bluuebunny/crossref_metadata_2025 huggingface dataset:
Thinking Through Every Step: How People With Spinal Cord Injuries Relearn to Walk
Authors: Jordan Meggan M. , Berkowitz Dana , Hannold Elizabeth , Velozo Craig A. , Behrman Andrea L.
Published: June 2013

In this article we explore how people with incomplete spinal cord injury (iSCI) create meaning out of their changing bodies as they undergo a therapeutic intervention called locomotor training (LT). Therapeutic interventions like LT are used to promote the recovery of walking ability among individuals with iSCI. The chronological nature of this study—interviews at three points throughout the 12-week intervention—enhances understanding of the recovering self after spinal cord injury. Drawing on a constructivist theoretical framework, we organize data according to three narrative frames. Participants interpreted LT as (a) a physical change that was meaningful because of its social significance, (b) a coping strategy for dealing with the uncertainty of long-term recovery, and (c) a moral strategy to reconstitute the self. We offer findings that lay the conceptual groundwork for generating new knowledge about what is important to people with iSCI as they relearn how to walk.
How HIV Diagnosis and Disclosure Affect Sexual Behavior and Relationships in Ugandan Fishing Communities
Authors: McArthur Moriah , Birdthistle Isolde , Seeley Janet , Mpendo Juliet , Asiki Gershim
Published: June 2013

In this article we examine how members of fishing communities on the shores of Lake Victoria in Uganda respond to HIV diagnosis in terms of disclosure to sexual partners. We then explore the subsequent changes in sexual behavior and relationships. To access this information, we collected life history data from 78 HIV-positive individuals in five fishing communities. We found that the strength of the sexual relationships shaped how and why individuals disclosed to partners, and that these relationships tended to be stronger when partners shared familial responsibility. Those who perceived their current sexual partnership to be weak sought to conceal their status by maintaining prediagnosis patterns of sexual behavior. The majority of the study’s participants rarely changed their sexual behavior following HIV diagnosis, regardless of their relationship’s strength. These findings elucidate barriers to disclosure and behavior change, and suggest that a life-course approach might enhance individual-level counseling so that counselors can provide tailored support to individuals regarding disclosure decisions and outcomes.
Efficacy of the End-of-Life Nursing Care Continuing Education Program for Nurses in General Wards in Japan
Authors: Yoshioka Saori , Moriyama Michiko , Ohno Yumiko
Published: June 2013

This study aimed to examine effectiveness of the End-of-life nursing care continuing education program for general ward nurses. A nonrandomized, before-after trial was conducted. The program was implemented for 25 nurses. The contents of the program consisted of the family assessment, general symptom management and practical use of theories and models regarding end-of-life nursing care. The primary outcome, implementation ability of end-of-life nursing care, was significantly improved after the program; improvements continued even at 2 months after. Similar results were obtained for nurses' confidence and knowledge concerning end-of-life nursing care. As for attitude toward end-of-life care, participants' scores were further elevated after the program. The participants rated the usefulness of the program as high. The effectiveness of the program was suggested from these results. In the future, this program should be widely used for in-service training.
Granulomatous Reaction Within the Thyroid Metastases of a Renal Cell Carcinoma
Authors: D’Angelo Francesco A. , Magistri Paolo , Antolino Laura , Socciarelli Fabio
Published: June 2013

Metastases of non-thyroid malignancies to the thyroid gland have been reported in 1.4% to 3% of patients undergoing thyroid surgery for thyroid malignancy. We report a case of thyroid metastases from renal cell carcinoma in a 57-year-old man, who underwent a left nephrectomy 11 years earlier for a renal cell carcinoma. The histological examination demonstrated a CD-10 positive and thyroglobulin and thyroid transcription factor-1 negative tissue, with numerous noncaseating gigantocellular granulomas. These findings are interesting for the possible role of the immune response in metastatic localizations.
The Impact of Molecular Morphology Techniques on the Expert Diagnosis in Melanocytic Skin Neoplasms
Authors: Ferrara Gerardo , Misciali Cosimo , Brenn Thomas , Cerroni Lorenzo , Kazakov Dmitry W. , Perasole Antonio , Russo Rosa , Ricci Roberto , Crisman Giuliana , Fanti Pier Alessandro , Passarini Beatrice , Patrizi Annalisa
Published: June 2013

Thirteen melanocytic skin neoplasms with a consultation diagnosis by A. Bernard Ackerman were submitted to immunohistochemistry for HMB-45, Ki67, cyclin D1, e-cadherin, and p16; 9/13 cases underwent fluorescence in situ hybridization (FISH) test targeting 6p25 (RREB1), 6q23 (MYB), centromere 6 (Cep6), and 11q13 (CCND1), as well as the centromere 7 (Cep7). A “consensus diagnosis” among 3 experts was also advocated both before and after morphomolecular information. Three neoplasms with a consultation diagnosis of Spitz nevus showed at least 3 abnormal immunohistochemical patterns; 2 of these cases were also FISH-positive for CCND1 gain, but none of them had a final consensus diagnosis of melanoma. Two neoplasms with a consultation diagnosis of congenital nevus received a consensus diagnosis of melanoma. Molecular morphology techniques can highlight the atypical features of melanocytic neoplasms and support existence of a morphobiologic “spectrum”: This should be mirrored in the final report by abandoning the dichotomic (benign vs malignant) diagnostic approach.
Aeroelastic instability analysis of NES-controlled systems via a mixed multiple scale/harmonic balance method
Authors: Luongo Angelo , Zulli Daniele
Published: June 2013

The issue of passively controlling aeroelastic instability of general nonlinear multi-degree-of-freedom systems, suffering from Hopf bifurcation, is addressed. The passive device consists of an essentially nonlinear oscillator (nonlinear energy sink [NES]), having the task of absorbing energy from the main structure. The mathematical problem is attacked by a new algorithm, based on a suitable combination of the multiple scale and the harmonic balance methods. The procedure is able to furnish the reduced amplitude modulation equations, which govern the slow flow around a critical manifold, on which the equilibrium points lie. The method is applied to a sample structure already studied in literature, consisting of a two-degree-of-freedom rigid airfoil under steady wind. It is shown that NES, under suitable conditions, can shift forward the bifurcation point and, moreover, it can reduce the amplitude of the limit cycles. Relevant asymptotic results are compared, for validation purposes, with numerical simulations.
Control of voltage profile with optimal control and placement of distributed generation using the refined bacterial foraging algorithm
Authors: Jaganathan S , Palaniswami S
Published: June 2013

This paper proposes a refined bacterial foraging algorithm (RBFA) for solving the multi-objective based optimal power dispatch with optimal placement of distributed generation (DG) to minimize the total real power loss, generation cost, the environmental emission and considering various controls and limits. The RBFA is based on the social foraging behavior of the Escherichia coli bacteria and its improved version of the basic bacterial foraging algorithm. The RBFA provides natural selection to eliminate poor foraging strategies for bacteria and to propagate other successful foraging strategies where foraging is proceeded using a position updating process, step length, search dimension and search direction with adaptation of basic foraging principles. Initially, the algorithm randomly generates the particle positions representing the size and location of DG and its proposal to solve the simultaneous optimization of the multi-objective problem. The proposed RBFA is used to determine the optimal sizes and locations of multi-DGs; the different types of DG are considered and the load flow is used to calculate the exact loss and to minimize simultaneously the economic cost and the emission of thermal units by changing the location and varying the sizes of the DG units. The test results indicate that the RBFA method can obtain better results than similar social behavior algorithm method on the IEEE30-bus system. The results are compared with and without DG units. The proposed method found the optimal location and sizing of DG units with control of the voltage profile, control of the cost of generation and control and reduction of environmental pollution and transmission losses.
Quality of tomato slices disinfected with ozonated water
Authors: Aguayo Encarna , Escalona Víctor , Silveira Ana Cecilia , Artés Francisco
Published: June 2013

Fresh-cut industry needs novel disinfectant to replace the use of chlorine. Ozone is one of the most powerful oxidizing agents and is applied in gaseous or aqueous form for sanitation purposes. However, the strong oxidative effect could affect the nutritional and sensorial quality, in particular, when time of washing is extended. For that reason, the overall impact of ozonated water (0.4 mg/L) dipping applied during 1, 3 and 5 min compared to control washed in water during 5 min was studied in tomato slices stored during 14 days at 5 ℃. According to the results, ozonated water treatment of 3 min achieved the best firmness retention, microbial quality (mesophilic, psychrotrophic and yeas load) and reduced the consumption of fructose and glucose. The use of ozonated water did not affect the total acidity, pH, total solid soluble, organic acid as ascorbic, fumaric or succinic acid and the sensorial parameters, which were only affected by storage time. However, the poor appearance, aroma and overall quality obtained in all treatments prevented shelf life of 14 days and the quality at acceptable levels was established in 10 days at 5 ℃. It is recommended to wash tomato slices with 0.4 mg/L ozonated water for 3 min only. Extending treatment duration did not improve the microbiological quality, possibly due to the extra time permitting the ozone to react with other components of the fruit tissue, undermining the antimicrobial benefits.
Steady State Laffer Curve with the Underground Economy
Authors: Busato Francesco , Chiarini Bruno
Published: June 2013

This article studies equilibrium effects of fiscal policy within a dynamic general equilibrium model where tax evasion and underground activities are explicitly incorporated. In particular, we show that a dynamic general equilibrium with tax evasion may give a rational justification for a variant of the Laffer curve for a plausible parameterization. From a revenue maximizing perspective, the key policy messages are that bringing tax payers to compliance would be better than threatening to punish them if convicted and that an economy without problems of compliance is much more sensitive to myopic behavior.
The centre of the world: The material construction of Eurocentric domination and hybridity in a Scandinavian 17th-century context
Authors: Nordin Jonas M
Published: June 2013

The New World was present in material representations in the 17th-century castle of Skokloster, Sweden, in contrast to the concepts of history and centrality that were used in the construction of a locality of power in a European colonial society. Material displays, architecture and art visually constructed the New World as an integral, yet inferior, part of the Old World. The commodification of the material culture of the North American Indian reproduced the dominion of the colonial powers but at the same time included the New World in the old. Parallel to this process was the integration of history on the estate. Architecture, the construction of landscape and material culture became an arena for the display of a new, hybrid global culture, signifying the advent of modernity. Although juxtaposed in their display, the New and Old Worlds mingled and created a world of hybridity expressed and executed in the castle and estate of Skokloster.
Beware of notarios: Neoliberal governance of immigrants as crime victims
Authors: Longazel Jamie G , Fleury-Steiner Benjamin
Published: June 2013

Drawing on David Garland’s (1996, 2001) observations about the ‘limits of the sovereign state’, we seek in this article to develop a critical understanding of the recent response in the USA to ‘notario fraud’—an unlawful act committed when a non-lawyer poses as an immigration attorney. While efforts to protect immigrants from fraud on their surface represent a counter to recent anti-immigrant policies, our analysis of materials distributed by what we term an anti-notario fraud apparatus suggests that such activity amounts to neoliberal governance. Specifically, we study immigrant advocacy groups’ discourse around the issue and argue that anti-notario efforts are akin to responsibilization. We also study how law enforcement officials discuss the issue and theorize how a one-dimensional framing of notarios as villains supports the neoliberal regime by protecting the state’s sovereignty to manufacture what Nicholas De Genova (2002) has called ‘deportability’.
The dialectics of multiculturalism: Constructing ‘new citizens’ in Spanish public broadcasting
Authors: Martínez Guillem Susana
Published: June 2013

This article reflects on the symbolic and material bases of multiculturalist ideology as it manifests itself in particular cultural practices taking place across the European Union (EU). To explore some of these dynamics, I focus my discussion on Babel, a Spanish public broadcasting production partially funded by the EU, which aims to promote intercultural dialogue through exposing viewers to different aspects of immigrants’ lives in Spain. The analysis highlights how, while explicitly endorsing multiculturalism and developing a pro-immigration stance, Babel’s stories also promote a restricted and restricting image of desirable immigrants. Thus, the show’s resignification efforts rely mostly on an implicit but systematic association between cultural similarity and economic productivity in its representations of acceptable immigrants. The article’s conclusion argues for the need to re-theorise the co-constitutive relationship between ‘cultural’ and ‘economic’ aspects of multiculturalist practices at large, as well as the specific shapes that they take in Western European societies.
Neoliberal capitalism and middle-class punitiveness: Bringing Erich Fromm’s ‘materialistic psychoanalysis’ to penology
Authors: Cheliotis Leonidas K
Published: June 2013

Why is it that imprisonment has undergone an explosive growth in the USA and Britain over the last three decades against the background of falling crime rates in both countries? And why has this development met with a significant and escalating degree of support among the public? To the extent that governing elites on either side of the Atlantic have been eliciting public support for their authority by inducing concerns about issues of crime and punishment, what explains the selection of crime as a means to this effect, and in what precise ways do crime and punishment fulfil their hidden political function? Moreover, how do Americans and Britons legitimate their consent to objectively irrational policies and the elites responsible for their formulation? In seeking to advance the study of these questions, the present article rediscovers the method and key findings of Erich Fromm’s ‘materialistic psychoanalysis’, bringing them to bear upon insights produced by political economies of contemporary punishment and related scholarship. Particular attention is paid to the hitherto understudied themes of the political production of middle-class support for punitive penal policies under conditions of neoliberal capitalism, and the crucial role played in this process by the privileged position accorded to violent street crime in the public domain.
Through the rearview mirror: Rethinking the Classic Maya Collapse in the light of Postclassic rural social transformation
Authors: Schwarz Kevin R.
Published: June 2013

Recent studies of post-collapse regeneration of early state societies have explained the renewed growth of social complexity using the concepts of template regeneration and stimulus regeneration. While such terms are useful generalized concepts, the discussion around them in practice inhibits an understanding of the various social processes implicated in the renewed growth of states, particularly due to the primary focus on elite urban populations. Rather than emphasizing types of regeneration, my approach analyzes how agents transformed rural communities during collapse and subsequent restructuring. Utilizing a case study from the Petén Lakes region, Guatemala, the article makes the point that rural commoners must be considered active to adequately characterize regeneration. An examination of the base of society focuses on intentional choices made to change settlement patterns, architecture and stone tool procurement and usage in order to better understand heterogeneity in the Classic-Postclassic transformation of Maya society (AD 750–1200).
Compressed sensing techniques for detecting damage in structures
Authors: Mascareñas David , Cattaneo Alessandro , Theiler James , Farrar Charles
Published: June 2013

One of the principal challenges facing the structural health monitoring community is taking large, heterogeneous sets of data collected from sensors, and extracting information that allows the estimation of the damage condition of a structure. Another important challenge is to collect relevant data from a structure in a manner that is cost-effective, and respects the size, weight, cost, energy consumption and bandwidth limitations placed on the system. In this work, we established the suitability of compressed sensing to address both challenges. A digital version of a compressed sensor is implemented on-board a microcontroller similar to those used in embedded SHM sensor nodes. The sensor node is tested in a surrogate SHM application using acceleration measurements. Currently, the prototype compressed sensor is capable of collecting compressed coefficients from measurements and sending them to an off-board processor for signal reconstruction using ℓ1 norm minimization. A compressed version of the matched filter known as the smashed filter has also been implemented on-board the sensor node, and its suitability for detecting structural damage will be discussed.
The Parts and Their Whole
Authors: Longstreth Richard
Published: June 2013

The traditional core of the University of Virginia campus, created by Thomas Jefferson in the early nineteenth century, affords an instructive case study in how restoration of its physical fabric can continue to be a viable treatment, lending new insight on its designer’s intent, while also allowing changes to the complex that have been made over time to remain and enhance its overall historical richness. This both-and planning strategy emphasizes the overarching importance of Jefferson’s scheme, but avoids the constraints of a museum piece or, worse, the lapsing into a themed cliché. The lessons learned with this project carry important implications of the treatment of historic districts that possess transcendent core physical attributes, yet also have other, minor qualities that contribute to the significance of the whole by virtue of their differences.
Anodal Transcranial Direct Current Stimulation Transiently Improves Contrast Sensitivity and Normalizes Visual Cortex Activation in Individuals With Amblyopia
Authors: Spiegel Daniel P. , Byblow Winston D. , Hess Robert F. , Thompson Benjamin
Published: June 2013

Background. Amblyopia is a neurodevelopmental disorder of vision that is associated with abnormal patterns of neural inhibition within the visual cortex. This disorder is often considered to be untreatable in adulthood because of insufficient visual cortex plasticity. There is increasing evidence that interventions that target inhibitory interactions within the visual cortex, including certain types of noninvasive brain stimulation, can improve visual function in adults with amblyopia. Objective. We tested the hypothesis that anodal transcranial direct current stimulation (a-tDCS) would improve visual function in adults with amblyopia by enhancing the neural response to inputs from the amblyopic eye. Methods. Thirteen adults with amblyopia participated and contrast sensitivity in the amblyopic and fellow fixing eye was assessed before, during and after a-tDCS or cathodal tDCS (c-tDCS). Five participants also completed a functional magnetic resonance imaging (fMRI) study designed to investigate the effect of a-tDCS on the blood oxygen level–dependent response within the visual cortex to inputs from the amblyopic versus the fellow fixing eye. Results. A subgroup of 8/13 participants showed a transient improvement in amblyopic eye contrast sensitivity for at least 30 minutes after a-tDCS. fMRI measurements indicated that the characteristic cortical response asymmetry in amblyopes, which favors the fellow eye, was reduced by a-tDCS. Conclusions. These preliminary results suggest that a-tDCS deserves further investigation as a potential tool to enhance amblyopia treatment outcomes in adults.
Fault tree linking versus event tree linking approaches: a reasoned comparison
Authors: Nusbaumer Olivier , Rauzy Antoine
Published: June 2013

Two well-known modelling approaches are in use in probabilistic risk assessment: fault tree linking and event tree linking. The question of which modelling approach is most appropriate for specific applications has been extensively, if not emotionally, debated among experts in the past two decades, addressing both modelling and quantification issues. In this article, we determine their degree of equivalence and build ‘methodological bridges’ between the two approaches from a mathematical and algorithmic perspective. We show that, under certain conditions, both modelling approaches are equivalent. Since both fault tree linking and event tree linking approaches are subject to limitations and approximations, established bridges make it possible to formulate important recommendations for probabilistic risk assessment practitioners and quantification engine developers.
The management of lower urogenital changes in the menopause
Authors: Singh Savita , Herwijnen Ineke van , Phillips Christian
Published: June 2013

Currently, 25% of women seek the advice of a medical professional for symptoms related to the menopause. However, with an increasingly ageing and medically aware population, it is likely this proportion will grow. The main symptoms related to the menopause are systemic vasomotor and localized urogenital symptoms. Numerous forms of estrogen have been used to alleviate these symptoms. Further problems that increase during the menopause include incontinence, pelvic organ prolapse and recurrent urinary tract infections. This article reviews the process by which estrogen affects the tissues of the urogenital tract, what symptoms occur during this period and what modalities of treatments are available.
Combined intravesical sodium hyaluronate/chondroitin sulfate therapy for interstitial cystitis/bladder pain syndrome: a prospective study
Authors: Giberti Claudio , Gallo Fabrizio , Cortese Pierluigi , Schenone Maurizio
Published: June 2013

Objectives:

The aim of this study was to verify the efficacy and safety of intravesical treatment combining sodium hyaluronate (HA) and chondroitin sulfate (CS) in patients with interstitial cystitis/bladder pain syndrome (IC/BPS).

Methods:

Between February 2010 and May 2011, 20 consecutive women with IC/BPS were treated with intravesical instillations containing sodium HA (1.6%; 800 mg/50 ml) and sodium CS (2%; 1 g/50 ml) weekly for the first month, biweekly for the second month, and then monthly for at least 3 months. Before and after treatment, all patients filled in the Interstitial Cystitis Symptom Index and Problem Index (ICSI/ICPI), the Patient Health Questionnaire 9 and the Pelvic Pain and Urgency/Frequency Patient Symptom Scale (PUF). Treatment efficacy was assessed by comparing the pre- and post-treatment mean scores of the three questionnaires using Student’s t test ( p value <0.05 was considered significant).

Results:

Statistically significant mean decreases in ICSI (from 13.0 to 9.3; p = 0.0003), ICPI (from 11.35 to 8.85; p = 0.0078) and PUF (from 20.0 to 15.75; p = 0.0007) questionnaire scores were seen. No cases of side effects or complications were observed. The mean follow up was 5 months.

Conclusions:

Despite the limitations of this study, the outcomes confirmed the role of combination therapy with HA and CS as a safe and effective option for the treatment of IC/BPS. Further randomized controlled studies with a higher number of patients and a longer follow-up period are needed to confirm these results.
The Influence of Meaning-making after Spousal Loss on Trajectories of Psychological Distress
Authors: Young Wendy B. , Foy Steven L.
Published: June 2013

Stress process researchers note that people actively seek to alter the impact of stressful life events through various coping mechanisms. Spousal bereavement sometimes requires individuals to revise their assumptions about the world and themselves. Meaning-making, comprising the dual processes of searching for and finding meaning, may be employed to alleviate symptoms of grief following spousal bereavement. The current study uses multilevel modeling to examine the influence of searching for and finding meaning on individual growth trajectories of psychological distress using data from 764 widows and widowers from a nationally representative longitudinal study. Results indicate that searching for meaning after spousal loss may be a double-edged sword: it is beneficial when meaning is found, but harmful when meaning remains elusive. Widows and widowers who searched for but did not find meaning exhibited the highest initial levels of psychological distress, but they also had slightly faster declines in psychological distress, becoming more similar to other meaning-making groups over time.
Economic Freedom and Employment in India
Authors: Pattanaik Falguni , Nayak Narayan Chandra
Published: June 2013

The recent move of Indian policymakers towards a more open economy with less government control is said to have brought about considerable changes in the policy structure with respect to the size of the government—expenditures, taxes and enterprises—legal structure and security of property rights, regulation of labour and business. Economic freedom, which encompasses these indicators, may have a potential impact on, and may facilitate better integration of, labour market outcomes such as labour quality and creating employment opportunities in India. In a federal system like India’s, economic and political institutions such as business regulation, taxation and government spending differ significantly across states. This study, considering 20 major Indian states, tests the hypothesis that greater economic freedom may lead to higher rates of employment for these states. The results indicate that economic freedom is likely to have a favourable impact on employment. The most important dimensions are strong rule of law and flexible regulations governing credit, labour and product markets. The rise in income per capita is a critical factor in this set-up.

JEL Classification: O40, E24
A Simple Model of Macroeconomic Instability in the Background of the Indian Economy
Authors: Datta Debabrata , Chatterjee Susmita
Published: June 2013

The article first looks at the working of an open economy under a situation of price flexibility in a static framework. This extends the Mundell–Fleming model and shows the effect of exchange rate movement in a richer perspective. The article then introduces the role of depreciation of domestic currency in increasing cost of production by increase in the cost of imported inputs and shows the possibility of multiple equilibria. This could lead to the emergence of an economic crisis in a country that is dependent on critical imported input and also suffering from current account deficit. If the outstanding loan amount of this economy is also large, the chances of a crisis are extremely high and policymakers should introduce measures with all earnestness to set right the situation. The article then considers a dynamic version of the macroeconomic model and shows a variety of equilibria. Although the usual case is one of global stability, there may be saddle point stability as well in several cases where ( a) depreciation of currency increases price substantially and ( b) confidence of the economy is low. But the most critical case could be one under current account deficit when foreign exchange reserves start declining. Here there is saddle point instability and if the confidence level of the economy is low, the economy could be prone to crisis. The article concludes that the Indian economy, in its current state, is exhibiting similar characteristics.

JEL Classification: F41, E32
Integration of HIV and Tuberculosis in the Community
Authors: Frasca Katherine , Cohn Jennifer
Published: June 2013

Current strategies are insufficient to contain the growing tuberculosis (TB) epidemic in areas of high HIV prevalence such as sub-Saharan Africa. Due to the increased risk of morbidity and mortality among those coinfected, early detection is critical. However, strategies dependent on passive, facility-based case finding have failed due to severe limitations in the HIV-positive population. There is growing evidence from multiple clinical trials that early initiation of antiretroviral therapy (ART) in patients coinfected with HIV and TB reduces mortality. Integration of community-based distribution of ART and TB medicines should be considered for coinfected patients to help improve retention in care and to off-load busy health systems. Several models of integration of HIV and TB care in sub-Saharan Africa have been successful. This review article examines the concepts of HIV and TB integration of testing and treatment at the community level.
Management System for a Pediatric Heart Pump
Authors: Johnson Carolynn R.
Published: June 2013

Companies understand that for a product to succeed, it must be designed with the user in mind; they also understand that to design for the user they must know their user. Yet many cling to the idea that they already know their user – knowledge gained through assumptions, anecdotes, customer service logs, sales relationships, and usability testing, rather than through unbiased observations and interviews with users. Design research – ethnography structured to support and inform product design – allows companies to truly understand their users. It illustrates the problems the user is striving to overcome and the obstacles in the way. It articulates the impact a product will have on the user’s life, both positive and negative, and allows for identification of the user’s goals – those willingly shared and those the user cannot or will not articulate. Design research provides insight into the user’s environment and how it, and artifacts within it, affect his or her frustrations and goals. This paper presents a design research case study illustrating the process and showcasing its advantages in the development of a pediatric heart pump management system.
Patient Falls
Authors: Hignett Sue , Griffiths Paula , Sands Gina , Wolf Laurie , Costantinou Eileen
Published: June 2013

Falls have consistently been the largest single category of reported incidents for acute hospital in-patients. The number of falls and risk factors have been identified and reported since the 1950s and are mostly unchanged in the 2010s. The main response to patient falls has been to treat the physiological and psychological presenting symptoms and condition by providing nursing care (mostly through assessment and monitoring) to minimise risk with the patient as a passive care recipient. As over 70% of falls are un-witnessed (unassisted) the active role of the patient in falls has not been fully explored. The new model (DIAL-F) is proposed which reverses the traditional Human Factors / Ergonomics model by describing the system elements in terms of the level of flexibility or transience (duration of action/involvement). The patient is the most transient element of the system, represented as a series of personas (archetypal descriptions) to include physical, cognitive and behavioural changes. This allows a more stimulating, riskier environment described as the ‘ horticultural model of care’.
Is Crew Resource Management Training Effective in Healthcare Settings?
Authors: O’Connor Paul , O’Dea Angela , Keogh Ivan
Published: June 2013

The healthcare industry has seen a recent proliferation in the adoption of team training, such as crew resource management (CRM). Empirical studies of the effectiveness of CRM-type training in healthcare were subjected to meta-analysis. Fourteen CRM evaluation studies were found to fulfill the a priori criteria for inclusion in the meta-analysis. The metrics of CRM training effectiveness analyzed were: reactions, attitudes, knowledge, behaviors, and organization. CRM trained participants responded positively to CRM, the training had large effects on the participants’ knowledge and behaviors, and a medium effect on their attitudes. The training was also found to have a medium effect on the number of errors/adverse events and a small effect on the time to complete clinical tasks. Although there are methodological limitations that mean the results from this study should be treated with a little caution, the findings are nevertheless encouraging.
Human–Systems Integration, Simulation, and the Nursing Shortage
Authors: Schatz Sae , Marraffino Andrea , Allen Christine , Tanaka Alyssa
Published: June 2013

In this paper, we briefly outline the many contributing factors to the nursing shortage and corresponding theory–practice gap. We then present initial research on addressing these shortfalls. In contrast to other treatments of this issue (e.g., Institute of Medicine [IOM], 2011), we specifically emphasize how advancements in medical simulation and its systematic integration could contribute to a solution. Additionally, we emphasize the importance of Human–Systems Integration processes for this course of action.
Challenges of Biomechanical Data Capture in an Anthropometrically Diverse Geriatric Population at Risk for Falls
Authors: Doig Alexa , Merryweather Andrew , Morse Janice , Bloswick Donald
Published: June 2013

A range of methodological challenges were encountered during a biomechanical study of 56 older adults ranging from ages 50-95 years of age. The sample included individuals with strength and gait impairments who were at risk for falls and fall-related injury. Methodological and participant-related issues encountered during data collection were 1) preventing falls and fall-related injuries, 2) difficulty with osteological landmark palpation and retroreflective marker placement due to obesity, 3) retroreflective marker obstruction by body fat and clothing, as well as the safety harness, hospital bed and other structures in the motion capture space, 4) marker loss during in-bed movements, 5) participant fatigue and instability necessitating trial modification. The development of a customized fall arrest system and other solutions will be discussed.
Stress in Medical Residency
Authors: Nystrom Daniel T. , Rantanen Esa M. , Lintern Gavan
Published: June 2013

Resident physicians endure substantial amounts of stress to acquire the necessary skills and knowledge to become competent, certified physicians. Multiple factors that contribute to high levels of stress in different areas of the healthcare domain have been identified, but stress continues to be a major problem despite this knowledge and efforts to reduce it. This study employed the framework of Cognitive Work Analysis to systematically review and organize relevant research literature to gain a holistic understanding of resident stress. The result of our work is a representation of resident physicians’ work domain with relevant literature investigating resident stress associated to each area of the representation. The representation provides an organizational structure to examine sources of stress that have been heavily investigated in the resident physicians work domain and identifies areas that lack systematic research.
Targeting acute myeloid leukemia by dual inhibition of PI3K signaling and Cdk9-mediated Mcl-1 transcription
Authors: Thomas Daniel , Powell Jason A. , Vergez Francois , Segal David H. , Nguyen Nhu-Y. N. , Baker Adele , Teh Tse-Chieh , Barry Emma F. , Sarry Jean-Emmanuel , Lee Erwin M. , Nero Tracy L. , Jabbour Anissa M. , Pomilio Giovanna , Green Benjamin D. , Manenti Stéphane , Glaser Stefan P. , Parker Michael W. , Lopez Angel F. , Ekert Paul G. , Lock Richard B. , Huang David C. S. , Nilsson Susie K. , Récher Christian , Wei Andrew H. , Guthridge Mark A.
Published: June 2013

Key Points

Simultaneous inhibition of Cdk9 and PI3K in human AML cells liberates Bak from both Mcl-1 and Bcl-xL, inducing Bak-dependent apoptosis. Dual inhibitors of Cdk9 and PI3K, such as PIK-75, have broad activity against malignant cells including human AML cells.
Mast cell activation contributes to sickle cell pathobiology and pain in mice
Authors: Vincent Lucile , Vang Derek , Nguyen Julia , Gupta Mihir , Luk Kathryn , Ericson Marna E. , Simone Donald A. , Gupta Kalpna
Published: June 2013

Key Points

Inhibition of mast cells with cromolyn or imatinib results in reduced systemic inflammation and neurogenic inflammation in sickle mice. Pharmacological inhibition or genetic depletion of mast cells in sickle mice ameliorates chronic and hypoxia/reoxygenation-induced pain.
Contrasting effects of Deadend1 (Dnd1) gain and loss of function mutations on allelic inheritance, testicular cancer, and intestinal polyposis
Authors: Zechel Jennifer L , Doerner Stephanie K , Lager Angela , Tesar Paul J , Heaney Jason D , Nadeau Joseph H
Published: June 2013

Background

Certain mutations in the Deadend1 (Dnd1) gene are the most potent modifiers of testicular germ cell tumor (TGCT) susceptibility in mice and rats. In the 129 family of mice, the Dnd1

Ter
mutation significantly increases occurrence of TGCT-affected males. To test the hypothesis that he Dnd1

Ter
allele is a loss-of-function mutation; we characterized the consequences of a genetically-engineered loss-of-function mutation in mice, and compared these results with those for Dnd1

Ter
.

Results

We found that intercrossing Dnd1

+/KO
heterozygotes to generate a complete loss-of-function led to absence of Dnd1

KO/KO
homozygotes and significantly reduced numbers of Dnd1

+/KO
heterozygotes. Further crosses showed that Dnd1

Ter
partially rescues loss of Dnd1

KO
mice. We also found that loss of a single copy of Dnd1 in Dnd1

KO/+
heterozygotes did not affect baseline occurrence of TGCT-affected males and that Dnd1

Ter
increased TGCT risk regardless whether the alternative allele was loss-of-function (Dnd1

KO
) or wild-type (Dnd1

+
). Finally, we found that the action of Dnd1

Ter
was not limited to testicular cancer, but also significantly increased polyp number and burden in the Apc

+/Min
model of intestinal polyposis.

Conclusion

These results show that Dnd1 is essential for normal allelic inheritance and that Dnd1

Ter
has a novel combination of functions that significantly increase risk for both testicular and intestinal cancer.
Transcript profiling by microarray and marker analysis of the short cotton (Gossypium hirsutum L.) fiber mutant Ligon lintless-1 (Li
1
)
Authors: Gilbert Matthew K , Turley Rickie B , Kim Hee Jin , Li Ping , Thyssen Gregory , Tang Yuhong , Delhom Christopher D , Naoumkina Marina , Fang David D
Published: June 2013

Background

Cotton fiber length is very important to the quality of textiles. Understanding the genetics and physiology of cotton fiber elongation can provide valuable tools to the cotton industry by targeting genes or other molecules responsible for fiber elongation. Ligon Lintless-1 (Li

1
) is a monogenic mutant in Upland cotton (Gossypium hirsutum) which exhibits an early cessation of fiber elongation resulting in very short fibers (< 6 mm) at maturity. This presents an excellent model system for studying the underlying molecular and cellular processes involved with cotton fiber elongation. Previous reports have characterized Li

1
at early cell wall elongation and during later secondary cell wall synthesis, however there has been very limited analysis of the transition period between these developmental time points.

Results

Physical and morphological measurements of the Li

1
mutant fibers were conducted, including measurement of the cellulose content during development. Affymetrix microarrays were used to analyze transcript profiles at the critical developmental time points of 3 days post anthesis (DPA), the late elongation stage of 12 DPA and the early secondary cell wall synthesis stage of 16 DPA. The results indicated severe disruption to key hormonal and other pathways related to fiber development, especially pertaining to the transition stage from elongation to secondary cell wall synthesis. Gene Ontology enrichment analysis identified several key pathways at the transition stage that exhibited altered regulation. Genes involved in ethylene biosynthesis and primary cell wall rearrangement were affected, and a primary cell wall-related cellulose synthase was transcriptionally repressed. Linkage mapping using a population of 2,553 F2 individuals identified SSR markers associated with the Li

1
genetic locus on chromosome 22. Linkage mapping in combination with utilizing the diploid G. raimondii genome sequences permitted additional analysis of the region containing the Li

1
gene.

Conclusions

The early termination of fiber elongation in the Li

1
mutant is likely controlled by an early upstream regulatory factor resulting in the altered regulation of hundreds of downstream genes. Several elongation-related genes that exhibited altered expression profiles in the Li

1
mutant were identified. Molecular markers closely associated with the Li

1
locus were developed. Results presented here will lay the foundation for further investigation of the genetic and molecular mechanisms of fiber elongation.
Combined methylation mapping of 5mC and 5hmC during early embryonic stages in bovine
Authors: de Montera Béatrice , Fournier Eric , Shojaei Saadi Habib Allah , Gagné Dominic , Laflamme Isabelle , Blondin Patrick , Sirard Marc-André , Robert Claude
Published: June 2013

Background

It was recently established that changes in methylation during development are dynamic and involve both methylation and demethylation processes. Yet, which genomic sites are changing and what are the contributions of methylation (5mC) and hydroxymethylation (5hmC) to this epigenetic remodeling is still unknown. When studying early development, options for methylation profiling are limited by the unavailability of sufficient DNA material from these scarce samples and limitations are aggravated in non-model species due to the lack of technological platforms. We therefore sought to obtain a representation of differentially 5mC or 5hmC loci during bovine early embryo stages through the use of three complementary methods, based on selective methyl-sensitive restriction and enrichment by ligation-mediated PCR or on subtractive hybridization. Using these strategies, libraries of putative methylation and hydroxymethylated sites were generated from Day-7 and Day-12 bovine embryos.

Results

Over 1.2 million sequencing reads were analyzed, resulting in 151,501 contigs, of which 69,136 were uniquely positioned on the genome. A total of 101,461 putative methylated sites were identified. The output of the three methods differed in genomic coverage as well as in the nature of the identified sites. The classical MspI/HpaII combination of restriction enzymes targeted CpG islands whereas the other methods covered 5mC and 5hmC sites outside of these regions. Data analysis suggests a transition of these methylation marks between Day-7 and Day-12 embryos in specific classes of repeat-containing elements.

Conclusions

Our combined strategy offers a genomic map of the distribution of cytosine methylation/hydroxymethylation during early bovine embryo development. These results support the hypothesis of a regulatory phase of hypomethylation in repeat sequences during early embryogenesis.
Validation of a newly proposed histopathological classification in Japanese patients with anti-neutrophil cytoplasmic antibody-associated glomerulonephritis
Authors: Iwakiri Takashi , Fujimoto Shouichi , Kitagawa Kiyoki , Furuichi Kengo , Yamahana Junya , Matsuura Yunosuke , Yamashita Atsushi , Uezono Shigehiro , Shimao Yoshiya , Hisanaga Shuichi , Tokura Takeshi , Wada Takashi , Kitamura Kazuo , Asada Yujiro
Published: June 2013

Background

A new histopathological classification of anti-neutrophil cytoplasmic antibody (ANCA)-associated glomerulonephritis was recently proposed. We evaluated the predictive value of this classification for renal outcome in Japanese patients.

Methods

We enrolled 122 patients with ANCA-associated glomerulonephritis diagnosed at several institutions in Japan between January 2000 and March 2010. Twenty patients were excluded because of observation durations of <1 year, and/or because their biopsy specimens contained <10 glomeruli. Renal biopsy specimens were categorized into four classes according to the proposed classification. We evaluated the predictive value of immunohistochemical staining for α-smooth muscle actin (SMA), Wilm’s tumor 1 (WT1), CD68, and cytokeratin for end-stage renal disease (ESRD).

Results

The study population included 54 men and 48 women. Age, estimated glomerular filtration rate (eGFR), and proteinuria were 66.3 ± 11.3 years, 21.6 ml/min. and 1.10 g/24 h, respectively. Eighty-six patients were positive for myeloperoxidase-ANCA, five were positive for proteinase 3-ANCA, and 11 were negative for both antibodies. Median follow-up time was 41.0 months. Twenty-three patients (22.5%) developed ESRD during the follow-up period. Twelve patients died during follow up; 7/12 patients developed ESRD before death, and 5/12 patients died without ESRD. The incidence of ESRD increased with sequential categories: focal, 2/46 (4.3%); crescentic, 9/32 (28%); mixed, 8/18 (44%); and sclerotic, 4/6 (67%). The focal class had the best renal survival and the sclerotic class had the worst renal survival (p < 0.001). Kaplan-Meier renal survival analysis was similar to that of the new classification system proposal. In the multivariate analysis, the classification system tended to be a prognostic factor for ESRD (p = 0.0686, crescentic, mixed and sclerotic vs. focal, hazard ratio (HR) [95% confidence interval, CI]; 2.99 [0.61–22.7], 5.04 [1.11–36.4] and 9.93 [1.53–85.7], respectively). α-SMA-positivity also tended to be associated with ESRD (p = 0.1074).

Conclusion

The new histopathological classification was associated with eGFR at 1 year and tended to be associated with ESRD in our Japanese cohort with ANCA-associated glomerulonephritis. α-SMA positivity might be an additional prognostic factor for ESRD.