bluuebunny/crossref_metadata_2025 huggingface dataset:
Six-Month Versus 12-Month Dual Antiplatelet Therapy After Implantation of Drug-Eluting Stents
Authors: Gwon Hyeon-Cheol , Hahn Joo-Yong , Park Kyung Woo , Song Young Bin , Chae In-Ho , Lim Do-Sun , Han Kyoo-Rok , Choi Jin-Ho , Choi Seung-Hyuk , Kang Hyun-Jae , Koo Bon-Kwon , Ahn Taehoon , Yoon Jung-Han , Jeong Myung-Ho , Hong Taek-Jong , Chung Woo-Young , Choi Young-Jin , Hur Seung-Ho , Kwon Hyuck-Moon , Jeon Dong-Woon , Kim Byung-Ok , Park Si-Hoon , Lee Nam-Ho , Jeon Hui-Kyung , Jang Yangsoo , Kim Hyo-Soo
Published: December 2011

Background—

The optimal duration of dual antiplatelet therapy (DAPT) after implantation of drug-eluting coronary stents remains undetermined. We aimed to test whether 6-month DAPT would be noninferior to 12-month DAPT after implantation of drug-eluting stents.

Methods and Results—

We randomly assigned 1443 patients undergoing implantation of drug-eluting stents to receive 6- or 12-month DAPT (in a 1:1 ratio). The primary end point was a target vessel failure, defined as the composite of cardiac death, myocardial infarction, or ischemia-driven target vessel revascularization at 12 months. Rates of target vessel failure at 12 months were 4.8% in the 6-month DAPT group and 4.3% in the 12-month DAPT group (the upper limit of 1-sided 95% confidence interval, 2.4%;
P
=0.001 for noninferiority with a predefined noninferiority margin of 4.0%). Although stent thrombosis tended to occur more frequently in the 6-month DAPT group than in the 12-month group (0.9% versus 0.1%; hazard ratio, 6.02; 95% confidence interval, 0.72–49.96;
P
=0.10), the risk of death or myocardial infarction did not differ in the 2 groups (2.4% versus 1.9%; hazard ratio, 1.21; 95% confidence interval, 0.60–2.47;
P
=0.58). In the prespecified subgroup analysis, target vessel failure occurred more frequently in the 6-month DAPT group than in the 12-month group (hazard ratio, 3.16; 95% confidence interval, 1.42–7.03;
P
=0.005) among diabetic patients.

Conclusions—

Six-month DAPT did not increase the risk of target vessel failure at 12 months after implantation of drug-eluting stents compared with 12-month DAPT. However, the noninferiority margin was wide, and the study was underpowered for death or myocardial infarction. Our results need to be confirmed in larger trials.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00698607.
Collagenase Total Occlusion-1 (CTO-1) Trial
Authors: Strauss Bradley H. , Osherov Azriel B. , Radhakrishnan Sam , Mancini G.B. John , Manners Allison , Sparkes John D. , Chisholm Robert J.
Published: December 2011

Background—

Percutaneous interventions for chronic total occlusions have low success rates, primarily because of failure of guide wire crossing. Collagen-rich matrix constitutes the main barrier to chronic total occlusion crossing. In preclinical studies, local delivery of a bacterial collagenase formulation improved guide wire crossing. The Collagenase Total Occlusion-1 (CTO-1) Trial is a phase I, dose-escalation trial to assess the safety and efficacy of collagenase therapy to facilitate guide wire crossing in coronary artery chronic occlusions.

Methods and Results—

Twenty subjects with ≥1 previous failure of chronic total occlusion guide wire crossing were enrolled at 2 sites. Subjects were treated in 4 distinct cohorts of 5 patients, with escalation of collagenase dose in each cohort from 300 to 1200 μg. Collagenase was locally delivered into the occlusions with either an over-the-wire balloon system (n=8) or a fine-cross microcatheter (n=12) for a period of 30 minutes. Subjects were brought back to the catheterization laboratory for guide wire crossing and angioplasty the next day. Guide wire crossing was successfully achieved in 15 subjects (75%). A soft-tip guide wire (Whisper, Pilot-50, Fielder XT) was either the sole or predominant guide wire used in 75% of successful crossings. Non–ST-segment–elevation myocardial infarctions occurred in 3 patients as a result of side-branch ischemia during stenting. Computed tomographic angiography at 3 months showed no late complications and patent stents in successfully treated chronic total occlusion. Anginal improvement occurred with a reduction in Canadian Cardiovascular Society class from baseline to 3 months (2.5±0.6 versus 0.9±0.9;
P
<0.001).

Conclusion—

Local delivery of collagenase into coronary chronic total occlusion is feasible and safe with encouraging guide wire crossing results in previously failed cases. Larger clinical trials are required to determine efficacy.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT01271335.
Evaluation of Multiple Biomarkers of Cardiovascular Stress for Risk Prediction and Guiding Medical Therapy in Patients With Stable Coronary Disease
Authors: Sabatine Marc S. , Morrow David A. , de Lemos James A. , Omland Torbjorn , Sloan Sarah , Jarolim Petr , Solomon Scott D. , Pfeffer Marc A. , Braunwald Eugene
Published: December 2011

Background—

Circulating biomarkers can offer insight into subclinical cardiovascular stress and thus have the potential to aid in risk stratification and tailoring of therapy.

Methods and Results—

We measured plasma levels of 4 cardiovascular biomarkers, midregional pro-atrial natriuretic peptide (MR-proANP), midregional pro-adrenomedullin (MR-proADM), C-terminal pro-endothelin-1 (CT-proET-1), and copeptin, in 3717 patients with stable coronary artery disease and preserved left ventricular ejection fraction who were randomized to trandolapril or placebo as part of the Prevention of Events With Angiotensin Converting Enzyme (PEACE) trial. After adjustment for clinical cardiovascular risk predictors and left ventricular ejection fraction, elevated levels of MR-proANP, MR-proADM, and CT-proET-1 were independently associated with the risk of cardiovascular death or heart failure (hazard ratios per 1-SD increase in log-transformed biomarker levels of 1.97, 1.48, and 1.47, respectively;
P
≤0.002 for each biomarker). These 3 biomarkers also significantly improved metrics of discrimination when added to a clinical model. Trandolapril significantly reduced the risk of cardiovascular death or heart failure in patients who had elevated levels of ≥2 biomarkers (hazard ratio, 0.53; 95% confidence interval, 0.36–0.80), whereas there was no benefit in patients with elevated levels of 0 or 1 biomarker (hazard ratio, 1.09; 95% confidence interval, 0.74–1.59;
P
interaction
=0.012).

Conclusions—

In patients with stable coronary artery disease and preserved left ventricular ejection fraction, our results suggest that elevated levels of novel biomarkers of cardiovascular stress may help identify patients who are at higher risk of cardiovascular death and heart failure and may be useful to select patients who derive significant benefit from angiotensin-converting enzyme inhibitor therapy.
Effects of variation in autoclave pressure, temperature, and vacuum-application time on porosity and mechanical properties of a carbon fiber/epoxy composite
Authors: Koushyar Hoda , Alavi-Soltani Seyed , Minaie Bob , Violette Melanie
Published: December 2011

This article presents results from investigation of the effects of variation in autoclave pressure, temperature, and vacuum-application time on porosity, hot/wet (H/W) and room temperature/dry (RT/D) short beam shear (SBS) strength, and failure mechanism of a commercial carbon fiber/epoxy prepreg, Cycom IM7/977-2 unidirectional tape. Fourteen cure cycles were designed to study a wide range of curing pressures, curing temperatures, and two different vacuum-application durations, including vacuum vented at recommended pressure and vacuum held throughout the cure cycle. The results showed that the SBS strength did not vary significantly over a relatively wide range of curing temperatures and pressures if vacuum was vented at recommended curing pressure; however, after a certain point, a decreasing trend in the SBS strength was observed by reducing the curing temperature and pressure. The C-scan images of panels cured with the vacuum held throughout the cure cycles revealed presence of a high-porosity cross-shaped defect at the center of the panels. The observed defect became larger as the curing pressure decreased. The correlation between the SBS strength and the void content was studied using theoretical models and experimental data. The investigation of the failure modes for each panel showed a change in both the H/W and the RT/D failure mechanism as a result of variation in curing temperature and pressure.
Experimental fabrication and characterization of out-of-plane fiber waviness in continuous fiber-reinforced composites
Authors: Wang J , Potter KD , Hazra K , Wisnom MR
Published: December 2011

This study presents the development of fabrication techniques and experimental measurements of out-of-plane fiber waviness in a continuous fiber-reinforced polymer composite. Literature on characterization and fabrication techniques was briefly reviewed. Three fabrication methods were developed: the transverse-strip method, ply-drop method, and constant-thickness ply-drop method. Experimental characterization demonstrated that specimens with a range of waviness parameters can be easily manufactured. The most important features of the techniques are ease of fabrication and simplicity of experimental setup. An industrial part was characterized optically to validate the techniques, showing a maximum misalignment angle of 5.3°.
Preparation and design of green sound-absorbing materials via pulp fibrous models
Authors: Liu Detao , Xia Kunfeng , Chen Wenxiong , Yang Rendang , Wang Bin
Published: December 2011

Novel green pulp fiber–based sound-absorbing materials (PSAMs) were produced, and their sound-absorbing performances were investigated in relation to the characteristics of the pulp fibrous models. Decreases in important fiber characteristics (e.g., fiber length, width) after the beating process caused a significant increase in the sound-absorbing properties of the PSAMs. The average sound-absorption coefficients of the PSAMs were found to possess a cubic-degree parabolic relationship with thickness. Scanning electron microscopy indicated that after the beating treatment, many new microfibrils detached from the cell walls and were reconstructed into new nanopores, which led to a decrease of the pore radius and an increase of the pore volume. These new nanopores served as new channels for sound wave movement and contributed to the increased consumption of sound energy. The results suggest that pulp fibers can partially or fully substitute for the inorganic fibers of acoustic materials used in many applications.
Effect of surface modification of poly-p-phenylenebenzobisoxazole fiber with lanthanum salt on flexural and tribological properties of composite with polyimide
Authors: Liang Yu , Xianhua Cheng
Published: December 2011

The effect of lanthanum (La) salt on surface treatment of poly-p-phenylenebenzobisoxazole (PBO) fiber on flexural and tribological properties of PBO fibers reinforced polyimide (PI) composites was investigated. Experimental results revealed that flexural strength and modulus were largely improved by La salt treatment. The La salt treated composite had lower friction coefficient and specific wear rate than that of untreated one under the same testing condition. The principle of improvement in interfacial adhesion between PBO fiber and PI matrix after La salt treatment was discussed. The surface characteristics of PBO fibers were characterized by X-ray photoelectron spectroscopy. It was found that the content of polar groups on the surface of PBO fiber treated by La salt increased compared with the untreated fiber. The increase in the amount of polar groups strengthened the interfacial adhesion between PBO fibers and PI matrix, and accordingly enhanced the flexural and tribological properties.
Studies on properties of as-cast Al6061-WC-Gr hybrid MMCs
Authors: Kumar GB Veeresh , Swamy ARK , Ramesha A
Published: December 2011

Aluminum (Al) alloys started replacing cast iron and bronze alloys in the manufacture of wear-resistant parts and are materials of interest owing to their low density, higher strength to weight ratio, which is an additional advantage in aerospace, marine and automotive applications. Al-metal matrix composite (MMC) materials are very much popular due to the reason that these composites possess good mechanical properties and higher wear resistance. This article is aimed to present the experimental results of microstructure, hardness, tensile, yield and compression strength, percentagage elongation, volumetric wear loss, and wear rate of Al6061-Tungsten Carbide (WC)–Graphite (Gr) reinforced hybrid MMCs. The composites were prepared using the liquid metallurgy technique, in which 0 to 4 wt% of WC particulates were dispersed into the matrix alloy in steps of 1 wt% by maintaining the Gr to 4 wt% constant. The experimental results indicate that the density of the hybrid-MMCs increases with increased WC content and further, agree to the values obtained through the rule of mixtures. The physical, mechanical and the tribological properties of the Al6061-WC-Gr hybrid MMCs were found to increase with increased WC content in the matrix at the cost of reduced ductility. The WC and Gr reinforcements contributed significantly in improving the wear resistance of Al6061-WC-Gr hybrid MMCs.
Investigation on fracture toughness of aluminum matrix composites reinforced with in situ titanium diboride particles
Authors: Wang Feifei , Li Jianguo , Xu Jianming , Li Xianfeng , Zhang Yijie , Wang Haowei
Published: December 2011

Compared to the massive damage caused by SiC/Al2O3 particles to fracture toughness of conventional metal matrix composites in previous reports, an effective improvement in fracture toughness of Al matrix composites with 3, 5.6, and 7.8 vol.% in situ nano/submicron TiB2 has been obtained by improving the particle size and distribution. It is found that the fracture toughness of TiB2/Al composites are only slightly lower than that of the unreinforced alloy, having a mere reduction of 3% to 8%. This is because the in situ TiB2 particles can weaken the damage caused by reinforcing phases to fracture toughness due to their fine sizes, near-spherical shapes, and relatively uniform distributions. Fractography shows the dominant fracture mechanisms of TiB2/Al composites are matrix rupture, eutectic silicon particles fracture as well as TiB2 particles separation.
Tensile properties degradation of GFRP composites containing nanoclay in three different environments
Authors: Zhu Hong-Gang , Leung Christopher KY , Kim Jang-Kyo , Liu Ming-Yang
Published: December 2011

Glass fiber-reinforced polymer (GFRP) composite with neat epoxy matrix and GFRP nanocomposite with epoxy–organoclay nanocomposite matrix were prepared. Their tensile properties degradation at elevated temperatures and in alkaline as well as freeze–thaw cycling environments was studied by performing the uniaxial tension test. Optical microscope in the transmission mode was employed to observe the failed specimens. Results show that the tensile properties of both materials degrade with increasing testing temperature or increasing immersion time in alkaline solution. Interestingly, the degradation rate is reduced, though insignificantly, when epoxy nanocomposite is used as the matrix material. This can be attributed to the improved thermo-mechanical property and barrier property of epoxy nanocomposite. When exposed to freeze–thaw cycles, the tensile properties of both materials degrade first and then level off. However, in this case, organoclay introduction has little effect on the degradation rate of GFRP tensile properties. The failure mechanisms of both materials in different environments were also discussed.
Synthesis of B4C, Al2O3, and AlB12 reinforced Al matrix nano composites via mechanochemical method
Authors: Torabi Omid , Ebrahimi-Kahrizsangi Reza
Published: December 2011

In this study, mechanochemical reactions in the ternary system of Al–B2O3–C were investigated. The starting materials were activated in a planetary ball mill under Argon atmosphere at different times. X-Ray diffraction and scanning electron microscopy (SEM) methods were used to characterize the products. The results showed that B4C, AlB12, and Al2O3 were formed at least after 4 h of milling. Furthermore, an aluminum borate (9Al2O3.2 B2O3) compound was formed during an aluminothermic reaction, as a by-product that could be diminished substantially by increasing the milling time to 20 h. SEM and TEM micrograph showed that the products were agglomerated and the range of particle size was within 100 nm. A high hardness value of 88 BHN with a compaction strength of 313 MPa can be achieved for the bulk sample sintered at 560°C for 90 min.
Surface roughness analysis in high-speed drilling of unreinforced and reinforced polyamides
Authors: Gaitonde VN , Karnik SR , Rubio J Campos , Abrão AM , Correia A Esteves , Davim J Paulo
Published: December 2011

In this work, surface roughness study in high-speed drilling of unreinforced polyamide (PA6) and reinforced polyamide with 30% of glass fibers (PA66 GF30) using cemented carbide (K20) tool has been carried out. The experiments were planned as per full factorial design of experiments. The effects of cutting speed and feed rate on centerline average surface roughness, maximum peak to valley height, and peak counts have been analyzed by developing response surface methodology based third-order mathematical models. The parametric analysis clearly indicates the influence of reinforced fiber on surface finish when high-speed cutting in drilling is used.
Alendronate Affects Osteoblast Functions by Crosstalk through EphrinB1-EphB
Authors: Shimizu E. , Tamasi J. , Partridge N.C.
Published: December 2011

Bisphosphonates are therapeutic agents in the treatment of post-menopausal osteoporosis. Although they have been associated with delayed healing in injured tissues, inappropriate femoral fractures, and osteonecrosis of the jaw (ONJ), the pathophysiological mechanisms involved are not clear. Our hypothesis is that alendronate, a member of the N-containing bisphosphonates, indirectly inhibits osteoblast function through the coupling of osteoclasts to osteoblasts by ephrinB-EphB interaction. We found that alendronate increased gene and protein expression of ephrinB1 and EphB1, as well as B3, in femurs of adult mice injected with alendronate (10 µg/100 g/wk) for 8 weeks. Alendronate suppressed the expression of bone sialoprotein (BSP) and osteonectin in both femurs and bone marrow osteoblastic cells of mice. After elimination of pre-osteoclasts from bone marrow cells, alendronate did not affect osteoblast differentiation, indicating the need for pre-osteoclasts for alendronate’s effects. Alendronate stimulated EphB1 and EphB3 protein expression in osteoblasts, whereas it enhanced ephrinB1 protein in pre-osteoclasts. In addition, a reverse signal by ephrinB1 inhibited osteoblast differentiation and suppressed BSP gene expression. Thus, alendronate, through its direct effects on the pre-osteoclast, appears to regulate expression of ephrinB1, which regulates and acts through the EphB1, B3 receptors on the osteoblast to suppress osteoblast differentiation.
The Monetary Costs of Crime to Middle Adulthood
Authors: Piquero Alex R. , Jennings Wesley G. , Farrington David
Published: December 2011

Objectives: Monetary cost estimates of criminal careers have been limited to specific samples, specific ages, and focused on the United States. This article is the first to examine the costs of a life course of crime in the United Kingdom. Method: This study uses longitudinal data from 411 South London males from the Cambridge Study in Delinquent Development (CSDD) to derive costs-of-crime estimates from childhood to middle adulthood (ages 10 to 50). Additional features include a calculation of cost estimates across distinct offending trajectories and centering on costs per offender. Results: Offending over the life course imposes a considerable amount of economic and social costs and these costs are differentially distributed across offending trajectories. The cost of high-rate chronic offending is nearly two and a half to ten times greater than the cost of high adolescence peaked offending, very low-rate chronic offending, and low adolescence peaked offending, respectively. It is estimated that a male high-rate chronic offender on average would impose an annual cost of £18 ($29) per U.K. citizen or a lifetime cost of £742 ($1,185) per U.K. citizen. Conclusions: As the average and total costs of crime were significantly different across offending trajectories, with high-rate chronics imposing the most financial burden, adopting prevention and intervention strategies aimed at reducing the number of high-rate chronics and/or speeding up their eventual desistance will offer many savings to the public and perhaps turn those negative costs into positive contributions.
Reading Growth of Students With Disabilities in the Context of a Large-Scale Statewide Reading Reform Effort
Authors: Sanford Amanda Kathleen , Park Yonghan , Baker Scott K.
Published: December 2011

The reading growth of 1,422 second- and third-grade students in special education was examined in the context of schools with 1 and 3 years of experience with Oregon Reading First. Findings suggested that (a) experience with Reading First was associated with greater student reading growth regardless of special education status, (b) students in special education made differentially less growth compared with peers not in special education, and (c) greater risk for reading failure and identification for special education was associated with poorer reading growth. Implications are discussed regarding the involvement of students in special education in Comprehensive School Reform initiatives and the need for more intensive instruction and assessment for students in special education and those at risk for reading failure.
Say It Like You Mean It: Mothers’ Use of Prosody to Convey Word Meaning
Authors: Herold Debora S. , Nygaard Lynne C. , Namy Laura L.
Published: December 2011

Prosody plays a variety of roles in infants’ communicative development, aiding in attention modulation, speech segmentation, and syntax acquisition. This study investigates the extent to which parents also spontaneously modulate prosodic aspects of infant directed speech in ways that distinguish semantic aspects of language. Fourteen mothers of two-year-old children read a picture book to their children in which they labeled pictures using dimensional adjectives (e.g., big, small, hot, cold). Recordings of the mothers’ input to their children were analyzed acoustically and antonyms within each dimension were compared. Mothers modulated aspects of their prosody including amplitude and duration of target words and sentences to distinguish dimensional adjectives. Mothers appear to recruit prosody in the service of word learning.
The Similarity of Plural Endings and Linking Elements in Regional Speech Variants of Dutch
Authors: Hanssen Esther , Banga Arina , Neijt Anneke , Schreuder Robert
Published: December 2011

The plural suffix - en ( noot+ en, ‘nuts’) is pronounced differently by speakers coming from different regions of the Netherlands. In this study, we compared the pronunciation of the plural suffix - en in phrases ( noot+ en kraken, ‘to crack nuts’) with linking en in compounds ( noot+ en+ kraker, ‘nutcracker’), because some claim that both are similar (Schreuder, Neijt, van der Weide, & Baayen, 1998), whereas others claim that they are not (Verkuyl, 2007). The pronunciations of 109 participants coming from five regions of the Netherlands were therefore compared in a picture naming task. A systematic relation between the pronunciations of plural - en and linking en was detected: Speakers from the Northern and Eastern regions produced [(ᵊ)n] most often for both the linking elements and plural endings, while speakers from the Middle and Western regions produced [ᵊ] most often for both. For speakers from the Southern region, we found no preference to pronounce either [ᵊ] or [ᵊn] in compounds or phrases. It is concluded that Dutch speakers often do not distinguish plural - en from linking en in their speech production. Possibly, speakers of Dutch consider linking en and plural - en as the same morpheme.
Coordination and Interpretation of Vocal and Visible Resources: ‘Trail-off’ Conjunctions
Authors: Walker Gareth
Published: December 2011

The empirical focus of this paper is a conversational turn-taking phenomenon in which conjunctions produced immediately after a point of possible syntactic and pragmatic completion are treated by co-participants as points of possible completion and transition relevance. The data for this study are audio-video recordings of 5 unscripted face-to-face interactions involving native speakers of US English, yielding 28 ‘trail-off’ conjunctions. Detailed sequential analysis of talk is combined with analysis of visible features (including gaze, posture, gesture and involvement with material objects) and technical phonetic analysis. A range of phonetic and visible features are shown to regularly co-occur in the production of ‘trail-off’ conjunctions. These features distinguish them from other conjunctions followed by the cessation of talk.
Heteronormativity in the University Classroom
Authors: Ripley Matthew , Anderson Eric , McCormack Mark , Rockett Ben
Published: December 2011

This article explores the complex relationship between an openly gay instructor, homophobia, and heteronormativity in a university classroom. The authors first tabulated the frequency with which the instructor used the lives of heterosexuals and homosexuals as examples of content or as content itself, and then they interviewed 32 students about their perceptions of these frequencies. They found that students significantly overestimated lesbian, gay, bisexual, and transgender (LGBT) frequencies and underestimated heterosexual ones. The authors develop two analytical concepts to highlight this form of heteronormativity: novelty attachment and content substitution. They explain these phenomena by suggesting that the novelty of using LGBT examples and discussing homosexuality as content results in the activation of stereotypes among otherwise gay-friendly students. They examine the cognitive underpinnings of this using social identity theory and call for further research to examine the applicability of their theory to other minority groups.
Developmental Pharmacokinetic Changes of Lamivudine in Infants and Children
Authors: Tremoulet Adriana H. , Nikanjam Mina , Cressey Tim R. , Chokephaibulkit Kulkanya , McKinney Ross , Mirochnick Mark , Capparelli Edmund V.
Published: December 2011

Lamivudine is a nucleoside reverse transcriptase inhibitor widely used in infants and children in combination antiretroviral therapy to treat human immunodeficiency virus (HIV) infection. Developmental changes in lamivudine pharmacokinetic disposition were assessed by combining data from 7 studies of lamivudine (Pediatric AIDS Clinical Trials Group 300, 353, 356, 358, 386, 1056, and 1069) representing subjects across the pediatric age continuum. A population pharmacokinetic model was developed to identify factors that influence lamivudine disposition. Age and Thai race were independent predictors of apparent clearance (CL/F), whereas the use of a fixed drug combination formulation (GPO‐VIR) was an independent predictor of bioavailability, with CL/F more than doubling from birth to adolescence. Serum creatinine was not associated with CL/F. Monte Carlo simulations were used to compare the lamivudine exposure achieved with World Health Organization (WHO) weight band and Food and Drug Administration (FDA) label dosing recommendations. WHO dosing yielded higher exposure during the first few months of life, but this difference was less pronounced between 6 months and 14 years of age. Overall, both FDA and WHO dosing provided similar AUC values to those previously reported in HIV‐infected adults. Lamivudine WHO weight band dosing results in therapeutic exposure in infants and children and may improve drug dosing in resource‐limited countries.
Assisted Breathing
Authors: Graham Amanda Jane
Published: December 2011

The Colombian artist Oscar Muñoz’s Aliento (Breath)—10 steel discs, photoserigraph with grease—is an experiment with materials. On the surface it is minimalist—art about the surface of art, the stuff art is made of. Yet Muñoz’s surfaces are deceiving, for his images become clear only when viewers breathe on them. With a breath, sepia photographs of desaparecidos—young Colombian men proclaimed “disappeared” by their government—appear and momentarily return viewers’ gaze. As the condensation fades on the mirror-like metal, so do the images. Here the aesthetic disappearance parallels the corporeal-political one. For a moment, viewers recognize the “Other” in their own reflections and in so doing begin to comprehend how Muñoz’s piece forces the repetition of the moment of encounter and in the process uncovers hidden truths.

La obra Aliento del artista colombiano Oscar Muñoz (10 discos de metal, fotoserigrafía con grasa) es un experimento con materiales. Superficialmente se trata de un trabajo minimalista—arte que habla sobre las superficies del arte y los materiales que la componen. Pero las superficies de Muñoz son engañosas, ya que las imágenes sólo aparecen debidamente cuando el espectador respira sobre ellas. Un aliento revela momentáneamente fotografías en sepia de jóvenes colombianos declarados desaparecidos por su gobierno. Conforme la condensación se esfuma del metal especular, las imágenes también se desvanecen y la desaparición estética hace eco al desvanecimiento corpóreo y político. Por un instante, el espectador reconoce al “Otro” en su propio reflejo y comienza así a entender las maneras en las que la obra de Muñoz obliga a repetir el momento del encuentro, develando en el proceso verdades ocultas.
Virtual Reality Cognitive-Behavior Therapy for Public Speaking Anxiety
Authors: Safir Marilyn P. , Wallach Helene S. , Bar-Zvi Margalit
Published: December 2011

Public speaking anxiety (PSA) is a common social phobia. Although cognitive-behavior therapy (CBT) is the treatment of choice, difficulties arise with both in vivo and in vitro exposure (lack of therapist control, patient’s inability to imagine, self-flooding, and a lack of confidentiality resulting from public exposure). Virtual reality CBT (VRCBT) enables a high degree of therapist control, thus overcoming these difficulties. In a previous publication, the authors reported on their findings that VRCBT ( n = 28) and CBT ( n = 30) groups were significantly more effective than a wait-list control (WLC; n = 30) group in anxiety reduction on four of five anxiety measures as well as on participant’s self-rating of anxiety during a behavioral task. No significant differences were found between VRCBT and CBT. However, twice as many clients dropped out of CBT (15) than from VRCBT (6). Results demonstrated that VRCBT is an effective and brief treatment regimen, equal to CBT. This brief report examined durability of these changes. They found that both VRCBT (25) and CBT (24) groups maintained their improvement from post treatment to follow-up, on all five measures. In addition, they found that the CBT group continued to improve from post treatment to follow-up on Liebowitz Social Anxiety Scale (LSAS) fear. Thus, treatment gains were maintained at a 1-year follow-up.
Severe Acute Malnutrition in Very Low Birth Weight Preterm Infants
Authors: Enweronu‐Laryea Christabel C. , Aryee Irene N. A. , Adei Eunice A. P.
Published: December 2011

Malnutrition in preterm low birth weight infants has adverse long‐term metabolic, growth, and neurodevelopmental effects. In the past 3 decades, parenteral nutrition, enriched preterm formula, and fortification of human milk have been used to alleviate these adverse effects. Unfortified human breast milk does not provide sufficient nutrients for the growth and development of preterm infants at the volumes recommended; however, it is usually the only source of nutrition available for such infants in low‐resource countries. Many newborns, including very low birth weight infants, are surviving in these countries because of concerted efforts to achieve the fourth millennium development goal. These efforts have not addressed the nutrition needs of sick preterm very low birth weight infants. The authors report 3 cases of severe acute malnutrition in very low birth weight newborns and suggest possible interventions.
The D‐Lightful Vitamin D for Child Health
Authors: Holick Michael F.
Published: December 2011

Vitamin D deficiency and insufficiency is common in children. Vitamin D deficiency is defined as a 25‐hydroxyvitamin D <20 ng/mL and insufficiency as 21–29 ng/mL. The major sources of vitamin D are sun exposure, diet, and supplements. In young children, vitamin D deficiency causes a mineralization defect of the skeleton, resulting in rickets. Vitamin D deficiency has been linked to many chronic diseases, including multiple sclerosis, type 1 diabetes, infectious diseases, heart disease, and type 2 diabetes. In utero vitamin D deficiency increases risk for preeclampsia and the need for a cesarean section. Children living at higher latitudes and who are presumed to be at increased risk for vitamin D deficiency are at higher risk for developing type 1 diabetes and multiple sclerosis later in life. The Institute of Medicine recommends that children 0–1 year and 1–18 years need 400 and 600 IU/d, respectively, of vitamin D for maximal skeletal health. The Endocrine Society's Clinical Guidelines recommended that to prevent and treat vitamin D deficiency, children 0–1 year and 1–18 years need 400–1000 and 600–1000 IU/d, respectively.
Strategic Delegation
Authors: Sengul Metin , Gimeno Javier , Dial Jay
Published: December 2011

This article reviews the strategic delegation literature and provides a theoretical framework that integrates this perspective into management research. The strategic delegation literature is built on the observation that, under strategic interdependence, delegation of decision making and accompanying actions can serve as commitments that influence competitive interactions with rivals and lead to beneficial outcomes. In this article, the authors first integrate diverse models and streams of research on strategic delegation in an organizing framework and highlight points of agreement and departure. This is the first comprehensive review of formal game-theoretical research purporting to show the strategic effects of delegation. The authors then integrate strategic delegation into strategic management and organization theory research in three main ways: They propose a common set of assumptions that would attune the strategic delegation perspective with other views and make it more relevant for management research, they outline ways in which the strategic delegation perspective can be linked to a set of theories of management, and finally they point out additional empirical research avenues that can exploit interindustry heterogeneity, intraindustry heterogeneity, and international differences in delegation instruments.
A Multidisciplinary Review of the Director Selection Literature
Authors: Withers Michael C. , Hillman Amy J. , Cannella Albert A.
Published: December 2011

Director selection is a critical board process and outcome that influences the board and its overall performance. Because of this influence, research from a variety of different disciplinary areas examines the antecedents and outcomes of director selection. The authors offer a synthesis of this literature from these different disciplines. The authors first delineate the process that drives the selection of an individual to a board. They then review and categorize the director selection literature into two distinct perspectives—a rational economic perspective focused on the organization-level benefits driving the selection decision and a socialized perspective emphasizing the social processes that influence the director selection process. Finally, from their review, the authors suggest promising areas of future research regarding director selection.
Insights and New Directions from Demand-Side Approaches to Technology Innovation, Entrepreneurship, and Strategic Management Research
Authors: Priem Richard L. , Li Sali , Carr Jon C.
Published: December 2011

The authors review the progress of three rapidly growing macro management literatures—in technology innovation, entrepreneurship, and strategic management—that have in common the use of a “demand-side” research perspective. Demand-side research looks downstream from the focal firm, toward product markets and consumers, to explain and predict those managerial decisions that increase value creation within a value system. Typical characteristics of demand-side, macro-level management research include clearly distinguishing value creation from value capture, emphasizing product markets as key sources of value-creation strategies for firms, viewing consumer preferences as dynamic and sometimes latent, and recognizing that managers’ differing decisions in response to consumer heterogeneity contribute to firm heterogeneity and, ultimately, value creation. The authors review recent demand-side findings showing that strategies based on consumer heterogeneity can result in competitive advantage even if the firm holds only obsolete or mundane resources, these advantages can be sustainable without resource- or ability-based barriers to imitation, successful innovations can be consumer driven rather than resource or technology driven, and consumer knowledge can play a key role in entrepreneurial idea discovery. These seemingly counterintuitive findings from demand-side research indicate the promise of future demand-side work for generating new knowledge useful to scholars and managers. The authors suggest directions for future demand-side research based on their review. What’s more, the research they review represents a start—but only a start—toward integrated theories that could attend to both the demand side and the producer side of the value creation equation.
Comparison of postdischarge physiotherapy versus usual care following primary total knee arthroplasty for osteoarthritis: an exploratory pilot randomized clinical trial
Authors: Lowe Catherine J Minns , Barker Karen L , Holder Roger , Sackley Catherine M
Published: December 2011

Objective: To evaluate a pilot trial of a postdischarge physiotherapy intervention to improve patient function versus usual physiotherapy in patients undergoing total knee arthroplasty aiming to assess: recruitment rate, feasibility and acceptability of the intervention and control, suitability of outcomes, retention and adverse events and to inform sample size calculation for a definitive trial.

Design: Exploratory pilot randomized controlled trial using independent assessment.

Setting: Mixed urban and rural, UK.

Participants: Patients undergoing primary, elective unilateral knee arthroplasty for osteoarthritis.

Intervention: Two additional home physiotherapy visits of functional weight-bearing exercises, functional task-specific training versus treatment as usual.

Main outcome: Oxford Knee Score at 12 months. Secondary outcomes: completion rates, adverse events, Knee Injury and Osteoarthritis Outcome Score, leg extensor power, timed 10-m walk, timed sit-to-stand, resource use diaries. Assessments completed at baseline (pre-operatively), 3, 6 and 12 months.

Results: Of 181 eligible participants 107 (59.1%) were randomized over 13 months, one participant withdrew, no adverse events. Intervention group n = 56 (mean age 67.8), control group n = 51 (mean age 70.8). The difference in mean change of Oxford Knee Scores between groups (intervention – control) at 12 months was 0.2 (95% confidence interval (CI) –3.8, 4.2), P = 0.94. Patient diaries revealed non-trial additional physiotherapy requires improved measurement.

Conclusions: Successful recruitment and retention rates were achieved. The intervention appeared feasible and acceptable but may be suboptimal in intensity given recent research. A sample size of 1271 participants would be required for a fully powered randomized controlled trial using the main outcome. However new outcomes, potentially of greater validity and responsiveness, require consideration.
The DRESS trial: a feasibility randomized controlled trial of a neuropsychological approach to dressing therapy for stroke inpatients
Authors: Walker Marion F , Sunderland Alan , Fletcher-Smith Joanna , Drummond Avril , Logan Pip , Edmans Judi A , Garvey Katherine , Dineen Robert A , Ince Paul , Horne Jane , Fisher Rebecca J , Taylor Jenny L
Published: December 2011

Objective:

To investigate two approaches to treating patients with persistent dressing problems and cognitive difficulties following stroke.

Design:

Pilot randomized controlled trial.

Setting:

Inpatient stroke rehabilitation service.

Subjects:

Seventy consecutive stroke patients with persistent dressing problems and accompanying cognitive difficulties at two weeks after their stroke.

Interventions:

Patients were randomly allocated to six weeks of either a systematic neuropsychological approach, based on analysis of dressing problems and further cognitive testing, or to the control group who received conventional (functional) dressing practice. Both groups received treatment three times a week in accordance with two separately prepared manuals.

Main measures:

Nottingham Stroke Dressing Assessment (NSDA), Line Cancellation, 10-hole peg transfer test, Object Decision, Gesture Imitation. Patients were assessed at six weeks after randomization by an independent assessor masked to group allocation.

Results:

Both neuropsychological and functional groups improved performance on the NSDA over the treatment period (31% and 22%, respectively) but there was no significant difference between groups at six weeks. However, the neuropsychological group showed a significantly greater improvement on a line cancellation test of visual neglect ( t(62) = 2.1, P < 0.05) and a planned subanalysis for those with right hemisphere damage showed a trend towards better dressing outcome ( P = 0.07, one-tailed).

Conclusions:

Results demonstrate the potential benefits of a systematic neuropsychological approach to dressing therapy, particularly for patients with right hemisphere damage. This study suggests the need for a phase III study evaluating the efficacy of a systematic neuropsychological approach in treating dressing difficulties, targeting patients with right hemisphere stroke and visuospatial impairments.
Psychometric comparison of the shortened Fugl-Meyer Assessment and the streamlined Wolf Motor Function Test in stroke rehabilitation
Authors: Fu Tiffany Szu-Ting , Wu Ching-yi , Lin Keh-chung , Hsieh Ching-ju , Liu Jung-sen , Wang Tien-ni , Ou-yang Pei
Published: December 2011

Objective:

We aimed to compare the responsiveness, concurrent and predictive validity of the shortened Fugl-Meyer Assessment (S-FMA) and the streamlined Wolf Motor Function Test (S-WMFT) in persons with subacute stroke.

Design:

Test–retest design.

Setting:

Departments of physical medicine and rehabilitation at three hospitals.

Participants:

Participants with first-time stroke ( N = 51; 38 men, 13 women; mean age ± SD, 55.1 ± 11.7 years) based on scores of Mini-Mental State Examination and Brunnstrom stage.

Interventions:

Participants received one of three rehabilitation therapies for three weeks and were evaluated at baseline and end of treatment.

Main outcome measures:

Responsiveness was examined using the paired t-test and the standardized response mean (SRM). Criterion validity was investigated using the Pearson’s correlation coefficient ( r).

Results:

Changes from baseline to end of treatment assessed by both tests were significant ( P < 0.001). The value for responsiveness of the S-FMA was significantly higher than that of the S-WMFT (SRM difference, 0.48; 95% confidence interval, 0.23–0.63). There were stronger associations between the comparison scales and the S-FMA ( r = 0.57–0.68) than with the S-WMFT ( r = 0.39–0.58).

Conclusions:

The S-FMA had better concurrent and predictive validity than the S-WMFT and was more sensitive to changes caused by rehabilitation therapies. The S-FMA is recommended for expedited assessment of arm motor function outcome in stroke patients receiving rehabilitative therapy.
Understanding Compassion Satisfaction, Compassion Fatigue and Burnout: A survey of the hospice palliative care workforce
Authors: Slocum-Gori Suzanne , Hemsworth David , Chan Winnie WY , Carson Anna , Kazanjian Arminee
Published: December 2011

Background:

Despite the increasingly crucial role of the healthcare workforce and volunteers working in hospice and palliative care (HPC), very little is known about factors that promote or limit the positive outcomes associated with practicing compassion.

Aim:

The purpose of this study was to: 1) understand the complex relationships among Compassion Satisfaction, Compassion Fatigue and Burnout within the hospice and palliative care workforce and 2) explore how key practice characteristics – practice status, professional affiliation, and principal institution – interact with the measured constructs of Compassion Satisfaction, Compassion Fatigue and Burnout.

Design:

Self-reported measures of Compassion Satisfaction, Compassion Fatigue and Burnout, using validated scales, as well as questions to describe socio-demographic profiles and key practice characteristics were obtained.

Setting/participants:

A national survey of HPC workers, comprising clinical, administrative, allied health workers and volunteers, was completed. Respondents from hospital, community-based and care homes informed the results of our study ( n = 630).

Results:

Our results indicate a significant negative correlation between Compassion Satisfaction and Burnout ( r = −0.531, p < 0.001) and between Compassion Satisfaction and Compassion Fatigue ( r = −0.208, p < 0.001), and a significant positive correlation between Burnout and Compassion Fatigue ( r = 0.532, p < 0.001). Variations in self-reported levels of the above constructs were noted by key practice characteristics. Levels of all three constructs are significantly, but differentially, affected by type of service provided, principal institution, practice status and professional affiliation. Results indicate that health care systems could increase the prevalence of Compassion Satisfaction through both policy and institutional level programs to support HPC professionals in their jurisdictions.