bluuebunny/crossref_metadata_2025 huggingface dataset:
Entrepreneurship, Information Technologies, and Educational-Based Virtuous Circles in Post-Industrialized Economies
Authors: Saiz-Álvarez José Manuel
Published: July 2013

Information Technologies are transforming traditional educational models based on new communication skills. Using a comparative analysis, the scope of this work is two-fold: (1) to study the importance of entrepreneurship and R&D in tertiary education and (2) to analyze which conditions must change in order to contribute to adopt this new IT-based model by the more traditional countries or university institutions that do not research, arguing they are focused on short-term goals only. Using a single OLS econometric model, the author demonstrates that R&D in companies and universities, both public and private, are complementary, R&D applied in education guarantees future positive externalities and creates IT educational societies, while globalization favors capital and human resources mobility, not only nationally but also internationally.
The Production of Learning Resources for the Study of Information Technology with Limited Project Management Capacity
Authors: Lamont Jenny
Published: July 2013

Mindset Network is a non-profit organization that develops educational resources in several sectors, including the schooling sector. In 2011, Mindset Learn, the schooling division of Mindset Network, completed a project to plan, design, and produce learning resources for grade 12 Information Technology. The learning resources provided learning support to 5,000 students in the 425 South African schools that offer the subject. Numerous challenges presented themselves during the implementation of the project. Major project management challenges were insufficient project resources and inadequate project management experience. Several content-related challenges included: the need to include two programming languages simultaneously, the diversity of language and demographics in schools, and disparities in facilities and educator competencies. Despite the limitations experienced during the implementation of the project, Mindset Learn concluded and distributed an impressive set of learning resources to IT schools in South Africa. Several lessons for future projects are evident.
Implementing a Course Management System in a Religious School Cooperative
Authors: Benson Angela D. , Tettegah Sharon Y.
Published: July 2013

Public and private K-12 schools are turning to course management systems to provide enhanced classroom and online learning opportunities for students. This case describes the system-wide implementation of a course management system to serve 3000 students in a school system consisting of 12 independent church schools in a southeastern state. The challenges this project faced included the geographic dispersion of the involved schools and project team, the variance in individual school populations, and the limited in-house support staff available in the district office and in the schools to support the project. The project manager introduced another challenge by choosing to use formal project management methodologies and tools for the first time in the school system with this project.
Planning and Implementation of a 21st Century Classroom Project
Authors: Rice Margaret L. , Bain Connie
Published: July 2013

A southeastern school district technology committee was tasked with designing and implementing a project to develop 21st century classrooms throughout the school district. After research, it was determined classrooms would include interactive whiteboards, slates that interact with whiteboards from anywhere in the room, mounted projectors, teacher laptops, document cameras, classroom sets of student response systems (clickers), podiums for the laptops and storage, and sound systems with voice enhancers. Project challenges included updating the school district’s infrastructure, training teachers, designing and remodeling classrooms in terms of electrical outlets and data drops, and ensuring equity for all the district’s schools. The district used a project-planning model that included research, collaboration, prioritizing, implementation (divided into four phases – infrastructure, teacher laptops, interactive classroom, equipment replacement), and evaluation. All phases were completed in two years and one cycle of Phase 4 (equipment replacement) was completed prior to a severe budget crisis in the state.
An Integrated Management Approach in a Higher Education Technology Support Unit
Authors: Boyd Lesley G. , Fresen Jill W.
Published: July 2013

This case study is located in the Department for Education Innovation (EI), a teaching and learning support unit at the University of Pretoria in South Africa. The initial problem was the need to apply project management and quality management principles to the services offered by the department to faculty members. The authors describe the implementation of a formal, online, process-based Quality Management System (QMS) designed to self evaluate, document, and improve the Instructional Design (ID) process that guides the development of educational technology solutions in EI. The project was completed in 2005 and was included in a CEN (European Committee for Standardization) Good Practice Guide for outstanding implementations of quality approaches in e-learning. The QMS provides a mechanism to support a consistent project management approach, and the case illustrates successful integration between three cycles: Project Management (PM), Quality Management (QM), and the ADDIE (Analysis, Design, Development, Implementation, and Evaluation) instructional design process.
Agile Management of a Mobile Application Development Project for Surgeon Workflows
Authors: Tawfik Andrew A. , Belden Jeffery L. , Moore Joi L.
Published: July 2013

This case describes the agile management methods for an iPhone software development project. The overall objective was to design a smartphone solution that allowed surgeons access to dynamic Electronic Health Record (EHR) data to optimize their workflow. Three separate organizations distributed the responsibilities. Specifically, the lead organization, Cerner Corporation, collaborated with the University of Missouri Health Care and University of Missouri Information Experience Lab to create the technology. Project goals included increased surgeon satisfaction; improved task efficiency, as measured by time spent retrieving lab and vital sign data on morning rounds; dynamic data accessibility; and increased revenue from new product sales. To accomplish these goals, agile project management was utilized, applying iterative usability methods to create deliverables within a short development cycle. Each development cycle focused on user-centered design principles. Several challenges were encountered related to the user-centered design methods, usability data extraction, academic collaborations, and interface design choices.
Refresher Training in Clinical Psychology Supervision
Authors: El-Farargy Nancy
Published: July 2013

Supervisory training for clinical psychologists is often a pre-requisite for practitioners taking on their first graduate trainee and for seasoned practitioners who require refresher training as evidence for continuing professional development. This case study outlines some supervisory models available within the literature and discusses a blended learning model of supervisor training specifically tailored for seasoned clinical psychology supervisors – with the deliverable being an online course to supplement a face-to-face delivery of supervisory training. In managing the work, a project management methodology is journeyed through, and covers the main context of the case, the e-strategy employed, an overview of the technology used, and the content of both the online and face-to-face components. Success factors surrounding the processes used are discussed, and implications of transition phases are outlined. In implementing an online component of blended learning, such information may support other project managers who may wish to benefit from and replicate any of the processes and tools used.
Social Networks and Knowledge Management
Authors: Gunjal Bhojaraju , Gaitanou Panorea , Yasin Sarah
Published: July 2013

This chapter gives a brief introduction to Knowledge Management (KM) and its components, emphasizing the role Social Networks (SNs) can play on KM. The authors will delineate the benefits of collaboration between the concept of Social Networking and the process of KM. With the advent of Web 2.0 technologies, it is a natural evolutionary outcome that SNs have driven the advancement of KM, and conversely KM has driven the advancement of SNs. In certain instances, SNs and KM have a symbiotic relationship whereby one cannot exist without the other. Moreover, an impact analysis will be performed to show that while SNs are an outcome of KM, both require each other in order to succeed where Social Software fits. This chapter is particularly intended to cater to the needs of librarians in a corporate environment and to show the impact and benefits of SNs and KM in the information world.
Strategic Knowledge Management System Framework for Supply Chain at an Intra-Organizational Level
Authors: Gaumand Cécile , Chapdaniel Alain , Dudezert Aurélie
Published: July 2013

In the Web 2.0 and organization 2.0 era, implementing Knowledge Management Systems (KMS) in Supply Chain (SC) in companies should contribute to gain sustainable competitive advantage. Using a case-study in an Italian SME (BONFIGLIOLI), this chapter seeks to propose new processes and recommendations to design and operate an efficient KMS for a SC at an intra-organizational level. This case study shows in particular the role of IT as an artifact implying individuals in organizational knowledge creation. It also shows that implementing KMS in SC makes SC actors change their cognitive scheme and work practices and calls for a new role of middle management.
Web 2.0 and Project Management
Authors: Barroso Antonio Carlos de Oliveira , Ricciardi Rita Izabel , Junior Jair Anunciação de Azevedo
Published: July 2013

The so called Web 2.0 has, in many ways, created the conditions for people to use the power of crowdsourcing. Many business areas and experts are taking advantage of this phenomenon, but what we see is just the beginning. As individuals we are being culturally transformed by Web 2.0 and are ready to use many of these new habits in our working practices. The boundaries between tools and applications we use to interact socially and to work are becoming fuzzier and paler. Management, in general, and specially knowledge and project management have a lot to gain by combining all of these possibilities. This chapter focuses on the synergy of Web 2.0 applications and services and project management needs. To some extent, a knowledge management lens is used to comment and to discuss the issues. Later it examines the Brazilian situation of current project management practices and discusses some cases of our own experience. Also, to gain insight on the path forward, helping levers and possible hampers are identified and discussed in the text. In general, our case study observations indicate that the use of these tools and platforms has become more than promising, because as people become familiar with them, they are usually converted to it.
Cardiopulmonary Exercise Test Findings in Symptomatic Mustard Gas Exposed Cases with Normal HRCT
Authors: Aliannejad Rasoul , Saburi Amin , Ghanei Mostafa
Published: July 2013

Many patients with sulfur mustard (SM) exposure present dyspnea in exertion while they have a normal pulmonary function test (PFT) and imaging. The cardiopulmonary exercise test (CPET) has been used for evaluation of dyspnea in exertion among patients with different pulmonary disorders focusing on assessing gas exchange. We evaluated subjects who were exposed to SM with normal imaging compared to the controls with CPET. A case‐control study was carried out on two groups in Tehran, Iran during 2010 to compare the CPET findings. The cases with a history of SM exposure and complaint of exertional dyspnea while they had normal physical examination, chest X‐ray, PFT, and nonsignificant air trapping in lung high resolution computed tomography (HRCT) were included. A group of sex‐ and age‐matched healthy people were considered as controls. One hundred fifty‐nine male patients (aged 37 ± 4.3 years) were enrolled as a case group and ten healthy subjects (aged 35 ± 5.9 years) as the control group. There was no significant difference in the demographic and baseline PFT characters between the two groups (P > 0.05). Only peak VO2/kg, VO2‐predicted, and RR peak were statistically different between cases and controls (P < 0.05). Despite the fact that abnormal gas exchange may be present in our cases, it does not explain the low VO2 in CPET. Also, impaired cell O2 consumption could be a hypothesis for low VO2 in these cases. It seems that routine assessment of lung structure cannot be effectively used for discrimination of the etiology of dyspnea in low‐dose SM exposed cases.
Magnetic Resonance Imaging of the Right Ventricle in Pediatric Pulmonary Arterial Hypertension
Authors: Blalock Shannon , Chan Frandics , Rosenthal David , Ogawa Michelle , Maxey Dawn , Feinstein Jeffrey
Published: July 2013

Pulmonary arterial hypertension (PAH) causes changes in the right ventricle (RV), affecting RV size and function, ultimately leading to death. These changes have been evaluated by cardiac MRI (CMR) in adults with PAH, but not in children. Using CMR in pediatric patients with PAH, we examined how RV size and function (1) compare to normal data, (2) change over time, and (3) compare to similar studies in the adult population. Data from two institutions were retrospectively reviewed. Subjects with PAH and a CMR were included. Baseline CMR variables (right and left ventricular end‐diastolic and end‐systolic volumes indexed for body surface area, and calculated stroke volume and ejection fraction) were compared to normative data and follow‐up CMR data. Twenty‐six subjects (15 female), age 2–16 (mean 11) years, with idiopathic PAH were included. All patients were on PAH medication, and 65% on prostacyclin therapy. The baseline 6‐Minute Walk Distance (6MWD; 481 ± 137) was normal. RV volumes and ejection fraction were markedly abnormal compared to normal data (P < 0.001). Follow‐up CMRs were analyzed in 15 patients. RV volumes and function and LV stroke volume showed no significant change over one year. Our pediatric patients with PAH have markedly abnormal right ventricles by CMR but have normal walk distances. The lack of change in CMR parameters over one year may represent a stable cohort and is different than similar studies in adults.
Schistosomiasis Causes Remodeling of Pulmonary Vessels in the Lung in a Heterogeneous Localized Manner: Detailed Study
Authors: Kolosionek Ewa , King Jayne , Rollinson David , Schermuly Ralph Theo , Grimminger Friedrich , Graham Brian B. , Morrell Nicholas , Butrous Ghazwan
Published: July 2013

Schistosomiasis is a global parasitic disease with high impact on public health in tropical areas. Schistosomiasis is a well‐described cause of pulmonary arterial hypertension (PAH). The exact pathogenesis is still unclear, though inflammatory mechanisms are suspected. Another unknown is whether the changes in the pulmonary vasculature are generalized or localized. We studied 13 mice infected with cercariae for 12 weeks compared with 10 control mice. In our model, we observed that the liver was a target during infection and was enlarged more than two‐fold after infection. However, right heart hypertrophy as measured by RV/(LV + S) ratio was not observed at this time point. Moreover, we noticed that 72% of the sampled lobes (92% of the lungs) harvested from these animals costained evidence of granulomatous changes, secondary to egg deposition. We systemically mapped the distribution of granulomatous lesions in right lung lobes (n = 43) of infected mice. We observed that the distribution of the granulomatous lesions was heterogeneous. Remodeled pulmonary vessels were seen in 26% of the lobes (46% of the lungs) and were observed only in close proximity to the granuloma. No remodeling was observed in the absence of granulomas. These findings support the view that pulmonary vascular remodeling is caused by the local presence of granulomas in PAH associated with schistosomiasis. The heterogeneous nature of the remodeling partly explains why many patients with schistosomiasis do not develop pulmonary hypertension.
Persistent Pulmonary Artery Hypertension in Patients Undergoing Balloon Mitral Valvotomy
Authors: Nair Krishna Kumar Mohanan , Pillai Harikrishnan Sivadasan , Titus Thomas , Varaparambil Ajitkumar , Sivasankaran Sivasubramonian , Krishnamoorthy Kavassery Mahadevan , Namboodiri Narayanan , Sasidharan Bijulal , Thajudeen Anees , Ganapathy Sanjay , Tharakan Jaganmohan
Published: July 2013

Pulmonary artery pressure (PAP) is known to regress after successful balloon mitral valvotomy (BMV). Data of persistent pulmonary artery hypertension (PPAH) following BMV is scarce. We analyzed the clinical, echocardiographic, and hemodynamic data of 701 consecutive patients who have undergone successful BMV in our institute from 1997 to 2003. Data of 287 patients who had PPAH (defined by pulmonary artery systolic pressure [PASP] of ≥ 40 mmHg at one year following BMV) were compared to the data of 414 patients who did not have PPAH. Patients who had PPAH were older (39.9 ± 9.9 years vs. 29.4 ± 10.1; P < 0.001). They had higher prevalence of atrial fibrillation (AF; 21.9 vs. 12.1%, P < 0.05), moderate or severe pulmonary artery hypertension (PAH) defined as PASP more than 50 mmHg (43.5 vs. 33.8%, P = 0.00), anatomically advanced mitral valve disease as assessed by Wilkin's echocardiographic score > 8 (33.7 vs. 23.2%, P < 0.001), and coexistent aortic valve disease (45.6 vs. 37.9%, P < 0.001) at the baseline. Those patients with PPAH had comparatively lower immediate postprocedural mitral valve area (MVA). On follow‐up of more than five years, the occurrence of restenosis (39.3 vs. 10.1%, P = 0.000), new onset heart failure (14% vs. 4%, P < 0.05) and need for reinterventions (9.5% vs. 2.8%, P < 0.05) were higher in the PPAH group. Patients with PPAH were older, sicker, and had advanced rheumatic mitral valve disease. They had higher incidence of restenosis, new onset heart failure, and need for reinterventions on long term follow‐up. PPAH represents an advanced stage of rheumatic valve disease and indicates chronicity of the disease, which may be the reason for the poorer prognosis of these patients. Patients with PPAH requires intense and more frequent follow‐up.
Clinical Evaluation of Dental Metal Hazards and Therapeutic Effects of Shortwave Diathermy in Dental Medicine
Authors: Mukai Chisato , Nakamoto Tetsuji , Kondo Yusuke , Masaki Chihiro , Ohta Atsumi , Hosokawa Ryuji
Published: July 2013

Objective

Shortwave diathermy causes increase in temperature from deep inside the body, results in upregulation of metabolism, and has analgesic effects. In this study, we explored the potential application of shortwave diathermy in the maxillofacial region by monitoring internal and external temperature changes, changes in blood flow, and resting saliva secretion under shortwave diathermy for subjects with and without dental metal restorations (MR) to confirm the safety and the limitation of shortwave diathermy for dental medicine.

Materials and methods

Twenty young healthy subjects were recruited (10 subjects with MR and 10 subjects without MR). Shortwave exposure was achieved with condenser-type probes placed on the bilateral mandibular angles, and the intraoral temperature was monitored. For functional analysis, unstimulated whole saliva before and after exposure was collected. The temperature and blood flow distributions of the exposed areas were then monitored by thermography and twodimensional (2D) laser Doppler flowmetry.

Results

Shortwave exposure for 20 minutes induced significant temperature increases in all groups (p ≤ 0.05). The subjects reported no discomfort. When subjects without MR held gold or titanium crowns in their mouths, the thermal effect by shortwave diathermy was reduced. Resting saliva upon exposure only increased significantly in metal-free subjects, and amylase concentration was also increased, but the level of the salivary stress biomarker chromogranin A was unchanged. Furthermore, thermography showed that shortwave diathermy significantly increased the surface temperature for cheek skin and the buccal mucosa; however, this increase failed to elevate surface blood flow.

Conclusion

Shortwave diathermy induces temperature increases in the maxillofacial region. MR did not cause excessive heating, on the contrary, reduce the thermal effect of shortwave radiation. The temperature rise maintains upregulation in salivary function, which could be utilized safely in dental medicine.

How to cite this article

Mukai C, Nakamoto T, Kondo Y, Masaki C, Ohta A, Hosokawa R. Clinical Evaluation of Dental Metal Hazards and Therapeutic Effects of Shortwave Diathermy in Dental Medicine. Int J Prosthodont Restor Dent 2012;2(3): 88-95.
Retention of Metal Crowns Luted to Implant Abutments of Two Different Diameters using Different Luting Agents
Authors: Matani Jay Dipak , Parulekar Natasha , Kheur Mohit , Jambhekar Shantanu , Supriya MK
Published: July 2013

Purpose

The desirable properties of a luting agent used for implant prostheses are adequate tensile strength for retention and at the same time render the crowns to be retrievable. No studies have reported a comparison of the retention of implant crowns luted with zinc phosphate and polymeric cements. Studying the retentive abilities of these cements utilizing varying sizes of implant abutments may provide new insights into their clinical behaviors.

Aim

To compare the retentive abilities of two luting agents, using them to lute crowns on implant abutments of different diameters.

Materials and methods

Two implants (3.7 and 6.0 mm diameter) were embedded in a resin block. Straight abutments of corresponding diameters were screwed into the implants. The height of abutments was kept equal for both abutments (8 mm). Seven copings were fabricated for each abutment. Groups 1 and 2 copings (14 copings) were tested for both luting agents; zinc phosphate and polymeric cement using a universal testing machine.

Results

For the abutment diameters tested, the retentive values of zinc phosphate was significantly greater than polymeric implant cement. For the broad abutment, zinc phosphate was significantly more retentive than polymeric implant cement. For the narrow abutment, retentive values of zinc phosphate and polymeric implant cement were almost similar.

Conclusion

The retentive values of zinc phosphate were significantly greater than polymeric implant cement. For broad abutment, zinc phosphate was more retentive whereas for narrow abutment, retentive values were almost similar.

How to cite this article

Matani JD, Parulekar N, Kheur M, Jambhekar S, Supriya MK. Retention of Metal Crowns Luted to Implant Abutments of Two Different Diameters using Different Luting Agents. Int J Prosthodont Restor Dent 2012;2(3):96-100.
Designing a Nasal Prosthesis using CAD-RP Technology
Authors: Vanitha R , Ramkumar K , Rajtilak G , Rajasekar V
Published: July 2013

A 37-year-old female patient reported to the hospital with a nasal defect due to carcinoma. She was previously restored with nasal prostheses, but was not satisfied with its cosmetic appeal. A computerized tomographic (CT) scan of the defect area was made and converted into 3- dimensional (3D) digital data using dedicated medical imaging software. From the 3D image, measurements of the defect were calculated and compared with various nasal fossa measurements available in the digital database. A 3D nose model which had measurements that closely matched the defect area was extracted and superimposed on the defect area and margins adjusted. The data files were then sent for rapid prototyping (RP). A RP model was fabricated which was duplicated in wax and processed. The final result was a nasal prosthesis that conformed well to the patients’ face and was also esthetically acceptable. The main advantage of computer-aided designing (CAD)-RP is that it allows trying various nasal forms on the patients face within few hours. This saves chair time, eliminates the impression step and provides patient and dentist an option of variety.

How to cite this article

Vanitha R, Ramkumar K, Rajtilak G, Rajasekar V. Designing a Nasal Prosthesis using CAD-RP Technology. Int J Prosthodont Restor Dent 2012;2(3):108-112.
Anterior Teeth and Smile Designing: A Prospective View
Authors: Vanitha R , Rajasekar V , Rajtilak G , Deepa S
Published: July 2013

Smile is a person's greatest beauty asset. A defective smile might be considered as a physical handicap as the mouth act as a focal point where a large share of attention is directed toward mouth and teeth, it would be nice to have some sort of tools to assess beauty, which currently does not exist.

Standards for beauty are actually a compilation and comparison of everything we have seen or experienced. Smile design is different from tooth design, with tooth design one is concerned with contour, position and color of individual teeth, while integration of these teeth into the face and facial features is paramount in smile design.

This article describes some average desirable characteristic features of smile to help and achieve optimum result in esthetic oral rehabilitation.

How to cite this article

Rajtilak G, Deepa S, Rajasekar V, Vanitha R. Anterior Teeth and Smile Designing: A Prospective View. Int J Prosthodont Restor Dent 2012;2(3):117-127.
Autoimmune (auto-inflammatory) syndrome induced by adjuvants – ASIA
Authors: Shoenfeld Yehuda , Maślińska Maria
Published: July 2013

Adiuwanty są niezbędne w dzisiejszej medycynie do zwiększenia odpowiedzi immunologicznej, co ma szczególne znaczenie w przypadku szczepionek. Adiuwanty stymulują zarówno wrodzoną, jak i nabytą odpowiedź immunologiczną. Idealny adiuwant powinien zwiększać odpowiedź immunologiczną, sam nie wywołując odpowiedzi swoistej lub reakcji niepożądanych. Jednak spostrzeżenia ostatnich lat dowodzą wpływu adiuwantów na rozwój autoimmunologicznych zapalnych chorób reumatycznych (autoimmune inflammatory rheumatic diseases – AIIRD) oraz rozwoju innych zdefiniowanych zespołów, takich jak zespół objawów chorobowych obserwowanych u uczestników wojny nad Zatoką Perską (Gulf War syndrome – GWS), zespół makrofagowego zapalenia mięśniowo-powięziowego (macrophagic myofascitis – MMF), fibromialgia (FB). Z wielu doniesień wiadomo, że w następstwie stosowania implantów silikonowych może również dojść do rozwoju nadreaktywnej odpowiedzi immunologicznej, określanej mianem siliconosis. Proponuje się, by te różne i zarazem wykazujące podobieństwo sytuacje kliniczne objąć wspólnym określeniem: autoimmunologiczny/autozapalny zespół indukowany przez adiuwanty (autoimmune/inflammatory syndrome induced by adjuvants – ASIA).
Shoulder joint replacement in rheumatoid arthritis – surgical treatment and physiotherapy
Authors: Prusinowska Agnieszka , Turski Piotr , Przepiórski Emil , Małdyk Paweł , Księżopolska-Orłowska Krystyna
Published: July 2013

W 1893 r. francuski chirurg Péan przeprowadził implantację endoprotezy stawu ramiennego u pacjenta z gruźliczą destrukcją stawu. Endoproteza była opracowana przez francuskiego dentystę Michale’a, który wykonał ją z platyny i hartowanej gumy. Dzięki tej pierwszej próbie okazało się, że implantacja sztucznego stawu ramiennego może zmniejszyć ból i poprawić jego funkcję. W ostatnich latach zaznaczył się znaczny postęp w dziedzinie implantacji sztucznych stawów, w tym także ramiennych. W artykule zostały opisane rodzaje stosowanych endoprotez oraz specyfika tego zabiegu w reumatoidalnym zapaleniu stawów (RZS), z uwzględnieniem wskazań do zabiegu oraz potencjalnego ryzyka operacji.

Opisane metody rehabilitacji dotyczą postępowania przygotowawczego do zabiegu chirurgicznego, wczesnej fazy usprawniania oraz ambulatoryjnego prowadzenia pacjenta z RZS. Autorzy przedstawiają algorytm rehabilitacji z uwzględnieniem zastosowania zaopatrzenia ortopedycznego, fizykoterapii oraz sprzętu do prowadzenia ciągłego, płynnego ruchu biernego (szyna CPM) od pierwszej doby po operacji. Proponowana kinezyterapia dotyczy zarówno klasycznej metodyki stopniowego wprowadzania ruchu czynnego po plastyce stawu ramienno-łopatkowego, jak i metod specyficznie dostosowanych do potrzeb chorych z zaawansowaną postacią RZS.
Patients’ preferences regarding biological treatment in doctors’ and patients’ opinions – the results of the RAISE* questionnaire survey
Authors: Tłustochowicz Małgorzata , Tłustochowicz Witold
Published: July 2013

Cel pracy: Ocena preferencji metod i częstości podawania leków biologicznych w opinii lekarzy reumatologów i chorych na reumatoidalne zapalenie stawów (RZS). Chorych pytano o problemy i uciążliwości związane ze stosowaniem leków biologicznych (zwłaszcza percepcji bólu związanego z podaniem preparatu). Pytania dotyczyły m.in. samodzielnego wstrzykiwania leku, korzystania z pomocy osób bliskich czy personelu medycznego, preferowanej formy podania leku oraz częstotliwości przyjmowania kolejnych dawek, poziomu zadowolenia ze skuteczności i bezpieczeństwa obecnie dostępnych terapii, niespełnionych potrzeb związanych z terapiami biologicznymi, modelu preparatu idealnego do terapii biologicznej RZS.

Materiał i metody: Badaniem ankietowym metodą wywiadu bezpośredniego standaryzowanego (PAPI) przeprowadzonym przez przeszkolonych ankieterów, będącym częścią międzynarodowego projektu RAISE, objęto 30 lekarzy reumatologów prowadzących leczenie biologiczne i 120 chorych przyjmujących leki biologiczne podskórnie (52%) bądź dożylnie (48%).

Wyniki: Lekarze uważali, że wykonanie przez chorego zastrzyku podskórnego jest łatwe lub bardzo łatwe, problemy z otwarciem opakowania są rzadkie (u 14%), natomiast częstsze z użyciem wstrzykiwacza (u 43%). Podskórna droga podania leku jest preferowana przez 83% chorych, którzy rzadko decydują się na leczenie drogą dożylną (3%). Zdaniem lekarzy 85% chorych wykonuje iniekcje samodzielnie oraz preferuje częstość podawania leku raz w miesiącu. Trudności z otwarciem opakowania zgłosiło 20 chorych (17%), z obsługą wstrzykiwacza 19 chorych (16%). Strach przed wkłuciem igły zgłosiło 29 chorych (24%). Działania niepożądane po lekach podskórnych wystąpiły u 29 chorych, a po lekach dożylnych u 12 (24% vs 10%) Najczęściej zgłaszano ból (20 chorych, tj. 17%) i uczulenie w miejscu wkłucia (10 chorych, tj. 8%). Z tego powodu u co czwartego chorego zastrzyk wykonuje osoba druga, najczęściej pielęgniarka. Drogę podskórną podania leku preferowało 46 chorych (38%), a dożylną 47 (39%), dla pozostałych badanych było to bez znaczenia. Preferowana przez chorych częstość podania leku to raz w miesiącu lub rzadziej.

Wnioski: Uzyskane opinie znacznie się różnią, dlatego autorzy uważają, że w wyborze drogi podania leku powinien uczestniczyć chory.
Meanders of rheumatology
Authors: Bernacka Krystyna
Published: July 2013

W artykule przedstawiono meandry reumatologii jako pojęcie topograficzne w historii poznawania procesów reumatycznych. Większość chorób reumatoidalnych należy bowiem do chorób tkanki łącznej o podłożu autoimmunologicznym, których przyczynę powstawania nadal bardzo trudno określić.
Takayasu arteritis: is disease activity assessment possible?
Authors: Rowińska-Osuch Anna , Więsik-Szewczyk Ewa , Olesińska Marzena
Published: July 2013

Choroba Takayasu (TA) jest rzadkim zapaleniem dużych tętnic. Początek choroby jest podstępny, może pozostać niezauważony. Przewlekłe zapalenie prowadzi do nieodwracalnych konsekwencji: powikłań sercowo-naczyniowych, niedrożności naczyń, zaniewidzenia czy przełomu nadciśnieniowego. Z uwagi na układowy charakter schorzenia pacjenci trafiają do specjalistów różnych dziedzin: reumatologów, okulistów, kardiologów i chirurgów naczyniowych. Dostępne metody farmakoterapii wpływają tylko na aktywne zmiany zapalne. Przedłużające się leczenie glikokortykosteroidami ma niekorzystne skutki odległe i nie powinno być nadużywane. Aby określić efekt leczenia, wybrać moment jego modyfikacji, konieczna jest ocena aktywności choroby. Celem prezentowanej pracy jest przedstawienie możliwości oceny aktywności TA.

W diagnostyce znaczącą rolę odgrywają badania obrazowe naczyń: ultrasonografia i rezonans magnetyczny. Prowadzone są prace dotyczące pozytonowej tomografii emisyjnej (positron emission tomography – PET), która jest badaniem czułym, ale trudno dostępnym, kosztownym i wymagającym walidacji. Poszukuje się również biomarkera, którego wartości korelowałyby z aktywnością choroby. Wśród potencjalnych kandydatów na biomarker są interleukiny 6, 12, 18. Aktualnie opracowywane są skale aktywności choroby, np. DEI.Tak (Disease Extent Index-Takayasu). Żadne z tych narzędzi nie jest uniwersalne.
Systemic lupus erythematosus in Slovakia – survey results
Authors: Rovenský Jozef , Lukáč Jozef , Tuchyňová Alena , Bernadič Marian
Published: July 2013

Toczeń rumieniowaty układowy (TRU) jest przewlekłą chorobą autoimmunologiczną o zróżnicowanym obrazie klinicznym i zmiennym przebiegu. Dane epidemiologiczne dostępne w literaturze się różnią. Częstość występowania TRU w populacji słowackiej dotychczas nie była oceniana. W artykule zostały po raz pierwszy przedstawione zbiorcze dane dotyczące częstości występowania, aktywności klinicznej oraz leczenia u chorych na TRU na Słowacji.
Air–snow transfer of nitrate on the East Antarctic Plateau – Part 1: Isotopic evidence for a photolytically driven dynamic equilibrium in summer
Authors: Erbland J. , Vicars W. C. , Savarino J. , Morin S. , Frey M. M. , Frosini D. , Vince E. , Martins J. M. F.
Published: July 2013

Abstract. Here we report the measurement of the comprehensive isotopic composition (δ15N, Δ17O and δ18O) of nitrate at the air–snow interface at Dome C, Antarctica (DC, 75°06' S, 123°19' E), and in snow pits along a transect across the East Antarctic Ice Sheet (EAIS) between 66° S and 78° S. In most of the snow pits, nitrate loss (either by physical release or UV photolysis of nitrate) is observed and fractionation constants associated are calculated. Nitrate collected from snow pits on the plateau (snow accumulation rate below 50 kg m−2 a−1) displays average fractionation constants of (−59±10) ‰, (+2.0±1.0) ‰ and (+8.7±2.4)‰ for δ15N, Δ17O and δ18O, respectively. In contrast, snow pits sampled on the coast show distinct isotopic signatures with average fractionation constants of (−16±14) ‰, (−0.2±1.5) ‰ and (+3.1±5.8) ‰, for δ15N, Δ17O and δ18O, respectively. Our observations corroborate that photolysis (associated with a 15N / 14N fractionation constant of the order of –48 ‰ according to Frey et al. (2009) is the dominant nitrate loss process on the East Antarctic Plateau, while on the coast the loss is less pronounced and could involve both physical release and photochemical processes. Year-round isotopic measurements at DC show a~close relationship between the Δ17O of atmospheric nitrate and Δ17O of nitrate in skin layer snow, suggesting a photolytically driven isotopic equilibrium imposed by nitrate recycling at this interface. Atmospheric nitrate deposition may lead to fractionation of the nitrogen isotopes and explain the almost constant shift of the order of 25 ‰ between the δ15N values in the atmospheric and skin layer nitrate at DC. Asymptotic δ15N(NO3−) values calculated for each snow pit are found to be correlated with the inverse of the snow accumulation rate (ln(δ15N as. + 1) = (5.76±0.47) ċ (kg m−2 a−1/ A) + (0.01±0.02)), confirming the strong relationship between the snow accumulation rate and the degree of isotopic fractionation, consistent with previous observations by Freyer et al. (1996). Asymptotic Δ17O(NO3−) values on the plateau are smaller than the values found in the skin layer most likely due to oxygen isotope exchange between the nitrate photoproducts and water molecules from the surrounding ice. However, the apparent fractionation in Δ17O is small, thus allowing the preservation of a portion of the atmospheric signal.
222Rn-calibrated mercury fluxes from terrestrial surface of southern Africa
Authors: Slemr F. , Brunke E.-G. , Whittlestone S. , Zahorowski W. , Ebinghaus R. , Kock H. H. , Labuschagne C.
Published: July 2013

Abstract. Gaseous elemental mercury (GEM) and 222Rn, a radioactive gas of primarily terrestrial origin with a half-life of 3.8 days, have been measured simultaneously at Cape Point, South Africa, since March 2007. Between March 2007 and December 2011, altogether 191 events with high 222Rn concentrations were identified. GEM correlated with 222Rn in 94 of the events and was constant during almost all the remaining events without significant correlation. The average GEM / 222Rn flux ratio of all events including the non-significant ones was −0.0001 with a standard error of ±0.0030 pg mBq−1. Weighted with the event duration, the average GEM / 222Rn flux ratio was −0.0048 ± 0.0011 pg mBq−1. With an emission rate of 1.1 222Rn atoms cm−2 s−1 and a correction for the transport time, this flux ratio corresponds to a radon-calibrated flux of about −0.54 ng GEM m−2 h−1 with a standard error of ±0.13 ng GEM m−2 h−1 (n = 191). With wet deposition, which is not included in this estimate, the terrestrial surface of southern Africa seems to be a net mercury sink of about −1.55 ng m−2 h−1. The additional contribution of an unknown but presumably significant deposition of reactive gaseous mercury would further increase this sink.
Hygroscopic mixing state of urban aerosol derived from size-resolved cloud condensation nuclei measurements during the MEGAPOLI campaign in Paris
Authors: Jurányi Z. , Tritscher T. , Gysel M. , Laborde M. , Gomes L. , Roberts G. , Baltensperger U. , Weingartner E.
Published: July 2013

Abstract. Ambient aerosols are a complex mixture of particles with different physical and chemical properties and consequently distinct hygroscopic behaviour. The hygroscopicity of a particle determines its water uptake at subsaturated relative humidity (RH) and its ability to form a cloud droplet at supersaturated RH. These processes influence Earth's climate and the atmospheric lifetime of the particles. Cloud condensation nuclei (CCN) number size distributions (i.e. CCN number concentrations as a function of dry particle diameter) were measured close to Paris during the MEGAPOLI campaign in January–February 2010, covering 10 different supersaturations (SS = 0.1–1.0%). The time-resolved hygroscopic mixing state with respect to CCN activation was also derived from these measurements. Simultaneously, a hygroscopicity tandem differential mobility analyser (HTDMA) was used to measure the hygroscopic growth factor (ratio of wet to dry mobility diameter) distributions at RH = 90%. The aerosol was highly externally mixed and its mixing state showed significant temporal variability. The average particle hygroscopicity was relatively low at subsaturation (RH = 90%; mean hygroscopicity parameter κ = 0.12–0.27) and increased with increasing dry diameter in the range 35–265 nm. The mean κ value, derived from the CCN measurements at supersaturation, ranged from 0.08 to 0.24 at SS = 1.0–0.1%. Two types of mixing-state resolved hygroscopicity closure studies were performed, comparing the water uptake ability measured below and above saturation. In the first type the CCN counter was connected in series with the HTDMA and and closure was achieved over the whole range of probed dry diameters, growth factors and supersaturations using the κ-parametrization for the water activity and assuming surface tension of pure water in the Köhler theory. In the second closure type we compared hygroscopicity distributions derived from parallel monodisperse CCN measurements and HTDMA measurements. Very good agreement was found at all supersaturations, which shows that monodisperse CCN measurements are a reliable alternative to determine the hygroscopic mixing state of ambient aerosols.
The link between organic aerosol mass loading and degree of oxygenation: an α-pinene photooxidation study
Authors: Pfaffenberger L. , Barmet P. , Slowik J. G. , Praplan A. P. , Dommen J. , Prévôt A. S. H. , Baltensperger U.
Published: July 2013

Abstract. A series of smog chamber (SC) experiments was conducted to identify factors responsible for the discrepancy between ambient and SC aerosol degree of oxygenation. An Aerodyne high-resolution time-of-flight aerosol mass spectrometer is used to compare mass spectra from α-pinene photooxidation with ambient aerosol. Composition is compared in terms of the fraction of particulate CO2+, a surrogate for carboxylic acids, vs. the fraction of C2H3O+, a surrogate for aldehydes, alcohols and ketones, as well as in the Van Krevelen space, where the evolution of the atomic hydrogen-to-carbon ratio (H : C) vs. the atomic oxygen-to-carbon ratio (O : C) is investigated. Low (near-ambient) organic mass concentrations were found to be necessary to obtain oxygenation levels similar to those of low-volatility oxygenated organic aerosol (LV-OOA) commonly identified in ambient measurements. The effects of organic mass loading and OH (hydroxyl radical) exposure were decoupled by inter-experiment comparisons at the same integrated OH concentration. An OH exposure between 3 and 25 × 107 cm−3 h is needed to increase O : C by 0.05 during aerosol aging. For the first time, LV-OOA-like aerosol from the abundant biogenic precursor α-pinene was produced in a smog chamber by oxidation at typical atmospheric OH concentrations. Significant correlation between measured secondary organic aerosol (SOA) and reference LV-OOA mass spectra is shown by Pearson's R2 values larger than 0.90 for experiments with low organic mass concentrations between 1.2 and 18 μg m−3 at an OH exposure of 4 × 107 cm−3 h, corresponding to about two days of oxidation time in the atmosphere, based on a global mean OH concentration of ~ 1 × 106 cm−3. α-Pinene SOA is more oxygenated at low organic mass loadings. Because the degree of oxygenation influences the chemical, volatility and hygroscopic properties of ambient aerosol, smog chamber studies must be performed at near-ambient concentrations to accurately simulate ambient aerosol properties.
Soil organic carbon dynamics following afforestation in the Loess Plateau of China
Authors: Lu N. , Liski J. , Chang R. Y. , Akujärvi A. , Wu X. , Jin T. T. , Wang Y. F. , Fu B. J.
Published: July 2013

Abstract. Soil organic carbon (SOC) is the largest terrestrial carbon pool and sensitive to land use and cover change; its dynamics is critical for carbon cycling in terrestrial ecosystems and the atmosphere. In this study, we combined a modeling approach and field measurements to examine the temporal dynamics of SOC following afforestation of former arable land at six sites under different climatic conditions in the Loess Plateau during 1980–2010. The results showed that the measured mean SOC increased to levels higher than before afforestation when taking the last measurements (i.e., at age 25 to 30 yr), although it decreased in the first few years at the wetter sites. The accumulation rates of SOC were 1.58 to 6.22% yr–1 in the upper 20 cm and 1.62 to 5.15% yr–1 in the upper 40 cm of soil. The simulations reproduced the basic characteristics of measured SOC dynamics, suggesting that litter input and climatic factors (temperature and precipitation) were the major causes for SOC dynamics and the differences among the sites. They explained 88–96, 48–86 and 57–74% of the variations in annual SOC changes at the soil depths of 0–20, 0–40, and 0–100 cm, respectively. Notably, the simulated SOC decreased during the first few years at all the sites, although the magnitudes of decreases were small at the drier sites. This suggested that the modeling may be advantageous in capturing SOC changes at finer time scale. The discrepancy between the simulation and measurement was a result of uncertainties in model structure, data input, and sampling design. Our findings indicated that afforestation promoted soil carbon sequestration at the study sites, which is favorable for further restoration of the vegetation and environment. Afforestation activities should decrease soil disturbances to reduce carbon release in the early stage. The long-term strategy for carbon fixation capability of the plantations should also consider the climate and site conditions, species adaptability, and successional stage of recovery.
Calcification intensity in planktonic Foraminifera reflects ambient conditions irrespective of environmental stress
Authors: Weinkauf M. F. G. , Moller T. , Koch M. C. , Kučera M.
Published: July 2013

Abstract. Planktonic Foraminifera are important marine calcifiers, and the ongoing change in the oceanic carbon system makes it essential to understand the influence of environmental factors on the biomineralisation of their shells. The amount of calcite deposited by planktonic Foraminifera during calcification has been hypothesized to reflect a range of environmental factors. However, it has never been assessed whether their calcification only passively responds to the conditions of the ambient seawater or whether it reflects changes in resource allocation due to physiological stress. To disentangle these two end-member scenarios, an experiment is required where the two processes are separated. A natural analogue to such an experiment occurred during the deposition of the Mediterranean sapropels, where large changes in surface water composition and stratification at the onset of the sapropel deposition were decoupled from local extinctions of planktonic Foraminifera species. We take advantage of this natural experiment and investigate the reaction of calcification intensity, expressed as size-normalized weight (SNW), of four species of planktonic Foraminifera to changing conditions during the onset of Sapropel S5 (126–121 ka) in a sediment core from the Levantine Basin. We observe a significant relationship between SNW and surface water properties, as reflected by stable isotopes in the calcite of Foraminifera shells, but we failed to observe any reaction of calcification intensity on ecological stress during times of decreasing abundance culminating in local extinction. The reaction of calcification intensity to surface water perturbation at the onset of the sapropel was observed only in surface dwelling species, but all species calcified more strongly prior to the sapropel deposition and less strongly within the sapropel than at comparable conditions during the present day. These results indicate that the high-salinity environment of the glacial Mediterranean Sea prior to sapropel deposition induced a more intense calcification, whereas the freshwater injection to the surface waters associated with sapropel deposition inhibited calcification. The results are robust to changes in carbonate preservation and collectively imply that changes in normalized shell weight in planktonic Foraminifera should reflect mainly abiotic forcing.