sethi Rosh K. V. , Rettig Eleni M. , Goguen Laura A. , Annino Donald J. , Uppaluri Ravindra , Edwards Heather A. , Faden Daniel L. , Schnipper Jeffrey L. , Dohan Daniel , Reich Amanda J. , Bergmark Regan W.
Published: May 2024

Importance

Timely diagnosis and treatment are of paramount importance for patients with head and neck cancer (HNC) because delays are associated with reduced survival rates and increased recurrence risk. Prompt referral to HNC specialists is crucial for the timeliness of care, yet the factors that affect the referral and triage pathway remain relatively unexplored. Therefore, to identify barriers and facilitators of timely care, it is important to understand the complex journey that patients undertake from the onset of HNC symptoms to referral for diagnosis and treatment.

Objective

To investigate the referral and triage process for patients with HNC and identify barriers to and facilitators of care from the perspectives of patients and health care workers.

Design, Participants, and Setting

This was a qualitative study using semistructured interviews of patients with HNC and health care workers who care for them. Participants were recruited from June 2022 to July 2023 from HNC clinics at 2 tertiary care academic medical centers in Boston, Massachusetts. Data were analyzed from July 2022 to December 2023.

Main Outcomes and Measures

Themes identified from the perspectives of both patients and health care workers on factors that hinder or facilitate the HNC referral and triage process.

Results

In total, 72 participants were interviewed including 42 patients with HNC (median [range] age, 60.5 [19.0-81.0] years; 27 [64%] females) and 30 health care workers (median [range] age, 38.5 [20.0-68.0] years; 23 [77%] females). Using thematic analysis, 4 major themes were identified: the HNC referral and triage pathway is fragmented; primary and dental care are critical for timely referrals; efficient interclinician coordination expedites care; and consistent patient−practitioner engagement alleviates patient fear.

Conclusions and Relevance

These findings describe the complex HNC referral and triage pathway, emphasizing the critical role of initial symptom recognition, primary and dental care, patient information flow, and interclinician and patient−practitioner communication, all of which facilitate prompt HNC referrals.
Structural investigations on the mitochondrial uncouplers niclosamide and FCCP
Authors: Ng Mei Ying , Song Zhi Jian , Tan Choon Hong , Bassetto Marcella , Hagen Thilo
Published: May 2024

There has been renewed interest in using mitochondrial uncoupler compounds such as niclosamide and carbonyl cyanide p‐(trifluoromethoxy)phenylhydrazone (FCCP) for the treatment of obesity, hepatosteatosis and diseases where oxidative stress plays a role. However, both FCCP and niclosamide have undesirable effects that are not due to mitochondrial uncoupling, such as inhibition of mitochondrial oxygen consumption by FCCP and induction of DNA damage by niclosamide. Through structure–activity analysis, we identified FCCP analogues that do not inhibit mitochondrial oxygen consumption but still provided good, although less potent, uncoupling activity. We also characterized the functional role of the niclosamide 4′‐nitro group, the phenolic hydroxy group and the anilide amino group in mediating uncoupling activity. Our structural investigations provide important information that will aid further drug development.
All's eco‐friendly that ends eco‐friendly: Short‐term memory effects in carbon footprint estimates of temporal item sequences
Authors: Sörqvist Patrik , Lindeberg Sofie , Marsh John E.
Published: May 2024

When people estimate the summative carbon footprint of a sequence of events, how are the individual events integrated? In three experiments, we found that summative carbon footprint judgments of item sequences are disproportionately influenced by items at the end of the sequence in comparison with those at the beginning—a recency effect. When, for example, sequences ended with a low carbon footprint item, they were assigned a lower carbon footprint than corresponding sequences with an identical content but different item order. The results also revealed that a green peak (presenting many low carbon footprint items at once) had a relatively large effect on estimates when the peak was contextually distinct from other items in terms of its valence. The results are consistent with an account within which distinctiveness of representations within short‐term memory differentially influences decision‐making and suggest that memory processes bias the perceived environmental footprint of temporally separated instances.
Effect of Homogenization Process on Microstructure and Mechanical Properties of 4047 Aluminum Alloy
Authors: Cheng Qian , Huang Rensong , Zhang Liu , Yang Wenhao , Zheng Shanju , Li Mengnie
Published: May 2024

In this study, the homogenization heat‐treatment process and microstructural evolution of 4047 aluminum alloy are investigated. In the results, it is revealed that the homogenization process induces partial dissolution of metastable phases and modification of the fine needle‐shaped eutectic Si. Within the 4047 aluminum alloy, the fine needle‐shaped eutectic Si undergoes granulation, involving two stages: crystal dissolution and granulation of broken crystals. After optimal homogenization heat treatment, the eutectic Si phase transformed from a fine needle‐shaped structure to small, regular spherical structures, reducing stress concentration and improving the interfacial bonding capability and internal structure of the alloy matrix. This significantly reduces the likelihood of microcrack formation within the alloy and effectively hinders crack propagation, enhancing the alloy's mechanical properties.
Organic A‐Site Cations Improve the Resilience of Inorganic Lead‐Halide Perovskite Nanocrystals to Surface Defect Formation
Authors: Otero‐Martínez Clara , Ye Junzhi , De Trizio Luca , Goldoni Luca , Rao Akshay , Pérez‐Juste Jorge , Hoye Robert L. Z. , Manna Liberato , Polavarapu Lakshminarayana
Published: May 2024

Lead halide perovskite nanocrystals (LHP NCs) are generally prone to surface defect formation during the purification process, resulting in a reduced photoluminescence (PL) quantum yield. The purification of LHP NCs using antisolvents leads to the detachment of surface atoms and ligandsin the form of alkylammonium‐halides or A‐carboxylates (A: Cs, methylammonium, MA, or formamidinium, FA. Currently, intense research is being carried out to improve the surface stability of LHP NCs using various long‐chain organic ligands that strongly bind to the surface of NCs. Herein, the findings on the higher surface stability of hybrid (MAPbBr3 and FAPbBr3) LHP NCs compared to that of inorganic CsPbBr3 NCs against purification with polar antisolvents are reported. It is discovered that the CsPbBr3 NC surface stability can be enhanced (reaching that of hybrid perovskite NCs) by the incorporation of a small amount of MA or FA A‐site organic cations into their lattice, corroborated by the evidence that the PL quantum yield of mixed A‐cation CsxFA1‐xPbBr3 and CsxMA1‐xPbBr3 NCs remains unaffected after several purification cycles. It is hypothesized that this is attributed to hydrogen bonding between the organic A‐site cations and the neighboring halides on the surface. These findings are not only fundamentally important but are also expected to have wide implications in the field of metal‐halide perovskite optoelectronics.
Confinement‐Driven Bulk Photovoltaic in Lead‐Free Hybrid Perovskite for Self‐Powered X‐Ray Detection
Authors: Fu Dongying , Ma Yanli , Chen Zhuo , Hou Zuoming , Luo Junhua
Published: May 2024

Lead‐free hybrid perovskites (HPs) are considered as environmentally friendly photodetection materials. However, there are few studies on self‐powered photodetection in lead‐free HPs, and most of them are achieved through the introduction of chiral ammonium cations induced bulk photovoltaic effect (BPVE). Notably, enantiomeric pure chiral ammonium cations are difficult to synthesize, the quantity is small and the price is high. Therefore, choosing achiral ammonium cations to induce BPVE in lead‐free HPs is crucial. Herein, achiral cations 1,3‐bis(aminomethyl)cyclohexane (1,3‐BMACH) is exploited to induce bulk photovoltaic through confinement effect in (1,3‐BMACH)BiI5, then self‐powered X‐ray detection is successfully realized. Due to the large space in zero‐dimensional (0 D) (MXD)BiI5 (MXD is meta‐xylylenediammonium), the confinement effect is not obvious, resulting in the disorderly arrangement of MXD2+ cations and a centrosymmetry structure of (MXD)BiI5. Benefiting from the large photovoltage (1.0 V) of (1,3‐BMACH)BiI5 under X‐ray, its single crystal devices exhibit ultra‐high sensitivity of 170 µC Gy−1 cm−2 and extremely low detection limit of 49 nGy s−1 under self‐powered mode, which almost surpassing most low‐dimensional single‐phase lead‐free HPs at 0 V bias. This work has promoted the application of lead‐free HPs in the field of self‐powered X‐ray detection.