bluuebunny/crossref_metadata_2025 huggingface dataset:
A framework for joint modeling and joint assessment of efficacy and safety endpoints for probability of success evaluation and optimal dose selection
Authors: He Weili , Cao Xiting , Xu Lu
Published: December 2011

The evaluation of clinical proof of concept, optimal dose selection, and phase III probability of success has traditionally been conducted by a subjective and qualitative assessment of the efficacy and safety data. This, in part, was responsible for the numerous failed phase III programs in the past. The need to utilize more quantitative approaches to assess efficacy and safety profiles has never been greater. In this paper, we propose a framework that incorporates efficacy and safety data simultaneously for the joint evaluation of clinical proof of concept, optimal dose selection, and phase III probability of success. Simulation studies were conducted to evaluate the properties of our proposed methods. The proposed approach was applied to two real clinical studies. On the basis of the true outcome of the two clinical studies, the assessment based on our proposed approach suggested a reasonable path forward for both clinical programs. Copyright © 2011 John Wiley & Sons, Ltd.
Reducing acid in dilute acid pretreatment and the impact on enzymatic saccharification
Authors: Chen Ye , Stevens Mark A , Zhu Yongming , Holmes Jason , Moxley Geoffrey , Xu Hui
Published: December 2011

Dilute acid pretreatment is a leading pretreatment technology for biomass to ethanol conversion due to the comparatively low chemical cost and effective hemicellulose solubilization. The conventional dilute acid pretreatment processes use relatively large quantities of sulfuric acid and require alkali for pH adjustment afterwards. Significant amounts of sulfate salts are generated as by-products, which have to be properly treated before disposal. Wastewater treatment is an expensive, yet indispensable part of commercial level biomass-to-ethanol plants. Therefore, reducing acid use to the lowest level possible would be of great interest to the emerging biomass-to-ethanol industry. In this study, a dilute acid pretreatment process was developed for the pretreatment of corn stover. The pretreatment was conducted at lower acid levels than the conventional process reported in the literature while using longer residence times. The study indicates that a 50% reduction in acid consumption can be achieved without compromising pretreatment efficiency when the pretreatment time was extended from 1–5 min to 15–20 min. To avoid undesirable sugar degradation and inhibitor generation, temperatures should be controlled below 170°C. When the sulfuric acid-to-lignocellulosic biomass ratio was kept at 0.025 g acid/g dry biomass, a cellulose-to-glucose conversion of 72.7% can be achieved at an enzyme loading of 0.016 g/g corn stover. It was also found that acid loading based on total solids (g acid/g dry biomass) governs the pretreatment efficiency rather than the acid concentration (g acid/g pretreatment liquid). While the acid loading on lignocellulosic biomass may be achieved through various combinations of solids loading and acid concentration in the pretreatment step, this work shows that it is unlikely to reduce acid use without undermining pretreatment efficiency simply by increasing the solid content in pretreatment reactors, therefore acid loading on biomass is indicated to be the key factor in effective dilute acid pretreatment.
Long‐term outcome and intervention of urea cycle disorders in Japan
Authors: Kido Jun , Nakamura Kimitoshi , Mitsubuchi Hiroshi , Ohura Toshihiro , Takayanagi Masaki , Matsuo Masafumi , Yoshino Makoto , Shigematsu Yosuke , Yorifuji Tohru , Kasahara Mureo , Horikawa Reiko , Endo Fumio
Published: December 2011

Urea cycle disorders (UCDs) are one of the most frequently inherited metabolic diseases in Japan, with an estimated prevalence of 1 per 50,000 live births. Here, we investigated the clinical manifestations, treatment, and prognosis of 177 patients with UCDs who were evaluated and treated from January 1999 to March 2009. These included 77 cases of neonatal‐onset UCDs and 91 cases of late‐onset UCDs. The most common UCD was ornithine transcarbamylase deficiency (OTCD), which accounted for 116 out of 177 patients. This result is similar to a previous study performed between 1978 and 1995 in Japan: OTCD accounted for about two‐thirds of the total number of UCD cases. We studied the relationship between prognosis and the peak blood ammonia level at the onset in 151 UCD patients. Compared with a previous survey conducted in Japan, we found that a greater number of patients survived without any mental retardation despite their peak blood ammonia levels being greater than 360 μmol/l. The 5‐year survival rate of patients with OTCD improved to 86% for those with the neonatal‐onset type and to 92% for those with the late‐onset type. We hypothesize that the increased survival rate is due to early diagnosis and better treatments that are now available in Japan. It is very important to diagnose and treat UCDs, especially OTCD, when the blood ammonia levels in patients are low. The outcome in patients with low blood ammonia levels was better than that in patients with high blood ammonia levels.
Women's decision making regarding choice of second trimester termination method for pregnancy complications
Authors: Kerns Jennifer , Vanjani Rachna , Freedman Lori , Meckstroth Karen , Drey Eleanor A. , Steinauer Jody
Published: December 2011

Objective

To describe how women terminating a pregnancy for fetal or maternal complications decide between surgical (dilation and evacuation [D&E]) and medical abortion.

Methods

A qualitative study was conducted among women who underwent D&E or medical abortion before 24 weeks of gestation for fetal anomalies or pregnancy complications at an academic medical center where both methods are offered. Women were interviewed by phone 1 week after the procedure about their counseling experiences and reasons for choosing a particular method. Data were analyzed by 3 researchers using a grounded theory approach, and interviews were stopped upon thematic saturation.

Results

Of the 21 women, 13 (62%) chose D&E and 8 (38%) chose medical abortion. Key themes that emerged from the interviews were valuing the ability to choose the method, and the importance of religious beliefs, abortion attitudes, and emotional coping style. Women's preferences for a method were largely based on their individual emotional coping styles.

Conclusion

Decisions to undergo D&E or medical abortion are highly personal and could affect how women recover after ending a desired pregnancy. Women should be offered counseling about and access to both methods. Understanding these decision processes may help when counseling women faced with these diagnoses and decisions.
Searching for Aboriginal Languages
Authors: Dixon R. M. W.
Published: December 2011

In the early 1960s, R. M. W. (Bob) Dixon was one of the first linguists to study the Aboriginal languages of northeast Queensland, Australia. He found that some languages of the coastal rainforest were still in daily use, but others were only half-remembered by a single elder. This autobiographical account of fourteen years of research, first published in 1984, paints a fascinating picture of the frontier society that existed in the region nearly fifty years ago. It reveals the difficulties and the excitement of linguistic fieldwork, but most of all it focuses on the people who agreed to work with Dixon and patiently helped him to understand their dauntingly complex languages. They allowed him to record their legends and songs and spent many hours answering his questions; this book is a poignant reminder of the fragility of their ancient culture.
Theology, Ideology and Liberation
Authors: Scott Peter
Published: December 2011

How is theology liberating? In the context of a post-Gorbachev world, where many demand freedom which the Western powers seem ill-equipped to deliver, is it even possible to envisage a liberative theology? Taking as his starting point the Marxist complaint that Christianity is ideological, Peter Scott argues that it is not enough for Christian theology to talk about liberation: it must be liberative. Stressing with feminist and liberation theologies the embodied, contextual nature of theology, the constructive proposal made here locates God's liberating abundance toward society in an interpretation of resurrection as social. Only in this way, in the author's view, can a trinitarian Christian account of liberation be adequately grounded. The book will be of interest to all those who wish to know if theology may speak truthfully about the transformation of society: it offers the shape of a liberative theology pointing towards social freedom.
Nonlinear landslide tsunami run-up
Authors: Özeren M. Sinan , Postacioglu Nazmi
Published: December 2011

Inhomogeneous nonlinear shallow-water equations are studied using the Carrier–Greenspan approach and the resulting equations are solved analytically. The Carrier–Greenspan transformations are commonly used hodograph transformations that transform the nonlinear shallow-water equations into a set of linear equations in which partial derivatives with respect to two auxiliary variables appear. Yet, when the resulting initial-value problem is treated analytically through the use of Green’s functions, the partial derivatives of the Green’s functions have non-integrable singularities. This has forced researchers to numerically differentiate the convolutions of the Green’s functions. In this work we remedy this problem by differentiating the initial condition rather than the Green’s function itself; we also perform a change of variables that renders the entire problem more easily treatable. This particular Green’s function approach is especially useful to treat sources that are extended in time; we therefore apply it to model the run-down and run-up of the tsunami waves triggered by submarine landslides. Another advantage of the method presented is that the parametrization of the landslide using sources is done within the integral algorithm that is used for the rest of the problem instead of treating the landslide-generated wave as a separate incident wave. The method proves to be more accurate than the techniques based on Bessel function expansions if the sources are very localized.
Laws versus Contracts: Shareholder Protections and Ownership Concentration in Brazil, 1890–1950
Authors: Musacchio Aldo
Published: December 2011

This article examines some of the institutional conditions that facilitated the development of equity markets in Brazil. A critical factor was the addition to corporate bylaws of protections for investors, which enabled relatively large corporations in Brazil to attract investors in large numbers. By availing themselves of this strategy, the firms generated a relatively low concentration of ownership before 1910. Archival evidence, such as company statutes and shareholder lists, reveals that the addition of voting rights to their bylaws, particularly maximum-vote provisions and graduated voting scales (which stipulated that less-than-proportional votes increase in parallel with shareholdings), allowed many Brazilian corporations to balance the relative voting power of their small and large investors. In companies that made such arrangements, the concentration of ownership and control was sharply lower than in the average company. Judging by the Brazilian companies examined for this article, it also appears that the concentration of control was significantly lower before 1910 than it is today.
Rent Seeking or Market Strengthening? Industry Associations in New Zealand Wool Broking
Authors: Ville Simon
Published: December 2011

This paper builds on recent conceptual work about associations that is drawn from the new institutional economics. It uses evidence from New Zealand wool broking to indicate the circumstances in which industry associations can operate effectively and in the broader public interest. Through their strong associative capacity and effective specialization of function, wool-broking industry associations developed flexible routines for managing wool auctions, mediated disputes, mitigated opportunism, addressed major market disruptions, and served as a communication channel with government. External pressures and monitoring from other business interests, governments, and a competitive wool market constrained rent-seeking behavior, preventing members from benefiting at the expense of others.
Women in the Service Industries: National Perspectives
Authors: Kwolek-Folland Angel , Walsh Margaret
Published: December 2011

The purpose of this special issue is to explore the relationship of gender in several national contexts to the service industriesbusinesses that provide benefit to others or produce items or infrastructure that support others. Several questions have guided our overall purpose. What do we learn about business history generally, and the service sector specifically, by taking gender into account? Is what we learn the same in different national contexts? If not, why not? We hope that the answers suggested in the essays will stimulate dialogue on both national case studies and comparative themes and will illuminate transnational patterns and perspectives in the history of women, gender, and business.
In the Shadow of the Swedish Welfare State: Women and the Service Sector
Authors: Andersson-Skog Lena
Published: December 2011

The twentieth-century history of the Swedish welfare state and public-service sector is critical to understanding the changing role of women in Sweden, as the expansion of the country's service production, beginning in the 1960s, has been mainly the result of wel-fare-state policies. Yet women's self-employment and wage work in the service industry has been neglected as an economic factor in both traditional economic and business history accounts and in historical studies of gender. Some suggestions are made for future explorations of the Swedish service sector as it operates in the shadow of the welfare state.
Female Entrepreneurship in Spain during the Nineteenth and Twentieth Centuries
Authors: Muoz Lina Glvez , Prez Paloma Fernndez
Published: December 2011

Structural changes during the past two centuries shaped Spanish women's economic activity in firms, family businesses, and self-employment, reflecting women's adaptation to a social system that assigned gender-specific roles and rights. In response to the discriminatory effects of labor segregation, Spain's female workers specialized in the service-sector jobs that were available to them. Until the twentieth century, Spanish women's business initiatives in this sector were mainly in domestic service, retail distribution, and social services. During the 1900s, the cumulative impact of rapid industrialization, the growth of service industries, legal reform, and the shift to a democratic system in Spain during the 1970s paved the way for women to enter public and private firms as professionals. As a result, more women became self-employed or helped to run family businesses related to tourism, the hotel and restaurant industries, design, fashion, and the arts.
Selling Elegant Glassware During the Great Depression: A. H. Heisey & Company and the New Deal
Authors: Nutting P. Bradley
Published: December 2011

The sale of luxury goods during the 1930s represents an incongruous aspect of American business that has been largely ignored by historians. This essay focuses on the efforts of one manufacturer of high-quality, elegant glassware, A. H. Heisey & Company of Newark, Ohio, to survive the Great Depression. Heisey created successful new sales strategies and product designs to meet the changing tastes of its customers. Although difficult to gauge with precision, Heisey's business also benefited from the overlapping influence of several New Deal measures: the Beer–Wine Revenue Act, the National Recovery Act, and the National Housing Act. Paradoxically, Heisey was most hampered by President Roosevelt's adoption of fiscal restraint in 1937, a policy that the company's Republican executives strongly advocated.
Alfred Chandler, Founder of Strategy: Lost Tradition and Renewed Inspiration
Authors: Whittington Richard
Published: December 2011

Richard Rumelt, Dan Schendel, and David Teece are clear: “The foundation of strategic management as a field may very well be traced to the 1962 publication of Chandler'sStrategy and Structure.”For these three doyens of strategy, Alfred Chandler was a fundamental influence on the shape of the strategic-management discipline that emerged in the 1960s and 1970s. Yet, unlike the two other pioneers they identify, Kenneth Andrews and Igor Ansoff, Chandler stood firmly outside the discipline, working as a business historian, not as a strategist. Remarkably, it is Chandler's work that resonates most strongly in the discipline today and, I shall argue, still offers the most powerful inspiration for scholarly work in the future.
Selling the American Way: The Singer Sales System in Japan, 1900–1938
Authors: Gordon Andrew
Published: December 2011

From 1900 through the 1920s, Singer put in place its proven selling system in Japan, despite making remarkably little adjustment to local conditions, and with a fair degree of success. But the company was hurt in the long run, with a turning point in the early- to mid-1930s, by its refusal to adapt—as its local competitors did—to the expectations of employees and the limited means of potential customers. Singer's dramatic rise and fall in Japan reveals ways in which practices of global capitalism are simultaneously transformed and transformative as they take root in particular locales.
Introduction: The Changing Organization of Industry
Authors: Duguid Paul
Published: December 2011

In his seminal 1972 essay on the “organization of industry,”G. B. Richardson argued that economists had generally viewed firms as “islands of planned co-ordination in a sea of market relations.” Business historians, too, had focused predominantly on the firm (or entrepreneur) and the market. In drawing attention when he did to the “dense networks of co-operation and affiliation by which firms are inter-related,” Richardson was on the forefront of what would become a noticeable shift in the analysis of business organization. There were many reasons for this transition. In particular, the comparative success of the “Japanese model,” with its “intermarket”keiretsudisturbed standard assumptions. (Richardson himself pointed to Japanese firms as thriving examples of interfirm relations.) Furthermore, it was becoming clear that in many emerging industries networked relations of industrial clusters were increasingly important. Comparative research suggested that new-technology firms with tightly drawn boundaries were at a competitive disadvantage compared to firms that had developed cooperative links not only to suppliers but even to competitors. To explain such developments, economists, organizational theorists, and business historians alike looked beyond not only the conventional boundaries of the firm but also the conventional boundaries of their disciplines. In particular, they turned to theories of networks, the topic of this special issue.
From Firm to Networked Systems
Authors: Hughes Thomas P.
Published: December 2011

Because of Alfred D. Chandler Jr.'s widely influential books and articles, historians of management and of business have often taken a firm, especially a manufacturing firm, as their unit of analysis. Despite its usefulness as an organizing concept, the firm-based approach does not take into consideration the management of networked systems, which have spread widely and posed major managerial challenges in recent decades. In the following essay, I shall compare the firm and the networked-systems approaches, but first I should stress that I am not dealing with networked systems in general, which are numerous and vary greatly in form. My attention, instead, is focused upon networked electric-power systems.
Networks and Entrepreneurship: The Modernization of the Textile Business in Porfirian Mexico
Authors: Gómez-Galvarriato Aurora
Published: December 2011

In Mexico, as in other parts of the world, the introduction of modern transportation and communications brought about major changes in the production and distribution of goods and in firms' management and structure. Between 1880 and 1910, the Mexican textile sector was modernized through the efforts of entrepreneurial French immigrants from Barcelonnette, whose closely knit network enabled them to succeed in overcoming limitations in the Mexican institutional framework.
Banking History and Archives in Latin America
Authors: Marichal Carlos
Published: December 2011

In recent years, business history has become a rich and varied terrain for research in Latin America. In this essay, I will present an overview of key aspects of banking history in the region, with an emphasis on the sources that are available in Argentina and Mexico. The extensive archives that have been built up in both countries offer historians the opportunity to study an array of topics: histories of individual banks; the evolution of banking systems; the relation between banking firms and industrial and agricultural development; the role of banks in government finance; the unique historical trajectories of central banks; the rise and relative decline of state-development banks; and the complex history of foreign banks in Latin America from the nineteenth century to the present.
Assessment of predictive ability of Epworth scoring in screening of patients with sleep apnoea
Authors: Sil A , Barr G
Published: December 2011

Method:

Numerous studies have considered the benefits, and the disadvantages, of the Epworth Sleepiness Scale. Following an extensive literature review, we found that the evidence was inconclusive as regards the diagnostic efficacy of Epworth scoring for obstructive sleep apnoea syndrome. We undertook a retrospective study of 343 patients who underwent a sleep assessment over a 10-year period at the Monklands Hospital.

Analysis and results:

A total of 238 patients did not have sleep apnoea whereas 105 patients did. The mean Epworth score in patients with obstructive sleep apnoea syndrome was 10.94 (95 per cent confidence interval 9.46–11.42), and in the non-apnoeic group it was 7.73 (95 per cent confidence interval 7.04–8.41). Logistic regression and receiver operating characteristic curves were used to assess the predictive ability of Epworth scoring. The scores only explained 7–10 per cent of the variation in the probability of occurrence of obstructive sleep apnoea syndrome. The odds ratio for Epworth scoring was 1.118, and only 69 per cent of cases were correctly classified by the Scale.

Conclusions:

The literature review suggested that the Epworth Sleepiness Scale is associated with a low effect size and/or low predictive value when correlated or regressed on the Apnoea–Hypopnoea Index or Respiratory Disturbance Index, thus limiting its value as a screening test. Our study concluded that the Epworth Scale is only marginally useful in predicting the occurrence of obstructive sleep apnoea syndrome. We believe that every patient with a direct or witnessed history of sleep apnoea with obstructive symptoms have some form of sleep assessment.
An unusual otoscopic finding associated with a type II first branchial cleft anomaly
Authors: Ebelhar A J , Potts K
Published: December 2011

Objective:

We report an interesting case involving a child with a branchial cleft anomaly with two fistulous tracts, one of which was associated with an unusual otoscopic finding.

Case report:

A seven-year-old girl presented with an apparent type II first branchial cleft cyst after an acute infection. Parotidectomy and excision of the tract were performed, with subsequent development of pre-auricular swelling three months later. Further surgery was performed to remove a second duplication anomaly of the external auditory canal. Otomicroscopy showed a fibrous band arising from the wall of the canal and attached to the tympanic membrane at the umbo.

Conclusion:

Otoscopic findings on physical examination can be important diagnostic clues in the early recognition of branchial cleft anomalies. The classification system proposed by Work may fail to describe some branchial cleft lesions.
Incremental benefits and cost of coordinated anxiety learning and management for anxiety treatment in primary care
Authors: Joesch J. M. , Sherbourne C. D. , Sullivan G. , Stein M. B. , Craske M. G. , Roy-Byrne P.
Published: December 2011

Background

Improving the quality of mental health care requires integrating successful research interventions into ‘real-world’ practice settings. Coordinated Anxiety Learning and Management (CALM) is a treatment-delivery model for anxiety disorders encountered in primary care. CALM offers cognitive behavioral therapy (CBT), medication, or both; non-expert care managers assisting primary care clinicians with adherence promotion and medication optimization; computer-assisted CBT delivery; and outcome monitoring. This study describes incremental benefits, costs and net benefits of CALM versus usual care (UC).

Method

The CALM randomized, controlled effectiveness trial was conducted in 17 primary care clinics in four US cities from 2006 to 2009. Of 1062 eligible patients, 1004 English- or Spanish-speaking patients aged 18–75 years with panic disorder (PD), generalized anxiety disorder (GAD), social anxiety disorder (SAD) and/or post-traumatic stress disorder (PTSD) with or without major depression were randomized. Anxiety-free days (AFDs), quality-adjusted life years (QALYs) and expenditures for out-patient visits, emergency room (ER) visits, in-patient stays and psychiatric medications were estimated based on blinded telephone assessments at baseline, 6, 12 and 18 months.

Results

Over 18 months, CALM participants, on average, experienced 57.1 more AFDs [95% confidence interval (CI) 31–83] and $245 additional medical expenses (95% CI $–733 to $1223). The mean incremental net benefit (INB) of CALM versus UC was positive when an AFD was valued ⩾$4. For QALYs based on the Short-Form Health Survey-12 (SF-12) and the EuroQol EQ-5D, the mean INB was positive at ⩾$5000.

Conclusions

Compared with UC, CALM provides significant benefits with modest increases in health-care expenditures.
Decontextualized language production in two languages: An investigation of children's word definition skills in Korean and English
Authors: KANG JENNIFER YUSUN
Published: December 2011

This study aimed to identify factors that contribute to bilingual children's decontextualized language production and investigate how schooling experience and bilingualism affect the development of this skill. The word definition skills of seventy Korean–English bilingual children whose first language was Korean, yet who had been schooled in English, were analyzed. The findings indicate that contrary to the results from previous studies, the participants' decontextualized language production was much better in their home language than in their school language, when considering both the formal linguistic structure and the communicative adequacy of their word definitions. In addition, limited cross-language transfer across tasks was present and cross-language contribution was observed only in the children's ability to achieve communicative adequacy, but not in their ability to construct conventional definition syntax. The results are discussed in terms of the linguistic and typological distance between the two languages and the potential effects of language-learning contexts.
Narratives at work: what can stories of older athletesdo?
Authors: PHOENIX CASSANDRA , GRIFFIN MERIDITH
Published: December 2011

Previous research has shown that young adults tend to identify and reinforce negative stereotypes of growing older. They can express both fear and trepidation regarding the bodily changes that occur with advancing age. With this in mind, in this paper we draw upon Frank's (2010) theoretical framework of socio-narratology to examine the work that stories cando. We take as a working example the impact that stories of ageing told by masters athletes might have upon young adults, and specifically their perceptions of (self-)ageing. Three focus groups were carried out with the young adults to examine their perceptions of (self-)ageing prior to and following their viewing of a digital story portraying images and narratives of mature, natural (‘drug-free’) bodybuilders. Our analysis pointed to a number specific capacities that stories of masters athletes might have, namely the potential to re-open young adults sense of narrative foreclosure, the stretching and expanding of existing imagined storylines, and increasing the availability of narrative options. We propose that understanding what stories can do, what they can do best, and the narrative environments that help and hinder this process is essential if our programmes and policies are to produce the results that are wanted.
Investigation of optical limiting characteristic based on the combination of stimulated Brillouin scattering and metal-phthalocyanine complex
Authors: Geng X.Z. , Hasi W.L.J. , Jin C.Y. , Lin D.Y. , He W.M. , Fan R.Q. , Lu Z.W.
Published: December 2011

In this paper, a scheme of compound optical limiting based on nonlinear material dissolved into Brillouin medium is proposed. Both nonlinear material and Brillouin medium used as the solvent play roles of optical limiting, so the proposed optical limiting scheme presents a lower output clamp value and flatter output energy compared with the single stimulated Brillouin scattering (SBS). Compound optical limiting of F16PCCu/acetone is prepared and output energy characteristic based on it is studied in this paper. Both the theoretical and experimental results indicate that the output clamp value and output energy based on the compound method is lower and flatter than that based on single SBS optical limiting. Some properties of the compound optical limiting, such as limiting energy range, limiting waveband, response speed, limiting threshold and damage threshold, also are analyzed and discussed in the later part of this paper.
Screening for methicillin-resistant Staphylococcus aureus (MRSA) in community-recruited injection drug users: are throat swabs necessary?
Authors: LLOYD-SMITH E. , HULL M. W. , HAWKINS D. , CHAMPAGNE S. , KERR T. , ROMNEY M. G.
Published: December 2011

We examined and described colonization of MRSA in the anterior nares and throat from 184 community-recruited injection drug users. Thirty-seven (20%) were positive for MRSA: most (34, 92%) were carriers in the nares; while only three (8%) were carriers detected by throat swabs alone. The majority (29, 78%) of MRSA isolates were PVL positive.
“Please Don’t Tell Me”
Authors: HERRING JONATHAN , FOSTER CHARLES
Published: December 2011

Knowledge is generally a good thing. People who know lots of bits of information are generally admired. Some of them win prizes in TV competitions. If you were offered the gift of having an entire encyclopedia wired into your brain, you would probably accept, without thinking. But we should be wary of assuming that all knowledge is good. Too much knowledge can inhibit rather than enable thought.
My Problems with the B-Word
Authors: GALBRAITH KYLE L.
Published: December 2011

Not to brag, but I am a hit at parties. I tend to shine in the company of new faces, oftentimes scientists who work with my spouse.
Crossing Invisible Lines
Authors: MICKELSEN RUTH
Published: December 2011

My path to bioethics was a long and uncharted one. My journey, through a rich and varied career and three postgraduate degrees, reflects the evolving narrative of both my own life and the field of bioethics.
What is a ventricle?
Authors: Anderson Robert H. , Mohun Timothy J. , Moorman Antoon F. M.
Published: December 2011

On the basis of both developmental and morphological evidence, we would suggest that a ventricle is best defined as any chamber within the ventricular mass possessing an apical trabecular component. Such ventricles can be of right or left morphology, and always coexist. The ventricles are normally formed when possessing all three of the inlet, apical trabecular, and outlet components, but incomplete when lacking one or both of the inlet and outlet components. Ventricles that are incomplete because of lack of the inlet component are always hypoplastic, with incomplete right ventricles being positioned antero-superiorly within the ventricular mass, and incomplete left ventricles located postero-inferiorly. Patients having such incomplete ventricles because of the lack of the inlet component have functionally univentricular hearts, although the functionally univentricular arrangement can also be produced in the setting of normally constituted but hypertrophied ventricles. Full analysis of ventricular morphology, therefore, requires attention not only to component make-up, but also size.
Hypoplastic left heart syndrome and other left heart disease: evolution of understanding from population-based analysis to molecular biology and back again – a brief overview
Authors: Brenner Joel I. , Kuehl Karen
Published: December 2011

Congenital cardiac disease is the most common birth defect, occurring in approximately 1 in 1000 live births. Congenital cardiac defects have associations, whether with gender, race, or specific chromosomal abnormalities, potentially allowing grouping of defects to be studied in an effort to develop an understanding of aetiological factors. The Baltimore-Washington Infant Study provides full ascertainment of a population of infants with congenital cardiac disease born in a defined geographic region. The fundamental hypotheses generated at the inception of the Baltimore-Washington Infant Study included the central idea that the outcome of birth, including the development of congenital cardiac malformations, was influenced by environmental factors and their route of introduction into a genetically susceptible host. Evidence exists that supports the concept that both genetic and environmental factors contribute to the development of diseases of the left heart.
Echocardiography of hypoplastic left heart syndrome
Authors: Nguyen Thieu , Miller Michelle , Gonzalez Javier , Nardell Katherine , Galas James , John John B. , Timofeev Stan , Lambou Rich , Douglas Kathryn , Marx Gerald
Published: December 2011

Echocardiography is critical in the assessment of patients with hypoplastic left heart syndrome. Fundamental techniques and standardised approaches are useful when evaluating patients with hypoplastic left heart syndrome prenatally, after birth, and before the Norwood operation (Stage 1); after the Norwood operation, before and after the superior cavopulmonary anastomosis (Stage 2); before and after the Fontan operation (Stage 3); and for chronic surveillance after the Fontan operation. From foetal assessment to ongoing surveillance after the Fontan procedure, echocardiography remains the primary technique for cardiac monitoring in this growing population of children and adults.
The hybrid approach – current knowns and unknowns: the perspective of cardiology
Authors: Ringewald Jeremy M. , Stapleton Gary , Suh Elsa J.
Published: December 2011

The hybrid approach to the treatment of patients with hypoplastic left heart syndrome most commonly includes transcatheter placement of a stent in the arterial duct and surgical placement of bands on the branch pulmonary arteries via median sternotomy. This manuscript will review the concept of hybrid palliation and discuss topics related to several time intervals: peri-procedural, post-procedural, interstage, and comprehensive stage 2.
Primary care cardiology for patients with hypoplastic left heart syndrome
Authors: Boris Jeffrey R.
Published: December 2011

Primary care cardiology is also known as ambulatory cardiology and outpatient cardiology. Primary care cardiology for the longitudinal management of patients with hypoplastic left heart syndrome is both poorly described and has limited evidence to justify its basis. This article briefly discusses the various complications that these patients can develop, reviews the medical literature, and describes a framework for the care of these complex patients from infancy to transition to care by specialists in adults with congenital cardiac disease.
Feeding, growth, nutrition, and optimal interstage surveillance for infants with hypoplastic left heart syndrome
Authors: Hehir David A. , Cooper David S. , Walters Elizabeth M. , Ghanayem Nancy S.
Published: December 2011

Improvement in operative survival of patients with hypoplastic left heart syndrome has led to increasing emphasis on prevention of interstage mortality. Many centres have improved interstage results through programmes of home monitoring following discharge after the Norwood (Stage 1) operation. Experience with heightened interstage surveillance has identified failure to thrive during infancy as a modifiable risk factor for this population, one that has been linked to concerning outcomes at subsequent palliative surgeries. Ensuring normal growth as an infant has thus become a priority of management of patients with functionally univentricular hearts. Herein, we review the existing evidence for best practices in interstage surveillance and optimal nutrition in infants with functionally univentricular hearts. In addition, we highlight data presented at HeartWeek 2011, from Cardiology 2011, the 15th Annual Update on Pediatric and Congenital Cardiovascular Disease, and the 11th Annual International Symposium on Congenital Heart Disease.
Extracorporeal cardiopulmonary resuscitation for post-operative cardiac arrest: indications, techniques, controversies, and early results – what is known (and unknown)
Authors: Chai Paul J. , Jacobs Jeffrey P. , Dalton Heidi J. , Costello John M. , Cooper David S. , Kirsch Roxanne , Rosenthal Tami , Graziano Joseph N. , Quintessenza James A.
Published: December 2011

Extracorporeal cardiopulmonary resuscitation may be defined as the use of extracorporeal membrane oxygenation for the support of patients who do not respond to conventional cardiopulmonary resuscitation. Data from national and international paediatric databases indicate that the use of extracorporeal cardiopulmonary resuscitation is increasing. Guidelines from the American Heart Association suggest that any patient with refractory cardiopulmonary resuscitation and potentially reversible causes of cardiac arrest is a candidate for extracorporeal cardiopulmonary resuscitation. One possible framework for selection of patients for extracorporeal cardiopulmonary resuscitation includes dividing patients on the basis of favourable or unfavourable characteristics. Favourable characteristics include cardiac disease, witnessed event in the intensive care unit, ability to deliver effective cardiopulmonary resuscitation, active patient monitoring present, favourable arterial blood gases, and early institution of extracorporeal membrane oxygenation. Unfavourable characteristics potentially include non-cardiac disease, an unwitnessed cardiac arrest, ineffective cardiopulmonary resuscitation, and severely acidotic arterial blood gases. Considering the significant resources and cost involved in the use of extracorporeal cardiopulmonary resuscitation, its use needs to be critically examined to improve outcomes, assess neurological recovery and quality of life, and help identify populations and other factors that may help guide in the selection of patients for successful extracorporeal cardiopulmonary resuscitation.
Foetal cardiac intervention: an ethical perspective
Authors: Mavroudis Constantine D.
Published: December 2011

Although recent advances have helped identify cases where foetal cardiac surgery might reverse the development of certain lesions, the indications and measurement of success in these procedures have yet to be established. Thus, both patients and physicians have a “burden of knowledge”, whereby a diagnosis is made without a clear course of action. The profound issues raised by foetal intervention, specifically the question of how concepts such as “patient” and “success” can be used, complicate this burden further and test the limits of language and logic. Similar issues raised in postmodern philosophy are discussed and can be incorporated into foetal cardiac surgery dialogues to produce a multi-disciplinary approach that will elucidate, not obfuscate, these issues in the future.
Changing attitudes to the management of hypoplastic left heart syndrome: a European perspective
Authors: Murtuza Bari , Elliott Martin J.
Published: December 2011

Background and aims

Several years ago, one of us described the difference in attitude to patients with hypoplastic left heart syndrome in the United States of America and Europe as similar to that between Mars and Venus. Uncertainty remains with regard to the long-term prognosis for patients with hypoplastic left heart syndrome. This prognosis may be considered in terms of survival, functional performance, including exercise capacity and neurodevelopment, as well as psychosocial effects on the patient, family, and siblings. Counselling parents where either an antenatal or postnatal diagnosis of hypoplastic left heart syndrome has been made requires practitioners to give information on these prognostic aspects. We wanted to see how attitudes among European surgeons have changed over the last few years.

Methods

We performed a review of recent European data for hypoplastic left heart syndrome and conducted a survey among surgeons in major European centres to ascertain key aspects of their attitudes to the management of patients with hypoplastic left heart syndrome and how they counsel parents.

Results and conclusions

As of January, 2011, 2392 citations in the PubMed database were available for the search string “hypoplastic left heart”. The majority of these were from the centres from the United States of America and Europe. The European Association for Cardio-Thoracic Surgery Congenital Heart Surgery Database shows an annual increase in the number of Norwood (Stage I) operations for hypoplastic left heart syndrome from 2003 to 2009, with a corresponding reduction in mortality. European rates of antenatal detection vary widely between centres, as do the rates of termination for a prenatal diagnosis of hypoplastic left heart syndrome. We observed a wide variation in the estimates of surgeons for survival and quality of life for surgical palliation of hypoplastic left heart syndrome, as well as in their estimates for actual rates of termination of pregnancy in their centres. Further, there was marked inconsistency in the information given to parents as part of the process of counselling. These issues remain to be resolved if parents are to make a fully informed decision for their child.
Deutsche Suchthilfestatistik 2009
Authors: Pfeiffer-Gerschel Tim , Künzel Jutta , Steppan Martin
Published: December 2011

Fragestellung: Darstellung von Behandlungs- und Patientenmerkmalen ambulanter und stationärer Einrichtungen der Suchtkrankenhilfe in Deutschland für das Jahr 2009. Methodik: Die Auswertung basiert auf aggregierten Daten von N = 936 (779 ambulanten und 157 stationären) Einrichtungen, die sich im Berichtsjahr 2009 an der DSHS beteiligt und 316.075 Betreuungen in ambulanten und 38.618 Behandlungen in stationären Einrichtungen dokumentiert haben. Voraussetzung für die Teilnahme der Einrichtungen an der DSHS ist eine Dokumentation der Arbeit entsprechend der Vorgaben des KDS (Deutscher Kerndatensatz). Auf der Grundlage des am IFT geführten Registers der Facheinrichtungen der Suchtkrankenhilfe in Deutschland kann für den ambulanten Bereich eine Erreichungsquote von 69 bis 74 % angenommen werden, für den stationären Bereich von 43 bis 48 %. Ergebnisse: Wie bereits in den Vorjahren stellen sowohl im ambulanten als auch im stationären Bereich Patienten mit Störungen aufgrund des Konsums von Alkohol (ambulant 56 %, stationär 75 % der Betreuungen), Opioiden (ambulant 18 %, stationär 9 % ) und Cannabis (ambulant 14 %, stationär 5 %) die drei größten Hauptdiagnosegruppen. Männer weisen dabei hinsichtlich der Zahl der Betreuungen und Behandlungen wesentlich höhere Anteile bei (fast) allen Hauptdiagnosen auf. Die durchschnittlichen Behandlungsdauern sind für alle Hauptdiagnosegruppen im ambulanten Bereich länger (m = 168 [Pathologisches Glücksspiel, PG] – 336 [Alkohol, Opioide] Tage mittlere Behandlungsdauer) als im stationären Bereich (m = 78 [PG] – 112 [Stimulantien] Tage). Der Anteil planmäßiger Beender ist vor allem bei Patienten mit primär Alkohol-bezogenen Störungen oder pathologischem Glücksspiel in stationären Einrichtungen deutlich höher als in der ambulanten Versorgung. Bei Opioid-, Cannabis- und Stimulantienkonsumenten gibt es keine vergleichbar gravierenden Unterschiede. Sowohl in den ambulanten als auch in den stationären Einrichtungen kamen über 80 % (ambulant) bzw. 92 % (stationär) der Personen mit einem planmäßigen Betreuungs-/Behandlungsende auch zu einem positiven Gesamtergebnis der durchgeführten Intervention.
Long‐term variation of driven and unloading effects on polar cap dynamics
Authors: Gao Ye , Kivelson Margaret G. , Walker Raymond J. , Weygand James M.
Published: December 2011

The influence of the solar wind on the magnetosphere‐ionosphere system can be described in terms of driven and unloading processes. In a driven process, the response is proportional to the input with at most a small time delay. In an unloading process, the input energy accumulates without a corresponding output until, after a significant time delay, the energy is unloaded. The polar cap index, which has been used as a monitor of the polar cap activity, can be decomposed into a driven component and an unloading component through a linear regression with the polar cap index as response andEK‐R, an electric field proposed by Kivelson and Ridley (2008) as representative of the electric field imposed on the ionosphere by magnetopause reconnection when saturation is taken into account, and AL index as predictors. Such an analysis has been systematically applied day‐by‐day to most of the days in solar cycle 23. The driven‐to‐unloading ratio (DUR) is characterized in terms of the ratio of the regression coefficients for an appropriately normalized representation of the predictors. We have found that the ratio of the responses of the driven component to the unloading component is smaller near solar maximum than near solar minimum with variation of around ±5%. There is also a strong annual variation of as much as ±15% with stronger driven‐to‐unloading ratio in summer than in winter. The variation of driven‐to‐unloading ratio in solar cycle 23 is explained in terms of enhancement of ionospheric conductance by electron precipitation during strong solar wind high‐speed streams and the annual variation can be understood as seasonal variation of conductance caused by solar illumination.
Antineutrino pulses could signal birth of neutron star
Authors: Lubkin Gloria B.
Published: December 2011

A bouncing baby neutron star emitting burps of antineutrinos may have been detected shortly after its birth in the collapse of an ordinary star. That is one explanation being offered for a curious event detected by a University of Pennsylvania–University of Texas–University of Torino collaboration, whose results were reported by Kenneth Lande at the Fourth International Conference on Neutrino Physics held in Downingtown, Pa. at the end of April.
NAL considers energy doubler, storage rings
Authors: Levi Barbara G.
Published: December 2011

The National Accelerator Laboratory was officially dedicated and named the Fermi National Accelerator Laboratory on 11 May. The lab regularly produces 300-GeV protons and has occasionally run at 400 GeV. It has achieved a beam intensity of 1013 protons per pulse (ppp) and is working toward its design intensity of 5×1013 PPP. Yet, even as the Fermi Lab has nearly achieved its original goals, planners there are contemplating future goals. In a talk at the April meeting of the APS in Washington, D.C., Don Edwards of the Fermi Lab described two new possibilities—an energy doubler and storage rings.