cssi/SciSciGPT-SciSciNet huggingface dataset:
Telephone psychotherapy and telephone care management for primary care patients starting antidepressant treatment: a randomized controlled trial.

ContextBoth antidepressant medication and structured psychotherapy have been proven efficacious, but less than one third of people with depressive disorders receive effective levels of either treatment.ObjectiveTo compare usual primary care for depression with 2 intervention programs: telephone care management and telephone care management plus telephone psychotherapy.DesignThree-group randomized controlled trial with allocation concealment and blinded outcome assessment conducted between November 2000 and May 2002.Setting and ParticipantsA total of 600 patients beginning antidepressant treatment for depression were systematically sampled from 7 group-model primary care clinics; patients already receiving psychotherapy were excluded.InterventionsUsual primary care; usual care plus a telephone care management program including at least 3 outreach calls, feedback to the treating physician, and care coordination; usual care plus care management integrated with a structured 8-session cognitive-behavioral psychotherapy program delivered by telephone.Main Outcome MeasuresBlinded telephone interviews at 6 weeks, 3 months, and 6 months assessed depression severity (Hopkins Symptom Checklist Depression Scale and the Patient Health Questionnaire), patient-rated improvement, and satisfaction with treatment. Computerized administrative data examined use of antidepressant medication and outpatient visits.ResultsTreatment participation rates were 97% for telephone care management and 93% for telephone care management plus psychotherapy. Compared with usual care, the telephone psychotherapy intervention led to lower mean Hopkins Symptom Checklist Depression Scale depression scores (P = .02), a higher proportion of patients reporting that depression was "much improved" (80% vs 55%, P<.001), and a higher proportion of patients "very satisfied" with depression treatment (59% vs 29%, P<.001). The telephone care management program had smaller effects on patient-rated improvement (66% vs 55%, P = .04) and satisfaction (47% vs 29%, P = .001); effects on mean depression scores were not statistically significant.ConclusionsFor primary care patients beginning antidepressant treatment, a telephone program integrating care management and structured cognitive-behavioral psychotherapy can significantly improve satisfaction and clinical outcomes. These findings suggest a new public health model of psychotherapy for depression including active outreach and vigorous efforts to improve access to and motivation for treatment.
DETERMINATION OF OPTIMUM BRINE CURING PROCEDURES FOR SMOKED CHICKEN

Optimization of curing procedures for smoked chicken was studied using surface response methodology. Preferred NaCl levels of 4–5% in the cooked meat were achieved with several combinations of cure time and brine NaCl concentrations. One excellent combination was 10.5% NaCl and 24 hr cure. Although data on sucrose did not give the optimum level, sucrose in the brine should be no more than 20–30% of the NaCl level. Sodium nitrate was not necessary for the short cure times of this study where NaNO2 and ascorbic acid were used in the curing brine. A short equilibration period of 6–12 hr after curing before cooking appeared adequate to allow sufficient dispersion of brine ingredients in the meat.
Characterization of allelopathic compounds from the red tide dinoflagellate Karenia brevis

Blooms and cultures of the red tide dinoflagellate Karenia brevis exude compounds that inhibit the growth of competing phytoplankton, but the identities of these compounds are unknown. We characterized allelopathic compounds from K. brevis using a variety of chromatographic and spectroscopic techniques. K. brevis produces multiple compounds that are inhibitory towards the Gulf of Mexico diatom Asterionellopsis glacialis. However, brevetoxins, potent neurotoxins responsible for massive fish kills and neurotoxic shellfish poisoning in humans, had no effect on A. glacialis growth. We determined that most allelopathic compounds produced by K. brevis are unstable, polar, organic molecules produced at low concentrations, which are either neutral or positively charged. K. brevis also produces a suite of less polar, but more stable compounds that are moderately allelopathic towards A. glacialis. Given that K. brevis encounters a variety of competitor species in the field, the production of multiple allelopathic compounds could provide a broader chemical arsenal to successfully inhibit these competitors. The allelopathic compounds characterized in more detail had molecular weights between 500 and 1000 Da and possessed aromatic functional groups. Metabolic fingerprinting of K. brevis extracts has not yet led to identification of specific compound(s) responsible for allelopathy. Our results indicate that the ability of K. brevis to outcompete co-occurring phytoplankton may be facilitated by the production of multiple allelopathic compounds.
Estimates nearL 1 for Fourier multipliers and maximal functions

Demonstration d'une version du theoreme des multiplicateurs de Hormander. Etude de quelques operateurs maximaux
Prevalence of myocardial ischemia during mechanical ventilation and weaning and its effects on weaning success.

Background Myocardial ischemia may be considered both a consequence of weaning from ventilation and a potential cause of weaning failure. A limited number of investigations have evaluated myocardial ischemia during mechanical ventilation and weaning and its effect on weaning success. The purpose of this pilot investigation was to determine the prevalence of myocardial ischemia in a diverse group of medical intensive care unit (MICU) patients during baseline mechanical ventilation, during weaning using continuous positive airway pressure, and up to 24 hours after extubation and to evaluate the relationship between ischemia and weaning failure. Methods This study was a prospective, repeated-measure, descriptive investigation that studied 43 ventilated MICU patients. Slightly more than half of participants were male (53%), and participants had a mean age of 51.1 ± 14.6 years and were ventilated an average of 11.7 ± 11.3 days. Myocardial ischemia was evaluated by examination of plasma cardiac troponin I, creatine phosphokinase–myocardial band (CK-MB), and ST-segment changes on electrocardiogram. Continuous electrocardiographic data were obtained by a calibrated, frequency-modulated, continuous 3-channel electrocardiographic recorder using leads I, II, and V2. Results Seventy percent of these participants ( n = 30) exhibited ST-segment deviation at some point during data collection (baseline mechanical ventilation, during weaning, after extubation). Twenty-four participants exhibited ST-segment deviation at baseline, 7 during weaning, and 8 after extubation. Nine participants exhibited ST-segment deviation at >1 data collection time point. None had ST-segment deviation at all 3 time points. Cardiac enzyme concentrations were highly variable; five participants demonstrated clinically important increases in either CK-MB and/or troponin I. Thirty-five percent of participants required >1 weaning trial. Participants who exhibited ST-segment deviation during baseline ventilation were 60% more likely to fail their initial weaning trial. There were no significant differences in CK-MB or troponin I levels between those participants who were successfully weaned with 1 trial and those who failed to wean during that first trial. Conclusions Silent myocardial ischemia was a common occurrence in this diverse group of MICU patients, although only 21% had previously diagnosed coronary disease. Clinicians must be aware of the potential for silent ischemia, monitor and evaluate their patients for such, and intervene to promote optimal cardiovascular function, particularly during the stress of ventilator weaning.
Kinetic effects and mechanisms limiting substitutional solubility in the formation of supersaturated alloys by pulsed laser annealing

Pulsed laser annealing of silicon implanted by Group (III,V) dopants leads to the formation of supersaturated alloys by nonequilibrium processes occurring in the interfacial region during liquid phase epitaxial regrowth. The distribution coefficient from the melt (k') and the maximum dopant substitutional solubility (C/sub s//sup max/) are far greater than equilibrium values and both are functions of growth velocity. Substitutional solubility is limited by lattice strain and by constitutional supercooling at the interface during regrowth. Values for C/sub s//sup max/ obtained at different velocities are compared with predictions of thermodynamic limits for solute trapping.
Facilitated transport via carrier—mediated diffusion in membranes: Part II. Mathematical aspects and analyses

Part II of this review is concerned with the mathematical analysis of facilitated transport. An exposition is given of the most generally useful techniques for obtaining asymptotic or approximate solutions to one-dimensional carrier-mediated diffusion in membranes, involving multiple permeant and carrier species which undergo one or more chemical reactions. Primary emphasis is devoted to the limiting regimes of weakly-perturbed membranes (small driving forces) and slow or fast reactions (small or large Damkohler numbers). Many of the results appearing in the literature are unified and extended, and a systematic procedure for using these to estimate membrane performance is put forth. Finally, some areas for further work are identified.
Cyclosporine Concentration Determinations for Monitoring and Pharmacokinetic Studies

The availability of the immunosuppressant cyclosporine has led to significant improvements in the recent success of clinical organ transplantation. Problems associated with cyclosporine therapy include serious adverse reactions, such as nephrotoxicity, wide variability in the drug's pharmacokinetics, and several complex drug interactions. Monitoring of drug concentrations is accepted as a part of the routine care of patients receiving cyclosporine. However, cyclosporine concentrations can be determined in different biologic fluids by either radioimmunoassay or high-performance liquid chromatographic techniques. Controversy exists regarding the optimal analytic technique to be used for cyclosporine monitoring and pharmacokinetic studies. This commentary addresses factors including: (1) why the monitoring of cyclosporine concentrations is important, (2) the differences between the biologic fluids and analytic techniques, (3) when monitoring and special pharmacokinetic studies are indicated, (4) what some major transplant centers have established as a “therapeutic range” for cyclosporine concentrations, and (5) provides guidelines for the optimal clinical monitoring of cyclosporine concentrations.
Shockwave therapy for chronic proximal hamstring tendinopathy.

ObjectiveTo compare the effectiveness of shockwave therapy with a traditional conservative treatment program for chronic proximal hamstring tendinopathy in professional athletes.DesignRandomized controlled trial, with 12 months of follow-up. Sample size was calculated with 80% power to show a differ
Towards a Theoretical Model of Performance Inhibiting Workplace Dynamics

A construct and model of performance inhibiting workplace dynamics is introduced to conceptualize the adverse consequences on performance and quality of certain interpersonal interactions in the workplace and behavioral instructions leading to double binds. Results of a literature review are presented which provide evidence for the existence of a set of workplace interactions that are associated with reduced performance and quality. It is hypothesized that the negative influences on employee performance in the model occur by alteration of one or more of the following three of Swanson’s performance variables at the individual level: mission/goal, capacity, or motivation. As a field that considers performance as an important outcome of its practice, human resource development scholars and practitioners need to understand such dynamics in order to eliminate or reduce their effects on employee performance.
Heat transfer from a cylindrical probe immersed in a three-phase slurry bubble column

Abstract Studies conducted on heat transfer and hydrodynamics in a slurry bubble column containing an air-water-magnetite system are described and discussed. In particular, the heat transfer coefficients between a 19 mm heat transfer probe and surrounding two- and three-phase dispersions and the air holdup were measured as functions of air velocity. Magnetite powders of average diameters 35.7, 49, 58, 69, 90.5, 115.5 and 137.5 μm, and powder concentrations up to 30 wt.% in the slurry were employed to investigate the dependence of air holdup and heat transfer coefficient on air velocity, particle diameter and solids concentration in the slurry at 308 K. The experimental results are compared with the predictions of several of the available correlations and models. The gas holdup in the three-phase system is found to be only slightly smaller than that in the corresponding two-phase system, and there is only a weak dependence on particle diameter and slurry concentration. The correlations given by Reilly et al. and Smith et al. appear to be reasonable in giving the upper and lower bounds respectively for the gas holdup in three-phase systems. The heat transfer coefficient for the three-phase system is slightly greater than that for the corresponding two-phase system, and there is only a weak dependence on particle diameter and slurry concentration. None of the available correlations and model expressions are considered adequate for representing the heat transfer data, but for approximate estimations, those given by Deckwer et al. and Kim et al. may be employed; these respectively give overestimates and underestimates of the data.
The influence of oestrogen and oestrogen metabolites on the sensitivity of the isolated rabbit aorta to catecholamines.

1. In the present study the influence of oestradiol, catechol oestrogens, and O-methylated oestrogens was determined on the contractile responses of the isolated rabbit aorta to (−)-adrenaline. 2. Oestradiol (40 μmol/l), 2-hydroxyoestradiol (2OHE2) (20 μmol/l), and 2-methoxyoestradiol (2MeOE2) (20 μmol/l) all sensitized the rabbit aorta to contractile responses to (−)-adrenaline. Similarly, the 2-hydroxy and 2-methoxy derivatives of oestrone and oestriol also sensitized the aorta to (−)-adrenaline-induced contractions. The largest degree of sensitization was seen in the presence of the 2-methoxysteroids. 3. Oestradiol and 2OHE2 did not increase responses of the aorta to (−)noradrenaline, while slight potentiation of contraction was seen in the presence of 2MeOE3. 4. The potentiating effect of 2OHE2 on contractile responses to (−)-adrenaline was abolished by prior treatment of the tissue with a COMT inhibitor (U-0521, 55 μmol/l). Conversely, pretreatment of the tissue with 2OHE2 prevented the augmented aortic contraction to (−)-adrenaline usually seen after inhibition of COMT. The non-additive nature of the sensitization seen after combined treatment with 2OHE2 and U-0521 was qualitatively similar to that seen following combined exposure to maximally effective concentrations of U-0521 and an inhibitor of extraneuronal uptake (hydrocortisone 100 μmol/l). 5. Oestradiol and 2MeOE2 reduced the formation of both the 3H-O-methylated, 3H-deaminated and the 3H-O-methylated deaminated metabolites of 3H-(−)-adrenaline (0.15 μmol/l) during exposure of the aorta to the tritiated catecholamine. Treatment of the aorta with the extraneuronal uptake inhibitor phenoxybenzamine (33 μmol/l) produced a similar inhibition of formation of all 3H-metabolites of 3H-(−)-adrenaline. 6. While preincubation with 2OHE2 markedly reduced the formation of 3H-O-methylated and 3H-O-methylated deaminated metabolites from 3H-(−)-adrenaline (0.15 μol/l), the formation of 3H-deaminated adrenaline metabolites was considerably enhanced by exposure to 2OHE2. Pretreatment of the aorta with the COMT inhibitor U-0521 produced a similar effect on 3H-adrenaline metabolism.
l-Deprenyl Protects Mesencephalic Dopamine Neurons from Glutamate Receptor-Mediated Toxicity In Vitro

L-Deprenyl is a relatively selective inhibitor of monoamine oxidase (MAO)-B that delays the emergence of disability and the progression of signs and symptoms of Parkinson's disease. Experimentally, deprenyl has also been shown to prevent neuronal cell death in various models through a mechanism that is independent of MAO-B inhibition. We examined the effect of deprenyl on cultured mesencephalic dopamine neurons subjected to daily changes of feeding medium, an experimental paradigm that causes neuronal death associated with activation of the NMDA subtype of glutamate receptors. Both deprenyl (0.5-50 microM) and the NMDA receptor blocker MK-801 (10 microM) protected dopamine neurons from damage caused by medium changes. The nonselective MAO inhibitor pargyline (0.5-50 microM) was not protective, indicating that protection by deprenyl was not due to MAO inhibition. Deprenyl (50 microM) also protected dopamine neurons from delayed neurotoxicity caused by exposure to NMDA. Because deprenyl had no inhibitory effect on NMDA receptor binding, it is likely that deprenyl protects from events occurring downstream from activation of glutamate receptors. As excitotoxic injury has been implicated in neurodegeneration, it is possible that deprenyl exerts its beneficial effects in Parkinson's disease by suppressing excitotoxic damage.
Anti-biofouling sulfobetaine polymer thin films on silicon and silicon nanopore membranes

Silicon nanopore membranes (SNM) with monodisperse pore size distributions have potential applications in bioartificial kidneys. A protein resistant thin film coating on the SNM is required to minimize biofouling and, hence, enhance the performance efficiency of SNM. In this work, a zwitterionic polymer, poly(sulfobetaine methacrylate) (polySBMA), was used to coat silicon and SNM substrates via a surface initiated atom transfer radical polymerization method. The polySBMA-coated surfaces were characterized using contact angle goniometry, X-ray photoelectron spectroscopy (XPS), ellipsometry and scanning electron microscopy (SEM). Resistance of the coatings to protein fouling was examined by measurement of fibrinogen adsorption from fibrinogen solution and human plasma on coated silicon surfaces. Results showed that the polySBMA coating suppresses non-specific adsorption of fibrinogen. The protein-repellent property of polySBMA thin film coating is comparable to that of PEG-based coatings. Analysis of the surfaces by XPS indicated that the films remained stable when stored under physiologic conditions over a 4-week period.
A Misdiagnosed Recurrent Pleural Effusion: A Utility for the Thoracic Ultrasound Examination

Introduction:Dyspnea due to pleural effusions is a common clinical scenario and has many underlying etiologies. Our case of a recurrent pleural effusion was misdiagnosed in part due to the complicated nature of the patient’s medical history. Nonetheless after a bedside thoracic ultrasound examination (TUE), the diagnosis became obvious.Case Description:A 63-year-old black female with congestive heart failure, end-stage renal disease, atrial fibrillation as well as a previously treated rare odontogenic carcinoma presented with shortness of breath. She reported having had “fluid drained” from her lungs a few months prior. During our encounter with this patient, a TUE was performed at beside and a large diaphragmatic mass was visualized. A malignant pleural effusion was suspected and an efficient and focused workup was tailored to our patient.Discussion:Apart from guiding the thoracentesis, the TUE is not part of the current recognized guidelines when evaluating a pleural effusion. The TUE may be undervalued...
Picosecond time-resolved cars in isotopically mixed crystals of benzene☆

Abstract Time-resolved coherent anti-Stokes Raman experiments are reported for the benzene crystal 991 cm−1 mode and in mixed C6H6/C 6D6 crystals. Addition of C6D6 results in an increase in the rate at which the excitation is trapped. This is explained by the recent theory of Velsko and Hochstrasser which predicts that the trapping rate should undergo a maximum at some isotopic impurity concentration, consistent with observations from time and frequency domain studies. A proper convolution procedure for CARS experiments in the time domain is presented.
Effects of Hemodialysis on Pure-Tone Thresholds and Blood Chemistry Measures

Eight adults suffering from end-stage renal disease and undergoing hemodialysis were subjected to pure tone audiometry before and after each of five consecutive hemodialysis treatments. In addition...
Assembly of the FtsZ ring at the central division site in the absence of the chromosome

The FtsZ ring assembles between segregated daughter chromosomes in prokaryotic cells and is essential for cell division. To understand better how the FtsZ ring is influenced by chromosome positioning and structure in Escherichia coli, we investigated its localization in parC and mukB mutants that are defective for chromosome segregation. Cells of both mutants at non-permissive temperatures were either filamentous with unsegregated nucleoids or short and anucleate. In parC filaments, FtsZ rings tended to localize only to either side of the central unsegregated nucleoid and rarely to the cell midpoint; however, medial rings reappeared soon after switching back to the permissive temperature. Filamentous mukB cells were usually longer and lacked many potential rings. At temperatures permissive for mukB viability, medial FtsZ rings assembled despite the presence of apparently unsegregated nucleoids. However, a significant proportion of these FtsZ rings were mislocalized or structurally abnormal. The most surprising result of this study was revealed upon further examination of FtsZ ring positioning in anucleate cells generated by the parC and mukB mutants: many of these cells, despite having no chromosome, possessed FtsZ rings at their midpoints. This discovery strongly suggests that the chromosome itself is not required for the proper positioning and development of the medial division site.
Alkyne Adducts of [W2(OCH2tBu)8]n (M = M): Comparisons of Bridging and Terminal Addition Products

Alkynes are found to react with [W2(OCH2tBu)8] (M = M) in hydrocarbon solvents at room temperature or 45 degrees C to give 1:1 adducts. These are shown to be either bridged (mu-PhCCH and mu-MeCCMe) or terminal-bound (eta2-PhCCMe) in the solid state by single-crystal X-ray crystallography. In solution NMR spectroscopy reveals that bridged and terminal species exist in equilibrium for MeCCH, MeCCMe, and PhCCMe. By NMR spectroscopy the PhCCH and Me3SiCCH adducts are present in solution in bridging and terminally bonded species, respectively. The interconversion of bridged and terminal-bound adducts is chemically rapid but slow on the NMR time scale even though each type of adduct shows fluxional behavior. Calculations employing density functional theory have been carried out on alkyne adducts of the model template W2(OCH3)8 and reveal very small differences in energy between a mu-skewed structure and one having a terminal eta2-alkyne.
Personality and attitudes: a re-emphasis upon the cognitive component.

Abstract Although attempts to demonstrate a relationship between one set of individual differences and the evaluative or behavioral components of an attitude usually have failed, this study examined the possibility that individual differences (i. e., personality) may be important in determining the cognitive component of the attitude (i. e., the rational support offered for the evaluative position or behavior). Students with idealistic value systems (i.e., justice, egalitarian, humanitarian oriented) endorsed idealistic justifications for their attitudinal position (i.e., pro or anti) toward the war in Vietnam. Pragmatic students (i. e., utilitarian, outcome oriented) endorsed the more pragmatic justifications supporting their attitude toward the war.
Sex and the bladder

Abstract In view of the close anatomical proximity and common embryological origin of the lower urinary and genital tracts it is not surprising to find that disordered function of one often affects the other. Invariably this relationship is forgotten and sexual difficulties are commonly overlooked in the assessment of lower urinary tract dysfunction. Urinary symptoms can result in sexual problems by many different mechanisms and sexual intercourse is often implicated as a primary cause of lower urinary tract dysfunction. Although the surgical management of urogenital complaints may be the primary cause of dyspareunia this important operative complication has received little interest. Sexual difficulties deepen with time and failure to recognize the presence and severity of sexual dysfunction may lead to the deterioration of interpersonal relationships despite the successful treatment of urinary disorders. Only by appropriate recognition and timly intervention can these problems be resolved. The urinary an...
MAOA Methylation is Associated with Nicotine and Alcohol Dependence in Women

In recent years, the role of epigenetic phenomenon, such as methylation, in mediating vulnerability to behavioral illness has become increasingly appreciated. One prominent locus at which epigenetic phenomena are thought to be in play is the monoamine oxidase A (MAOA) locus. In order to examine the role of methylation at this locus, we performed quantitative methylation analysis across the promoter region of this gene in lymphoblast lines derived from 191 subjects participating in the Iowa Adoption Studies (IAS). We analyzed the resulting data with respect to genotype and lifetime symptom counts for the more common major behavioral disorders in the IAS, antisocial personality disorder (ASPD), and substance use disorders (alcohol (AD) and nicotine dependence (ND)). We found that methylation status was significantly associated with lifetime symptom counts for ND (P < 0.001) and AD (P < 0.008) in women, but not men. Furthermore, a trend was found for women homozygous for the 3,3 allele to have a higher degree of overall methylation than women homozygous for the 4,4 allele (P < 0.10). We conclude that methylation of MAOA may play a significant role in common psychiatric illness and that further examination of epigenetic processes at this locus is in order.
Stability of growth rates in energy technologies

Abstract We transform the logistics equation to a difference equation after determining characteristic growth rates for selected energy technologies. Using estimates of time intervals between successive generations, we then use methodologies introduced in recent studies of transitions to chaos in order to identify limits between stable and unstable growth rates. This approach leads to conclusions that are consistent with two well-known and important results: 1. (i) the first commercialization of any new energy technology is highly unstable because it requires a long period of time and represents a very large percentage increase in availability; 2. (ii) nuclear reactors in the U.S. have been introduced at either too fast a total growth rate or too long a construction time between successive generations to allow stable growth.
Involuntary defection in two-level games*

Ratification failures are prevalent in international relations, but due to the assumption of unitary actors in international relations theory, theoretical analysis has been underdeveloped. In formalizing Putnam's metaphor of two-level games, this article shows that incomplete information about the preferences of domestic actors is crucial for understanding ratification failures. Furthermore, institutional mechanisms affect bargaining outcomes through their impact on information revelation. In particular, it is found that two-sided constraints lead to relatively equitable bargaining outcomes and that renegotiation and pre-negotiation poll-taking can induce strategic voting by domestic constituents, thereby exacerbating domestic constraints.
The application of renormalization group techniques to quarks and strings

Recent work by K.G.Wilson, A.A.Migdal and others has led to a statistical mechanical treatment of systems of interaction quarks and strings. This work is summarized here. The major topics discussed include boson and fermion variables in statistical mechanics; descriptions of local and gauge symmetries; exact solutions of one-dimensional problems with nearest-neighbor interactions; exact solutions of two dimensional problems with plaquette interactions; Wilson's model of quarks and strings; asymptotic freedom and trapping for this model; the effect of a phase transition in this system; approximate recursion relations of the Migdal form. Finally, all this is put together to give a partial argument for the simultaneous existence of asymptotic freedom and trapping O/sub 2/ in the quark-string case. Arguments are developed which distinguish this case from the superficially analogous example of quantum electrodynamics.
A Pilot Test of Videoconferencing to Improve Access to a Stroke Risk-Reduction Programme for Veterans:

We conducted a pilot study to determine the feasibility of using videoconferencing for a programme of self-management to prevent stroke (V-STOP). A total of 37 Veterans with a history of stroke, or with multiple risk factors for stroke, were enrolled in the study from two rural sites. The V-STOP intervention consisted of 6 weekly sessions of self-management classes and clinic visits delivered via videoconferencing, with one or two individual telephone counselling sessions. Participants' mean satisfaction scores were 4.7 out of 5, indicating very high approval of the programme. Attendance was 87%, almost twice as high as at an equivalent in-person programme. Access was improved as participants saved, on average, 160 km by travelling to a community centre instead of the main Veterans Administration facility. Stroke risk knowledge and self-management behaviours such as communication with healthcare providers significantly improved from baseline. Overall, videoconferencing is feasible for delivering self-management classes and clinic visits and the V-STOP programme shows promise as a method for delivery of self-management education and preventive care services to reduce stroke risk.
Study of protein kinase C antagonists on cortical granule exocytosis and cell-cycle resumption in fertilized mouse eggs

Although pharmacological agonists of protein kinase C (PKC) stimulate some events of mammalian egg activation, including cortical granule (CG) exocytosis, it is not known if these events are dependent on PKC activation during the normal process of fertilization. In order to examine the potential role of PKC in CG exocytosis, this study investigated whether PKC agonists faithfully mimic CG release and whether PKC antagonists block fertilization-induced CG release in mature mouse eggs. Phorbol ester (TPA, 2.5 ng/ml) treatment resulted in an atypical pattern of CG release in which there was a greater net loss of CGs in the equatorial region of the egg than in the region opposite the spindle. This pattern also was in contrast to that during fertilization, in which CG release occurred randomly throughout the cortex. Fertilization experiments utilized two different PKC inhibitors, bisindolyl-maleimide (5 μM) and chelerytherine (0.8 μM), targeted to both the “conserved” substrate and ATP binding domains of PKC. Simultaneous use of both inhibitors at maximal concentrations (compatible with fertilization and above their IC50S) resulted in no detectable inhibition of CG release in treated fertilized eggs compared to controls. In addition, no inhibition of anaphase onset was observed in treated fertilized eggs. Activity of the inhibitors was verified by demonstrating that they blocked the induction of CG loss by TPA. Moreover, 1 μM staurosporine, a potent but less specific antagonist of PKC, also did not block CG loss, whereas the metaphase-anaphase transition was temporarily inhibited. The results indicate that TPA does not faithfully mimic CG release in fertilized eggs, that a role for PKC in CG release at fertilization remains to be established, and that other calcium-dependent effectors may be involved in CG exocytosis. Mol Reprod Dev 46:216–226, 1997. © 1997 Wiley-Liss, Inc.
Patient desires: A model for assessment of patient preferences for care of severe or terminal illness

Objective: Patient-centered care is better achieved through a comprehensive understanding of patients' preferences for how they want to live their life and how they want to influence their own death. Though much has been written on identifying goals of care, it is often difficult for clinicians to articulate patient goals to guide care planning. We explored the literature on patient's preferences for their care in chronic or life-limiting illness to develop a model for assessment of patient perspectives. We then illustrated our model with composite patients from our clinics and we provide questions to guide patient discussion.Methods: We searched MEDLINE from 1986 to 2004 for primary research articles that relate primarily to a patient's preferences for his or her care. We reviewed over 3500 titles, abstracts, and research papers. Hundreds of articles described patients' quality of life, health status, or satisfaction. We excluded consensus guidelines, non-English papers, reviews, and articles focused on medical professional perspectives. Forty-eight studies focused primarily on patient preferences. Using an iterative process, we identified unique issues and broader themes in patients' desires for their care.Results: Studies focused on patients with cancer, those in hospice or those with terminal disease. Three domains emerged: patient feelings about disease, feelings about suffering, and feelings about the circumstances of death. Attention was given to the differences between patients in terms of the strength and persistence of feelings in each domain.Significance of results: Based on existing data, there are three fundamental domains of patient perspective that influence preferences for care. These domains can be assessed by the care team to guide the development of a plan of care and to identify areas of conflict. Our review identifies gaps in the end-of-life literature and areas for future work in patient preferences.
The electrocardiogram after standard exercise as a functional test of the heart

Abstract An objective test of cardiac function is of importance in distinguishing functional from organic heart disease. It is useful in diagnosis and is helpful in studying the progress of disease and the degree of physical disability. It is of particular value when other examinations of the heart are negative, i.e., physical examination, electrocardiogram, fluoroscopy, exercise tolerance test, etc. The test to be described in this report consists of recording an electrocardiogram after a definite amount of work, standardized for the patient's age, sex, and weight. 1–4 It is essential to utilize a standard amount of work; for even healthy persons, if they exercise to excess, may have abnormal electrocardiographic responses. 5–10 It is therefore important that the exertion to which the patient is subjected will not produce abnormal electrocardiographic changes in any healthy person. This has been verified for the standard two-step test. In addition to recording the electrocardiogram after the two-step test, the patient's exercise tolerance can be measured in the ordinary way, that is, by obtaining blood pressure and pulse rate readings before and after exercise. 1, 2
Proteasomal Degradation of TRIM5α during Retrovirus Restriction

The host protein TRIM5α inhibits retroviral infection at an early post-penetration stage by targeting the incoming viral capsid. While the detailed mechanism of restriction remains unclear, recent studies have implicated the activity of cellular proteasomes in the restriction of retroviral reverse transcription imposed by TRIM5α. Here, we show that TRIM5α is rapidly degraded upon encounter of a restriction-susceptible retroviral core. Inoculation of TRIM5α-expressing human 293T cells with a saturating level of HIV-1 particles resulted in accelerated degradation of the HIV-1-restrictive rhesus macaque TRIM5α protein but not the nonrestrictive human TRIM5α protein. Exposure of cells to HIV-1 also destabilized the owl monkey restriction factor TRIMCyp; this was prevented by addition of the inhibitor cyclosporin A and was not observed with an HIV-1 virus containing a mutation in the capsid protein that relieves restriction by TRIMCyp IVHIV. Likewise, human TRIM5α was rapidly degraded upon encounter of the restriction-sensitive N-tropic murine leukemia virus (N-MLV) but not the unrestricted B-MLV. Pretreatment of cells with proteasome inhibitors prevented the HIV-1-induced loss of both rhesus macaque TRIM5α and TRIMCyp proteins. We also detected degradation of endogenous TRIM5α in rhesus macaque cells following HIV-1 infection. We conclude that engagement of a restriction-sensitive retrovirus core results in TRIM5α degradation by a proteasome-dependent mechanism.
Managing virtual communities of practice to drive product innovation

The natural phenomenon of the gathering of individuals has always provided an opportunity for social and economic research. In particular, studies examining company organisation emphasise the role of communities of practice in the transference of knowledge, enhancement of skills and coordination of employees. Business and economic researchers are now paying more attention to the potential use of this knowledge generated from accumulations of minds, in terms of innovating company production. This literature review offers an overview of the impact of ICT on the formation and functioning of these communities, with a focus on virtual communities of practice (vCoP). The innovative potential of vCoP in terms of New Product Development is examined. Several conceptual ideas to rationalise the online environment and avenues for further research are proposed.
Patient Expectation Is the Most Important Predictor of Discharge Destination After Primary Total Joint Arthroplasty

The purpose of this study was to identify preoperative predictors of discharge destination after total joint arthroplasty. A retrospective study of three hundred and seventy-two consecutive patients who underwent primary total hip and knee arthroplasty was performed. The mean length of stay was 2.9 days and 29.0% of patients were discharged to extended care facilities. Age, caregiver support at home, and patient expectation of discharge destination were the only significant multivariable predictors regardless of the type of surgery (total knee versus total hip arthroplasty). Among those variables, patient expectation was the most important predictor (P < 0.001; OR 169.53). The study was adequately powered to analyze the variables in the multivariable logistic regression model, which had a high concordance index of 0.969.
Remembering things without context: development matters.

Spatial context supports memory retrieval in adults. To understand the development of these effects, context effects on object recognition were tested in neurotypical children ages 3 years to adulthood (n 3–6 years = 34, n 10–16 years = 32, n college age = 22) and individuals with Down syndrome (DS) ages 10–29 years (n = 21). Participants engaged in an object recognition task; objects were presented in scenes and either remained in that same scene or were removed at test. In some groups (< 4.5 years and with DS) context effects were present even though object recognition was poor. After 4.5 years, children demonstrated memory flexibility, while later in adolescence context effects reemerged, showing nonlinearity in the development of these effects.
Detailed characteristics of drop-laden mixing layers: LES predictions compared to DNS

Results have been compared from Direct Numerical Simulation (DNS) and Large Eddy Simulation (LES) of a temporal mixing layer laden with evaporating drops, to assess the ability of LES to reproduce detailed characteristics of DNS.
Waveform design and scheduling in space-time adaptive radar

Waveform design and waveform scheduling are addressed in the context of space time adaptive processing (STAP) for radar. An air-borne radar with an array of sensors is assumed, which interrogates ground based targets. The designed waveform is assumed to be transmitted over one coherent processing interval (CPI). The waveform design and waveform scheduling problems are formulated with a cost function similar to the Minimum Variance Distortionless Response (MVDR) cost function as in classical radar STAP. Least-squared solutions for the designed waveform are obtained. It is shown that both the designed waveform and the scheduled waveforms will depend on the spatial and Doppler responses of the desired target; in particular, its spatial and temporal steering vectors. The focus of this paper will be the performance of the designed and scheduled waveforms for unknown correlation matrices but estimated from the training data, and will be addressed via simulations.
Control and coordination in uninhabited combat air vehicles

Distributed control of a group of uninhabited combat air vehicles (UCAVs) is a challenging problem in the area of large-scale systems. We propose a hierarchical control architecture for coordinated control of UCAVs. Several open problems in the areas of modeling, analysis, and control are also identified.
Cardiac Rehabilitation and Survival in Older Coronary Patients

Objectives This study assessed the effects of cardiac rehabilitation (CR) on survival in a large cohort of older coronary patients. Background Randomized controlled trials and meta-analyses have shown that CR improves survival. However, trial participants have been predominantly middle-aged, low- or moderate-risk, white men. Methods The population consisted of 601,099 U.S. Medicare beneficiaries who were hospitalized for coronary conditions or cardiac revascularization procedures. One- to 5-year mortality rates were examined in CR users and nonusers using Medicare claims and 3 analytic techniques: propensity-based matching, regression modeling, and instrumental variables. The first method used 70,040 matched pairs, and the other 2 techniques used the entire cohort. Results Only 12.2% of the cohort used CR, and those users averaged 24 sessions. Each technique showed significantly lower (p Conclusions Mortality rates were 21% to 34% lower in CR users than nonusers in this socioeconomically and clinically diverse, older population after extensive analyses to control for potential confounding. These results are of similar magnitude to those observed in published randomized controlled trials and meta-analyses in younger, more selected populations.
Time-dependent wave packet propagation using quantum hydrodynamics

A new approach for propagating time-dependent quantum wave packets is presented based on the direct numerical solution of the quantum hydrodynamic equations of motion associated with the de Broglie–Bohm formulation of quantum mechanics. A generalized iterative finite difference method (IFDM) is used to solve the resulting set of non-linear coupled equations. The IFDM is 2nd-order accurate in both space and time and exhibits exponential convergence with respect to the iteration count. The stability and computational efficiency of the IFDM is significantly improved by using a “smart” Eulerian grid which has the same computational advantages as a Lagrangian or Arbitrary Lagrangian Eulerian (ALE) grid. The IFDM is generalized to treat higher-dimensional problems and anharmonic potentials. The method is applied to a one-dimensional Gaussian wave packet scattering from an Eckart barrier, a one-dimensional Morse oscillator, and a two-dimensional (2D) model collinear reaction using an anharmonic potential energy surface. The 2D scattering results represent the first successful application of an accurate direct numerical solution of the quantum hydrodynamic equations to an anharmonic potential energy surface.
The efficacy of an ACLS training program for resuscitation from cardiac arrest in a rural community

Study objective: To determine whether an advanced cardiac life support (ACLS) course in a rural hospital will improve resuscitation success from cardiac arrest. Design: A retrospective case review of all patients in cardiac arrest during a 13-month period before and after the institution of an ACLS training program. Setting: Emergency department of a 42-bed rural, community hospital in a community with no prehospital advanced life support or early defibrillation. Participants: All patients in cardiac arrest were entered into the data base. Twenty-nine patients were included in the pre-ACLS period and 35 in the post-ACLS period. There were no significant differences in age, gender, initial rhythm, comorbid diseases, witnessed versus unwitnessed arrest, or total arrest time in the patients in the pre-ACLS period compared with those in the post-ACLS period. Intervention: ACLS provider training. Main results: Patients in cardiac arrest who had ventricular fibrillation/tachycardia as their initial rhythm had significant improvement in resuscitation success compared with patients in ventricular fibrillation/tachycardia in the pre-ACLS period (six of 15 versus none of nine, P P Conclusion: The institution of an ACLS-provider course in a rural community hospital was associated with improvement in initial resuscitation for patients with ventricular fibrillation/tachycardia and out-of-hospital arrest.
High-Resolution Molecular Characterization of 15q11-q13 Rearrangements by Array Comparative Genomic Hybridization (Array CGH) with Detection of Gene Dosage

Maternally derived duplication of the imprinted region of chromosome 15q11-q14 leads to a complex neurobehavioral phenotype that often includes autism, cognitive deficits, and seizures. Multiple repeat elements within the region mediate a variety of rearrangements, including interstitial duplications, interstitial triplications, and supernumerary isodicentric marker chromosomes, as well as the deletions that cause Prader-Willi and Angelman syndromes. To elucidate the molecular structure of these duplication chromosomes, we designed a high-resolution array comparative genomic hybridization (array CGH) platform. The array contains 79 clones that form a gapped contig across the critical region on chromosome 15q11-q14 and 21 control clones from other autosomes and the sex chromosomes. We used this array to examine a set of 48 samples from patients with segmental aneuploidy of chromosome 15q. Using the array, we were able to determine accurately the dosage, which ranged from 1 to 6 copies, and also to detect atypical and asymmetric rearrangements. In addition, the increased resolution of the array allowed us to position two previously reported breakpoints within the contig. These results indicate that array CGH is a powerful technique to study rearrangements of proximal chromosome 15q.
The State of Media Literacy: A Response to Potter

Potter's essay on the state of media literacy purports to represent the current state of the field, but omits much of the innovative work that has emerged in the last 10 years from scholars across the fields of communication, education, and public health. The review does not include mention of the development of numerous media literacy education initiatives by educational practitioners working in both formal and in informal education. By conceptualizing media literacy as a response to counteract the negative effects of mass media and popular culture, Potter fails to capture the depth and complexity of the field.