bluuebunny/crossref_metadata_2025 huggingface dataset:
Changing demographics of pulmonary arterial hypertension in congenital heart disease
Authors: Mulder B.J.M.
Published: December 2010

Pulmonary arterial hypertension (PAH) is a serious complication of congenital heart disease (CHD). Without early surgical repair, around one-third of paediatric CHD patients develop significant PAH. Recent data from the Netherlands suggest that >4% of adult CHD patients have PAH, with higher rates in those with septal defects. A spectrum of cardiac defects is associated with PAH-CHD, although most cases develop as a consequence of large systemic-to-pulmonary shunts. Eisenmenger's syndrome, characterised by reversed pulmonary-to-systemic (right-to-left) shunt, represents the most advanced form of PAH-CHD and affects as many as 50% of those with PAH and left-to-right shunts. It is associated with the poorest outcome among patients with PAH-CHD. 40 yrs ago, ∼50% of children with CHD requiring intervention died within the first year, and <15% survived to adulthood. Subsequent advances in paediatric cardiology have seen most patients with CHD survive to adulthood, with resulting shifts in the demographics of CHD and PAH-CHD. The number of adults presenting with CHD is increasing and, although mortality is decreasing, morbidity is increasing as older patients are at increased risk of arrhythmia, heart failure, valve regurgitation and PAH. Data show that probability of PAH increases with age in patients with cardiac defects.
Management of severe pulmonary arterial hypertension
Authors: Vachiéry J-L. , Simonneau G.
Published: December 2010

Pulmonary arterial hypertension (PAH) is a severe, progressive condition of the small pulmonary vessels that leads to increased pulmonary vascular resistance, right ventricular failure and death. Patients in World Health Organization functional class (WHO FC) IV are the most severely affected in terms of disease severity, symptomatic impairment, exercise capacity and haemodynamics, with a very poor prognosis and low survival rate. Recent developments in PAH-specific therapies have conferred significant prognostic improvements upon PAH patients, especially when coupled with management strategies such as goal-oriented therapy and combination treatment. Despite these important developments, the outlook for WHO FC IV PAH patients remains poor. This article examines the recommendations for WHO FC IV patients that appear in current PAH treatment guidelines and the research underpinning this guidance, and discusses possible future directions for treatment of this severely unwell patient population.
BrEPS: a flexible and automatic protocol to compute enzyme-specific sequence profiles for functional annotation
Authors: Bannert C , Welfle A , aus dem Spring C , Schomburg D
Published: December 2010

Background

Models for the simulation of metabolic networks require the accurate prediction of enzyme function. Based on a genomic sequence, enzymatic functions of gene products are today mainly predicted by sequence database searching and operon analysis. Other methods can support these techniques: We have developed an automatic method "BrEPS" that creates highly specific sequence patterns for the functional annotation of enzymes.

Results

The enzymes in the UniprotKB are identified and their sequences compared against each other with BLAST. The enzymes are then clustered into a number of trees, where each tree node is associated with a set of EC-numbers. The enzyme sequences in the tree nodes are aligned with ClustalW. The conserved columns of the resulting multiple alignments are used to construct sequence patterns. In the last step, we verify the quality of the patterns by computing their specificity. Patterns with low specificity are omitted and recomputed further down in the tree. The final high-quality patterns can be used for functional annotation. We ran our protocol on a recent Swiss-Prot release and show statistics, as well as a comparison to PRIAM, a probabilistic method that is also specialized on the functional annotation of enzymes. We determine the amount of true positive annotations for five common microorganisms with data from BRENDA and AMENDA serving as standard of truth. BrEPS is almost on par with PRIAM, a fact which we discuss in the context of five manually investigated cases.

Conclusions

Our protocol computes highly specific sequence patterns that can be used to support the functional annotation of enzymes. The main advantages of our method are that it is automatic and unsupervised, and quite fast once the patterns are evaluated. The results show that BrEPS can be a valuable addition to the reconstruction of metabolic networks.
Bacteriocyte dynamics during development of a holometabolous insect, the carpenter ant Camponotus floridanus
Authors: Stoll Sascha , Feldhaar Heike , Fraunholz Martin J , Gross Roy
Published: December 2010

Background

The carpenter ant Camponotus floridanus harbors obligate intracellular mutualistic bacteria (Blochmannia floridanus) in specialized cells, the bacteriocytes, intercalated in their midgut tissue. The diffuse distribution of bacteriocytes over the midgut tissue is in contrast to many other insects carrying endosymbionts in specialized tissues which are often connected to the midgut but form a distinct organ, the bacteriome. C. floridanus is a holometabolous insect which undergoes a complete metamorphosis. During pupal stages a complete restructuring of the inner organs including the digestive tract takes place. So far, nothing was known about maintenance of endosymbionts during this life stage of a holometabolous insect. It was shown previously that the number of Blochmannia increases strongly during metamorphosis. This implicates an important function of Blochmannia in this developmental phase during which the animals are metabolically very active but do not have access to external food resources. Previous experiments have shown a nutritional contribution of the bacteria to host metabolism by production of essential amino acids and urease-mediated nitrogen recycling. In adult hosts the symbiosis appears to degenerate with increasing age of the animals.

Results

We investigated the distribution and dynamics of endosymbiotic bacteria and bacteriocytes at different stages during development of the animals from larva to imago by confocal laser scanning microscopy. The number of bacteriocytes in relation to symbiont-free midgut cells varied strongly over different developmental stages. Especially during metamorphosis the relative number of bacteria-filled bacteriocytes increased strongly when the larval midgut epithelium is shed. During this developmental stage the midgut itself became a huge symbiotic organ consisting almost exclusively of cells harboring bacteria. In fact, during this phase some bacteria were also found in midgut cells other than bacteriocytes indicating a cell-invasive capacity of Blochmannia. In adult animals the number of bacteriocytes generally decreased.

Conclusions

During the life cycle of the animals the distribution of bacteriocytes and of Blochmannia endosymbionts is remarkably dynamic. Our data show how the endosymbiont is retained within the midgut tissue during metamorphosis thereby ensuring the maintenance of the intracellular endosymbiosis despite a massive reorganization of the midgut tissue. The transformation of the entire midgut into a symbiotic organ during pupal stages underscores the important role of Blochmannia for its host in particular during metamorphosis.
Azelnidipine protects myocardium in hyperglycemia-induced cardiac damage
Authors: Kain Vasundhara , Kumar Sandeep , Puranik Amrutesh S , Sitasawad Sandhya L
Published: December 2010

Background

Azelnidipine (AZL), a long-acting dihydropyridine-based calcium antagonist, has been recently approved and used for treating ischemic heart disease and cardiac remodeling after myocardial infarction, however, its effect on hyperglycemia-induced cardiac damage has not been studied.

Methods

This study examined the effect of AZL on circulating markers of cardiac damage, altered lipid and cytokines profile and markers of oxidative stress including homocysteine in diabetic rats.

Results

STZ induced diabetes caused a significant increase in blood glucose levels. It also resulted in an increase in the levels of homocysteine and cardiac damage markers, like Troponin-1, CK-MB, CK-NAC, uric acid, LDH and alkaline phosphatase. Moreover, there was an increase in the levels of proinflammatory cytokines like TNF-α, IFN-γ, and TGF-β and decrease in the levels of IL-4 and IL-10. Additionally, there was increase in the levels of cholesterol, triglycerides, LDL, VLDL and a decrease in HDL in these animals. There was an altered antioxidant enzyme profile which resulted in a notable increase in the levels of oxidative stress markers like lipid peroxides, nitric oxide and carbonylated proteins. Compared with the untreated diabetic rats, AZL treatment significantly reduced the levels of troponin-1 (P < 0.05), CK-MB (P < 0.05), CK-NAC (P < 0.05), uric acid (P < 0.05), LDH (P < 0.05) and alkaline phosphatase (P < 0.05). It also reduced the levels of the TNF-α (P < 0.05), IFN-γ (P < 0.05), and TGF-β (P < 0.05) and increased the levels of IL-4 (P < 0.05). A significant decrease in the serum cholesterol (P < 0.05), triglycerides (P < 0.05), LDL (P < 0.05), VLDL (P < 0.05) and a significant rise in levels of HDL (P < 0.05) was also observed. Treatment with AZL corrected the distorted antioxidant enzyme profile resulting in a significant decrease in the levels of lipid peroxides, nitric oxide and carbonylated proteins.

Conclusion

Our results indicate that AZL treatment can reduce the risk of hyperglycemia induced metabolic disorders and its role can be further extended to explore its therapeutic potential in diabetic patients with cardiac complications.
Using Critical Literacy to Explore Genetics and its Ethical, Legal, and Social Issues with In-Service Secondary Teachers
Authors: Gleason Michael L. , Melançon Megan E. , Kleine Karynne L. M.
Published: December 2010

The described interdisciplinary course helped a mixed population of in-service secondary English and biology teacher-participants increase their genetics content knowledge and awareness of Ethical, Legal, and Social Implications (ELSI) that arose from discoveries and practices associated with the Human Genome Project. This was accomplished by applying a critical literacy approach that allows people develop cognitive skills such that they are able to “read the world” ( Wink, 2004 ). The approach is one that permits readers to go beyond the literal text to examine what is present as well as what is missing as it relates to issues of equity and fairness. Becoming critically literate enabled these teacher-participants to challenge the subtle attitudes, values, and beliefs conveyed by a range of written and oral texts. The teacher-participants in this course improved their critical literacy skills by actively reading, critically writing about, and using evidence to support their conclusions about issues arising from advances in human genetics. A biologist, a linguist, and an educator collaboratively designed and taught the course. The personalized focus on the integration of thoughtful reading and writing in this class enhanced the teacher-participants' (n = 16) professional and intellectual development and will potentially improve learning in their biology and English classrooms in the future.
Teaching the Process of Molecular Phylogeny and Systematics: A Multi-Part Inquiry-Based Exercise
Authors: Lents Nathan H. , Cifuentes Oscar E. , Carpi Anthony
Published: December 2010

Three approaches to molecular phylogenetics are demonstrated to biology students as they explore molecular data from Homo sapiens and four related primates. By analyzing DNA sequences, protein sequences, and chromosomal maps, students are repeatedly challenged to develop hypotheses regarding the ancestry of the five species. Although these exercises were designed to supplement and enhance classroom instruction on phylogeny, cladistics, and systematics in the context of a postsecondary majors-level introductory biology course, the activities themselves require very little prior student exposure to these topics. Thus, they are well suited for students in a wide range of educational levels, including a biology class at the secondary level. In implementing this exercise, we have observed measurable gains, both in student comprehension of molecular phylogeny and in their acceptance of modern evolutionary theory. By engaging students in modern phylogenetic activities, these students better understood how biologists are currently using molecular data to develop a more complete picture of the shared ancestry of all living things.
The American Science Pipeline: Sustaining Innovation in a Time of Economic Crisis
Authors: Hue Gillian , Sales Jessica , Comeau Dawn , Lynn David G. , Eisen Arri
Published: December 2010

Significant limitations have emerged in America's science training pipeline, including inaccessibility, inflexibility, financial limitations, and lack of diversity. We present three effective programs that collectively address these challenges. The programs are grounded in rigorous science and integrate through diverse disciplines across undergraduate, graduate, and postdoctoral students, and resonate with the broader community. We discuss these models in the context of current economic constraints on higher education and the urgent need for our institutions to recruit and retain diverse student populations and sustain the successful American record in scientific education and innovation.
Teaching the Process of Science: Faculty Perceptions and an Effective Methodology
Authors: Coil David , Wenderoth Mary Pat , Cunningham Matthew , Dirks Clarissa
Published: December 2010

Most scientific endeavors require science process skills such as data interpretation, problem solving, experimental design, scientific writing, oral communication, collaborative work, and critical analysis of primary literature. These are the fundamental skills upon which the conceptual framework of scientific expertise is built. Unfortunately, most college science departments lack a formalized curriculum for teaching undergraduates science process skills. However, evidence strongly suggests that explicitly teaching undergraduates skills early in their education may enhance their understanding of science content. Our research reveals that faculty overwhelming support teaching undergraduates science process skills but typically do not spend enough time teaching skills due to the perceived need to cover content. To encourage faculty to address this issue, we provide our pedagogical philosophies, methods, and materials for teaching science process skills to freshman pursuing life science majors. We build upon previous work, showing student learning gains in both reading primary literature and scientific writing, and share student perspectives about a course where teaching the process of science, not content, was the focus. We recommend a wider implementation of courses that teach undergraduates science process skills early in their studies with the goals of improving student success and retention in the sciences and enhancing general science literacy.
A Diagnostic Assessment for Introductory Molecular and Cell Biology
Authors: Shi Jia , Wood William B. , Martin Jennifer M. , Guild Nancy A. , Vicens Quentin , Knight Jennifer K.
Published: December 2010

We have developed and validated a tool for assessing understanding of a selection of fundamental concepts and basic knowledge in undergraduate introductory molecular and cell biology, focusing on areas in which students often have misconceptions. This multiple-choice Introductory Molecular and Cell Biology Assessment (IMCA) instrument is designed for use as a pre- and posttest to measure student learning gains. To develop the assessment, we first worked with faculty to create a set of learning goals that targeted important concepts in the field and seemed likely to be emphasized by most instructors teaching these subjects. We interviewed students using open-ended questions to identify commonly held misconceptions, formulated multiple-choice questions that included these ideas as distracters, and reinterviewed students to establish validity of the instrument. The assessment was then evaluated by 25 biology experts and modified based on their suggestions. The complete revised assessment was administered to more than 1300 students at three institutions. Analysis of statistical parameters including item difficulty, item discrimination, and reliability provides evidence that the IMCA is a valid and reliable instrument with several potential uses in gauging student learning of key concepts in molecular and cell biology.
A Model for Using a Concept Inventory as a Tool for Students' Assessment and Faculty Professional Development
Authors: Marbach-Ad Gili , McAdams Katherine C. , Benson Spencer , Briken Volker , Cathcart Laura , Chase Michael , El-Sayed Najib M. , Frauwirth Kenneth , Fredericksen Brenda , Joseph Sam W. , Lee Vincent , McIver Kevin S. , Mosser David , Quimby B. Booth , Shields Patricia , Song Wenxia , Stein Daniel C. , Stewart Richard , Thompson Katerina V. , Smith Ann C.
Published: December 2010

This essay describes how the use of a concept inventory has enhanced professional development and curriculum reform efforts of a faculty teaching community. The Host Pathogen Interactions (HPI) teaching team is composed of research and teaching faculty with expertise in HPI who share the goal of improving the learning experience of students in nine linked undergraduate microbiology courses. To support evidence-based curriculum reform, we administered our HPI Concept Inventory as a pre- and postsurvey to approximately 400 students each year since 2006. The resulting data include student scores as well as their open-ended explanations for distractor choices. The data have enabled us to address curriculum reform goals of 1) reconciling student learning with our expectations, 2) correlating student learning with background variables, 3) understanding student learning across institutions, 4) measuring the effect of teaching techniques on student learning, and 5) demonstrating how our courses collectively form a learning progression. The analysis of the concept inventory data has anchored and deepened the team's discussions of student learning. Reading and discussing students' responses revealed the gap between our understanding and the students' understanding. We provide evidence to support the concept inventory as a tool for assessing student understanding of HPI concepts and faculty development.
Robert Full
Authors: Hoopes Laura L. Mays
Published: December 2010

Note from the Editor

Educator Highlights for CBE–LSE show how professors at different kinds of institutions educate students in life sciences with inspiration and panache.
Epidemiology and trends in non-fatal self-harm in three centres in England: 2000–2007
Authors: Bergen Helen , Hawton Keith , Waters Keith , Cooper Jayne , Kapur Navneet
Published: December 2010

Background

Self-harm is a common reason for presentation to a general hospital, with a strong association with suicide. Trends in self-harm are an important indicator of community psychopathology, with resource implications for health services and relevance to suicide prevention policy. Previous reports in the UK have come largely from single centres.

Aims

To investigate trends in non-fatal self-harm in six general hospitals in three centres from the Multicentre Study of Self-harm in England, and to relate these to trends in suicide.

Method

Data on self-harm presentations to general hospital emergency departments in Oxford (one), Manchester (three) and Derby (two) were analysed over the 8-year period 1 January 2000 to 31 December 2007.

Results

Rates of self-harm declined significantly over 8 years for males in three centres (Oxford: −14%; Manchester: −25%; Derby: −18%) and females in two centres (Oxford: −2% (not significant); Manchester: −13%; Derby: −17%), in keeping with national trends in suicide. A decreasing proportion and number of episodes involved self-poisoning alone, and an increasing proportion and number involved other self-injury (e.g. hanging, jumping, traffic related). Episodes involving self-cutting alone showed a slight decrease in numbers over time. Trends in alcohol use at the time of self-harm and repetition within 1 year were stable.

Conclusions

There were decreasing rates of non-fatal self-harm over the study period that paralleled trends in suicide in England. This was reflected mainly in a decline in emergency department presentations for self-poisoning.
Neuroanatomical correlates of psychosis in temporal lobe epilepsy: voxel-based morphometry study
Authors: Sundram Frederick , Cannon Mary , Doherty Colin P. , Barker Gareth J. , Fitzsimons Mary , Delanty Norman , Cotter David
Published: December 2010

Background

Temporal lobe epilepsy is associated with a significant risk of psychosis but there are only limited studies investigating the underlying neurobiology.

Aims

To characterise neuroanatomical changes in temporal lobe epilepsy and comorbid psychosis.

Method

The study population comprised all individuals with temporal lobe epilepsy on the epilepsy database at the National Centre for Epilepsy and Epilepsy Neurosurgery in Ireland (Beaumont Hospital) between 2002 and 2006. Ten people with temporal lobe epilepsy with psychosis were matched for age, gender, handedness, epilepsy duration, seizure laterality, severity of epilepsy and anti-epileptic medication with ten comparison participants with temporal lobe epilepsy only. Participants received a magnetic resonance imaging scan and voxel-based morphometry analyses were applied to grey and white matter anatomy.

Results

Significant grey matter reduction was found bilaterally in those with temporal lobe epilepsy with psychosis in the temporal lobes in the inferior, middle and superior temporal gyri and fusiform gyri, and unilaterally in the left parahippocampal gyrus and hippocampus. Significant extra-temporal grey matter reduction was found bilaterally in the insula, cerebellum, caudate nuclei and in the right cingulum and left inferior parietal lobule. Significant white matter reduction in those with temporal lobe epilepsy with psychosis was found bilaterally in the hippocampus, parahippocampal/fusiform gyri, middle/inferior temporal gyri, cingulum, corpus callosum, posterior thalamic radiation, anterior limb of internal capsule and white matter fibres from the caudate nuclei, and unilaterally in the left lingual gyrus and right midbrain and superior temporal gyrus.

Conclusions

Significant grey and white matter deficits occur in temporal lobe epilepsy with psychosis. These encompass the medial temporal lobe structures but also extend to lateral temporal and extra-temporal regions. Some of these deficits overlap with those found in schizophrenia.
Effectiveness of home treatment for elderly people with depression: randomised controlled trial
Authors: Klug Günter , Hermann Gerhard , Fuchs-Nieder Brigitte , Panzer Manuela , Haider-Stipacek Andrea , Zapotoczky Hans Georg , Priebe Stefan
Published: December 2010

Background

There is little evidence available about what service models are effective in the treatment of elderly people with depression.

Aims

To test the effectiveness of home treatment for elderly people with depression living independently.

Method

In a randomised controlled trial, 60 out-patients aged over 64 years with major depression were allocated to a home treatment model over a 1-year period or to conventional psychiatric out-patient care. The primary outcome was the level of depressive symptoms after 3 and 12 months. The secondary outcomes were global functioning, subjective quality of life (SQOL), admissions to nursing homes, duration of psychiatric hospital treatments and the cost of care.

Results

Individuals receiving home treatment had significantly fewer symptoms of depression, better global functioning and a higher SQOL at 3 months and at 12 months. Over 1 year they had fewer admissions to nursing homes, spent less time in psychiatric in-patient care and the cost of care was lower.

Conclusions

Home treatment appears an effective and cost-effective service model for elderly people with depression.
Survey of general practitioners' attitudes towards psychiatry
Authors: Thompson Catherine , Dogra Nisha , McKinley Robert
Published: December 2010

Aims and method

There is a lack of current data regarding attitudes of doctors towards psychiatry. General practitioners (GPs) are increasingly involved in teaching psychiatry, and their attitudes towards psychiatry may affect their ability to promote psychiatry. The main aim of the study is to inform on current attitudes of GPs towards psychiatry as a discipline. The Attitudes Towards Psychiatry (ATP-30) questionnaire was administered to all GPs within Shropshire.

Results

The response rate was 61% (n = 145 from N = 239). The mean score for the ATP-30 was 113.9. An association was found between GP trainer status and higher ATP-30 scores. Positive associations were found between demographic data (age, length of career, postgraduate experience of psychiatry, involvement in undergraduate teaching, GP trainer status) and individual response items on the ATP-30 scale.

Clinical implications

General practitioners in Shropshire have a positive attitude towards psychiatry. Associations between demographic data and ATP-30 scores indicate that GPs with more experience of psychiatry and those involved in training may have more positive attitudes. The main limitation of the study is the lack of proven validity of the scale for use in this population. The positive attitude towards psychiatry is consistent with GPs providing the role models needed if they are to be involved to a greater degree with teaching and promoting psychiatry as a career. The need for the development of a more specific tool or an update to the existing tool is discussed.
Custom and standard care: implications for the future role of doctors in mental health
Authors: Abed Riadh T.
Published: December 2010

Bohmer's concepts of custom and standard care are briefly discussed with specific reference to their implications for the role of doctors in mental health services. It is argued that these concepts help to clarify the unique contribution of doctors within multidisciplinary teams and help define the limits of standardisation in mental health services.
Do Provincial Drug Benefit Initiatives Create an Effective Policy Lab? The Evidence from Canada
Authors: Pomey Marie-Pascale , Morgan Steve , Church John , Forest Pierre-Gerlier , Lavis John N. , McIntosh Tom , Smith Neale , Petrela Jennifer , Martin Elisabeth , Dobson Sarah
Published: December 2010

Although the costs of doctors' visits and hospital stays in Canada are covered by national public health insurance, the cost of outpatient prescription drugs is not. To solve problems of access, Canadian provinces have introduced provincial prescription drug benefit programs. This study analyzes the prescription drug policymaking process in five Canadian provinces between 1992 and 2004 with a view to (1) determining the federal government's role in the area of prescription drugs; (2) describing the policymaking process; (3) identifying factors in each province's choice of a policy; (4) identifying patterns in those factors across the five provinces; and (5) assessing the federal government's influence on the policies chosen. Analysis shows that despite significant differences in policy choices, the ideological motivations of the provinces were unexpectedly similar. The findings also highlight the importance of institutional factors, for example, in provinces' decision to compete rather than to collaborate. We conclude that, to date, Canada's federalism laboratory has only partly benefited the Canadian public. Cost pressures may, however, eventually overcome barriers to cooperation between the provincial and the federal governments, enabling them to capitalize on Canada's federal structure to improve the accessibility and affordability of drugs.
Rebuilding the Past: Health Care Reform in Post-Katrina Louisiana
Authors: Clark Mary A.
Published: December 2010

After Hurricane Katrina, there was good reason to believe that a gaping window of opportunity had opened for Louisiana to revamp its safetynet health care system. But two years of discussions among stakeholders within Louisiana and extensive negotiations with federal officials resulted in no such change. This article argues that any explanation for this outcome needs to incorporate both structure and process. In terms of structure, the rules of the Medicaid disproportionate-share hospital (DSH) program give states substantial independent authority to decide which hospitals to fund. Federal authorities could not force Louisiana, which had historically turned its DSH money over to the state hospital system, to redirect it toward an insurance expansion. In the process of negotiation after Katrina, those who defended the institutions wedded to the prestorm status quo conducted a better strategy than their challengers. They narrowed the purview of the Louisiana Health Care Redesign Collaborative, set up to propose changes in the safety net to the federal government, such that the question of whether to rebuild Charity Hospital in New Orleans was off the table. Meanwhile, on a separate track, the state and the Department of Veterans Affairs successfully pursued a plan to jointly build replacement hospitals.
Including the “I” in Virtuality and Modern Job Design: Extending the Job Characteristics Model to Include the Moderating Effect of Individual Experiences of Electronic Dependence and Copresence
Authors: Gibson Cristina B. , Gibbs Jennifer L. , Stanko Taryn L. , Tesluk Paul , Cohen Susan G.
Published: December 2010

This paper extends the job characteristics model (JCM) to address virtual work design. We argue that the effects of critical job characteristics (task significance, autonomy, and feedback) on psychological states (experienced meaningfulness, responsibility, and knowledge of results) differ depending on two important elements of virtuality and their interactions with important social mechanisms: individual experiences of electronic dependence and its interaction with intimacy and the interaction of copresence with identification. Findings across 177 workers from a variety of settings varying in industry, size, and structure supported several moderating effects of virtuality and three-way interactions that included intimacy and identification, suggesting important modifications of the JCM. In addition, effects were not uniformly parallel for both elements of virtuality, emphasizing the need to differentiate between the effects of electronic dependence and copresence. We discuss the implications of these findings for theory and practice.
Identity in Organizations: Exploring Cross-Level Dynamics
Authors: Ashforth Blake E. , Rogers Kristie M. , Corley Kevin G.
Published: December 2010

Most research on organization-based identities focuses on a single level of analysis, typically the individual, group, or organization. As a spur to more cross-level identity research, we offer speculative discussions on two issues concerning nested identities. First, regarding the processes through which identities become linked across levels, we explore how identities at one level of analysis enable and constrain identities at other levels. We argue that, for a collective identity, intrasubjective understanding (“I think”) fosters intersubjective understanding (“we think”) through interaction, which in turn fosters generic understanding—a sense of the collective that transcends individuals (“it is”). Second, regarding the content of linked identities, we suggest that identities are relatively isomorphic across levels because organizational goals require some internal coherence. However, for various intended and unintended reasons, isomorphism is often impeded across levels, and identities tend to become somewhat differentiated.
The cost and consequences of proximal femoral fractures which require further surgery following initial fixation
Authors: Thakar C. , Alsousou J. , Hamilton T. W. , Willett K.
Published: December 2010

We evaluated the cost and consequences of proximal femoral fractures requiring further surgery because of complications. The data were collected prospectively in a standard manner from all patients with a proximal femoral fracture presenting to the trauma unit at the John Radcliffe Hospital over a five-year period. The total cost of treatment for each patient was calculated by separating it into its various components. The risk factors for the complications that arose, the location of their discharge and the mortality rates for these patients were compared to those of a matched control group. There were 2360 proximal femoral fractures in 2257 patients, of which 144 (6.1%) required further surgery. The mean cost of treatment in patients with complications was £18 709 (£2606.30 to £60.827.10), compared with £8610 (£918.54 to £45 601.30) for uncomplicated cases (p < 0.01), with a mean length of stay of 62.8 (44.5 to 79.3) and 32.7 (23.8 to 35.0) days, respectively. The probability of mortality after one month in these cases was significantly higher than in the control group, with a mean survival of 209 days, compared with 496 days for the controls. Patients with complications were statistically less likely to return to their own home (p < 0.01).

Greater awareness and understanding are required to minimise the complications of proximal femoral fractures and consequently their cost.
Winner of the Frank Horan essay prize: The effect of war on the evolution of the treatment of open fractures
Authors: Hindle P.
Published: December 2010

This paper outlines the history of advances made in the treatment of open fractures that have occurred during wartime.
Retrospective Evaluation of Home Medicines Review by Pharmacists in Older Australian Patients Using the Medication Appropriateness Index
Authors: Castelino Ronald L , Bajorek Beata V , Chen Timothy F
Published: December 2010

Background:

Home Medicines Review (HMR), a community-based collaborative service provided by general practitioners (GPs) and accredited pharmacists in Australia, has demonstrated effectiveness in preventing, detecting, and resolving medication-related problems. The Medication Appropriateness Index (MAI) has been found to be a reliable, valid, standardized instrument for assessment of multiple elements of drug therapy prescribing.

Objective:

To retrospectively evaluate the impact of HMRs on the appropriateness of prescribing, using the MAI as a tool to categorize pharmacists' recommendations.

Methods:

A retrospective analysis was performed on a sample of 270 HMR cases pertaining to community-dwelling older people (≥65 years) in New South Wales, Australia. The HMRs were collected from 7 accredited pharmacists using purposive sampling. All HMRs were conducted between February 2006 and October 2009. MAI scores were retrospectively calculated at baseline, after the HMR service based on the pharmacist's recommendations to the GP, and following uptake of the pharmacist's recommendations by the GP.

Results:

The mean ± SD age of the patients was 75.3 ± 7.4 years and 55% were female. Overall, almost all (99%; n = 267) patients had at least 1 inappropriate rating at baseline and more than 50% (n = 154) of the patients had a cumulative MAI score >15. The mean MAI score at baseline was 18.6 ± 11.3, which decreased to 9.3 ± 7.5 after HMR. The number of patients with a cumulative MAI score ≥15 increased to 216 after the HMR service, compared to 116 at baseline. Pharmacists' recommendations documented in the HMR reports and uptake of these recommendations by the GP resulted in a statistically significant decrease in the MAI scores (both p < 0.001).

Conclusions:

The study demonstrates that the provision of medication reviews by accredited pharmacists can improve the appropriateness of prescribing as demonstrated by the change in MAI score and, hence, has the potential to improve patient outcomes. Pharmacists who perform medication reviews could also consider including the systematic approach of applying the MAI to assist in optimizing prescribing in older people.
Diabetes: The Impact of Clinical Pharmacy Services Integrated into Medical Homes on Diabetes-Related Clinical Outcomes
Authors: Johnson Kathleen A , Chen Steven , Cheng I-Ning , Lou Mimi , Gregerson Paul , Blieden Carla , Baron Mel , McCombs Jeffrey
Published: December 2010

Background:

Pharmacist services have expanded in the US health-care system from traditional roles to include comprehensive clinical services, but many studies lack comparison groups to evaluate outcomes of these clinical services.

Objective:

To evaluate the clinical outcomes of uninsured or underinsured patients with type 2 diabetes who received care from pharmacists in local “safety net” clinic medical homes compared to outcomes of patients from clinics receiving usual care without the services of clinical pharmacists.

Methods:

Pharmacists provided comprehensive pharmacy services in safety net clinic medical homes for uninsured patients in a major urban city. Referred patients had poor diabetes control (hemoglobin A1c [A1C] >9%). Pharmacists conducted comprehensive evaluations of medications, made adjustments, monitored adherence, and provided education and follow-up. Intervention patients were compared to similar patients who were receiving usual care but were not seen by a pharmacist. Outcomes evaluated were the change in A1C levels and achievement of treatment goals. Data were derived from chart reviews retrospectively. Multivariate least-squares and logistic regression models were used to estimate the impact of the intervention.

Results:

Two hundred twenty-two intervention and 262 control patients were evaluated. Patients receiving care from pharmacists had adjusted A1C levels reduced by 1.38% relative to usual care, increasing the likelihood of achieving an A1C <7% by 3-fold (p < 0.001 for both estimates).

Conclusions:

The integration of clinical pharmacy services into safety net medical homes was associated with improvement in clinical outcomes of patients with diabetes.
Chemistry meets nutrition: Toward a systems biological description of human metabolism
Authors: Lorkowski Stefan
Published: December 2010

Chemistry was already pioneered by ancient Egyptians up to 4000 years ago. Despite its age, chemistry is by no means a dying scientific discipline. The different branches of study within chemistry have infiltrated all fields of life science research, and nobody can work in this area without using chemistry in the broadest sense. The present article is a personal view on how chemistry supports life science research, in particular in the field of nutrition and metabolism research. It provides insight into how chemistry, in close collaboration with life science research, helps to fill the gaps between our current fragmentary understanding and the comprehensive knowledge required for better understanding the molecular details of metabolism, health and disease, and aging. The most important contributions of the chemical disciplines to these studies with respect to a systems biological description of human nutrition and metabolism will be outlined.
Quantitative Measurements of Loss on Ignition in Iron Ore Using Laser-Induced Breakdown Spectroscopy and Partial Least Squares Regression Analysis
Authors: Yaroshchyk Pavel , Death David L. , Spencer Steven J.
Published: December 2010

Laser-induced breakdown spectroscopy (LIBS) and partial least squares regression (PLSR) have been applied to perform quantitative measurements of a multiple-species parameter known as loss on ignition (LOI), in a combined set of run-of-mine (ROM) iron ore samples originating from five different iron ore deposits. Global calibration models based on 65 samples and their duplicates from all the deposits with LOI ranging from 0.5 to 10 wt% are shown to be successful for prediction of LOI content in pressed pellets as well as bulk ore samples. A global independent dataset comprising a further 60 samples was used to validate the model resulting in the best validation R2 of 0.87 and root mean square error of prediction (RMSEP) of 1.1 wt% for bulk samples. A validation R2 of 0.90 and an RMSEP of 1.0 wt% were demonstrated for pressed pellets. Data preprocessing is shown to improve the quality of the analysis. Spectra normalization options, automatic outlier removal and automatic continuum background correction, which were used to improve the performance of the PLSR method, are discussed in detail.
Real-Time, in-situ, Extinction Spectroscopy Studies on Silver-Nanoseed Formation
Authors: Tang Bin , Xu Shuping , Jian Xiaoguang , Tao Jinlong , Xu Weiqing
Published: December 2010

In this paper, real-time extinction spectroscopy was employed to analyze in situ the fast formation process of silver seeds. The influencing factors for silver-seed formation, including the concentration of the reducer (NaBH4), the amount of stabilizer (citrate), and the addition procedure of NaBH4, were evaluated. The configuration of the surface plasmon resonance (SPR) spectra of silver nanoparticles, which reflected the morphology of the produced silver seeds, was found to be distinctly affected by the NaBH4 concentration. Homogeneous silver nanoparticles were obtained when the added NaBH4 was lower in concentration than 2.00 mM. In contrast, higher concentrations of reducing agent (≥3.00 mM NaBH4) resulted in uneven silver nanoparticles. Mie theory was applied to clarify the correlation of the SPR and the size of the silver seeds. Repeated additions of a small amount of the reducing agent could increase the monodispersity and isotropy of silver seeds. Real-time extinction spectroscopy is a convenient technique that achieves the in-situ and nondestructive measurement of intermediates in the formation process of silver nanoseeds.
Laser-Induced Breakdown Spectroscopy (LIBS), Part I: Review of Basic Diagnostics and Plasma—Particle Interactions: Still-Challenging Issues within the Analytical Plasma Community
Authors: Hahn David W. , Omenetto Nicoló
Published: December 2010

Laser-induced breakdown spectroscopy (LIBS) has become a very popular analytical method in the last decade in view of some of its unique features such as applicability to any type of sample, practically no sample preparation, remote sensing capability, and speed of analysis. The technique has a remarkably wide applicability in many fields, and the number of applications is still growing. From an analytical point of view, the quantitative aspects of LIBS may be considered its Achilles' heel, first due to the complex nature of the laser–sample interaction processes, which depend upon both the laser characteristics and the sample material properties, and second due to the plasma–particle interaction processes, which are space and time dependent. Together, these may cause undesirable matrix effects. Ways of alleviating these problems rely upon the description of the plasma excitation-ionization processes through the use of classical equilibrium relations and therefore on the assumption that the laser-induced plasma is in local thermodynamic equilibrium (LTE). Even in this case, the transient nature of the plasma and its spatial inhomogeneity need to be considered and overcome in order to justify the theoretical assumptions made. This first article focuses on the basic diagnostics aspects and presents a review of the past and recent LIBS literature pertinent to this topic. Previous research on non-laser-based plasma literature, and the resulting knowledge, is also emphasized. The aim is, on one hand, to make the readers aware of such knowledge and on the other hand to trigger the interest of the LIBS community, as well as the larger analytical plasma community, in attempting some diagnostic approaches that have not yet been fully exploited in LIBS.
The Sense of Well-Being Inventory as a Quality of Life Measure for People With Spinal Cord Injury
Authors: Catalano Denise , Kim Jeong-Han , Ditchman Nicole M. , Shin Hyun-Uk , Lee Jungeun , Chan Fong
Published: December 2010

The purpose of this study was to validate theSense of Well-Being Inventory(SWBI), a quality of life measure, for people with spinal cord injury. Four hundred and five participants were recruited from the Canadian Paraplegia Association for this study. The participants were asked to complete a research packet containing a demographic questionnaire, the SWBI, theRosenberg Self-Esteem Scale, and theAcceptance of Disability Scale. Exploratory and confirmatory factor analyses of the SWBI and correlational analyses of the SWBI factors with other psychosocial variables were conducted. Exploratory and confirmatory factor analyses validated a four-factor structure (financial, family and social, psychological, and physical wellbeing) for the SWBI. SWBI factors are positively related to self-esteem and disability acceptance. With continuing research to document reliability and validity, the SWBI appears to have great potential as a vocational rehabilitation outcome measurement for people with spinal cord injury.
Performance of nuclear matrix protein 22 urine marker and voided urine cytology in the detection of urinary bladder tumors
Authors: Smrkolj Tomaž , Mihelič Miro , Sedlar Aleš , Sterle Igor , Osredkar Joško , Sedmak Boris
Published: December 2010

Background: Cystoscopy with urinary cytology is the gold standard for the diagnosis and follow-up of patients with tumors of the urinary bladder. The aim of the study was to evaluate the performance of the nuclear matrix protein 22 (NMP22) tumor marker test, BladderChek® point-of-care test and voided urinary cytology for the detection and follow-up of bladder tumors.

Methods: NMP22 was measured using an ELISA assay in stabilized voided urine and using the BladderChek® test. Voided urinary cytology was performed on urine samples. Results were compared to cystoscopic findings and histopathological examination results after transurethral resection of the bladder lesion.

Results: For the prediction of malignant histopathological result, sensitivity and specificity were 45.2% and 75.0%, respectively, for NMP22 at a cut-off of 7.5 kU/L, 17.7% and 100% for the BladderChek® test and 37.0% and 100% for voided urine cytology. For the prediction of suspicious or positive cystoscopic finding, sensitivity and specificity were 40.4% and 72.1%, respectively, for NMP22 at a cut-off of 7.5 kU/L, 14.8% and 93.8% for the BladderChek® test and 26.8% and 98.1% for voided urine cytology.

Conclusions: The NMP22 quantitative test showed higher sensitivity and lower specificity compared with voided urine cytology, whereas the sensitivity of the BladderChek® test was low. We could not recommend any of the three non-invasive tests as a replacement for cystoscopy for the diagnosis or follow-up of urinary bladder tumors.