bluuebunny/crossref_metadata_2025 huggingface dataset:
Challenges in Measuring the Impact of Interruption on Patient Safety and Workflow Outcomes
Authors: Li S. Y. W. , Dunn A. G. , Coeira E. , Magrabi F.
Published: July 2011

Objective: To examine the problem of studying interruption in healthcare.

Methods: Review of the interruption literature from psychology, human-computer interaction; experimental studies of electronic prescribing and error behaviour; observational studies in emergency and intensive care.

Results: Primary task and interruption variables which contribute to the outcomes of an interruption include the type of task (primary and interrupting task); point of interruption; duration of interruption; similarity of interruptive task to primary task; modality of interruption; environmental cues; and interruption handling strategy. Effects of interruption on task performance can be examined by measuring errors, the time on task, interruption lag and resumption lag.

Conclusions: Interruptions are a complex phenomenon where multiple variables including the characteristics of primary tasks, the interruptions themselves, and the environment may influence patient safety and work-flow outcomes. Observational studies present significant challenges for recording many of the process variables that influence the effects of interruptions. Controlled experiments provide an opportunity to examine the specific effects of variables on errors and efficiency. Computational models can be used to identify the situations in which interruptions to clinical tasks could be disruptive and to investigate the aggregate effects of interruptions.
Les ressources de l'imaginaire
Authors: Guiouillier Bertrand
Published: July 2011

L’usage de l’imaginaire est spontané chez l’enfant. Il est une ressource naturelle dont l’adulte use dans la littérature et le cinéma. L’imaginaire est une puissance active au service de l’imagination et de la créativité. Elle est aussi une voie d’accès privilégiée à l’inconscient que les psychanalystes rêve-éveillé utilisent. À travers quelques exemples de cures, l’auteur expose combien l’introduction d’un espace imaginaire dans la cure a un rôle dynamisant, permet la création de soi par soi, il participe à la construction d’une identité plus assurée.
Rêver en séance
Authors: Fabre Nicole
Published: July 2011

Rêver en séance, c’est mettre en jeu et faire jouer ensemble deux imaginaires, celui du patient et celui de l’analyste. A travers l’analyse d’une séquence de cure, nous voyons la patiente accéder à une nouvelle construction du roman de sa vie. Nous sommes amenés à considérer que le rêve-éveillé renforce l’aspect « œuvre analytique » de toute cure par son mode de mise en travail de l’imaginaire
De l'inclassable à « l'espèce d'espace » : l'intermédiarité et ses enjeux en géographie
Authors: Merle Anthony
Published: July 2011

Résumé L’intermédiarité : « mot-valise » supplémentaire ou concept novateur ? L’objectif de cet article est de proposer des éléments de réflexion sur la place de l’intermédiarité en géographie. Chaque géographe, notamment lorsqu’il catégorise l’espace, se retrouve confronté à l’intermédiarité, même s’il n’en utilise pas nécessairement le terme. Comment définir l’intermédiarité et pour quel(s) apport(s) disciplinaire(s) ? Cet article est une synthèse de la bibliographie existante sur le sujet, croisée à un travail de terrain mené dans les Alpes du Nord, plus précisément sur le territoire du syndicat mixte de l’avant-pays savoyard.
Théorie cellulaire, science économique et République dans l'œuvre de François-Vincent Raspail autour de 1830
Authors: Frobert Ludovic
Published: July 2011

Résumé François-Vincent Raspail (1794-1878) fut l’un des principaux héros républicains du xix e siècle français. Son engagement politique débuta au lendemain des Trois Glorieuses de juillet 1830, Raspail jouant rapidement un rôle incontournable tant à la Société des amis du peuple qu’à la Société des droits de l’homme. Opposant politique, il fut aussi un chimiste auteur notamment d’un important Nouveau traité de chimie organique (1833) dans lequel il présentait des avancées majeures dans le domaine de la théorie cellulaire. En 1834-1835, il fondait et dirigeait le journal Le Réformateur où il allait également présenter une longue série de contributions sur la « science économique ». Cet article se propose d’étudier les relations qui se nouent alors dans la réflexion de Raspail entre chimie, idée républicaine et science économique.
L'allégorie romantique
Authors: Margantin Laurent
Published: July 2011

À partir de la célèbre distinction de Goethe entre symbole et allégorie, on associe ordinairement le premier au classicisme et la seconde au romantisme. L’approche de l’allégorie par le premier romantisme allemand ( Frühromantik ) est toutefois marquée par une réflexion philosophique originale à travers laquelle des auteurs comme Friedrich Schlegel et Novalis lui assignent une fonction précise, notamment dans le cadre de l’écriture romanesque, loin des clichés religieux auxquels on renvoie la plupart du temps le romantisme.
Allégories réelles
Authors: Cabanès Jean-Louis , Reverzy Éléonore
Published: July 2011

Le XIX e siècle est le siècle de l’image et de l’imagerie. Il entretient une relation complexe avec l’allégorie, qu’il récuse pour la tradition classique qu’elle inscrit et les conventions qu’elle véhicule, mais qu’il récupère pour ces mêmes conventions – qu’il les détourne par l’ironie ou les réinvente dans de nouveaux contextes, de nouveaux lieux. Le type, avatar de la personnification allégorique, est ainsi une mise en forme de la pensée en offrant une synthèse du réel. Il place l’universel face au singulier auquel il ne se réduit pas, lors même qu’il en existe une clef, un modèle. Il se fonde sur une doxa ou sur un réservoir d’images qui assure son efficacité et sa reconnaissance par le lecteur. L’allégorie sert également à figurer des instances psychiques et à concrétiser des sentiments abstraits, non sans ironie, comme c’est le cas chez Flaubert et les Goncourt.
« Je ne suis pas en train de parler d'autres choses » : l'allégorie politique dans l'œuvre poétique de Victor Hugo
Authors: Charles-Wurtz Ludmila
Published: July 2011

Une lecture politique des Contemplations se superpose à la lecture autobiographique. Le deuil que dit le poète est celui de l’enfant noyée dans la Seine, mais aussi celui de la liberté ; car, depuis le coup d’État du 2 décembre 1851, la liberté est « couchée à terre/Comme une femme morte et qu’on vient de noyer » ( Châtiments , I, 11). On se demandera quels liens ce recueil entretient avec celui, explicitement politique, qu’est Châtiments , et comment le sens autobiographique et le sens allégorique du recueil se combinent. Si Hugo juge nécessaire de créer une allégorie politique trois ans après la publication d’un recueil explicitement politique, c’est parce que le point de vue adopté dans les deux recueils n’est pas le même : dans Les Contemplations , c’est la souffrance du sujet historique (du sujet singulier s’éprouvant comme sujet de l’Histoire), et non plus celle du sujet collectif (le peuple), qui est représentée. Ce phénomène n’est pas isolé dans les recueils postérieurs à la proscription. Le rapport qu’entretiennent L’Année terrible (1872) et L’Art d’être grand-père (1877) est analogue à celui qui lie Les Contemplations à Châtiments .
Sculpter l'indicible : crises de l'allégorie autour de 1848
Authors: Baridon Laurent
Published: July 2011

L’allégorie sculptée envahit l’espace public comme les intérieurs de la bourgeoisie à partir du milieu du XIX e siècle. Le phénomène est paradoxal car la statuaire et l’allégorie sont l’une et l’autre déconsidérées. La crise qui les touche est d’abord esthétique. Le Romantisme promeut le symbole et Baudelaire stigmatise cet « art de Caraïbes » qu’est la sculpture. Le discrédit est aussi politique. Après avoir triomphé pendant la Révolution, la statuaire allégorique semble impuissante à incarner les idéaux républicains en 1848. Cette étude de la Fontaine Saint-Michel propose l’hypothèse que l’allégorie acquiert un fonctionnement symbolique au début du Second Empire. Érigée au cœur du nouveau Paris et sur les ruines des combats de juin 1848, elle place la cité et la nation sous la protection d’un archange victorieux du Diable, incarnation d’une république sociale, encadré des deux chimères représentant ses « faux systèmes » politiques. Suggérée par Jules Castagnary, cette interprétation ne devait pas être perçue par la foule des trottoirs. Omniprésente, l’allégorie était devenue une marchandise proliférant sur les bibelots des salons, aux devantures des boutiques ou sur les places publiques, une de ses « fantasmagories » décrites par Walter Benjamin.
Une légitimation critique du roman historique : l'exemple de Cinq-Mars
Authors: Hautbout Isabelle
Published: July 2011

Pionnier du roman historique tel qu’il se développe en France au XIX e siècle, Alfred de Vigny doit le défendre contre des accusations de mensonge. C’est ainsi qu’en 1829, il fait précéder Cinq-Mars de « Réflexions sur la vérité dans l’art ». La défense des choix du romancier contre les prétentions des historiens ne se limite cependant pas à ce manifeste idéaliste ; elle se trouve au cœur même du roman. Vigny y met en cause les interprétations surnaturelles invoquant la Providence ou le Destin pour expliquer des faits auxquels il applique plutôt des causes humaines et une lecture politique. Critique envers Richelieu, son analyse s’oppose à des sources grossièrement louangeuses, qui ne sont guère citées que pour être contredites et complexifiées. Plus largement, Cinq-Mars met en doute la possibilité d’appréhender et de représenter une réalité insaisissable. Le roman suggère cependant qu’il peut en offrir le reflet le plus fidèle en s’affirmant comme illusion. Vigny légitime ainsi le genre émergeant du roman historique en engageant une interrogation profonde de l’écriture des faits, des êtres et du monde.
L'assurantialisation de la société française
Authors: Ewald François
Published: July 2011

Résumé La Révolution française avait interdit l’assurance. Aussi bien les assurances sur la vie (« La vie n’a pas de prix », disait Portalis) que les assurances de biens (elles invitent à la négligence). Deux siècles plus tard, l’examen du budget des protections montre qu’en presque totalité elles relèvent de l’assurance. En matière de sécurité, le phénomène essentiel est l’assurancialisation de la société, processus qui s’est poursuivi continuellement sous l’égide de politiques publiques pourtant adossées sur des programmes fort différents : « responsabilité » au XIX e siècle, « solidarité » au XX e . Les politiques de protection futures sont déterminées par la gestion de cet héritage.
Student-Centered Outcomes Evaluation of the Clinical Immersion Program: Five Years Later
Authors: Diefenbeck Cynthia A. , Hayes Evelyn R. , Wade Gail H. , Herrman Judith W.
Published: July 2011

Curricular innovation is an ever-present element of nursing education. It is incumbent for nurse educators to evaluate their curricula and its outcomes to ensure quality nursing education. This article describes a comprehensive student-centered outcome evaluation of the Clinical Immersion Model. This model and the foundational components unique to the curricular design and the senior clinical immersion are described. Several methods of evaluation, including National Council Licensure Examination for Registered Nurses pass rates, exit surveys, alumni surveys, and a senior nursing student focus group, are presented. Implications of this evaluation and future directions are explored to inform potential implementation and adaptation of this effective curriculum by other schools of nursing.
Animosity, Antagonism, and Avatars: Teaching Conflict Management in Second Life
Authors: Evans Dena A. , Curtis Anthony R.
Published: July 2011

Conflict exists in all health care organizations and may take many forms, includinglateralorhorizontal violence. The Essentials of Baccalaureate Nursing Educationidentified the development of conflict resolution strategies as core knowledge required of the bachelor’s of science in nursing generalist. However, learning the art of conflict management takes both time and practice. With competition for clinical space increasing, class time in short supply, and traditional clinical opportunities for teaching conflict management lacking, a virtual approach to teaching conflict resolution was explored through the use of Second Life®. The project presented here explored students’ perceptions of this unique approach to learning conflict management and sought to examine the effectiveness of this teaching method.
Optical Coherence Tomography in the Diagnosis and Management of Optic Neuritis and Multiple Sclerosis
Authors: Costello Fiona E. , Klistorner Alexander , Kardon Randy
Published: July 2011

Optic neuritis (ON) is an inflammatory optic nerve injury, which is strongly associated with multiple sclerosis (MS). Optical coherence tomography (OCT) has the potential to provide a reliable means of capturing axonal deficits, which can be paired to tests of visual function to provide a structural–functional paradigm of brain injury. In this respect, the eye provides a unique view into the effects of central nervous system inflammation, which may enhance the understanding of disease mechanisms that contribute to neurological disability in MS. This review addresses the published experience with OCT in the diagnosis and treatment of patients with ON and MS, and discusses the applications of OCT in ongoing clinical trials. The potential gains and limitations of spectral-domain OCT as an evolving technology and surrogate marker of axonal brain injury are also discussed.
Extracellular Histones Are Mediators of Death through TLR2 and TLR4 in Mouse Fatal Liver Injury
Authors: Xu Jun , Zhang Xiaomei , Monestier Marc , Esmon Naomi L. , Esmon Charles T.
Published: July 2011

We previously reported that extracellular histones are major mediators of death in sepsis. Infusion of extracellular histones leads to increased cytokine levels. Histones activate TLR2 and TLR4 in a process that is enhanced by binding to DNA. Activation of TLR4 is responsible for the histone-dependent increase in cytokine levels. To study the impact of histone release on pathology we used two models: a Con A-triggered activation of T cells to mimic sterile inflammation, and acetaminophen to model drug-induced tissue toxicity. Histones were released in both models and anti-histone Abs were protective. TLR2- or TLR4-null mice were also protected. These studies imply that histone release contributes to death in inflammatory injury and in chemical-induced cellular injury, both of which are mediated in part through the TLRs.
Silencing MicroRNA-155 Ameliorates Experimental Autoimmune Encephalomyelitis
Authors: Murugaiyan Gopal , Beynon Vanessa , Mittal Akanksha , Joller Nicole , Weiner Howard L.
Published: July 2011

IFN-γ–producing Th1 and IL-17–producing Th17 cells are the key participants in various autoimmune diseases, including multiple sclerosis and its animal model, experimental autoimmune encephalomyelitis (EAE). Although both of these T cell subsets are known to be regulated by specific transcription factors and cytokines, the role of microRNAs that control these two inflammatory T cell subsets and whether targeting microRNAs can have therapeutic effects are not known. In this study, we show that microRNA-155 (Mir-155) expression is elevated in CD4+ T cells during EAE, and Mir-155−/− mice had a delayed course and reduced severity of disease and less inflammation in the CNS. The attenuation of EAE in Mir-155−/− mice was associated with a decrease in Th1 and Th17 responses in the CNS and peripheral lymphoid organs. The T cell-intrinsic function of Mir-155−/− was demonstrated by the resistance of Mir-155−/− CD4+ T cell-repleted Rag-1−/− mice to EAE. Finally, we found that anti–Mir-155 treatment reduced clinical severity of EAE when given before and after the appearance of clinical symptoms. These findings demonstrate that Mir-155 confers susceptibility to EAE by affecting inflammatory T cell responses and identify Mir-155 as a new target for therapeutic intervention in multiple sclerosis.
Immune Unresponsiveness to Secondary Heterologous Bacterial Infection after Sepsis Induction Is TRAIL Dependent
Authors: Gurung Prajwal , Rai Deepa , Condotta Stephanie A. , Babcock Jeffrey C. , Badovinac Vladimir P. , Griffith Thomas S.
Published: July 2011

Sepsis is the leading cause of death in most intensive care units, and patients who survive the hyperinflammation that develops early during sepsis later display severely compromised immunity. Not only is there apoptosis of lymphoid and myeloid cells during sepsis that depletes these critical cellular components of the immune system, but also the remaining immune cells show decreased function. Using a cecal-ligation and puncture (CLP) model to induce intra-abdominal polymicrobial peritonitis, we recently established a link between the apoptotic cells generated during sepsis and induction of sepsis-induced suppression of delayed-type hypersensitivity. The present study extends this earlier work to include a secondary heterologous bacterial infection (OVA257-expressing Listeria monocytogenes [LM-OVA]) subsequent to sepsis initiation to investigate sepsis-induced alterations in the control of this secondary infection and the associated naive Ag-specific CD8 T cell response. We found that CLP-treated wild-type (WT) mice had a reduced ability to control the LM-OVA infection, which was paralleled by suppressed T cell responses, versus sham-treated WT mice. In contrast, CLP-treated Trail−/− and Dr5−/− mice were better able to control the secondary bacterial infection, and the Ag-specific CD8 T cell response was similar to that seen in sham-treated mice. Importantly, administration of a blocking anti-TRAIL mAb to CLP-treated WT mice was able to restore the ability to control the LM-OVA infection and generate Ag-specific CD8 T cell responses like those seen in sham-treated mice. These data further implicate TRAIL-dependent immune suppression during sepsis and suggest TRAIL neutralization may be a potential therapeutic target to restore cellular immunity in septic patients.
Adoption of Health Information Exchange by Emergency Physicians at Three Urban Academic Medical Centers
Authors: Shapiro J. , Vaidya S. , Kuperman G. , Genes N.
Published: July 2011

Objectives: Emergency physicians are trained to make decisions quickly and with limited patient information. Health Information Exchange (HIE) has the potential to improve emergency care by bringing relevant patient data from non-affiliated organizations to the bedside. NYCLIX (New York CLinical Information eXchange) offers HIE functionality among multiple New York metropolitan area provider organizations and has pilot users in several member emergency departments (EDs).

Methods: We conducted semi-structured interviews at three participating EDs with emergency physicians trained to use NYCLIX. Among “users” with > 1 login, responses to questions regarding typical usage scenarios, successful retrieval of data, and areas for improving the interface were recorded. Among “non-users” with ≤1 login, questions about NYCLIX accessibility and utility were asked. Both groups were asked to recall items from prior training regarding data sources and availability.

Results: Eighteen NYCLIX pilot users, all board certified emergency physicians, were interviewed. Of the 14 physicians with more than one login, half estimated successful retrieval of HIE data affecting patient care. Four non-users (one login or less) cited forgotten login information as a major reason for non-use. Though both groups made errors, users were more likely to recall true NYCLIX member sites and data elements than non-users. Improvements suggested as likely to facilitate usage included a single automated login to both the ED information system (EDIS) and HIE, and automatic notification of HIE data availability in the EDIS All respondents reported satisfaction with their training.

Conclusions: Integrating HIE into existing ED workflows remains a challenge, though a substantial fraction of users report changes in management based on HIE data. Though interviewees believed their training was adequate, significant errors in their understanding of available NYCLIX data elements and participating sites persist.
Leitura e metacognição: uma experiência em sala de aula
Authors: Neves Dulce Amélia de Brito
Published: July 2011

Focaliza o ensino de estratégias metacognitivas de leitura no curso de Especialização em Gestão de Unidades de Informação, durante a primeira parte da disciplina “Representação do conhecimento e da informação”. O foco central está voltado para a relação entre cognição, metacognição, construção de conceitos e a representação da informação. Evidencia, ainda, a importância de uma permanente reconstrução de conhecimentos, saberes e atitudes, assinalando com a perspectiva da construção de caminhos possíveis para a formação dos profissionais da informação, de modo a incorporar as mudanças que poderão compor um novo perfil desse profissional.
Aspectos profissionais do bibliotecário
Authors: Figueiredo Marco Aurélio Castro de , Souza Renato Rocha
Published: July 2011

O presente artigo apresenta os resultados de uma pesquisa bibliográfica seguida de um survey, que buscaram caracterizar a atuação do profissional bibliotecário no contexto social atual. Os resultados apontam para um mercado heterogêneo e em transformação, assim como para os grandes desafios a serem enfrentados pelos profissionais na sociedade atual.
Tecnologia de identificação por radiofreqüência: fundamentos e aplicações em automação de bibliotecas
Authors: Godoy Viera Angel Freddy , Viera Sonia Dominga Godoy , Viera Lourdes Elizabeth Godoy
Published: July 2011

A tecnologia de identificação por radiofreqüência (RFID) é a mais nova tecnologia que, de forma acelerada, está sendo introduzida nas principais bibliotecas do mundo para a gestão eletrônica do acervo e implementação de serviços de auto-atendimento, entre outros serviços. Este artigo tem por objetivo apresentar os princípios de funcionamento da tecnologia RFID, seus componentes, as barreiras na adoção desta tecnologia e exemplos de iniciativas de implementação em bibliotecas. A metodologia utilizada foi a pesquisa bibliográfica e documental sobre a tecnologia RFID com aplicação em bibliotecas. Os resultados do trabalho mostram que esta tecnologia está se expandindo cada vez mais em nível mundial, no âmbito das bibliotecas. Conclui-se que a tecnologia RFID é uma das tecnologias de automação de bibliotecas que deve ser considerada na gestão eletrônica do acervo, tendo em vista às grandes vantagens que oferece.
O tesouro de conhecimentos de um bairro chamado maré: pessoas como fontes de informação
Authors: Chalaça Anderson Morais , Freire Isa Maria , Miranda Marcos Luiz Cavalcanti de
Published: July 2011

Apresenta o resultado de pesquisa, em nível exploratório, abordando as pessoas, cidadãos comuns, como fontes de informação para uma dada comunidade, na perspectiva da responsabilidade social do profissional bibliotecário. Discorre sobre o campo da pesquisa, o bairro Maré e suas comunidades. Utiliza a metodologia da pesquisa-ação para criar uma equipe de pesquisa e investigar a existência dessas pessoas e sua atuação como fontes de informação na comunidade. Procura dar visibilidade ao “invisível”, identificando onde e como funcionam a busca, recuperação e uso da informação nas pessoas detentoras de conhecimento, em uma dada comunidade. Utiliza a técnica de entrevista estruturada para o registro do conhecimento de uma dessas fontes, seus ofícios e talentos, revelando como adquiriu esse conhecimento e se o transmite para outras pessoas. Apresenta um formato para um sítio virtual contendo o Tesouro de conhecimentos de Comunidades da Maré.
Weaning of opioids and benzodiazepines at home after critical illness in infants: A cost-effective approach
Authors: Ista, PhD, RN Erwin , Van Dijk, PhD Monique , Gischler, MD, PhD Saskia , De Leeuw, RN Mirjam , Poley, PhD Marten J. , Tibboel, MD, PhD Dick
Published: July 2011

Objective: To evaluate the feasibility of infants’ weaning of opioids and sedatives at home.Design: Retrospective observational study.Setting: Level 3 pediatric intensive care unit.Patients: Neonates treated for congenital diaphragmatic hernia (CDH) with extra corporeal membrane oxygenation (ECMO).Intervention: Eligible infants were discharged early and further weaned of analgesics and/or sedatives at home.Results: Of the 30 neonates treated for CDH with ECMO from 2003 to 2005, 15 survived. Five of these were weaned at home, on the guidance of telephone contact once a week. The mean infusion rates of morphine and midazolam for these children were significantly higher than those for other infants. Weaning at home took 11, 42, 107, 173, and 180 days, respectively, in the resultant mean savings on hospitalization costs per patient amounted to €150,000.Conclusions: The results indicate that home weaning reduced the length of hospital stay by a median of 107 days for the five infants in this study, and thereby considerably reduced healthcare costs. Parents need to be informed clearly about possible withdrawal symptoms and should consent in this strategy. The strategy of final weaning with the aid of weekly telephone consultations with a consultant pediatric intensivist was feasible for these parents.
Evaluation of study discontinuations with tapentadol immediate release and oxycodone immediate release in patients with low back or osteoarthritis pain
Authors: Vorsanger, PhD, MD Gary , Xiang, PhD Jim , Okamoto, ScD Akiko , Upmalis, MD David , Moskovitz, MD Bruce
Published: July 2011

Objective: To examine discontinuations due to nausea and/or vomiting or constipation with tapentadol immediate release (IR) or oxycodone IR treatment.Design: Post hoc analyses of a 90-day, phase 3, randomized, double-blind, flexibledose study.Setting: United States, Canada, United Kingdom.Patients: Adults with moderate to severe low back or osteoarthritis (OA) pain for ≥3 months.Interventions: Tapentadol IR 50 or 100 mg or oxycodone HCl IR 10 or 15 mg every 4-6 hours as needed.Main outcome measures: Adverse events and discontinuations were recorded.Results: Post hoc analyses included data from 679 patients receiving tapentadol IR and 170 receiving oxycodone IR (4:1 randomization). Tapentadol IR 50 or 100 mg and oxycodone HCl IR 10 or 15 mg provided similar levels of pain relief. Overall, 21.2 percent of patients receiving tapentadol IR discontinued treatment for adverse events versus 31.2 percent of patients receiving oxycodone IR. The percentage of patients who discontinued for nausea and/or vomiting was significantly lower with tapentadol IR (5.9 percent) than oxycodone IR (14.7 percent; p = 0.0003); patients treated with oxycodone IR discontinued because of nausea and/or vomiting significantly earlier than with tapentadol IR (p < 0.0001). The percentage of patients who discontinued because of constipation was significantly lower with tapentadol IR (1.5 percent) than with oxycodone IR (5.9 percent; p = 0.0023); patients treated with oxycodone IR discontinued because of constipation significantly earlier versus tapentadol IR (p = 0.0003).Conclusions: A lower percentage of patients discontinued because of nausea and/or vomiting or constipation with tapentadol IR versus oxycodone IR while receiving comparable pain relief, suggesting tapentadol may improve the management of low back and OA pain.
Long-term tolerability and effectiveness of oxymorphone extended release in patients with cancer
Authors: Slatkin, MD Neal E. , Rhiner, RN, MSN, NP Michelle I. , Gould, PhD Errol M. , Ma, PhD Tina , Ahdieh, PhD Harry
Published: July 2011

Objective: To evaluate the long-term safety, tolerability, and effectiveness of oxymorphone extended release (ER) in patients with cancer-related pain.Design: Post hoc analysis of two ≥1-year open-label extension studies.Setting: Multiple US cancer treatment facilities.Patients: Patients with cancer pain who had participated in two short-term crossover comparator trials of oxymorphone ER: one open-label and one doubleblind randomized.Interventions: Patients who had been taking oxymorphone ER continued the dose established in the previous study. Patients who had been taking a comparator opioid were switched to an equianalgesic dose of oxymorphone ER. All patients underwent individualized oxymorphone ER dose titration to optimize effectiveness and tolerability.Assessments: Current, average, worst, and least pain scores were normalized to a 100-point scale. Patients rated treatment on a five-point global assessment of study medication (Poor = 1 to Excellent = 5). All adverse events (AEs) were recorded.Results: Of the 80 patients who entered the extension trials, 26 completed 52 weeks, 7 discontinued owing to loss of effectiveness, and 20 discontinued owing to AEs, most of which were unrelated to study drug. No significant increase in mean (standard deviation [SD]) average pain intensity was observed from baseline (30.5 [19.6], 100-point scale) to final visit (35.9 [21.1], p = 0.37). The most common AEs were concomitant disease progression (28.8 percent, n = 23), nausea (22.5 percent, n = 18), dyspnea (16.3 percent, n = 13), fatigue (16.3 percent, n = 13), and edema of the lower limb (15 percent, n = 12).Conclusions: In these patients with pain related to cancer, oxymorphone ER was generally well tolerated and provided stable long-term pain control.
Psychosocial distress in patients treated for cancer pain: A prospective observational study
Authors: O’Mahony, MB BCh, BAO Sean , Goulet, PhD Joseph Lucien , Payne, MD Richard
Published: July 2011

Introduction: Untreated emotional distress negatively impacts the management of cancer pain.Objectives: The authors evaluated 64 patients with cancer pain who completed baseline and follow-up measures to identify if (1) measures of psychosocial wellbeing, pain intensity, and pain management were associated with survival time; (2) higher opioid doses were associated with less psychosocial distress; and (3) intrasubject correlations across time altered the relationship between pain, depression, social support, spirituality, and increased desire for hastened death (DHD).Methods: The main outcome measures included the Brief Pain Inventory (BPI), Daily Morphine Equivalent Dose (DMED), Beck Depression Inventory-II (BDI-II), DHD scale, Bottomley Social Support Scale, FACIT Spiritual Well-Being Scale (FACIT-Sp), Karnofsky Performance Rating Scale (KPRS), and State-Trait Anxiety Inventory (STAI).Results: There were significant differences between baseline and follow-up DHD (0.84 vs 1.38, p = 0.021) and BPI scores (6.36 vs 4.86, p < 0.001). Lower existential wellbeing was associated with reduced survival (HR = 0.78, p = 0.019); improvement in pain was associated with longer survival (HR = 1.33, p = 0.034). Higher religious wellbeing was associated with higher probability of survival to 1 year (HR = 0.41, p = 0.014), as was higher KPRS (HR = 0.97, p = 0.001) but not DMED > 300 mg. Higher existential distress and lower Bottomley scores were associated with higher hazard ratios for death at 1 year (HR = 2.78, p = 0.02) and (HR = 14.94, p = 0.002). There were significant differences in average BDI-II for persons with BPI > 7 versus those with moderate or mild pain (12.12 vs 6.82, p < 0.0001) and in DHD (1.71 vs 0.64, p = 0.002). Depression decreased in persons with DMED > 300 mg between baseline and follow-up (−1.67 vs 2.72, p = 0.024). Mean DHD was lower for persons whose pain improved versus others (0.96 vs 2.0, p = 0.026). A generalized linear model was conducted with DHD as the dependent variable and the other above variables as predictors. Higher existential wellbeing and KPRS were associated with lower DHD (β = −0.135, p = 0.049) and (β = −0.79, p = 0.006), respectively.Conclusions: The major findings of this study are that in persons with cancer pain, lower social support and existential wellbeing, but not higher DMED, were associated with shorter survival time. Treatment of cancer pain was associated with lessening of emotional distress. Lower levels of existential wellbeing and physical performance status appear to be associated with greater DHD.
Steady-state pharmacokinetics of extended-release hydromorphone (OROS® hydromorphone): A randomized study in healthy volunteers
Authors: Moore, MSc Kenneth Todd , St-Fleur, BSc Dominique , Marricco, MSc Nadia Cardillo , Ariyawansa, MSc Jay , Pagé, MSc Véronique , Natarajan, PhD Jayalakshmi , Morelli, MD, FRCP Gaetano , Richarz, MD Ute
Published: July 2011

The steady-state pharmacokinetics of an extended-release formulation of hydromorphone, OROS® hydromorphone, was investigated in a randomized, openlabel, crossover study in healthy volunteers. Participants were randomly assigned to receive 16 mg of OROS hydromorphone once daily and 4 mg of immediaterelease hydromorphone four times daily for five consecutive days. The two treatments were separated by a washout period of 7-14 days. Naltrexone was given throughout both treatment periods to block the opioid effects of hydromorphone. Steady-state hydromorphone concentrations were statistically analyzed using Helmert contrasts to determine when steady state was reached. A total of 30 participants were enrolled, of whom 29 completed both treatment periods. The two treatments produced comparable steady-state plasma drug concentrations, but peakto-trough fluctuations were smaller with OROS hydromorphone (61 percent vs 172 percent) in comparison with immediate release hydromorphone. Overall systemic exposure to hydromorphone was similar between the two formulations. The ratio of the geometric means between the two formulations for the area under the concentration-time curves at steady state was 105.2 percent with a 90% confidence interval (CI) of 99.8-110.8 (geometric mean: 102.7 percent; 90% CI: 97.6-108.2 after correcting for measured drug content), which was within the bioequivalence range (80-125 percent). The analysis of Helmert contrasts showed that steadystate conditions were attained by day 4. Both treatments were well tolerated. This study shows that OROS hydromorphone maintains steady-state plasma drug concentrations within the same range as immediate-release hydromorphone at the same total daily dose, with less fluctuation.
Considerations for the upcoming FDA REMS proposal
Authors: Peppin, DO, FACP John F. , Coleman, PhD John J , Kirsh, PhD Kenneth L.
Published: July 2011

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Supra Acetabular Bone Mineral Density Measurements after Hip Resurfacing Arthroplasty at Short Term Follow Up
Authors: Yahia Chabane Ait , Diwanji Sanket , Ganapati Muthu , Vendittoli Pascal-André , Lavigne Martin
Published: July 2011

Implantation of a cementless press-fit acetabular cup during hip arthroplasty alters stress transfer to the periacetabular bone, resulting in stress shielding of cancellous bone and enhanced load transfer to cortical bone. Theoretically, the thicker, stiffer and larger acetabular cup of a hip resurfacing may increase periacetabular bone stress shielding.

We attempted to assess the matter (at a minimum of 2 years after surgery) by measuring any difference in supra acetabular bone mineral density (BMD) between the side implanted with a thick monoblock cobalt-chromium (Co-Cr) acetabular component during hip resurfacing (HR) and the opposite non-operated side.

We retrospectively recruited 44 patients who had undergone metal-on-metal hybrid hip resurfacing for unilateral osteoarthritis of the hip joint. BMD of the supra acetabular bone of both hips was measured using a dual energy X-ray absorptiometry (DEXA) scan.

The BMD measured in Zone 2 was not different on the operated side (1.69 g/cm2 ± 0.48) compared with the non-operated side (1.70 g/cm2 ±0.49) (p=0.904).

Contrary to our expectations, implantation of a monoblock Co-Cr acetabular component during HR did not cause significant stress-shielding of supra acetabular cancellous bone.
Bacterial display in combinatorial protein engineering
Authors: Löfblom John
Published: July 2011

Technologies for display of recombinant protein libraries are today essential tools in many research‐intensive fields, such as in the drug discovery processes of biopharmaceutical development. Phage display is still the most widely used method, but alternative systems are available and are becoming increasingly popular. The most rapidly expanding of the alternative systems are the cell display‐based technologies, offering innovative strategies for selection and characterization of affinity proteins. Most investigations have focused on eukaryotic yeast for display of protein libraries, but similar systems are also being developed using prokaryotic hosts. This review summarizes the field of bacterial surface display with a strong emphasis on library applications for generation of new affinity proteins. The main focus will be on the most recent progress of the work on primarily Escherichia coli, but also on studies using a recently developed system for display on Gram‐positive Staphylococcus carnosus. In addition, general strategies for combinatorial protein engineering using cell display are discussed along with the latest developments of new methodologies with comparisons to mainly phage display technology.
Bioprocess monitoring by marker gene analysis
Authors: Schweder Thomas
Published: July 2011

The optimization and the scale up of industrial fermentation processes require an efficient and possibly comprehensive analysis of the physiology of the production system throughout the process development. Furthermore, to ensure a good quality control of established bioprocesses, on‐line analysis techniques for the determination of marker gene expression are of interest to monitor the productivity and the safety of bioprocesses. A prerequisite for such analyses is the knowledge of genes, the expression of which is critical either for the productivity or for the performance of the bioprocess. This work reviews marker genes that are specific indicators for stress‐ and nutrient‐limitation conditions or for the physiological status of the bacterial production hosts Bacillus subtilis, Bacillus licheniformis and Escherichia coli. The suitability of existing gene expression analysis techniques for bioprocess monitoring is discussed. Analytical approaches that enable a robust and sensitive determination of selected marker mRNAs or proteins are presented.
Low‐Dimensional Frameworks in Solid State Chemistry of Mo6 and Re6 Cluster Chalcohalides
Authors: Perrin André , Perrin Christiane
Published: July 2011

The low‐dimensional Mo6 and Re6 cluster chalcohalides synthesised from solid‐state reactions at high temperature are reviewed. Their crystal structures are described in terms of interunit connectivities involving inner and apical ligands shared between adjacent cluster units. It will be shown that such architectures are controlled by the geometry of the M6L14 cluster units, the steric hindrance of the ligands linked to the M6 cluster, the specific location imposed on the halogen or chalcogen ligand and the most favourable electron count on the cluster core, considering halogen and chalcogen stoichiometries.
Lanthanide Aminoisophthalate Coordination Polymers: A Promising System for Tunable Luminescent Properties
Authors: Luo Yun , Calvez Guillaume , Freslon Stéphane , Bernot Kevin , Daiguebonne Carole , Guillou Olivier
Published: July 2011

Reactions in water between the disodium salt of 5‐amino‐1,3‐benzenedicarboxylic acid or 5‐aminoisophthalate (Na2aip) and lanthanide chlorides lead to two families of coordination polymers with the respective general chemical formulae {[Ln6(aip)7(H2O)24]·2(aip)·6H2O}∞in which Ln = Tm or Yb (Family 1) and {[Ln2(aip)2(H2O)10]·(aip)·4H2O}∞in which Ln = La–Er (except Pm) or Y (Family 2). Compounds belonging to Family 1 are isostructural. The crystal structure has been solved for the Er‐containing compound. This compound crystallizes in the monoclinic system, space groupP21/n(n°14) witha= 13.3439(3) Å,b= 27.3332(8) Å,c= 15.7191(4) Å,β= 97.90(1)°,V= 5680.41(82) Å3andZ= 4. The crystal structure can be described as the juxtaposition of double helicoidal chains. Additional aminoisophthalate ions insuring the electroneutrality of the network are lying in the interchain space. Compounds belonging to Family 2 are isostructural. The crystal structure has been solved for the Eu‐containing compound. This compound crystallizes in the monoclinic system, space group Pn (n°7) witha= 11.3427(2) Å,b= 10.6663(1) Å,c= 15.1639(3) Å,β= 97.8998(9)°,V= 1817.19(5) Å3andZ= 2. The crystal structure can be described as the juxtaposition of zigzag double chains. Additional aminoisophthalate ligands are lying in the interchain space insuring the electroneutrality of the network. The luminescent properties under UV irradiation of these compounds have been explored. In particular, quantum yields, lifetimes and colorimetric coordinates of the Tb‐, the Sm‐, and the Dy‐containing coordination polymers have been determined.
Molecular Modeling Study of the Carbohydrate Region of the Endotoxin from Burkholderia cenocepacia ET‐12
Authors: Ieranò Teresa , Nurisso Alessandra , Lanzetta Rosa , Parrilli Michelangelo , Silipo Alba , Imberty Anne , Molinaro Antonio
Published: July 2011

In this work we define the solution conformation of the saccharide of a lipopolysaccharide molecule extracted from a clinical isolate strain of the human opportunistic pathogen Burkholderia cenocepacia. The conformational behavior has been explored by means of NMR spectroscopy, NOE‐based conformational analysis, molecular modeling (MM), and molecular dynamics (MD) studies. The results indicate a remarkable rigidity of the inner core region, ascribable to the structural motifs essential for bacterial surviving, which markedly contributes to the strength, stability, and rigidity of the cellular membrane. On the other hand, the monosaccharide residues extending from the inner core to the outer core region show significant flexibility and can be the target of recognition and binding of endogenous and host‐released proteins. This study sheds light on the three dimensional arrangement of Burkholderia LPS and is an important step toward developing a structure–function relationship analysis of the virulence factor that is responsible for the severe pathogenicity Burkholderia.
Patrick John Brenchley (1936–2011)
Authors: Donovan Stephen K. , Harper David A. T. , Marshall James D.
Published: July 2011

This paper is a tribute to Dr Pat Brenchley, Ordovician geologist, educator and former Editor‐in‐Chief of the Geological Journal. It forms the introduction to this Special Issue in his memory. Copyright © 2011 John Wiley & Sons, Ltd.
Topography‐Induced Cell Adhesion to Acr‐sP(EO‐stat‐PO) Hydrogels: The Role of Protein Adsorption
Authors: Schulte Vera A. , Diez Mar , Möller Martin , Lensen Marga C.
Published: July 2011

Topographic surface patterning of intrinsically non‐adhesive P(EO‐stat‐PO)‐based hydrogels can lead to the adhesion and spreading of fibroblasts. Explanations for this unexpected behavior are discussed, particularly with regard to non‐specific protein adsorption from the serum‐supplemented culture medium. The presence of serum proteins is shown to be essential for adhesion. Adsorption of plasma and ECM proteins (Fibronectin (FN) and Vitronectin (VN)) to the hydrogels is possible. The effect of VN on initial cell adhesion is analyzed in detail. It appears that VN is the main serum component that is crucial for initial cell adhesion to PEG and that surface topography is essential for further, durable adhesion establishment, and spreading.

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Polybenzimidazolium‐Based Solid Electrolytes
Authors: Henkensmeier Dirk , Kim Hyoung‐Juhn , Lee Hye‐Jin , Lee Dong Hoon , Oh In‐Hwan , Hong Seong‐Ahn , Nam Suk‐Woo , Lim Tae‐Hoon
Published: July 2011

A series of methyl, benzyl, and mixed polybenzimidazolium halides was synthesised and characterised by NMR spectroscopy. Membranes were formed and ion exchanged with hydroxides. These membranes are of interest for use in potentially platinum‐free anionic exchange membrane fuel cells. Crosslinked membranes were obtained by the addition of α,α′‐dibromo‐p‐xylene to the casting solution. The ion conductivity of membranes was determined by impedance spectroscopy. A hydroxide conductivity of 29 mS · cm−1 at 26 °C and 58 mS · cm−1 at 60 °C was obtained. The thermal and hydrolytic stability was investigated and a pathway for hydrolytic degradation proposed. Hydroxide ions react at the 2 position, the intermediate carbinol opens to the amine–amide, and further degrades under chain scission to diamine and carboxylic acid.

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Clay‐Catalyzed Cracking Leads to Suppressed Flammability in Clay–Polyolefin Nanocomposites
Authors: Kunkel Bryanna M. , Peoples Brian C. , Yung Cathleen M. , Scott Susannah L.
Published: July 2011

Organoclay–polyolefin nanocomposites have been shown to exhibit slightly increased thermal stability and decreased flammability, compared to unfilled polyolefins. In contrast, we find that when the clay has not been organically modified, the resulting polyolefin nanocomposites are less thermally stable and, unexpectedly, also much less flammable. In this contribution, we investigate the mechanistic origins of these effects. Clay–polyolefin nanocomposites were prepared by in situ polymerization of ethylene or propylene, using a catalyst adsorbed onto the clay. Decreased thermal stability is attributed to clay‐catalyzed polymer decomposition, while decreased flammability arises in part from clay‐catalyzed formation of a polyaromatic char from olefins trapped in the material by the dispersed nanofiller.

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A Novel Strategy for the Controlled Synthesis of Silver Halide/Polyaniline Nanocomposites with Different Polyaniline Morphologies
Authors: Yin Huajie , Yang Jiping
Published: July 2011

Silver halide/polyaniline nanocomposites with different polyaniline morphologies, i.e., nanotubes and nanofibers, were successfully synthesized simply based on the general chemical oxidation polymerization process of aniline in halide acid aqueous solution (i.e., HCl or HBr) with the presence of dodecylbenzenesulfonic acid (DBSA)‐stabilized silver nanoparticles (NPs) as the precursors of silver halide NPs (i.e., AgCl or AgBr). X‐ray diffraction (XRD) and FT‐IR results confirmed the structures of resultant silver halide/polyaniline nanocomposites. TEM and SEM images demonstrated that AgCl or AgBr NPs were well‐dispersed and embedded in the polyaniline matrix. The reasons for the new strategy for the preparation of silver halide/polyaniline nanocomposites were based on two key points: the first was the high reactivity of silver NPs with HCl or HBr to generate AgCl/AgBr NPs. Second, with the assistance of DBSA, polyaniline could be synthesized with various nanostructures, i.e., nanotubes and nanofibers.

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Dynamic Electrical and Rheological Percolation in Isotactic Poly(propylene)/Carbon Black Composites
Authors: Huang Shilin , Liu Zhengying , Yin Chaolu , Wang Yu , Gao Yongjuan , Chen Chen , Yang Mingbo
Published: July 2011

Flocculation of the filler particles in isotactic poly(propylene)/carbon black (iPP/CB) composite melts provides a way to understand electrical and rheological percolation processes. The iPP/CB composites were prepared by mild compounding to ensure a good filler dispersion. Electrical and dynamic rheological characterizations are used to monitor the network formation process in the composite melts. It is found that rheological percolation is more difficult to achieve than the electrical percolation in iPP/CB composites. The discrepancy comes from the different mechanisms for electron transport and stress transfer through the filler network.

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