bluuebunny/crossref_metadata_2025 huggingface dataset:
Cardiac Output Measurements in Septic Patients: Comparing the Accuracy of USCOM to PiCCO
Authors: Horster Sophia , Stemmler Hans-Joachim , Strecker Nina , Brettner Florian , Hausmann Andreas , Cnossen Jitske , Parhofer Klaus G. , Nickel Thomas , Geiger Sandra
Published: December 2011

USCOM is an ultrasound-based method which has been accepted for noninvasive hemodynamic monitoring in various clinical conditions (USCOM, Ultrasonic cardiac output monitoring). The present study aimed at comparing the accuracy of the USCOM device with that of the thermodilution technique in patients with septicemia. We conducted a prospective observational study in a medical but noncardiological ICU of a university hospital. Septic adult patients (median age 55 years, median SAPS-II-Score 43 points) on mechanical ventilation and catecholamine support were monitored with USCOM and PiCCO (). Seventy paired left-sided CO measurements (transaortic access = COUS-A) were obtained. The mean COUS-Awere 6.55 l/min (±2.19) versus COPiCCO6.5 l/min (±2.18). The correlation coefficient was . Comparison by Bland-Altman analysis revealed a bias of −0.36 l/min (±0.99 l/min) leading to a mean percentage error of 29%. USCOM is a feasible and rapid method to evaluate CO in septic patients. USCOM does reliably represent CO values as compared to the reference technique based on thermodilution (PiCCO). It seems to be appropriate in situations where CO measurements are most pertinent to patient management.
Propositional Density and Apolipoprotein E Genotype among Persons at Risk for Familial Alzheimer’s Disease
Authors: Medina Luis D. , Rodriguez-Agudelo Yaneth , Geschwind Daniel H. , Gilbert Paul E. , Liang Li-Jung , Cummings Jeffrey L. , Ringman John M.
Published: December 2011

Background/Aims: A relationship between decreased propositional density (p-density) in young adulthood and future risk for Alzheimer’s disease (AD) has been postulated, but multiple interpretations of the nature of this relationship are possible. This study explored the relationship between familial AD (FAD) mutation status, apolipoprotein E (APOE) genotype, and p-density. Methods: Thirty-five non-demented persons at risk for FAD mutations were recruited. Subjects wrote brief biographical essays from which p-density, the ratio of the number of unique ideas to the number of words in the text, was calculated. Mixed-effects regression models were used to examine the relationship of p-density and FAD mutation status and APOE genotype. Results: FAD mutation status was not significantly associated with p-density. However, results from both models indicated that the presence of the APOE Ε4 allele was significantly associated with p-density (p < 0.0001), with APOE Ε4 carriers having lower p-density than non-carriers. Conclusions: Our results are consistent with an influence of APOE status on p-density in young adulthood that is independent of the AD risk per se and suggest the previous finding of increased risk for the development of AD in persons with decreased p-density may be related to APOE genotype.
Intracranial Atherosclerosis Is Associated with Progression of Neurological Deficit in Subcortical Stroke
Authors: Hallevi Hen , Chernyshev Oleg Y. , El Khoury Ramy , Soileau Michael J. , Walker Kyle C. , Grotta James C. , Savitz Sean I.
Published: December 2011

Background: Progression of neurological deficit (PND) is a frequent complication of acute subcortical ischemic stroke (SCS). The role of intracranial atherosclerosis (IAS) in PND is controversial. Our goal was to evaluate IAS on admission, as predictor of PND in SCS patients. Methods: SCS patients were identified from our prospective database from 2004 to 2008. Clinical and laboratory data were collected from charts, and radiographic data from original radiographs. The proximal intracranial arteries were graded as patent, irregular, stenotic, or occlusion. IAS was defined as irregularity or stenosis. PND was defined as a change in the National Institutes of Health Stroke Scale >1 point. Results: Two hundred and two SCS patients were identified. In 14%, PND occurred at a median of 2 days from onset. Univariate analysis by infarct location showed the following to be associated with PND: for anterior circulation infarcts (centrum semiovale/basal ganglia), M1 atherosclerosis (p = 0.042); for posterior circulation infarcts, vertebral artery atherosclerosis (p = 0.018). For both groups, we found a non-significant association with age (p = 0.2) and HbA1c levels (p = 0.095). No association was found with admission glucose levels. Multivariate analysis showed the following association with PND: for anterior circulation infarcts, M1 atherosclerosis (OR 4.7; 95% CI 1.2–18.8; p = 0.03); for pontine infarcts, vertebral artery atherosclerosis (OR 5.8; 95% CI 1.1–29.4; p = 0.033). There was an increase in PND likelihood with an increasing number of atherosclerotic vessels. Discussion: In our cohort of SCS patients, PND was associated with IAS of the responsible vessels. These results suggest a role for IAS in the pathogenesis of PNF in SCS patients.
Provider-Directed Imaging Stress Testing Reduces Health Care Expenditures in Lower-Risk Chest Pain Patients Presenting to the Emergency Department
Authors: Miller Chadwick D. , Hoekstra James W. , Lefebvre Cedric , Blumstein Howard , Hamilton Craig A. , Harper Erin N. , Mahler Simon , Diercks Deborah B. , Neiberg Rebecca , Hundley W. Gregory
Published: December 2011

Background—

Among intermediate- to high-risk patients with chest pain, we have shown that a cardiac magnetic resonance (CMR) stress test strategy implemented in an observation unit (OU) reduces 1-year health care costs compared with inpatient care. In this study, we compare 2 OU strategies to determine among lower-risk patients if a mandatory CMR stress test strategy was more effective than a physicians' ability to select a stress test modality.

Methods and Results—

On emergency department arrival and referral to the OU for management of low- to intermediate-risk chest pain, 120 individuals were randomly assigned to receive (1) a CMR stress imaging test (n=60) or (2) a provider-selected stress test (n=60: stress echo [62%], CMR [32%], cardiac catheterization [3%], nuclear [2%], and coronary CT [2%]). No differences were detected in length of stay (median CMR=24.2 hours versus 23.8 hours,
P
=0.75), catheterization without revascularization (CMR=0% versus 3%), appropriateness of admission decisions (CMR 87% versus 93%,
P
=0.36), or 30-day acute coronary syndrome (both 3%). Median cost was higher among those randomly assigned to the CMR-mandated group ($2005 versus $1686,
P
<0.001).

Conclusions—

In patients with lower-risk chest pain receiving emergency department–directed OU care, the ability of a physician to select a cardiac stress imaging modality (including echocardiography, CMR, or radionuclide testing) was more cost-effective than a pathway that mandates a CMR stress test. Contrary to prior observations in individuals with intermediate- to high-risk chest pain, in those with lower-risk chest pain, these results highlight the importance of physician-related choices during acute coronary syndrome diagnostic protocols.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00869245.
Determinants and Consequences of Renal Function Variations With Aldosterone Blocker Therapy in Heart Failure Patients After Myocardial Infarction
Authors: Rossignol Patrick , Cleland John G.F. , Bhandari Sunil , Tala Stéphane , Gustafsson Finn , Fay Renaud , Lamiral Zohra , Dobre Daniela , Pitt Bertram , Zannad Faiez
Published: December 2011

Background—

We evaluated the effect of the selective mineralocorticoid receptor antagonist eplerenone on renal function and the interaction between changes in renal function and subsequent cardiovascular outcomes in patients with heart failure and left ventricular systolic dysfunction after an acute myocardial infarction in the Eplerenone Post–Acute Myocardial Infarction Heart Failure Efficacy and Survival Study (EPHESUS).

Methods and Results—

Serial changes in estimated glomerular filtration rate (eGFR) were available in 5792 patients during a 24-month follow-up. Patients assigned to eplerenone had a decline in eGFR with an adjusted mean difference of −1.4±0.3 mL · min
−1
· 1.73 m
−2
compared with placebo (
P
<0.0001), an effect that appeared within the first month (−1.3±0.4 mL · min
−1
· 1.73 m
−2
) and persisted throughout the study. Overall, 914 patients experienced a decline in eGFR >20% in the first month, 16.9% and 14.7% in the eplerenone and placebo groups, respectively (odds ratio, 1.15; 95% confidence interval, 1.02–1.30;
P
=0.017). In multivariate analyses, determinants of this early decline in eGFR were female sex, age ≥65 years, smoking, left ventricular ejection fraction <35%, and use of eplerenone and loop diuretic. An early decline in eGFR by >20% was associated with worse cardiovascular outcomes independently of baseline eGFR and of the use of eplerenone, which retained its prognostic benefits even under these circumstances.

Conclusions—

In patients with heart failure after acute myocardial infarction and receiving standard medical care, an early decline in eGFR is not uncommon and is associated with poor long-term outcome. Eplerenone induced a moderately more frequent early decline in eGFR, which did not affect its clinical benefit on cardiovascular outcomes.
'Tenebo hunc ordinem', Methods and structure of medieval law lectures (12th–14th centuries). –
Authors: Padovani Andrea
Published: December 2011

The well known ordo legendi diffused by Cinus among later commentators was a framework structured as a sequence of various steps and moments: divisio textus, positio casus, collectio notabilium, oppositiones and quaestiones. Some of them appear early in the didactic experience of Ioannes Bassianus and, more extensively, in the lecturae held, during the 13th century, by jurists, theologians and artistae as well: to be sure, with relevant differences mainly concerning the meaning of the employed terms. The decay of the glossa as a tool to explain the Corpus Iuris of Justinian in the schools and the diffusion of new styles in approaching the legal texts, made the expositio ordinis a frequent, somehow basic element of the lectura and of the commentum. From the times of Odofredus it occurs mainly when the lex meets heavy problems of interpretation: but not always in the complete sequence of the above mentioned moments. Contraria and quaestiones mark in any case the core of the exposition, according to the scholastic role of medieval dialectics. Different in their respective purposes, they nevertheless share the same logical procedure. From this point of view, an interesting and still inexplicable convergence of methods (and related terminology) can be observed in the age of Cinus between lawyers and artistae, both teaching at the University of Bologna.
India and Its Maturing BPO IT Sector
Authors: bin Yahya Faizal
Published: December 2011

Business process outsourcing (BPO) has become a key component of any global business model. One of the main BPO hubs in the world is India with its large pool of relatively-skilled human capital and lower wages. However, the BPO industry in India is maturing and facing constraints and challenges to further expansion. Some of these constraints include lack of employable talent, social norms, increasing operational cost and breaches of security in handling clients’ confidential data. This paper aims to examine Indian BPO companies’ aim to mitigate and resolve these constraints to growth. Some of the possible solutions to tightening labour market and increasing operational costs included recruitment and relocating BPO companies to tier two and three cities.
The limits and prospects of union power: Addressing mass redundancy in the steel industry
Authors: Stroud Dean , Fairbrother Peter
Published: December 2011

Worker and union responses to mass redundancy announcements are complex. This article explores a mass redundancy announcement with the purpose of shedding light on the way collective responses are shaped at such times. The article focuses on steelworker redundancies in South Wales (United Kingdom) in 2001 and 2002, which occurred at the Corus plc steelworks at Ebbw Vale in Blaenau Gwent and Llanwern, Newport, and argues that management handles such announcements in strategic ways to neutralize collective responses. Further, the article contends that the way trade unions organize and operate can result in union members being demobilized, thereby restricting alternative courses of action. Central to the analysis are understandings of the ways information, in the form of rumour and through more formal channels, flows between management, union and the membership/workforce.
Changes and Consistencies in Diabetes Education Over 5 Years
Authors: Martin Annette Lenzi
Published: December 2011

Purpose

The purpose of the National Diabetes Education Practice Survey (NPS) of the American Association of Diabetes Educators (AADE) is to describe the current diabetes education practice and specific interventions and responsibilities of diabetes educators in the United States.

Method

The 2010 NPS contained 52 items addressing diabetes education program structure, processes, interventions, outcomes, quality improvement, and adoption of health care reform models and AADE guidelines. The survey was hosted online, with 2513 AADE members participating. The 2010 results were compared with those from previous surveys.

Results

The majority of 2010 respondents provided diabetes education at one site, most commonly in a clinical outpatient/managed care setting. A wide range of services, including patient support, were provided. Team member functions, hours spent, and instructional methods also varied widely. More than half of programs measured at least one behavioral and clinical outcome in 2010. Most programs engaged in quality improvement. Many respondents were unfamiliar with the patient-centered medical home and accountable care organization models.

Conclusions

The results highlight the need for educators to increase their reporting of outcomes. Educators are also urged to raise their knowledge of health care delivery reform models. Wider adoption of AADE diabetes education practice guidelines will help ensure effective team involvement and optimal patient-centered education. Despite an increase in hours spent on diabetes self-management education and training (DSME/T) and clinical functions in diabetes education, many programs operated at a financial loss in 2010, underscoring the need for improved reimbursement of these services. Continuation of the NPS biannually is recommended.
Health Communication With Chinese Americans About Type 2 Diabetes
Authors: Ho Evelyn Y. , Chesla Catherine A. , Chun Kevin M.
Published: December 2011

Purpose

Chinese Americans are at high risk for type 2 diabetes and face some health disparities that can be attributed to language barriers, cultural differences, and access to care. The purpose of this article is to review current literature and establish best practices regarding health communication about type 2 diabetes for Chinese Americans. The authors reviewed clinical research literature from January 2000 to April 2011 to assess current knowledge about providing diabetes management guidance to Chinese Americans.

Conclusions

To improve health communication and dissemination of health information to Chinese Americans regarding diabetes and diabetes management, research scholars, health care providers, and diabetes educators can analyze current health messages by source, message, audience, channel, and destination characteristics. Extensive research has led to clear guidelines focusing on language-appropriate materials, an understanding of Chinese food beliefs and family practices, and the importance of culturally competent health care providers. However, many Chinese Americans are using Chinese foods and medicinal herbs with little communication between patients and providers about these practices. Although Chinese Americans are not a homogenous group, this article points to a set of cultural considerations that health care providers should address when working with Chinese Americans. By attending to various qualities of health messages, efforts at diabetes prevention and management may be greatly enhanced.
Geographic information system-based healthcare waste management planning for treatment site location and optimal transportation routeing
Authors: Shanmugasundaram Jothiganesh , Soulalay Vongdeuane , Chettiyappan Visvanathan
Published: December 2011

In Lao People’s Democratic Republic (Lao PDR), a growth of healthcare centres, and the environmental hazards and public health risks typically accompanying them, increased the need for healthcare waste (HCW) management planning. An effective planning of an HCW management system including components such as the treatment plant siting and an optimized routeing system for collection and transportation of waste is deemed important. National government offices at developing countries often lack the proper tools and methodologies because of the high costs usually associated with them. However, this study attempts to demonstrate the use of an inexpensive GIS modelling tool for healthcare waste management in the country. Two areas were designed for this study on HCW management, including: (a) locating centralized treatment plants and designing optimum travel routes for waste collection from nearby healthcare facilities; and (b) utilizing existing hospital incinerators and designing optimum routes for collecting waste from nearby healthcare facilities. Spatial analysis paved the way to understand the spatial distribution of healthcare wastes and to identify hotspots of higher waste generating locations. Optimal route models were designed for collecting and transporting HCW to treatment plants, which also highlights constraints in collecting and transporting waste for treatment and disposal. The proposed model can be used as a decision support tool for the efficient management of hospital wastes by government healthcare waste management authorities and hospitals.
Constraints to healthcare waste treatment in low-income countries – a case study from Somaliland
Authors: Di Bella Veronica , Ali Mansoor , Vaccari Mentore
Published: December 2011

In low-income countries, healthcare waste is mixed with the municipal waste stream and rarely receives special attention. This paper presents the lessons learned from a pilot project targeted to improve healthcare waste management in Hargeisa (Somaliland). The interventions were carried out in three of the main hospitals in the city. Consideration was also given to improve the overall situation regarding the management of healthcare waste. Three De Montfort incinerators were built and training was provided to operators, waste workers and healthcare personnel. Although the incinerators were constructed in accordance with the required standards, major constraints were identified in the operational phase: irregular de-ashing procedures, misuse of safety equipment, and ineffective separation of healthcare waste were seen in this phase. The paper concludes that in other small hospitals in the developing world, such as those in Hargeisa, on-site incineration by use of low-cost, small-scale incinerators could be successfully applied as an interim solution, provided that an agreed and acceptable plan of operation and maintenance is in place and responsibilities for the management of the facility are clearly identified. Moreover, when replicating this experience in other settings even greater importance should be given to the technical capacity building of operators and pressure should be exercised on local administrations in order to control and supervise the whole management system.
The Limits of Federal Activism in Education Policy
Authors: Vergari Sandra
Published: December 2011

The evolution of the federal role in education policy has entailed increasing activism in matters traditionally controlled by states and school districts. However, the expanding federal role has not resulted in a zero sum game for states and localities. Focusing on the policy-implementation process, this article examines recent state and local responses to federal activism in education policy. The study demonstrates how states and localities are able to protect their perceived interests by resisting and reshaping federal education policy.
Flexible Response
Authors: Shelly Bryan
Published: December 2011

The federal government promised that it would limit waiver grants to states for the No Child Left Behind Act of 2001 (NCLB). It largely kept that promise, but states did gain significant flexibility through amendments to accountability plans. OLS model estimates showed that larger, more affluent, and more Republican states submitted more amendment requests and the federal Department of Education approved the amendments of states that received more federal funding, had a more developed standardized testing system in place prior to NCLB, and voted Republican. These findings suggested new avenues of exploration for scholars of executive federalism.
Nonlinear free vibration of orthotropic graphene sheets using nonlocal Mindlin plate theory
Authors: Setoodeh AR , Malekzadeh P , Vosoughi AR
Published: December 2011

This article deals with the small-scale effect on the nonlinear free vibration of orthotropic single-layered graphene sheets using the nonlocal elasticity plate theory. The formulations are based on the Mindlin plate theory, and von Karman-type nonlinearity is considered in strain displacement relations. Virtual work principle is used to derive the nonlinear nonlocal plate equations in which the effects of rotary inertia and transverse shear are included. The differential quadrature method is employed to reduce the governing nonlinear partial differential equations to a system of nonlinear algebraic eigenvalue equations. The efficiency and accuracy of the method are demonstrated by comparing the developed result with those available in literature. The methodology is capable of studying large-amplitude vibration characteristics of nanoplates with different sets of boundary conditions. The effects of various parameters on the nonlinear vibrations of nanoplates are presented.
Real-time optimal techniques for unmanned air vehicles fuel saving
Authors: Akhtar N , Whidborne J F , Cooke A K
Published: December 2011

Dynamic soaring can save fuel by the extraction of low-altitude wind shear energy. The problem of generating energy-saving trajectories in real time for an unmanned powered sailplane is considered. A method called ‘inverse dynamics in the virtual domain’ is investigated. The method results in rapid solution generation and is suitable for real-time applications. Three-dimensional unmanned aerial vehicle equations of motion and a non-linear wind gradientmodel are used. Trajectories are generated to minimize the total power used per horizontal distance travelled for cross-wind travelling and in the total power used per total time in air for loitering mode. Trajectory following issues are addressed and an architecture for the control system is briefly described. A method for the estimation of wind shear gradient parameters is proposed. Validation is performed using a full six-degree-of-freedom model of a powered sailplane to verify the trajectory generation method.
Derivation of an efficient element for free vibration analysis of rotating tapered Timoshenko beams using basic displacement functions
Authors: Shahba A , Attarnejad R , Semnani S Jandaghi , Shahriari V , Dormohammadi A A
Published: December 2011

The accuracy of results predicted by finite element method considerably depends on the shape functions used to formulate the displacement field along the element. In this article, a novel approach is introduced to derive an efficient beam element. Special functions, namely Basic Displacement Functions (BDFs), are introduced and derived through power series solution of the static part of the governing differential equations for rotating tapered Timoshenko beams. It is shown that the shape functions could be derived in terms of BDFs through basic principles of structural mechanics. It is shown that the proposed shape functions have the advantage of including the effect of the rotational speed, hub radius, and varying cross-sectional dimensions. In order to verify the competency of the present element in the determination of natural frequencies, several numerical examples are carried out, and the results compared with those in the literature.
An ‘academic’ dilemma: The tale of archives and records management
Authors: Shepherd Elizabeth
Published: December 2011

This article discusses the development of academic research in the archives and records management field. It is argued that the field has faced a dilemma between educating graduates for work in a professional domain and developing robust research methods and frameworks for the emerging academic discipline. The article reports on some projects which have developed research frameworks and networks in the UK and internationally and considers some future directions for archives and records management research. In the light of the Research Assessment Exercise 2008, and in preparation for the Research Excellence Framework 2014, this is a good time to take stock of the progress made in this sub field of LIS and map its future strategic direction.
The cross-validated AUC for MCP-logistic regression with high-dimensional data
Authors: Jiang Dingfeng , Huang Jian , Zhang Ying
Published: December 2011

We propose a cross-validated area under the receiving operator characteristic (ROC) curve (CV-AUC) criterion for tuning parameter selection for penalized methods in sparse, high-dimensional logistic regression models. We use this criterion in combination with the minimax concave penalty (MCP) method for variable selection. The CV-AUC criterion is specifically designed for optimizing the classification performance for binary outcome data. To implement the proposed approach, we derive an efficient coordinate descent algorithm to compute the MCP-logistic regression solution surface. Simulation studies are conducted to evaluate the finite sample performance of the proposed method and its comparison with the existing methods including the Akaike information criterion (AIC), Bayesian information criterion (BIC) or Extended BIC (EBIC). The model selected based on the CV-AUC criterion tends to have a larger predictive AUC and smaller classification error than those with tuning parameters selected using the AIC, BIC or EBIC. We illustrate the application of the MCP-logistic regression with the CV-AUC criterion on three microarray datasets from the studies that attempt to identify genes related to cancers. Our simulation studies and data examples demonstrate that the CV-AUC is an attractive method for tuning parameter selection for penalized methods in high-dimensional logistic regression models.
Contesting Co-Inquiry
Authors: van Oudheusden Michiel , De Zutter Hannes
Published: December 2011

This article explores how social scientists, ethicists, and nanotechnologists construct research decisions together, while engaged in a Flemish participatory technology assessment on nanotechnologies. It finds that they routinely probe one another to make substantive contributions but avoid the argumentative initiative itself through various discursive strategies, such as reversing roles and delegating responsibility. It argues that these strategies emanate through the project’s methodology of co-inquiry, which depends on sharing and partnership, whereas some members resist participating on initiators’ terms. It links such “noncommunicative” action to unresolved disagreements between participants about project ends, conflicting approaches to decision making, and divergent appreciations of “uncertainty.”
Analysis and simulation of a snake robot based on muscles and vertebrae anatomy of snake
Authors: Faraji H , Barazandeh F
Published: December 2011

This article presents a new model of a wheel-less snake-like robot based on snake anatomy. Most prior research studies that have been done on snake robot were focused on emulating the locomotion appearance. In this article, linear actuators were employed to emulate muscles’ behaviour rather than using torque motors between every module. In addition, springs and dampers were utilized between ribs in order to resemble muscles better and conduct the force. Then, dynamic equation of this model is derived to understand legless locomotion.
Youth Custody, Resettlement and the Right to Social Justice
Authors: Gray Patricia
Published: December 2011

Rapid increases in rates of youth custody until quite recently, and breaches of human rights inside institutions for young offenders in England and Wales, have been a repeated source of criticism among youth justice commentators. However, this article focuses on the issue of resettlement to argue that current attempts to improve resettlement provision for young people leaving custody are beset with failure because of the way the concept of resettlement has been interpreted by policy makers. Instead of acknowledging broader structural constraints arising from poverty and socio-economic disadvantage, young people’s social needs on release from custody have been individualized and equated with correcting perceived personal deficits. The end result is that the concept of resettlement has been criminalized, as young people’s needs on leaving custody have been framed in a discourse of individual pathology and responsibilization. The article concludes by considering how young people’s resettlement needs could be advanced through the development of a transformative rights based approach which, while framed around the 1989 United Nations Convention on the Rights of the Child, is informed by social justice ideals.
‘I Would Have Been Able to Hear What They Think’: Tensions in Achieving Restorative Outcomes in the English Youth Justice System
Authors: Newbury Alex
Published: December 2011

This article presents findings from in-depth, semi-structured interviews with young offenders and Victim Liaison Officers, and observations of youth offender panels. It focuses upon the attitudes of young offenders towards victims and their reactions to the prospect of meeting the victim of their offending face-to-face as part of their referral order. Significant tensions between the aspirations of restorative justice and the reality of present practice in the English system are examined. The article proposes change in relation to justice disposals for incipient young offenders, particularly in relation to the ubiquitous use of restorative justice approaches for this group.
A study on non-linear wave forces and motion responses of a tri-hull carrier vessel
Authors: Senan Aswathy , Krishnankutty Parameswaran
Published: December 2011

This paper deals with the estimation of the non-linear wave forces and the subsequent motion response of a tri-hull carrier vessel. The finite element method and the panel method are used for numerical estimation of the forces and motions of the vessel. The numerical results are compared with the pitch and roll motions obtained from physical model tests carried out in a wave flume at the Indian Institute of Technology Madras for regular waves in a head sea and a beam sea for the zero-speed stationary condition. The results show that inclusion of the second-order wave excitation force in the equation of motion for the vessel results in closer prediction of the response amplitude operator to the experimental values in non-linear waves.
A Case Study of Leadership Transition
Authors: Cocklin Barry , Wilkinson Jane
Published: December 2011

Few studies of school leadership succession document the processes of continuity and change, especially within situations where there has been a strong tradition of tenure of principal, within a ‘quality’ school. This article examines how a new principal with a commitment towards notions of Learning Community Schools, ‘quality’ teaching and leadership, followed on from a long-standing prior principal with a more hierarchical and ‘traditional’ approach to leadership. At the same time, the prior principal had engaged community, and effectively contributed to the considerable status of his school within the district. Hence, the article examines the processes by which the school continued to be effective, in major part due to a smooth leadership transition that acknowledged and built upon the strengths of both the former and incumbent principals. In short, a context of continuity and change in leadership succession. Accordingly, the research adds to a small body of literature in increasing our knowledge base about leadership succession in a context of stability and continuity, rather than crisis. It suggests how ‘quality schools’ may be maintained and nourished via positive transitions in school leadership, where tenure is extensive, and in contexts with strong community ties and historical involvement.
Narrowing the Gap between ‘Intention and Reality’
Authors: Pearson Sue
Published: December 2011

In England, the governing body of each school has duties in relations to special educational needs (SEN), and these have recently been extended. It is common practice for responsibility for this area to be delegated to an individual governor or subgroup of governors. Clearly, such arrangements are dependent upon an effective relationship between the governing body, and the staff of the school, in particular the special educational needs coordinator (SENCO) who is responsible for coordinating SEN provision. There is a lack of recent relevant research and the perspectives of the SENCOs are under-represented. This research examines those relationships using data gathered via an electronic questionnaire completed by a national sample of SENCOs ( n =191). While examples of good practice exist, the intentions of the national policy are only partly realized in many schools, with a gap existing between policy and reality.
Principals and the Politics of Resistance to Change
Authors: Starr Karen
Published: December 2011

Governments hold principals accountable for leading and managing significant change for school improvement, primarily demonstrated through enhanced student test results. Research evidence suggests, however, that schools are slow to change, that many individuals are resistant to major change and that school reforms are often cursory or short lived. The stakes for principals to produce measurable improvements are rising, as are disincentives for failure. This article discusses the experiences of Australian principals overseeing major change in the context of rapid structural and policy reform. It focuses specifically on the micro-politics of resistance, through an exploration of principals' experiences and perceptions about leading major change. The article closes with suggestions for future research and leadership practice.
People with Disabilities
Authors: Houtenville Andrew , Kalargyrou Valentini
Published: December 2011

A survey of employers at 320 hospitality companies in the United States found a set of similar concerns and challenges regarding employment of persons with disabilities, although several of these issues are the result of lack of employer education. While small and medium-size companies had somewhat different issues than large companies, all firms had several concerns in common, starting with the belief that those with disabilities could not do the work. Another top concern was the potential cost of unspecified accommodations under the provisions of the Americans with Disabilities Act, even though the record shows that most such accommodations are not exceptionally costly. Other potential concerns were the possibility that persons with disabilities would not have requisite skills or be as productive, and that supervisors would be uncomfortable supervising persons with disabilities and would not know how to discipline or evaluate them. Larger companies are more likely than small firms to actively recruit persons with disabilities, and those that do so are relatively less concerned about potential costs and the safety of those workers than those who do not. Among the policies that would encourage more hiring of workers with disabilities cited by the managers are employer tax credits and incentives, flexible work schedules, and disability awareness training. On balance, the survey indicates that greater knowledge about persons with disabilities would enhance their hiring prospects, particularly since those with disabilities constitute a loyal and stable pool of workers with a long record of satisfactory job performance.
Shaping Environments Conductive to Creativity
Authors: Hon Alice H. Y.
Published: December 2011

A great deal of research on creativity is based on the principle of intrinsic motivation, which underlies creative performance and mediates the effects of contextual factors on employee creativity. Using a sample of Chinese employees from hotel industry, this study’s findings support the intrinsic motivation principle. This study applies the self-determination theory to model and examine intrinsic motivation and shows that a sense of autonomous motivation among employees plays a significant role in predicting employee creativity. Factors that promote creativity through autonomous motivation include a climate for creativity, empowering leadership, and coworker support. On the other hand, both task and personal conflict were negatively related to autonomous motivation. A controlling or coercive management style characterized by a focus on punishment, obligations, or external standards appears to be antithetical to employee creativity.
Treating pulmonary arterial hypertension: current treatments and future prospects
Authors: Raja Shahzad G. , Raja Shahbaz M.
Published: December 2011

Pulmonary arterial hypertension (PAH) consists of a group of heterogeneous but distinct disorders characterized by complex proliferation of the pulmonary vascular endothelium and progressive pulmonary vascular remodeling that leads to right ventricular failure and death. Over the past two decades, significant advances in our understanding of the pathobiology of PAH have led to the development of several therapeutic targets in this disease. Besides conservative therapeutic strategies such as anticoagulation and diuretics, the current treatment paradigm for PAH targets the mediators of the three main biologic pathways that are critical for its pathogenesis and progression: endothelin receptor antagonists inhibit the upregulated endothelin pathway by blocking the biologic activity of endothelin-1; phosphodiesterase-5 inhibitors prevent breakdown and increase the endogenous availability of cyclic guanosine monophosphate, which signals the vasorelaxing effects of the downregulated mediator nitric oxide; and prostacyclin derivatives provide an exogenous supply of the deficient mediator prostacyclin. In addition to these established current therapeutic options, a large number of potential therapeutic targets are being investigated. These novel therapeutic targets include soluble guanylyl cyclase, phosphodiesterases, tetrahydrobiopterin, 5-hydroxytryptamine (serotonin) receptor 2B, vasoactive intestinal peptide, receptor tyrosine kinases, adrenomedullin, rho kinase, elastases, endogenous steroids, endothelial progenitor cells, immune cells, bone morphogenetic protein and its receptors, potassium channels, metabolic pathways, and nuclear factor of activated T cells. This review provides an overview of the current therapeutic options and potential therapeutic targets for PAH.
High-risk cytogenetics and persistent minimal residual disease by multiparameter flow cytometry predict unsustained complete response after autologous stem cell transplantation in multiple myeloma
Authors: Paiva Bruno , Gutiérrez Norma C. , Rosiñol Laura , Vídriales María-Belén , Montalbán María-Ángeles , Martínez-López Joaquín , Mateos María-Victoria , Cibeira María-Teresa , Cordón Lourdes , Oriol Albert , Terol María-José , Echeveste María-Asunción , de Paz Raquel , de Arriba Felipe , Palomera Luis , de la Rubia Javier , Díaz-Mediavilla Joaquín , Sureda Anna , Gorosquieta Ana , Alegre Adrian , Martin Alejandro , Hernández Miguel T. , Lahuerta Juan-José , Bladé Joan , San Miguel Jesús F.
Published: December 2011

The achievement of complete response (CR) after high-dose therapy/autologous stem cell transplantation (HDT/ASCT) is a surrogate for prolonged survival in multiple myeloma; however, patients who lose their CR status within 1 year of HDT/ASCT (unsustained CR) have poor prognosis. Thus, the identification of these patients is highly relevant. Here, we investigate which prognostic markers can predict unsustained CR in a series of 241 patients in CR at day +100 after HDT/ASCT who were enrolled in the Spanish GEM2000 (n = 140) and GEM2005 < 65y (n = 101) trials. Twenty-nine (12%) of the 241 patients showed unsustained CR and a dismal outcome (median overall survival 39 months). The presence of baseline high-risk cytogenetics by FISH (hazard ratio 17.3; P = .002) and persistent minimal residual disease by multiparameter flow cytometry at day +100 after HDT/ASCT (hazard ratio 8.0; P = .005) were the only independent factors that predicted unsustained CR. Thus, these 2 parameters may help to identify patients in CR at risk of early progression after HDT/ASCT in whom novel treatments should be investigated.
Site-Specific Design Spectra for Vertical Ground Motion
Authors: Gülerce Zeynep , Abrahamson Norman A.
Published: December 2011

This paper contains ground-motion prediction equations (GMPEs) for the vertical-to-horizontal spectral acceleration (V/H) ratio, and the methods for constructing vertical design spectra that are consistent with the probabilistic seismic hazard assessment results for the horizontal ground motion component. The GMPEs for V/H ratio consistent with the horizontal GMPE of Abrahamson and Silva (2008) are derived using the Pacific Earthquake Engineering Research Center's Next Generation of Ground-Motion Attenuation Models (PEER-NGA) database (Chiou et. al. 2008). The proposed V/H ratio GMPE is dependent on the earthquake magnitude and distance, consistent with previous models, but it differs from previous studies in that it accounts for the differences in the nonlinear site-response effects on the horizontal and vertical components. This difference in nonlinear effects results in large V/H ratios at short spectral periods for soil sites located close to large earthquakes. A method to develop vertical design spectra dependent on the horizontal component uniform hazard spectrum that accounts for the correlation between the variability of the horizontal ground-motion model and the variability of the V/H ratio ground-motion model is proposed.
Mental health around and after the menopause
Authors: Sandilyan Malarvizhi Babu , Dening Tom
Published: December 2011

The menopause is a time in a woman's life when it is recognized that biological and social changes can impact upon mental wellbeing. Several studies have investigated the relationship between menopause and psychological symptoms, especially depression, with mixed results. In part, this is due to a considerable overlap between depressive symptoms and those due to declining estrogen levels, causing challenges in assessment. However it appears that vulnerable women are at a higher risk of succumbing to depression during menopausal transition. Antidepressants remain the mainstay of treating depressive symptoms, with little conclusive evidence for hormone replacement therapy. Memory problems during menopause are a common complaint, but there is no demonstrated link to subsequent dementia. This paper also reviews considerations of diagnosis and treatment of postmenopausal depression.
RNA single strands bind to a conserved surface of the major cold shock protein in crystals and solution
Authors: Sachs Rolf , Max Klaas E.A. , Heinemann Udo , Balbach Jochen
Published: December 2011

Bacterial cold shock proteins (CSPs) regulate the cellular response to temperature downshift. Their general principle of function involves RNA chaperoning and transcriptional antitermination. Here we present two crystal structures of cold shock protein B from Bacillus subtilis (Bs-CspB) in complex with either a hexanucleotide (5′-UUUUUU-3′) or heptanucleotide (5′-GUCUUUA-3′) single-stranded RNA (ssRNA). Hydrogen bonds and stacking interactions between RNA bases and aromatic sidechains characterize individual binding subsites. Additional binding subsites which are not occupied by the ligand in the crystal structure were revealed by NMR spectroscopy in solution on Bs-CspB·RNA complexes. Binding studies demonstrate that Bs-CspB associates with ssDNA as well as ssRNA with moderate sequence specificity. Varying affinities of oligonucleotides are reflected mainly in changes of the dissociation rates. The generally lower binding affinity of ssRNA compared to its ssDNA analog is attributed solely to the substitution of thymine by uracil bases in RNA.
Protease Inhibitor–Associated QT Interval Prolongation
Authors: Hunt Kimberley , Hughes Christine A , Hills-Nieminen Cara
Published: December 2011

Objective:

To evaluate the literature on protease inhibitor (PI)-associated QT interval prolongation and risk for torsade de pointes in patients infected by HIV.

Data Sources:

Primary literature was identified through MEDLINE (1950-August 2011) and EMBASE (1980-August 2011), using the following search terms: antiretroviral agents, HIV, protease inhibitors, QTc, QT prolongation, and torsade de pointes.

Study Selection and Data Extraction:

English-language case reports of antiretroviral therapy–associated QT interval prolongation, studies of healthy volunteers, or studies that evaluated the impact of Pls on QT interval in patients infected with HIV were reviewed and selected. Article bibliographies and conference abstracts were also reviewed.

Data Synthesis:

Several case reports, as well as in vitro data, have implicated PIs as a potential cause of QT interval prolongation and/or torsade de pointes. Saquinavir, therapeutically boosted with the potent CYP3A4 inhibitor ritonavir, was the only PI shown to be associated with significant QT interval prolongation in studies with healthy volunteers. While 1 case control study in HIV-infected patients found that nelfinavir or efavirenz, a nonnucleoslde reverse transcriptase inhibitor, increased the risk of QT interval prolongation, larger prospective studies have not demonstrated any significant increase in QT interval following exposure to PIs. Similar risk factors for QT interval prolongation seen in non-HIV-infected patients, such as older age, female sex, ethnicity, cardiac conditions, diabetes mellitus, and concomitant use of other QT interval-prolonging medications, especially methadone, were risk factors identified in studies of HIV-infected patients.

Conclusions:

PIs do not appear to independently predispose patients to QT interval prolongation. However, other risk factors (both HIV-related and non-HIV-related) may increase the risk of QT interval prolongation. Available data suggest that baseline and follow-up electrocardiogram monitoring are unnecessary precautions, but may be considered in patients who are initiating PI therapy and are on multiple medications with proarrhythmic potential and/or have multiple comorbidities, increasing the risk.