bluuebunny/crossref_metadata_2025 huggingface dataset:
Evidence-based psychotherapies II: changes in models of treatment and treatment delivery
Authors: Kazdin Alan E
Published: June 2014

Decades of psychotherapy research have yielded a few hundred interventions with strong evidence on their behalf. In the prior companion article, methodological and substantive concerns were raised in relation to what we can say about evidence-based psychotherapies and their impact. Among the methodological concerns are the control conditions to which evidence-based psychotherapies are compared, selective reporting of measures, and the paucity of evidence that evidence-based psychotherapies have clinically significant impact. Among the substantive concerns are limited findings to help direct patients to treatments from which they are likely to profit and to understand the mechanisms responsible for therapeutic change. In this article, two shifts in evidence-based psychotherapy research are highlighted to convey novel and needed directions to augment the impact of treatment and the scale on which it can be delivered. First, transdiagnosis and transtreatment are discussed as a departure from traditional evidence-based psychotherapy research by emphasizing interventions that can be applied across multiple domains. Common biological, psychological, and environmental underpinnings of many disorders and select treatments showing reliable changes across multiple problems are altering evidence-based psychotherapy research. Second, novel models of treatment delivery have emerged from global health care, business, economics, and the media, and are well outside of mainstream mental health professions. Two models (task shifting and best-buy interventions) illustrate how different ways of delivering treatment are essential to reach large and diverse swaths of unserved individuals and have impact on the burden of mental illness.
Stratified Item Selection and Exposure Control in Unidimensional Adaptive Testing in the Presence of Two-Dimensional Data
Authors: Kalinowski Kevin E. , Natesan Prathiba , Henson Robin K.
Published: June 2014

It is not uncommon to use unidimensional item response theory models to estimate ability in multidimensional data with computerized adaptive testing (CAT). The current Monte Carlo study investigated the penalty of this model misspecification in CAT implementations using different item selection methods and exposure control strategies. Three item selection methods—maximum information (MAXI), a-stratification (STRA), and a-stratification with b-blocking (STRB) with and without Sympson–Hetter (SH) exposure control strategy—were investigated. Calibrating multidimensional items as unidimensional items resulted in inaccurate item parameter estimates. Therefore, MAXI performed better than STRA and STRB in estimating the ability parameters. However, all three methods had relatively large standard errors. SH exposure control had no impact on the number of overexposed items. Existing unidimensional CAT implementations might consider using MAXI only if recalibration as multidimensional model is too expensive. Otherwise, building a CAT pool by calibrating multidimensional data as unidimensional is not recommended.
A Review of Commercial Software Packages for Multidimensional IRT Modeling
Authors: Han Kyung (Chris) T. , Paek Insu
Published: June 2014

In this study, the authors evaluate several commercially available multidimensional item response theory (MIRT) software packages, including IRTPRO 2.1, Mplus 7.1, FlexMIRT, and EQSIRT, as well as their built-in estimation algorithms, and compare them for their performance in MIRT model estimation. The study examines the performance of model parameter recovery via a series of simulations based on four approaches for latent structuring—within-item MIRT, between-item MIRT, a mixture of within- and between-item MIRT and a bifactor model. The simulation studies focused on realistic conditions and models that researchers and practitioners are likely to encounter in practice. The results showed that the studied software packages recovered the item parameters reasonably well but differed greatly in terms of the types of data and models they could handle and also the run time required for estimation completion.
‘Nothing to report’: a semi-longitudinal investigation of the print media coverage of sportswomen in British Sunday newspapers
Authors: Godoy-Pressland Amy
Published: June 2014

The under-representation of female athletes by print media has been widely acknowledged by feminist media scholars. However, there have been a number of recent studies which suggest that things are changing in terms of progress towards gender equality. In light of such studies this article examines the representation of sportswomen in five British Sunday newspapers, three broadsheets ( The Sunday Times, The Observer and The Sunday Telegraph), and two tabloids (the Mail on Sunday and the Sunday Express), over a 24-month period (January 2008–December 2009). The results suggest that sportswomen are still overwhelmingly under-represented in British print media.
Borderlands: Rescaling economic development in Northern England in the context of greater Scottish autonomy
Authors: Shaw Keith , Robinson Fred , Blackie Jonathan
Published: June 2014

This article argues that the space created by the clearing away of the English regional ‘institutional architecture’ after 2010 allows local authorities, in particular, to consider new flexible place-based approaches to economic development not possible under the old system. In this context, economic development activities, initiatives and alliances can now be developed to cover geographical areas that ‘make sense’, rather than being imposed or being chosen through habit: it is an opportunity to rescale or recalibrate traditional spatial approaches to place-based economic development. Here we discuss some implications of that, particularly how local authorities in the North East of England and Cumbria are responding – or could respond – to the potential granting of greater economic and fiscal powers to Scotland resulting from pressures for further devolution and the 2014 referendum on independence. We look at the emerging opportunities for collaborative approaches to cross-border economic development; this is an issue that is virtually absent from any contemporary studies of local economic development in the UK. Drawing upon recent research, the article outlines the case for a ‘Borderlands’ approach – which brings together the five local authority areas adjacent to the border – to develop joint approaches to economic development in areas such as transport, tourism, business development and superfast broadband. In addition to such cross-border alliances, we also point to opportunities to reinvigorate co-operation between the North East and Cumbria. The prospect of further autonomy for Scotland is stimulating a new interest in the North East, Cumbria and Scotland in working more collaboratively together, but the outcome of that (whatever the referendum result) may depend upon how the Anglo-Scottish border is perceived. We argue that it needs to be seen less as a barrier and more as an enabling mechanism which brings new opportunities for a relationship based on ‘co-optition’.
Improving Agreement About Intervention Plans in Probation by Decision Support
Authors: Bosker Jacqueline , Witteman Cilia , Hermanns Jo , Heij Donnalee
Published: June 2014

Reliability in decision making about intervention plans is a necessary condition for evidence-based probation work and equal treatment of offenders. Structuring decision making can improve agreement between clinical decision makers. In a former study however, we found that in Dutch probation practice structured risk and needs assessment did not result in acceptable agreement about intervention plans. The Dutch probation services subsequently introduced a tool for support in decision making on intervention plans. This article addresses the question whether the use of this tool results in better agreement between probation officers. A significant and meaningful improvement in agreement was found on all domains of the intervention plan. Implications for probation practice are discussed.
A dimensionless analysis of Poisson’s ratio and stress distribution for anisotropic materials
Authors: Yeh Hsien-Liang , Huang Chieh-Wen , Tsai Ming-Hung
Published: June 2014

The effect of various offaxis angles and lamina material properties on the Poisson’s ratio and the stress distribution of a circular cutout in an orthotropic composite plate under off-axis loading are presented. Based on the generalized Hook’s law, the generalized plane stress condition and the complex variable method, a dimensionless analysis is used to evaluate the influence of various elastic moduli E1, E2, G12, and ν12 on the Poisson’s ratio and the stress distribution along the boundary of the circular cutout under various off-axis loadings. The results obtained from this dimensionless analysis provide a set of general design guidelines for structural laminates with high precision requirements in the engineering applications.
Cost data modelling and searching to support low-volume, high-complexity, long-life defence system development
Authors: Cheung Wai M , Marsh Robert , Newnes Linda B , Mileham Antony R , Lanham John D
Published: June 2014

This article presents a data modelling and a semi-automatic data searching method to support cost estimation in the product development process, particularly for low-volume, high-complexity and long-life products typified by defence products and systems. This article covers a literature review in the area of cost estimation in product development, the data sets needed to perform cost estimation, the method of modelling the data and the techniques of supporting cost data searching. The proposed method will be used to support cost estimation of product development decisions for defence electronic products. To compare with the traditional approach, the method has demonstrated that by creating a centralized environment such as the ‘databases and using a data-driven’ approach. The system is made more efficient by reducing the number of processes in carrying out cost estimation, and thus, this provides more information to make an informed concept design decision during the product development process based on the system’s competence of instant cost estimation feedback.
Insights into the development of the tumble motion using the direct and indirect steady-flow test methods
Authors: Liu Daming , Jia Ming , Wang Tianyou , Zhao Peng , Jin Shuai , Liu Shuliang
Published: June 2014

The measurement and evaluation of the tumble motion in an engine cylinder are widely achieved by steady-flow tests. However, there is absence of a standard methodology for the evaluation of the tumble motion in the steady-flow tests. The aim of this paper is to analyse the variation in the evolution of the tumble motion with different tumble test methods. Both steady-flow tests and particle image velocimetry measurements were carried out on a commercial four-valve spark ignition engine. The results showed that, for the indirect test method, the variation in the diameter of the cross pipe has a negligible effect on the non-dimensional tumble intensity, although the angular momentum flux is proportional to the diameter of the cross pipe owing to the conservation of the rotational kinetic energy flux. For the direct test method, there is an obviously abrupt rise in the tumble intensity with increasing valve lift because the in-cylinder flow evolves into a single large-scale tumble vortex in a short transition phase. Moreover, the rotational speed of the tumble flow increases when a dummy cylinder with a smaller outlet diameter is used in the direct test method.
High-risk human papillomavirus in HIV-infected women undergoing cervical cancer screening in Lilongwe, Malawi: a pilot study
Authors: Reddy Deepa , Njala Joseph , Stocker Penny , Schooley Alan , Flores Martiniano , Tseng Chi-Hong , Pfaff Colin , Jansen Perry , Mitsuyasu Ronald T , Hoffman Risa M
Published: June 2014

Rates of abnormal visual inspection with acetic acid and prevalence of high-risk human papillomavirus (HPV) subtypes have not been well characterized in HIV-infected women in Malawi. We performed a prospective cohort study of visual inspection with acetic acid (N = 440) in HIV-infected women aged 25--59 years, with a nested study of HPV subtypes in first 300 women enrolled. Of 440 women screened, 9.5% (N = 42) had abnormal visual inspection with acetic acid with 69.0% (N = 29) having advanced disease not amenable to cryotherapy. Of 294 women with HPV results, 39% (N = 114) of women were positive for high-risk HPV infection. Only lower CD4 count (287 cells/mm3 versus 339 cells/mm3, p = 0.03) and high-risk HPV (66.7% versus 35.6%, p < 0.01) were associated with abnormal visual inspection with acetic acid. The most common high-risk HPV subtypes in women with abnormal visual inspection with acetic acid were 35 (33.3%), 16 (26.7%), and 58 (23.3%). Low CD4 cell count was associated with abnormal visual inspection with acetic acid and raises the importance of early antiretroviral therapy and expanded availability of visual inspection with acetic acid. HPV vaccines targeting additional non-16/18 high-risk HPV subtypes may have greater protective advantages in countries such as Malawi.
The gender–culture double bind in Israeli–Palestinian peace negotiations: A narrative approach
Authors: Aharoni Sarai B.
Published: June 2014

This article investigates structural conditions for women’s inclusion/exclusion in peace negotiations by focusing on the linkage between acts of gender stereotyping and cultural framing. Through a narrative analysis of semi-structured interviews with Israeli negotiators and administrators who participated in official negotiations during the Oslo peace process, I link two recent claims about how gender may affect negotiators’ understandings of strategic exchange: the gendered devaluation effect and the gender–culture double bind hypothesis. Building upon postcolonial feminist critique, I argue that narratives about women and cultural difference (a) demonstrate and engage with Israeli essentialist and Orientalist discourses about Arab culture and masculinity; (b) manifest how ideas about strategic dialogue and negotiations are gendered; and (c) convey how policymakers and negotiators may use cultural claims to rationalize women’s exclusion from diplomatic and strategic dialogue. Furthermore, the study implies that dominant framings of Israeli–Palestinian negotiations as a binary East–West encounter need to be replaced by a more nuanced conceptualization of cultural identity that captures contextual aspects of difference, including the existence of military power and masculine dominance.
Accounting artefacts as a means of augmenting knowledge of the past: The case of Chief Hillis Hadjo and Lieutenant-Colonel Edward Nicolls
Authors: Francis Graham , Samkin Grant
Published: June 2014

Accounting artefacts are a useful source of information on the history of accounting techniques. However, as this article discusses and demonstrates, they can also contain rich narrative that provides additional historical insight. This article describes a journey of discovery to understand the contextual historiography surrounding an accounting artefact, looking at how the artefact came into being and its ramifications for the two main protagonists: a Creek Chief, Hillis Hadjo, and a British Officer, Lieutenant-Colonel Edward Nicolls.
Comparison of two methods for measurement of equine insulin
Authors: Banse Heidi E. , McCann Joseph , Yang Fan , Wagg Catherine , McFarlane Dianne
Published: June 2014

Diagnosis of equine hyperinsulinemia requires an accurate method for quantification of equine insulin concentrations. The objectives of the current study were to compare 2 commercially available techniques for measurement of equine insulin, the radioimmunoassay (RIA) and chemiluminescent immunoassay (CIA). Recovery was poor for both assays, but worse for the CIA. Serial dilution of a high endogenous insulin sample yielded better linearity for the RIA ( r2 = 0.99, P < 0.001) than the CIA ( r2 = 0.92, P = 0.009). Bland–Altman analysis indicated that the CIA was, on average, 91 pmol/l higher than the RIA, with wide limits of agreement (95% limits of agreement: –508 to 691 pmol/l). These findings suggest that results between the assays should not be considered interchangeable.
Detection and genetic characterization of Canine parvovirus and Canine coronavirus strains circulating in district of Tirana in Albania
Authors: Cavalli Alessandra , Desario Costantina , Kusi Ilir , Mari Viviana , Lorusso Eleonora , Cirone Francesco , Kumbe Ilirjan , Colaianni Maria Loredana , Buonavoglia Domenico , Decaro Nicola
Published: June 2014

An epidemiological survey for Canine parvovirus 2 (CPV-2) and Canine coronavirus (CCoV) was conducted in Albania. A total of 57 fecal samples were collected from diarrheic dogs in the District of Tirana during 2011–2013. The molecular assays detected 53 and 31 CPV- and CCoV-positive specimens, respectively, with mixed CPV–CCoV infections diagnosed in 28 dogs. The most frequently detected CPV type was 2a, whereas IIa was the predominant CCoV subtype. A better comprehension of the CPV–CCoV epidemiology in eastern European countries will help to assess the most appropriate vaccination strategies to prevent disease due to infections with these widespread agents of acute gastroenteritis in the dog.
Caregivers Confronted With the Withdrawal of Artificial Nutrition at the End of Life
Authors: Piot Elise , Leheup Benoît F. , Goetz Christophe , Quilliot Didier , Niemier Jean-Yves , Wary Bernard , Ducrocq Xavier
Published: June 2014

Background:

Withdrawing artificial nutrition in palliative care is an issue that often leads to ethical dilemmas among health care providers, despite clinical guidelines.

Objectives:

To describe the experience of health care providers confronted with the withdrawing of artificial nutrition at the end of life and identifying the factors related to the level of ethical dilemmas.

Methods:

Cross-sectional survey questionnaire of all the nurses and nurses’ aides working in medicine, surgery, and palliative care departments of a regional hospital and who have already been confronted with the withdrawal of artificial nutrition.

Results:

Of 818 questionnaires sent, 274 were returned (response rate 33.5%); 60% (163) of the care providers who responded were involved in withdrawing artificial nutrition at the end of life. Among these, 42 (25.8%) had always or often been affected with ethical dilemmas, and 97 (60%) responded that withdrawing artificial nutrition had always or often been preceded by a multidisciplinary discussion. Items significantly associated with a high level of ethical dilemmas were (1) existence of differences in opinion within the health care team, (2) lack of information regarding the indication of the withdrawal of artificial nutrition, (3) feeling uncomfortable with the patient and his or her relatives, (4) guilt, (5) feeling of abandonment of care, and (6) uneasiness.

Conclusion:

Health care providers seem to have a lack of information and consensus regarding the withdrawal of artificial nutrition at the end of life. The ethical dimension of withdrawing artificial nutrition in palliative care has a strong impact on care providers, regardless of the circumstances of the withdrawal.
Comparison of Glucose Measures in Patients Receiving Concomitant Paroxetine and Pravastatin to Other SSRI/Statin Combinations
Authors: Orrico Kathleen B. , Huynh My Hanh , Olson Clifford W.
Published: June 2014

Background: An analysis of the US Food and Drug Administration’s Adverse Event Reporting System database found evidence suggesting that the combination of the cholesterol-lowering drug pravastatin and the antidepressant paroxetine, produced a significant increase in average blood glucose measures. Objective: Our intent was to investigate the reproducibility of these findings by conducting a similar analysis of administrative and prescription claims data from patients receiving primary care at the Palo Alto Medical Foundation. Method: We conducted an observational, retrospective review of 2149 adult patient records to compare mean measures of blood glucose between groups receiving concomitant paroxetine and pravastatin with the pooled means of those receiving 19 different combinations of a statin and a selective serotonin reuptake inhibitor (SSRI) antidepressant. Analysis of covariance (ANCOVA) was used to compare random glucose, fasting glucose, and glycosylated hemoglobin mean values, while adjusting for the covariates of age, gender, body mass index, and weight in patients with and without a diagnosis of diabetes mellitus. Result: A total of 65 observations were analyzed from patients receiving concomitant paroxetine and pravastatin and 2084 from those receiving 19 other statin-SSRI pairs. The ANCOVA showed that significant covariate relationships included the diagnosis of diabetes mellitus, male gender, and body weight. After adjusting for covariates, no significant difference was found between the 3 mean glucose measures of the pravastatin-paroxetine pair groups and the corresponding means of the pooled statin-SSRI pair groups (P > 0.05). Conclusion: Outpatients receiving concomitant pravastatin and paroxetine did not have significantly different mean glucose measures as compared with those receiving other statin-SSRI drug combinations.
Set-based development using an integrated product and manufacturing system platform
Authors: Levandowski Christoffer , Michaelis Marcel T , Johannesson Hans
Published: June 2014

A platform is commonly used as a basis for generating a number of derivative products, after which it is replaced by a new platform. For some companies, a more viable approach is to adopt a continuous platform that is sustained and expanded over time. This applies to companies that have to provide highly customized products while not in control of interfaces, suppliers in the aerospace industry, for example. For them, the traditional part-based generation of platforms is not sufficient, and more flexibility must be built into the platform. This article proposes an approach for continuous platform development, based on an integrated artifact model and connected development processes. The processes apply set-based concurrent engineering to develop derivative products and to extend the bandwidth of the platform. The artifact model serves as a basis for development and connects products and manufacturing systems to enable informed design decisions that span across the lifecycle. The proposed approach incorporates two modes of platform use. Mode I is applied for configuring products to order within the bandwidth of the platform. This includes automatic concept evaluation using a pallet of computer-aided engineering tools and supporting tools. Mode II is applied when the bandwidth does not suffice to cover the required functionality and therefore needs to be expanded. This article exemplifies the approach through a case from a supplier in the aerospace industry.
Analysis of a contact problem with unilateral constraint and slip-dependent friction
Authors: Barboteu Mikael , Cheng Xiao-liang , Sofonea Mircea
Published: June 2014

We consider a mathematical model which describes the equilibrium of an elastic body in frictional contact with an obstacle. The contact is modelled with normal compliance and unilateral constraint, associated with a slip-dependent version of Coulomb’s law of dry friction. We present a weak formulation of the problem, then we state and prove an existence and uniqueness result of the solution. The proof is based on arguments of elliptic quasivariational inequalities. We also study the finite element approximations of the problem and derive error estimates. Finally, we provide numerical simulations which illustrate both the behaviour of the solution related to the frictional contact conditions and the convergence order of the error estimates.
Polybrominated diphenyl ether levels in dust collected from cars in Kuwait: Implications for human exposure
Authors: Gevao Bondi , Shammari Fatema , Ali Lulwa N.
Published: June 2014

Polybrominated diphenyl ethers (PBDEs) are semivolatile organic compounds (SVOCs) with a ubiquitous environmental distribution. Their presence in cars is linked to their use as flame retardants in electronic items and instrument panels, high-impact plastics, foam and fabric of car seats. The goal of this study was to investigate the occurrence and concentration of PBDEs in dust samples collected from 19 randomly selected cars in normal use in Kuwait and to assess human non-dietary ingestion exposure to these compounds. The concentrations of the total target PBDEs, Σ14PBDEs, were log normally distributed and ranged from 68 to 17,200 ng/g. BDE-209 was the dominant congener in all cars examined with concentrations ranging from 52 to 16,100 ng/g which, on average, accounted for 77% of the Σ14PBDEs measured. Using the measured concentrations the estimated human non-dietary ingestion exposure based on median PBDE concentrations ranged from 0.034 ng/kg-bw/day for adults to 0.138 ng/kg-bw/day for toddlers. The exposure estimate for drivers was the highest at 0.170 ng/kg-bw/day. This study supports the previous findings of photolytic debromination of BDE-209 to lower brominated congeners known to be more bioaccumulative and toxic.
Moving Beyond the Punitive Legacy: Taking Stock of Persistent Problems in Juvenile Justice
Authors: Goshe Sonya
Published: June 2014

As the US reins in the punitive excesses in juvenile justice with encouraging changes, it may be tempting to herald a new era of progressive reform. This article contends that such optimism may be premature, and identifies three persistent problems within the US juvenile justice system, which left unexamined, promise to perpetuate a ‘punitive legacy’ that will impede progressive change. The ideology of ‘callous self-sufficiency’, ongoing neglect of youth welfare and human rights, and the logic of risk management and cost-effectiveness each encourage harmful practices, and they work individually and collectively to create a climate inhospitable to lasting progressive transformation.
Utility of the Cognitive Difficulties Scale and Association With Objective Test Performance
Authors: Buelow Melissa T. , Tremont Geoffrey , Frakey Laura L. , Grace Janet , Ott Brian R.
Published: June 2014

Subjective memory complaints (SMCs) are commonly noted in memory disorder clinic patients. The present study sought to examine the presence of SMCs on the Cognitive Difficulties Scale (CDS) in older adults and to examine the relationship between CDS scores and current cognitive ability. Participants were 50 adults diagnosed with possible/probable Alzheimer’s disease (AD), 100 with amnestic mild cognitive impairment (MCI) and 84 cognitively healthy controls (HCs). Participants completed a neuropsychological evaluation and the self- and informant-reported CDS. Results indicated that greater self-reported SMCs were noted in the group with MCI ; however, self-reported CDS scores were associated with cognition in HCs only. Informant-reported CDS scores were predictive of cognitive ability in the diagnosis of MCI but not AD, indicating the importance of obtaining caregiver report in the evaluation of memory disorders. As AD is a neurodegenerative disorder, SMCs lose value in determining degree of cognitive impairment as disease stage increases.
Polysaccharides from Laminaria japonica show hypoglycemic and hypolipidemic activities in mice with experimentally induced diabetes
Authors: Jia Xibei , Yang Juan , Wang Zhi , Liu Ruichan , Xie Rujuan
Published: June 2014

Diabetes mellitus (DM) is a chronic metabolic disorder of the endocrine system. The rapid increase in the incidence of DM is a serious public health concern worldwide. The treatment of DM and its complications mainly involves the use of chemically or biochemically synthesized drugs, but these drugs also have adverse side effects. Therefore, there is an urgent need to search for drugs from natural sources that would cause fewer side effects. This study aimed to determine whether polysaccharides from Laminaria japonica (LJP) exert hypoglycemic and hypolipidemic effects in mice with alloxan-induced diabetes. To this end, diabetes was induced by alloxan injection (200 mg/kg body weight [bw], intraperitoneal [ip]). After induction of diabetes, diabetic mice were randomly divided into five groups: diabetic control (DC) group, glibenclamide-treated (DG) group, low-dose LJP-treated (DLL) group, moderate-dose LJP-treated (DML) group, and high-dose LJP-treated (DHL) group, with normal mice used as the control group (NC group). After treatment for 28 days, body weight, fasting blood glucose (FBG), serum insulin, total cholesterol (TC), triglyceride (TG), high-density lipoprotein-cholesterol (HDL-C), and low-density lipoprotein-cholesterol (LDL-C) levels were measured. The results revealed that LJP administration prevented body-weight loss, decreased FBG levels, and increased serum insulin levels in diabetic mice. Furthermore, it decreased TC, TG, and LDL-C levels, and increased HDL-C levels in these mice. Thus, the results indicate that LJP possesses hypoglycemic and hypolipidemic activities and polysaccharides from LJP may hold promise for the development of a drug of natural origin for the treatment of DM.
Staying Away From School
Authors: Hughes Marion R. , Gaines Jonathan S. , Pryor Douglas W.
Published: June 2014

Perceptions of school safety, fear of crime among students, and school avoidance have received increasing research attention in recent decades. Feeling unsafe at school impacts mental health, absenteeism, and academic success. We focus on a behavioral indicator of heightened concern about safety among high school students. Using 2011 National Youth Risk Behavior Survey data, we examine how crime victimization, bullying, drug use, weapon carrying, defensibility, media exposure, social integration, and school disorder affect school avoidance. Complementary log–log regression results indicate differences in predictors across sex, race/ethnicity, and class year. Implications for policy and future research on school avoidance are discussed.
The investigation and management of broad complex tachycardia and ventricular standstill presenting in pregnancy: A case report
Authors: Sengupta Anshuman , Slater Tom A , Sainsbury Paul A
Published: June 2014

A 23 year old pregnant lady at 35 weeks gestation presented to accident and emergency with worsening dyspnoea, palpitations and dizziness. Twelve lead electrocardiogram, routine bloods and echocardiography were normal. Ambulatory monitoring previously had shown an episode of monomorphic broad complex tachycardia (BCT) and a short episode of ventricular standstill. She was admitted for cardiac monitoring until delivery. Several episodes of ventricular standstill and self-terminating BCT were recorded, which were not associated with symptoms. The patient's symptoms either corresponded with sinus rhythm or supraventricular tachycardia. She underwent elective caesarean section at 37 weeks with no complications. The patient's symptoms reduced considerably post delivery, and she was discharged three days later. Unfortunately she then had a presyncopal episode whilst holding her baby. Due to concern regarding the safety of her baby she had a permanent pacemaker implanted to allow safe beta-blockade. She remains asymptomatic six months later.
Computing the Surveillance Error Grid Analysis
Authors: Kovatchev Boris P. , Wakeman Christian A. , Breton Marc D. , Kost Gerald J. , Louie Richard F. , Tran Nam K. , Klonoff David C.
Published: June 2014

Introduction:

The surveillance error grid (SEG) analysis is a tool for analysis and visualization of blood glucose monitoring (BGM) errors, based on the opinions of 206 diabetes clinicians who rated 4 distinct treatment scenarios. Resulting from this large-scale inquiry is a matrix of 337 561 risk ratings, 1 for each pair of (reference, BGM) readings ranging from 20 to 580 mg/dl. The computation of the SEG is therefore complex and in need of automation.

Methods:

The SEG software introduced in this article automates the task of assigning a degree of risk to each data point for a set of measured and reference blood glucose values so that the data can be distributed into 8 risk zones. The software’s 2 main purposes are to (1) distribute a set of BG Monitor data into 8 risk zones ranging from none to extreme and (2) present the data in a color coded display to promote visualization. Besides aggregating the data into 8 zones corresponding to levels of risk, the SEG computes the number and percentage of data pairs in each zone and the number/percentage of data pairs above/below the diagonal line in each zone, which are associated with BGM errors creating risks for hypo- or hyperglycemia, respectively.

Results:

To illustrate the action of the SEG software we first present computer-simulated data stratified along error levels defined by ISO 15197:2013. This allows the SEG to be linked to this established standard. Further illustration of the SEG procedure is done with a series of previously published data, which reflect the performance of BGM devices and test strips under various environmental conditions.

Conclusions:

We conclude that the SEG software is a useful addition to the SEG analysis presented in this journal, developed to assess the magnitude of clinical risk from analytically inaccurate data in a variety of high-impact situations such as intensive care and disaster settings.
Bone marrow stromal cell–derived exosomes as communicators in drug resistance in multiple myeloma cells
Authors: Wang Jinheng , Hendrix An , Hernot Sophie , Lemaire Miguel , De Bruyne Elke , Van Valckenborgh Els , Lahoutte Tony , De Wever Olivier , Vanderkerken Karin , Menu Eline
Published: June 2014

Key Points

BMSCs and MM cells mutually communicate through exosomes, which carry selective cytokines. BMSC-derived exosomes favor MM cell proliferation, migration, and survival and induce drug resistance to bortezomib.
Magnetic resonance direct thrombus imaging differentiates acute recurrent ipsilateral deep vein thrombosis from residual thrombosis
Authors: Tan Melanie , Mol Gerben C. , van Rooden Cornelis J. , Klok Frederikus A. , Westerbeek Robin E. , Iglesias del Sol Antonio , van de Ree Marcel A. , de Roos Albert , Huisman Menno V.
Published: June 2014

Key Points

Diagnostic management of ipsilateral recurrent DVT of the leg is complicated because residual DVT is common and mimics acute DVT on CUS. MRDTI is able to reproducibly distinguish acute ipsilateral recurrent DVT from 6-month-old chronic residual thrombi in the leg veins.
von Willebrand factor, Jedi knight of the bloodstream
Authors: Springer Timothy A.
Published: June 2014

When blood vessels are cut, the forces in the bloodstream increase and change character. The dark side of these forces causes hemorrhage and death. However, von Willebrand factor (VWF), with help from our circulatory system and platelets, harnesses the same forces to form a hemostatic plug. Force and VWF function are so closely intertwined that, like members of the Jedi Order in the movie Star Wars who learn to use “the Force” to do good, VWF may be considered the Jedi knight of the bloodstream. The long length of VWF enables responsiveness to flow. The shape of VWF is predicted to alter from irregularly coiled to extended thread-like in the transition from shear to elongational flow at sites of hemostasis and thrombosis. Elongational force propagated through the length of VWF in its thread-like shape exposes its monomers for multimeric binding to platelets and subendothelium and likely also increases affinity of the A1 domain for platelets. Specialized domains concatenate and compact VWF during biosynthesis. A2 domain unfolding by hydrodynamic force enables postsecretion regulation of VWF length. Mutations in VWF in von Willebrand disease contribute to and are illuminated by VWF biology. I attempt to integrate classic studies on the physiology of hemostatic plug formation into modern molecular understanding, and point out what remains to be learned.
Validation of a guideline-based decision support system for the diagnosis of primary headache disorders based on ICHD-3 beta
Authors: Dong Zhao , Yin Ziming , He Mianwang , Chen Xiaoyan , Lv Xudong , Yu Shengyuan
Published: June 2014

Background

China may have the largest population of headache sufferers and therefore the most serious burden of disease worldwide. However, the rate of diagnosis for headache disorders is extremely low, possibly due to the relative complexity of headache subtypes and diagnostic criteria. The use of computerized clinical decision support systems (CDSS) seems to be a better choice to solve this problem.

Methods

We developed a headache CDSS based on ICHD-3 beta and validated it in a prospective study that included 543 headache patients from the International Headache Center at the Chinese PLA General hospital, Beijing, China.

Results

We found that the CDSS correctly recognized 159/160 (99.4%) of migraine without aura, 36/36 (100%) of migraine with aura, 20/21 (95.2%) of chronic migraine, and 37/59 (62.7%) of probable migraine. This system also correctly identified 157/180 (87.2%) of patients with tension-type headache (TTH), of which infrequent episodic TTH was diagnosed in 12/13 (92.3%), frequent episodic TTH was diagnosed in 99/101 (98.0%), chronic TTH in 18/20 (90.0%), and probable TTH in 28/46 (60.9%). The correct diagnostic rates of cluster headache and new daily persistent headache (NDPH) were 90.0% and 100%, respectively. In addition, the system recognized 32/32 (100%) of patients with medication overuse headache.

Conclusions

With high diagnostic accuracy for most of the primary and some types of secondary headaches, this system can be expected to help general practitioners at primary hospitals improve diagnostic accuracy and thereby reduce the burden of headache in China.
N-acetylcysteine improves established monocrotaline-induced pulmonary hypertension in rats
Authors: Chaumais Marie-Camille , Ranchoux Benoît , Montani David , Dorfmüller Peter , Tu Ly , Lecerf Florence , Raymond Nicolas , Guignabert Christophe , Price Laura , Simonneau Gérald , Cohen-Kaminsky Sylvia , Humbert Marc , Perros Frédéric
Published: June 2014

Background

The outcome of patients suffering from pulmonary arterial hypertension (PAH) are predominantly determined by the response of the right ventricle to the increase afterload secondary to high vascular pulmonary resistance. However, little is known about the effects of the current available or experimental PAH treatments on the heart. Recently, inflammation has been implicated in the pathophysiology of PAH. N-acetylcysteine (NAC), a well-known safe anti-oxidant drug, has immuno-modulatory and cardioprotective properties. We therefore hypothesized that NAC could reduce the severity of pulmonary hypertension (PH) in rats exposed to monocrotaline (MCT), lowering inflammation and preserving pulmonary vascular system and right heart function.

Methods

Saline-treated control, MCT-exposed, MCT-exposed and NAC treated rats (day 14–28) were evaluated at day 28 following MCT for hemodynamic parameters (right ventricular systolic pressure, mean pulmonary arterial pressure and cardiac output), right ventricular hypertrophy, pulmonary vascular morphometry, lung inflammatory cells immunohistochemistry (monocyte/macrophages and dendritic cells), IL-6 expression, cardiomyocyte hypertrophy and cardiac fibrosis.

Results

The treatment with NAC significantly decreased pulmonary vascular remodeling, lung inflammation, and improved total pulmonary resistance (from 0.71 ± 0.05 for MCT group to 0.50 ± 0.06 for MCT + NAC group, p < 0.05). Right ventricular function was also improved with NAC treatment associated with a significant decrease in cardiomyocyte hypertrophy (625 ± 69 vs. 439 ± 21 μm2 for MCT and MCT + NAC group respectively, p < 0.001) and heart fibrosis (14.1 ± 0.8 vs. 8.8 ± 0.1% for MCT and MCT + NAC group respectively, p < 0.001).

Conclusions

Through its immuno-modulatory and cardioprotective properties, NAC has beneficial effect on pulmonary vascular and right heart function in experimental PH.
Determination of sample size for a multi-class classifier based on single-nucleotide polymorphisms: a volume under the surface approach
Authors: Liu Xinyu , Wang Yupeng , Sriram TN
Published: June 2014

Background

Data on single-nucleotide polymorphisms (SNPs) have been found to be useful in predicting phenotypes ranging from an individual’s class membership to his/her risk of developing a disease. In multi-class classification scenarios, clinical samples are often limited due to cost constraints, making it necessary to determine the sample size needed to build an accurate classifier based on SNPs. The performance of such classifiers can be assessed using the Area Under the Receiver Operating Characteristic (ROC) Curve (AUC) for two classes and the Volume Under the ROC hyper-Surface (VUS) for three or more classes. Sample size determination based on AUC or VUS would not only guarantee an overall correct classification rate, but also make studies more cost-effective.

Results

For coded SNP data from D(≥2) classes, we derive an optimal Bayes classifier and a linear classifier, and obtain a normal approximation to the probability of correct classification for each classifier. These approximations are then used to evaluate the associated AUCs or VUSs, whose accuracies are validated using Monte Carlo simulations. We give a sample size determination method, which ensures that the difference between the two approximate AUCs (or VUSs) is below a pre-specified threshold. The performance of our sample size determination method is then illustrated via simulations. For the HapMap data with three and four populations, a linear classifier is built using 92 independent SNPs and the required total sample sizes are determined for a continuum of threshold values. In all, four different sample size determination studies are conducted with the HapMap data, covering cases involving well-separated populations to poorly-separated ones.

Conclusion

For multi-classes, we have developed a sample size determination methodology and illustrated its usefulness in obtaining a required sample size from the estimated learning curve. For classification scenarios, this methodology will help scientists determine whether a sample at hand is adequate or more samples are required to achieve a pre-specified accuracy. A PDF manual for R package “SampleSizeSNP” is given in Additional file 1, and a ZIP file of the R package “SampleSizeSNP” is given in Additional file 2.
Serum TFF3 may be a pharamcodynamic marker of responses to chemotherapy in gastrointestinal cancers
Authors: Xiao Li , Liu Yun-Peng , Xiao Chuan-Xing , Ren Jian-Lin , Guleng Bayasi
Published: June 2014

Background

As a secreted protein, serum trefoil factor 3 (TFF3) has been reported to be a biomarker of several malignancies. We further investigated whether TFF3 can be applied as a biomarker for and predictor of responses to chemotherapy in gastrointestinal cancer.

Methods

Serum and urine samples were collected from 90 patients with gastric cancer, 128 patients with colorectal cancer and 91 healthy individuals. Serum and urine TFF3 levels were measured using an ELISA.

Results

Serum and urine TFF3 levels were significantly higher in the patients with gastric and colorectal cancer compared with the healthy individuals (P < 0.05). Higher serum levels of TFF3 were significantly correlated with distant metastasis and an advanced stage in the two types of cancer (P < 0.05). Age and the number of lymph node metastases were significantly correlated with serum TFF3 levels in colorectal cancer, and decreased serum TFF3 levels were significantly correlated with responses to chemotherapy in both the gastric and the colorectal cancer partial response (PR) groups. A combination of serum and urine data did not significantly improve the detection of either cancer, although urine levels have shown a significant negative relationship with the glomerular filtration rate (GFR).

Conclusions

Our data indicate that TFF3 may be an effective biomarker of tumor stage and the presence of distant metastasis, and may be a pharmacodynamic marker of response to chemotherapy in gastrointestinal cancer.
A simple block diagonal precoding for multi-user MIMO broadcast channels
Authors: Khan Md Hashem Ali , Cho K M , Lee Moon Ho , Chung Jin-Gyun
Published: June 2014

The block diagonalization (BD) is a linear precoding technique for multi-user multi-input multi-output (MIMO) broadcast channels, which is able to completely eliminate the multi-user interference (MUI), but it is not computationally efficient. In this paper, we propose the block diagonal Jacket matrix decomposition, which is able not only to extend the conventional block diagonal channel decomposition but also to achieve the MIMO broadcast channel capacity. We also prove that the QR algorithm achieves the same sum rate as that of the conventional BD scheme. The complexity analysis shows that our proposal is more efficient than the conventional BD method in terms of the number of the required computation.
Gain and Loss of Function of P2X7 Receptors: Mechanisms, Pharmacology and Relevance to Diabetic Neuropathic Pain
Authors: Ursu Daniel , Ebert Philip , Langron Emily , Ruble Cara , Munsie Leanne , Zou Wei , Fijal Bonnie , Qian Yue-Wei , McNearney Terry A , Mogg Adrian , Grubisha Olivera , Merchant Kalpana , Sher Emanuele
Published: June 2014

Background:

Genetic causes of exaggerated or reduced pain sensitivity in humans are well known. Recently, single nucleotide polymorphisms (SNPs) in the gene P2RX7, coding for the ATP-gated ion channel P2X7, have been described that cause gain-of-function (GOF) and loss-of-function (LOF), respectively of this channel. Importantly, P2RX7 SNPs have been associated with more or less severe pain scores in patient suffering of post-mastectomy pain and osteoarthritis.

Results:

The functional consequences of some P2RX7 SNPs (rs208294 (His155Tyr), rs1718119 (Ala348Thr) and rs3751143 (Glu496Ala)) were studied in recombinant cells in vitro. Our findings suggest a correlation between GOF and LOF of P2X7 and actual channel protein expression. Both channel and pore function for these mutant P2X7 receptors changed in parallel to protein levels. On the other hand, the mutant receptors did not differ in their sensitivity to known P2X7 agonists and antagonists. We further demonstrated that in patients with diabetic peripheral neuropathic pain (DPNP), the presence of the GOF SNPs rs208294 (His155Tyr) and rs1718119 (Ala348Thr) is associated, in females, with higher pain intensity scores.

Conclusions:

Our present results confirm the physiological relevance of some of the SNPs in the P2RX7 gene and show that the presence of these genetic variants correlates with pain sensitivity also in a diabetic neuropathic pain patient population.