bluuebunny/crossref_metadata_2025 huggingface dataset:
The impact of information and communication technology on public governance and corruption in China
Authors: Lee Ming-Hsuan , Lio Mon-Chi
Published: April 2014

A large number of studies have examined the impact of information and communication technology on governance and corruption. However, few studies have explored the situation in China. While the Chinese government is fully committed to the development of ICT, it has also invested a great amount of resources into controlling the dissemination of information. Therefore, it is worth exploring whether ICT has had a positive impact on governance and corruption in China as found in other countries in previous studies. We conducted empirical tests utilizing provincial data from 2004 to 2010 and a Dynamic Panel Data Model. The results showed that ICT had a positive impact on the governance of provincial governments in China. ICT had two different effects on corruption: ICT helped corruption cases come to light and ultimately helped reduce corruption.
Inter-hospital transfer of ECMO-assisted patients with a portable miniaturized ECMO device: 4 years of experience
Authors: Raspé C , Rückert F , Metz D , Hofmann B , Neitzel T , Stiller M , Gielen S , Nestler F , Ebbighausen N , Steinke T , Bucher M , Bushnaq H
Published: April 2014

Objectives:

Extracorporeal membrane oxygenation (ECMO) in patients with severe pulmonary failure is able to keep patients alive until organ regeneration, until shunting out for further diagnostic and therapeutic options or until transportation to specialized centers. Nonetheless, extracorporeal techniques require a high degree of expertise, so that a confinement to specialized centers is meaningful. Following from this requirement, the need for inter-hospital transfer of patients with severely compromised pulmonary function is rising.

Methods:

We report about our experience with a portable ECMO system during inter-hospital air or ground transfer of patients with cardiopulmonary failure.

Results:

The portable ECMO system was used for transportation to the center and in-hospital treatment in 36 patients with an average age of 53 years suffering from respiratory failure. Accordingly, the ECMO system was implanted as a veno-venous extracorporeal system. Pre-ECMO ventilation time was 5.2 (2-9) days. Twelve patients were transported to our institution by ground and 24 patients by air ambulance over a median distance of 46 km. With the assistance of the ECMO device, prompt stabilization of cardiopulmonary function could be achieved in all patients without any technical complications. Post-ECMO ventilation was 9.8 days. Weaning from the ECMO system was successful in 61% of all patients after a median device working period of 12.7 days; median ICU stay was 34 days and a survival rate of 64% of patients was achieved. Technical (8%) and device-associated bleeding (11%)/thromboembolic (8%) complication rates showed very acceptable levels.

Conclusion:

Our experience demonstrates that miniaturized, portable ECMO therapy allows location-independent, out-of-center stabilization of pulmonary compromised patients with consecutive inter-hospital transfer and further in-house treatment, so that sophisticated ECMO therapy can be offered to every patient, even in hospitals with primary healthcare.
Duloxetine in the treatment of burning mouth syndrome refractory to conventional treatment: A case report
Authors: Kim Yeon-Dong , Lee Ji-Hye , Shim Jee-Hoon
Published: April 2014

Patients with burning mouth syndrome (BMS) report burning sensation and pain involving the tongue and oral mucosa without any apparent medical or dental cause. The pathogenesis of this syndrome remains unclear and there is currently no standard treatment. BMS is, therefore, often misdiagnosed and its management is complex. This lack of clinical expertise may result in decreased health-related quality of life and increased psychological distress among patients with BMS. The present case report involves a 77-year-old female patient with BMS refractory to conventional treatment with nerve block and medication, who was successfully treated with duloxetine. Duloxetine may become a new therapeutic option in the management of BMS.
Prison Inmates’ Right to Hunger Strike
Authors: Kanaboshi Naoki
Published: April 2014

Hunger strikes have long been used as a means of protest, as a last resort, especially by those in prison. Recently, government officials have responded to hunger strikes with force-feeding, an approach that has generated considerable international attention. The purpose of this article is to analyze the nature and the scope of the right to hunger strike in prisons in the United States under both the First Amendment and the Due Process Clause, and to provide a policy recommendation for prison administrators based on a review of case law. This article stresses the nature of hunger strikes as symbolic speech protected by the First Amendment, an analysis that has yet to be extensively discussed by either criminal justice or law scholars. This article argues that retaliatory force-feeding or punishment of hunger strikers generally violates the First Amendment, regardless of the prison officials’ professed justification. This article further argues that, given the inherently peaceful nature of hunger strikes, force-feeding for the supposed purpose of prison safety may lack a reasonable basis and therefore may well violate the inmates’ right to refuse medical treatment. Hunger strike policy recommendations are also provided.
Using Information From the Violence Risk Scale to Understand Different Patterns of Change
Authors: Yesberg Julia A. , Polaschek Devon L. L.
Published: April 2014

Research rarely has shown that in-program change in correctional rehabilitation is related to long-term outcome (i.e., recidivism), and surprisingly little is known about what happens to progress after treatment, especially for “lifers” whose release may not be imminent. This study investigated patterns of treatment response for 35 life-sentenced treatment completers of an intensive cognitive-behavioral program for high-risk male violent prisoners. Using Violence Risk Scale (VRS) ratings at pre-treatment, post-treatment, and 6 to 12 months following the program, we found that prisoners’ mean treatment response was positive both at program end and follow-up. However, a fine-grained analysis identified five distinct change patterns within the sample. Importantly, the direction and volume of in-program change did not necessarily predict post-program change, and the highest risk prisoners did not benefit as much as those at medium-high risk. The findings suggest that (a) a better understanding of the effects of treatment may be gained by examining change beyond the end of interventions, including a focus on the individual and contextual factors that promote and inhibit generalization and (b) more therapeutic attention may be warranted for monitoring treatment change to maximize conditions for continued gain beyond the end of the program.
Complexity evaluation of nonlinear dynamic behavior of mechanisms with clearance joints by using the fractal method
Authors: Xiang Wuweikai , Yan Shaoze , Wu Jianing , Gao Robert X
Published: April 2014

Dynamic behavior of mechanisms with clearance joints often exhibits nonlinear dynamic characteristics due to the collisions between the journal and bearing. However, previous studies could not quantify the complexity of the dynamic response. In this paper, based on the Poincaré map and correlation dimension, a fractal method is proposed to evaluate the complexity of nonlinear dynamic response of mechanisms with clearance joints. Motion equations of mechanical systems with clearance joints are described. A slider–crank mechanism is employed to demonstrate the efficiency of the fractal method and to discuss the influence of the clearance size and crank speed on the complexity of the dynamic response.
Dynamic instability of a spherical joint under various contact areas
Authors: Kang Jaeyoung
Published: April 2014

The contact area and the negative friction velocity slope on dynamic instability of spherical joint are theoretically investigated. The contact area may be influenced by the various loading and design conditions between a ball and socket. The non-conformal contact is adopted for the static and dynamic derivations. This contact geometry is selected as the major design parameter in this study. The numerical results reveal that the smaller contact area produces the higher propensity of modal instability.
Health literacy and health information behavior of Florida public library users: A mixed methods study
Authors: Yi Yong J.
Published: April 2014

The study aimed to examine users’ self-perceived health information behavior according to their health literacy ability. The proficiency levels for health literacy were measured by scores on the Short Test of Functional Health Literacy Ability (S-TOFHLA). The study conducted self-administered surveys with 131 public library users and semi-structured intensive interviews with 20 users as a follow-up. Surveys found that most participants had proficient levels of health literacy, and there was an association between health literacy and some demographic characteristics such as gender and educational level. The majority assessed their health information behavior as high. Interviewees identified critical barriers to seeking, evaluating, and using health information delivered by public libraries. Findings provided insights into public libraries for better assistance for their users’ particular needs such as preferred resources or services. Above all, the findings acknowledged the challenges of current services, and suggested the strategies for coping with them.
Funnel plot control limits to identify poorly performing healthcare providers when there is uncertainty in the value of the benchmark
Authors: Manktelow Bradley N , Seaton Sarah E , Evans T Alun
Published: April 2014

There is an increasing use of statistical methods, such as funnel plots, to identify poorly performing healthcare providers. Funnel plots comprise the construction of control limits around a benchmark and providers with outcomes falling outside the limits are investigated as potential outliers. The benchmark is usually estimated from observed data but uncertainty in this estimate is usually ignored when constructing control limits. In this paper, the use of funnel plots in the presence of uncertainty in the value of the benchmark is reviewed for outcomes from a Binomial distribution. Two methods to derive the control limits are shown: (i) prediction intervals; (ii) tolerance intervals. Tolerance intervals formally include the uncertainty in the value of the benchmark while prediction intervals do not. The probability properties of 95% control limits derived using each method were investigated through hypothesised scenarios. Neither prediction intervals nor tolerance intervals produce funnel plot control limits that satisfy the nominal probability characteristics when there is uncertainty in the value of the benchmark. This is not necessarily to say that funnel plots have no role to play in healthcare, but that without the development of intervals satisfying the nominal probability characteristics they must be interpreted with care.
Sensorless resistive-based control of shape memory alloy actuators in locking mechanism
Authors: Yousefian Reza , Kia Michael A , Zadeh Mehrdad H
Published: April 2014

This article presents a sensorless resistive-based control method to control shape memory alloy wire actuators to be used in the development of a laparoscopic surgical locking system. Shape memory alloy wire electrical resistance is measured to control the martensite phase fraction of shape memory alloy wire. The martensite phase fraction is calculated based on mathematical heating model, resistance models, and the measured resistance. Experiments are conducted to evaluate the validity and performance of the method in the control of the locking system angle. The results show that the sensorless resistive-based control method accurately controls the wire without using any position sensors, resulting in the lower cost, size, and weight of the system. The results show very small steady-state errors, verifying the practicability of this method. The sensorless resistive-based control method has the potential to be used in many applications in which cost and space are limited and the use of an external sensor is impossible or costly.
Chronic Pain and Risk Factors for Opioid Misuse in a Palliative Care Clinic
Authors: Childers Julie W. , King Linda A. , Arnold Robert M.
Published: April 2014

Objectives:

To describe the prevalence of chronic pain and the risk of opioid misuse in a palliative care clinic.

Methods:

We reviewed patient records for 6 months for source of pain, treatment status, opioid misuse risk (Cut down, Annoyed, Guilty, and Eye-opener [CAGE] and Screener and Opioid Assessment for Patients with Pain version 1.0—Short Form [SOAPP-SF] scores), and urine drug screens.

Results:

Of 323 patients, 91% had cancer, 56% undergoing cancer treatment, while 28% had no evidence of disease. Eighty-six (27%) patients had noncancer pain. In all, 46% of new patients had positive scores on the SOAPP-SF and 15% had a positive CAGE. Of the less than 5% of visits that included a urine drug screen, 56% had aberrant results.

Conclusion:

Chronic pain and indicators of opioid misuse risk were prevalent. Outpatient palliative care practices should develop policies to address these issues.
Analytical and experimental studies on ballistic impact behavior of 2D woven fabric composites
Authors: Pandya KS , Kumar Ch V Sesha , Nair NS , Patil PS , Naik NK
Published: April 2014

A generalized analytical formulation is presented for the prediction of ballistic impact behavior of 2D woven fabric composite laminates impacted with a rigid cylindrical projectile. The formulation is valid for a wide range of laminate thicknesses. The formulation is based on stress wave propagation and energy balance between the projectile and the composite target. During the ballistic impact event, the energy lost by the projectile is absorbed by the target through various damage and energy absorbing mechanisms such as compression of the target directly below the projectile, compression in the region surrounding the impacted zone, shear plugging, stretching and tensile failure of yarns/layers in the region consisting of primary yarns, tensile deformation of yarns/layers in the region consisting of secondary yarns, conical deformation on the back face of the target, delamination, matrix cracking, and friction between the projectile and the target. The formulation presented considers both shear plugging and tensile failure during conical deformation. Solution procedure for the evaluation of ballistic impact performance is presented. Experimental validation is performed on the ballistic impact behavior of two types of composite specimens: 2D plain weave E-glass/epoxy and 2D 8H satin weave T300 carbon/epoxy. Typical results on ballistic limit velocity and energy absorbed by various mechanisms are presented.
Examining Relationship Satisfaction and Individual Distress for Low-to-Moderate Income Couples in Relationship Education
Authors: Carlson Ryan G. , Daire Andrew P. , Bai Haiyan
Published: April 2014

Although economic disadvantage is linked to poor relationship quality and increased individual distress, emerging literature supports couples and relationship education as effective at improving relationship quality for low-income couples. However, relationship education’s influence on individual distress for low-income couples has not yet been determined. We provided relationship education using the Prevention Relationship Enhancement Program curriculum to 96 low-to-moderate income married couples with children and examined changes in relationship quality and individual distress pre, post, and 3–6 months after intervention. We found significant improvements in relationship satisfaction and significant individual distress decreases. Implications are discussed.
Conversion From Sildenafil to Tadalafil
Authors: Frantz Robert P. , Durst Louise , Burger Charles D. , Oudiz Ronald J. , Bourge Robert C. , Franco Veronica , Waxman Aaron B. , McDevitt Susanne , Walker Susan
Published: April 2014

Purpose:

Among phosphodiesterase type 5 inhibitors, tadalafil offers clinicians a once-daily alternative to 3 times daily sildenafil for the treatment of pulmonary arterial hypertension (PAH). This study assessed the safety and patient satisfaction with conversion from sildenafil to tadalafil.

Methods:

In this multicenter, prospective, 6-month study, patients with PAH were instructed to take their last dose of sildenafil in the evening and initiate tadalafil 40 mg/d the next morning. Patients completed the Treatment Satisfaction Questionnaire for Medication at baseline and 30, 90, and 180 days after transition to assess PAH symptoms and patient satisfaction. Safety was assessed on the basis of recorded adverse events (AEs).

Results:

Of the 35 patients who met the study criteria, 56% were receiving ≥2 PAH therapies. At the time of transition, the sildenafil dose ranged from 40 to 300 mg/d, with 20% of the patients on >20 mg of sildenafil 3 times daily. Transition to tadalafil was generally well tolerated, and the incidence of common AEs, except for myalgia, appeared to decrease over time on tadalafil therapy. Five (14%) patients switched back to sildenafil. A greater percentage of patients were satisfied than were dissatisfied after conversion to tadalafil (55% vs 19% at 90 days), while 26% felt about the same degree of satisfaction. Conversion to tadalafil resulted in significant improvement in patient ratings of therapy convenience.

Conclusions:

Transition of patients from sildenafil to tadalafil was usually well tolerated, with improved convenience and may enhance treatment satisfaction.
ADHD Symptomatology and Risky Health, Driving, and Financial Behaviors in College
Authors: Graziano Paulo A. , Reid Adam , Slavec Janine , Paneto Adrian , McNamara Joseph P. , Geffken Gary R.
Published: April 2014

Objective: To examine the extent to which effortful control (EC) and sensation seeking (SS) tendencies explain the association between the severity of ADHD symptoms and risky behaviors. Method: Participants included 555 college students (66% females) who completed self-report measures assessing their ADHD symptoms, EC abilities, SS tendencies, and risky health (e.g., substance use) and driving/financial behaviors (e.g., misuse of credit cards). Results: Severity of college students’ ADHD symptoms, EC abilities, and SS tendencies were related to all risky behaviors. Multiple mediational analyses further indicated that students’ SS tendencies significantly mediated the association between ADHD symptoms and the risky health factor but not the risky driving/financial factor. EC, however, significantly mediated the association between ADHD symptoms and both the risky health and driving/financial factors. Conclusion: The current study provides initial data showing potentially different mechanisms that explain the link between college students’ severity of ADHD symptoms and risky behaviors.
Psychiatric Comorbidities in a New Zealand Sample of Adults With ADHD
Authors: Rucklidge Julia J. , Downs-Woolley Michelle , Taylor Mairin , Brown Jason A. , Harrow Sarah-Eve
Published: April 2014

Objective: To examine the rates of psychiatric comorbidities within a New Zealand sample of adults with ADHD compared with a community control group. Method: We merged six data sets to obtain a sample of 222 adults (158 ADHD, 64 controls). Comorbidities were assessed using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders ( 4th ed. text rev. [ DSM-IV-TR]) Axis-I disorders. Results: Both groups were equivalent in IQ, socioeconomic status, gender, education, income levels, and age. Lifetime rates of psychiatric disorders were significantly higher in the ADHD group (83%) versus the control group (52%) with higher rates of major depressive disorder (MDD; 65% vs. 36%), social phobia (31% vs. 11%), substance abuse (26% vs. 8%), and alcohol abuse (32% vs. 14%). Within the ADHD group, other than a group difference in specific phobias, there were no gender differences. Conclusion: The findings are consistent with international research; adults with ADHD in New Zealand have higher rates of psychiatric disorders than the general population.
Adult ADHD Screening in Alcohol-Dependent Patients Using the Wender–Utah Rating Scale and the Adult ADHD Self-Report Scale
Authors: Daigre Constanza , Roncero Carlos , Rodríguez-Cintas Laia , Ortega Lluisa , Lligoña Anna , Fuentes Sonia , Pérez-Pazos Jesús , Martínez-Luna Nieves , Casas Miguel
Published: April 2014

Objective: The aim was to analyze the psychometric properties of two screening instruments, Wender-Utah Rating Scale (WURS) that evaluates childhood ADHD and Adult ADHD Self-Report Scales (ASRS) that assesses symptoms in adulthood, in alcohol-dependent patients. Method: A total of 355 outpatients were included. Conners’ adult ADHD diagnostic interview results were used as a gold standard in childhood and adulthood ADHD. Results: The WURS with a 41 cutoff had a sensitivity of 79.6% and a specificity of 60.3%. The ASRS with a 14 cutoff had a sensitivity of 86.7% and specificity of 66.1%. Analyzing both rating scales in combination, it was observed that patients with positive ASRS and WURS presented a sensitivity of 92.3%. Patients with positive ASRS, but negative WURS, presented a specificity of 73.6%. Conclusion: WURS and ASRS are useful tools in the diagnosis of adult ADHD in alcohol-dependent patients; with the use of both instruments, the psychometric properties are substantially improved.
The Effects of Benchmarking of Public Works Performance Measures on the Cost-Effectiveness of Service Delivery
Authors: Klase Kenneth A.
Published: April 2014

This research is an empirical analysis of the effects of the benchmarking of Efficiency Performance Measures on total costs for six Public Works service delivery areas based on data over the period 1998 to 2011 from municipalities participating in the North Carolina Performance Measurement Project, a well-established and nationally recognized performance measurement and benchmarking system. The results of this research are significant in providing empirical evidence that the benchmarking of Efficiency Performance Measures for the six Public Works service delivery areas had modestly positive impacts on total cost-effectiveness in a significant percentage of these Public Works service delivery areas. The results reflect that management decision-making utilizing performance measures in a benchmarking context, especially in Public Works service delivery areas, can be effective and that performance measurement and benchmarking can achieve identifiable efficiencies and modest improvements in cost-effective outcomes in Public Works service delivery areas over time.
Land-use Controls, Fiscal Zoning, and the Local Provision of Education
Authors: Hanushek Eric A. , Yilmaz Kuzey
Published: April 2014

Considerable prior analysis has gone into the study of zoning restrictions on locational choice and on fiscal burdens, but none addresses the level and distribution of public goods provided under fiscal zoning. Our analysis emphasizes the interplay between land-use restrictions and public good provision, focusing on schooling outcomes. We extend existing general equilibrium models of location and the provision of education so that fiscal zoning can be put into Tiebout choice. Some households create a fiscal burden, motivating the use of exclusionary land-use controls by local governments. We then analyze the market effects of different land-use controls (minimum lot size [MLS] zoning, local public finance with a head tax, and growth restrictions through fringe zoning) and demonstrate how household behavior directly affects the equilibrium outcomes and the provision of the local public good.
‘No news today’: talk of witnessing with families of missing people
Authors: Parr Hester , Stevenson Olivia
Published: April 2014

The paper contributes new ways of thinking about and responding to interview talk in the context of recent scholarship on interviewing, orality and witnessing. We proceed by paying attention to specific examples of interview talk on the experience of absence via the collecting of narratives from families of missing people. We highlight how ambiguous emotions are bound up with broader ways of recognizing such talk, largely exercised here as reflections on what is involved in witnessing those who are missing in communications with police. Tensions that may be produced by official ways of regarding and responding to family character witness of the missing are discussed in the context of two case studies. In response to these tensions, we offer suggestions for finding different spaces through which to value such ‘witness talk’ by families, particularly via ideas from grief scholarship. The paper concludes by briefly reflecting on how interviewing encounters might produce versions of praxis in which the content of talk is not just, and simply, ‘apprehended’ as academic evidence.
Impact of Aphasia on Consciousness Assessment
Authors: Schnakers Caroline , Bessou Helene , Rubi-Fessen Ilona , Hartmann Alexander , Fink Gereon R. , Meister Ingo , Giacino Joseph T. , Laureys Steven , Majerus Steve
Published: April 2014

Background. Previous findings suggest that language disorders may occur in severely brain-injured patients and could interfere with behavioral assessments of consciousness. However, no study investigated to what extent language impairment could affect patients’ behavioral responses. Objective. To estimate the impact of receptive and/or productive language impairments on consciousness assessment. Methods. Twenty-four acute and subacute stroke patients with different types of aphasia (global, n = 11; Broca, n = 4; Wernicke, n = 3; anomic, n = 4; mixed, n = 2) were recruited in neurology and neurosurgery units as well as in rehabilitation centers. The Coma Recovery Scale–Revised (CRS-R) was administered. Results. We observed that 25% (6 out of 24) of stroke patients with a diagnosis of aphasia and 54% (6 out of 11) of patients with a diagnosis of global aphasia did not reach the maximal CRS-R total score of 23. An underestimation of the consciousness level was observed in 3 patients with global aphasia who could have been misdiagnosed as being in a minimally conscious state, even in the absence of any documented period of coma. More precisely, lower subscores were observed on the communication, motor, oromotor, and arousal subscales. Conclusion. Consciousness assessment may be complicated by the co-occurrence of severe language deficits. This stresses the importance of developing new tools or identifying items in existing scales, which may allow the detection of language impairment in severely brain-injured patients.
Quantifying Individual Components of the Timed Up and Go Using the Kinect in People Living With Stroke
Authors: Vernon Stephanie , Paterson Kade , Bower Kelly , McGinley Jennifer , Miller Kimberly , Pua Yong-Hao , Clark Ross A.
Published: April 2014

Background. The Microsoft Kinect presents a simple, inexpensive, and portable method of examining the independent components of the Timed Up and Go (TUG) without any intrusion on the patient. Objective. This study examined the reliability of these measures, and whether they improved prediction of performance on common clinical tests. Methods. Thirty individuals with stroke completed 4 clinical assessments, including the TUG, 10-m walk test (10MWT), Step Test, and Functional Reach test on 2 testing occasions. The TUG was assessed using the Kinect to determine 7 different functional components. Test–retest reliability was assessed using intraclass correlation coefficient (ICC), redundancy using Spearman’s correlation, and score prediction on the clinical tests using multiple regression. Results. All Kinect-TUG variables possessed excellent reliability (ICC(2,k) > 0.90) except trunk flexion angle (ICC = 0.73). Trunk flexion angle and first step length were nonredundant with total TUG time. When predicting 10MWT and Step Test scores, adding step length into regression models comprising age and total TUG time improved model performance by 7% ( P <.01) and 6% ( P =.03), respectively. Specifically, an interquartile range increase in first step length (0.19 m) was associated with a 0.15 m/s faster gait speed and 1.8 more repetitions on the Step Test. These effect sizes were comparable to our minimal detectable change scores of 0.17 m/s for gait speed and 1.71 repetitions for the Step Test. Conclusions. Using the Kinect to independently assess the multiple components of the TUG may provide reliable and clinically useful information. This could enable efficient and information-rich large-scale assessments of physical deficits following stroke.
Community-Based Exercise for Chronic Disease Management
Authors: Weinrich Michael , Stuart Mary , Benvenuti Francesco
Published: April 2014

Although only a small proportion of older adults in the United States engage in recommended amounts of physical exercise, the health benefits of exercise for this population and the potential for lowering health care costs are substantial. However, access to regular exercise programs for the frail elderly and individuals with disabilities remains limited. In the context of health reform and emerging opportunities in developing integrated systems of care, the experience in Tuscany in implementing a community-based program of exercise for the elderly should be of interest.
Skin Blood Perfusion and Cellular Response to Insertion of Insulin Pen Needles With Different Diameters
Authors: Præstmark Kezia Ann , Jensen Casper Bo , Stallknecht Bente , Madsen Nils Berg , Kildegaard Jonas
Published: April 2014

Background:

Today most research on pen needle design revolves around pain perception statements through clinical trials, but these are both costly, timely, and require high sample sizes. The purpose of this study was to test if tissue damage, caused by different types of needles, can be assessed by evaluating skin blood perfusion response around needle insertion sites.

Method:

Three common sized pen needles of 28G, 30G, and 32G as well as hooked 32G needles, were inserted into the neck skin of pigs and then removed. Laser Speckle Contrast Analysis was used to measure skin blood perfusion for 20 minutes after the insertions. Seven pigs were included in the study and a total of 118 randomized needle insertions were conducted. Histology was made of tissue samples inserted with 18G, 28G, and 32G needles, and stained to quantify red and white blood cell response.

Results:

Based on area under curve, calculated for each individual blood perfusion recording and grouped according to needle type, skin blood perfusion response relates to needle diameter. The response was significantly higher after insertions with 28G and hooked 32G needles than with 30G ( P < .05) and 32G ( P < .01) needles. Histology results were not significant, but there was a trend of an increased response with increasing needle diameter.

Conclusions:

Skin blood perfusion response to pen needle insertions rank according to needle diameter, and the tissue response caused by hooked 32G needles corresponds to that of 28G needles. The relation between needle diameter and trauma when analyzing histology was also suggested.
Development of the Likelihood of Low Glucose (LLG) Algorithm for Evaluating Risk of Hypoglycemia
Authors: Dunn Timothy C. , Hayter Gary A. , Doniger Ken J. , Wolpert Howard A.
Published: April 2014

Objective:

The objective was to develop an analysis methodology for generating diabetes therapy decision guidance using continuous glucose (CG) data.

Methods:

The novel Likelihood of Low Glucose (LLG) methodology, which exploits the relationship between glucose median, glucose variability, and hypoglycemia risk, is mathematically based and can be implemented in computer software. Using JDRF Continuous Glucose Monitoring Clinical Trial data, CG values for all participants were divided into 4-week periods starting at the first available sensor reading. The safety and sensitivity performance regarding hypoglycemia guidance “stoplights” were compared between the LLG method and one based on 10th percentile (P10) values.

Results:

Examining 13 932 hypoglycemia guidance outputs, the safety performance of the LLG method ranged from 0.5% to 5.4% incorrect “green” indicators, compared with 0.9% to 6.0% for P10 value of 110 mg/dL. Guidance with lower P10 values yielded higher rates of incorrect indicators, such as 11.7% to 38% at 80 mg/dL. When evaluated only for periods of higher glucose (median above 155 mg/dL), the safety performance of the LLG method was superior to the P10 method. Sensitivity performance of correct “red” indicators of the LLG method had an in sample rate of 88.3% and an out of sample rate of 59.6%, comparable with the P10 method up to about 80 mg/dL.

Conclusions:

To aid in therapeutic decision making, we developed an algorithm-supported report that graphically highlights low glucose risk and increased variability. When tested with clinical data, the proposed method demonstrated equivalent or superior safety and sensitivity performance.
The Importance of Attribution
Authors: Bui My-Trinh , Jeng Don Jyh-Fu , Lin Chinho
Published: April 2014

Using attribution theory, this study examines 207 travel consumers’ views of five online travel communities (namely, Lonelyplanet, Travellerspoint, Tripadvisor, VirtualTourist, and Wayn) and their intentions to patronize one of the websites’ affiliates, Expedia. As a starting point, customers form an opinion of the community website itself based on communication quality and service quality. A high-quality experience, which includes interaction with other community members, engenders loyalty to the community website. With that base, the study tested three aspects of attributional responsiveness (evaluative satisfaction, cognitive loyalty, and affective belonging) and found that they could act as mediating factors to convey favorable attribution to the online communities’ affiliates, as represented by Expedia. Thus, a high standard of information and service will receive a favorable response from the online travel community, and that response can then be transferred to the community’s affiliates, in the form of purchases and return visits.
A Relationship With God? Connecting with the Divine to Assuage Fears of Interpersonal Rejection
Authors: Laurin Kristin , Schumann Karina , Holmes John G.
Published: April 2014

We examine the possibility that people can leverage their “relationship” with God as a stand-in for interpersonal relationships. More specifically, we hypothesize that people will seek closeness with the divine when facing the threat of interpersonal rejection and that conversely, they will seek interpersonal closeness when facing the threat of divine rejection. We test this idea across four studies. Along the way, we test additional predictions derived from the close relationships literature, concerning the consequences of this process and the moderating role of self-esteem. Taken together, our findings add to the literature on God as a relationship partner and connect this idea to the dynamic ebb and flow of interpersonal connection.
Arnold Gesell’s Developmental Assessment Revalidation Substantiates Child-Oriented Curriculum
Authors: Guddemi Marcy , Sambrook Andrea , Wells Sallie , Randel Bruce , Fite Kathleen , Selva Gitta , Gagnon Kelly
Published: April 2014

Educators and parents are increasingly concerned about effects of high-stakes testing on children who may not be developmentally ready to perform tasks according to rigorous standards of today’s kindergartens. In response to this issue, and to provide new psychometric data for the Gesell Developmental Observation (GDO), Gesell Institute conducted a nationwide study with nearly 1,300 children aged 3 to 6 years. Results confirm that children are able to perform developmental items according to a sequential trajectory of increasing difficulty, relative to their chronological age in 6-month intervals, and that performance mastery on items does not occur at the same time for all children of the same age. Results support the continued use of the revised GDO, now named the Gesell Developmental Observation–Revised (GDO-R), as an instrument to determine a child’s developmental level along a continuous path of growth and learning. Also discussed is the importance of establishing effective and appropriate academic goals based on a child’s developmental assessment results.
Medulloblastoma in an Adult With Late Extraneural Metastases to the Mediastinum
Authors: Ghose Abhimanyu , Morris John C. , Breneman John C. , Essell James , Wang Jiang , Benzaquen Sadia
Published: April 2014

Background. Medulloblastoma, although the most common brain tumor of childhood, is exceedingly rare in adults. These tumors have a propensity for local recurrence and to metastasize along the leptomeninges; however, extraneural metastases are very rare and typically occur in the bone or bone marrow. We have not come across any case in literature of medulloblastoma with mediastinal metastases in an adult. Case Presentation. We report a case of medulloblastoma in a 38-year-old lady who was treated with surgery followed by craniospinal radiation. Ten years later she presented with hoarseness from true vocal cord paralysis. She was diagnosed to have infiltrating metastases of her medulloblastoma to the mediastinum, which was confirmed by biopsy. There was no local recurrence. This was treated with chemotherapy followed by stem cell rescue, and she remained progression free for 2 years. Conclusion. Medulloblastomas are rare in adults and can present with late extraneural metastases following treatment. Although most common reported sites are bone and bone marrow, late metastases to other unexpected areas like the mediastinum are possible too and warrant awareness. This can be treated with chemotherapy followed by high-dose chemotherapy and stem cell rescue in a young patient with good performance status.
Parenteral glutamine supplementation in critical illness: a systematic review
Authors: Wischmeyer Paul E , Dhaliwal Rupinder , McCall Michele , Ziegler Thomas R , Heyland Daren K
Published: April 2014

Introduction

The potential benefit of parenteral glutamine (GLN) supplementation has been one of the most commonly studied nutritional interventions in the critical care setting. The aim of this systematic review was to incorporate recent trials of traditional parenteral GLN supplementation in critical illness with previously existing data.

Methods

All randomized controlled trials of parenterally administered GLN in critically ill patients conducted from 1997 to 2013 were identified. Studies of enteral GLN only or combined enteral/parenteral GLN were excluded. Methodological quality of studies was scored and data was abstracted by independent reviewers.

Results

A total of 26 studies involving 2,484 patients examining only parenteral GLN supplementation of nutrition support were identified in ICU patients. Parenteral GLN supplementation was associated with a trend towards a reduction of overall mortality (relative risk (RR) 0.88, 95% confidence interval (CI) 0.75, 1.03, P = 0.10) and a significant reduction in hospital mortality (RR 0.68, 95% CI 0.51, 0.90, P = 0.008). In addition, parenteral GLN was associated with a strong trend towards a reduction in infectious complications (RR 0.86, 95% CI 0.73, 1.02, P = 0.09) and ICU length of stay (LOS) (WMD –1.91, (95% CI -4.10, 0.28, P = 0.09) and significant reduction in hospital LOS (WMD -2.56, 95% CI -4.71, -0.42, P = 0.02). In the subset of studies examining patients receiving parenteral nutrition (PN), parenteral GLN supplementation was associated with a trend towards reduced overall mortality (RR 0.84, 95% CI 0.71, 1.01, P = 0.07).

Conclusions

Parenteral GLN supplementation given in conjunction with nutrition support continues to be associated with a significant reduction in hospital mortality and hospital LOS. Parenteral GLN supplementation as a component of nutrition support should continue to be considered to improve outcomes in critically ill patients.
Cross-species analysis of genetically engineered mouse models of MAPK driven colorectal cancer identifies hallmarks of human disease
Authors: Belmont Peter J. , Budinska Eva , Jiang Ping , Sinnamon Mark J. , Coffee Erin , Roper Jatin , Xie Tao , Rejto Paul A. , Derkits Sahra , Sansom Owen J. , Delorenzi Mauro , Tejpar Sabine , Hung Kenneth E. , Martin Eric S.
Published: April 2014

Effective treatment options for advanced colorectal cancer (CRC) are limited, survival rates are poor, and this disease continues to be a leading cause of cancer-related deaths worldwide. Despite being a highly heterogeneous disease, a significant subset of patients with sporadic CRC typically harbor relatively few established 'driver' lesions. Here, we describe a collection of genetically engineered mouse models (GEMM) of sporadic CRC that combine lesions frequently altered in human patients, including well-characterized tumor suppressors and activators of MAPK signaling. Primary tumors from these models were profiled, and individual GEMM tumors segregated into groups based on their genotypes. Unique allelic and genotypic expression signatures were generated from these GEMMs and applied to clinically annotated human CRC patient samples. We provide evidence that a Kras signature derived from these GEMMs is capable of distinguishing KRAS mutant patients, and tracks with poor prognosis in two independent human patient cohorts. Further, the analysis of a panel of human CRC cell lines suggests that high expression of the GEMM Kras signature correlates with sensitivity to targeted pathway inhibitors. Together, these findings implicate GEMMs as powerful preclinical tools with the capacity to recapitulate relevant human disease biology, and support the use of genetic signatures generated in these models to facilitate future drug discovery and validation efforts.
Sampling of Phenol in Water by Diffusive Gradients Using Thin Film Technique
Authors: Dong Jia , Li Liangchen , Jiang Zhiwen , Zhang Gang , Sun Ting
Published: April 2014

For the first time, new diffusive gradients in thin film (DGT) device using molecularly imprinted polymers as the binding agents and the nylon membrane as the diffusive layer have been developed for the sampling of phenol in water. The diffusion coefficient of phenol through the nylon membrane was 0.79 × 10−6 cm2 s−1, which was measured by the diffusion cell method. The binding agent of the DGT device was prepared by precipitation polymerization by molecularly imprinted technique using methacrylic acid as the functional monomer and ethyleneglycodimethacrylate as the crosslinker. The accumulated mass of phenol by the DGT device increased linearly with time (R2 = 0.9940). The ratio of the concentrations sampled by the DGT device to the concentration of the bulk solution was 0.97 ± 0.06. The results confirmed that the developed DGT device was suitable for the quantitative sampling of phenol in aqueous solution. The performance of the DGT device was independent of pH in the range 3–7 and ionic strength 0.0001–0.1 mol L−1. As a conclusion, the DGT device can be used for accurately sampling phenol in water.
Spin-crossover and LIESST Effect for Iron(III) Complex Based on π–π Stacking by Coordination Programming
Authors: Nakaya Manabu , Shimayama Kodai , Takami Kohei , Hirata Kazuya , Alao Amolegbe Saliu , Nakamura Masaaki , Lindoy Leonard F , Hayami Shinya
Published: April 2014

Spin-crossover (SCO) iron(III) compounds, [Fe(qnal-OMe)2]PF6·acetone (1) and [Fe(qnal-OMe)2]BPh4·2MeOH (2) (qnal-OMe: 7-methoxy-1-[(8-quinolinylimino)methyl]-2-naphthalenol), were prepared and characterized by X-ray single-crystal structure analysis, temperature-dependent magnetic susceptibility, and Mössbauer spectroscopy measurements. The compounds exhibited SCO behavior with thermal hysteresis loop (T1/2↑ = 202 K, T1/2↓ = 194 K for 1 and T1/2↑ = 304 K, T1/2↓ = 194 K for 2). Moreover, the light-induced excited spin-state trapping (LIESST) effect was observed for the compounds when the samples were illuminated (1000 nm) at 5 K. We suggest that the introduction of a strong intermolecular interaction, such as π–π stacking, can play an important role in the observed dynamic phase transition.
miR-19b promotes tumor growth and metastasis via targeting TP53
Authors: Fan Yu , Yin Shenyi , Hao Yang , Yang Junyu , Zhang Hanshuo , Sun Changhong , Ma Ming , Chang Qing , Xi Jianzhong Jeff
Published: April 2014

Tumor suppressor TP53 (or p53) is one of the most important regulators in numerous physiological and pathological processes. Recently, the miRNA-mediated post-transcription regulation of p53 has been studied. However, systematic studies of miRNA targeting sites within the p53 gene are still a challenging task. Here, we developed a dual-color assay capable of identifying miRNA targeting sites in a certain gene, specifically p53, in a simple, direct, and robust manner. Results showed that p53 was a direct and critical target of miR-19b, but not miR-19a, regardless of sequence similarity. Overexpression of miR-19b observed in human cancer cells can diminish p53 protein levels and, subsequently, downstream components such as Bax and p21. This miR-19b-mediated p53 reduction was shown to promote cell cycle, cell migration or invasion, and repress senescence and apoptosis in vitro. Further investigation revealed that miR-19b controls tumor growth and metastasis in vivo. Therefore, it is possible that miR-19b antagomirs or sponges could be developed as therapeutic agents against tumor development.
Ten years of the resource-based habitat paradigm: the biotope-habitat issue and implications for conserving butterfly diversity
Authors: Dennis Roger L. H. , Dapporto Leonardo , Dover John W.
Published: April 2014

The widely used term ‘habitat’ underlies all aspects of a species’ (and community’s) population size, consequently population changes, distribution and range size and changes; ultimately, habitat parameters determine the status of species, whether thriving or threatened with extinction. Habitat parameters also lie at the root of species’ evolution (speciation) involving cycles of resource specialism/generalism. A basic problem is that habitat has long been treated as synonymous with biotope. But, the two variable terms habitat and biotope describe very different phenomena and we make a case for clarity in the use of the term ‘habitat’, especially when the focus is conserving biodiversity. In this review, in reference to butterflies, we distinguish habitat from biotope as a real, grounded resources-based and conditions-based entity, and explain how usage of the terms greatly affects our perception of population status, and of population, distribution, range and speciation processes, central to conserving biodiversity.