bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of HIV Protease Inhibitors on Progression of Monocrotaline- and Hypoxia-Induced Pulmonary Hypertension in Rats
Authors: Gary-Bobo Guillaume , Houssaini Amal , Amsellem Valerie , Rideau Dominique , Pacaud Pierre , Perrin Aline , Brégeon Jérémy , Marcos Elisabeth , Dubois-Randé Jean-Luc , Sitbon Olivier , Savale Laurent , Adnot Serge
Published: October 2010

Background—

Pulmonary hypertension (PH) is among the complications of HIV infection. Combination antiretroviral therapy may influence the progression of HIV-related PH. Because Akt signaling is a potential molecular target of HIV protease inhibitors (HPIs), we hypothesized that these drugs altered monocrotaline- and hypoxia-induced PH in rats by downregulating the Akt pathway, thereby inhibiting pulmonary artery smooth muscle cell proliferation.

Methods and Results—

Daily treatment with each of 3 first-generation HPIs (ritonavir 30 mg/kg, amprenavir 100 mg/kg, and nelfinavir 500 mg/kg) started 3 weeks after a subcutaneous monocrotaline injection (60 mg/kg) substantially diminished pulmonary artery pressure, right ventricular hypertrophy, number of muscularized pulmonary vessels, pulmonary arterial wall thickness, and proliferating pulmonary vascular Ki67-labeled cells without affecting vessel caspase 3 staining. HPI treatment partially prevented the development of hypoxia- and monocrotaline-induced PH. Monocrotaline-induced PH was associated with marked activation of Akt signaling in the lungs and proximal pulmonary arteries, with increases in phosphorylated Akt, phosphorylated glycogen-synthase-kinase-3β (GSK3), and phosphorylated endothelial nitric oxide synthase, all of which decreased markedly after treatment with each HPI. In contrast, PH-associated increases in phosphorylated extracellular signal-related kinase 1/2 and myosin light-chain phosphatase were unaltered by the HPIs. The 3 HPIs and the phosphatidylinositol 3-kinase inhibitor LY294002 inhibited platelet-derived growth factor–induced phosphorylation of Akt and GSK3 in cultured pulmonary artery smooth muscle cells and blocked cell proliferation; this last effect was abolished by the GSK3 inhibitor SB216763.

Conclusion—

These results support an effect of HPIs on pulmonary vascular remodeling mediated by inhibition of Akt phosphorylation and consequently of pulmonary artery smooth muscle cell proliferation.
Persistence of Mortality Reduction After the End of Randomized Therapy in Clinical Trials of Blood Pressure–Lowering Medications
Authors: Kostis William J. , Thijs Lutgarde , Richart Tom , Kostis John B. , Staessen Jan A.
Published: October 2010

Long-term follow-up of clinical trials of blood pressure–lowering medications has suggested a continuation of event reduction after study completion. We evaluated the persistence of mortality benefit of these agents after the end of clinical trials, when all of the patients were advised to take the same open-label therapy. We performed a meta-analysis of randomized clinical trials using blood pressure–lowering medications, used in patients with hypertension, myocardial infarction, or left ventricular systolic dysfunction, (n=18; 132 854 patients; 11 988 deaths) when a second report describing results after the end of the trial was available. During the randomized (first) phase, 80% (interquartile range: 75% to 83%) of the patients randomized to receive active therapy actually received it compared with 16% (interquartile range: 7% to 22%) of those randomized to control. In this phase, mortality was lower in the intervention group (odds ratio: 0.84 [95% CI: 0.79 to 0.90];
P
<0.0001). Mortality was also lower during the open-label follow-up (second) phase (odds ratio: 0.85 [95% CI: 0.79 to 0.91];
P
<0.0001), when all of the patients were advised to take the same therapy, and rates of receiving active therapy were similar in the 2 groups (59% [interquartile range: 46% to 77%], among those originally randomized to active, and 43% [interquartile range: 20% to 68%], in the control). Several sensitivity analyses indicated stability of the effects. In studies of antihypertensive medications, a decrease in overall mortality persists after the end of trial phase, when most patients in both the intervention and control groups receive active therapy. These analyses imply that earlier intervention would result in better clinical outcomes.
The Vertical Structures of Atmospheric Temperature Anomalies Associated with Two Flavors of El Niño Simulated by AMIP II Models
Authors: Zhou Tianjun , Zhang Jie
Published: October 2010

Recent studies have identified different modes associated with two flavors of El Niño in terms of the three-dimensional structure of atmospheric temperature. The first is a deep-warm mode, which features a coherent zonal mean warming throughout the troposphere from 30°N to 30°S with cooling aloft. The second is a shallow-warm mode, which features strong wave signatures in the troposphere with warmth (coolness) over the central Pacific (western Pacific). The ability to simulate these two modes is a useful metric for evaluating climate models. To understand the reproducibility of these two modes, the authors analyzed the multimodel ensemble mean (MMEM) of 11 atmospheric general circulation models (AGCMs) that participated in the second phase of the Atmospheric Model Intercomparison Project (AMIP II). Each model was run in an AGCM-alone mode forced by historical sea surface temperatures covering the period 1980–99. The authors find that atmospheric temperature variability is generally well captured in the MMEM of AMIP II models, demonstrating that the observational changes documented here are driven by SST changes during the El Niño events and the variety of vertical temperature structures associated with two flavors of El Niño are highly reproducible. The model skill for the first mode is slightly higher than the second mode. The skill in the upper troposphere–lower stratosphere is lower than for the tropospheric counterpart, especially at high latitudes. The performances of individual models are also assessed. The authors also show some differences from previous data analyses, including the variance accounted for by the two modes, as well as the lead–lag relationship of the shallow-warm mode with the Niño-3.4 index.
Time Scales of Variability of the Tropical Atmosphere Derived from Cloud-Defined Weather States
Authors: Tselioudis George , Rossow William B.
Published: October 2010

The recent analysis of Rossow et al. used a clustering technique to derive six tropical weather states (WS) based on mesoscale cloud-type patterns and documented the spatial distribution of those WS and the modes of variability of the convective WS in the tropical western Pacific. In this study, the global tropics are separated into 30° × 30° regions, and a clustering algorithm is applied to the regional WS frequency distributions to derive the dominant modes of weather state variability (or the climate state variability) in each region. The results show that the whole tropical atmosphere oscillates between a convectively active and a convectively suppressed regime with the exception of the eastern parts of the two ocean basins, where the oscillation is between a stratocumulus and a trade cumulus regime. The dominant mode of both those oscillations is the seasonal cycle with the exception of the eastern Indian and western–central Pacific region, where El Niño frequencies dominate. The transitions between the convectively active and suppressed regimes produce longwave (LW) and shortwave (SW) top-of-atmosphere (TOA) radiative differences that are of opposite sign and of similar magnitude, being of order 20–30 W m−2 over ocean and 10–20 W m−2 over land and thus producing an overall balance in the TOA radiative budget. The precipitation differences between the convectively active and suppressed regimes are found to be of order 2.5–3 mm day−1 over ocean and 1–2.4 mm day−1 over land. Finally, the transitions between the stratocumulus and shallow cumulus regimes produce noticeable TOA SW differences of order 10–20 W m−2 and very small TOA LW and precipitation differences. The potential climate feedback implications of the regime radiation and precipitation differences are discussed.
Tropical Indian Ocean Influence on Northwest Pacific Tropical Cyclones in Summer following Strong El Niño*
Authors: Du Yan , Yang Lei , Xie Shang-Ping
Published: October 2010

In the summer following a strong El Niño, tropical cyclone (TC) number decreases over the Northwest (NW) Pacific despite little change in local sea surface temperature. The authors’ analysis suggests El Niño–induced tropical Indian Ocean (TIO) warming as the cause. The TIO warming forces a warm tropospheric Kelvin wave that propagates into the western Pacific. Inducing surface divergence off the equator, the tropospheric Kelvin wave suppresses convection and induces an anomalous anticyclone over the NW Pacific, both anomalies unfavorable for TCs. The westerly vertical shear associated with the warm Kelvin wave reduces the magnitude of vertical shear in the South China Sea and strengthens it in the NW Pacific, an east–west variation that causes TC activity to increase and decrease in respective regions. These results help improve seasonal TC prediction.
Gender and Candidate Communication: Effects of Stereotypes in the 2008 Election
Authors: Banwart Mary Christine
Published: October 2010

The purpose of this study was to revisit the trait and belief approaches tested by Huddy and Terkildsen (1993a, 1993b) to determine to what extent these are still used by voters in evaluating female and male candidates, particularly after exposure to campaign communication run on behalf of the candidates. Through an experimental design, participants were exposed to candidate’s advertising in two mixed-gender congressional races from the 2008 election cycle. The results indicate that traditional trait stereotypes continue to be generated in the evaluation of female candidates, although the generation of belief (policy) stereotypes are more complicated. Whereas party affiliation influences perceptions of issue competency, vote choice also produces effects on both trait evaluations and perceptions of issue competency. These results ultimately suggest that voters’ application of belief and trait stereotypes encourages still further study by scholars and consideration by female candidates running for office.
Relational Processes in Career Transition: Extending Theory, Research, and Practice
Authors: Motulsky Sue L.
Published: October 2010

A growing body of work in relational theory and career decision making explores how relational processes, not just people’s relationships but more broadly their connections to self, others, and society, inform career development and counseling. This article presents the results of a qualitative research study of midlife women in career transition that contributes to building an empirical foundation for relational perspectives in career development. Feminist relational psychology, specifically relational cultural theory, frames the study, focusing attention on gender and culture in the context of relational influences. It extends the current research by focusing on career transition for midcareer, midlife women. Findings presented here illustrate the ways participants’ connections across a range of relationships enhanced and supported the process of career change and how their disconnections hindered, and sometimes halted, their movement through the transition. Implications for research and practice are offered.
Socioeconomic Disadvantage, School Attendance, and Early Cognitive Development
Authors: Ready Douglas D.
Published: October 2010

Over the past several decades, research has documented strong relationships between social class and children’s cognitive abilities. These initial cognitive differences, which are substantial at school entry, increase as children progress through school. Despite the robust findings associated with this research, authors have generally neglected the extent to which school absenteeism exacerbates social class differences in academic development among young children. Using growth-curve analyses within a three-level hierarchical linear modeling framework, this study employs data from the Early Childhood Longitudinal Study (ECLS-K) to examine the links between children’s social class, school absences, and academic growth during kindergarten and first grade. Results suggest that the effects of schooling on cognitive development are stronger for lower socioeconomic status (SES) children and that the findings associated with theories of summer learning loss are applicable to literacy development during early elementary school. Indeed, although they continue to achieve at lower absolute levels, socioeconomically disadvantaged children who have good attendance rates gain more literacy skills than their higher SES peers during kindergarten and first grade.
“Ageing Out”
Authors: Shoveller Jean , Chabot Cathy , Johnson Joy L. , Prkachin Ken
Published: October 2010

Despite a general decline, early-age motherhood continues to manifest disproportionately among young women living in rural/remote Canada. Although public health interventions exist to ameliorate the negative impacts, key determinants of young mothers’ well-being exist in sectors outside of health. Moreover, there is no clear understanding of how social context interacts with policy to enhance/detract from interventions. We undertook an ethnographic study in a northern Canadian city to investigate the impacts of sociocultural conditions and policy interventions on young mothers. “Ageing out” was identified as an important example of the intersection between social context and policy. “Ageing out” occurs when State-provided educational/income supports are removed because a young mother reaches the age of majority. Ageing out within unsupportive social contexts compounds negative consequences for young mothers, especially in relation to housing, parenting, and employment. The findings illustrate how some policy interventions have negative consequences that exacerbate health and social inequities.
U.S. Juvenile Arrests
Authors: Tapia Mike
Published: October 2010

This study addresses the link between gang membership and arrest frequency, exploring the Gang × Socioeconomic status interaction on those arrests. Notoriously poor, delinquent, and often well-known to police, America’s gang youth should have very high odds of arrest. Yet it is unclear whether mere membership in a gang increases the risk of arrest or whether it must be accompanied by high levels of delinquency to have an effect. There are surprisingly few tests of the arrest risk associated solely with group membership. The several studies that provide such a test have yielded mixed results. Revisiting this issue with longitudinal youth data for the nation, random effects Poisson models find main effects for gang membership and SES on arrest, controlling for demographic and legal items. However, interaction effects obtain paradoxical findings consistent with research on “out-of-place” effects for high-SES gang youth, and protective effects for low-SES gang youth. These findings are discussed in terms of their implications for labeling theory and the federal initiative on disproportionate minority contact (DMC) with the juvenile justice system.
Rethinking Youth Political Socialization
Authors: Gordon Hava R. , Taft Jessica K.
Published: October 2010

This article draws from the experiences and narratives of teenage activists throughout the Americas in order to add a needed dimension, that of peer political socialization, to the larger political and civic socialization literature. The authors argue that although the existing literature emphasizes the roles and responsibilities of adults in shaping young people’s civic capacities, the roles that young people play in socializing each other for political engagement is underexplored. Based on two qualitative studies of teenage activists throughout North and Latin America, the authors argue that teenage activists, who are largely left out of this literature, represent a different process by which youth engage in politics. We use teenagers’ narratives about their own youth-led political socialization to extend the existing theorizing on youth civic engagement, rethink some of its core tenets, and elucidate the roles that young people themselves play in the processes of political socialization.
Authority and Freedom in the Interpretation of Locke’s Political Theory
Authors: Stanton Timothy
Published: October 2010

This essay argues that many modern discussions of Locke’s political theory are unconsciously shaped by an imaginative picture of the world inherited from the past, on which authority and freedom are fundamentally antipathetic. The consequences of this picture may be seen in the distinction made customarily in Locke studies between the ‘authoritarian’ Locke of Two Tracts on Government, for whom authority descends from God, and the later, ‘liberal,’ Locke, for whom authority arises from the will and agreement of individuals, and felt in the emphases placed on consent and resistance in most interpretations of Lockean political thought. The essay examines the composition and contours of this picture and, by holding up a mirror to contemporary Locke scholarship, draws attention to some of the ways in which it unwittingly distorts Locke’s thinking.
Clinicians’ Competence in Assessing Cultural Mistrust Among African American Psychiatric Patients
Authors: Whaley Arthur L.
Published: October 2010

A two-stage culturally sensitive diagnostic procedure allows for the assessment of cultural factors in paranoid symptom expression among African Americans. The first stage eliminates clinician bias by ensuring that diagnosticians adhere to DSM criteria. The second stage removes cultural bias by having cultural experts (i.e., African American mental health professionals) give best-estimate diagnoses using the same symptom data along with cultural knowledge. The present study uses the culturally sensitive diagnostic interview paradigm and structural equation modeling to examine the effects of demographic background, patients’ self-report of paranoid symptoms, and patients’ self-report of cultural mistrust on clinicians’ ratings of cultural mistrust for a sample of 116 Black psychiatric inpatients. Full and reduced models were tested using structural equation modeling, and the reduced model was the best fit to the data. The results suggest that clinicians can identify cultural mistrust in Black psychiatric patients. Implications for cultural competence training to prevent psychiatric misdiagnosis are discussed.
The problem of national industrial relations traditions in European works councils: The example of BMW
Authors: Whittall Michael
Published: October 2010

In recent years IR scholars have attempted to understand how European works councils (EWCs) function. There exists a common consensus that there is much room for improvement. One key problem, maybe even the main problem, concerns the hold that national industrial relations practices continue to have over EWC delegates. This article argues that even though a high degree of suspicion existed among BMW and Rover delegates in the first exchanges following the foundation of the BMW EWC, a sense of empathy and respect for each other’s respective ways of doing business eventually prevailed. Undoubtedly, this was more noticeable among British trade unionists.
The Relationship Between Executive Function, AD/HD, Overeating, and Obesity
Authors: Dempsey Anita , Dyehouse Janice , Schafer John
Published: October 2010

Attention-deficit/hyperactivity disorder (AD/HD) and obesity are complex, costly disorders affecting physical, emotional, and social well-being. Executive function (EF), the cognitive ability for self-understanding and regulation, is often impaired in AD/HD, yet rarely considered in treatment of obese individuals with AD/HD. The hypothesis for this study is that low EF is seen in individuals with 4 or more symptoms of adult AD/HD and is associated with overeating behaviors leading to obesity. A nonexperimental single group design was used. A volunteer convenience sample ( n = 125) completed EF, AD/HD, eating, and BMI measures. Path analysis tested the hypothesized/ modified model. Chi square (χ2 = 6.15, df = 6, p = .4) and RMSEA (0.014) indicated a very good fit for the data. Assessment of EF and AD/HD symptoms in obese individuals is supported. Further study is needed to more fully understand this relationship and to develop strategies to address overeating behaviors in obese individuals with AD/HD.
The Combined Analysis of Uncertainty and Patient Heterogeneity in Medical Decision Models
Authors: Koerkamp Bas Groot , Stijnen Theo , Weinstein Milton C. , Hunink M. G. Myriam
Published: October 2010

The analysis of both patient heterogeneity and parameter uncertainty in decision models is increasingly recommended. In addition, the complexity of current medical decision models commonly requires simulating individual subjects, which introduces stochastic uncertainty. The combined analysis of uncertainty and heterogeneity often involves complex nested Monte Carlo simulations to obtain the model outcomes of interest. In this article, the authors distinguish eight model types, each dealing with a different combination of patient heterogeneity, parameter uncertainty, and stochastic uncertainty. The analyses that are required to obtain the model outcomes are expressed in equations, explained in stepwise algorithms, and demonstrated in examples. Patient heterogeneity is represented by frequency distributions and analyzed with Monte Carlo simulation. Parameter uncertainty is represented by probability distributions and analyzed with 2nd-order Monte Carlo simulation (aka probabilistic sensitivity analysis). Stochastic uncertainty is analyzed with 1st-order Monte Carlo simulation (i.e., trials or random walks). This article can be used as a reference for analyzing complex models with more than one type of uncertainty and patient heterogeneity.
Feminism, Gender studies, and Medieval Studies
Authors: Caviness Madeline H.
Published: October 2010

This article traces the multiple and rapid changes that have occurred during the past fifteen years, in theorizing “sex/gender arrangements”. A secondary aspect is the reception, application and above all modification of these theories by some scholars of European medieval cultural production, in which varieties of difference are found that do not apply in modern societies. Deconstruction of the binary m/f (whether thought of as sexual or gender difference) erupted among feminist thinkers in the 1990s and eventually “queered” academic discourses by destabilizing labels that had been naturalized, including a consistent gender identity for the individual in medieval or modern society. The author claims that queer and post-colonial theory, far from being antithetical to feminist theory, are out-growths of it, and exist in parallel; the proponents of each are concerned with the societal forces, including our own discourses, that maintain difference, and create communities of oppression Yet it is also necessary to raise the question, when will the next radical departure occur, and how will new theories be generated?
Between Poiesis and Praxis: Women and Art
Authors: Collin Françoise
Published: October 2010

If we think of artistic creation as a basic dimension of humanity we need to question the absence of female artists in history. We should also look at their gradual emergence in the late 20th century, an emergence that coincides with the feminist movement and a change in the conception of art itself, revealed chiefly by Duchamp.

But does art by women have some specificity? Without giving a definite answer as far as subject matter is concerned, we note that the conditions suited to both history and the history of art may affect their creation but without specifying it ontologically. If, moreover, some women artists define their work as feminist, it is through an act that combines artistic and political transgression. The exhibition currently arranged by the Georges Pompidou Centre, elles@beaubourg, provides new resources for these complex questions.
Bio-Technosciences in Philosophy: Challenges and Perspectives for Gender Studies in Philosophy
Authors: Lettow Susanne
Published: October 2010

Since the 1960s the bio/technosciences have occupied a central place in philosophical thinking. The paper sets out three theoretical configurations embodying major challenges for today's gender studies in philosophy, since they raise an obstacle, each in its own way, to the discussion on implications of the bio/technosciences in the political field and the area of gender theory: firstly naturalism in the field of the philosophy of science; secondly the paradigm of applied ethics; and thirdly the discourse of philosophical anthropology that has been reactivated in philosophical debates about the bio/technosciences. To conclude, some of the future tasks will be mentioned which fall to gender studies in philosophy.
Buckling behavior of blade-, angle-, T-, and hat-stiffened FRP panels subjected to in-plane shear
Authors: Hemendra Kumar Jain  , Upadhyay Akhil
Published: October 2010

This article presents parametric studies on simply supported laminated composite stiffened panels subjected to in-plane shear loading. A number of models were analyzed using ANSYS and a database is prepared for blade-, angle-, T-, and hat-stiffened laminated composite panels. Studies are carried out by changing the type of stiffeners, the panel orthotropy ratio, smeared extensional stiffness ratio of stiffener to that of the plate, and extensional stiffness to shear stiffness ratio of the plate. The difference in buckling behavior of different types of stiffened panels is presented. Based on key parameters influencing the buckling behavior, guidelines for better stiffener proportioning are developed, which will be helpful to the designers.
An Ecological Perspective on the Community Translation of Exercise Research for Older Adults
Authors: Chard Sarah E. , Stuart Mary
Published: October 2010

Regular exercise lowers the risk of disease progression for many chronic illnesses, but older adults experience relatively low rates of exercise. Although multiple intervention studies indicate that community-based programs can facilitate exercise participation, whether this research has resulted in widespread targeted exercise programs within communities is unknown. This study seeks to understand the ecological context of exercise for older adults through a cross-sectional survey of community exercise facilities within a mid-Atlantic city. The findings highlight the limited nature of the existing exercise infrastructure and reveal gaps in the community translation of research evidence regarding exercise adherence. An expansion in the availability of community exercise programs for older adults and more uniform policies to support older adult exercise are needed.
Interpersonal Sensitivity, Status, and Stereotype Accuracy
Authors: Kenny David A. , Snook Amanda , Boucher Eliane M. , Hancock Jeffrey T.
Published: October 2010

A classic question in social and organizational psychology is whether low-status persons are more accurate in the perception of their high-status partners than the latter are in their perception of their subordinates. In a series of studies, Snodgrass (1985, 1992) tested this idea. She found that subordinates were more accurate at judging how their bosses viewed them than bosses were at judging how their subordinates viewed them, but that bosses were more accurate at judging how subordinates viewed themselves than subordinates were at judging how bosses viewed themselves. We believe, however, that these results were obscured by stereotype accuracy. Using previously collected data, we found that stereotype accuracy does lead to the pattern previously observed by Snodgrass. We also discovered that when we controlled for stereotype accuracy, subordinates’ perceptions were generally more accurate than those of their bosses, which supports Snodgrass’s original hypothesis.
Mining the internet for linguistic and social data: An analysis of ‘carbon compounds’ in Web feeds
Authors: Koteyko Nelya
Published: October 2010

The potential of the Web for applied linguistic research is being increasingly recognized. As the internet is a particularly valuable source of data on recent changes in meaning, Mautner (2005b) made a plea for more discourse analysts to work with Web-based texts in order to study important social developments. Taking up this suggestion, this article introduces an approach based on the analysis of recent updates to Web-based sources. A special purpose corpus, compiled from Web feeds containing so-called lexical ‘carbon compounds’, such as, for example, carbon credit, carbon diet, carbon sinner, is studied with corpus linguistic tools to explore the online dimension of the interpretative struggle around the issue of climate change mitigation. The analysis reveals semantic associations surrounding the compounds and highlights connotational differences that signal both support and criticism of the climate mitigation initiatives proposed by policy makers and environmentalists.
The production of ‘defectiveness’ as a linguistic resource in broadcast evangelical discourse: A discursive psychology approach
Authors: Xanthopoulou Penny
Published: October 2010

This article explores the social construction of the notion of defectiveness in broadcast evangelical discourse. The data come from the God TV (USA) and the flagship TV channel God Channel (UK). The analysis focuses on the action-orientated and rhetorical business (Potter, 1996) accomplished by employing descriptions and displays of defectiveness. Specifically, this article investigates how notions of a general ‘human’ and direct ‘personal’ defectiveness are negotiated, and for what reasons, in this particular Christian talk. The focus here is on how and what actions people perform with their talk in these environments, when doing interactional work and presenting specific versions of arguments, stories etc. (Edwards, 2005).
Losartan potassium/hydrochlorothiazide (Preminent®) and hyponatremia: Case series of 40 patients
Authors: Kinoshita Hiroyuki , Kobayashi Kenichiro , Yaguramaki Touru , Yasuda Mutsuko , Fujiki Kazuhiko , Tomiyama Junji , Koga Nobunori , Yakushiji Fumiatsu
Published: October 2010

The clinical course of losartan potassium/hydrochlorothiazide (Preminent®)-induced hyponatremia has not been described. We summarized 40 patients with Preminent-induced hyponatremia. The study involved 15 (37.5%) men and 25 (62.5%) women (mean age [SD], 76.4 [8.3] years; range, 55–95). Their sodium levels before Preminent administration were 139.5 (4.9) mEq/L (range, 131–145; reference range, 135–147). The duration from the day of Preminent administration to the day with the lowest sodium level was 59.3 (64.9) days (range, 2–207; median, 24). Most patients for whom this duration was <50 days exhibited progressive symptoms, whereas most of those for whom this duration was >50 days did not exhibit progressive symptoms but exhibited symptoms after fever or appetite loss. The lowest sodium value was 114.4 (8.2) mEq/L (range, 99–133). The duration from the time of Preminent discontinuation to (1) the time of early recovery and (2) the time of final recovery was 6.8 (5.5) days (range, 1–20; median, 5) and 11.6 (7.6) days (range, 2–29; median, 7.5), respectively. Of the 40 patients, 36 (90.0%) achieved full recovery, 1 (2.5%) suffered from after-effects due to central pontine myelinolysis, 1 (2.5%) died, and 2 (5.0%) were unknown. In the analysis of other adverse effects of Preminent and the same adverse effects of other three angiotensin II receptor blocker (ARB)/thiazide combinations, hyponatremia was observed as a primary adverse effect of all ARB/thiazide combinations. However, hyperesthesia dermatitis was reported as an adverse effect of Preminent only.
An overview of robust methods in medical research
Authors: Farcomeni Alessio , Ventura Laura
Published: October 2010

Robust statistics is an extension of classical parametric statistics that specifically takes into account the fact that the assumed parametric models used by the researchers are only approximate. In this article, we review and outline how robust inferential procedures may routinely be applied in practice in the biomedical research. Numerical illustrations are given for the t-test, regression models, logistic regression, survival analysis and ROC curves, showing that robust methods are often more appropriate than standard procedures.
Covariate-adjusted response-adaptive designs for longitudinal treatment responses: PEMF trial revisited
Authors: Biswas Atanu , Park Eunsik , Bhattacharya Rahul
Published: October 2010

Response-adaptive designs have become popular for allocation of the entering patients among two or more competing treatments in a phase III clinical trial. Although there are a lot of designs for binary treatment responses, the number of designs involving covariates is very small. Sometimes the patients give repeated responses. The only available response-adaptive allocation design for repeated binary responses is the urn design by Biswas and Dewanji [Biswas A and Dewanji AA. Randomized longitudinal play-the-winner design for repeated binary data. ANZJS 2004; 46: 675–684; Biswas A and Dewanji A. Inference for a RPW-type clinical trial with repeated monitoring for the treatment of rheumatoid arthritis. Biometr J 2004; 46: 769–779.], although it does not take care of the covariates of the patients in the allocation design. In this article, a covariate-adjusted response-adaptive randomisation procedure is developed using the log-odds ratio within the Bayesian framework for longitudinal binary responses. The small sample performance of the proposed allocation procedure is assessed through a simulation study. The proposed procedure is illustrated using some real data set.
Development of a Macroscopic Damage Model for Woven Ceramic Matrix Composites
Authors: Marcin Lionel , Maire Jean-Francois , Carrère Nicolas , Martin Eric
Published: October 2010

The aim of this article is to propose a macroscopic damage model, which describes the nonlinear behavior observed on woven composites with ceramic matrix. The model is built within a thermodynamic framework with internal variables. First of all, the efficiency of the model to describe the mechanical behavior of carbon fiber-reinforced ceramic matrix composites is outlined. Then, the predictive capability of the model is evaluated with the help of an alternate torsion test.
A Combined Model for Hardening, Softening, and Damage Processes in Advanced Heat Resistant Steels at Elevated Temperature
Authors: Naumenko Konstantin , Altenbach Holm , Kutschke Andreas
Published: October 2010

Phenomenological constitutive equations that describe inelastic behavior of advanced steels at elevated temperature are developed. To characterize hardening, recovery, and softening processes, a composite model with creep-hard and creep-soft constituents is applied. The volume fraction of the creep-hard constituent is assumed to decrease toward a saturation value. This approach reproduces well the primary creep as a result of stress redistribution between constituents and tertiary creep as a result of softening. To describe the whole tertiary creep stage, a damage variable in the sense of continuum damage mechanics is introduced. The material parameters and the response functions in the model are calibrated against experimental creep curves for X20CrMoV12-1 steel. For the verification, simulations of the inelastic response are performed and the results compared with experimental data including creep under stress change conditions and stress-strain response under constant strain rate. Furthermore, the lifetime predictions are analyzed and compared with the published creep rupture strength data. The results show that the consideration of both softening and damage processes is necessary to characterize the long-term strength in a wide stress range. Finally, the model is generalized to the multi-axial stress state.
Time scales of consumption: Children, money and transactional orders
Authors: Ruckenstein Minna
Published: October 2010

Recent research into children’s consumption argues for the centrality of children and childhood in rethinking and revising notions of consumer culture. This article introduces the model of time scales of consumption for exploring children’s talk about money. An analysis of short- and long-term cycles of exchange opens for scrutiny the complex ways in which children are affected by, and contribute to, processes of consumption. Culturally, money is usually an open resource; it can be converted into a collector’s item, a bribe, a promise or a goal, and used for solidifying and transforming social relations. Children’s notions of money talk about the cultural underpinnings of money and consumer culture that define and affect both children’s and adults’ future orientations. In addition, the perspective of children confirms that money is linked to everyday cosmologies that reproduce temporal dimensions and rely on the centrality of thrift. Etnographic study of time scales of consumption thus offer important insights for exploring the reproduction and transformation of consumer culture over generations.
Improving student engagement: Ten proposals for action
Authors: Zepke Nick , Leach Linda
Published: October 2010

Since the 1980s an extensive research literature has investigated how to improve student success in higher education focusing on student outcomes such as retention, completion and employability. A parallel research programme has focused on how students engage with their studies and what they, institutions and educators can do to enhance their engagement, and hence success. This article reports on two syntheses of research literature on student engagement and how this can be enhanced. It first synthesizes 93 research studies from ten countries to develop a conceptual organizer for student engagement that consists of four perspectives identified in the research: student motivation; transactions between teachers and students; institutional support; and engagement for active citizenship. Secondly, the article synthesizes findings from these perspectives as ten propositions for improving student engagement in higher education. It concludes by identifying some limitations with the conceptual organizer and one suggestion for developing a more integrated approach to student engagement.
The medium makes the message: Effects of cues on students’ lecture notes
Authors: Huxham Mark
Published: October 2010

Previous work has shown that students’ notes often fail to record key facts and concepts. The relatively recent widespread adoption of PowerPoint slides and handouts might now help students to record key issues, but only if they can recognize the cues that identify these. 238 note-sets were taken from first-year students attending four lectures using copy paper. In each lecture four separate possible cues were identified: a slide, a statement, a discussion and an ‘interactive window’ (a short problem-solving session embedded in the lecture). Notes were analysed for word counts, abbreviations, note-taking styles and quality of content. Word counts showed non-normal distributions; most students recorded relatively few words but some recorded more than double the modal number. Word counts and the quality of notes were significantly related in three of the four lectures. Most note-sets had no abbreviations and showed a simple linear layout (without, for example, concept maps or new diagrams). Interactive windows produced higher-quality notes than discussions or statements. Hence different cues produce different notes, and lecturers should consider the effects of their lecturing cues on the notes their students will record.
An ‘endless struggle’: a qualitative study of general practitioners’ and practice nurses’ experiences of managing multimorbidity in socio-economically deprived areas of Scotland
Authors: O'Brien Rosaleen , Wyke Sally , Guthrie Bruce , Watt Graham , Mercer Stewart
Published: October 2010

Objectives: To understand general practitioners’ (GPs) and practice nurses’ (PNs) experiences of managing multimorbidity in deprived areas and elicit views on what might help.

Methods: Qualitative interviews with 19 GPs and PNs in four practices with a high percentage of patients living in the top 15% most deprived areas of Scotland. Data were analysed using constant comparison.

Results: Professionals’ discussions of how they managed multimorbidity captured: (1) definitions of multimorbidity that included multiple social, psychological, and health problems associated with deprivation; (2) descriptions of the ‘endless struggle’ of patients trying to manage illnesses in the midst of chaotic lives with limited personal, social, and material resources; (3) accounts of the ongoing struggle of professionals trying to manage, with personal consequences for some; and (4) ideas on what might help, including ‘whole person’ approaches.

Discussion: Professionals’ discussions of the difficulties that they face personally and attempt to help those most in need reflect both the continuing existence of the ‘inverse care law’ and the need for whole system changes to enhance the effectiveness of primary care for patients with multimorbidity in deprived areas.
Hoxa3 promotes the differentiation of hematopoietic progenitor cells into proangiogenic Gr-1+CD11b+ myeloid cells
Authors: Mahdipour Elahe , Charnock Jayne C. , Mace Kimberly A.
Published: October 2010

Injury induces the recruitment of bone marrow-derived cells (BMDCs) that contribute to the repair and regeneration process. The behavior of BMDCs in injured tissue has a profound effect on repair, but the regulation of BMDC behavior is poorly understood. Aberrant recruitment/retention of these cells in wounds of diabetic patients and animal models is associated with chronic inflammation and impaired healing. BMD Gr-1+CD11b+ cells function as immune suppressor cells and contribute significantly to tumor-induced neovascularization. Here we report that Gr-1+CD11b+ cells also contribute to injury-induced neovascularization, but show altered recruitment/retention kinetics in the diabetic environment. Moreover, diabetic-derived Gr-1+CD11b+ cells fail to stimulate neovascularization in vivo and have aberrant proliferative, chemotaxis, adhesion, and differentiation potential. Previously we demonstrated that gene transfer of HOXA3 to wounds of diabetic mice is taken up by and expressed by recruited BMDCs. This is associated with a suppressed inflammatory response, enhanced neovascularization, and accelerated wound healing. Here we show that sustained expression of Hoxa3 in diabetic-derived BMD Gr-1+CD11b+ cells reverses their diabetic phenotype. These findings demonstrate that manipulation of adult stem/progenitor cells ex vivo could be used as a potential therapy in patients with impaired wound healing.
Association of genomic loci from a cardiovascular gene SNP array with fibrinogen levels in European Americans and African-Americans from six cohort studies: the Candidate Gene Association Resource (CARe)
Authors: Wassel Christina L. , Lange Leslie A. , Keating Brendan J. , Taylor Kira C. , Johnson Andrew D. , Palmer Cameron , Ho Lindsey A. , Smith Nicholas L. , Lange Ethan M. , Li Yun , Yang Qiong , Delaney Joseph A. , Tang Weihong , Tofler Geoffrey , Redline Susan , Taylor Herman A. , Wilson James G. , Tracy Russell P. , Jacobs David R. , Folsom Aaron R. , Green David , O'Donnell Christopher J. , Reiner Alexander P.
Published: October 2010

Several common genomic loci, involving various immunity- and metabolism-related genes, have been associated with plasma fibrinogen in European Americans (EAs). The genetic determinants of fibrinogen in African Americans (AAs) are poorly characterized. Using a vascular gene-centric array in 23 634 EA and 6657 AA participants from 6 studies comprising the Candidate Gene Association Resource project, we examined the association of 47 539 common and lower frequency variants with fibrinogen concentration. We identified a rare Pro265Leu variant in FGB (rs6054) associated with lower fibrinogen. Common fibrinogen gene single nucleotide polymorphisms (FGB rs1800787 and FGG rs2066861) significantly associated with fibrinogen in EAs were prevalent in AAs and showed consistent associations. Several fibrinogen locus single nucleotide polymorphism associated with lower fibrinogen were exclusive to AAs; these include a newly reported association with FGA rs10050257. For IL6R, IL1RN, and NLRP3 inflammatory gene loci, associations with fibrinogen were concordant between EAs and AAs, but not at other loci (CPS1, PCCB, and SCL22A5-IRF1). The association of FGG rs2066861 with fibrinogen differed according to assay type used to measure fibrinogen. Further characterization of common and lower-frequency genetic variants that contribute to interpopulation differences in fibrinogen phenotype may help refine our understanding of the contribution of hemostasis and inflammation to atherothrombotic risk.
American Society of Hematology/American Society of Clinical Oncology clinical practice guideline update on the use of epoetin and darbepoetin in adult patients with cancer
Authors: Rizzo J. Douglas , Brouwers Melissa , Hurley Patricia , Seidenfeld Jerome , Arcasoy Murat O. , Spivak Jerry L. , Bennett Charles L. , Bohlius Julia , Evanchuk Darren , Goode Matthew J. , Jakubowski Ann A. , Regan David H. , Somerfield Mark R.
Published: October 2010

Purpose: To update American Society of Hematology/American Society of Clinical Oncology recommendations for use of erythropoiesis-stimulating agents (ESAs) in patients with cancer. Methods: An Update Committee reviewed data published between January 2007 and January 2010. MEDLINE and the Cochrane Library were searched. Results: The literature search yielded one new individual patient data analysis and four literature-based meta-analyses, two systematic reviews, and 13 publications reporting new results from randomized controlled trials not included in prior or new reviews. Recommendations: For patients undergoing myelosuppressive chemotherapy who have a hemoglobin (Hb) level less than 10 g/dL, the Update Committee recommends that clinicians discuss potential harms (eg, thromboembolism, shorter survival) and benefits (eg, decreased transfusions) of ESAs and compare these with potential harms (eg, serious infections, immune-mediated adverse reactions) and benefits (eg, rapid Hb improvement) of RBC transfusions. Individual preferences for assumed risk should contribute to shared decisions on managing chemotherapy-induced anemia. The Committee cautions against ESA use under other circumstances. If used, ESAs should be administered at the lowest dose possible and should increase Hb to the lowest concentration possible to avoid transfusions. Available evidence does not identify Hb levels ≥ 10 g/dL either as thresholds for initiating treatment or as targets for ESA therapy. Starting doses and dose modifications after response or nonresponse should follow US Food and Drug Administration–approved labeling. ESAs should be discontinued after 6 to 8 weeks in nonresponders. ESAs should be avoided in patients with cancer not receiving concurrent chemotherapy, except for those with lower risk myelodysplastic syndromes. Caution should be exercised when using ESAs with chemotherapeutic agents in diseases associated with increased risk of thromboembolic complications. Table 1 lists detailed recommendations.