bluuebunny/crossref_metadata_2025 huggingface dataset:
Wear Performance of Tetrazine Modified Multiwalled Carbon Nanotube/Epoxy Composites
Authors: Aibo Zhang , Wei Liu , Ming Li , Yaping Zheng
Published: October 2008

A graft-amino functional group was built on the surface of multi-walled carbon nanotubes (MWNTs) by the receation of tetrazine with Π-bond of MWNTs. A kind of multi-walled carbon nanotube (MWNT)/epoxy composite was prepared by means of tetrazine modified multiwalled carbon nanotube at elevated temperature. The interface properties of MWNT/epoxy composites were improved by the building of a chemical bond between the graft-amino group on the wall of nano-carbon tubes and epoxy functional group. The reaction mechanism is presented in Figure 2. The state of MWNT after modification was characterized by transmission electron microscopy (TEM) and Perkin Elmer Spectrum (FTIR). It was found that the morphology and structure of MWNT show great changes by treated tetrazine and MWNT was found well-dispersed in the matrix. The MWNT/epoxy (EP) composite exhibited a lower friction coefficient and lower wear rate compared to those without tetrazine modification. The friction coefficient of the composites is 6.5% lower than that of untreated MWNTs/EP composites and the wear rate is 71.4% lower. The dispersion of MWNTs has remarkable effect on the tribological properties of the composites and is presented in Figure 3.
Hygrothermal Aging Effect on Fatigue Behavior of GLARE
Authors: Da Silva D.A. , Botelho E.C. , Rezende M.C.
Published: October 2008

This article reports on the experimental characterization of the fatigue behavior of GLARE laminate taking into account the hygrothermal effects. The environmental factors can limit the applications of composites by deteriorating the mechanical properties during service. The importance of temperature at the time of conditioning plays an important role in environmental degradation of such composite materials. In this work, the experiments showed that the hygrothermal conditioning can induce significant changes in the material properties. Due to the effect of the hygrothermal aging, both the tensile and fatigue values of the studied systems have been reduced, that is, the absorbed moisture has deleterious effects on the physical properties of metal—fiber composite laminates.
Three Models of the 3D Filling Simulation for Injection Molding: A Brief Review
Authors: Cardozo D.
Published: October 2008

This article reviews the state-of-the-art research and development in the 3D filling simulation of injection molding, most notably the different models. The article organizes prior studies into three sequential categories, namely, mid-plane models, surface models, and solid models. In the mid-plane models, the arbitrary planar mid-plane is used to represent the three-dimensional geometry of the part. Their model and formulation are presented based on the Hele—Shaw approximation. The article further discusses the main disadvantage of the mid-plane models, which introduces the surface models. The surface models represent a three-dimensional part with a boundary or skin mesh on the outside surfaces of a solid geometric model. This kind of model still adopts the Hele—Shaw approximation, but can avoid the re-modeling of the mid-plane. Subsequently, the situations that cannot be accurately predicted using the Hele—Shaw approximation are discussed, in which a full 3D simulation has become a promising solution. The leading 3D simulation approaches are summarized, including the finite element method, the finite volume method, the control-volume-based finite-element-method, and the boundary element method. The tracking algorithms of the melt fronts are also described.
Permeability of Hybrid Reinforcements and Mechanical Properties of their Composites Molded by Resin Transfer Molding
Authors: Schmidt T.M. , Goss T.M. , Amico S.C. , Lekakou C.
Published: October 2008

The aim of this study was to carry out RTM experiments to determine in-plane permeability of glass mats, non-woven polypropylene flow media (PP) and hybrids (glass + PP), with different stacking sequences, and to compare these with various sisal mats and hybrids (glass + sisal). RTM composites were also molded. Permeability decreased for higher fiber content and, for the same fiber volume content, the permeability of the sisal mats was much higher than that of glass mats and also higher than that of the PP non-woven core, often used as an infiltration medium. Besides, a tendency of increasing permeability with sisal fiber length (up to 30 mm) was noticed. The use of the sisal mat as a flow medium increased the permeability of the hybrid reinforcement and slightly improved the mechanical properties of the composite. Hence, the sisal mat may be indicated in engineering applications as a substitute for commercial flow media, widely used in the process called RTM light.
Mechanical Properties of Glass-Fiber Reinforced Epoxy Composites Filled with Al 2O3 Particles
Authors: Asi Osman
Published: October 2008

An experimental study has been carried out to investigate the mechanical properties of glass-fiber reinforced epoxy composite filled with different proportions of Al2O3 particles. As a comparison, the mechanical properties of unfilled glass-fiber reinforced epoxy composite were also evaluated under identical test conditions. The results showed that while ultimate tensile strength and shear strength of the composites decreased with increasing Al2O3 particles content, flexural strength increased with the Al2O3 particles content of up to 10% beyond which it decreased. Compared with the flexural properties of the unfilled glass-fiber reinforced epoxy composite, with the addition of 10 wt% of Al2O3 particle in the matrix, flexural strength, and flexural modulus were increased by 33 and 78%, respectively.
Low Temperature Izod Impact Studies of Blends Based on Impact Grade Polypropylene and Ethylene-α-Octene Copolymer
Authors: Das Vishal , Pandey A.K. , Krishna Bal
Published: October 2008

With an aim to enhance low temperature impact strength, blends of PP-cp (Impact Grade PP) and metallocene-catalyzed plastomer (EXACT® ethylene-α-octene copolymer) were prepared using a co-rotating, intermeshing twin-screw extruder in 90 : 10, 80 : 20, 70 : 30, and 60 : 40 weight ratio. Rheological properties studied by Haake’ single-screw extruder with torque rheometer attachment and capillary die showed pseudoplastic melt behavior at 220°C in the shear rate range of 400—4000 s—1. Density and MFI determinations showed minimal change. Morphology studied by low voltage scanning electron microscope (LVSEM) of blend samples showed distinct biphasic blend morphology wherein PP-cp as continuous phase and plastomer as spherical domains (0.5—2 μm size) with stabilized distribution and dispersion. Izod impact strength of the blends at varied temperatures (23, 0, -10, -20, -30, and -40°C) showed substantial enhancement in low temperature impact strength compared to the base polymer (from 44 J/m in case of pure PP-cp to 539 J/m in case of 40% plastomer blend at -40°C).
Women's Bodies Aging
Authors: McCormick Marie L.
Published: October 2008

Women's bodies at every age are expressions of self and culture. In a culture that values slender, taut-skinned youth, the embodied selves of postmenopausal women are dismissed and devalued, jeopardizing self-esteem and increasing the potential for depression and anxiety. Drawing from a qualitative research project on aging and embodied womanhood, this article describes the lived experience of women aging in this social-cultural context. It emphasizes social workers' roles as policy advocates, researchers, and educators in reshaping the cultural discourse and as direct practitioners revising and affirming the embodied selves of women as valued and valuable in the second half of life.
Displaced Women in Northern Ghana
Authors: McGadney-Douglass Brenda Faye , Ahadzie William K.
Published: October 2008

This article presents the findings of field research in Ghana in 2002 about internal displacement stemming from multiethnic violence in northern Ghana in 1994, known as the “Guinea Fowl War.” Indigenous, gender-specific knowledge from displaced Ghanaian women is presented in the context of feminist perspectives on the consequences of regional wars on non-combatants. The research generated indigenous material for social work education about interethnic peace building and conflict resolution. The discussion includes first-person responses about warning signs, origins of conflict, immediate and long-term responses, social consequences, and an integration of findings with feminist perspectives on conflict resolution and policies that are designed to aid internally displaced women.
Doing Justice
Authors: Hancock Tina U.
Published: October 2008

Social workers in small towns and rural communities who restrict their practice on moral grounds may be oppressive to women who are seeking a range of reproductive health options and clients with the gay/lesbian lifestyle. On the basis of observations of students who were enrolled in a rural-based BSW program in a conservatively religious affiliated university, the author presents a typology that categorizes the students' views on justice and oppression and willingness to work in practice situations with which the students disagree on moral grounds. Three orientations are illustrated: an ethic of conformity, an ethic of individualism, and an ethic of care. Implications for practice and teaching are discussed.
Gender Differences in Depression
Authors: Chonody Jill M. , Siebert Darcy Clay
Published: October 2008

The authors propose a novel theoretical approach for conceptualizing gender differences in depression. Although the empirical literature documents an array of variables that are related to depression, most theories focus on microlevel variables at the expense of macrolevel variables in their conceptualization. This article focuses on the potential importance of power differentials in the etiology of depression in women who cohabit with men and presents an integrated theoretical model that will be useful for both practice and research.
Stillbirth
Authors: Cacciatore Joanne , Bushfield Suzanne
Published: October 2008

Stillbirth occurs in approximately 1 out of 110 births in the United States, yet little is understood about this experience. Unexplained stillbirths are major contributors to the developed world's perinatal mortality, as only about half have an identifiable cause of death. Because stillbirths are unpredictable and thus unpreventable, given the current state of science, researchers have called for more uniform definitions, a stricter postmortem protocol, standardized data collection, and increased funding to aid in prevention. The macrosystem for stillbirths includes epidemiology and public health systems that gather statistics on the incidence of stillbirth and its known causes and state record keeping related to both birth and death. Legitimation for women who have experienced stillbirth, through legislative and terminological changes, education, and research, is overdue, despite fears that related policy will trump reproductive rights. This article explores recent policy changes promoted by grassroots organizations relating to how stillbirths are recorded.
Inabel Burns Lindsay
Authors: Crewe Sandra Edmonds , Brown Annie Woodley , Gourdine Ruby Morton
Published: October 2008

Described as an activist, educator, researcher, and administrator, Inabel Burns Lindsay served as the first dean of the Howard University School of Social Work, and her extraordinary accomplishments have served as a beacon for generations of social work educators and practitioners. During her formative years as a social worker, she honed in on the importance of examining culture in delivering services in the public welfare system. As she built a school of social work, which she described as “second to none,” she served as a moral conscience for the profession and repeatedly demonstrated through her writings and actions an uncompromising pursuit of social justice for all, both inside and outside the profession. This article profiles the courage and leadership skills of this transformational leader and uses her struggle against racism and sexism to inform the current realities of the profession.
Criminal Rewards
Authors: Brown Andraé L.
Published: October 2008

Since 1985, the claim of parent alienation syndrome (PAS) has represented the extreme collusion of male entitlement, the mental health profession, and family courts. PAS is a pseudoscientific theory used to prevent battered women from protecting their children from exposure to violent and abusive fathers. It asserts that children who resist parents' visits are not legitimately seeking protection from their fathers but have been “alienated” from their fathers by their mothers. This article examines the impact of PAS on families, its admissibility in courts, and the role of social workers and other mental health practitioners in custody cases through the lens of a social worker, a social justice activist, and a mother who is involved in a PAS custody case.
Sattareh Farman Farmaian
Authors: Saleh Mahasin F.
Published: October 2008

In 1958, a social revolution was started by Sattareh Farman Farmaian, who established the social work profession in Iran. Sattareh's far-reaching work had tremendous effects on the people of her country, even after she was forced into exile during the 1979 Iranian Revolution. Sattareh was the founder and director of the Tehran School of Social Work, as well as the founder and executive director of both the Family Planning Association and Community Welfare Centers of Iran. This article includes excerpts from an interview with her that focus on her life work and lessons for contemporary international social work practice.
Adult metformin ingestions reported to Texas poison control centers, 2000–2006
Authors: Forrester MB
Published: October 2008

Metformin is an oral hypoglycemic agent used in the management of type 2 diabetes mellitus. Limited information exists on adult metformin ingestions reported to poison control centers. The distribution of adult metformin ingestions reported to Texas poison control centers during 2000–2006 was determined for various factors. In addition, triage guidelines for the management of isolated ingestions were drafted. Of 1528 total metformin ingestions, 58% involved coingestants. Of the 264 ingestions of metformin alone, where the final medical outcome was known, dose ingested was reported for 66%. The mean reported dose was 4739 mg (range 500–60,000 mg). Ingestions of ≤2500 mg and >5000 mg reported doses differed with respect to the proportion involving suspected attempted suicide (6% versus 81%), serious final medical outcome (3% versus 19%), and referral to a health care facility (3% versus 83%). Using 5000 mg as a threshold dose for referral to a health care facility, 91% of cases not already at or en route to a health care facility were managed according drafted triage guidelines.
Early-onset pancytopenia and skin ulcer following low-dose methotrexate therapy
Authors: Hocaoglu N , Atilla R , Onen F , Tuncok Y
Published: October 2008

Pancytopenia is a rare but serious adverse effect of low-dose methotrexate (MTX) sodium therapy, and this case report describes a very early-onset of pancytopenia and cutaneous lesions after three days of ingestion. A 64-year-old man was presented to Emergency Department with weakness, fever, poor appetite, nausea, and vomiting after he had had accidentally ingested MTX tablets (2.5 mg) twice a day for the last three days. On initial examination, several painful lesions in his oral mucosa and a cutaneous ulceration on his right foot were also observed. He had severe pancytopenia, poor kidney functions, and abnormal coagulation parameters. The blood level of MTX was found to be within therapeutic range. He was treated with leucovorine, intravenous antibiotics, and appropriate blood transfusions; he was discharged from hospital without any sequela. Pancytopenia associated with low-dose (cumulative dose of 15 mg in 3 days) MTX therapy had not been reported previously. The Naranjo probability scale showed pancytopenia and skin ulcer associated with low-dose MTX therapy as probable adverse reactions. Risk factors for pancytopenia such as renal insufficiency, hypoalbuminemia, low folate levels, concomitant infections, concomitant use of drugs, and folate supplementation were not identified in our patient. Although pancytopenia associated with low-dose MTX therapy is not expected as early as 3 days after initiation of the therapy, physicians should also be aware of this life threatening adverse effect during the very first days of MTX therapy for rheumatoid arthritis patients.
Incidence of poisoning deaths in Finland in 1971–2005
Authors: Kivistö JE , Mattila VM , Parkkari J , Kannus P
Published: October 2008

Poisonings cause considerable morbidity and mortality worldwide. However, only few countries have published nationwide statistics on poisoning deaths. Based on the Official Cause-of-Death Statistics of Finland, we investigated the incidence and secular trend of poisoning deaths in Finland in 1971–2005. Alcohol poisoning deaths and other poisoning deaths were analyzed separately. During the 35-year study period, other poisoning deaths (non-alcohol) increased from 2.6/100,000 in men and 1.4/100,000 in women in 1971 to 6.8/100,000 and 3.2/100,000 in 2005, respectively. Alcohol poisoning death rates also increased from 9.6/100,000 in men and 0.7/100,000 in women in 1971 to 16.8/100,000 and 4.2/100,000 in 2005, respectively. In the early 1970s, the incidence rates of alcohol deaths were about 10 times higher in men compared with women, whereas in the last few years of observation, men's incidence rate was only about four times higher. Our study showed that alcohol and other poisoning deaths increased in Finland between 1971 and 2005. Men’s risk was markedly higher than women’s risk, but in the later years, women’s risk was increasing. Poisoning death rates among children and adolescents were low throughout the period.
Electrophysiological safety of sibutramine HCl
Authors: Kim KS , Park SJ , Lee HA , Kim DK , Kim EJ
Published: October 2008

Sibutramine is known to induce cardiovascular side effects such as tachycardia, vasodilation, and hypertension. The present study was aimed to examine the effects of sibutramine on action potential of guinea pig papillary muscle, recombinant hERG currents (IhERG), and inward currents (INa and ICa) of rat ventricular myocytes. Sibutramine at 30 μg/mL induced a shortening of action potential duration (APD) of guinea pig papillary muscle; on average, APD30 and APD90 were shortened by 23% and 17% at a stimulation rate of 1 Hz, respectively. Sibutramine suppressed the following currents: IhERG (IC50:2.408 ± 0.5117 μg/mL), L-type Ca current (IC50:2.709 ± 0.4701 μg/mL), and Na current (IC50:7.718 ± 1.7368 μg/mL). Sibutramine blocked IhERG, ICa, and INa in a concentration-dependent manner. In conclusion, sibutramine exerted a shortening effect on APD in guinea pig papillary muscle through its more powerful blocking effects on ICa and INa rather than IhERG.
Expert opinion: fomepizole may ameliorate the need for hemodialysis in methanol poisoning
Authors: Hovda KE , Jacobsen D
Published: October 2008

Fomepizole is now the antidote of choice in methanol poisoning. The use of fomepizole may also change the indications for hemodialysis in these patients. We have addressed this change in a review of articles on methanol poisonings. Review of the literature (through PubMed®) combined with our own experiences from two recent methanol outbreaks in Estonia and Norway. The efficiency of dialysis during fomepizole treatment was reported in only a few reports. One recent study challenged the old indications, suggesting a new approach with delayed or even no hemodialysis. Methanol-poisoned patients on fomepizole treatment may be separated into two categories: 1) The critically ill patient, with severe metabolic acidosis (base deficit >15 mM) and/or visual disturbances should be given buffer, fomepizole and immediate hemodialysis: dialysis removes the toxic anion formate, and assists in correcting the metabolic acidosis, thereby also reducing formate toxicity. The removal of methanol per se is not important in this setting because fomepizole prevents further production of formic acid. 2) The stable patient, with less metabolic acidosis and no visual disturbances, should be given buffer and fomepizole. This treatment allows for the possibility to delay, or even drop, dialysis in this setting, because patients will not develop more clinical features from methanol poisoning when fomepizole and bicarbonate is given in adequate doses. Indications and triage for hemodialysis in methanol poisonings should be modified. Delayed hemodialysis or even no hemodialysis may be an option in selected cases.
A case for deliberation in response to hormesis research
Authors: Elliott KC
Published: October 2008

Research on the phenomenon of hormesis (i.e., low-dose stimulatory effects caused by normally inhibitory or toxic substances) has recently provoked a good deal of debate. Formal mechanisms for deliberation and public participation are increasingly popular strategies for responding to controversial decisions in environmental policy, but they have been used only to a limited extent in response to scientific research itself. This commentary introduces natural scientists to some of the social scientific literature on these issues and argues for the importance of “diagnosing” whether controversial areas of policy relevant research would benefit from some form of deliberation. It provides a tentative diagnosis in the case of hormesis research, recommending a varied deliberative approach. There are many reasons to pursue broadly based deliberation in response to hormesis, including the potential to promote more productive research projects, alleviate public distrust, and prevent bias. Deliberative proceedings in this case should address judgments associated with at least four activities: (1) choosing projects and designing studies, (2) developing terminology, (3) interpreting and evaluating studies, and (4) applying research results to public policy. Although an advisory group composed primarily of experts might provide an adequate starting point, more intensive deliberative processes would be valuable before developing major changes to regulatory policy.
A nutrient mixture suppresses carbon tetrachloride–induced acute hepatic toxicity in ICR mice
Authors: Roomi MW , Kalinovsky T , Roomi NW , Ivanov V , Rath M , Niedzwiecki A
Published: October 2008

We examined the effect of a nutrient mixture (NM) that contains lysine, proline, ascorbic acid, and green tea extract in mice treated with carbon tetrachloride (CCl4), a model of liver injury in which free radical, oxidative stress, and cytokine production are closely linked. Seven-week-old male Imprinting Control Region (ICR) mice were divided into four groups (A–D) of five animals each. Groups A and C mice were fed a regular diet for 2 weeks, whereas groups B and D mice were supplemented with 0.5% NM (w/w) during that period. Groups A and B received corn oil i.p., whereas groups C and D received CCl4 (25 μL/kg, in corn oil, i.p.). All animals were killed 24 h after CCl4 administration, serum was collected to assess liver and kidney functions, and livers and kidneys were excised for histology. Mean serum aspartate aminotransferase and alanine aminotransferase were comparable in groups A and B, increased markedly in group C, and significantly lowered in group D compared with group C. CCl4 had no significant effect on renal markers (blood urea nitrogen [BUN], creatinine, and BUN/creatinine ratio). CCl4 administration caused an intense degree of liver necrosis that was less severe in the NM fed group D. These results indicate that NM could be a useful supplement in preventing acute chemical-induced liver toxicity.
You & Your Body
Authors: Ward Vicky , Howdle Peter , Hamer Susan
Published: October 2008

Universities are beginning to recognize that failing to engage with local communities can result in decreased public confidence, decreased credibility, and the slow uptake and implementation of research. This has led to significant interest in the concept and practices of public engagement, particularly within science. This article presents a case study of a biomedical public engagement project at the University of Leeds, United Kingdom. The authors discuss how the project has highlighted the barriers and facilitators to engaging the adult public with biomedical research and university communities.
Cerebrospinal Fluid Apolipoprotein E, Calcium and Cerebral Vasospasm after Subarachnoid Hemorrhage
Authors: Alexander Sheila A. , Kerr Mary E. , Balzer Jeffrey , Horowitz Michael , Kassam Amin , Kim Yookyung , Hoffman Leslie , Conley Yvette P.
Published: October 2008

Intracellular calcium (Ca ++) regulation of cerebral vessels is impaired after subarachnoid hemorrhage (SAH), making secondary pathways, such as that involving apolipoprotein E, potentially more influential. To evaluate cerebrospinal fluid (CSF) apolipoprotein E and Ca++ levels as biomarkers of cerebral vasospasm, we examined changes in levels over time and apolipoprotein E (APOE) ε4 allele presence after SAH in individuals with and without vasospasm. We hypothesized that individuals with low apolipoprotein E levels, increased Ca++ levels and/or at least one copy of the APOE ε4 allele would have vasospasm. Daily samples from 50 participants, aged 18—75, with SAH were used to quantify apolipoprotein E and Ca++ levels. Vasospasm was verified using cerebral angiogram and/or elevated transcranial Dopplers in combination with clinical neurologic deterioration. Overall apolipoprotein E levels were higher in individuals with the APOE ε4 allele (p = .02) or angiographic vasospasm (p = .01), but there were no differences between individuals with and without symptomatic vasospasm. There were no significant changes in apolipoprotein E levels over time. Individuals with the ε4 allele had lower Ca ++ levels (p = .02) with trends suggesting a different pattern of change over time (p = .07). CSF Ca++ levels were lower in individuals with symptomatic vasospasm (p < .01). Change in apolipoprotein E and Ca ++ levels (p = .006) correlated over time regardless of genotype or vasospasm status. These findings suggest that apolipoprotein E and Ca ++ may be interacting after SAH, but this interaction does not appear to influence vasospasm.
White Matter Hyperintensities and Medication Adherence
Authors: Insel Kathleen C. , Reminger Sheryl L. , Hsiao Chao-Pin
Published: October 2008

White matter hyperintensities (WMH) are associated with hypertension, age, and cognitive function, but the association between WMH and medication adherence has not been examined. The intent of this investigation was to consider the potential implications of hypertension-related brain morphological changes on medication adherence and thereby improve understanding of the self-management consequences of hypertension. The associations between WMH, blood pressure, age, cognitive function (specifically assessments of prefrontal function), and medication adherence were examined in 16 middle-aged and older adults self-managing at least one prescribed antihypertensive agent. Magnetic resonance imaging using an axial fluid attenuated inversion recovery (FLAIR) sequence was used to assess the presence of WMH. Cognitive assessments included measures of executive function, working memory, attention, and immediate recall. Adherence was monitored for 8 weeks using electronic medication monitoring. More WMH were associated with poorer adherence (rs = —.25) and with higher systolic blood pressure (rs = .46), although these relationships were not statistically significant. WMH were associated with cognitive assessments in the expected direction including Digit Span Backward (rs = —.53, p < .05). Adherence was associated with immediate memory (rs = .54, p < .05) and inversely associated with failure to maintain set on the Wisconsin Card Sorting Test (WCST; r s = —.61, p < .05). These findings provide preliminary evidence for the association between WMH, assessments of prefrontal function, and medication adherence.
Maternal Heart Rate Variability and Fetal Behavior in Hypertensive and Normotensive Pregnancies
Authors: Brown C. Ann , Lee Charlotte T. , Hains Sylvia M. J. , Kisilevsky Barbara S.
Published: October 2008

The relation between maternal heart rate variability (HRV) and fetal behavior was examined in hypertensive and normotensive pregnant women. A total of 40 mother—fetal pairs (n = 20 normotensive mothers; n = 20 hypertensive mothers) at 33—41 weeks' gestation were observed using a standardized procedure lasting approximately 50 min. It included the following measurements: maternal beat-by-beat arterial blood pressure and HRV; spontaneous fetal heart rate (HR), body and breathing movements; and an estimate of amniotic fluid volume. The women in the hypertensive group had higher average body mass index (BMI) (33.7 vs. 28.8 kg/m2 ) than the normotensive group. In the normotensive group, there was no association between maternal HRV and fetal gestational age, HR, body or breathing movements. In the hypertensive group, maternal HRV measures of low-frequency, high-frequency, and total power were associated with fetal gestational age; also, there was an association between maternal autonomic modulation of HR and fetal spontaneous HR. These findings suggest that the maternal autonomic system influences fetal cardiac function in pregnancies complicated by hypertension.
A Systematic Review of Exercise Interventions in Patients With Heart Failure
Authors: Tai Mei-Kuei , Meininger Janet C. , Frazier Lorraine Q.
Published: October 2008

The incidence of heart failure (HF) is increasing as the population ages. Pharmacotherapy is an important component of treatment and yields significant improvements in survival and quality of life. In recent decades, exercise has gradually become accepted as an intervention beneficial to patients with HF, but more information is needed to clarify the effects of exercise and optimize interventions. Therefore, a systematic review of randomized controlled trials published from 1966 to October 2006 was carried out via PubMed. About 69 trials were reviewed, which used as main outcome measures: (a) central hemodynamic parameters, (b) peripheral blood flow, (c) endothelial function, (d) activation of neurohormones and cytokine systems, (e) structure of and metabolism in skeletal muscles, and/or (f) quality of life. Study findings suggest that the favorable physiological responses to exercise might slow some of the pathophysiological progression of HF. However, most of the trials reviewed here were based on relatively small samples and selected participant groups, and the exercise programs varied widely. These limitations and inconsistencies need to be addressed through further studies. Furthermore, reliable strategies for maintaining the positive effects of exercise and extending them to patients' daily life and quality of life are scarce in these trials. These domains need further exploration through rationally designed, large-scale randomized controlled trials.
Cerebrospinal Fluid Phospholipid Changes Following Traumatic Brain Injury
Authors: Pasvogel Alice E. , Miketova Petra , Moore Ida M. (Ki)
Published: October 2008

Traumatic brain injury (TBI) is a leading cause of morbidity and mortality, with approximately 1.4 million people suffering a TBI each year. With TBI, a cascade of events is initiated including the activation of phospholipases, which leads to the disruption of the lipid bilayer of the membrane of neurons and neuroglia. The purpose of this study is to describe phospholipid changes following TBI. A total of 39 cerebrospinal fluid samples were obtained from the ventricular catheter system of 10 participants who received a TBI as a result of a motor vehicle crash, being struck by a vehicle as a pedestrian, or a fall. Phospholipids were extracted from samples and measured by normal-phase high-performance liquid chromatography with ultraviolet detector at a wavelength of 206 nm. The highest mean concentration of lysophosphatidylcholine occurred on Day 1 after injury. The concentration of phosphatidylserine was variable, with the highest mean concentration occurring on Day 2 after injury. The highest mean concentrations of phosphatidylethanolamine, phosphatidylcholine, and sphingomyelin occurred on Day 4 after injury. Findings provide preliminary evidence for disruption of central nervous system membrane phospholipids following TBI.
Symptoms of Postpartum Depression Associated With Elevated Levels of Interleukin-1 Beta During the First Month Postpartum
Authors: Corwin Elizabeth J. , Johnston Nancy , Pugh Linda
Published: October 2008

Postpartum depression (PPD) is a devastating disorder that may carry lifetime consequences. Although several psychosocial risks for PPD have been identified, biological contributors are unclear. Elevated inflammatory cytokines contribute to depression in nonpregnant, nonpostpartum populations; yet, their role in PPD has been minimally studied. The objective of this study is to determine whether inflammatory cytokines early in the postpartum period contribute to the development of PPD. Women were recruited within 24 hr of delivery, and 26 provided urine for analysis of interleukin-1 beta (IL-1β) and interleukin-6 (IL-6) on postpartum days 7, 14, and 28. Participants completed a depression symptom survey (Centers for Epidemiologic Studies Depression Scale; CES-D) on Day 28. An increase in IL-1β was seen on Day 14 in women with symptoms of depression (CES-D ! 11) on Day 28 compared to levels in women without depressive symptoms (F = 4.50, p = .045). These preliminary findings suggest elevated IL-1β early in the postpartum period may increase the risk of PPD. Further studies involving a larger sample of women, including those clinically diagnosed with PPD, are required.
Gestational Diabetes Mellitus: Physical Exercise and Health Outcomes
Authors: Snapp Carol A. , Donaldson Sue K.
Published: October 2008

Purpose: Gestational diabetes mellitus (GDM) is a serious complication of pregnancy associated with increased risk of adverse outcomes for both mother and infant. This study assesses the association of maternal exercise during GDM pregnancy and selected maternal and infant adverse GDM-related outcomes. The analysis uses information derived from the 1988 National Maternal Infant Health Survey (NMIHS) data. Methods: Women in the 1988 NMIHS database were identified and grouped as to having experienced a non-GDM (n = 2,952,482) or GDM (n = 105,600) pregnancy. Non-GDM and GDM groups were compared as to demographic and personal-attribute variables. The second part of this study focused on the women with GDM pregnancy, specifically a subset (n = 75,160) who met inclusion/exclusion criteria for the study of exercise during pregnancy. Each was categorized to either the exercise group or the nonexercise group. Results: The non-GDM and GDM groups of pregnant women were not different as to the variables studied, except that older age and increased body mass index (BMI) were associated with GDM pregnancy. For the study of exercise during GDM pregnancy, the only variable that was associated with the exercise group was size of the infant. Participants in the exercise group were less likely than those in the nonexercise group to have delivered a large for gestational age (LGA) infant (F [1, 4314] = 9.82, p = .0017). Implications: The results of this study suggest that moderate maternal leisure time physical exercise during GDM pregnancy may reduce the risk of delivery of an LGA infant.
Exogenous Irritant-Induced Airway Hyperreactivity and Inhibition of Soluble Guanylyl Cyclase
Authors: Antošová Martina , Strapková Anna , Turčan Tomáš
Published: October 2008

The majority of nitric oxide (NO) effects in the respiratory system are caused by stimulation of soluble guanylyl cyclase (sGC) with subsequent increase of cyclic guanosine monophosphate (cGMP) production. The importance of this mechanism of NO action in airway hyperreactivity (AHR) pathogenesis is unknown. Therefore, the aim of our experiment was to examine the changes of airway reactivity enhanced by toluene vapor exposure in the presence or inhibition of sGC activity in guinea pigs. Animals were treated with a nonspecific sGC inhibitor, methylene blue, in a dose of 50 or 100 mg/kg body weight, administered by intraperitoneal injection 30 min before or after exposure to toluene vapors. The toluene exposure lasted 2 hr in each of 3 consecutive days under in vivo conditions. Thereafter, the tracheal and lung tissue smooth muscle response to cumulative doses of mediators (histamine or acetylcholine) was recorded under in vitro conditions. The exposure to toluene vapors significantly increased the airway reactivity to both mediators in comparison with the healthy animal group. The administration of methylene blue decreased the amplitude of airway smooth muscle contraction in toluene-induced hyperreactivity. The decreases were dependent on the inhibitor doses, on a regimen of administration (before or after toluene inhalation), the level of the respiratory system (trachea, lung), and the bronchoconstrictor mediators. Our results suggest that the interaction between NO and sGC may be important for airway reactivity changes, but other mechanisms of NO action are important in AHR pathogenesis, too.
The Current State of Nursing Performance Measurement, Public Reporting, and Value-Based Purchasing
Authors: Kurtzman Ellen T. , Dawson Ellen M. , Johnson Jean E.
Published: October 2008

Over the last decade, there has been a substantial investment in holding health care providers accountable for the quality of care provided in hospitals and other settings of care. This investment has been realized through the proliferation of national policies that address performance measurement, public reporting, and value-based purchasing. Although nurses represent the largest segment of the health care workforce and despite their acknowledged role in patient safety and health care outcomes, they have been largely absent from policy setting in these areas. This article provides an analysis of current nursing performance measurement and public reporting initiatives and presents a summary of emerging trends in value-based purchasing, with an emphasis on activities in the United States. The article synthesizes issues of relevance to advancing the current climate for nursing quality and concludes with key issues for future policy setting.
The Oregon Consortium for Nursing Education
Authors: Tanner Christine A. , Gubrud-Howe Paula , Shores Louise
Published: October 2008

The Oregon Consortium for Nursing Education (OCNE) is a statewide coalition designed as a long-term solution to the nursing shortage and in response to the need for a new kind of nurse to care for Oregon's aging and increasingly diverse population. It is an effort to increase capacity in schools of nursing by making the best use of scarce faculty, classrooms, and clinical training resources in the delivery of a standard curriculum on 13 campuses, including 8 community colleges and the 5 campuses of the OHSU School of Nursing. This article describes the development of OCNE, including infrastructure development, creation of the shared curriculum, redesign of clinical education, faculty development, and plans for evaluation. If OCNE is successful in achieving its goals, it holds substantial policy implications for the development of nursing education systems, design of curricula, use of simulation as a component of clinical education, and delivery of clinical education.
Endovascular Abdominal Aortic Aneurysm Repair: A Community Hospital's Experience
Authors: Madden Nicholas , Baril Donald T. , Wertz Richard , DeMarsico Arthur , Rhee Robert Y. , Chaer Rabih A.
Published: October 2008

Endovascular abdominal aortic aneurysm repair (EVAR) has become the first-line approach for the treatment of abdominal aortic aneurysms. Outcomes outside of tertiary care settings remain unknown. The purpose of this study is to report the midterm outcomes of EVAR in a community hospital. A retrospective review of 75 elective, consecutive EVARs performed at a single nonacademic community hospital was performed. There were no conversions to open repair during or after endovascular repair. The mean follow-up was 18 months. There were no postoperative ruptures or aneurysm-related deaths. At 24 months, freedom from aneurysm-related death was 100%, freedom from secondary interventions was 91%, and freedom from endoleak was 69%. EVAR in the community setting is a safe and durable procedure, even in a medically high-risk population. Comparable outcomes can be achieved to tertiary care centers, in carefully selected patients with favorable anatomy.
Cessation of Epilepsy in an 8-Year-Old Girl Following Removal of Carotid Body Paraganglioma
Authors: Wall Michael L. , Davies Robert S. M. , Warfield Adrian T. , Simms Malcolm H.
Published: October 2008

We present a case of an 8-year-old girl with established focal epilepsy, whose fits resolved permanently after excision of a carotid body paraganglioma.
Cerebral Hyperperfusion After Carotid Stenting: A Transcranial Doppler and SPECT Study
Authors: Sfyroeras Giorgos S. , Karkos Christos D. , Arsos Georgios , Liasidis Charalampos , Dimitriadis Athanassios S. , Papazoglou Konstantinos O. , Gerassimidis Thomas S.
Published: October 2008

Aim: To document the incidence of symptomatic cerebral hyperperfusion after carotid stenting and to determine possible predisposing factors.

Methods: A prospective study of 29 consecutive patients undergoing carotid stenting. All patients underwent 1) brain computed tomography scan and magnetic resonance imaging, 2) transcranial Doppler including assessment of cerebrovascular reactivity of the ipsilateral middle cerebral artery and 3) 99m hexamethyl-propyleneamine oxime brain single photon emission computed tomography, before and after the procedure.

Results: A total of 5 patients developed adverse neurological events, 4 of them transient. Cerebral hyperperfusion was documented in two of these (6.9%). Both had exhausted cerebrovascular reactivity in the preoperative transcranial Doppler examination. No consistent pattern of interhemispheric asymmetry in brain perfusion was found in these patients.

Conclusions: Symptomatic cerebral hyperperfusion is not uncommon after carotid stenting. There seems to be a link between exhausted cerebrovascular reactivity of the ipsilateral middle cerebral artery and increased risk of cerebral hyperperfusion.
Endovascular Management of Hoarseness Due to a Thoracic Aneurysm: Case Report and Review of the Literature
Authors: Lew Wesley K. , Patel Kevin , Haqqani Omar P. , Weaver Fred A.
Published: October 2008

Although uncommon, hoarseness can be a presenting symptom of a thoracic aneurysm. We present a case of a 67-year-old man with hoarseness, subsequently found to have left vocal paralysis. On workup, a computed tomography scan demonstrated a saccular thoracic aneurysm compressing the recurrent laryngeal nerve at the aortopulmonary window. About 6 months after treatment with an endovascular stent graft, the aneurysm sac decreased in size and hoarseness resolved without further surgical intervention. Although uncommonly mentioned as an indication for surgery, hoarseness from a thoracic aneurysm can be successfully managed with endovascular stent grafting.
Pathophysiology, diagnosis, and management of aortic dissection
Authors: Patel Pawan D. , Arora Rohit R.
Published: October 2008

Aortic dissection is an uncommon but potentially fatal disease with catastrophic complications. A high level of suspicion is required for successful diagnosis as presenting symptoms are so variable that dissection may be overlooked in up to 39% of cases. It most commonly presents in the elderly population with a history of chronic hypertension. Rapid intervention is necessary as delay leads to higher mortality. Despite advances in diagnostic and therapeutic techniques, morbidity and mortality remains high. Advances in diagnostic imaging have raised the awareness of variants of aortic dissection, including intramural hemorrhage and penetrating aortic ulcer. This distinction is important as the clinical course of these variants differs from that of classical aortic dissection, and thus treatment may also differ. Understanding of these variants has also led to the recognition of markers that may help predict progression to classical aortic dissection and thus warrant closer vigilance in selected patient populations. The recognition that rapid diagnosis is required for management of aortic dissection has led to the investigation of serum tests as diagnostic aids. Serum smooth muscle myosin heavy chain, d-dimer, and serum soluble elastin fragments are promising tests that may help raise suspicion for the diagnosis of acute aortic dissection. The high mortality associated with surgical therapy has led to investigation of alternative approaches. Endovascular therapy has emerged as a viable option in patients with type B dissection who are too unstable for surgery. However, long-term follow up is required to validate this procedure.
cIAP1-dependent TRAF2 degradation regulates the differentiation of monocytes into macrophages and their response to CD40 ligand
Authors: Dupoux Alban , Cartier Jessy , Cathelin Séverine , Filomenko Rodolphe , Solary Eric , Dubrez-Daloz Laurence
Published: October 2008

Peripheral blood monocytes are plastic cells that migrate to tissues and differentiate into various cell types, including macrophages, dendritic cells, and osteoclasts. We have described the migration of cellular inhibitor of apoptosis protein 1 (cIAP1), a member of the IAP family of proteins, from the nucleus to the Golgi apparatus in monocytes undergoing differentiation into macrophages. Here we show that, once in the cytoplasm, cIAP1 is involved in the degradation of the adaptor protein tumor necrosis factor receptor–associated factor 2 (TRAF2) by the proteosomal machinery. Inhibition of cIAP1 prevents the decrease in TRAF2 expression that characterizes macrophage formation. We demonstrate that TRAF2 is initially required for macrophage differentiation as its silencing prevents Iκ-Bα degradation, nuclear factor-κB (NF-κB) p65 nuclear translocation, and the differentiation process. Then, we show that cIAP1-mediated degradation of TRAF2 allows the differentiation process to progress. This degradation is required for the macrophages to be fully functional as TRAF2 overexpression in differentiated cells decreases the c-Jun N-terminal kinase–mediated synthesis and the secretion of proinflammatory cytokines, such as interleukin-8 and monocyte chemoattractant protein 1 (MCP-1) in response to CD40 ligand. We conclude that TRAF2 expression and subsequent degradation are required for the differentiation of monocytes into fully functional macrophages.