bluuebunny/crossref_metadata_2025 huggingface dataset:
Simulations of the Present and Late-Twenty-First-Century Western North Pacific Tropical Cyclone Activity Using a Regional Model
Authors: Wu Liang , Chou Chia , Chen Cheng-Ta , Huang Ronghui , Knutson Thomas R. , Sirutis Joseph J. , Garner Stephen T. , Kerr Christopher , Lee Chia-Jung , Feng Ya-Chien
Published: January 2014

A high-resolution regional atmospheric model is used to simulate present-day western North Pacific (WNP) tropical cyclone (TC) activity and to investigate the projected changes for the late twenty-first century. Compared to observations, the model can realistically simulate many basic features of the WNP TC activity climatology, such as the TC genesis location, track, and lifetime. A number of spatial and temporal features of observed TC interannual variability are captured, although observed variations in basinwide TC number are not. A relatively well-simulated feature is the contrast of years when the Asian summer monsoon trough extends eastward (retreats westward), more (fewer) TCs form within the southeastern quadrant of the WNP, and the corresponding TC activity is above (below) normal over most parts of the WNP east of 125°E. Future projections with the Coupled Model Intercomparison Project phase 3 (CMIP3) A1B scenario show a weak tendency for decreases in the number of WNP TCs, and for increases in the more intense TCs; these simulated changes are significant at the 80% level. The present-day simulation of intensity is limited to storms of intensity less than about 55 m s−1. There is also a weak (80% significance level) tendency for projected WNP TC activity to shift poleward under global warming. A regional-scale feature is a projected increase of the TC activity north of Taiwan, which would imply an increase in TCs making landfall in north China, the Korean Peninsula, and parts of Japan. However, given the weak statistical significance found for the simulated changes, an assessment of the robustness of such regional-scale projections will require further study.
Simulated Global Swell and Wind-Sea Climate and Their Responses to Anthropogenic Climate Change at the End of the Twenty-First Century
Authors: Fan Yalin , Lin Shian-Jiann , Griffies Stephen M. , Hemer Mark A.
Published: January 2014

The seasonal structure of the wind sea and swell is analyzed from the existing 29-yr surface gravity wave climatology produced using a coupled atmosphere–wave model. The swell energy fraction analysis shows that swell dominates most of the World Ocean basins for all four seasons, and the Southern Ocean swells dominate swell in the global ocean. The swells are loosely correlated with the surface wind in the midlatitude storm region in both hemispheres, while their energy distribution and propagation direction do not show any relation with local winds and vary significantly with season because of nonlinear interactions. The same coupled system is then used to investigate the projected future change in wind-sea and swell climate through a time-slice simulation. Forcing of the coupled model was obtained by perturbing the model sea surface temperatures and sea ice with anomalies generated by representative Working Group on Coupled Modelling (WGCM) phase 3 of the Coupled Model Intercomparison Project (CMIP3) coupled models that use the IPCC Fourth Assessment Report (AR4) A1B scenario late in the twenty-first century. Robust responses found in the wind seas are associated with modified climate indices. A dipole pattern in the North Atlantic during the boreal winter is associated with more frequent occurrence of the positive North Atlantic Oscillation (NAO) phases under global warming, and the wind-sea energy increase in the Southern Ocean is associated with the continuous shift of the southern annular mode (SAM) toward its positive phase. Swell responses are less robust because of nonlinearity. The only consistent response in swells is the strong energy increase in the western Pacific and Indian Ocean sector of the Southern Ocean during the austral winter and autumn.
Representing Extremes in a Daily Gridded Precipitation Analysis over the United States: Impacts of Station Density, Resolution, and Gridding Methods
Authors: Gervais Melissa , Tremblay L. Bruno , Gyakum John R. , Atallah Eyad
Published: January 2014

This study focuses on errors in extreme precipitation in gridded station products incurred during the upscaling of station measurements to a grid, referred to as representativeness errors. Gridded precipitation station analyses are valuable observational data sources with a wide variety of applications, including model validation. The representativeness errors associated with two gridding methods are presented, consistent with either a point or areal average interpretation of model output, and it is shown that they differ significantly (up to 30%). An experiment is conducted to determine the errors associated with station density, through repeated gridding of station data within the United States using subsequently fewer stations. Two distinct error responses to reduced station density are found, which are attributed to differences in the spatial homogeneity of precipitation distributions. The error responses characterize the eastern and western United States, which are respectively more and less homogeneous. As the station density decreases, the influence of stations farther from the analysis point increases, and therefore, if the distributions are inhomogeneous in space, the analysis point is influenced by stations with very different precipitation distributions. Finally, ranges of potential percent representativeness errors of the median and extreme precipitation across the United States are created for high-resolution (0.25°) and low-resolution areal averaged (0.9° lat × 1.25° lon) precipitation fields. For example, the range of the representativeness errors is estimated, for annual extreme precipitation, to be from +16% to −12% in the low-resolution data, when station density is 5 stations per 0.9° lat × 1.25° lon grid box.
On the Identification of the Downward Propagation of Arctic Stratospheric Climate Change over Recent Decades*
Authors: Ivy Diane J. , Solomon Susan , Thompson David W. J.
Published: January 2014

Dynamical coupling between the stratospheric and tropospheric circumpolar circulations in the Arctic has been widely documented on month-to-month and interannual time scales, but not on longer time scales. In the Antarctic, both short- and long-term coupling extending from the stratosphere to the surface has been identified. In this study, changes in Arctic temperature, geopotential height, and ozone observed since the satellite era began in 1979 are examined, comparing dynamically quiescent years in which major sudden stratospheric warmings did not occur to all years. It is shown that this approach clarifies the behavior for years without major warmings and that dynamically quiescent years are marked by a strengthening of the Arctic polar vortex over the past 30 years. The associated declines in stratospheric temperatures, geopotential height, and ozone are qualitatively similar to those obtained in the Antarctic (albeit weaker), and propagate downward into the Arctic lowermost stratosphere during late winter and early spring. In sharp contrast to the Antarctic, the strengthening of the Arctic stratospheric vortex appears to originate at a higher altitude, and the propagation to the Arctic troposphere is both very limited and confined to the uppermost troposphere, even when only dynamically quiescent years are considered in the analysis.
Powerless Insulated DC–AC Voltage Measurement by Photovoltaic Energy Harvesting from a P–N Collector–Base Junction in an Opto-Insulator
Authors: Rodríguez-Rodríguez Joaquín H
Published: January 2014

This paper presents a simple and inexpensive powerless electrical insulated voltage measuring sensor using optical couplers for AC and DC voltage measurement, by harvesting the optical photovoltaic energy from a P–N collector–base junction in an opto-insulator to generate an output voltage proportional to the voltage input. A voltage transducer was built with a low-cost opto-insulator circuit and tested to evaluate the voltage measurement capabilities. The system proved to operate properly for AC power line and DC voltages and switching voltages with a bandwidth of 10 kHz. Applications for the powerless insulated DC–AC voltage sensor are in power electronics, voltage measurement, and control.
Notched compression strength of 18-ply laminates with various percentages of 0° plies
Authors: Nettles Alan Tate
Published: January 2014

The use of knockdown factors (percent reduction of undamaged compression strength) to account for flaws such as impact damage or holes have been used to infer the notched strength of laminates. It has been observed that this criterion tends to over-predict the strength of laminates with a high percentage of 0° plies. This paper examines some limited data from the literature and presents new data that compares knockdown calculated notched compression strength values with those measured experimentally for laminates with various percentages of 0° plies. Results show that the trend of over-predicting the notched compression strength of laminates as the percentage of 0°plies increases, based on a knockdown factor, is observed, but the difference can be within scatter except at very high percentages of 0° plies.
Recombinant Biglycan Promotes Bone Morphogenetic Protein-induced Osteogenesis
Authors: Miguez P.A. , Terajima M. , Nagaoka H. , Ferreira J.A.R. , Braswell K. , Ko C.C. , Yamauchi M.
Published: January 2014

The aim of this study was to determine the effects of glutathione-S-transferase-fused recombinant biglycan (GST-BGN) on craniofacial bone regeneration. We recently demonstrated a positive effect of tissue-derived BGN on bone morphogenetic protein 2 (BMP-2) function, which is exerted likely via the BGN core protein. Here, we investigated the effects of GST-BGN lacking any posttranslational modifications on BMP-2 function in vitro and in vivo. In the C2C12 cell culture system, BMP-2-induced Smad 1/5/8 phosphorylation and alkaline phosphatase activity were both enhanced by the addition of GST-BGN. For the in vivo effect, we employed a Sprague-Dawley rat mandible defect model utilizing 1 µg (optimal) or 0.1 µg (suboptimal) of BMP-2 combined with 0, 2, 4, or 8 µg of GST-BGN. At 2 weeks post-surgery, newly formed bone was evaluated by microcomputed tomography and histologic analyses. The results revealed that the greatest amounts of bone within the defect were formed in the groups of suboptimal BMP-2 combined with 4 or 8 µg of GST-BGN. Also, bone was well organized versus that formed by the optimal dose of BMP. These results indicate that recombinant BGN is an efficient substrate to promote low-dose BMP-induced osteogenesis.
A theoretical model of maximum hairiness of staple ring-spun yarns
Authors: Huang XX , Tao XM , Xu BG
Published: January 2014

This paper proposes a theoretical model for maximum hairiness, defined as the number of fiber ends with a certain length in the surface layer of a unit length of ring-spun yarn. These fiber ends have the potential to become protruding hairs, that is, form hairiness of the spun yarn. With consideration of yarn twist, but excluding loops and wild fibers, this model predicts the maximum yarn hairiness or maximum numbers of potential fiber ends with various lengths, which is derived by employing kernel estimation of fiber length distribution. A hairiness contribution factor is introduced as the ratio between the number of fiber ends in the surface layer that potentially contribute to yarn hairiness and the total number of fiber ends in the yarn cross-section. Previous and the present models associated with hairiness or fiber ends are discussed and compared with the measured number of hairs to verify the proposed theoretical model for maximum hairiness of ring-spun yarn.
Thoughtlessness and resentment
Authors: Schupmann Benjamin A.
Published: January 2014

Is a devoted Nazi or a zombie bureaucrat a greater moral and political problem? Because the dangers of immoral fanaticism are so clear, the dangers of mindless bureaucracy are easy to overlook. Yet zombie bureaucrats have contributed substantially to the greatest catastrophes of the 20th century, doing so seemingly oblivious to the monstrous qualities of their actions. Hannah Arendt’s work on thoughtlessness raises a dilemma: if Eichmann, the architect of the Nazi Final Solution, truly was a thoughtless ‘cog’, lacking in intentionality, can one really hold him morally accountable for the evil qualities of his acts? This article relates Arendt’s ‘thought’ and Strawson’s and Bilgrami’s discussion of ‘reactive attitudes’ and Sartre’s concept of ‘bad faith’. To find a basis for moral accountable in seemingly thoughtless cases like Eichmann’s. Although Arendt’s Eichmann is an extreme example, finding a basis to hold him accountable is valuable because ‘little Eichmanns’ will persist as long as impersonal forces structure and depress reactive attitudes.
The National Toxicology Program Web-based Nonneoplastic Lesion Atlas
Authors: Cesta Mark F. , Malarkey David E. , Herbert Ronald A. , Brix Amy , Hamlin Melvin H. , Singletary Emily , Sills Robert C. , Bucher John R. , Birnbaum Linda S.
Published: January 2014

Toxicologists and pathologists worldwide will benefit from a new, website-based, and completely searchable Nonneoplastic Lesion Atlas just released by the U.S. National Toxicology Program (NTP). The atlas is a much-needed resource with thousands of high-quality, zoomable images and diagnostic guidelines for each rodent lesion. Liver, gallbladder, nervous system, bone marrow, lower urinary tract and skin lesion images, and diagnostic strategies are available now. More organ and biological systems will be added with a total of 22 chapters planned for the completed project. The atlas will be used by the NTP and its many pathology partners to standardize lesion diagnosis, terminology, and the way lesions are recorded. The goal is to improve our understanding of nonneoplastic lesions and the consistency and accuracy of their diagnosis between pathologists and laboratories. The atlas is also a useful training tool for pathology residents and can be used to bolster any organization’s own lesion databases. Researchers have free access to this online resource at www.ntp.niehs.nih.gov/nnl.
A Grounded Theory of Fitness Training and Sports Participation in Young Adult Male Offenders
Authors: Van Hout Marie Claire , Phelan David
Published: January 2014

Research has underscored the need to generate a clear and coherent theoretical underpinning relating to the social processes attached to involvement in fitness training and organized sports when engaging in young adult offender community reintegration supports. The research utilized a collective and instrumental case study approach to explore the learning and associational experiences of Irish young adult male offenders’ participation in fitness training and organized sports during community reintegration. Grounded theory was used to guide and analyze the research, which involved nine in-depth interviews with adult male participants engaging in two community reintegration projects. The emergent theory presents a winding trajectory of prior positive experiences with sports during childhood, rejection of positive leisure activities while engaging in substance use and crime, and the importance of fitness training and sports in providing a new pro-social identity and daily routine while reintegrating. Solitary and compulsive participation was common, with certain sports imparting new values, discipline, and coping mechanisms. Findings can be used to improve lifestyle and sports programs designed to support young adult offenders.
Platelet-Rich Plasma as a Treatment for Patellar Tendinopathy
Authors: Dragoo Jason L. , Wasterlain Amy S. , Braun Hillary J. , Nead Kevin T.
Published: January 2014

Background:

Previous studies have shown improvement in patellar tendinopathy symptoms after platelet-rich plasma (PRP) injections, but no randomized controlled trial has compared PRP with dry needling (DN) for this condition.

Purpose:

To compare clinical outcomes in patellar tendinopathy after a single ultrasound-guided, leukocyte-rich PRP injection versus DN.

Study Design:

Randomized controlled trial; Level of evidence, 1.

Methods:

A total of 23 patients with patellar tendinopathy on examination and MRI who had failed nonoperative treatment were enrolled and randomized to receive ultrasound-guided DN alone (DN group; n = 13) or with injection of leukocyte-rich PRP (PRP group; n = 10), along with standardized eccentric exercises. Patients and the physician providing follow-up care were blinded. Participants completed patient-reported outcome surveys before and at 3, 6, 9, 12, and ≥26 weeks after treatment during follow-up visits. The primary outcome measure was the Victorian Institute of Sports Assessment (VISA) score for patellar tendinopathy at 12 weeks, and secondary measures included the visual analog scale (VAS) for pain, Tegner activity scale, Lysholm knee scale, and Short Form (SF-12) questionnaire at 12 and ≥26 weeks. Results were analyzed using 2-tailed paired and unpaired t tests. Patients who were dissatisfied at 12 weeks were allowed to cross over into a separate unblinded arm.

Results:

At 12 weeks after treatment, VISA scores improved by a mean ± standard deviation of 5.2 ± 12.5 points ( P = .20) in the DN group (n = 12) and by 25.4 ± 23.2 points ( P = .01) in the PRP group (n = 9); at ≥26 weeks, the scores improved by 33.2 ± 14.0 points ( P = .001) in the DN group (n = 9) and by 28.9 ± 25.2 points ( P = .01) in the PRP group (n = 7). The PRP group had improved significantly more than the DN group at 12 weeks ( P = .02), but the difference between groups was not significant at ≥26 weeks ( P = .66). Lysholm scores were not significantly different between groups at 12 weeks ( P = .81), but the DN group had improved significantly more than the PRP group at ≥26 weeks ( P = .006). At 12 weeks, 3 patients in the DN group failed treatment and subsequently crossed over into the PRP group. These patients were excluded from the primary ≥26-week analysis. There were no treatment failures in the PRP group. No adverse events were reported. Recruitment was stopped because interim analysis demonstrated statistically significant and clinically important results.

Conclusion:

A therapeutic regimen of standardized eccentric exercise and ultrasound-guided leukocyte-rich PRP injection with DN accelerates the recovery from patellar tendinopathy relative to exercise and ultrasound-guided DN alone, but the apparent benefit of PRP dissipates over time.
The life and times of Francis Geach MD, FRS (1730–1798), Senior Surgeon to the Royal Naval Hospital, Plymouth (1778–1798)
Authors: Peters Timothy J , Payne Lynda , Levell Nick J
Published: January 2014

Francis Geach MD, FRS was surgeon to the Royal Naval Hospital, Plymouth from about 1765 until he died in 1798. The son of a sail maker, he was born and raised in Plymouth. He was apprenticed to a surgeon in 1745 and probably undertook some medical training in London but he spent his professional career in Plymouth as a naval surgeon and in private practice. Geach had a particular interest in trauma and skin disease and was highly respected as a diagnostic physician, notably of inflammatory disorders, but he also had an interest in local issues including the cause of Devonshire colic. He was noted for the recognition of the skin disease of Francis Beaufort, later Admiral Sir Francis, as Greek leprosy (psoriasis) and for the recognition and support he gave to Sir William Knighton, physician and private secretary to the Prince Regent, later George IV. This article summarises Francis Geach’s genealogy, medical and academic practice, his breadth of interests and his contribution to Devonshire life in the 18th century.
Joseph Erlanger (1874–1965): the cardiovascular investigator who won a Nobel Prize in neurophysiology
Authors: Breathnach Caoimhghín S , Moynihan John B
Published: January 2014

Born in San Francisco in 1874 into the family of German immigrants in which he was the only one to proceed beyond elementary education, Joseph Erlanger graduated from the University of California (Berkeley) in 1894. He was about to enter the local Cooper Medical School when he was told that the new medical school in Johns Hopkins University (Baltimore) aimed to surpass all others, and there he graduated and was later coached for a career in academic life by William H Howell (1860–1945). In due course he held the Chairs of Physiology in the University of Wisconsin (Madison) and Washington University at St Louis, Missouri. He showed that the Bundle of His is indeed the functional link between the atria and the ventricles in the mammalian heart and that the Korotkoff sounds are produced by a ‘breaker’ phenomenon resulting from instability of the pulse wave in a partially occluded artery. With Herbert S Gasser (1888–1963) he was awarded the Nobel Prize in 1944 for their work on action currents in peripheral nerve fibres. The history of science occupied him during his retirement. He died at St Louis in 1965.
Young Adults’ Strategies for Managing Social Support During Weight-Loss Attempts
Authors: Faw Meara H.
Published: January 2014

Obesity and being overweight often result in serious health problems. Despite growing awareness of the dangers associated with being overweight, many individuals struggle to lose weight. Investigators have identified social support as a key element in weight-loss attempts. Unfortunately, little has been done to investigate how people solicit social support from members of their pre-existing social network without a structured intervention. To address this limitation, I conducted in-depth interviews with 25 participants. Through grounded theory analysis of these interviews, I developed a typology of support management strategies used by overweight young adults when attempting to lose weight. I outline these strategies, their perceived success, and implications for future research in this article.
Dual Intraventricular Plus Systemic Antibiotic Therapy for the Treatment of Klebsiella pneumoniae Carbapenemase–Producing Klebsiella pneumoniae Ventriculitis
Authors: Nevrekar Sonia , Cunningham Kathleen C. , Greathouse Kasey M. , Panos Nicholas G.
Published: January 2014

Objective: To report a case of Klebsiella pneumoniae carbapenemase (KPC)-producing K pneumoniae ventriculitis successfully treated with dual intraventricular plus systemic antibiotic therapy. Case Summary: A 43-year-old woman with a ventriculoperitoneal shunt was transferred from a nursing home with fever, altered mental status, and leukocytosis. She was found to have KPC-producing K pneumoniae ventriculitis. Combination intraventricular antibiotic therapy with colistin and gentamicin plus systemic colistin and amikacin led to the resolution of infection. Discussion: Utilization of intraventricular or intrathecal antibiotics has been described in the literature for multidrug resistant (MDR) Gram-negative central nervous system (CNS) infections; however, none of the cases were caused by a KPC-producing organism. Given the pathogenicity and limited treatment options for this resistant organism, we utilized intraventricular colistin 10 mg and intraventricular gentamicin 10 mg in combination with systemic colistin and amikacin. An extensive literature search revealed several case reports and case series of documented MDR Acinetobacter baumanii CNS infections successfully treated with intraventricular colistin or aminoglycoside therapy with good tolerability. Additionally, recent pharmacokinetic analyses suggest improved cerebrospinal fluid (CSF) concentrations with direct CNS antimicrobial administration in combination with systemic therapy. Although our patient’s cerebral spinal fluid cultures were cleared with dual intraventricular plus systemic therapy, she continued to deteriorate clinically because of her comorbid conditions and required hospice admission. Conclusions: This describes the first reported case of KPC-producing K pneumoniae ventriculitis microbiologically cured based on negative blood and CSF cultures with a combination of intraventricular and systemic therapy.
Antithrombotics in Heart Failure With Reduced Ejection Fraction and Normal Sinus Rhythm
Authors: Prom Rathasen , Usedom James E. , Dull Ryan B.
Published: January 2014

Objective: To review the thromboembolic risk, pathophysiology associated with the risk, and literature investigating the use of antithrombotics in patients with heart failure with reduced ejection fraction and normal sinus rhythm (HFrEF-NSR). Data Sources: An English language literature search was performed with MEDLINE/PubMed and Embase from January 1950 to October 2013 using the search terms heart failure, HFrEF, systolic heart failure, cardiomyopathy, left ventricular dysfunction, sinus rhythm, thromboembolism, deep vein thrombosis, pulmonary embolism, myocardial infarction, acute coronary syndrome, acute coronary events, coronary artery disease, stroke, and cerebrovascular events to identify relevant articles. References in the retrieved articles were also assessed to identify other important articles. Study Selection and Data Abstraction: All pertinent original studies, reviews, consensus documents, and guidelines were evaluated for inclusion. Data Synthesis: Patients with HFrEF-NSR may be predisposed to developing thromboembolic events. Studies that have examined the role of antithrombotics (warfarin and/or antiplatelet therapy) for reducing thromboembolic risk have been inconclusive. The WASH and HELAS pilot trials—the only studies with a no-antithrombotics or placebo comparator group—did not find a benefit with antithrombotic therapy but found an increased risk of bleeding with warfarin and of hospitalizations with aspirin. Although the clinical outcome studies (WATCH and WARCEF) suggested that warfarin may reduce stroke risk compared with antiplatelet therapy, the lack of a placebo group and lower-than-projected enrollment prevents definitive conclusions from being made. Conclusions: Current evidence does not support the routine use of antithrombotics for preventing thromboembolic events in patients with HFrEF-NSR without compelling indications.
Intravenous Warfarin and Heparin-Induced Thrombocytopenia
Authors: Burger Christina F. , Schlesinger Joseph J.
Published: January 2014

Objective: To describe the diagnosis, management, and monitoring of a patient with heparin-induced thrombocytopenia (HIT) with thrombosis and simultaneous bleeding risk treated with argatroban and transitioned to intravenous (IV) warfarin secondary to the inability to administer enteral medications. Case Summary: A 71-year-old man was admitted to the surgical intensive care unit (SICU) following aortic valve repair, coronary artery bypass, and ascending aortic aneurysm repair. On postoperative day 9, he was found to have a pulmonary embolism, and therapeutic heparin was started. The following day, his platelet count was found to have dropped precipitously. HIT was diagnosed, heparin was discontinued, and argatroban was initiated. On postoperative day 22, anticoagulation was discontinued because of massive gastrointestinal bleeding. On postoperative day 35, multiple venous thromboses were found, and argatroban was restarted. The patient developed a high-output enterocutaneous fistula, eliminating the option of enteral route of medication administration. The multidisciplinary SICU team transitioned the patient from argatroban to IV warfarin for long-term anticoagulation. The international normalized ratio was monitored and remained therapeutic throughout his admission without further thrombotic complications. Discussion: HIT occurs when antibodies develop to heparin–platelet factor 4 complexes, causing simultaneous hypercoagulability and thrombocytopenia. It is diagnosed based on both clinical factors and laboratory testing. Treatment includes discontinuation of all forms of heparin; initiation of a nonheparin anticoagulant, such as argatroban; and transition to warfarin. Conclusions: IV warfarin is a therapeutic option for patients with malabsorption issues. A multidisciplinary team in an intensive care setting optimizes cost-effective, patient-centered, and safe care.
Pharmacists Need Recognition as Providers to Enhance Patient Care
Authors: White C. Michael
Published: January 2014

Objective: To demonstrate that pharmacists are vital but currently underutilized direct care providers and that full provider status and inclusion into advanced multidisciplinary team models is needed. Data Sources: Literature was accessed through Ovid MEDLINE from 1990 to the present using the terms pharmacy care, pharmacist care, medication therapy management, and pharmaceutical care. Web-based searching and backward citation tracking was conducted for context and additional citations. Data Synthesis: There is strong data showing that pharmacists in patient care roles contribute to intermediate and final health outcomes improvements and cost-effectiveness. The general perception of pharmacists from prominent people in the Federal Government, some medical societies, and from physicians and nurses who work with pharmacists most closely is overwhelmingly positive. However, the penetration of pharmacists into complementary patient care roles is minimized by an antiquated reimbursement structure that needs to change. There are critical future primary care provider shortages that will be exacerbated under health care reform, and pharmacists can be a part of the solution if the reimbursement environment was altered. Conclusions: For all the data and support for expanded direct patient care pharmacist services, pharmacists are marginalized by an antiquated reimbursement structure. Pharmacists need to be granted Medicare provider status, and new models of primary care need to include pharmacists in patient care roles in order to more fully meet the needs of patients.
Drug-Drug Interaction Between Methotrexate and Levetiracetam Resulting in Delayed Methotrexate Elimination
Authors: Bain Emily , Birhiray Ruemu E. , Reeves David J.
Published: January 2014

Objective: To report a case of delayed methotrexate (MTX) elimination while receiving concomitant levetiracetam. Case Report: A 46-year-old man with relapsed osteosarcoma of the base of the skull receiving high-dose MTX tolerated his first cycle of MTX with elimination to nontoxic MTX levels (≤0.1 µmol/L) within 90 hours. After hospital discharge, the patient experienced seizures secondary to brain metastasis and started on levetiracetam, which was continued as maintenance therapy. The patient experienced delayed MTX elimination during cycles 2, 3, and 4 while receiving levetiracetam. On average, elimination to nontoxic MTX levels took 130 hours (106-144 hours). Before the fifth cycle of MTX, lorazepam was substituted for the levetiracetam. MTX was eliminated to nontoxic levels within 95 hours. During all cycles, the patient received standard supportive care and serum creatinine remained stable. No other drugs known to interact with MTX were administered. Discussion: This possible drug interaction has only been reported once in the pediatric population. With a score of 6 on the Drug Interaction Probability Scale for evaluating causation of drug interactions, it is probable that the delayed MTX elimination was caused by an interaction with levetiracetam. Conclusion: Coadministration of levetiracetam and MTX may result in delayed elimination of MTX, increasing the likelihood of toxicity. Consideration should be given to temporarily switching from levetiracetam to another antiepileptic (ie, lorazepam) to prevent this interaction. This is particularly important in those experiencing delayed elimination with prior cycles of concomitant MTX and levetiracetam or those at greater risk for MTX toxicity.
Predictors of Completeness of Patients’ Self-reported Personal Medication Lists and Discrepancies With Clinic Medication Lists
Authors: Lee Kirby P. , Nishimura Kris , Ngu Becky , Tieu Leslie , Auerbach Andrew D.
Published: January 2014

Background: Transfer of medication information during transitions in care is crucial to preventing medication errors. Few studies evaluate patients’ self-reported personal medication lists. Objectives: To assess completeness of personal medication lists and identify factors associated with incomplete personal lists and discrepancies between personal and clinic medication lists. Methods: We analyzed patients’ personal medication lists at an academic hospital preoperative clinic from January 2010 to October 2010. Completeness of personal medication lists was measured as reporting the name, dose, and frequency for all prescription and nonprescription medications or dietary supplements. Discrepancies between personal and clinic medication lists were measured as omitted medications or differing directions. Results: Among 94 patients meeting inclusion criteria, 82 (87%) personal medication lists were evaluated. Most personal lists were incomplete (56%; 46/82), missing information for at least one medication reported; 94% (77/82) of personal lists had at least one discrepancy with clinic medication lists (median 4 discrepancies per patient list). On multivariate analyses, taking 10 or more medications (adjusted odds ratio [OR] = 3.52; 95% CI = 1.37 to 9.08) and being divorced, widowed, or single (adjusted OR = 3.10; 95% CI = 1.05 to 9.12) were independent predictors of incomplete personal medication lists. Taking 10 or more medications (adjusted OR = 3.44; 95% CI = 1.35 to 8.78) was also associated with higher rates of medication discrepancies. Conclusions: Patients’ self-reported personal medication lists are often incomplete and have discrepancies with clinic medication lists. Interventions are needed to improve medication information transfer between patients, providers and healthcare systems.
Combination of Fluticasone Furoate and Vilanterol for the Treatment of Chronic Obstructive Pulmonary Disease
Authors: Bollmeier Suzanne G. , Prosser Theresa R.
Published: January 2014

Objective: To evaluate the efficacy and safety of the combination of fluticasone furoate/vilanterol (FF/VI) and compare it with other inhaled combination corticosteroid/long-acting β2-receptor agonists for maintenance treatment of chronic obstructive pulmonary disease (COPD). Data Sources: A PubMed and EMBASE search in June 2013 using the MeSH terms fluticasone and vilanterol identified trials using this combination for COPD. Additional information was gathered from references cited in the identified publications, the manufacturer, and package insert as well as the ClinicalTrials.gov registry. Study Selection/Data Extraction: Preference was given to randomized controlled clinical trials. Data from animal trials, clinical trials for asthma, and non-English sources were excluded. Data Synthesis: Given once daily, FF/VI improves trough forced expiratory volume at 1 s by about 230 mL in a 28-day trial versus placebo. However, a more modest increase (100-130 mL) was seen in 2 longer 28-week trials. In the longest trial of 1 year, a slight but significant decrease in the yearly rate of moderate plus severe exacerbations, the time to first moderate or severe exacerbation, and the frequency of exacerbations requiring systemic corticosteroids was seen. There was no difference in the rate of exacerbations requiring hospitalization. The product appears to have the adverse effect profile typical of its class. Conclusions: Of the inhaled corticosteroid/long-acting β2 receptor agonist combinations, VI/FF is the first allowing once-daily dosing. Similar to the other combination products, it may slightly decrease the incidence of COPD exacerbations in the patient subset with Global Initiative for Chronic Obstructive Lung Disease risk category C or D. There are no direct safety or efficacy data comparing this with other available inhaled combination products. The once-daily dosing might improve adherence in select patients. The Ellipta delivery device may assist some who are unable to use other devices correctly.
The discreet charm of political parties
Authors: Enyedi Zsolt
Published: January 2014

The article reflects on Peter Mair's work in addressing the claims of the decline of party thesis. The cartel party model is discussed, the relationship between parties and the state, the collusion of parties, the quality of representation provided by them, their organizational responses to environmental change, and their patterns of competition. Critical assessment of the theoretical arguments and a review of the relevant empirical evidence indicate that parties possess more autonomy and influence than suggested by the decline of party thesis and its attendant components, such as the dealignment model. Some of the commonly cited symptoms of party decline are corroborated, but the article highlights the adaptive organizational and social strategies of parties. These strategies, together with the success of parties in maintaining an essentially bipolar pattern of competition, contribute to the resilience of party politics.
Acknowledgment after mass violence: Effects on psychological well-being and intergroup relations
Authors: Vollhardt Johanna Ray , Mazur Lucas B. , Lemahieu Magali
Published: January 2014

Four experiments in the context of the Armenian Genocide (Study 1), the Kielce Pogrom (Study 2), and the Holocaust (Studies 3 and 4) examined the effects of experiencing acknowledgment (vs. lack of acknowledgment) of historical ingroup victimization on psychological well-being and on intergroup relations. Armenian and Jewish American participants, respectively, read about the former perpetrator group’s acknowledgment or lack of acknowledgment of the ingroup’s victimization. Participants in the acknowledgment condition reported higher levels of psychological well-being (indicated by more positive and less negative affect) and greater willingness to reconcile with the former perpetrator group, compared to participants in the no acknowledgment condition and to a neutral baseline control condition (Study 4). Two studies also revealed significant effects on resentment of the perpetrator group.
Uncertainty in maritime risk analysis: Extended case study on chemical tanker collisions
Authors: Sormunen Otto-Ville E , Goerlandt Floris , Häkkinen Jani , Posti Antti , Hänninen Maria , Montewka Jakub , Ståhlberg Kaarle , Kujala Pentti
Published: January 2014

Uncertainty is inherent to risk analysis. Therefore, it is extremely important to properly address the issue of uncertainty. In the field of risk analysis for maritime transportation systems, the effect of uncertainty is rarely discussed or quantified. For this reason, this article discusses a case study dealing with risk analysis for a chemical spill in the Gulf of Finland and analyses the related uncertainties by adopting a systematic framework. Risk is assessed in terms of the expected spill frequency and spill volumes caused by collisions between ships and chemical tankers in the Gulf of Finland. This is done by applying a collision consequence with a novel approach-to-collision-speed linkage model and Gulf of Finland–specific causation factors, which are based on reanalysing accident data. This article also presents a metamodel for assessing collision probability with initial vessel speeds for any given scenario where a chemical tanker is about to be struck by another vessel. Even when conducting a risk analysis using state-of-the-art methods, there is still a medium-high degree of uncertainty in the model presented in this article, which only becomes apparent when conducting a systematic uncertainty assessment analysis. However, an uncertainty assessment is an important part of quantitative maritime risk analysis. For this purpose, a qualitative framework for uncertainty assessment analysis is introduced for general use in the field of maritime risk analysis.
Drafting an Army
Authors: Carter Marcus , Gibbs Martin , Harrop Mitchell
Published: January 2014

Multiple recent works have emphasized the contribution that nondigital game scholarship can make to the study of games and gameplay. Warhammer 40,000 is the market dominator of the nondigital tabletop wargame genre. In this article, we perform a ludological analysis of the process of preparing, or drafting, an army for a competitive Warhammer 40,000 tournament. We find that there are four interrelated categories of resources that influence this fundamentally playful process. Our results indicate that this process of preparation constitutes a core component of the appeal of Warhammer 40,000. This emphasizes the importance of understanding the diverse activities that go into gameplay that often exceed the computer game “client” or board of play. We suggest the category of engagement pastime to encapsulate these extended, ongoing elements of Warhammer 40,000’s appeal, which we define as a collection of interlinked and associated activities that serve to occupy one’s time and thoughts pleasantly.
A Preliminary Validation Study of the Korean Version of the Minnesota Self-Determination Scales for Adults With Intellectual Disabilities
Authors: Cho Jaehyun
Published: January 2014

The Minnesota Self-Determination Scale (MSDS) was translated into Korean. The Korean version was then validated using a sample of 40 individuals with intellectual disabilities between the ages of 19 and 45 years, the legal age of adults in South Korea. The evidence of the reliability and validity was examined. The test–retest was good (.84-.94). The internal consistency was excellent (.96-.99). The construct validity with other Korean translated self-determination measure (K-SDS) was acceptable (.50-.51). The findings indicated that the K-MSDS was an appropriate measure with acceptable psychometric properties. The Korean version was the first self-determination measure for adults with disabilities.
Evaluation of an HIV Adherence Counseling Program in La Romana, Dominican Republic
Authors: Winter Meredith C. , Halpern Mina , Brozovich Ava , Neu Natalie
Published: January 2014

Research has demonstrated that adherence to antiretroviral therapy (ART) results in lower rates of morbidity and mortality associated with HIV infection, yet adherence remains a challenge in resource-limited settings like the Dominican Republic. Clínica de Familia La Romana addressed this problem with an education-based adherence program for adult patients new to ART, and this retrospective cohort study aimed to evaluate the impact of this intervention. Appointment adherence and biological markers were assessed in cases and controls through 12 months. A total of 101 participants were included, with 61 controls and 40 cases. The baseline CD4 count was 162 and 157 cells/mm3 in controls and cases, respectively. Cases showed a 15-fold increase in CD4 count compared with a 2.5-fold increase in controls. Cases were more likely to adhere to appointments with adherence rates of 86% versus 76% in controls. There was no difference between the rates of treatment abandonment, transfer of care, or death.
The Impact of Key HIV Intervention Components as Predictors of Sexual Barrier Use
Authors: Chitalu Ndashi , Mumbi Mirriam , Cook Ryan , Weiss Stephen M. , Jones Deborah
Published: January 2014

Behavioral interventions have utilized a variety of strategies and components to reduce HIV risk. This article describes the partner intervention, a couple-based group HIV risk reduction intervention implemented in 6 urban community health clinics in Lusaka, Zambia, and examines the components of the intervention and their relationship with condom use. Couple members completed assessments on condom use, acceptability, willingness to use condoms, communication, intimate partner violence (IPV), self-efficacy, and HIV information at baseline and 6 months’ follow-up. This study examined the relative impact of elements of the intervention as predictors of condom use. Changes in acceptability had the greatest overall influence on condom use, followed by social support, relationship consensus, and willingness to use condoms. Changes in self-efficacy, IPV, negotiation, and information had no influence. Results support the use of multidimensional approaches in behavioral interventions and highlight the importance of identifying critical elements of interventions to maximize risk reduction outcomes.
AIDS-Associated Cardiac Lymphoma—A Review
Authors: Bush Larry M. , Urrutia Jose G. , Rodriguez Eduardo A. , Perez Maria T.
Published: January 2014

Despite treatment with potent and effective combination antiretroviral medications, the incidence of non-Hodgkin lymphoma (NHL) in the population living with HIV/AIDS remains significantly higher than that in noninfected individuals. The majority of the HIV-infected patients with NHL present with advanced stage extranodal disease of the B-cell phenotype. Lymphomas are the second most common tumors involving the heart in HIV-infected patients. Although the heart may serve as the primary focus of the lymphoma, in most HIV-related cases, cardiac lymphomatous involvement is part of a metastatic process that originated elsewhere.
High CD56++CD16- natural killer (NK) cells among suboptimal immune responders after four years of suppressive antiretroviral therapy in an African adult HIV treatment cohort
Authors: Bayigga Lois , Nabatanzi Rose , Sekiziyivu Prossy Naluyima , Mayanja-Kizza Harriet , Kamya Moses R , Kambugu Andrew , Olobo Joseph , Kiragga Agnes , Kirimunda Sam , Joloba Moses , Nakanjako Damalie
Published: January 2014

Background

Up to 40% of HIV-infected individuals receiving Highly Active Antiretroviral Therapy (HAART) have poor CD4+ T-cell recovery. The role of natural killer (NK) cells in immune recovery during HAART is not well understood. We described the profiles of NK cell subsets and their expression of activating receptor, NKG2D and cytotoxicity receptor NKp46 among suboptimal immune responders to despite four years of suppressive HAART.

Methods

A case control study utilized frozen peripheral blood mononuclear cells (PBMC) from a cohort of HIV-infected adults that initiated HAART in 2004/5, at CD4 < 200 cells/μl. Cases were ‘suboptimal’ responders; patients within the lowest quartile of CD4+ T-cell reconstitution, with a median CD4 count increase of 129 (-43-199) cells/μl (difference between CD4 count at baseline and after 4 years of HAART) and controls were ‘super-optimal’ responders; patients within the highest quartile of CD4 T-cell reconstitution with a median CD4 count increase of 528 (416-878) cells/μl). Expression of NK cell lineage markers (CD56+/-CD16+/-) and receptors NKG2D and NKp46, was measured among PBMC from 29 cases of ‘suboptimal’ responders’ and 23 controls of ‘super-optimal responders’, and compared among ‘suboptimal’ and ‘super-optimal’ responders. NK cell populations were compared using the Holm Sidak multiple comparison test and p values < 0.05 were considered statistically significant. Data was analyzed using FLOWJO and GraphPad Prism 6.

Results

‘Suboptimal responders’ had a higher proportion of cytokine producing CD56++CD16+/- (CD56bri) NK cells than the ‘super-optimal responders’ p = 0.017, and CD56neg NK cells were lower among suboptimal than super-optimal responders (p = 0.007). The largest NK cell subset, CD56dim, was comparable among suboptimal responders and ‘super-optimal immune responders’. Expression of NKG2D and NKp46 receptors on NK cell subsets (CD56bri, CD56neg and CD56dim), was comparable among ‘suboptimal’ and ‘super-optimal’ immune responders.

Conclusions

The pro-inflammatory CD56++CD16-- NK cells were higher among ‘suboptimal’ responders relative to ‘super-optimal’ responders, despite four years of suppressive HAART. Alteration of NK cell populations could inhibit host immune responses to infections among suboptimal responders. We recommend further analysis of NK cell function among suboptimal immune responders in order to inform targeted interventions to optimize immune recovery among HAART-treated adults.