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Selected AbstractsAn Empirically Based Method of Q-Matrix Validation for the DINA Model: Development and ApplicationsJOURNAL OF EDUCATIONAL MEASUREMENT, Issue 4 2008Jimmy De La Torre Most model fit analyses in cognitive diagnosis assume that a Q matrix is correct after it has been constructed, without verifying its appropriateness. Consequently, any model misfit attributable to the Q matrix cannot be addressed and remedied. To address this concern, this paper proposes an empirically based method of validating a Q matrix used in conjunction with the DINA model. The proposed method can be implemented with other considerations such as substantive information about the items, or expert knowledge about the domain, to produce a more integrative framework of Q-matrix validation. The paper presents the theoretical foundation for the proposed method, develops an algorithm for its practical implementation, and provides real and simulated data applications to examine its viability. Relevant issues regarding the implementation of the method are discussed. [source] The alcohol industry and public interest scienceADDICTION, Issue 2 2010Kerstin Stenius ABSTRACT Aims This report argues that the growing involvement of the alcohol industry in scientific research needs to be acknowledged and addressed. It suggests a set of principles to guide ethical decision-making in the future. Methods We review relevant issues with regard to relationships between the alcohol industry and the international academic community, especially alcohol research scientists. The guiding principles proposed are modelled after expert committee statements, and describe the responsibilities of governmental agencies, the alcohol industry, journal editors and the academic community. These are followed by recommendations designed to inform individuals and institutions about current ,best practices' that are consistent with the principles. Findings and conclusions Growing evidence from the tobacco, pharmaceutical and medical fields suggests that financial interests of researchers may compromise their professional judgement and lead to research results that are biased in favour of commercial interests. It is recommended that the integrity of alcohol science is best served if all financial relationships with the alcoholic beverage industry are avoided. In cases where research funding, consulting, writing assignments and other activities are initiated, institutions, individuals and the alcoholic beverage industry itself are urged to follow appropriate guidelines that will increase the transparency and ethicality of such relationships. [source] A pilot study comparing a type 1 nurse-led diabetes clinic with a conventional doctor-led diabetes clinicEUROPEAN DIABETES NURSING, Issue 1 2004J Charlton Diabetes Nurse Specialist Abstract A prospective comparative pilot study was designed to assess and compare care delivered by a diabetes specialist nurse (DSN) and standard doctor-led care for patients with type 1 diabetes. The philosophy was to provide an individualised, patient-centred, lifestyle-based approach. In all, 60 patients with type 1 diabetes were randomised to either the nurse-led clinic (NLC) or a conventional clinic. NLC patients received medical input during their annual screening appointment. In the nurse-led system patients prioritised relevant issues with the aid of a ,Waiting Area Menu'. The menu consisted of pertinent topics relevant to living with diabetes. Care interventions were then agreed and targets discussed. To date the results of DSN intervention include: 60% of patients changing to a more appropriate insulin regimen; 36% changing equipment following update from the DSN; 20% needing initiation of cardiovascular medication; and 26% being referred to other health care professionals. The mean HbA1c changed by -0.25% in the NLC group and by -0.06% in the control group (ns). During the pilot there were several barriers which we had not anticipated. These included staffing resources, and organisational and time management issues. However, feedback from patient questionnaires demonstrated that the majority of patients preferred the NLC. Copyright © 2004 FEND. [source] Local control of photovoltaic distributed generation for voltage regulation in LV distribution networks and simulation toolsEUROPEAN TRANSACTIONS ON ELECTRICAL POWER, Issue 6 2009Stefania Conti Abstract The increasing connection of distributed generation (DG) in distribution networks may affect the quality of power offered to customers. One of the most relevant issues is the possibility to have unacceptable voltage rise at the point of common coupling (PCC). This work focuses on the problem of voltage control in LV distribution networks in the presence of photovoltaic (PV) DG. The paper presents a local voltage control method based on PV generation curtailment as an alternative to ,on/off' operation, typically required by distribution operators to prevent overvoltage at the PCCs by means of overvoltage protections embedded in the PV unit. To show the effect of the proposed local voltage control, a simulation tool, developed in MATLAB®,Simulink® environment, is presented. Appropriate numerical models for network components and PV generators are provided in order to describe computer simulation implementation of the test system. The final results show that the control system is able to adjust the active power output of local generators to keep the voltage profile of the feeder, in which DG is installed, within the range allowed by Norm EN 50160. Copyright © 2008 John Wiley & Sons, Ltd. [source] The pros and cons of noninferiority trialsFUNDAMENTAL & CLINICAL PHARMACOLOGY, Issue 4 2003Stuart J. Pocock Abstract Noninferiority trials comparing new treatment with an active standard control are becoming increasingly common. This article discusses relevant issues regarding their need, design, analysis and interpretation: the appropriate choice of control group, types of noninferiority trial, ethical considerations, sample size determination and potential pitfalls to consider. [source] Agency, Postmodernism, and the Causes of ChangeHISTORY AND THEORY, Issue 4 2001Michael L. Fitzhugh This theme issue's call for papers notes that "several prevalent and influential historical practices of the last thirty years have limited agency's significance, . . . seeing the human as the patient of History rather than its agent." The questions implicit in this statement are nowhere more urgent than in those practices collectively known as the "linguistic turn." Yet such questions have been explored sparsely enough in relation to this movement that some adherents can still insist that the ideas they favor do not devalue agency, while many simply ignore the issue and incorporate agency as an integral part of their work. By examining a largely unremarked episode in Michel Foucault's highly influential thought and considering its connections to foundational assumptions of the linguistic turn, we seek to demonstrate in detail why the premises that underlie both structuralism and poststructuralism (the theoretical movements most deeply implicated in the direction the linguistic turn has taken in history) logically require the denial of agency as a causal force and ultimately compel the conclusion that no change can occur in realities as interpreted by humans. We illustrate the intractability of these logical problems by analyzing unsatisfactory defenses from some of the few linguistic-turn historians who have discussed relevant issues, after which we conclude by suggesting that attention to current work in linguistics and cognitive science may help resolve such difficulties. [source] On the differentiation of the Rodrigues formula and its significance for the vector-like parameterization of Reissner,Simo beam theoryINTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN ENGINEERING, Issue 9 2002M. Ritto-Corrêa Abstract In this paper we present a systematic way of differentiating, up to the second directional derivative, (i) the Rodrigues formula and (ii) the spin-rotation vector variation relationship. To achieve this goal, several trigonometric functions are grouped into a family of scalar quantities, which can be expressed in terms of a single power series. These results are then applied to the vector-like parameterization of Reissner,Simo beam theory, enabling a straightforward derivation and leading to a clearer formulation. In particular, and in contrast with previous formulations, a relatively compact and obviously symmetric form of the tangent operator is obtained. The paper also discusses several relevant issues concerning a beam finite element implementation and concludes with the presentation of a few selected illustrative examples. Copyright © 2002 John Wiley & Sons, Ltd. [source] Critical Realism and Causality: Tracing the Aristotelian LegacyJOURNAL FOR THE THEORY OF SOCIAL BEHAVIOUR, Issue 2 2009STEPHEN PRATTEN Rom Harré's generative account of causality has been drawn on heavily by advocates of critical realism. Yet Harré argues that critical realists often exaggerate the extent to which powerful causal explanations of social phenomena can be developed. Certain proponents of critical realism have responded to Harré's criticisms by suggesting that it is useful to consider the relevant issues in relation to the familiar Aristotelian classification of four causes. In this paper I contribute to this debate and pursue a similar strategy. The paper adds to existing contributions in two ways. Firstly, I outline how Harré sees his generative account of causality as linking up with Aristotelian themes. It emerges that Harré at times conceives of his generative theory as part of an alternative to the Aristotelian system while at other times he draws connections between it and a reformulated account of formal causality. Secondly, I argue that when we consider the positions of Harré and proponents of critical realism on the scope of causal explanation in the social realm in relation to the interpretation of final causes offered by another philosopher profoundly influenced by the Aristotelian tradition, namely Charles Peirce, we can see both as limited in certain respects. [source] Chimpanzees in hepatitis C virus research: 1998,2007JOURNAL OF MEDICAL PRIMATOLOGY, Issue 1 2010R.H. Bettauer Abstract Background, Chimpanzees have been widely used in hepatitis C virus (HCV) research, but their endangered status and high financial and ethical costs have prompted a closer review. Methods, One hundred and nine articles published in 1998,2007 were analyzed for the number of chimpanzees involved, experimental procedures, objectives and other relevant issues. Results, The articles described the use of 852 chimpanzees, but accounting for likely multiple uses, the number of individual chimpanzees involved here is estimated to be approximately 500. Most articles addressed immunology and inoculation studies. A significant portion of studies lasted for several months or years. Approximately one half of the individual chimpanzees were each used in 2,10 studies. Conclusions, Significant financial and scientific resources have been expended in these chimpanzee HCV studies. Discussion addresses troublesome questions presented by some of the reviewed articles, including statistical validity, repeatability, and biological relevance of this model. These concerns merit attention as future approaches to HCV research and research priorities are considered. [source] Lactate Detection by MRS in Mitochondrial Encephalopathy: Optimization of Technical ParametersJOURNAL OF NEUROIMAGING, Issue 1 2008Antônio José da Rocha MD ABSTRACT Mitochondriopathies are a heterogeneous group of diseases with variable phenotypic presentation, which can range from subclinical to lethal forms. They are related either to DNA mutations or nuclear-encoded mitochondrial genes that affect the integrity and function of these organelles, compromising adenosine triphosphate (ATP) synthesis. Magnetic resonance (MR) is the most important imaging technique to detect structural and metabolic brain abnormalities in mitochondriopathies, although in some cases these studies may present normal results, or the identified brain abnormalities may be nonspecific. Magnetic resonance spectroscopy (MRS) enables the detection of high cerebral lactate levels, even when the brain has normal appearance by conventional MR scans. MRS is a useful tool for the diagnosis of mitochondriopathies, but must be correlated with clinical, neurophysiological, biochemical, histological, and molecular data to corroborate the diagnosis. Our aim is to clarify the most relevant issues related to the use of MRS in order to optimize its technical parameters, improving its use in the diagnosis of mitochondriopathies, which is often a challenge. [source] The HPV Vaccine: Framing the Arguments FOR and AGAINST Mandatory Vaccination of All Middle School GirlsJOURNAL OF SCHOOL HEALTH, Issue 6 2008Cheryl A. Vamos MPH ABSTRACT Background:, Human papillomavirus (HPV), the virus responsible for cervical cancer, is the most common viral sexually transmitted infection in the United States. A vaccine was approved in 2006 that is effective in preventing the types of HPV responsible for 70% of cervical cancers and 90% of genital warts. Proposals for routine and mandatory HPV vaccination of girls have become sources of controversy for parents of school-aged youth, legislators, members of the medical community, and the public at large. Methods:, The purpose of this article was to articulate the arguments used by advocates who either oppose or endorse routine, mandatory administration of the vaccine to school-aged girls, thereby assisting school health personnel in being effective participants in framing the relevant issues. Results:, Controversy is grounded in moral, religious, political, economic, and sociocultural arguments including whether concerns that the vaccine increases sexual risk taking, sends mixed messages about abstaining from sexual intercourse, usurps parental authority, and increases the potential for development of new health disparities are offset by the value of administering a cost-effective, age-appropriate public health measure targeting a life-threatening problem. Conclusions:, Careful consideration of the medical evidence and public health implications is critical but understanding the context of the debate is no less important to the task of responding to public concerns. School health personnel have a role in the discussion about HPV immunization. Being able to articulate the arguments presented herein can help authorities' responsiveness to parents and community groups as the dialogue about this particular health issue evolves further. [source] Review article: drug-induced liver injury in clinical practiceALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 1 2010E. Björnsson Aliment Pharmacol Ther 2010; 32: 3,13 Summary Background, Drug-induced liver injury (DILI) is an important differential diagnosis in many patients in clinical hepatology. DILI is the leading cause of acute liver failure and is an important safety issue when new drugs are developed. Aims, To provide a review of the recent data on DILI with particular focus on the most common and relevant issues seen in clinical practice. Methods, A Medline search was undertaken to identify relevant literature using search terms including ,drug-induced liver injury' and ,hepatotoxicity'. Results, The true incidence of DILI remains unknown but incidence up to 14 cases per 100 000 inhabitants and year has been reported. Antibiotics, analgesics and NSAIDs are the most common drugs causing liver injury. Idiosyncratic DILI has been shown to have a dose-dependent component and drugs without significant hepatic metabolism rarely cause DILI. Chronic elevation in liver enzymes can develop after DILI but this is rarely associated with clinical morbidity or mortality. Conclusions, Drug-induced liver injury remains a diagnostic challenge. Multicentre studies and international collaborative work with well-characterized patients will increase our understanding of liver injury associated with drugs. New therapies for acute liver failure resulting from drugs are needed. [source] Perspectives: molecular genetic research in human obesityOBESITY REVIEWS, Issue 3 2003J. Hebebrand Summary Within the past decade the molecular basis of single forms of monogenic obesity has been elucidated. With the exception of functionally relevant mutations in the melanocortin-4 receptor gene, which occur in approximately 2,4% of extremely obese individuals, all other currently known monogenic forms are rare and additionally associated with distinct endocrinological abnormalities. A large number of association studies have been performed in ,normal' obesity. Whereas many associations have been reported, it is largely unclear which of these represent true positive findings. Over 20 genome scans pertaining to obesity and related phenotypes have been performed; specific chromosomal peak regions have been identified in different scans. We review the current status and discuss relevant issues related to phenotyping, association and linkage studies. We recommend that the procedure via which a consensus is reached as to what constitutes a true positive association finding requires formalization. [source] Agglomeration and the adjustment of the spatial economy,PAPERS IN REGIONAL SCIENCE, Issue 3 2005Pierre Philippe Combes Urban systems; new economic geography; urban and regional policy; diagrammatic exposition Abstract., We consider the literature on urban systems and New Economic Geography to examine questions concerning agglomeration and how areas respond to shocks to the economic environment. We first propose a diagrammatic framework to compare the two approaches. We then use this framework to study a number of extensions and to consider several policy relevant issues. [source] On the Tasks of a Population Commission: A 1971 Statement by Donald RumsfeldPOPULATION AND DEVELOPMENT REVIEW, Issue 3 2003Article first published online: 20 APR 200 In its most familiar form, analytic assessment of the impact of demographic change on human affairs is the product of a decentralized cottage industry: individual scholars collecting information, thinking about its meaning, testing hypotheses, and publishing their findings. Guidance through the power of the purse and through institutional design that creates and sustains cooperating groups of researchers can impose some order and coherence on such spontaneous activity. But the sum total of the result may lack balance and leave important aspects of relevant issues inadequately explored. Even when research findings are picked up by the media and reach a broader public, the haphazardness of that process helps further to explain why the salience of population change to human welfare and its importance in public policymaking are poorly understood. The syndrome is not unique to the field of population, but the typically long time-lags with which aggregate population change affects economic and social phenomena make it particularly difficult for the topic to claim public attention. A time-tested, if less than fool-proof remedy is the periodic effort to orchestrate a systematic and thorough examination of the causes, consequences, and policy implications of demographic processes. Because the most potent frame for policymaking is the state, the logical primary locus for such stocktaking is at the country level. The Commission on Population Growth and the American Future was a uniquely ambitious enterprise of this sort. The Commission was established by the US Congress in 1970 as a result of a presidential initiative. Along with the work of two earlier British Royal Commissions on population, this US effort, mutatis mutandis, can serve as a model for in-depth examinations conducted at the national level anywhere. Chaired by John D. Rockefeller 3rd, the Commission submitted its final report to President Richard M. Nixon in March 1972. The background studies to the report were published in seven hefty volumes; an index to these volumes was published in 1975. Reproduced below is a statement to the Commission delivered on April 14, 1971 by Donald Rumsfeld, then Counsellor to President Nixon and in charge of the Office of Economic Opportunity. (Currently, Mr. Rumsfeld serves as US Secretary of Defense.) The brief statement articulates with great clarity the objectives of the Commission and the considerations that prompted them. The text originally appeared in Vol. 7 (pp. 1-3) of the Commission's background reports, which contains the statements at public hearings conducted by the Commission. National efforts toward comprehensive scientific reviews of population issues have their analogs at the international level. Especially notable on that score were the preparatory studies presented at the 1954 Rome and 1965 Belgrade world population conferences. The world population conferences that took place in Bucharest in 1974, in Mexico City in 1984, and in Cairo in 1994 were intergovernmental and political rather than scientific and technical meetings, but they also generated a fair amount of prior research. The year 2004 will break the decadal sequence of large-scale international meetings on population, and apart from the quadrennial congresses of the IUSSP, which showcase the voluntary research offerings of its members, none is being planned for the coming years. A partial substitute will be meetings organized by the UN's regional economic and social commissions. The first of these took place in 2002 for the Asia-Pacific region; the meetings for the other regions will be held in 2003-04. The analytic and technical contribution of these meetings, however, is expected to be at best modest. National efforts of the type carried out 30 years ago by the Commission on Population Growth and the American Future would be all the more salutary. [source] Closed-Loop Supply Chains: An Introduction to the Feature Issue (Part 1)PRODUCTION AND OPERATIONS MANAGEMENT, Issue 3 2006V. Daniel R. Guide Jr. Closed-loop supply chains (CLSC) have product returns at the center of attention. Our view is that CLSC are best managed from a business perspective where organizations seek to maximize value recovery. The research in the feature issue, and our experiences, shows that there are still numerous, unresolved, managerially relevant issues that deserve further investigation. We also observe that there is a pressing need to validate the assumptions in our models using interdisciplinary, industry-driven research. The time is right for production and operations management to play a central role in the sustainability movement slowly taking hold in practice. [source] QUOTE-geneca: development of a counselee-centered instrument to measure needs and preferences in genetic counseling for hereditary cancerPSYCHO-ONCOLOGY, Issue 5 2005Arwen Pieterse Counselees' motives for seeking genetic counseling for hereditary cancer have already been investigated, however not using instruments based on counselees' perspective. In addition, expectations regarding the process of counseling have scarcely been assessed. This article describes the construction and psychometric properties of the QUOTE-geneca, a counselee-centered instrument intended to measure needs and preferences in genetic counseling for hereditary cancer. Formulation of the items involved input from counselees and the instrument was derived from a conceptual framework for measuring patient satisfaction. Two-hundred new counselees completed a questionnaire containing the instrument and measures of coping style (TMSI), generalized anxiety (STAI) and cancer-related stress reactions (IES), prior to their first consultation. Results showed that the instrument captures relevant issues of concern with high internal consistency, and was associated, as expected, with validated measures of coping style and distress. Responses showed that major concerns prior to counseling relate to: receiving information about risk and preventive strategies; the procedure of counseling; and preferences on how the interaction with the counselor proceeds. Receiving emotional support and discussing emotional aspects were considered relatively less important. Increasing insight into individual needs may help counselors in better addressing these concerns, potentially increasing the likelihood of successful counseling. Copyright © 2004 John Wiley & Sons, Ltd. [source] Meaningful Voices: How Psychologists, Speaking as Psychologists, Can Inform Social PolicyANALYSES OF SOCIAL ISSUES & PUBLIC POLICY, Issue 1 2004David M. Frost Kitzinger and Wilkinson (2004) posit that social advocacy can be argued for within both a discourse of equal rights and a discourse of mental health. They suggest that psychological evidence, because it is bound to a discourse of mental health, is currently not useful in advancing the campaigns for equal marriage rights. In our response to their argument, we (1) agree that the currently available psychological evidence is limited; (2) make the case that it is still important for psychologists to produce evidence that speaks to this debate; and (3) suggest how psychologists, still speaking as psychologists, can produce evidence that speaks to this debate through underutilized theoretical and methodological approaches to relevant issues. The authors analyze a key statement by United States President George W. Bush on the meaning of marriage and the available psychological literature on same-sex relationships to support their position. [source] Unique Characteristics of Emergency Care Research: Scope, Populations, and InfrastructureACADEMIC EMERGENCY MEDICINE, Issue 10 2009D. Mark Courtney MD Abstract The National Institutes of Health (NIH) Clinical and Translational Science Awards (CTSA) program and the 2006 Institute of Medicine (IOM) Report on the future of emergency care highlight the need for coordinated emergency care research (ECR) to improve the outcomes of acutely ill or injured patients. In response, the Society for Academic Emergency Medicine (SAEM) and the American College of Emergency Physicians (ACEP) sponsored the Emergency Care Research Network (ECRN) Conference in Washington, DC, on May 28, 2008. The conference objectives were to identify the unique nature of ECR and the infrastructure needed to support ECR networks and to understand the optimal role of emergency medicine (EM) and other acute care specialties in research networks. Prior to the conference, participants responded to questions addressing the relevant issues that would form the basis of breakout session discussions; two of these breakout questions are summarized in this report: 1) what makes EM research unique? and 2) what are the critical components needed to establish and maintain networked ECR? Emergency care research was defined as "the systematic examination of patient care that is expected to be continuously available to diverse populations presenting with undifferentiated symptoms of acute illness, or acutely decompensated chronic illness, and whose outcomes depend on timely diagnosis and treatment." The chain of ECR may extend beyond the physical emergency department (ED) in both place and time and integrate prehospital care, as well as short- and long-term outcome determination. ECR may extend beyond individual patients and have as the focus of investigation the actual system of emergency care delivery itself and its effects on the community with respect to access to care, use of resources, and cost. Infrastructure determinants of research network success identified by conference participants included multidisciplinary collaboration, accurate long-term outcome determination, novel information technology, intellectual infrastructure, and wider network relationships that extend beyond the ED. [source] Structure and Function of Emergency Care Research Networks: Strengths, Weaknesses, and ChallengesACADEMIC EMERGENCY MEDICINE, Issue 10 2009Linda Papa MD Abstract The ability of emergency care research (ECR) to produce meaningful improvements in the outcomes of acutely ill or injured patients depends on the optimal configuration, infrastructure, organization, and support of emergency care research networks (ECRNs). Through the experiences of existing ECRNs, we can learn how to best accomplish this. A meeting was organized in Washington, DC, on May 28, 2008, to discuss the present state and future directions of clinical research networks as they relate to emergency care. Prior to the conference, at the time of online registration, participants responded to a series of preconference questions addressing the relevant issues that would form the basis of the breakout session discussions. During the conference, representatives from a number of existing ECRNs participated in discussions with the attendees and provided a description of their respective networks, infrastructure, and challenges. Breakout sessions provided the opportunity to further discuss the strengths and weaknesses of these networks and patterns of success with respect to their formation, management, funding, best practices, and pitfalls. Discussions centered on identifying characteristics that promote or inhibit successful networks and their interactivity, productivity, and expansion. Here the authors describe the current state of ECRNs and identify the strengths, weaknesses, and potential pitfalls of research networks. The most commonly cited strengths of population- or disease-based research networks identified in the preconference survey were access to larger numbers of patients; involvement of physician experts in the field, contributing to high-level study content; and the collaboration among investigators. The most commonly cited weaknesses were studies with too narrow a focus and restrictive inclusion criteria, a vast organizational structure with a risk of either too much or too little central organization or control, and heterogeneity of institutional policies and procedures among sites. Through the survey and structured discussion process involving multiple stakeholders, the authors have identified strengths and weaknesses that are consistent across a number of existing ECRNs. By leveraging the strengths and addressing the weaknesses, strategies can be adopted to enhance the scientific value and productivity of these networks and give direction to future ECRNs. [source] The internet: From basics to telesurgeryANZ JOURNAL OF SURGERY, Issue 1 2002John C. Hall The exponential growth in information technology is resulting in a rapid increase in the ability to develop useful applications on the Internet. The purpose of the present article is to provide a brief review of the Internet with a consideration of its relevance to surgeons. This review is intended to indicate a range of relevant issues, rather than to discuss any specific topic in depth. It is becoming difficult for surgeons to reach their full potential unless they exploit Internet-based activities. This is because the ability to rapidly capture information of quality is an essential ingredient in a reflective approach to surgical problems. More futuristic is the prospect of using computer-based technology to operate upon patients from a distance (telesurgery). [source] Structure validation in chemical crystallographyACTA CRYSTALLOGRAPHICA SECTION D, Issue 2 2009Anthony L. Spek Automated structure validation was introduced in chemical crystallography about 12,years ago as a tool to assist practitioners with the exponential growth in crystal structure analyses. Validation has since evolved into an easy-to-use checkCIF/PLATON web-based IUCr service. The result of a crystal structure determination has to be supplied as a CIF-formatted computer-readable file. The checking software tests the data in the CIF for completeness, quality and consistency. In addition, the reported structure is checked for incomplete analysis, errors in the analysis and relevant issues to be verified. A validation report is generated in the form of a list of ALERTS on the issues to be corrected, checked or commented on. Structure validation has largely eliminated obvious problems with structure reports published in IUCr journals, such as refinement in a space group of too low symmetry. This paper reports on the current status of structure validation and possible future extensions. [source] Merkel cell carcinoma (primary cutaneous neuroendocrine carcinoma): An overview on managementAUSTRALASIAN JOURNAL OF DERMATOLOGY, Issue 3 2006Michael J Veness SUMMARY Merkel cell carcinoma is an uncommon but aggressive primary cutaneous neuroendocrine (small cell) carcinoma. There is ongoing debate regarding the optimal treatment of this disease. The early literature comprised small institutional studies with inherent weaknesses. Recent data have emerged from larger studies, including those from Australian institutions, that adds support to a multimodality approach as best practice. Despite this, the outcome for patients with unfavourable disease remains poor and in most series 25,30% of patients die as a direct result of Merkel cell carcinoma. The head and neck is the commonest site for presentation (50,60%) and wide excision (2,3 cm) of the primary lesion is usually recommended, although achieving this is often difficult within functional and cosmetic constraints. All clinically node-negative patients should be considered candidates for elective nodal treatment and those with clinical nodal disease should undergo nodal dissection and adjuvant radiotherapy. Recent evidence suggests that patients treated with surgery and adjuvant locoregional radiotherapy experience a better disease-free survival compared with those undergoing surgery alone. The role of platinum-based chemotherapy is evolving. The aim of this article is to discuss relevant issues in the management of a patient with Merkel cell carcinoma. [source] Stimulation and microswitch-based programs for enhancing indices of happiness: a maintenance assessmentBEHAVIORAL INTERVENTIONS, Issue 1 2003Giulio E. Lancioni This study assessed whether stimulation and microswitch-based programs maintained their positive impact on indices of happiness over time. Three people with multiple disabilities, who had participated in a study comparing these programs, continued to be exposed to them over a maintenance period of 5 or 6 months. Maintenance data showed that the frequencies of indices of happiness increased or remained unchanged for two participants and declined for the third. The frequencies of microswitch activations were higher for two of the participants and largely unchanged for the other. Procedural aspects of the study, implications of the findings, and relevant issues for new research are discussed. Copyright © 2003 John Wiley & Sons, Ltd. [source] The Usefulness of Chronic Heart Failure Treatments in Chronic Cardiac Graft FailureCARDIOVASCULAR THERAPEUTICS, Issue 1 2010Osman Najam Following cardiac transplantation, registry data has demonstrated a gradual improvement in survival over the last several decades, which is testament to continual improvement in aftercare strategy. However, a significant number of patients will eventually develop a new syndrome of chronic heart failure, owing to the multitude of physiological processes that occur after transplantation. This condition, referred to as chronic graft failure (CGF) should be regarded as a unique illness rather than one that is simply analogous with chronic heart failure. In particular, the unique pathophysiological (and pharmacological) environment in the setting of CGF presents a challenging situation to the transplant physician. There is uncertainty over which treatments to offer given a paucity of clinical trial data to support the use of standard heart failure treatments in CGF. In this review, we discuss which chronic heart failure treatments could be considered in the setting of CGF based on their mechanisms of action, benefits within the native heart failure setting, and the relevant issues within the posttransplant environment. [source] What Caused the Sharp Downturn in the Chinese Economy during the Global Financial Crisis?CHINA AND WORLD ECONOMY, Issue 4 2010A Critical Note on Causality in Trade Linkage E32; F14; P33 Abstract In responding to a view that attributes sharp downturns in the Chinese economy in late 2008 and early 2009 to the "collapse of external demand," the present paper scrutinizes three relevant issues: How have large Chinese importers behaved in a demand-price setting? How have Chinese commodity imports and exports interacted in recent years? Did the downturns in China's export growth come earlier and were they deeper than those in Chinese import growth? All answers appear to suggest a conclusion contrary to the abovementioned view: sharp downturns in China's trade and economy during the recent global financial crisis were, to a large extent, caused by certain domestic factors, or by factors that should not be regarded as entirely "external." Insomuch as globalization has advanced, a large economy like China's today faces new potential sources of macroeconomic disturbances, from inside and outside. [source] | ||||||||||||||||||||||