bluuebunny/crossref_metadata_2025_split huggingface dataset:
Experimental buckling of a simple aerofoil under combined shear and in-plane bending
Authors: Featherston C A 
Published: March 2004

The buckling loads and postbuckling behaviour of complex structures can only be determined analytically by simplifying them into a number of component parts and examining these individually using existing design rules. This approach does not consider the effect of geometric imperfections and large deflections or the interaction between overall and local buckling modes. Alternatively, finite element analysis can be used. This approach has the advantage of allowing geometry, boundary and loading conditions to be modelled more accurately. Large-scale deflections and material plasticity can be modelled, the effects of imperfections examined and all possible modes of failure considered. This paper outlines a series of experiments carried out to determine the accuracy of these two alternative techniques in predicting the buckling loads and postbuckling behaviour for the case of a simple aerofoil under combined shear and in-plane bending.
Stress in V-section band clamps
Authors: Shoghi K , Barrans S M , Rao H V 
Published: March 2004

This paper presents an analysis of the stresses in V-section band clamps by examining the correlation between experimental work and theoretical models. Theoretical models incorporating traditional beam-bending theories and allowing for friction were developed to calculate the stress distribution and displacements within the clamps. The theoretical models demonstrated that the normal manufacturing tolerances associated with this type of component, combined with the uncontrolled operating parameters, will produce a wide variation in working stresses. These theoretical models were validated using strain and displacement measurements from a test with a V-section band clamp positioned around rigid flanges. The experimental results all fell within the range of stresses predicted by the theoretical models. The paper provides a knowledge base for the rational design of V-section band clamps.
Impact of a non-homogeneous sphere on a rigid surface
Authors: Carré M J , James D M , Haake S J 
Published: March 2004

This paper examines the impact behaviour of a non-homogenous sphere (in this case a cricket ball with a rolled core construction) with a rigid surface. Experiments were carried out to measure the force-deflection behaviour of a cricket ball during a normal impact in two orientations (impacting on the seam and perpendicular to the seam). For the two orientations of impact, a disparity was found in terms of the force-deflection behaviour. Greater deformation was found for impacts landing on the seam, compared to those landing perpendicular to the seam. Comparisons with quasi-static test data suggested that only the bottom third of the ball may have been compressed during impact. The dynamic force-deflection behaviour was modelled using a mass attached to a Hertzian spring in parallel with a damper whose damping coefficient varied with the contact area. The coefficients in the model could be described using the velocity before impact alone. The model was found to be in good agreement with the experimental data. The model was then extended to predict oblique impacts by incorporating a measured coefficient of friction. This performed well in predicting the rebound velocity, angle and spin of a cricket ball after oblique impact with a cricket pitch. Inconsistencies in the results were attributed to deformation in the pitch surface.
A Hybrid Genetic/Optimization Algorithm for Finite-Horizon, Partially Observed Markov Decision Processes
Authors: Lin Zong-Zhi , Bean James C. , White Chelsea C. 
Published: March 2004

The partially observed Markov decision process (POMDP) is a generalization of a Markov decision process that allows for noise-corrupted and costly observations of the underlying system state. The value function of the infinite horizon POMDP is known to be piecewise affine and convex in the probability mass vector over the state space. Such a function can be represented by a finite set of affine functions. In this paper, we develop and evaluate an exact algorithm, GAMIP, which combines a genetic algorithm and a mixed integer program to construct the minimal set of affine functions that describes the value function. Numerical results indicate that GAMIP takes up to 60% less time to construct the minimal set than does the most efficient linear programming-based exact solution method in the literature.
Pharmacologic Management of Alzheimer Disease Part I: Hormonal and Emerging Investigational Drug Therapies
Authors: Flynn Barbara L 
Published: March 2004

OBJECTIVE: To provide information about current genetic research in Alzheimer disease (AD) and potential pharmacologic interventions. Investigational pharmacologic management of AD, including serenics, hormonal therapy, neurotransmitter augmentation, neurobiologic agents, nootropics, and ampakines are also reviewed. DATA SOURCES: Studies, review articles, and editorials identified from MEDLINE searches (from January 1993 to December 1996), and bibliographies of identified articles. STUDY SELECTION: Studies, review articles, and editorials addressing current areas of AD pharmacotherapy research, including hormonal therapy and select investigational agents. DATA EXTRACTION: Pertinent information was selected and the data were synthesized into a review format. DATA SYNTHESIS: AD is a devastating disease characterized by progressive memory loss, cognitive decline, and behavioral disturbances. The behavioral problems associated with AD can present a difficult clinical challenge. Many patients with AD are intolerant of traditional pharmacologic management, including antipsychotics, antidepressants, and anxiolytics. Hormonal agents, including estrogen, medroxyprogesterone, and cyproterone acetate, may be efficacious therapeutic alternatives in the management of sexual behavioral disturbances in men. Research regarding estrogen's role in AD prevention and effect on cognitive function and behavioral symptoms in women with AD are evaluated. Studies evaluating neurotransmitter augmentation and neurobiologic agents in AD are reviewed. CONCLUSIONS: Environmental, genetic, neurobiologic, hormonal, and neurotransmitter influences, and their respective roles in AD pathology, are being investigated. Researchers concur that it is imperative to recognize the correlation of these factors in the etiology of AD to design effective prevention and treatment strategies. Additional studies are essential to elucidate the most efficacious treatments for AD and the attendant behavioral disturbances.
Management of Patients with Type 2 Diabetes by Pharmacists in Primary Care Clinics
Authors: Coast-Senior Elizabeth A , Kroner Beverly A , Kelley Catherine L , Trilli Lauren E 
Published: March 2004

OBJECTIVE: To determine the impact of clinical pharmacists involved in direct patient care on the glycemic control of patients with type 2 diabetes mellitus. DESIGN: Eligible patients included those with type 2 diabetes who received insulin or were initiated on insulin therapy by the pharmacists and were willing to perform self-monitoring of blood glucose. The pharmacists provided diabetes education, medication counseling, monitoring, and insulin initiation and/or adjustments. All initial patient interactions with the pharmacists were face-to-face. Thereafter, patient–pharmacist interactions were either face-to-face or telephone contacts. SETTING: Two primary care clinics in a university-affiliated Veterans Affairs Medical Center. PARTICIPANTS: Study subjects were patients with type 2 diabetes who were referred to the pharmacists by their primary care providers for better glycemic control. OUTCOME MEASURES: Primary outcome variables were changes from baseline in glycosylated hemoglobin, fasting blood glucose, and random blood glucose measurements. Secondary outcomes were the number and severity of symptomatic episodes of hypoglycemia, and the number of emergency room visits or hospitalizations related to diabetes. Twenty-three veterans aged 65 ± 9.4 years completed the study. Fifteen (65%) patients were initiated on insulin by the pharmacists; 8 (35%) were already using insulin. Patients were followed for a mean ± SD of 27 ± 10 weeks. Glycosylated hemoglobin, fasting blood glucose concentrations, and random blood glucose concentrations significantly decreased from baseline by 2.2% (p = 0.00004), 65 mg/dL (p < 0.01), and 82 mg/dL (p = 0.00001), respectively. Symptomatic hypoglycemic episodes occurred in 35% of patients. None of these episodes required physician intervention. CONCLUSIONS: This study demonstrates that pharmacists working as members of interdisciplinary primary care teams can positively impact glycemic control in patients with type 2 diabetes requiring insulin.
Pharmacologic Management of Alzheimer Disease Part II: Antioxidants, Antihypertensives, and Ergoloid Derivatives
Authors: Flynn Barbara L , Ranno Anthony E 
Published: March 2004

OBJECTIVE: To provide information about research evaluating antioxidants in Alzheimer disease (AD) and to discuss the potential role of β-blockers, angiotensin-converting enzyme inhibitors, clonidine, guanfacine, nimodipine, and ergoloid derivatives in AD therapy. DATA SOURCES: Studies, review articles, and editorials identified from MEDLINE searches (from 1989 to 1997) and bibliographies of identified articles. STUDY SELECTION: Studies and review articles addressing antioxidant, antihypertensive, and ergoloid derivative pharmacotherapy research. DATA EXTRACTION: Pertinent information was selected and the data synthesized into a review format. DATA SYNTHESIS: AD is a progressive neuropsychiatric disorder of unknown etiology. Studies evaluating the possible association between a free radical mechanism in AD and the potential role of antioxidants are reviewed. Additionally, the role of β-blockers, angiotensin-converting enzyme inhibitors, clonidine, guanfacine, nimodipine, and ergoloid derivatives in AD management are discussed. CONCLUSIONS: Preliminary evidence suggests that antioxidants may have a protective effect against the development of AD. Additional prospective, double-blind, placebo-controlled studies are needed to determine the role of antioxidants in the prevention and management of AD. Understanding the role of antioxidants in AD may suggest alternative agents that have similar pharmacologic activity. β-Blockers may be an option to control agitation in AD patients for whom anxiolytics or antipsychotics are ineffective or are contraindicated because of their adverse effect profiles. Other agents that may have a role in AD therapy include angiotensin-converting enzyme inhibitors, nimodipine, and ergoloid derivatives. Clonidine and guanfacine have thus far shown little promise in improving cognitive function in AD. Further prospective, double-blind, placebo-controlled trials will be necessary to elucidate the role of these agents in AD management.
Local Therapy for Cytomegalovirus Retinitis
Authors: Smith Curtis L 
Published: March 2004

OBJECTIVE: To examine the role of intraocular therapy in the management of cytomegalovirus (CMV) retinitis associated with AIDS. DATA SOURCES: A MEDLINE search was conducted for the years 1980–1997. In addition, relevant articles were cross-referenced to screen for additional information. The AIDS/HIV Treatment Directory was searched for information on ongoing studies. STUDY SELECTION/DATA EXTRACTION: Data regarding the use of local antiviral therapy for CMV retinitis are cited. Emphasis was placed on randomized, controlled trials, but descriptive studies are also included. DATA SYNTHESIS: Intraocular drug administration is an alternative therapy for CMV retinitis that avoids some of the disadvantages associated with systemic treatment. Intravitreal ganciclovir 200–2000 μg once weekly has been studied in a number of nonrandomized studies. Although initially effective, intravitreal ganciclovir is associated with a significant relapse rate and development of contralateral CMV retinitis. Intraocular ganciclovir implants offer the advantage of less frequent interventions and constant drug concentrations in the vitreous. Time to progression is significantly longer in patients receiving implants versus intravenous therapy; however, there is a higher incidence of contralateral eye retinitis and extraocular CMV disease with the implants. Currently, the intraocular implant is being studied in combination with oral ganciclovir to decrease the incidence of systemic CMV disease. Foscarnet and cidofovir have also been administered intravitreally for CMV retinitis. Cidofovir may offer the advantage of a long intracellular half-life, which would allow infrequent dosing; however, further study is needed to determine a safe and effective intraocular dosage. CONCLUSIONS: Systemic therapy continues as standard management for CMV retinitis. Local therapy has some advantages and disadvantages, but larger, randomized, controlled trials comparing systemic therapy with local therapy must be completed to define its exact role. Data from an ongoing trial of local plus oral therapy will better define this role.
Atypical Antipsychotics: Part II Adverse Effects, Drug Interactions, and Costs
Authors: Brown Candace S , Markowitz John S , Moore Thea R , Parker Nicole G 
Published: March 2004

OBJECTIVE: To compare the adverse effects, drug interactions, and costs of conventional and atypical agents, and to provide a summary of therapeutic guidelines. Part I compared the pharmacology, pharmacokinetics, and efficacy of atypical and conventional agents. DATA SOURCES: Information was retrieved from a MEDLINE English-language literature search from June 1986 to June 1998 and by review of references. Indexing terms included atypical antipsychotics, neuroleptics, clozapine, risperidone, olanzapine, sertindole, quetiapine, and ziprasidone. STUDY SELECTION: Comparative studies were selected when possible; placebo-controlled studies were included when data were limited on newer atypical antipsychotics. DATA EXTRACTION: Emphasis was placed on properly designed clinical trials that assessed dosage, expanded efficacy, enhanced adverse effect profile, and cost. DATA SYNTHESIS: Significant adverse effects are agranulocytosis with clozapine, dose-dependent extrapyramidal side effects (EPS) with risperidone, and neuroleptic malignant syndrome with clozapine and risperidone. Clinically relevant drug interactions may occur with clozapine–lorazepam, clozapine–fluvoxamine, and sertindole– quinidine. Newer atypical agents have high acquisition costs but may reduce noncompliance and rehospitalization rates. CONCLUSIONS: Risperidone or olanzapine are recommended as first-line agents for schizophrenia due to accumulating controlled trials and clinical experience. Quetiapine should be considered with partial response or if EPS develop, and clozapine is an option with treatment-refractory patients. Atypical agents may contribute to a better quality of life, but conventional neuroleptics are the first choice for strictly cost considerations.
Ranitidine Bismuth Citrate in the Treatment of Helicobacter Pylori Infection and Duodenal Ulcer
Authors: Vondracek Thomas G 
Published: March 2004

OBJECTIVE: To review the clinical pharmacology of ranitidine bismuth citrate in the treatment of Helicobacter pylori (HP) Infection and Duodenal Ulcer. DATA SOURCES: A MEDLINE search of the English-language literature from 1992 to January 1997 was conducted using the key terms Tritec, ranitidine, and bismuth. References of articles pertaining to treatment of duodenal ulcer or HP were extensively searched for relevant sources. DATA EXTRACTION: All articles pertaining to ranitidine bismuth citrate were considered for inclusion, with emphasis placed on randomized, double-blind trials. Priority was placed on data pertaining to regimens that are currently approved by the Food and Drug Administration for the treatment of duodenal ulcer in conjunction with HP. DATA SYNTHESIS: Each tablet of ranitidine bismuth citrate 400 mg contains 162 mg of ranitidine base, 128 mg of trivalent bismuth, and 110 mg of citrate. It uses the acid-suppressive actions of ranitidine and the antimicrobial and mucosal protective effects of bismuth to eradicate HP. Ranitidine bismuth citrate in conjunction with clarithromycin represents one of four treatment regimens currently approved in the US for duodenal ulcer associated with HP infection. In four double-blind, randomized trials, this agent has achieved HP eradication rates of 73–94% and duodenal ulcer healing rates of 73–89%. It is given twice daily for 28 days, and is associated with very low rates of adverse effects. CONCLUSIONS: Relative to some therapeutic alternatives, ranitidine bismuth citrate plus clarithromycin may be simpler to take and have less adverse effects, but may be more expensive. Compared with omeprazole plus clarithromycin, it is less expensive, may have lower ulcer healing rates, but may be more effective in eradicating HP. The role of ranitidine bismuth citrate will continue to evolve as more patients are treated, and other regimens continue to be tested for duodenal ulcer healing and HP eradication.
Pharmacotherapeutic Issues for Women of Childbearing Age with Epilepsy
Authors: Chang Shu-Ing , McAuley James W 
Published: March 2004

James W McAuley BSPharm PhD, Assistant Professor of Pharmacy Practice and Administration and Neurology, Colleges of Pharmacy and Medicine, The Ohio State University OBJECTIVE: To provide an overview of key pharmacotherapeutic issues in epilepsy for the woman of childbearing potential. DATA SOURCES: A MEDLINE search (1966–1997) was done to identify pertinent literature. Chapters in epilepsy textbooks, pregnancy registries, and their respective bibliographies were also evaluated. STUDY SELECTION AND DATA EXTRACTION: All identifiable sources written in English were evaluated. DATA SYNTHESIS: Epilepsy is a common neurologic disorder. It is estimated that nearly 1 million American women of childbearing age have epilepsy. There are many women's health issues in epilepsy. These include menstrual cycle influences on seizure activity, contraceptive–antiepileptic drug interactions, pharmacokinetic changes during pregnancy, teratogenicity of antiepileptic drugs, breast-feeding, and quality of life. These issues challenge both the woman with epilepsy and the many healthcare providers involved in her care. This article reviews these issues and makes recommendations. It addresses both the first-generation antiepileptic drugs (phenobarbital, phenytoin, carbamazepine, valproic acid) and the newer or second-generation agents (felbamate, gabapentin, lamotrigine, topiramate, tiagabine). CONCLUSIONS/RECOMMENDATIONS: Drug interactions between enzyme-inducing antiepileptic drugs and contraceptives are well documented. Higher doses of oral contraceptives or a second contraceptive method are suggested if epileptic women use an enzyme-inducing antiepileptic drug. Planned pregnancy is highly recommended and counseling before conception is crucial. Prepregnancy counseling should include, but is not limited to, folic acid supplementation, optimal control of seizure activity, monotherapy with the lowest effective antiepileptic drug dose, and medication adherence. Patient information should be provided about the risk of teratogenicity and the importance of prenatal care. Antiepileptic drug dosage adjustments may be necessary and should be based on clinical symptoms, not solely on serum drug concentrations. While the future holds promise for many aforementioned women's issues in epilepsy, many questions remain to be answered.
Update on Drug Interactions with Azole Antifungal Agents
Authors: Lomaestro Ben M , Piatek Michelle Ann 
Published: March 2004

OBJECTIVE: T o review and update the incidence, mechanism, and clinical relevance of drug interactions with itraconazole, ketoconazole, and fluconazole. DATA SOURCES: Literature was identified by MEDLINE search (from January 1990 to May 1997) using the name of each antifungal and the term “interaction” as MeSH headings. Abstracts were identified by literature citation and by review of Interscience Conference on Antimicrobial Agents and Chemotherapy from 1995 to 1996. STUDY SELECTION: Randomized, controlled, double-blind studies were emphasized; however, uncontrolled studies and case reports were also included. In vitro data were selected from literature review and citations. DATA EXTRACTION: Data were evaluated with respect to study design, clinical relevance, magnitude of interaction, and recommendations provided. DATA SYNTHESIS: The incidence of fungal infections and consequent azole antifungal usage continues to increase. By virtue of their antifungal mechanism (i.e., inhibition of cytochrome P450 fungal enzyme systems), azoles have been investigated and implicated in several drug interactions. The magnitude of interactions can vary from trivial to potentially fatal, and also vary with specific azole and interactant. CONCLUSIONS: The azole antifungal agents represent a commonly used class of agents with a broad range of potential interactions. Recent data have increased our understanding of drug-drug interactions with azoles. Pharmacists are in a unique position to identify these interactions and to intervene to decrease their morbidity and improve patient care.
Syndrome of Inappropriate Antidiuretic Hormone Associated with Vinorelbine Therapy
Authors: Garrett Clifford A , Simpson Thomas A 
Published: March 2004

OBJECTIVE: To describe onset of syndrome of inappropriate antidiuretic hormone (SIADH) associated with vinorelbine therapy for advanced breast cancer. CASE SUMMARY: A 50-year-old white woman with a history of advanced breast cancer refractory to other treatment modalities was receiving vinorelbine. Blood chemistries revealed severely depleted sodium and potassium concentrations from a normal baseline within a 7-day period. A recheck of blood chemistries confirmed hyponatremia. The patient was admitted to the hospital and treated for SIADH. After successful treatment, she was given demeclocycline prophylactically and rechallenged with vinorelbine without recurrence of the syndrome. DISCUSSION: SIADH has been reported as a complication of treatment with vinca alkaloids. To our knowledge, this is the first report of this syndrome related to vinorelbine therapy. CONCLUSIONS: Because of its structural similarity to the other vinca alkaloids, vinorelbine is believed to be responsible for SIADH in our patient. Clinicians should be aware of the possibility that vinorelbine may cause SIADH and possibly hypokalemia.