bluuebunny/crossref_metadata_2025 huggingface dataset:
Carotid Thromboembolism Associated with Nephrotic Syndrome Treated with Dabigatran
Authors: Sasaki Yosuke , Raita Yoshihiko , Uehara Genta , Higa Yasushi , Miyasato Hitoshi
Published: March 2014

Nephrotic syndrome (NS) may be complicated by thromboembolism, which occasionally manifests as stroke. Although the optimal, standardized approach to the prophylaxis and management of thromboembolic complications associated with NS has not been established, anticoagulation with heparin and subsequent warfarin is the de facto standard of treatment. Dabigatran, a novel direct thrombin inhibitor, has become a substitute for warfarin and heparin for many indications, including the prophylaxis of stroke associated with nonvalvular atrial fibrillation and postoperative thromboprophylaxis in orthopedic patients. We report a 35-year-old male with NS due to membranous nephropathy (MN) that presented with carotid thromboembolism. Because the patient developed drug-induced hepatitis due to warfarin, we attempted treatment with dabigatran and were successful in continuing the medication without any complications. We also reviewed the literature on stroke associated with NS. Twenty-one prior cases have been reported, and the review of these cases revealed some interesting points. The age of onset ranged from 19 to 59 years. Most of the reported cases sustained a stroke at earlier ages than patients with atherosclerosis and atrial fibrillation, which suggests that NS may independently predispose individuals to arterial and venous thromboses. MN was the most common underlying pathology. Given that a standardized approach to the prophylaxis and management of thrombotic complications associated with NS has not been established, our experience suggests that dabigatran is a valid new treatment option for thrombotic complications of NS.
Disturbed Flow Promotes Endothelial Senescence via a p53-Dependent Pathway
Authors: Warboys Christina M. , de Luca Amalia , Amini Narges , Luong Le , Duckles Hayley , Hsiao Sarah , White Alex , Biswas Shukti , Khamis Ramzi , Chong Chuh K. , Cheung Wai-Mun , Sherwin Spencer J. , Bennett Martin R. , Gil Jesus , Mason Justin C. , Haskard Dorian O. , Evans Paul C.
Published: March 2014

Objective—

Although atherosclerosis is associated with systemic risk factors such as age, high cholesterol, and obesity, plaque formation occurs predominately at branches and bends that are exposed to disturbed patterns of blood flow. The molecular mechanisms that link disturbed flow–generated mechanical forces with arterial injury are uncertain. To illuminate them, we investigated the effects of flow on endothelial cell (EC) senescence.

Approach and Results—

LDLR
−/−
(low-density lipoprotein receptor
−/−
) mice were exposed to a high-fat diet for 2 to 12 weeks (or to a normal chow diet as a control) before the assessment of cellular senescence in aortic ECs. En face staining revealed that senescence-associated β-galactosidase activity and p53 expression were elevated in ECs at sites of disturbed flow in response to a high-fat diet. By contrast, ECs exposed to undisturbed flow did not express senescence-associated β-galactosidase or p53. Studies of aortae from healthy pigs (aged 6 months) also revealed enhanced senescence-associated β-galactosidase staining at sites of disturbed flow. These data suggest that senescent ECs accumulate at disturbed flow sites during atherogenesis. We used in vitro flow systems to examine whether a causal relationship exists between flow and EC senescence. Exposure of cultured ECs to flow (using either an orbital shaker or a syringe-pump flow bioreactor) revealed that disturbed flow promoted EC senescence compared with static conditions, whereas undisturbed flow reduced senescence. Gene silencing studies demonstrated that disturbed flow induced EC senescence via a p53-p21 signaling pathway. Disturbed flow–induced senescent ECs exhibited reduced migration compared with nonsenescent ECs in a scratch wound closure assay, and thus may be defective for arterial repair. However, pharmacological activation of sirtuin 1 (using resveratrol or SRT1720) protected ECs from disturbed flow–induced senescence.

Conclusions—

Disturbed flow promotes endothelial senescence via a p53-p21–dependent pathway which can be inhibited by activation of sirtuin 1. These observations support the principle that pharmacological activation of sirtuin 1 may promote cardiovascular health by suppressing EC senescence at atheroprone sites.
Triiodothyronine Facilitates Weaning From Extracorporeal Membrane Oxygenation by Improved Mitochondrial Substrate Utilization
Authors: Files Matthew D. , Kajimoto Masaki , O'Kelly Priddy Colleen M. , Ledee Dolena R. , Xu Chun , Des Rosiers Christine , Isern Nancy , Portman Michael A.
Published: March 2014

Background

Extracorporeal membrane oxygenation (
ECMO
) provides a bridge to recovery after myocardial injury in infants and children, yet morbidity and mortality remain high. Weaning from the circuit requires adequate cardiac contractile function, which can be impaired by metabolic disturbances induced either by ischemia‐reperfusion and/or by
ECMO
. We tested the hypothesis that although
ECMO
partially ameliorates metabolic abnormalities induced by
ischemia‐reperfusion
, these abnormalities persist or recur with weaning. We also determined if thyroid hormone supplementation (triiodothyronine) during
ECMO
improves oxidative metabolism and cardiac function.

Methods and Results

Neonatal piglets underwent transient coronary ischemia to induce cardiac injury then were separated into 4 groups based on loading status. Piglets without coronary ischemia served as controls. We infused into the left coronary artery [2‐
13
C]pyruvate and [
13
C
6
,
15
N]
l
‐leucine to evaluate oxidative metabolism by gas chromatography‐mass spectroscopy and nuclear magnetic resonance methods.
ECMO
improved survival, increased oxidative substrate contribution through pyruvate dehydrogenase, reduced succinate and fumarate accumulation, and ameliorated
ATP
depletion induced by ischemia. The functional and metabolic benefit of
ECMO
was lost with weaning, yet triiodothyronine supplementation during ECMO restored function, increased relative
pyruvate dehydrogenase
flux, reduced succinate and fumarate, and preserved
ATP
stores.

Conclusions

Although
ECMO
provides metabolic rest by decreasing energy demand, metabolic impairments persist, and are exacerbated with weaning. Treating
ECMO
‐induced thyroid depression with triiodothyronine improves substrate flux, myocardial oxidative capacity and cardiac contractile function. This translational model suggests that metabolic targeting can improve weaning.
What Makes Family Caregivers Happy During the First 2 Years Post Stroke?
Authors: Cameron Jill I. , Stewart Donna E. , Streiner David L. , Coyte Peter C. , Cheung Angela M.
Published: March 2014

Background and Purpose—

This study aimed to identify aspects of the caregiving situation contributing to family caregivers’ psychological well-being.

Methods—

Longitudinal cohort study with structured quantitative interviews 1, 3, 6, and 12 months post stroke. A subset of participants also completed surveys 18 and 24 months post stroke. Participants included individuals hospitalized for their first stroke and their family caregivers. Psychological well-being was assessed by the Positive Affect Scale.

Results—

A total of 399 stroke survivor, caregiver dyads completed the 1-year follow-up and 80 dyads completed the second year of follow-up. Using mixed effects modeling for longitudinal data, caregivers reported more psychological well-being when they provided more assistance to stroke survivors who had fewer symptoms of depression, better cognitive functioning, and who had more severe strokes. In addition, caregivers who maintained participation in valued activities had more mastery, gained personally providing care, were in better physical health, were older, and were from Quebec reported more psychological well-being. Caregivers followed for a second year post stroke reported better psychological well-being when caring for stroke survivors with fewer symptoms of depression and more severe strokes and when the caregivers had a greater sense of mastery and gained more personally providing care.

Conclusions—

Our findings contribute to the caregiver intervention development literature by identifying aspects of the caregiving situation that are associated with positive outcomes. Incorporating specific aspects, for example, strategies to enhance caregiver mastery into programs and services offered to caregivers may enhance their positive experiences with providing care and ultimately enhance the sustainability of the caregiving situation.
Public Perceptions of Mental Capacities of Nonhuman Animals
Authors: Kupsala Saara , Vinnari Markus , Jokinen Pekka , Räsänen Pekka
Published: March 2014

Mental capacities are an essential basis on which people give moral concern to nonhuman animals. Hence, it is important to investigate public perceptions of animal mind and the factors underlying these perceptions. Although research into citizen beliefs in animal mind has been increasing, population-based studies utilizing multivariate methods have been scarce. In this article, public perceptions of animal mind are investigated with a nationwide survey in Finland (n= 1,824). Eight animal species positioned differently in cultural categorizations are included in the analysis. Dogs were ascribed the most capacities, followed by cows, pigs, wolves, and elk. Citizens expressed a low belief in the mental capacities of chicken, salmon, and shrimp. Classifying animals as companions, food, and threat influences the perceptions of animal mind. Young age, having a companion animal, valuing societal equality, and concern for animal welfare and for animal utilization are connected to a greater belief in animal mind.
Untangling σαβαχθανι (Matt 27:46 and Mark 15:34)
Authors: Lerner Berel Dov
Published: March 2014

Abstract

The word σαβαχθανι appearing in Jesus’ cry of despair in Matt 27:46 and Mark 15:34 may be read as the Hebrew סבכתני, “you have tangled me up.” On this reading, Jesus may be expressing his connection with the ram which Abraham sacrificed instead of his son Isaac, since that ram was described as being caught by the horns in a סבך (Gen 22:13).
Der titulus crucis
Authors: Förster Niclas
Published: March 2014

Abstract

The historical reliability of the titulus crucis as quoted in the Gospel of Mark is substantiated by its unique position in the practice of executions in pagan und Jewish tradition. With its inscription, Pontius Pilate sought to dash messianic expectations for the Jewish kingdom. The threat posed by messianic pretenders to Roman rule is demonstrated by Simon and Athronges, two self-appointed Jewish kings entering into the public sphere around Passover in 4 bce. It is therefore likely that these events coloured Pontius Pilate’s interpretation of Jesus’ entry into Jerusalem as being along the lines of the uprising of the two messianic kings Simon and Athronges.
Four new species of Alebroides Matsumura (Hemiptera: Cicadellidae: Typhlocybinae) from China
Authors: YU XIAOFEI , YANG MAOFA
Published: March 2014

Four new species of the empoascine leafhopper genus Alebroides Matsumura are reported from China: A. strumae Yu & Yang, sp. nov., A. chiasmaticus Yu & Yang, sp. nov., A. serrulatus Yu & Yang, sp. nov. and A. spanner Yu & Yang, sp. nov. A list of all Chinese species of the genus is provided.
A Simple Model of the Response of the Atlantic to the North Atlantic Oscillation
Authors: Zhai Xiaoming , Johnson Helen L. , Marshall David P.
Published: March 2014

The response of an idealized Atlantic Ocean to wind and thermohaline forcing associated with the North Atlantic Oscillation (NAO) is investigated both analytically and numerically in the framework of a reduced-gravity model. The NAO-related wind forcing is found to drive a time-dependent “leaky” gyre circulation that integrates basinwide stochastic wind Ekman pumping and initiates low-frequency variability along the western boundary. This is subsequently communicated, together with the stochastic variability induced by thermohaline forcing at high latitudes, to the remainder of the Atlantic via boundary and Rossby waves. At low frequencies, the basinwide ocean heat content changes owing to NAO wind forcing and thermohaline forcing are found to oppose each other. The model further suggests that the recently reported opposing changes of the meridional overturning circulation in the Atlantic subtropical and subpolar gyres between 1950–70 and 1980–2000 may be a generic feature caused by interplay between the NAO wind and thermohaline forcing.
Atmospheric Duct Estimation Using Radar Sea Clutter Returns by the Adjoint Method with Regularization Technique
Authors: Zhao Xiaofeng , Huang Sixun
Published: March 2014

This paper focuses on retrieving the atmospheric duct structure from radar sea clutter returns by the adjoint approach with the regularization technique. The adjoint is derived from the split-step Fourier parabolic equation method, and the regularization term is constructed by the background refractivity field. To ensure successful implementations of the regularization, the L-curve criterion is used to find the optimal regularization parameter. The feasibility of the proposed method is validated by the numerical simulations of different noise-level clutter returns, as well as a real clutter profile measured by the S-Band Space Range Radar located in Wallops Island. In the process of inversions, the refractivity profile is first obtained by genetic algorithm, and then it is used as the background field for the adjoint method. The retrieved results indicate that, with an appropriate regularization parameter, the structure of the background refractivity profile can be improved by the proposed method.
The Subject in an Uproar
Authors: Strubbe Glenn , Vanheule Stijn
Published: March 2014

From Jacques Lacan’s theory of anxiety, principles are deduced for a Lacanian-oriented treatment of panic disorder. This Lacanian approach is related to Freud’s theory of the actual neuroses, and is comparable in some ways with the approach taken in Panic-Focused Psychodynamic Psychotherapy (PFPP). The Lacanian conceptualization of panic retains the idea that both repressed material and unsymbolized mental states lie at its basis. People suffering from panic attacks are overwhelmed by signifiers, aspects of corporeal excitation, and/or existential questions that remain too Real. Psychoanalytic therapy aims to create a name for such Real elements. The three registers that Lacan situates at the basis of his psychoanalytic approach (the Symbolic, the Imaginary, and the Real) are discussed, as well as the treatment principles for conducting this clinical work. The case study of a young woman with panic disorder is presented to illustrate how a brief, Lacanian-oriented treatment (forty-eight sessions) progressed, and where the patient managed to both name and find a symbolic place for psychic experiences that were too Real. During this treatment, the patient overcame her avoidant-defensive mode of functioning and her persistent difficulties related to separation.
Patterns of Disease Distribution of Lower Extremity Peripheral Arterial Disease
Authors: Chen Qian , Shi Yang , Wang Yutang , Li Xiaoying
Published: March 2014

Peripheral arterial disease (PAD) is a common manifestation of atherosclerosis that is associated with an increased risk of mortality and cardiovascular (CV) events. Peripheral arterial disease involves the arteries distal to the aortic bifurcation in a nonuniform manner. Studies have shown that symptoms and prognosis of patients with PAD vary according to the location and size of the affected artery. Several modalities have been used to identify the location of PAD, including noninvasive evaluations and invasive procedures. Peripheral arterial disease has a risk factor profile similar to that associated with coronary artery disease (ie, age, gender, diabetes, smoking, hypertension, and hyperlipidemia). Many studies have shown that the distribution, extent, and progression of PAD are influenced by CV risk factors but the findings are not consistent. Management strategies for PAD are different for proximal and distal PAD. The objective of this review is to discuss the patterns of diseases distribution in patients with PAD.
Serum Albumin Levels on Admission Are Associated With Angiographic No-Reflow After Primary Percutaneous Coronary Intervention in Patients With ST-Segment Elevation Myocardial Infarction
Authors: Kurtul Alparslan , Ocek Adil Hakan , Murat Sani Namik , Yarlioglues Mikail , Demircelik Muhammed Bora , Duran Mustafa , Ergun Gokhan , Cay Serkan
Published: March 2014

Low serum albumin (SA) levels are associated with increased cardiovascular mortality. We investigated whether baseline SA levels are associated with no-reflow following primary percutaneous coronary intervention (pPCI). A total of 536 patients (aged 60 ± 13 years; 74% men) who underwent pPCI were enrolled. The patients were divided into 2 groups: no-reflow and normal-reflow. No-reflow was defined as thrombolysis in myocardial infarction ≤2 flow. Admission SA levels were significantly lower in the no-reflow group than in the normal-reflow group (3.55 ± 0.44 vs 4.01 ± 0.32 mg/dL, P < .001). Also, high-sensitivity C-reactive protein (hsCRP), creatinine, creatine kinase myocardial band isoenzyme, and troponin T were significantly higher while hemoglobin and left ventricular ejection fraction (LVEF) were significantly lower in the no-reflow group. In multivariate analysis, SA level remained an independent predictor of angiographic no-reflow (odds ratio 0.114, 95% confidence interval 0.032-0.405, P = .001) together with LVEF, hsCRP, and baseline culprit artery patency. Admission SA level was an independent predictor of no-reflow after pPCI.
Testing an Ecological Account of Spaciousness in Real and Virtual Environments
Authors: Meagher Benjamin R. , Marsh Kerry L.
Published: March 2014

Cognitions about one’s physical environment have a clear psychological impact on inhabitants. However, judgments of a setting’s spaciousness have been shown to be based not solely on the dimensions of the enclosure but also on a number of seemingly incidental environmental properties. Nevertheless, a theoretical integration and explanation of these various effects has been lacking. Across five experiments conducted in the laboratory and in virtual reality, we test an affordance-based account, which proposes that impressions of spaciousness are influenced by the wealth of behavioral opportunities offered by the environment. These experiments test how the functional arrangement of furniture (Experiments 1 and 2) and the priming of particular behaviors (Experiments 3a, 3b, and 3c) affect perceivers’ spatial impressions of the environment. These findings emphasize that cognitions about spaciousness are determined not by a passive calculation of area but are instead tied to its ability to facilitate physical activity.
Major court and tribunal decisions in Australia in 2013
Authors: Byrnes Michael , Arndt Julian
Published: March 2014

This article examines a number of decisions of the High Court of Australia, the Federal Court of Australia, the Fair Work Commission and the Local Court of NSW from 2013 regarding industrial law issues including the application of the Fair Work Act 2009. In the decision of Commonwealth Bank of Australia v Barker, the Full Federal Court confirmed the existence of an implied term of mutual trust and confidence in an Australian employment contract. The Federal Court of Australia's decision in Warrell v Walton examined the right of parties to be represented before the Fair Work Commission. The High Court of Australia's decision in Construction Forestry Mining & Energy Union v Mammoet Australia Pty Ltd allowed an appeal from the decision of the Federal Court of Australia which had held that accommodation provided to fly-in/fly-out employees constituted payment for the purposes of a protected industrial action. The interpretation of section 90(2) of the Fair Work Act 2009 received its first judicial analysis in a decision by the New South Wales Local Court in Stephen Edward Ryan v Whitehaven Coal Mining Pty Ltd. Lastly, with the Fair Work Commission's specific bullying jurisdiction to commence on 1 January 2014, the decision of Harris v Workpac Pty Ltd provided an example of an approach that the Fair Work Commission may take in its newly conferred jurisdiction.
Out of Place
Authors: Carroll Leo , Gonzalez M. Lilliana
Published: March 2014

Objectives:

Test hypotheses drawn from Smith and Alpert’s social conditioning theory that explains biased policing as the result of implicit racial stereotypes. Distinguishing between frisks and searches, we hypothesize that (1) Black drivers are more likely than White drivers to be frisked and searched; (2) racial disparity is greater in frisks than searches; (3) racial disparity in frisks, but not searches, is conditional upon the racial composition of the community; and (4) that drivers’ race is not related to the productivity of searches.

Methods:

Data are all traffic stops made by the Rhode Island State Police in 2006, exclusive of those in which a search was mandatory. Multinomial and binary logistic regressions are employed to estimate models of frisks, searches, search productivity, and to test the conditional effect of community context.

Results:

Each of the four hypotheses is supported.

Conclusion:

Biased policing is largely the product of implicit stereotypes that are activated in contexts in which Black drivers appear out of place and in police actions that require quick decisions providing little time to monitor cognitions. This insight has important implications for police training. Because of limitations in this study, additional research that distinguishes frisks and searches is needed.
Fairness Means More to Some Than Others
Authors: Collins Brian J. , Mossholder Kevin W.
Published: March 2014

We examined when job embeddedness might serve as a boundary condition between interactional fairness and employee behavior. Specifically, we explored whether elements of affective attachment associated with job embeddedness moderated relations of supervisors’ interactional fairness with citizenship behavior and production deviance. Results from a field and a scenario study supported the idea that interactional fairness exerts a stronger effect on these outcomes for employees embedded in their jobs than for their less attached coworkers. We found this result even after controlling for turnover intent. Practical implications and directions for future research are discussed.
The Relationship between Population Dynamics and Urban Hierarchy
Authors: Bigotte Joao F. , Antunes Antonio P. , Krass Dmitry , Berman Oded
Published: March 2014

Spatial planners often make “comprehensive” decisions on the location of public service facilities by using the concept of urban hierarchy: population centers at the upper level of the hierarchy (typically large cities) get the highest level facilities, such as specialized hospitals and universities, while the centers at the lower levels of hierarchy get lower-level facilities. Intuitively, this suggests that there should be a link between urban hierarchy designations and population dynamics in future periods. This link must be taken into account in planning decisions, as it suggests that today’s decisions affect tomorrow’s demand for services. Indeed, this link was assumed in a previously published planning model. Yet, no direct evidence of such a link appears in the literature. The primary goal of this article is to fill this gap by using the census data for Portugal for the period 1991–2001 and the changes in the urban hierarchy that were implemented during 1980s and early 1990s. While our results support the link between urban hierarchy designations and population dynamics that has been assumed in previously published work, the mechanism describing this link appears to be somewhat different from the one postulated previously. Several extensions and directions for future work are also discussed.
Comparison of Photoacoustically Derived Hemoglobin and Oxygenation Measurements with Contrast-Enhanced Ultrasound Estimated Vascularity and Immunohistochemical Staining in a Breast Cancer Model
Authors: Eisenbrey John R. , Merton Daniel A. , Marshall Andrew , Liu Ji-Bin , Fox Traci B. , Sridharan Anush , Forsberg Flemming
Published: March 2014

In this preliminary study, we compared two noninvasive techniques for imaging intratumoral physiological conditions to immunohistochemical staining in a murine breast cancer model. MDA-MB-231 tumors were implanted in the mammary pad of 11 nude rats. Ultrasound and photoacoustic (PA) scanning were performed using a Vevo 2100 scanner (Visualsonics, Toronto, Canada). Contrast-enhanced ultrasound (CEUS) was used to create maximum intensity projections as a measure of tumor vascularity. PAs were used to determine total hemoglobin signal (HbT), oxygenation levels in detected blood (SO2 Avg), and oxygenation levels over the entire tumor area (SO2 Tot). Tumors were then stained for vascular endothelial growth factor (VEGF), cyclooxygenase-2 (Cox-2), and the platelet endothelial cell adhesion molecule CD31. Correlations between findings were analyzed using Pearson’s coefficient. Significant correlation was observed between CEUS-derived vascularity measurements and both PA indicators of blood volume ( r = 0.49 for HbT, r = 0.50 for SO2 Tot). Cox-2 showed significant negative correlation with SO2 Avg ( r = −0.49, p = 0.020) and SO2 Tot ( r = −0.43, p = 0.047), while CD31 showed significant negative correlation with CEUS-derived vascularity ( r = −0.47, p = 0.036). However, no significant correlation was observed between VEGF expression and any imaging modality ( p > 0.08). Photoacoustically derived HbT and SO2 Tot may be a good indicator of tumor fractional vascularity. While CEUS correlates with CD31 expression, photoacoustically derived SO2 Avg appears to be a better predictor of Cox-2 expression.
Spontaneous Incidence of Oncocytic Proliferative Lesions in Control Rat Kidney
Authors: Hard Gordon C. , Seely John Curtis , Betz Laura J.
Published: March 2014

The spontaneous incidence of foci of oncocytic proliferation (oncocytic hyperplasia and oncocytoma) was assessed in a histopathological reevaluation of the kidneys of 2,391 male and female Fischer 344 (F344) groups of control rats from long-term carcinogenicity studies (involving 24 chemicals) that had been conducted by the National Toxicology Program. The overall incidence of oncocytic proliferation was 0.3%, with a male preponderance over females at 0.5% (6/1,236) versus 0.09% (1/1,155), respectively. In males, there appeared to be an association of oncocytic proliferation with advanced spontaneous chronic progressive nephropathy. Oncocytoma or oncocytic hyperplasia appear to be rare lesions in F344 rats, and observations from these carcinogenicity studies suggest that they are slow growing and tend to occur late in a rodent’s life span.
The Teaching/Research Trade-Off in Law
Authors: Ginsburg Tom , Miles Thomas J.
Published: March 2014

Background:

There is a long scholarly debate on the trade-off between research and teaching in various fields, but relatively little study of the phenomenon in law. This analysis examines the relationship between the two core academic activities at one particular school, the University of Chicago Law School, which is considered one of the most productive in legal academia.

Method:

We measure of scholarly productivity with the total number of publications by each professor for each year, and we approximate performance in teaching with course loads and average scores in student evaluations for each course. In OLS regressions, we estimate scholarly output as a function of teaching loads, faculty characteristics, and other controls. We also estimate teaching evaluation scores as a function of scholarly productivity, fixed effects for years and course subject, and faculty characteristics.

Result:

Net of other factors, we find that, under some specifications, research and teaching are positively correlated. In particular, we find that students’ perceptions of teaching quality rises, but at a decreasing rate, with the total amount of scholarship. We also find that certain personal characteristics correlate with productivity.

Conclusion:

The recent debate on the mission of American law schools has hinged on the assumption that a trade-off exists between teaching and research, and this article’s analysis, although limited in various ways, casts some doubt on that assumption.
The architecture of a probation office
Authors: Phillips Jake
Published: March 2014

This article illustrates how the physicality of a probation office can be considered to reflect several important changes in the probation service’s recent history through analysis of research conducted in a probation office. Moreover, I argue that the design of probation offices has an important impact on practice. I suggest that the relationship between the ‘protected’ zone of the office and the ‘unprotected’ zone of the waiting area and interview rooms is similar to Goffman’s ‘front stage’ and ‘back stage’ (introduced in his book, The Presentation of Self in Everyday Life) and expand on his theory of social action by describing how the architecture of probation represents and potentially perpetuates the creation of an 'us and them' attitude in probation. The article then moves onto the exterior and location of the office to look at how these represent probation’s move away from the communities it serves. This has significant consequences if the policy of probation moves towards modes of practice which no longer prioritize standardization and punishment over professional judgment and the importance of the offender−officer relationship. The article concludes by looking at some examples of more inclusive forms of office design and architecture.
Economic impact analysis of an end-of-life programme for nursing home residents
Authors: Teo W-S Kelvin , Raj Anusha Govinda , Tan Woan Shin , Ng Charis Wei Ling , Heng Bee Hoon , Leong Ian Yi-Onn
Published: March 2014

Background:

Due to limited end-of-life discussions and the absence of palliative care, hospitalisations are frequent at the end of life among nursing home residents in Singapore, resulting in high health-care costs.

Aim:

Our objective was to evaluate the economic impact of Project Care at the End-of-Life for Residents in homes for the Elderly (CARE) programme on nursing home residents compared to usual end-of-life care.

Design and settings/participants:

Project CARE was introduced in seven nursing homes to provide advance care planning and palliative care for residents identified to be at risk of dying within 1 year. The cases consisted of nursing home residents enrolled in the Project CARE programme for at least 3 months. A historical group of nursing home residents not in any end-of-life care programme was chosen as the matched controls. Cost differences between the two groups were analysed over the last 3 months and final month of life.

Results:

The final sample comprised 48 Project CARE cases and 197 controls. Compared to the controls, the cases were older with more comorbidities and higher nursing needs. After risk adjustment, Project CARE cases demonstrated per-resident cost savings of SGD$7129 (confidence interval: SGD$4544–SGD$9714) over the last 3 months of life and SGD$3703 (confidence interval: SGD$1848–SGD$5557) over the last month of life (US$1 = SGD$1.3).

Conclusion:

This study demonstrated substantial savings associated with an end-of-life programme. With a significant proportion of the population in Singapore requiring nursing home care in the near future, these results could assist policymakers and health-care providers in decision-making on allocation of health-care resources.
The effects of advance care planning on end-of-life care: A systematic review
Authors: Brinkman-Stoppelenburg Arianne , Rietjens Judith AC , van der Heide Agnes
Published: March 2014

Background:

Advance care planning is the process of discussing and recording patient preferences concerning goals of care for patients who may lose capacity or communication ability in the future. Advance care planning could potentially improve end-of-life care, but the methods/tools used are varied and of uncertain benefit. Outcome measures used in existing studies are highly variable.

Aim:

To present an overview of studies on the effects of advance care planning and gain insight in the effectiveness of different types of advance care planning.

Design:

Systematic review.

Data sources:

We systematically searched PubMed, EMBASE and PsycINFO databases for experimental and observational studies on the effects of advance care planning published in 2000–2012.

Results:

The search yielded 3571 papers, of which 113 were relevant for this review. For each study, the level of evidence was graded. Most studies were observational (95%), originated from the United States (81%) and were performed in hospitals (49%) or nursing homes (32%). Do-not-resuscitate orders (39%) and written advance directives (34%) were most often studied. Advance care planning was often found to decrease life-sustaining treatment, increase use of hospice and palliative care and prevent hospitalisation. Complex advance care planning interventions seem to increase compliance with patients’ end-of-life wishes.

Conclusion:

The effects of different types of advance care planning have been studied in various settings and populations using different outcome measures. There is evidence that advance care planning positively impacts the quality of end-of-life care. Complex advance care planning interventions may be more effective in meeting patients’ preferences than written documents alone. More studies are needed with an experimental design, in different settings, including the community.
Openness to Gender Atypical Occupations in Youth
Authors: Alm Susanne , Bäckman Olof
Published: March 2014

The article analyses aspects of gender composition and social dominance in peer groups and school classes and their effects on the degree of openness to gender-atypical occupations in young adolescents. The data set used contains information for some 13,000 girls and boys living in Stockholm in the early 1960s. Results from multi-level regressions show that gender composition is significantly related to openness to gender-atypical occupations at peer-group level only. As the causal direction of this relationship can be questioned, the result should be interpreted with caution. Concerning aspects of dominance, quite substantive effects on individual openness to gender-atypical occupations are found for girls, albeit not for boys. Thus, for girls, the degree of openness to gender-atypical occupations of the most central girl in the school class significantly affects the degree of openness to gender-atypical occupations of individual girls in that school class.
Detection of cell apoptosis in pelvic lymph nodes of patients with cervical cancer after neoadjuvant chemotherapy
Authors: Zhang Haiyan , Peng Wei , Zhang Yangde
Published: March 2014

Objective

To investigate if the administration of neoadjuvant chemotherapy (NACT) reduces pelvic lymph node metastasis by inducing tumour cell apoptosis in patients with cervical cancer.

Methods

This study enrolled patients with stage Ib2–IIb cervical cancer who underwent surgery with (NACT group) or without (control group) prior cisplatin-based chemotherapy. Immunohistochemical staining of caspase-3 and an in situ terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labelling assay were used to measure the levels of apoptosis in primary tumours and pelvic lymph nodes.

Results

A total of 185 patients participated in the study: 102 in the NACT group and 83 in the control group. Treatment was considered to be clinically effective in 69.6% (71/102) of the NACT group. The rate of metastasis in the NACT group (20.6%; 21/102) was significantly lower than the control group (42.2%; 35/83). The level of caspase-3 immunostaining and the rate of apoptosis in primary tumours and pelvic lymph nodes in the NACT group were significantly higher than in the control group.

Conclusions

NACT appeared to limit pelvic node metastasis by inducing tumour cell apoptosis in patients with cervical cancer.
Population geography II
Authors: Tyner James A.
Published: March 2014

The geographic study of mortality is enjoying a renaissance. This is indicated by the growing number of studies on necropolitics, thanatopolitics, ‘deathscapes’, and the inequalities of premature death. Population geographers, however, have contributed little to the broader theoretical conceptualization – and spatiality – of mortality. Previously, I encouraged population geographers to reflect on the survivability of vulnerable populations. In this second progress report, I extend this focus through a reconsideration of mortality from the standpoint of survivability. As a discipline, population geography has long engaged with the concept of ‘premature’ death; here it is indicated how this concept is intimately bound to the modernist ordering of life that dominates our contemporary understanding of bodies and populations. First, I reflect on the embodiment of mortality, and this is followed by a critical engagement with the ‘bio-logics’ of life and death. I maintain that population geography is well positioned to contribute to ongoing debates regarding who lives, who dies, and who decides.
Biochemical changes in the brain of hemiplegic migraine patients measured with 7 tesla 1H-MRS
Authors: Zielman R , Teeuwisse WM , Bakels F , Van der Grond J , Webb A , van Buchem MA , Ferrari MD , Kruit MC , Terwindt GM
Published: March 2014

Aim

The aim of this study was to assess biochemical changes in the brain of patients with hemiplegic migraine in between attacks.

Methods

Eighteen patients with hemiplegic migraine (M:F, 7:11; age 38 ± 14 years) of whom eight had a known familial hemiplegic migraine (FHM) mutation (five in the CACNA1A gene (FHM1), three in the ATP1A2 gene (FHM2)) and 19 age- and sex-matched healthy controls (M:F, 7:12; mean age 38 ±  12 years) were studied. We used single-voxel 7 tesla 1H-MRS (STEAM, TR/TM/TE = 2000/19/21 ms) to investigate four brain regions in between attacks: cerebellum, hypothalamus, occipital lobe, and pons.

Results

Patients with hemiplegic migraine showed a significantly lower total N-acetylaspartate/total creatine ratio (tNAA/tCre) in the cerebellum (median 0.73, range 0.59–1.03) than healthy controls (median 0.79, range (0.67–0.95); p = 0.02). In FHM1 patients with a CACNA1A mutation, the tNAA/tCre was lowest.

Discussion

We found a decreased cerebellar tNAA/tCre ratio that might serve as an early biomarker for neuronal dysfunction and/or loss. This is the first high-spectral resolution 7 tesla 1H-MRS study of interictal biochemical brain changes in hemiplegic migraine patients.
College Students as Helpful Bystanders Against Sexual Violence
Authors: Brown Amy L. , Banyard Victoria L. , Moynihan Mary M.
Published: March 2014

Prior research documents that perceived peer norms are related to bystanders’ intentions and intervention behaviors in the context of sexual violence. Given the popularity of bystander intervention programming, it is important to know if variables like gender, race, or year in college impact intervention attitudes/behaviors or interact with perceived peer norms. Also relatively unexplored is the question of missed opportunities for intervention. For our final sample of 232 college students (66% female, 36% Black), screened by age, race, and missing data from an initial pool of 315 respondents, perceived peer norms supporting intervention positively predicted willingness to intervene against sexual violence (bystander intentions) but did not independently predict bystander behaviors or missed opportunities for intervention. Although women reported greater bystander intentions than did men, and Black participants reported more bystander behaviors than did White participants, gender, race, and year in college often interacted with peer norms and with each other in complex ways. Specifically, the predicted positive relationship between peer norms and bystander behaviors was observed only among Black students in at least their second year of college, and the predicted negative relationship between peer norms and missed opportunities was observed only for Black men. These nuances in factors that influence bystander actions have important implications for tailoring prevention tools on college campuses.
Improving Antibiotic De-Escalation in Suspected Ventilator-Associated Pneumonia
Authors: Oxman David A. , Adams Christopher D. , Deluke Gretchen , Philbrook Lauren , Ireland Peter , Mitani Aya , Panizales Christia , Frendl Gyorgy , Rogers Selwyn O.
Published: March 2014

Background:

Recommendations for treatment of ventilator-associated pneumonia (VAP) emphasize early empiric broad-spectrum antibiotics. However, appropriate antibiotic de-escalation is also critical for optimal patient care.

Materials and Methods:

We examined how often intensivists in our institution appropriately de-escalated antibiotics in cases of suspected VAP, and whether decision support by intensive care unit pharmacists could improve rates of antibiotic targeting and early antibiotic discontinuation in low-risk patients.

Main Results:

A total of 92 (observation phase = 50; intervention phase = 42) patients with suspected VAP were identified. During the observation phase, 39 cases yielded positive sputum cultures, but in only 23 (59%) were antibiotics targeted to culture results. This rate improved during the intervention phase when 29 (91%) of 32 cases with positive cultures were targeted ( P value .003). There were 48 cases in which the risk of pneumonia was considered low. Of the 26 low-risk cases in the observation phase, 5 (19%) had antibiotics discontinued early versus 5 (23%) of the 22 cases in the intervention phase.

Conclusions:

Decision support by clinical pharmacists significantly improved rates of appropriate antibiotic targeting in cases of culture-positive suspected VAP but did not have a significant effect on early antibiotic discontinuation in patients at low risk of true pneumonia.
Optimization of a redundantly actuated parallel kinematic mechanism for a 5-degree-of-freedom hybrid machine tool
Authors: Xie Fugui , Liu Xin-Jun , Zhou Yanhua
Published: March 2014

In this article, a novel redundant 3-degree-of-freedom parallel kinematic mechanism with high rotational capability is proposed and alternate configurations are presented. Taking the motion/force transmissibility into consideration, a local minimized transmission index is introduced and suggested to act as the performance evaluation criterion for this redundantly actuated parallel kinematic mechanism. On this basis, the optimum design of the proposed parallel kinematic mechanism is carried out and its rotational capability is investigated. The result indicates that the rotational capability of the proposed mechanism can surpass 115°. Compared with traditional parallel kinematic mechanisms, this represents a substantial advantage for practical applications. Using the redundant parallel kinematic mechanism as the parallel module, a redundant hybrid machine tool capable of five-face machining in one setup is developed and applied in the manufacture of parts with freeform surfaces.
Development of rheology vacuum low-pressure die casting with electromagnetic stirrer and vacuum system
Authors: Jin Chul Kyu , Bae Jung Woon , Kang Chung Gil
Published: March 2014

In this study, a rheology vacuum low-pressure die caster is developed by installing a vacuum system in the die and an electromagnetic stirrer in the rasing pipe of a low-pressure die casting system. The cavity dimensions are 130 mm in the filling direction and 110 mm in the vertical direction, with a thickness of 1 mm. The fluidity of the material inside the die cavity is improved by maintaining the vacuum state inside the die. The electromagnetic stirrer is attached to the outside of the rasing pipe, which connects the furnace to the lower die. The application of the electromagnetic stirrer enables the achievement of microstructure with fine and globular primary α-Al particles by disrupting the dendrite structure. A mild filling simulation is conducted using a commercial casting analysis program prior to an experiment with the rheology vacuum low-pressure die caster. The rheological behaviour of the material inside the die is observed. A rheological thin plate is fabricated by applying a melt temperature of 615 °C, a vacuum of 60 Torr, and a gas pressure of 15 bar. There is little eutectic structure, with primary aluminium grains of 30 µm or below that are mostly distributed due to the effects of stirring. The tensile strength and elongation are 120 MPa and 15%, respectively. The hardness is 61–66 HV.
Multi-objective optimization of wire electrical discharge machining process using evolutionary computation method: Effect of cutting variation
Authors: Golshan Abolfazl , Ghodsiyeh Danial , Izman Sudin
Published: March 2014

This article focuses on comparing the performance of brass wire and zinc-coated brass wire that are widely used as the wire electrode in wire electrical discharge machining. To this end, an evolutionary computation method is presented based on non-dominated sorting genetic algorithm in order to find an optimization of rough cutting of the Ti-6Al-4V titanium alloy with the aid of response surface methodology modeling. This research examines the effects of three process parameters, namely, pulse on-time, pulse off-time, and peak current on the process outputs, that is, material removal rate, sparking gap, and white layer thickness. The obtained results indicated that zinc-coated wire was more predictable and it showed more reliable response in the experimental and modeling results. Additionally, the optimization results for both wires demonstrated the high performance of non-dominated sorting genetic algorithm approach to obtain the Pareto optimal set of solutions.
Identifying the root causes of damage on the wheels of heavy haul locomotives and its mitigation
Authors: Ekberg Anders , Kabo Elena , Karttunen Kalle , Lindqvist Bernt , Lundén Roger , Nordmark Thomas , Olovsson Jan , Salomonsson Ove , Vernersson Tore
Published: March 2014

The paper illustrates how damage patterns in the form of rolling contact fatigue (RCF) on wheels, can be employed to identify and improve underlying operational conditions. The focus is on RCF of locomotive wheels operating on the Iron Ore Line in northern Sweden and Norway. Seasonal changes and damage patterns are charted. Potential root causes for observed damage patterns are identified and investigated. Mitigating actions are proposed and the efficiency of implemented actions is quantified.
Fuzzy predictive control of three-tank system based on a modeling framework of hybrid systems
Authors: Sarailoo Morteza , Rezaie Behrooz , Rahmani Zahra
Published: March 2014

In this article, a fuzzy predictive control scheme is proposed for controlling liquid level in a three-tank system in the presence of disturbances and uncertainties. The three-tank system is considered as a hybrid system, and a hybrid model of the system is obtained using the mixed logical dynamical modeling approach. Nonlinear parts of the system are linearized based on a piecewise affine linear method. Then, a model predictive control is designed based on the hybrid model and applied to the three-tank system. Although the performance of the model predictive control method is satisfactory in normal condition, it suffers from the problem of bias in output in the presence of disturbance and uncertainty. In this article, a fuzzy supervisor is utilized to adjust the main predictive controller such that the effects of disturbance and uncertainties are degraded by using zero-offset tracking. The proposed fuzzy predictive control scheme has advantages of simplicity and efficiency in normal operation, and strong robustness in the presence of disturbances and uncertainties. Simulation results demonstrate the effectiveness and superiority of the method.