bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluating the implementation of nurse-initiated HIV rapid testing in three Veterans Health Administration substance use disorder clinics
Authors: Conners E E , Hagedorn H J , Butler J N , Felmet K , Hoang T , Wilson P , Klima G , Sudzina E , Anaya H D
Published: November 2012

Individuals with substance use disorders (SUDs) are at higher risk of HIV infection, yet recent studies show rates of HIV testing are low among this population. We implemented and evaluated a nurse-initiated HIV oral rapid testing (NRT) strategy at three Veterans Health Administration SUD clinics. Implementation of NRT includes streamlined nurse training and a computerized clinical reminder. The evaluation employed qualitative interviews with staff and a quantitative evaluation of HIV testing rates. Barriers to testing included lack of laboratory support and SUD nursing resistance to performing medical procedures. Facilitators included the ease of NRT integration into workflow, engaged management and an existing culture of disease prevention. Six-months post intervention, rapid testing rates at SUD clinics in sites 1, 2, and 3 were 5.0%, 1.1% and 24.0%, respectively. Findings indicate that NRT can be successfully incorporated into some types of SUD subclinics with minimal perceived impact on workflow and time.
An audit of partner notification for syphilis and HIV
Authors: Armstrong H , Fernando I
Published: November 2012

Partner notification (PN) is a vital tool used by genitourinary (GU) medicine services in the public health control of sexually transmitted infections. We audited our PN outcomes for syphilis and HIV, over an 18-month period, at the Edinburgh GUM clinic. Follow-up information on testing was only available for 58% of traceable syphilis contacts and 59% of traceable HIV contacts, though substantially larger percentages in each case, respectively 78% and 90%, were informed regarding their risk of exposure. Furthermore, the department achieved screening verification in 78% of identifiable syphilis contacts and 94% of identifiable HIV partners.
Three-dimensional modelling of the venous system by direct multislice helical computed tomography venography: technique, indications and results
Authors: Uhl J F
Published: November 2012

The aim of multislice helical computed tomography venography (CTV) is to provide a precise, global and three-dimensional (3D) anatomical depiction of the venous network of the lower limbs. A multislice and multidetector spiral CT acquisition of the lower limbs with contrast injection of the dorsal foot produces about 1000 slices in 30 seconds. Dedicated volume-rendering software can compute a realistic and interactive 3D model of the venous system in realtime. This new tool furnishes an accurate 3D representation of the whole venous system of the lower limb with a realistic 3D model of the limbs, providing a road map of the varicose networks complementary to the duplex ultrasound (DUS). CTV allows a complete morphological study of the deep veins, including the detection of anatomical variations and proximal venous obstruction, not easily detectable by DUS. In the case of deep vein thrombosis, it has been shown to be a good diagnostic tool, well correlated with sonography. It also demonstrates, in some cases, haemodynamic patterns which are not available by DUS, particularly for perforator veins and congenital vascular malformations. The use of virtual reality techniques enables a complete anatomical study of both deep and superficial veins including a virtual dissection of the limbs. CTV is also a great educational tool to learn anatomy of the venous system and a powerful research tool to improve our knowledge of venous anatomy.
The Concept of Fluid Potential and its Practical Application to Petroleum Exploration
Authors: Pang Xiongqi , Chen Dongxia , Liu Keyu , Jiang Zhenxue
Published: November 2012

In the practical petroleum exploration, there appears to be some issues and confusions when the concept of fluid potential of Hubbert (1953) and England (1987) is applied. If the four kinds of energy in a fluid potential (e.g. buoyancy, stratigraphic pressure, capillary pressure and hydrodynamic forces) are simply added together, it will confuse the relationship between the mechanisms of different forces that cause petroleum to migrate and accumulate while neglect the differences caused by the different forces that control the hydrocarbon accumulation, and thus mix the contributions of different forces to hydrocarbon pooling. The causes to these issues include human factors such as inadequate understanding and/or over simplification of the practical problems and misunderstanding of Hubbert's original formula. To make the fluid potential concept more useful and powerful in the practical petroleum exploration further revision and perfection to the conceptual model of fluid potential is required. Fluid potential can be expressed as the potential energy of a unit volume of fluid within a sedimentary basin. For the convenience of discussion, it is here expressed as the work that requires to be done by a unit volume of hydrocarbon fluid in its internal migration to the effective source rock center. In the study of the effect of fluid potential on the control of petroleum, attention should be paid to the fact that different types of fluid potential are produced by different dynamic forces, to which the relative strength consideration must be given respectively. The migration, accumulation and pooling of petroleum may be realized by the joint control of multiple dynamic forces, and the characteristics of such movements remain unchanged in zones with low potential. A successful practical application of the fluid potential concept to petroleum exploration is exemplified using an example from the Dongying Depression, the Bohai Bay Basin, east China, where over 90% of the commercial discoveries in the reservoirs within the Shahejie Formation are distributed in areas with both favourable lithofacies and a low potential.
Cenozoic Tectonic Migration Characteristics in Qikou Sag of Bohai Basin, China
Authors: Zhang Dongdong , Liu Chiyang , Huang Yijian , Chen Siqian
Published: November 2012

Tectonic migration, a widespread geographic phenomenon prevailing in China basins, refers to that tectonic movement, sedimentation, magmatism and other geological process in basin have regularly migrated towards a particular direction in a certain geological evolution period, which are triggered by tectonization such as tectonic plate motion, mantle uplift and so on. Statistics obtained from elements of faults and materials on sedimentary and volcanic in Qikou sag are analyzed to study the movement and characteristics of tectonic migration. It is shown in the research that in Cenozoic fault activity, sedimentation and magmatism of the sag presented the characteristics of regular migration from the southwest to northeast. Besides, the faults strikes, controlling sedimentary fault strike and controlling magmatic activity structural trend changed from northeast in Sha-3 period to nearly east-west in Sha-1 period. And this phenomenon of migration is also common in other sags of Bohai basin. The regional geological background and thermodynamic characteristics of Qikou sag together demonstrate that this tectonic migration may be the performance of the deep mantle material activities on the superficial layer in Bohai basin as a result of both mantle motion and plate movement. In Qikou sag the tectonic migration has important influences on hydrocarbon accumulation.
The Effects of Small Scale Hydroelectric Power Plants Located in the Eastern Black Sea Basin in Turkey
Authors: Aras Egemen
Published: November 2012

Although the geopolitical position of Turkey has a great importance, Turkey is not able to benefit from its natural resources adequately and so the foreign dependency of energy is rising explosively. For this reason, an attempt is being made to increase energy production by constructing small scale hydroelectric power plants in Turkey. The Eastern Black Sea Basin is an important basin located in the northeast part of Turkey, with a high surface water potential. The unused water potential of this region, where there is a great amount of precipitation, was brought into use with the enactment of a law 2001. Under this law, the construction of numerous small scale plants was begun. In this study, the status of small scale plants, of which construction has started or is already completed as well as those in the project phase, were examined on a province by province basis for 2011, and the economical contribution of these plants to regional and national economy and the ecological effects were analyzed.
Analysis of the Sorption Efficiency of Acid, Basic and Direct Dyes Using Chitosan, Fly Ashes Immobilized onto Chitosan and Modified Sawdust Immobilized onto Chitosan as Sorbents
Authors: Filipkowska Urszula , Rodziewicz Joanna
Published: November 2012

In this study, we analyzed the sorption and desorption of three dyes, namely, acid red 18 (AR18), basic violet 10 (BV10) and direct black 22 (DB22), onto three sorbents of waste material chosen from different branches of industry, namely, chitosan, modified sawdust and fly ash — sorbent 1: chitosan beads, sorbent 2: modified sawdust immobilized onto chitosan and sorbent 3: fly ashes immobilized onto chitosan. Each of these sorbent materials was investigated to determine multiple application feasibility in sorption and desorption cycles. Our study demonstrated that the number of sorption/desorption cycles depended on both the dye and the sorbent. The highest number of sorption/desorption cycles (i.e. n = 7) was achieved for a combination of BV10 and sorbent 2, i.e. modified sawdust immobilized onto chitosan. A comparable effectiveness of six cycles was observed for a combination of AR18 and sorbent 1 (chitosan beads). However, only one sorption/desorption cycle was achieved for sorbent 3, irrespective of the type of dye used.
Metal Organic Framework as an Adsorbent for Desulphurization
Authors: Zhao Xueqin , Xin Chunling , Yin Yanchao , Tian Xiaoguang , Li Yongchao , Bian Wanying , Lian Piyong
Published: November 2012

In this study, a metal organic framework (MOF-14) was successfully synthesized under hydrothermal conditions and applied in deep desulphurization. In this article, as-synthesized MOF-14 samples were characterized by powder X-ray diffraction, thermogravimetric analysis and microscopic photography. The desulphurization effect of MOF-14 was quantified by adsorbing organosulphur compounds, such as thiophene, benzothiophene, dibenzothiophene and 4,6-dimethyldibenzothiophene from model petrol. The experimental result revealed that MOF-14 is an excellent adsorbent in removing organosulphur compounds from model petrol. In addition, it was proved that MOF-14 is highly selective towards the removal of organosulphur compounds from aromatic model petrol. Regeneration experiments show the reversible nature of the adsorbent.
Using Aqueous Kaolinite Suspension as a Medium for Removing Phosphate from Water
Authors: Gupta Susmita Sen , Bhattacharyya Krishna G.
Published: November 2012

Phosphates enter into water bodies mainly from non-point sources such as agriculture fields, which promote algal growth and cause eutrophication in lakes, wetlands, etc. Therefore, it is important to identify methods to reduce the level of phosphates in water bodies. In this work, we used kaolinite and its calcined and acid-activated forms as adsorbents for removing phosphate from an aqueous medium under different conditions of pH, concentration, amount of adsorbent, time and temperature. Our results showed that weakly acidic pH (∼5.0) favoured the adsorption of phosphates, which attained equilibrium within 180 min. The interactions followed second-order kinetics. Our data fitted well with linear isotherm models. A part of the phosphate interacts chemically with kaolinite, while some amount may be weakly held. Experiments at 303, 313, 323 and 333 K showed that the interactions are exothermic, with decreasing entropy and Gibbs' energy. We found that acid-activated kaolinite had the highest adsorption capacity for phosphate.
The Uncertainty of the Proposed Single Number Ratings for Airborne Sound Insulation
Authors: Mahn Jeffrey , Pearse John
Published: November 2012

A replacement of the ISO 717-1 standard for the calculation of the single number ratings for airborne sound insulation has been proposed. The proposed replacement, ISO 16717-1 introduces new single number ratings for airborne sound insulation. The weighted sound reduction index which has traditionally been calculated from the sound reduction index measured in the 1/3 octave bands from 100 Hz to 3150 Hz will be replaced by a new single number rating Rliving which is calculated from the 1/3 octave bands between 50 Hz and 5000 Hz. The uncertainty of the proposed single number ratings has been estimated using the ISO Guide to the Expression of Uncertainty in Measurement (GUM) and validated using Monte Carlo simulations. The uncertainty of the single number ratings of 200 building elements was evaluated. It was found that the uncertainty of the single number ratings is highly dependent on the shape of the sound reduction index curve. The uncertainty of the new single number rating Rliving was found to be greater than the uncertainty of the traditional weighted sound reduction index for 98% of the 200 lightweight building elements included in the evaluation. It is recommended that the current weighted sound reduction index be maintained in the replacement standard until the uncertainty of the calculation of the sound reduction index at the low frequencies can be reduced through a redefinition of the measurand.
Separability of Distortion Products in Room Impulse Response Measurements with Maximum Length Sequences
Authors: Ćirić Dejan G. , Pantić Aleksandar
Published: November 2012

In the room impulse response measurements, one of the common disturbances affecting the measured results is nonlinearity. When maximum length sequences are applied for the measurements, the distortion products are distributed along the estimated impulse response. While this property of maximum length sequences has been widely used in the auditory system applications for characterization of a nonlinear system, it has not been exploited in room acoustics. Due to this reason, the possibility of separating the distortion products in the measurements of the room impulse responses with maximum length sequences is analyzed in this paper. The results show that this measurement method is sensitive to nonlinearities, but the separability of the distortion products could reduce the nonlinearity effects.
Experimental Evaluation of Crossties in Large Reinforced Concrete Columns under Pure Compression
Authors: Lee Tai-Kuang , Chen Cheng-Cheng , Tsou Pen-Chu , Lin Ku-Tao , Lee Wei-Wei , Pan Austin D.E.
Published: November 2012

The effectiveness of crossties in six sets of large-scale reinforced concrete short columns under monotonic axial compression is evaluated experimentally. The primary variables were type of crosstie engagement, type of crosstie, and crosstie placement offset. It was observed that minor placement offset up to 20 mm between hooks of crossties and longitudinal steel bars does not bring unfavorable consequences in confinement. The crosstie hook engagement of both hoop and longitudinal steel bar is better than that engagement of the longitudinal steel bar alone, but it is difficult in installation. Crossties composed of two straight end-180-deg hook steel bars give the best performance among the types of crosstie and it is convenient to facilitate the fabrication of reinforcing cages. However, the effectiveness under cyclic loading needs further study.
Volume and Cost Minimization of a Tubular Truss with Displacement-Constraint
Authors: Farkas J. , Jármai K.
Published: November 2012

The minimum volume and cost of a simply supported planar truss with N-type bracing is optimized. The lower chord of the truss is horizontal, but the symmetric upper chord parts are non-parallel and their inclination angle as well as the cross-sectional area of CHS (circular hollow section) rods are optimized. For the calculation of required cross-sectional area of compression struts closed formulae are used as a good approximation of Eurocode 3 buckling curve. A special method is developed for the minimum volume design considering the deflection constraint. In the case of a strong displacement constraint the cross-sectional areas required for the allowed deflection are larger than those required for stress and buckling constraints. The cost function includes the cost of material, cutting and grinding of CHS strut ends, assembly, welding and painting. Special mathematical methods are used to find the optima in the case of a numerical problem.
Experimental Study of Rain Effects on Vortex Shedding of Long Span Bridge Girders
Authors: Xin Dabo , Li Hui , Wang Liang , Ou Jinping
Published: November 2012

Vortex-induced vibration tests for a girder of a long-span bridge was carried out by studying vortex-induced vibration characteristics under the simultaneous actions of wind and rain, taking the separated twin-box girder section model as the research object specimen. A system providing simultaneous actions of wind and rain was built in the atmospheric boundary layer wind tunnel. After analysis of the amplitude-frequency characteristics of the vortex-induced vibration for different rainfall intensities, vortex-induced vibration characteristics as influenced by rainfall were obtained. Experimental results show that the wind speed when oscillation starts and the lock-in wind speed region for a slotted section model is not affected by different rainfall intensities, but the maximum amplitudes of vortex-excited resonance do have some differences. The stochastic vibration time histories for a closed section model do show effects due to different rainfall intensities, and that amplitude of vibration increases with wind speed. The closed model has the better performance in resisting vortex-induced vibration than the slotted model. The displacement amplitude under the simultaneous actions of wind and rain is bigger than the displacement amplitude under purely wind loads, the greatest increase being 25%. When rainfall intensity is light, raindrops remain attached to the surface of the structures, without bouncing and splashing. When the rainfall intensity reaches a specific value, bouncing and splashing of the raindrops can be seen.
Seismic Behaviour and Seismic Design of Single-Layer Reticulated Shells with Semi-Rigid Joint System
Authors: Fan Feng , Wang Minling , Cao Zhenggang , Shen Shizhao
Published: November 2012

An investigation of the seismic behaviour and a design method for single-layer reticulated shells with semi-rigid joints is described in this paper. A semi-rigid joint system has some bending and rotational rigidity that lying between that of a rigid-joint and a pin-joint. The seismic capacity of Kiewit reticulated shells with bolt-ball joints is analyzed in detail on the basis of the bending rigidity of the bolt-ball joint reported by others. The change rules of natural frequency and seismic internal force coefficient are reviewed by analyzing of large-scale shells with different span, depth-to-span ratio, bending rigidity, roof load, section size of members and seismic wave parameters. The seismic internal force coefficient (under the influence of bending moment) for shells with a semi-rigid joint system is summarized statistically to provide the maximal seismic response envelop.
Properties and applications of non-shrinkage chemical grout for repairing and strengthening of concrete structures
Authors: Ju H. , Lee D. , Kim K. , Kim D. , Kwak J.
Published: November 2012

Epoxy resins are widely used in structural repairing and strengthening work, but most of them typically require primer works and are vulnerable to water. To overcome such limits, a non-shrinkage chemical grout (NCG) has been developed in this research, which provides a strong chemical bond strength utilizing Silanol/Si-OH. The material characteristics of the NCG were investigated from experiments and the applications of non-shrinkage chemical grout were also provided. The experimental investigation indicates that NCG has much improved performance compared to a typical epoxy product, which implies that the NCG can be widely used for repairing and strengthening work.
Optimization application of air-jet nozzle in ring spinning system
Authors: Zhu Guocheng , Ibrahim Sayed , Kremenakova
Published: November 2012

The application of air-jet nozzle in ring spinning system has been turned up in the last decade, and the greatest advantage reported is the reducing of hairiness. In this paper, an attempt has been made to optimize the utility of a single air-jet nozzle in ring spinning system. Some parameters, such as air pressure, the distance between front roller nip line and air-jet nozzle inlet, and the number of orifices were adjusted to get a better quality yarn. In order to confirm the role of these parameters, the properties of ring and jet-ring spun yarns were compared. All the samples were characterized in terms of count, twist, irregularity, hairiness and strength. The results showed that the properties of yarns were improved significantly by setting suitable parameters, but not all of the parameters were significant in each performance index of yarns.
Smart Phones and Multi-Servers
Authors: Loo Alfred , Chung CW , Lam Alan
Published: November 2012

A smart phone can work as a Web server. Phone owners can access/update the content of their phones with a standard Web browser, and join a P2P system as a client or server. Thus, they can share resources with other people. New applications can be developed using the new concept, and corporations can improve their processes. Examples are provided in this paper.

Software developers should also pay attention to this new direction in communications. Programs written for mobile phones are difficult to develop as there are so many different operating systems. New applications can be written to run under the Web server and do not need to interact directly with operating systems, which will make it easier to port application programs to different phone models. Thus, applications can be developed more quickly and later deploy different hardware and software platforms. In addition, development costs can be reduced.
Simulations of Light-Induced Molecular Transformations in Multiple Dimensions with Incremental Sparse Surrogates
Authors: Mokrauer David , Kelley C. T. , Bykhovski Alexei
Published: November 2012

Simulations of light-induced molecular conformational transformations have traditionally been limited to a single degree of freedom because of the complexity of potential energy calculations. We propose a method of simulation that incrementally builds a surrogate for the potential energy function by computing gridpoints in parallel. We incorporate Smolyak's algorithm for sparse interpolation as the energy surrogates since it keeps the number of gridpoints at a manageable number. Our multi-dimensional algorithm is applied to the molecule 2-butene whose transition path is well known.
Risk Preferences and Their Robust Representation
Authors: Drapeau Samuel , Kupper Michael
Published: November 2012

To address the plurality of interpretations of the subjective notion of risk, we describe it by means of a risk order and concentrate on the context invariant features of diversification and monotonicity. Our main results are uniquely characterized robust representations of lower semicontinuous risk orders on vector spaces and convex sets. This representation covers most instruments related to risk and allows for a differentiated interpretation depending on the underlying context that is illustrated in different settings: for random variables, risk perception can be interpreted as model risk, and we compute among others the robust representation of the economic index of riskiness. For lotteries, risk perception can be viewed as distributional risk and we study the “value at risk.” For consumption patterns, which excerpt an intertemporality dimension in risk perception, we provide an interpretation in terms of discounting risk and discuss some examples.
Opinion Fluctuations and Disagreement in Social Networks
Authors: Acemoğlu Daron , Como Giacomo , Fagnani Fabio , Ozdaglar Asuman
Published: November 2012

We study a tractable opinion dynamics model that generates long-run disagreements and persistent opinion fluctuations. Our model involves an inhomogeneous stochastic gossip process of continuous opinion dynamics in a society consisting of two types of agents: (1) regular agents who update their beliefs according to information that they receive from their social neighbors and (2) stubborn agents who never update their opinions and might represent leaders, political parties, or media sources attempting to influence the beliefs in the rest of the society. When the society contains stubborn agents with different opinions, the belief dynamics never lead to a consensus (among the regular agents). Instead, beliefs in the society fail to converge almost surely, the belief profile keeps on fluctuating in an ergodic fashion, and it converges in law to a nondegenerate random vector.

The structure of the graph describing the social network and the location of the stubborn agents within it shape the opinion dynamics. The expected belief vector is proved to evolve according to an ordinary differential equation coinciding with the Kolmogorov backward equation of a continuous-time Markov chain on the graph with absorbing states corresponding to the stubborn agents, and hence to converge to a harmonic vector, with every regular agent's value being the weighted average of its neighbors' values, and boundary conditions corresponding to the stubborn agents' beliefs. Expected cross products of the agents' beliefs allow for a similar characterization in terms of coupled Markov chains on the graph describing the social network.

We prove that, in large-scale societies, which are highly fluid, meaning that the product of the mixing time of the Markov chain on the graph describing the social network and the relative size of the linkages to stubborn agents vanishes as the population size grows large, a condition of homogeneous influence emerges, whereby the stationary beliefs' marginal distributions of most of the regular agents have approximately equal first and second moments.
Evaluation of [−2] proPSA and Prostate Health Index (phi) for the detection of prostate cancer: a systematic review and meta-analysis
Authors: Filella Xavier , Giménez Nuria
Published: November 2012

The usefulness of %[−2] proPSA and Prostate Health Index (phi) in the detection of prostate cancer are currently unknown. It has been suggested that these tests can distinguish prostate cancer from benign prostatic diseases better than PSA or %fPSA. We performed a systematic review and meta-analysis of the available scientific evidence to evaluate the clinical usefulness of %[−2] proPSA and phi. Relevant published papers were identified by searching computerized bibliographic systems. Data on sensitivity and specificity were extracted from 12 studies: 10 studies about %[−2] proPSA (3928 patients in total, including 1762 with confirmed prostate cancer) and eight studies about phi (2919 patients in total, including 1515 with confirmed prostate cancer). The sensitivity for the detection of prostate cancer was 90% for %[−2] proPSA and phi, while the pooled specificity was 32.5% (95% CI 30.6–34.5) and 31.6% (95% CI 29.2–34.0) for %[−2] proPSA and phi, respectively. The measurement of %[−2] proPSA improves the accuracy of prostate cancer detection in comparison with PSA or %fPSA, particularly in the group of patients with PSA between 2 μg/L and 10 μg/L. Similar results were obtained measuring phi. Using these tests, it is possible to reduce the number of unnecessary biopsies, maintaining a high cancer detection rate. Published results also showed that %[−2] proPSA and phi are related to the aggressiveness of the tumor.
Konzept für einen biologisch inspirierten, semi-passiven pneumatisch angetriebenen zweibeinigen Prothesen-Roboter-Hybrid
Authors: Bauer Ch. , Mors Mona , Fischer A. , Stein Thorsten , Mikut Ralf , Schulz Stefan
Published: November 2012

Ein Schwerpunkt bei der Entwicklung von Laufmaschinen liegt auf der Stabilisierung der Maschine während der Fortbewegung. Sechsbeinige Laufmaschinen sind in der Lage, permanent statische Stabilität zu garantieren. Bei Vierbeinern ist dies nur auf bestimmte Gangmuster beschränkt und Zweibeiner sind auf dynamische Stabilität angewiesen. Die Arbeiten in diesem Artikel basieren auf Bewegungsstudien von beidseitig amputierten Probanden, die trotz passiver Prothesen stabil laufen können. Zur Übertragung dieses Konzepts auf Laufmaschinen wird ein neuartiger zweibeiniger Demonstrator mit einer künstlichen Wirbelsäule vorgestellt, der über pneumatische Aktoren in der Hüfte und in der Wirbelsäule angetrieben wird. Zusätzlich kommen nichtaktuierte Knie- und Fußprothesenteile zum Einsatz. Das Ziel besteht darin, zweibeinige, unteraktuierte, dadurch leichte und energieeffiziente Roboter zu entwickeln. Neben dem Hardwaredesign und dem Zusammenspiel der einzelnen Komponenten wird auch die Bewegungsgenerierung, die auf biologisch inspirierten Zentralen Mustergeneratoren basiert sowie die experimentelle Erprobung des Demonstrators beschrieben.
Cooperative Control Design for Robot-Assisted Balance During Gait
Authors: Vallery Heike , Bögel Alexander , O´Brien Carolyn , Riener Robert
Published: November 2012

Avoiding falls is a challenge for many persons in aging societies, and balance dysfunction is a major risk factor. Robotic solutions to assist human gait, however, focus on average kinematics, and less on instantaneous balance reactions. We propose a controller that only intervenes when needed, and that avoids stability issues when interacting with humans: Assistance is triggered only when balance is lost, and this action is purely feed-forward. Experiments show that subjects who start falling during gait can be uprighted by such feed-forward assistive forces.
THERAPY OF ENDOCRINE DISEASE: GH therapy in adult GH deficiency: A review of treatment schedules and the evidence for low starting doses
Authors: Gasco Valentina , Prodam Flavia , Grottoli Silvia , Marzullo Paolo , Longobardi Salvatore , Ghigo Ezio , Aimaretti Gianluca
Published: November 2012

Recombinant human GH has been licensed for use in adult patients with GH deficiency (GHD) for over 15 years. Early weight- and surface area-based dosing regimens were effective but resulted in supraphysiological levels of IGF1 and increased incidence of side effects. Current practice has moved towards individualised regimens, starting with low GH doses and gradually titrating the dose according to the level of serum IGF1 to achieve an optimal dose. Here we present the evidence supporting the dosing recommendations of current guidelines and consider factors affecting dose responsiveness and parameters of treatment response. The published data discussed here lend support for the use of low GH dosing regimens in adult GHD. The range of doses defined as ‘low dose’ in the studies discussed here (∼1–4 mg/week) is in accordance with those recommended in current guidelines and encompasses the dose range recommended by product labels.
Contrasts between the effects of zinc-α2-glycoprotein, a putative β3/2-adrenoceptor agonist and the β3/2-adrenoceptor agonist BRL35135 in C57Bl/6 (ob/ob) mice
Authors: Wargent Edward T , O'Dowd Jacqueline F , Zaibi Mohamed S , Gao Dan , Bing Chen , Trayhurn Paul , Cawthorne Michael A , Arch Jonathan R S , Stocker Claire J
Published: November 2012

Previous studies by Tisdaleet al. have reported that zinc-α2-glycoprotein (ZAG (AZGP1)) reduces body fat content and improves glucose homeostasis and the plasma lipid profile in Aston (ob/ob) mice. It has been suggested that this might be mediated via agonism of β3- and possibly β2-adrenoceptors. We compared the effects of dosing recombinant human ZAG (100 μg, i.v.) and BRL35135 (0.5 mg/kg, i.p.), which is in rodents a 20-fold selective β3- relative to β2-adrenoceptor agonist, given once daily for 10 days to male C57Bl/6Lepob/Lepobmice. ZAG, but not BRL35135, reduced food intake. BRL35135, but not ZAG, increased energy expenditure acutely and after sub-chronic administration. Only BRL35135 increased plasma concentrations of glycerol and non-esterified fatty acid. Sub-chronic treatment with both ZAG and BRL35135 reduced fasting blood glucose and improved glucose tolerance, but the plasma insulin concentration 30 min after administration of glucose was lowered only by BRL35135. Both ZAG and BRL35135 reduced β1-adrenoceptor mRNA levels in white adipose tissue, but only BRL35135 reduced β2-adrenoceptor mRNA. Both ZAG and BRL35135 reduced β1-adrenoceptor mRNA levels in brown adipose tissue, but neither influenced β2-adrenoceptor mRNA, and only BRL35135 increased β3-adrenoceptor and uncoupling protein-1 (UCP1) mRNA levels in brown adipose tissue. Thus, ZAG and BRL35135 had similar effects on glycaemic control and shared some effects on β-adrenoceptor gene expression in adipose tissue, but ZAG did not display the thermogenic effects of the β-adrenoceptor agonist, nor did it increase β3-adrenoceptor orUCP1gene expression in brown adipose tissue. ZAG does not behave as a typical β3/2-adrenoceptor agonist.
Poor pubertal protein nutrition disturbs glucose-induced insulin secretion process in pancreatic islets and programs rats in adulthood to increase fat accumulation
Authors: de Oliveira Júlio Cezar , Lisboa Patrícia Cristina , de Moura Egberto Gaspar , Barella Luiz Felipe , Miranda Rosiane Aparecida , Malta Ananda , Franco Claudinéia Conationi da Silva , Ribeiro Tatiane Aparecida da Silva , Torrezan Rosana , Gravena Clarice , Mathias Paulo Cezar de Freitas
Published: November 2012

Similar to gestation/lactation, puberty is also a critical phase in which neuronal connections are still being produced and during which metabolic changes may occur if nutrition is disturbed. In the present study we aimed to determine whether peripubertal protein restriction induces metabolic programming. Thirty-day-old male rats were fed either a low protein (LP group) diet (4% w/w protein) or a normal protein (NP group) diet (23%) until 60 days of age, when they received the NP diet until they were 120 days old. Body weight (BW), food intake, fat tissue accumulation, glucose tolerance, and insulin secretion were evaluated. The nerve electrical activity was recorded to evaluate autonomous nervous system (ANS) function. Adolescent LP rats presented hypophagia and lower BW gain during the LP diet treatment (P<0.001). However, the food intake and BW gain by the LP rats were increased (P<0.001) after the NP diet was resumed. The LP rats presented mild hyperglycemia, hyperinsulinemia, severe hyperleptinemia upon fasting, peripheral insulin resistance and increased fat tissue accumulation and vagus nerve activity (P<0.05). Glucose-induced insulin secretion was greater in the LP islets than in the NP islets; however, the cholinergic response was decreased (P<0.05). Compared with the islets from the NP rats, the LP islets showed changes in the activity of muscarinic receptors (P<0.05); in addition, the inhibition of glucose-induced insulin secretion by epinephrine was attenuated (P<0.001). Protein restriction during adolescence caused high-fat tissue accumulation in adult rats. Islet dysfunction could be related to an ANS imbalance.
Investigation of the mechanisms contributing to the compensatory increase in insulin secretion during dexamethasone-induced insulin resistance in rhesus macaques
Authors: Cummings Bethany P , Bremer Andrew A , Kieffer Timothy J , D'Alessio David , Havel Peter J
Published: November 2012

Dexamethasone has well-described effects to induce insulin resistance and increase insulin secretion. Herein, we examined potential contributors to the effect of dexamethasone to increase insulin secretion in rhesus macaques. Six male rhesus macaques received daily injections of either saline or dexamethasone (0.25 mg/kg i.m. for 7 days) in random order with 3 weeks between treatments. At the end of the treatment period, animals were fasted overnight and underwent a feeding study the next day, during which blood samples were taken before and for 60 min after a meal in order to assess islet hormone and incretin secretion. Dexamethasone induced marked increases in fasting plasma insulin, glucagon, leptin, and adiponectin concentrations (P<0.05). Surprisingly, the glycemic response after meal ingestion was decreased twofold during dexamethasone treatment (P<0.05). Dexamethasone-treated animals exhibited a significant increase in both insulin and glucose-dependent insulinotropic polypeptide (GIP) secretion during the feeding study (P<0.05). However, glucagon-like peptide-1 secretion was significantly lower in dexamethasone-treated animals compared with controls (P<0.01). Fasting and meal-stimulated pancreatic polypeptide concentrations (an index of the parasympathetic input to the islet) did not differ between saline and dexamethasone treatments. However, the proinsulin:insulin ratio was decreased throughout the feeding study with dexamethasone treatment suggesting an improvement of β-cell function (P<0.05). In conclusion, the maintenance of euglycemia and reduction of postprandial glycemia with short-term dexamethasone treatment appears to be due to the marked elevations of fasting and meal-stimulated insulin secretion. Furthermore, increases in postprandial GIP secretion with dexamethasone treatment appear to contribute to the effect of dexamethasone treatment to increase insulin secretion.
Victimization and Suicidality Among Dutch Lesbian, Gay, and Bisexual Youths
Authors: van Bergen Diana D. , Bos Henny M. W. , van Lisdonk Jantine , Keuzenkamp Saskia , Sandfort Theo G. M.
Published: November 2012

We examined Netherlands Institute for Social Research data, collected between May and August 2009, on 274 Dutch lesbian, gay, and bisexual youths. The data showed that victimization at school was associated with suicidal ideation and actual suicide attempts. Homophobic rejection by parents was also associated with actual suicide attempts. Suicidality in this population could be reduced by supporting coping strategies of lesbian, gay, and bisexual youths who are confronted with stigmatization by peers and parents, and by schools actively promoting acceptance of same-sex sexuality.
Predictors of Active Injection Drug Use in a Cohort of Patients Infected With Hepatitis C Virus
Authors: Reed Carrie , Bliss Caleb , Stuver Sherri O. , Heeren Timothy , Tumilty Sheila , Horsburgh C. Robert , Samet Jeffrey H. , Cotton Deborah J.
Published: November 2012

Objectives. We investigated potential risk factors for active injection drug use (IDU) in an inner-city cohort of patients infected with hepatitis C virus (HCV).

Methods. We used log-binomial regression to identify factors independently associated with active IDU during the first 3 years of follow-up for the 289 participants who reported ever having injected drugs at baseline.

Results. Overall, 142 (49.1%) of the 289 participants reported active IDU at some point during the follow-up period. In a multivariate model, being unemployed (prevalence ratio [PR] = 1.93; 95% confidence interval [CI] = 1.24, 3.03) and hazardous alcohol drinking (PR = 1.67; 95% CI = 1.34, 2.08) were associated with active IDU. Smoking was associated with IDU but this association was not statistically significant. Patients with all 3 of those factors were 3 times as likely to report IDU during follow-up as those with 0 or 1 factor (PR = 3.3; 95% CI = 2.2, 4.9). Neither HIV coinfection nor history of psychiatric disease was independently associated with active IDU.

Conclusions. Optimal treatment of persons with HCV infection will require attention to unemployment, alcohol use, and smoking in conjunction with IDU treatment and prevention.
Unhealthy Interactions: The Role of Stereotype Threat in Health Disparities
Authors: Aronson Joshua , Burgess Diana , Phelan Sean M. , Juarez Lindsay
Published: November 2012

Stereotype threat is the unpleasant psychological experience of confronting negative stereotypes about race, ethnicity, gender, sexual orientation, or social status.

Hundreds of published studies show how the experience of stereotype threat can impair intellectual functioning and interfere with test and school performance. Numerous published interventions derived from this research have improved the performance and motivation of individuals targeted by low-ability stereotypes.

Stereotype threat theory and research provide a useful lens for understanding and reducing the negative health consequences of interracial interactions for African Americans and members of similarly stigmatized minority groups. Here we summarize the educational outcomes of stereotype threat and examine the implications of stereotype threat for health and health-related behaviors.
Association Between Community Socioeconomic Position and HIV Diagnosis Rate Among Adults and Adolescents in the United States, 2005 to 2009
Authors: An Qian , Prejean Joseph , McDavid Harrison Kathleen , Fang Xiangming
Published: November 2012

Objectives. We examined the association between socioeconomic position (SEP) and HIV diagnosis rates in the United States and whether racial/ethnic disparities in diagnosis rates persist after control for SEP.

Methods. We used cases of HIV infection among persons aged 13 years and older, diagnosed 2005 through 2009 in 37 states and reported to national HIV surveillance through June 2010, and US Census data, to examine associations between county-level SEP measures and 5-year average annual HIV diagnosis rates overall and among race/ethnicity–sex groups.

Results. The HIV diagnosis rate was significantly higher for individuals in the low-SEP tertile than for those in the high-SEP tertile (rate ratios for low- vs high-SEP tertiles range = 1.68–3.38) except for White males and Hispanic females. The SEP disparities were larger for minorities than for Whites. Racial disparities persisted after we controlled for SEP, urbanicity, and percentage of population aged 20 to 50 years, and were high in the low-SEP tertile for males and in low- and high-SEP tertiles for females.

Conclusions. Findings support continued prioritization of HIV testing, prevention, and treatment to persons in economically deprived areas, and Blacks of all SEP levels.
The Politicization of Abortion and the Evolution of Abortion Counseling
Authors: Joffe Carole
Published: November 2012

The field of abortion counseling originated in the abortion rights movement of the 1970s. During its evolution to the present day, it has faced significant challenges, primarily arising from the increasing politicization and stigmatization of abortion since legalization. Abortion counseling has been affected not only by the imposition of antiabortion statutes, but also by the changing needs of patients who have come of age in a very different era than when this occupation was first developed. One major innovation—head and heart counseling—departs in significant ways from previous conventions of the field and illustrates the complex and changing political meanings of abortion and therefore the challenges to abortion providers in the years following Roe v Wade.
Effectiveness of a Community Health Worker Cardiovascular Risk Reduction Program in Public Health and Health Care Settings
Authors: Krantz Mori J. , Coronel Stephanie M. , Whitley Elizabeth M. , Dale Rita , Yost Jason , Estacio Raymond O.
Published: November 2012

Objectives. We evaluated whether a program to prevent coronary heart disease (CHD) with community health workers (CHWs) would improve CHD risk in public health and health care settings.

Methods. The CHWs provided point-of-service screening, education, and care coordination to residents in 34 primarily rural Colorado counties. The CHWs utilized motivational interviewing and navigated those at risk for CHD into medical care and lifestyle resources. A software application generated a real-time 10-year Framingham Risk Score (FRS) and guideline-based health recommendations while supporting longitudinal caseload tracking. We used multiple linear regression analysis to determine factors associated with changes in FRS.

Results. From 2010 to 2011, among 4743 participants at risk for CHD, 53.5% received medical or lifestyle referrals and 698 were retested 3 or more months after screening. We observed statistically significant improvements in diet, weight, blood pressure, lipids, and FRS with the greatest effects among those with uncontrolled risk factors. Successful phone interaction by the CHW led to lower FRS at retests (P = .04).

Conclusions. A CHW-based program within public health and health care settings improved CHD risk. Further exploration of factors related to improved outcomes is needed.
Web 2.0 for Health Promotion: Reviewing the Current Evidence
Authors: Chou Wen-ying Sylvia , Prestin Abby , Lyons Claire , Wen Kuang-yi
Published: November 2012

As Web 2.0 and social media make the communication landscape increasingly participatory, empirical evidence is needed regarding their impact on and utility for health promotion. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we searched 4 medical and social science databases for literature (2004–present) on the intersection of Web 2.0 and health.

A total of 514 unique publications matched our criteria. We classified references as commentaries and reviews (n = 267), descriptive studies (n = 213), and pilot intervention studies (n = 34).

The scarcity of empirical evidence points to the need for more interventions with participatory and user-generated features. Innovative study designs and measurement methods are needed to understand the communication landscape and to critically assess intervention effectiveness. To address health disparities, interventions must consider accessibility for vulnerable populations.
Changes in Service Delivery Patterns After Introduction of Telemedicine Provision of Medical Abortion in Iowa
Authors: Grossman Daniel A. , Grindlay Kate , Buchacker Todd , Potter Joseph E. , Schmertmann Carl P.
Published: November 2012

Objectives. We assessed the effect of a telemedicine model providing medical abortion on service delivery in a clinic system in Iowa.

Methods. We reviewed Iowa vital statistic data and billing data from the clinic system for all abortion encounters during the 2 years prior to and after the introduction of telemedicine in June 2008 (n = 17 956 encounters). We calculated the distance from the patient’s residential zip code to the clinic and to the closest clinic providing surgical abortion.

Results. The abortion rate decreased in Iowa after telemedicine introduction, and the proportion of abortions in the clinics that were medical increased from 46% to 54%. After telemedicine was introduced, and with adjustment for other factors, clinic patients had increased odds of obtaining both medical abortion and abortion before 13 weeks’ gestation. Although distance traveled to the clinic decreased only slightly, women living farther than 50 miles from the nearest clinic offering surgical abortion were more likely to obtain an abortion after telemedicine introduction.

Conclusions. Telemedicine could improve access to medical abortion, especially for women living in remote areas, and reduce second-trimester abortion.
Reproductive Rights Activism in the Post-Roe Era
Authors: Fried Marlene Gerber
Published: November 2012

Since the US Supreme Court decision legalizing abortion (Roe v Wade), there has been a constant and broad attack on all aspects of women’s reproductive and parenting rights. The consequences have been devastating, especially for women whose race, age, legal, or economic status makes them targets of discrimination.

At the same time, these threats have galvanized activism. There has been tremendous growth in the number of organizations and coalitions working to protect abortion rights, as well as advocating a broader reproductive rights, health, and justice agenda.

This article describes the major activist trends in this period, focusing primarily on those that have been less visible. Documenting activist history allows us to draw inspiration and important lessons for the future.