bluuebunny/crossref_metadata_2025 huggingface dataset:
Beyond Classroom Borders
Authors: Kelly Millicent J.
Published: April 2013

This article provides an overview of collaborative service learning activities as they are incorporated into university curricula designed for the nontraditional student. The basic tenets of the concept of andragogy are briefly reviewed to emphasize the special considerations that need to be addressed to ensure the successful inclusion of collaborative service initiatives for the adult learner. Some specific inclusion suggestions are offered to maximize the impact and meaningfulness of these unique learning opportunities.
Team Innovation Processes
Authors: Goh Kenneth T. , Goodman Paul S. , Weingart Laurie R.
Published: April 2013

This study investigates cycles of planning, enacting, and reviewing activities over time in teams engaged in creative projects. Drawing on longitudinal case studies of two interactive media development teams, two distinct cycles of planning, enacting, and reviewing activities are identified: experimentation cycles and validation cycles. Experimentation cycles are discovery-oriented processes where teams gather insights into project requirements, constraints, and design specifications through trial-and-error. Validation cycles are correction-oriented processes where teams align their output with project requirements through incremental modifications. These findings are then built on to develop testable propositions about the relationship between the duration of planning, enacting, and reviewing activities and the innovativeness and quality of team outcomes.
Free Improvisation
Authors: Niknafs Nasim
Published: April 2013

Improvisation, the third content standard for the National Standards for Music Education (Music Educators National Conference, 1994), has received less attention from music teachers. This article advocates for more improvisation specifically free improvisation in general music classrooms. The nature of free improvisation, and its evolution in the Unites States and Europe is presented, followed by a rationale in incorporating free improvisation in general music classrooms. It is emphasized that free improvisation can be a successful entry point for those teachers who do not have ample time or do not feel comfortable using improvisation activities. Free improvisation has two distinct and valuable features: it can be played by anyone regardless of age and musical capability, and it is the accumulation of musical identities of all the participants involved in making the music. This author asserts that free improvisation is inherently democratic, and by using it teachers can create a space for students to feel more self-assured, and autonomous.
Impact of a Palliative Care Consult Service
Authors: Whitford Kevin , Shah Nilay D. , Moriarty James , Branda Megan , Thorsteinsdottir Bjoerg
Published: April 2013

Established hospital palliative care consult services (PCCS) have been associated with reduced costs and length of stay, decreased symptom burden, and increased satisfaction with care. Using a retrospective case–control design, we analyzed administrative data of patients seen by PCCS while hospitalized at the Rochester, Minnesota Mayo Clinic hospitals from 2003 to 2008. The PCCS patients were matched to 3:1. A total of 1477 patients seen by the PCCS were matched with 4431 patients not seen. Costs for patients seen and discharged alive were US$35 449 (95% confidence interval [CI] US$34 157-US$36 686) compared to US$37 447 (95% CI US$36 734-US$38 126), without PCCS consultation. Costs for PCCS patients that died during hospitalization were US$54 940 (95% CI US$51 483-US$58 576) and non-PCCS patients were US$79 660 (95% CI US$76 614-US$83 398).
Professional Boundary Issues in Pediatric Palliative Care
Authors: Jankowski Jane B.
Published: April 2013

This article explores the hypothesis that when a child has a life-limiting illness, the interpersonal boundaries between the patient, the patient’s parents, and the health care team members differ from traditional provider, patient, and parent boundaries because of the unique dynamics of palliative care in pediatrics. Providers from the Journey’s Palliative Care Team at Albany Medical Center completed a brief survey about working in pediatric palliative care and what ethical challenges they have faced in trying to maintain professional boundaries as new palliative care providers. A retrospective review of survey responses and a review of relevant literature offer insight into the various concerns reported by the Journey’s team. Conclusions about delivering comprehensive ethically sound palliative care services may serve as a pathway for future studies.
Communication as an Approach to Resolve Conflict About the Implementation of Palliative Care
Authors: Zhang Zhe , Cheng Wen-Wu
Published: April 2013

The main aim of palliative care is to provide relief from pain and distressing symptoms and to offer psychological and spiritual support to enhance the quality of life. We present a case of an elderly Chinese patient with major depressive disorder who was a doctor himself, and through his experience of treating patients had become afraid about the complications of advanced disease. He wished to forgo treatment, which was in conflict with those of his family. This report highlights the role of the palliative medical team in improving outcomes through enabling communication to occur between the family and the patient to achieve the best outcomes. This should lead to better training provision for the involved medical staff.
Increasing Body Mass Index, Blood Pressure, and Acanthosis Nigricans Abnormalities in School-Age Children
Authors: Otto Debra E. , Wang Xiaohui , Garza Viola , Fuentes Lilia A. , Rodriguez Melinda C. , Sullivan Pamela
Published: April 2013

This retrospective quantitative study examined the relationships among gender, Acanthosis Nigricans (AN), body mass index (BMI), and blood pressure (BP) in children attending school Grades 1–9 in Southwest Texas. Of the 34,897 health screening records obtained for the secondary analysis, 32,788 were included for the study. A logistic regression analysis was carried out with AN as the dependent variable, with year, gender, BMI, and BP as independent variables. The results indicate that the rate of children in each grade with three positive markers increased 2% during a 3-year period between 2008 and 2010. In the 5-year period between 2005 and 2010, a clear trend of significantly higher numbers of children with both AN and BMI markers was apparent. Gender played a significant role as females were more likely to have the AN marker than males. Further study is indicated based on the increasing trend of school-age children in Texas with positive markers for AN, increased BMI and BP.
Validity and Reliability Reporting Practices in the Field of Health Education and Behavior
Authors: Barry Adam E. , Chaney Beth , Piazza-Gardner Anna K. , Chavarria Enmanuel A.
Published: April 2013

Health education and behavior researchers and practitioners often develop, adapt, or adopt surveys/scales to quantify and measure cognitive, behavioral, emotional, and psychosocial characteristics. To ensure the integrity of data collected from these scales, it is vital that psychometric properties (i.e., validity and reliability) be assessed. The purpose of this investigation was to (a) determine the frequency with which published articles appearing in health education and behavior journals report the psychometric properties of the scales/subscales employed and (b) outline the methods used to determine the reliability and validity of the scores produced. The results reported herein are based on a final sample of 967 published articles, spanning seven prominent health education and behavior journals between 2007 and 2010. Of the 967 articles examined, an exceedingly high percentage failed to report any validity (ranging from 40% to 93%) or reliability (ranging from 35% to 80%) statistics in their articles. For health education/behavior practitioners and researchers to maximize the utility and applicability of their findings, they must evaluate the psychometric properties of the instrument employed, a practice that is currently underrepresented in the literature. By not ensuring the instruments employed in a given study were able to produce accurate and consistent scores, researchers cannot be certain they actually measured the behaviors and/or constructs reported.
Optimizing process creation and execution on multi-core architectures
Authors: Kulkarni Abhishek , Ionkov Latchesar , Lang Michael , Lumsdaine Andrew
Published: April 2013

The execution of a single process multiple data (SPMD) application involves running multiple instances of a process with possibly varying arguments. With the widespread adoption of massively multicore processors, there has been a focus towards harnessing the abundant compute resources effectively in a power-efficient manner. Although much work has been done towards optimizing distributed process launch using hierarchical techniques, there has been a void in studying the performance of spawning processes within a single node. Reducing the latency to spawn a new process locally results in faster global job launch. Further, emerging dynamic and resilient execution models are designed on the premise of maintaining process pools for fault isolation and launching several processes in a relatively shorter period of time. Optimizing the latency and throughput for spawning processes would help improve the overall performance of runtime systems, allow adaptive process-replication reliability and motivate the design and implementation of process management interfaces in future manycore operating systems. In this paper, we study the several limiting factors for efficient spawning of processes on massively multicore architectures. We have developed a library to optimize launching multiple instances of the same executable. Our microbenchmarks show a 20–80% decrease in the process spawn time for multiple executables. We further discuss the effects of memory locality and propose NUMA-aware extensions to optimize launching processes with large memory-mapped segments including dynamic shared libraries. Finally, we describe vector operating system interfaces for spawning a batch of processes from a given executable on specific cores. Our results show a speedup of a factor of 40–50 over the traditional method of launching new processes using fork and exec system calls.
Concurrent somatotroph and plurihormonal pituitary adenomas in a cat
Authors: Sharman Mellora , FitzGerald Louise , Kiupel Matti
Published: April 2013

An 8-year-old, male neutered, domestic longhair cat was referred for investigation of insulin-resistant diabetes mellitus. Routine haematology, serum biochemistry, urinalysis (including culture), total T4 and urine creatinine:cortisol ratio were unremarkable, but markedly increased insulin-like growth factor-1 concentration was identified and a pituitary mass was subsequently documented. The cat was treated conservatively with the dopamine agonist L-deprenyl and was re-presented 16 months later for worsening polyuria, polydipsia, polyphagia, marked lumbar muscle atrophy, development of a pendulous abdomen and marked thinning of the abdominal skin. Hyperadrenocorticism was diagnosed based on abdominal ultrasonography, dexamethasone suppression testing and endogenous adrenocorticotropic hormone (ACTH). The cat was treated with trilostane (30 mg q24h PO) and showed some clinical improvement, but developed an opportunistic fungal infection and skin fragility syndrome 4.5 months after commencing treatment, and was euthanased. A double-pituitary adenoma comprising a discrete somatotroph adenoma and a separate plurihormonal adenoma (positive immunoreactivity for ACTH, melanocyte-stimulating hormone and follicle-stimulating hormone) was identified on post-mortem examination. These two pituitary adenomas were suspected to have arisen as independent neoplastic entities with the plurihormonal tumour either being clinically silent at the initial presentation or having developed over the subsequent 16 months.
Language contact, language mixing and identity: The Akan spoken by Ghanaian immigrants in northern Italy
Authors: Guerini Federica
Published: April 2013

In this paper, it will be argued that the Akan spoken within the Ghanaian immigrant community in Bergamo is currently going through a transitional process that leads from code-switching to language mixing, as illustrated in Auer ((1999) From codeswitching via language mixing to fused lects: Towards a dynamic typology of bilingual speech. International Journal of Bilingualism, 3, 309–332). Analysis of excerpts drawn from a sample of face-to-face interactions, as well as formal interviews (comprising 27 hours of recordings in total), involving a selected group of Ghanaian immigrants in northern Italy will provide a useful starting point for discussing a distinguishing feature of the variety of Akan spoken by the above-mentioned immigrants – that is, the systematic insertion of English ‘chunks’ (e.g. single words or phrases) which do not appear to fulfil any pragmatic or discursive function. It will be argued that this ‘mixed’ variety of Akan is an expressive device of considerable importance within the community’s repertoire, which is regularly employed in informal spontaneous interactions not only by those community members who speak Akan as a lingua franca, but by Akan native speakers as well.
Ewe borrowings into Logba
Authors: Dorvlo Kofi
Published: April 2013

Logba, a Ghana-Togo Mountain language, operates an active noun class system in which there is agreement within the noun phrase (NP) and the subject NP is cross-referenced on the verb in a form that agrees with the class of the subject. As a minority language dominated by Ewe, a non-noun class language, it is exposed to the phenomenon of borrowing. In this paper, I examine the repercussions of borrowing in terms of nouns, locative verbs, grammatical items, and culturally loaded expressions. I will show that nouns borrowed from Ewe are allocated to a class with similar semantics, while verbs show the subject–noun cross-reference on them in a clause. Grammatical items—relativizers, conjunctions, and clause linkers—have forms very similar to those found in Ewe. Other forms of borrowing shown in this paper are proverbs, riddles, and emotional expressions calqued in Logba from Ewe. It is noted that there is generalization and simplification going on among younger native speakers of Logba. The paper concludes that there is a contact-induced change in progress in which a noun class system of a minority language is exposed to interference by a majority language.
Differences in social relations between persons with type 2 diabetes and the general population
Authors: Hempler Nana Folmann , Ekholm Ola , Willaing Ingrid
Published: April 2013

Aims: Poor social support and lack of social network are well-established risk factors for morbidity and mortality in general populations. Good social relations, such as social support and network contacts, are associated with better self-management and fewer psychosocial problems in persons with type 2 diabetes. The aim of this study was to investigate whether persons with type 2 diabetes have poorer social relations than the general population. Methods: We conducted a cross-sectional survey in three settings: a specialist diabetes clinic (SDC) ( n = 1084), a web panel (WP) consisting of persons with type 2 diabetes ( n = 1491) and a sample from the 2010 Danish Health and Morbidity Survey, representative of the general population ( n = 15,165). We compared social relations using multivariate logistic regression. Results: Compared to the general population, persons with type 2 diabetes more often lived without a partner (SDC, OR 1.75, 95% CI 1.49–2.06; WP, OR 1.64, 95% CI 1.43–1.87), met with family less than once a month (SDC, OR 1.78, 95% CI 1.40–2.27; WP, OR 2.35, 95% CI 1.94–2.84) and were less certain they could count on help from others in case of illness (WP, OR 1.23, 95% CI 1.08–1.41). Conclusions: Our findings suggest that persons with type 2 diabetes have poorer social relations than the general population. From a public health point of view, special attention is needed with regards to strengthening existing networks and establishing alternative networks among persons with type 2 diabetes.
When minutes count: Tension and trust in the relationship between emergency managers and the media
Authors: McLean Hamish , Power Mary R
Published: April 2013

In crisis and disaster situations the accuracy, scope, credibility and timeliness of media information depend on relationships between journalists and emergency managers. In the chaos of an unfolding disaster this relationship relies heavily on trust. This specific area has received sparse research attention. Accordingly, we reviewed and synthesized literature on trust, and used qualitative analysis of interviews to examine how elite practitioners viewed the importance of trust in the relationships built up with one another both prior to and during disasters. Two main findings emerged: that there was a need to develop shared definitions of trust and articulation of common goals; and that institutional and personal relationships need to be nurtured in the periods between disasters rather than solely during crisis events. These findings warrant dissemination among both media and crisis managers and further research into establishing shared concepts of trust that both partners could use in more effective collaboration.
Dialogic pedagogy in Hong Kong: Introducing art and culture
Authors: Mui Ma So
Published: April 2013

This paper presents an examination of the learning of pre-service Visual Arts teachers through dialogic pedagogy. Dialogic education gives students the power to speak in their own voices, and through the interactions which take place between them, relationships, identities and ideologies are constructed. The dialogic process examined in this paper was conducted prior to the teaching of concepts relating to art. It involved pairs of students, with one student bringing and describing his/her favourite artwork and the other responding. The data revealed that the participants learned in an interactive way, and through self-reflection and a process of critical thinking. Dialogic pedagogy favours the development of interpersonal relationships; a supportive learning environment which enhances students’ understanding is built up. After use of dialogic pedagogy for over three years in teaching this course the scope of the students’ knowledge was extended and they had become more motivated to learn.
Discrimination and Psychological Distress Among Recently Released Male Prisoners
Authors: Turney Kristin , Lee Hedwig , Comfort Megan
Published: April 2013

Though theoretical perspectives suggest experiences of stigma and discrimination after release may be one pathway through which incarceration leads to poor mental health, little research considers the relationship between discrimination and mental health among former inmates. In this article, data from a sample of men recently released from prison to Oakland or San Francisco, California ( N = 172), are used to consider how criminal record discrimination and racial/ethnic discrimination are independently and cumulatively associated with psychological distress. Results indicate that (a) the frequency of criminal record discrimination and racial/ethnic discrimination are similar; (b) both forms of discrimination are independently, negatively associated with psychological distress; and (c) the level of racial/ethnic discrimination does not alter the association between criminal record discrimination and psychological distress. The results highlight that criminal record discrimination is an important social stressor with negative implications for the mental health of previously incarcerated individuals.
Female Athlete Triad
Authors: Chu Stephanie M. , Gustafson Karen E. , Leiszler Matthew
Published: April 2013

The passage of Title IX in 1972 resulted in a tremendous increase in the number of females participating in high school and collegiate athletics. This rise in female athletes sparked new focus areas of research in sports medicine related to woman with an important area emerging in 1980, the female athlete triad. This triad consisting of low energy availability, menstrual irregularities, and bone health disruption spans a spectrum of severity and has evolved both in diagnosis and in management throughout the years. Many health questions arise for female athletes and their health care providers, often concerning the most effective management and treatment strategies for this triad. This review examines the research and latest advancements in recognizing and understanding the female athlete triad and explores the most current recommendations for treatment and prevention.
Accommodating missingness when assessing surrogacy via principal stratification
Authors: Elliott Michael R , Li Yun , Taylor Jeremy MG
Published: April 2013

Background

When an outcome of interest in a clinical trial is late-occurring or difficult to obtain, surrogate markers can extract information about the effect of the treatment on the outcome of interest. Understanding associations between the causal effect (CE) of treatment on the outcome and the causal effect of treatment on the surrogate is critical to understanding the value of a surrogate from a clinical perspective.

Purpose

Traditional regression approaches to determine the proportion of the treatment effect explained by surrogate markers suffer from several shortcomings: they can be unstable and can lie outside the 0–1 range. Furthermore, they do not account for the fact that surrogate measures are obtained post randomization, and thus, the surrogate–outcome relationship may be subject to unmeasured confounding. Methods to avoid these problems are of key importance.

Methods

Frangakis and Rubin suggested assessing the CE within prerandomization ‘principal strata’ defined by the counterfactual joint distribution of the surrogate marker under the different treatment arms, with the proportion of the overall outcome CE attributable to subjects for whom the treatment affects the proposed surrogate as the key measure of interest. Li et al. developed this ‘principal surrogacy’ approach for dichotomous markers and outcomes, utilizing Bayesian methods that accommodated nonidentifiability in the model parameters. Because the surrogate marker is typically observed early, outcome data are often missing. Here, we extend Li et al. to accommodate missing data in the observable final outcome under ignorable and nonignorable settings. We also allow for the possibility that missingness has a counterfactual component, a feature that previous literature has not addressed.

Results

We apply the proposed methods to a trial of glaucoma control comparing surgery versus medication, where intraocular pressure (IOP) control at 12 months is a surrogate for IOP control at 96 months. We also conduct a series of simulations to consider the impacts of nonignorability, as well as sensitivity to priors and the ability of the decision information criterion (DIC) to choose the correct model when parameters are not fully identified.

Limitations

Because model parameters cannot be fully identified from data, informative priors can introduce nontrivial bias in moderate sample size settings, while more noninformative priors can yield wide credible intervals.

Conclusions

Assessing the linkage between CEs of treatment on a surrogate marker and CEs of a treatment on an outcome is important to understanding the value of a marker. These CEs are not fully identifiable; hence, we explore the sensitivity and identifiability aspects of these models and show that relatively weak assumptions can still yield meaningful results.
Computation of remaining useful life on a physic-based model and impact of a prognosis on the maintenance process
Authors: Lorton Ariane , Fouladirad Mitra , Grall Antoine
Published: April 2013

The aim of this article is double: propose a methodology for a probabilistic prognosis, and examine how the prognosis result impacts the maintenance process. First, the prognosis problem is mathematically defined: it consists in computing the distribution of the remaining useful life of the system conditionally to on-line available information. Considering on-line information allows to provide a specific prognosis for each system according to its life. Second, a global methodology is proposed when the state of the system and its degradations are modeled using a Markov process. This method is basically a two-step technique. On one hand, it requires the computation of the conditional law of the system regarding the available observations. On the other hand, it involves the computation of the reliability of the system. Some reliability computation techniques are proposed when the Markov process is a piecewise deterministic Markov process. The method is illustrated on an aeronautic example: a pneumatic valve within the bleed air system, used to provide regulated air (pressure, temperature) in the cabin. Eventually, the prognosis result is used to help maintenance optimization on an illustrative example. It highlights that the prognosis mainly improves the maintenance decision if the on-line available information is accurate enough.
When the Wolf Wears Sheep’s Clothing
Authors: Ashton-James Claire E. , Levordashka Ana
Published: April 2013

Current research into the elicitors of nonconscious behavioral mimicry focuses almost exclusively on prosocial motives. Alternatively, the present research investigates whether the self-centered desire to be liked by others also induces mimicry. We investigate this issue by measuring the mimicry behavior of narcissists—a “dark personality” that is uniquely characterized by a desire to be liked by rather than by genuine liking for people. Narcissists are particularly motivated to form social alliances with high-status others. Hence, it was hypothesized that narcissistic participants would show more mimicry of higher status others (compared to lower status others). Support for this hypothesis was provided by a mixed within- and between-subjects field experiment in which the mimicry behavior of participants identified as being above or below average in subclinical narcissism was observed in a scripted interaction with a higher and lower status other.
Bi-stable resistive switching characteristics in Ti-doped ZnO thin films
Authors: Younis Adnan , Chu Dewei , Li Sean
Published: April 2013

Ti-doped ZnO (ZnO/Ti) thin films were grown on indium tin oxide substrates by a facile electrodeposition route. The morphology, crystal structure and resistive switching properties were examined, respectively. The morphology reveals that grains are composed of small crystals. The (002) preferential growth along c-axis of ZnO/Ti could be observed from structural analysis. The XPS study shows the presence of oxygen vacancies in the prepared films. Typical bipolar and reversible resistance switching effects were observed. High R
OFF/R
ON ratios (approximately 14) and low operation voltages within 100 switching cycles are obtained. The filament theory and the interface effect are suggested to be responsible for the resistive switching phenomenon.
Age-related autoimmunity
Authors: Vadasz Zahava , Haj Tharwat , Kessel Aharon , Toubi Elias
Published: April 2013

Older persons have higher autoimmunity but a lower prevalence of autoimmune diseases. A possible explanation for this is the expansion of many protective regulatory mechanisms highly characteristic in the elderly. Of note is the higher production of peripheral T-regulatory cells.

The frequent development of autoimmunity in the elderly was suggested to take place in part due to the selection of T cells with increased affinity to self-antigens or to latent viruses. These cells were shown to have a greater ability to be pro-inflammatory, thereby amplifying autoimmunity. During aging, thymic T-regulatory cell output decreases in association with the loss of thymic capacity to generate new T cells. However, to balance the above mentioned autoimmunity and prevent the development of autoimmune diseases, there is an age-related increase in peripheral CD4+ CD25highFoxP3+ T-regulatory cells. It remains unclear whether this is an age-related immune dysfunction or a defense response. Whatever the reason, the expansion of T-regulatory cells requires payment in terms of an increased incidence of cancer and higher susceptibility to infections.
Morphology of the transverse ligament of the atlas and the alar ligaments in the silver fox (Vulpes vulpes var)
Authors: Kupczynska Marta , Barszcz Karolina , Janczyk Pawel , Wasowicz Michal , Czubaj Norbert
Published: April 2013

Background

Recent new anatomical and histological features of craniocervical junction in dogs and cats were described providing evidence of differences between the carnivore species. No information on these structures in foxes exists.

Results

Two parts of the alar ligaments were found. A longer one aroused from dens of axis to the internal (medial) surface of the occipital condyles and was called apical part. A shorter part originated from the entire length of the lateral edge of the dens of axis and terminated on the internal wall of the vertebral foramen of atlas and thus was called the lateral part. The transverse ligament of the atlas was widened in the mid region, above the dens of axis, and thickened at enthesis. Periosteal fibrocartilage was detected in the transverse ligament of the atlas at the enthesis, and sesamoid fibrocartilage was present on periphery in the middle of the ligament.

Conclusions

The craniocervical junction in foxes differs in part from other carnivores such as dogs and cats but resembles that of mesaticephalic dogs. The sesamoid and periosteal fibrocartilage supports the transverse ligament of the atlas whereas the alar ligaments have no cartilage.
Heterotopic ossification in the reaming tract of a percutaneous antegrade femoral nail: a case report
Authors: Botolin Sergiu , Mauffrey Cyril , Hammerberg E Mark , Hak David J , Stahel Philip F
Published: April 2013

Introduction

Heterotopic ossification is a rare complication of musculoskeletal injuries, characterized by bone growth in soft tissues. Percutaneous antegrade intramedullary nailing represents the ‘gold standard’ for the treatment of femur shaft fractures. Minor bone growth is frequently seen around the proximal end of reamed femoral nails (so-called ‘callus caps’), which are asymptomatic and lack a therapeutic implication. The occurrence of excessive, symptomatic heterotopic ossification around the entry site of an antegrade femoral nail is rarely described in the literature.

Case presentation

We present the case of a 28-year-old Caucasian woman who developed extensive heterotopic ossification around the reaming seeds of a reamed femoral nail. She developed severe pain and significantly impaired range of motion of the hip joint, requiring revision surgery for heterotopic ossification resection and adjunctive local irradiation. She recovered full function of the hip and remained asymptomatic at her two-year follow-up appointment.

Conclusions

Severe heterotopic ossification represents a rare but potentially detrimental complication after percutaneous femoral nailing of femur shaft fractures. Diligent care during the reaming procedure, including placement of a trocar to protect from osteogenic seeding of the soft tissues, may help decrease the risk of developing heterotopic ossification after reamed antegrade femoral nailing.
Scottish and Newcastle Antiemetic Pre-treatment for paracetamol poisoning study (SNAP)
Authors: Thanacoody H K Ruben , Gray Alasdair , Dear James W , Coyle Judy , Sandilands Euan A , Webb David J , Lewis Steff , Eddleston Michael , Thomas Simon HL , Bateman D Nicholas
Published: April 2013

Background

Paracetamol (acetaminophen) poisoning remains the commonest cause of acute liver injury in Europe and North America. The intravenous (IV) N-acetylcysteine (NAC) regimen introduced in the 1970s has continued effectively unchanged. This involves 3 different infusion regimens (dose and time) lasting over 20 hours. The same weight-related dose of NAC is used irrespective of paracetamol dose. Complications include frequent nausea and vomiting, anaphylactoid reactions and dosing errors. We designed a randomised controlled study investigating the efficacy of antiemetic pre-treatment (ondansetron) using standard NAC and a modified, shorter, regimen.

Methods/Design

We designed a double-blind trial using a 2 × 2 factorial design involving four parallel groups. Pre-treatment with ondansetron 4 mg IV was compared against placebo on nausea and vomiting following the standard (20.25 h) regimen, or a novel 12 h NAC regimen in paracetamol poisoning. Each delivered 300 mg/kg bodyweight NAC. Randomisation was stratified on: paracetamol dose, perceived risk factors, and time to presentation. The primary outcome was the incidence of nausea and vomiting following NAC. In addition the frequency of anaphylactoid reactions and end of treatment liver function documented. Where clinically necessary further doses of NAC were administered as per standard UK protocols at the end of the first antidote course.

Discussion

This study is primarily designed to test the efficacy of prophylactic anti-emetic therapy with ondansetron, but is the first attempt to formally examine new methods of administering IV NAC in paracetamol overdose. We anticipate, from volunteer studies, that nausea and vomiting will be less frequent with the new NAC regimen. In addition as anaphylactoid response appears related to plasma concentrations of both NAC and paracetamol anaphylactoid reactions should be less likely. This study is not powered to assess the relative efficacy of the two NAC regimens, however it will give useful information to power future studies. As the first formal randomised clinical trial in this patient group in over 30 years this study will also provide information to support further studies in patients in paracetamol overdose, particularly, when linked with modern novel biomarkers of liver damage, patients at different toxicity risk.

Trial registration

EudraCT number 2009-017800-10, ClinicalTrials.gov IdentifierNCT01050270
The effect of polymer and CaCl2 concentrations on the sulfasalazine release from alginate-N,O-carboxymethyl chitosan beads
Authors: Tavakol Moslem , Vasheghani-Farahani Ebrahim , Hashemi-Najafabadi Sameereh
Published: April 2013

In this study, pH-sensitive blended polymeric beads were prepared by ionic gelation of mixed alginate and N,O-carboxymethyl chitosan (NOCC) solutions in aqueous media containing calcium chloride. To prepare drug-loaded beads, sulfasalazine (SA) as a model drug was added to the initial aqueous polymer solution. These beads were characterized and evaluated in vitro as potential carriers for colon-specific drug delivery. A 32 full factorial experimental design was employed to evaluate the effect of polymer and CaCl2 concentrations on swelling and drug release behavior of the beads in simulated gastrointestinal tract fluid. It was found that the rate of swelling and drug release decreased significantly with increasing polymer and CaCl2 concentrations, but polymer concentration was more effective than CaCl2 concentration. The beads prepared using 4.5% polymer concentration and 4% CaCl2 concentration retained approximately 60% of the loaded drug before approaching the simulated colonic fluid. Based on the results, the alginate-NOCC beads prepared with high polymer concentration could be potentially suitable polymeric carriers for colon-specific delivery of SA.
Reversibly Crosslinked Polymeric Micelles Formed by Autonomously Exchangeable Dynamic Covalent Bonds
Authors: Nishihara Masamichi , Imato Keiichi , Irie Atsushi , Kanehara Takeshi , Kano Arihiro , Maruyama Atsushi , Takahara Atsushi , Otsuka Hideyuki
Published: April 2013

We report the preparation of amphiphilic block copolymer micelles with dynamic covalent bonds as autonomously exchangeable crosslinkers with high tolerance against oxygen. Diarylbibenzofuranone (DABBF) was employed as a crosslinker owing to its durability to oxygen and autonomous exchangeability at ambient temperature. It was confirmed that the amphiphilic block copolymer containing the DABBF unit has the capability to form micelles and can form a crosslinking with an exchangeable structure in the presence of oxygen.
Going for Gold: British Medical Olympians 1908–2008
Authors: Islam Shofiq , Taylor Christopher J , Cole Jennifer L , Walton Gary M , Hoffman Gary R
Published: March 2013

The modern Olympic Games began in 1896. Baron Pierre de Coubertin, founder of the International Olympic Committee (IOC), is commonly considered to be the father of these Games. The modern Olympics are often viewed as a revival of the Games of antiquity, which were held on a four-yearly cycle.
Primary care training for oral surgery: challenges and possibilities
Authors: Renton Tara , Balmer Colette
Published: March 2013

This article assesses some of the challenges facing provision of high quality oral surgery care within primary care settings. This paper aims to highlight funding, regulation and governance of dental specialist training, and raises some advancing issues that we need to consider.
Issues for commissioning conscious sedation for oral surgery
Authors: Coulthard Paul
Published: March 2013

The shift of large volume oral surgery care provision out of secondary care into primary care desired by the National Health Service (NHS) requires a radical address for the provision of inhalational and intravenous sedation commissioning and provision. This paper aims to address some of the issues arising, and provides some suggested resolutions and opportunities.
Workforce in oral surgery: current and potential challenges and opportunities
Authors: Renton Tara
Published: March 2013

The relatively new specialty of oral surgery has been disadvantaged in developing an appropriate workforce needed to deliver the aspirations of the 2010 National Health Service (NHS) white paper Equity and Excellence: Liberating the NHS. This article aims to address how we may estimate the oral surgery workforce required to support these developments and identify challenges as well as opportunities.
Important Change with Heparin Labels; Benadryl Dispensed Instead of Vitamins for Home Parenteral Nutrition; Potassium and Sodium Acetate Injection Mix-Ups; Don't Truncate, Stem, or Shorten Drug Names
Authors: Cohen Michael R. , Smetzer Judy L.
Published: April 2013

These medication errors have occurred in health care facilities at least once. They will happen again—perhaps where you work. Through education and alertness of personnel and procedural safeguards, they can be avoided. You should consider publishing accounts of errors in your newsletters and/or presenting them at your inservice training programs.

Your assistance is required to continue this feature. The reports described here were received through the Institute for Safe Medication Practices (ISMP) Medication Errors Reporting Program. Any reports published by ISMP will be anonymous. Comments are also invited; the writers’ names will be published if desired. ISMP may be contacted at the address shown below.

Errors, close calls, or hazardous conditions may be reported directly to ISMP through the ISMP Web site ( www.ismp.org ), by calling 800-FAIL-SAFE, or via e-mail at ismpinfo@ismp.org . ISMP guarantees the confidentiality and security of the information received and respects reporters’ wishes as to the level of detail included in publications.
Perampanel
Authors: Cada Dennis J. , Levien Terri L. , Baker Danial E.
Published: April 2013

Each month, subscribers to The Formulary Monograph Service receive 5 to 6 well-documented monographs on drugs that are newly released or are in late phase 3 trials. The monographs are targeted to Pharmacy & Therapeutics Committees. Subscribers also receive monthly 1-page summary monographs on agents that are useful for agendas and pharmacy/nursing in-services. A comprehensive target drug utilization evaluation/medication use evaluation (DUE/MUE) is also provided each month. With a subscription, the monographs are sent in print and are also available on-line. Monographs can be customized to meet the needs of a facility. A drug class review is now published monthly with The Formulary Monograph Service. Through the cooperation of The Formulary, Hospital Pharmacy publishes selected reviews in this column. For more information about The Formulary Monograph Service. Through the cooperation of The Formulary, Hospital Pharmacy publishes selected reviews in this column. For more information about The Formulary Monograph Service, call The Formulary at 800-322-4349. The April 2013 monograph topics are alogliptin, crofelemer, lomitapide, ponatinib, and sumatriptan iontophoretic transdermal. The DUE/MUE is on alogliptin.
Tech for Patient Engagement: Make it Personal!
Authors: Felkey Bill G. , Fox Brent I.
Published: April 2013

The quest for a reformed health care system in which patients are engaged and are active participants is clearly a marathon, not a sprint. In this article, we go beyond channel management, which we addressed previously, and focus on the content of communication exchanges that you will have with patients.
How gender and generation matter: examples from research on divorced parents and adult children
Authors: Herlofson Katharina
Published: March 2013

The purpose of this article is to highlight the importance of taking gender and generational position seriously in research on intergenerational family relations, using as illustration the association between parents’ marital status and perceived quality of the relationship between parents and adult children. The data stem from the Norwegian Life-course, Generations and Gender Study (N = 15,156). Findings revealed the importance of considering who is being asked and which parent–child dyad (mother–son, mother–daughter, father–son, and father–daughter) is in question. Respondents’ generational position mattered considerably. Parents perceived the relationship as more positive, compared to views of adult children. The contrast was magnified when parents were divorced. How gender mattered differed by generational position. Mothers perceived the relationship quality as higher than fathers did, whereas daughters rated the quality as lower, compared to sons. When parents were divorced, data from children showed stronger dyad contrasts than parent-derived data.
Interpreting our lives: memory, truth and fiction
Authors: Eckstein Sue
Published: March 2013

Interpreters is a novel that explores the secrets and lies within families, the parent–child relationship, the interpretation of the past and the collective and personal guilt of a generation who grew up in Nazi Germany. Mindful of the moral and ethical issues inherent in memoir and autobiography, I explore the challenges and dilemmas encountered in creating a work of autobiographical fiction that draws on the experiences of those who may never have expected, or wanted, their stories to be told. I attempt to ensure ethical and artistic integrity by recording emotional rather than actual truths, by changing the stories’ and the characters’ natures, and liberating myself from the constraints of conventional life writing with its requirement for historical accuracy, logical timeframe and expectation of truthfulness.
Influence of Cations on Aggregation Rates in Mg-Montmorillonite
Authors: Katz Al. , Xu Min , Steiner Jeffrey C. , Trusiak Adrianna , Alimova Alexandra , Gottlieb Paul , Block Karin
Published: March 2013

Critical-zone reactions involve inorganic and biogenic colloids in a cation-rich environment. The present research defines the rates and structure of purified Mg-montmorillonite aggregates formed in the presence of monovalent (K+) and divalent (Ca2+, Mg 2+) cations using light-extinction measurements. Time evolution of turbidity was employed to determine early-stage aggregation rates. Turbidity spectra were used to measure the fractal dimension at later stages. The power law dependence of the stability ratios on cation concentration was found to vary with the reciprocal of the valence rather than the predicted reciprocal of valence-squared, indicating that the platelet structure may be a factor influencing aggregation rates. The critical coagulation concentrations (CCC) (3 mM for CaCl2, 4 mM for MgCl2, and 70 mM for KCl) were obtained from the stability ratios. At a later time and above a minimal cation concentration, turbidity reached a quasi-stable state, indicating the formation of large aggregates. Under this condition, an approximate turbidity forward-scattering correction factor was applied and the fractal dimension was determined from the extinction spectra. For the divalent cations, the fractal dimensions were 1.65 ± 0.3 for Ca2+ and 1.75 ± 0.3 for Mg2+ and independent of cation concentrations above the CCC. For the monovalent cation, the fractal dimension increased with K+ concentration from 1.35 to 1.95, indicating a transition to a face-to-face geometry from either an edge-to-edge or edge-to-face orientation.
Weathering of Almandine Garnet: Influence of Secondary Minerals on the Rate-Determining Step, and Implications for Regolith-Scale Al Mobilization
Authors: Price Jason R. , Bryan-Ricketts Debra S. , Anderson Diane , Velbel Michael A.
Published: March 2013

Secondary surface layers form by replacement of almandine garnet during chemical weathering. This study tested the hypothesis that the kinetic role of almandine’s weathering products, and the consequent relationships of primary-mineral surface texture and specific assemblages of secondary minerals, both vary with the solid-solution-controlled variations in Fe and Al contents of the specific almandine experiencing weathering.

Surface layers are protective (PSL) when the volume of the products formed by replacement is greater than or equal to the volume of the reactants replaced. Under such circumstances, reaction kinetics at the interface between the garnet and the replacing mineral are transport controlled and either transport of solvents or other reactants to, or products from, the dissolving mineral is rate limiting. Beneath PSLs, almandine garnet surfaces are smooth, rounded, and featureless. Surface layers are unprotective (USL) when the volume of the products formed by replacement is less than the volume of the reactants replaced. Under such circumstances, reaction kinetics at the interface between the garnet and the replacing mineral are interface controlled and the detachment of ions or molecules from the mineral surface is rate limiting. Almandine garnet surfaces beneath USLs exhibit crystallographically oriented etch pits. However, contrary to expectations, etch pits occur on almandine garnet grains beneath some layers consisting of mineral assemblages consistent with PSLs.

Based on the Pilling-Bedworth criterion, surface layers are more likely to be protective over a broad range of reactant-mineral compositions when they contain goethite, kaolinite, and pyrolusite. However, this combination requires specific ranges of Fe and Al content of the natural reacting almandine garnet. To form a PSL of goethite and kaolinite, an almandine garnet must have a minimum Al stoichiometric coefficient of ~3.75 a.p.f.u., and a minimum Fe stoichiometric coefficient of ~2.7 a.p.f.u.

Product minerals also influence the mobility of the least-mobile major rock-forming elements. A PSL consisting of goethite, gibbsite, and kaolinite yields excess Al for export during almandine garnet weathering. As the quantity of kaolinite present in the PSL decreases, the amounts of Al available for export increases.
Newton strata in the loop group of a reductive group
Authors: Viehmann Eva
Published: March 2013

We generalize purity of the Newton stratification to purity for a single break point of the Newton point in the context of local $G$-shtukas respectively of elements of the loop group of a reductive group. As an application we prove that elements of the loop group bounded by a given dominant coweight satisfy a generalization of Grothendieck's conjecture on deformations of $p$-divisible groups with given Newton polygons.