bluuebunny/crossref_metadata_2025 huggingface dataset:
Mutual face preservation among Asian speakers of English as a Lingua Franca
Authors: Walkinshaw Ian , Kirkpatrick Andy
Published: August 2014

This study identifies strategies used by speakers of ELF from Asia-Pacific countries for managing rapport in response to potentially face-threatening utterances in informal, non-hierarchical situations. The analysis, which draws on the Asian Corpus of English (ACE), reveals numerous points of contact with existing studies of English as a lingua franca. Potentially face-threatening utterances were usually – though not always – countered with a move to normalise the flow of conversation and maintain interactional rapport. There was also a preference for safe topics and an avoidance of potentially sensitive ones. Humour and laughter were frequently employed, possibly to signal equanimity with interlocutors. Yet two communicative strategies emerged which appeared to depart from the general pattern of rapport preservation. The first was mock impoliteness, which was possibly employed to signal solidarity with recipients but which risks evaluation as impolite regardless of intentionality. The second was bald on-record contradiction of or counterclaim against potentially face-threatening propositions or assessments. We theorise that these were delivered on-record to facilitate lingua franca communication: speakers avoided using complex or idiomatic language to ensure addressee comprehension, while recipients refrained from making an evaluative judgment of direct disagreement to allow for limitations or idiosyncrasies in their interlocutors' speech.
The Common European Framework of Reference from the perspective of English as a lingua franca: what we can learn from a focus on language regulation
Authors: Hynninen Niina
Published: August 2014

This paper discusses the Common European Framework of Reference for Languages (CEFR) in relation to research conducted on English as a lingua franca (ELF). The following aspects will be considered: (a) the native speaker and native language culture foci particularly of the proficiency level descriptors in the CEFR, and why they are conceptually problematic from an ELF perspective, and (b) the ways ELF speakers have been found to regulate language in ELF interaction (e.g., by correcting and commenting on language) and how the regulation can be seen to construct alternative norms for English used in lingua franca settings. The paper seeks answers to McNamara’s (2012) call for articulating the construct of ELF communication in a way that it can act as the focus for the assessment of English. It will be argued that a crucial aspect in reaching this goal is to reconsider some of the fundamental assumptions of language use presented in the CEFR. This includes not only moving beyond native speaker--non-native speaker contacts and the idea of a native speaker target culture, but also moving towards more context-aware assessment criteria, which would be informed by research on language regulatory practices in ELF interaction.
Case innovation and agentive marking: A comparative overview of Central Indo-Aryan
Authors: Phillips Maxwell P.
Published: August 2014

A split-ergative construction had developed during the late MIA period (Bubenik 1998; Peterson 1998) in which subjects of perfective transitive clauses were marked ergative by an oblique form, in contrast with the nominative form for non-ergative subjects. Later in the NIA period, most NIA languages (e.g. Urdu/Hindi) developed a postpositional clitic that was added to the oblique suffix, while others (e.g. Sindhi) continued to mark ergative subjects with a generic oblique suffix. This paper focuses on one exceptional case: the Dehwali language of Gujarat. Dehwali has an ergative marker that is a fusional suffix (i.e. layer I – Masica 1991: 231) and appears to inflect to agree in number and gender with the subject it marks.

I will present two possible scenarios as to the origin of the Dehwali ergative marker: that it may be the remnant of an archaic MIA oblique form, or that it may be a more recent innovation as the result of increased contact with neighbouring varieties. Based on theories of grammaticalisation, I argue that the former hypothesis is more likely. These theories show that it is not uncommon for oblique case forms (i.e. ablative; genitive) to carry agentive properties.
Local case semantics in Kalasha
Authors: Heegård Jan
Published: August 2014

The article presents a semantic analysis of five local suffixes in the Indo-Aryan language Kalasha (north-west Pakistan): the three locative suffixes -a, -una and -ai and the two ablative suffixes -ani and -aw. It is shown that these suffixes have both spatial and non-spatial functions. In their basic semantics, the five local suffixes differentiate between point-like location, location on a surface and location in a container. In their non-spatial functions they encode in a systematic way differences with respect to dispersion, visibility and referentiality. It is argued that the five local suffixes constitute a closed-set inflectional case paradigm. As a supplementing areal-typological perspective, non-spatial semantics of case markers in neighbouring Hindu Kush languages is included in the analysis.
Elementos para unha revisión textual das cantigas trobadorescas: sobre a segmentación de 'o' e 'a'
Authors: Ferreiro Manuel
Published: August 2014

A frecuente aparición da terminación <-a> e <-o> (ás veces elemento inicial) en numerosas unidades lingüísticas é un feito que multiplica as posibilidades segmentativo-interpretativas de tales vogais finais (ou iniciais), pola polivalencia destes elementos, xa que combinan as funcións de artigo e de pronome en fun­ción de complemento directo, para alén de  poder ser tamén preposición (a), forma verbal (á), contrac­ción da preposición a co artigo feminino (à) e, mesmo, prefixo (a-).Partindo da importancia que o proceso de segmen­tación ten para o estabelecemento do texto crítico medieval, e tendo en conta os factores condicionantes e mais certo carácter de subxectividade desta operación ecdótica, neste artigo faise unha revisión do corpus da poesía trobadoresca profana para levantar múltiplos problemas existentes na segmentación das secuencias  e  nas edicións de referencia.Deste modo, a partir da revisión dos manuscritos e do confronto coas principais edicións existentes, son moi numerosas as propostas de rectificación textual no corpus lírico medieval galego-portugués que se fan a partir dunha perspectiva segmentativa.
Capeverdean reflexives: the importance of a silent Voice
Authors: Pratas Fernanda
Published: August 2014

In Capeverdean, a Portuguese-based Creole language, many reflexive contexts do not show any overt reflexi­ve expression. This is the case of transitive verbs like bisti ‘dress’ in simple clauses: Ana bisti ‘Ana has dressed herself’. This is a perplexing fact, given that there is an anaphor of the SELF-type available in the language: (si) kabesa — literally ‘his/her head’ —, meaning ‘himself/ herself’, which participates in reflexive clauses with other verbs. The current paper explores this puzzle, en­ding with a proposal supported empirically and also by recent studies for other languages. This novel analysis goes as follows: all Capeverdean finite sentences, ex­cept unaccusatives, have a Voice head, responsible for assigning external theta-roles. This also includes middles, passives and this type of reflexives. It is this Voice head that, in spite of being silent, attracts the internal argument to a preverbal position and provides the in­terpretation for an implicit external argument, which is syntactically active.
Correspondencias léxicas entre a fala de Cáceres e o portugués
Authors: Álvarez Pérez Xosé Afonso
Published: August 2014

No Val de Xálima fálanse tres variedades romances es­treitamente relacionadas que, no seu conxunto, son co­ñecidas co glotónimo fala. Desde o seu redescubrimento, vai xa para un cuarto de século, a polémica sobre a súa adscrición lingüística é intensa. Unha das posturas reivin­dica o carácter galego da fala, apoiándose en argumen­tos históricos (procesos medievais de repoboamento) e lingüísticos (supostas similitudes destas variedades co galego que non existirían nas linguas veciñas). En 2013, o Prof. Xosé-Henrique Costas, o maior referente da reivin­dicación da galeguidade dos falares de Xálima, publicou un volume que recompila diversos traballos sobre varios aspectos da fala; entre eles, un estudo de varias ducias de designacións lexicais que, segundo Costas, son exclu­sivos da fala (por exemplo, arcaísmos) ou ben paralelos entre o galego e as falas de Xálima que non existen nin en portugués nin en castelán. Non obstante, unha lectura do texto revelou que varias das formas alí incluídas eran ben coñecidas no portugués dialectal, polo que se facía nece­sario verificar a validez do conxunto da listaxe. O obxec­tivo deste traballo foi realizar un exame sistemático da presenza ou ausencia desas supostas formas específicas da fala nos materiais dialectais casteláns e portugueses. Os resultados confirmaron a hipótese de partida. Un im­portante número das designacións expostas por Costas están presentes nos dialectos portugueses (non só nos lindeiros co Val de Xálima) e incluso na lingua estándar; non faltaron tampouco correspondencias con variedades dialectais estremeñas e salmantinas. As conclusións do traballo reivindican a necesidade de ter ben presentes os materiais dialectais á hora de examinar as características lingüísticas da fala, unha precaución necesaria para dar solidez ó debate científico sobre a súa orixe.
Ion Channel Remodelling in Atrial Fibrillation
Authors: Voigt Niels , Dobrev Dobromir ,   Division of Experimental Cardiology, Medical Faculty Mannheim, University of Heidelberg, Mannheim,   Division of Experimental Cardiology, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany. E: dobromir.dobrev@medma.uni-heidelberg.de
Published: August 2014

Atrial fibrillation (AF) is the most common arrhythmia and is associated with substantial cardiovascular morbidity and mortality, with stroke being the most critical complication. Present drugs used for the therapy of AF (antiarrhythmics and anticoagulants) have major limitations, including incomplete efficacy, risks of life-threatening proarrhythmic events and bleeding complications. Non-pharmacological ablation procedures are efficient and apparently safe, but the very large size of the patient population allows ablation treatment of only a small number of patients. These limitations largely result from limited knowledge about the underlying mechanisms of AF and there is a hope that a better understanding of the molecular basis of AF may lead to the discovery of safer and more effective therapeutic targets. This article reviews the current knowledge about AF-related ion-channel remodelling and discusses how these alterations might affect the efficacy of antiarrhythmic drugs.
Measuring Left Ventricular Ejection Fraction – Techniques and Potential Pitfalls
Authors: Foley Thomas A , Mankad Sunil V , Anavekar Nandan S , Bonnichsen Crystal R , Miller Michael F , Morris Todd D , Araoz Philip A ,   Radiologist, Department of Radiology,   Cardiologist,   Cardiologist,   Cardiology Fellow, Division of Cardiology, Department of Medicine, Mayo Clinic, Rochester, US,   Radiologist, Department of Radiology,   Cardiologist,   Radiologist, Department of Radiology, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, US. E: paraoz@mayo.edu
Published: August 2014

Prognosis and therapeutic decisions are often based on left ventricular ejection fraction (LVEF), which means the LVEF needs to be accurately measured. Many imaging modalities can measure LVEF. Each of these modalities is subject to measurement errors that can lead to the inaccurate calculation of LVEF. This article reviews the most common non-invasive imaging modalities – i.e., echocardiography, magnetic resonance imaging (MRI), computed tomography (CT), radionuclide angiography, gated myocardial perfusion single-photon emission computed tomography (SPECT) and gated myocardial perfusion positron emission tomography (PET) – used to measure LVEF, as well as the common sources of error with each of them. It is important to understand these sources of errors in order to prevent them, and recognise them when they do occur so that they can be corrected if possible.
Ruptured Sinus of Valsalva in an Asymptomatic patient – a Case Report
Authors: Moreels Sofie , Dymarkowski Steven , De Ridder Serge ,   Division of Cardiology, University Hospital of Leuven, Tervuursestraat 71/2, 3000 Leuven, Belgium. E: sofiemoreels@yahoo.com,   Division of Radiology, University Hospital of Leuven,   Division of Cardiology, St Elizabeth Hospital, Herentals, Belgium
Published: August 2014

A rupture of a sinus of Valsalva is a rare cardiac anomaly. A continuous murmur may be the first clinical sign. Transoesophageal echocardiography is the preferred diagnostic tool. Additional imaging techniques can be used to confirm the diagnosis. In case of rupture, prognosis is poor and therefore repair is always required. In this case report, we describe a 65-year-old asymptomatic patient with a continuous cardiac murmur leading to the diagnosis of a previously unsuspected ruptured sinus of Valsalva. Surgery was suggested even tough the patient was asymptomatic.
Bifurcation Coronary Lesions – Approaches to Bifurcation Management
Authors: Stankovic Goran , Mehmedbegovic Zlatko , Zivkovic Milorad ,   Clinic for Cardiology, Department for Diagnostic and Catheterisation Laboratories, Clinical Centre of Serbia, Medical School of Belgrade, 8 Koste Todorovica, 11000 Belgrade, Serbia. E: gorastan@sbb.rs,   Clinic for Cardiology, Department for Diagnostic and Catheterisation Laboratories, Clinical Centre of Serbia, Medical School of Belgrade,   Clinic for Cardiology, Department for Diagnostic and Catheterisation Laboratories, Clinical Centre of Serbia, Medical School of Belgrade
Published: August 2014

The most important question in bifurcation percutaneous coronary intervention (PCI) is selecting the appropriate strategy for an individual bifurcation and optimising the performance of this technique. Provisional T stenting remains the gold-standard technique for most bifurcations as routine two-vessel stenting does not improve either angiographic or clinical outcomes for most patients with coronary bifurcation lesions. However, further studies are required to determine which bifurcation lesions may particularly benefit from a two-stent strategy as an intention to treat. In this article, we highlight what we know about the treatment of bifurcation lesions and, based on this knowledge, offer our recommendations and a practical approach to bifurcation intervention.
Drug-coated Balloons – History and Peripheral Vascular Opportunities
Authors: Scheller Bruno , Cremers Bodo , Schmitmeier Stephanie , Schnorr Beatrix , Clever Yvonne , Speck Ulrich ,   Klinische und Experimentelle Interventionelle Kardiologie, Universität des Saarlandes, 66421 Homburg/Saar, Germany. E: bruno.scheller@uks.eu; Klinik für Innere Medizin III, Universitätsklinikum des Saarlandes, Homburg/Saar,   Klinik für Innere Medizin III, Universitätsklinikum des Saarlandes, Homburg/Saar,   Abteilung für Radiologie, Experimentelle Radiologie, Charité, Universitätsklinikum, Berlin,   Klinik für Innere Medizin III, Universitätsklinikum des Saarlandes, Homburg/Saar,   Abteilung für Radiologie, Experimentelle Radiologie, Charité, Universitätsklinikum, Berlin
Published: August 2014

One of the most innovative fields of modern medical research is the percutaneous transluminal treatment of vascular disease. During recent decades considerable advances have been made in intravascular interventions for the treatment of coronary and peripheral arterial disease. Despite these advances, the long-term outcome remains an area of concern in many applications. Restenosis is still a challenge in endovascular medicine and has thus been referred to as the Achilles’ heel of percutaneous intervention. Therefore, novel strategies have been developed to overcome this problem. These include drug-eluting stents and the more recently introduced non-stent-based local drug delivery systems (in particular the drug-coated balloon). Results from several pre-clinical and clinical studies indicate that short-term exposure of injured arteries to paclitaxel delivered from regular angioplasty balloons may be sufficient to reduce late lumen loss and restenosis rates during a critical period of time after the angioplasty of diseased coronary and peripheral arteries. Although the number of published trials and patients treated is still limited, data available seem to prove that restenosis inhibition by immediate drug release is feasible. This article reviews the history of the drug-coated balloon and then focuses on peripheral artery trials.
The Future of Abdominal Aortic Aneurysm Treatment and the Role of Totally Percutaneous Endografting
Authors: Capoccia Laura , Riambau Vincent ,   Vascular Surgery Division, Department of Surgery ‘P Stefanini’, Policlinico Umberto I, University of Rome ‘La Sapienza’,   Professor and Chief of Vascular Surgery Division, Thorax Institute, Hospital Clinic, University of Barcelona, Villarroel 170, 08036 Barcelona, Spain. E: riambau@meditex.es; vriambau@clinic.ub.es
Published: August 2014

Endovascular abdominal aortic aneurysm repair (EVAR) has experienced a continuous spread worldwide as a result of the constant drive to develop innovative methods and devices that enable physicians to achieve therapeutic aims while reducing procedural risks and patient discomfort. Randomised controlled studies have demonstrated clear early benefits over open repair in terms of mortality and morbidity, but a high reintervention rate jeopardised the EVAR outcome. Complications in EVAR, such as endoleaks, separation of modular components, stent or hook fractures and distal migration of the endograft, can lead to aneurysm enlargement and thus to the native risk of aneurysm rupture. In order to prevent such complications and minimise potential re-interventions, new-generation stent grafts, low-profile delivery systems and new percutaneous closing devices have been developed and adopted, making a totally percutaneous approach possible and desirable. Nevertheless, operators must be aware and trained to face every complication that could possibly develop during and after the procedure. Given these circumstances, EVAR is under consideration as the first line of treatment for abdominal aortic aneurysms.
Development of a Science-based Drug-eluting Balloon
Authors: van der Linde Ferry ,   Associated Research Engineer, Blue Medical Devices, Steenovenweg 19, NL-5708 HN Helmond, The Netherlands. E: ferry.vanderlinde@bluemedical.com
Published: August 2014

The continuous development of medical devices, more specifically devices for interventional cardiology, ensures constant improvement in the treatment of patients with coronary artery diseases (CAD), satisfying the increasing needs and demands of patients and cardiologists. These increased demands combined with expanding regulations have created the necessity to transform standard product development into science-based, evidence-guided projects. Two newly approved drug-eluting balloon (DEB) products, Protégé and Pioneer, developed by Blue Medical, are based on such scientific evidence gathered using new, innovative methods and combining independent science data during all development phases, leading to scientifically supported improved patient care.
A Review of Available Angioplasty Guiding Catheters, Wires and Balloons – Making the Right Choice
Authors: Ali Ronan , Greenbaum Adam B , Kugelmass Aaron D ,   Lecturer in Adult Internal Medicine, Faculty of Medical Sciences, University of the West Indies, St Augustine, Trinidad,   Director, Cardiac Catheterization Laboratory, Henry Ford Hospital, Detroit, Michigan, US,   Chief of Cardiology and Medical Director, Heart and Vascular Program, Baystate Medical Center, 759 Chestnut Street, Springfield, Massachusetts, US. E: aaron.kugelmassmd@bhs.org
Published: August 2014

The basic equipment involved in percutaneous coronary interventions – guiding catheters, guide wires and dilation catheters (balloons) – have undergone significant evolution which has allowed for improvements in procedural success and safety. The coronary interventionalist should possess a thorough working knowledge of the available equipment and the ability to select specific equipment for a given case based on the coronary anatomy, lesion characteristics and the complexity of the planned intervention. Equipment selection is often the difference between a straightforward intervention and a technically challenging one that may result in complications.
Strategies and Outcomes for Proximal and Distal Embolic Protection Devices – A Review
Authors: Kovacs Flora , Macdonald Sumaira ,   Specialist Registrar in Clinical Radiology,   Consultant Vascular Radiologist and Honorary Clinical Senior Lecturer, Interventional Radiology, Freeman Hospital, Freeman Road, High Heaton, Newcastle Upon Tyne, NE7 7DN, UK. E: Sumaira.Macdonald@nuth.nhs.uk
Published: August 2014

Both carotid endarterectomy (CEA) and carotid artery stenting (CAS) are associated with small, but clinically important and discrepant, rates of procedural complications, including cerebral and myocardial ischaemic events, cranial nerve injury and access site haematoma. Embolic protection devices (EPDs) may lower the rate of ipsilateral ischaemic events during CAS and are considered by the majority of interventionists to be mandatory during CAS, although there are no available data from randomised trials based on clinical outcomes to support this practice (perhaps because many thousands of patients would be required to adequately power a trial based on stroke and death endpoints). A recent systematic review of non-randomised data supports the use of EPDs. Worldwide experience demonstrates that all available protection strategies will capture macroemboli generated during endovascular manipulation of carotid bifurcation plaque, thus clearly implying an added level of protection for the brain when these systems are employed, but different philosophies of protection manage the microembolic burden of CAS (i.e. those particles less than 1 mm in diameter) in very different ways. These differences may be assessed by the evaluation of microembolic signals (MES) on transcranial Doppler (TCD) and of new hyperintensities (‘new white lesions’) on diffusion-weighted magnetic resonance imaging (DWMRI) of the brain. Differences between proximal and distal systems may assume clinical relevance, but further work is required before definitive conclusions can be drawn. This article focuses on the clinical and subclinical differences between protection strategies and provides a pragmatic treatment paradigm to support clinical decision-making.
Adipose-Derived Regenerative Cells for the Treatment of Patients with Non-revascularisable Ischaemic Cardiomyopathy – The PRECISE Trial
Authors: Sridhar P , Hedrick M , Baker T , Perin J , Conlan B ,   Cytori Therapeutics, 3020 Callan Road, San Diego, CA 92121, US. E: psridhar@cytori.com,   Cytori Therapeutics,   Cytori Therapeutics,   Cytori Therapeutics,   Cytori Therapeutics
Published: August 2014

Adipose-derived regenerative cells (ADRCs) continue to be evaluated for use in the treatment of patients with chronic heart failure, particularly in those refractory to, or not suitable for, currently available options. This population of cells has demonstrated the ability to facilitate wound repair through the restoration of blood flow in ischaemic conditions, reduction in inflammation and apoptosis, and regeneration of damaged tissue through stem cell differentiation into multiple cell lineages, including cardiac muscle. This approach is particularly useful in the repair or restoration of function to ischaemic tissues in patients where the body’s natural repair mechanisms have failed or been exhausted, such as patients with non-revascularisable, refractory heart failure. The use of ADRCs for these patients has numerous advantages. Primarily, the cells are accessed from a patient’s own tissue, minimising the risk of disease transmission or rejection. Further, the heterogeneity of the cells generates an orchestrated response that targets all phases of the wound healing process. Finally, the cells are readily accessible in real-time without the need for cell expansion, making it a virtually off-the-shelf therapy option. The Celution® System is a safe, GMP-compliant technology designed to automate the preparation of ADRCs at the patient’s bedside. It has been clinically validated for safety and feasibility in two completed cardiac trials; one for acute myocardial infarction and the other for chronic myocardial ischaemia. It is being further evaluated in two ongoing clinical trials for the same indications. In this article, a summary of 18-month follow-up data using the Celution technology for the treatment of patients with non-revascularisable, symptomatic, ischaemic cardiomyopathy will be presented. While additional studies are planned to confirm the efficacy of these cells in the cardiac setting, early clinical data shows promising trends towards the improvement of cardiac function and mortality rate using a technology that can potentially significantly reduce treatment costs compared to the current standard-of-care.
Coronary Revascularisation in Patients Eligible Only for Percutaneous Coronary Intervention or Coronary Artery Bypass Grafting – A Review with a Specific Focus on the Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery Nested Registries
Authors: Head Stuart J , Bogers Ad JJC , Kappetein A Pieter ,   Department of Cardiothoracic Surgery, Erasmus University Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands. E: s.head@erasmusmc.nl,   Department of Cardiothoracic Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands,   Department of Cardiothoracic Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands
Published: August 2014

In many patients, comparable results can be achieved either with coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI). The comparison of PCI versus CABG is frequently reported in randomised trials, national registries, multicentre collaborations and single-centre experiences. However, the patients included in these analyses are either highly selected (trials), or comprehensive (national registries and retrospective studies). Large registries differ from each other since indications for PCI or CABG may be different among geographic regions, hence the large PCI:CABG ratio variability that has been described. Some patients can only undergo bypass surgery because they have too complex coronary artery disease deemed unsuitable to be treated with PCI. In contrast, PCI can be the only treatment option if patients are deemed inoperable due to advanced age or severe co-morbidities. Separate analyses of these patients that are excluded from randomisation is needed to fully understand the strength, limitations and outcomes of PCI and CABG in selected patients. This review summarises the data of patients ineligible for randomisation and focuses specifically on the Synergy between percutaneous coronary intervention with Taxus and cardiac surgery (SYNTAX) PCI and CABG nested registries.
Coronary Artery Bypass Grafting Versus Percutaneous Coronary Intervention for Unprotected Left Main Disease – A Review
Authors: McNulty Edward ,   Kaiser San Francisco Medical Center, and Assistant Clinical Professor, University of California San Francisco School of Medicine, 2200 O’Farrell Street, San Francisco, CA 94115, US. E: edward.j.mcnulty@kp.org
Published: August 2014

There have been over a dozen studies in the drug-eluting stent era comparing the effectiveness of percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) surgery for the treatment of unprotected left main disease. These studies have been both randomised and observational in nature. While both methodologies provide important insights, careful consideration of their respective strengths and limitations is imperative in generalising their findings.
Acute Coronary Syndrome in Pre- and Post-partum Women – A Review
Authors: Aprigliano Gianfranco , Palloshi Altin , Morici Nuccia , Ferraresi Roberto , Bianchi Michele , Anzuini Angelo ,   Interventional Cardiovascular Unit, Cardiology Department, Istituto Clinico Città Studi, via Mazzini, 9 A Cassina De’Pecchi, MI 20060, Milan, Italy. E: gianfrancoaprigliano@hotmail.com,   Interventional Cardiovascular Unit, Cardiology Department, Istituto Clinico Città Studi, Milan, Italy,   Cardiologia 1, Azienda Ospedaliera Ospedale Niguarda Ca’ Granda, Milan, Italy,   Interventional Cardiovascular Unit, Cardiology Department, Istituto Clinico Città Studi, Milan, Italy,   Interventional Cardiovascular Unit, Cardiology Department, Istituto Clinico Città Studi, Milan, Italy,   Cardiology Department, Istituto Clinico Mater Domini. Castellanza, Italy
Published: August 2014

Acute coronary syndrome (ACS) during pregnancy and the post-partum period are weighed by a high mortality rate for the mother and foetus. They should be considered as multifactorial diseases with a special role for sexual hormones. In this setting, ACS is mostly related to an early atherosclerotic disease, even if other conditions are responsible. Indeed, an important part is due to spontaneous coronary artery dissection, more common during delivery and the post-partum period. In the remaining situation, an isolated intracoronary thrombus or a normal angiographic pattern can be found at angiography. Pathophysiology is still uncertain with different hypothetical mechanisms. Prompt diagnosis of ACS and aetiology are essential for an optimal therapeutic strategy. Difficulties in treatment management is a matter for debate, especially in pre-partum women. In the last two decades improvements of diagnostic tools, coronary angiography and subsequent percutaneous treatment have changed the natural history of this rare condition.
Current Concepts in the Clinical Utility of Platelet Reactivity Testing
Authors: Jean-Philippe Collet ,   Professeur des Universités-Praticien Hospitalier, Institut de Cardiologie – INSERM U 937, ACTION, Groupe Hospitalier Pitié-Salpêtrière, Paris, France. E: jean-philippe.collet@psl.aphp.fr
Published: August 2014

The pharmacodynamic effect of clopidogrel varies among individuals; approximately a third will have high on-treatment platelet reactivity (HTPR) to adenosine diphosphate and may benefit from more intensive antiplatelet therapy. Platelet reactivity testing has an important role in monitoring the therapeutic efficiency of clopidogrel and the safety of more potent drugs that confer an increased bleeding risk, because it provides a direct measure of the biological effect of these drugs. Numerous studies have demonstrated an association between HTPR and the risk of cardiac events in acute coronary syndrome (ACS) or after percutaneous coronary intervention (PCI). While the prognostic value of platelet reactivity testing following PCI has been demonstrated repeatedly in cohort studies and meta-analyses, randomised controlled studies investigating the clinical utility of the technique to guide treatment decisions failed to improve clinical outcomes of clopidogrel-treated patients undergoing stent implantation. Available data suggest that platelet function monitoring may be carried out in clopidogrel-treated patients with a higher risk of thrombotic events. These include patient risk factors such as body mass index (BMI), type 2 diabetes, and those prior unexpected ischemic events such as stent thrombosis, as well as procedural risk factors. As we move towards conclusively defining a therapeutic window associated with both cardiovascular (upper threshold) and bleeding risk (lower threshold) for antiplatelet agents, platelet reactivity testing will become a central tool in the practice of personalised strategies.
Evidence-based Management of Cardiogenic Shock After Acute Myocardial Infarction
Authors: Werdan Karl , Russ Martin , Buerke Michael , Prondzinsky Roland , Dietz Sebastian ,   Department of Medicine III, Department of Medicine and Heart Centre, University Clinics Halle(Saale), Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Str. 40, D-06120 Halle (Saale), Germany. E: karl.werdan@uk-halle.de,   Dachau,   Siegen,   Merseburg, Germany,   Halle(Saale)
Published: August 2014

Guidelines for evidence-based management of patients with cardiogenic shock after acute myocardial infarction focuses on early revascularisation of the occluded coronary artery as well as on support of cardiac failure and improvement of impaired organ perfusion. Also of great importance is effective treatment of shock complications, especially acute respiratory failure and other forms of multiple organ dysfunction syndrome (MODS). Cardiovascular therapy has to be accompanied by best general intensive care of these critically ill patients with high mortality. Most lives can be saved by early revascularisation, and this class I recommendation has a high level of evidence. So far, most of the other guideline recommendations are of low evidence level, in most cases based on expert opinions. Recently, the Intra-aortic Balloon Pump in Cardiogenic Shock II (IABP SHOCK II) trial with 600 patients has shown that adjunctive IABP therapy – for long a class I recommendation – does not reduce 30-day and six-month motality.
The Role of Bioresorbable Scaffolds in Meeting the Challenges of Bifurcations
Authors: Schmermund Axel , Eggebrecht Holger ,   Cardioangiologisches Centrum Bethanien, Im Prüfling 23, D-60389, Frankfurt, Germany. E: A.Schmermund@ccb.de,   Cardioangiologisches Centrum Bethanien, Frankfurt, Germany
Published: August 2014

Side branches are frequently related to periprocedural complications. Considering any side branches >1 millimetres (mm), side branch occlusion or reduced flow may occur in approximately 10 % of interventional procedures. First data indicate that bioresorbable vascular scaffolds (BVS) behave similar compared with modern drug-eluting stents (DES) with regard to compromising or occluding sizeable side branches. Although technically more demanding compared with modern DES, it appears to be feasible to dilate side branches after crossing BVS cells. Preliminary data suggest at least balloon diameters up to 2.5 mm can be used, but safety remains unclear. Instead of kissing balloon dilatation, rather sequential balloon dilatation should be employed. Anecdotic evidence suggests BVS can be used even in relatively complex coronary anatomy, e.g. bifurcations distal to chronic total occlusion. Certainly more data are needed. As of today, BVS offer promise not only for the treatment of simple coronary lesions but also bifurcations. Given successful side branch protection, they might allow for restoring the native coronary anatomy in the sense ofrestitutio ad integrum.
Post-stroke depression
Authors: Schulte-Altedorneburg Mónika , Bereczki Dániel
Published: August 2014

Cerebrovascular diseases are associated with a high incidence of psychiatric disorders. Depressive illness after stroke has been extensively investigated during the last three decades. Post-stroke depression is estimated to occur in 30–35% of the patients during the first year after stroke. Numerous studies have given information on its prevalence, pathogenesis, clinical course, treatment and prevention. Despite the high level of comorbidity, depressive symptoms appear to remain frequently unrecognized and untreated. This has a negative effect on the rehabilitation, quality of live, cognitive function and mortality of stroke patients. Orv. Hetil., 2014, 155(34), 1335–1343.
Cardiovascular screening programme in the Central Hungarian region. The Budakalász Study
Authors: Bagyura Zsolt , Kiss Loretta , Édes Eszter , Lux Árpád , Polgár Lívia , Soós Pál , Szenczi Orsolya , Szelid Zsolt , Vadas Réka , Józan Péter , Bagdy György , Merkely Béla
Published: August 2014

Introduction: The reduction in mortality due to prevention programmes observed in some European countries is not currently reached in Hungary. Effective prevention is based on the screening of risk factors and health state of the population. Aim: The goal of this study was to develop a longitudinal, population-based screening programme in the Central Hungarian region in order to collect information on the health state and cardiovascular risk profile of the citizens and discover new potential cardiovascular risk factors. Method: The Budakalász Study is a self-voluntary programme involving the adult population (>20 yrs, approx. 8000 persons), and it consists of questionnaires, non-invasive tests (anthropometry, cardiac echo, carotid duplex scan, blood pressure measurement, ankle-brachial index), venous blood sample collection and laboratory tests. Results: Until January, 2014, 2420 persons (30% of the population, male: 41.2%, average age 54.8 years) participated in the programme. Cardiovascular morbidity was higher in contrast to a former national survey. The number of risk factors and, therefore, 10-year cardiovascular risk were also elevated in this population. Conclusions: These findings underline the importance of screening programmes and effective therapies. Orv. Hetil., 2014, 155(34), 1344–1352.
Naturopathic Doctors’ Perspectives on Mental Health and Psychiatric Drugs: Results of a Pilot Survey
Authors: Prousky Jonathan E.
Published: August 2014

This pilot survey presents for the first-time naturopathic doctors’ (NDs) perspectives on mental health and psychiatric drugs. The survey only involved NDs practicing in North American jurisdictions (i.e., Arizona, Oregon, Washington State, and the Canadian province of British Columbia) that allow for psychiatric drug prescribing. Some 80 survey requests were e-mailed, and 21 respondents (about 26%) completed the survey. The results showed that NDs see many patients having mental health complaints and tend not to favor prescribing psychiatric drugs. The results also showed that most NDs believe that psychiatric drugs work by having psychoactive effects, that psychiatric drugs are not effective long-term treatments, that they are not safe and effective when prescribed to children, and that they are not safe for pregnant women. Most NDs also reported that psychotherapy and psychosocial treatments are effective by themselves and do not require the addition of psychiatric drugs to improve outcomes. With respect to understanding psychiatric disorders, most NDs did not subscribe to the notion of brain disorders and also felt psychiatric diagnoses to be ineffective. The overarching positive outcome from this very preliminary investigation is that with these added prescriptive privileges, most NDs have maintained their holistic, humane, and ecological orientation to understanding human suffering and health, which best exemplifies and differentiates naturopathic medicine from other forms of primary and specialized mental health care.
Validating a Lifestyle Physical Activity Measure for People With Serious Mental Illness
Authors: Bezyak Jill L. , Chan Fong , Chiu Chung-Yi , Kaya Cahit , Huck Garrett
Published: August 2014

Purpose: To evaluate the measurement structure of the Physical Activity Scale for Individuals With Physical Disabilities (PASIPD) as an assessment tool of lifestyle physical activities for people with severe mental illness.

Method: A quantitative descriptive research design using factor analysis was employed. A sample of 72 individuals with severe mental illness was used to examine the factorial structure of the PASIPD, which contains 12 items and 5 factors.

Results: Principal components analysis results indicate that the 5-factor structure of the PASIPD can be replicated with people with severe mental illness, which include light/moderate recreation and physical activity, housework, vigorous sport and recreation, lawn and garden work, and occupation.

Conclusions: The results underscore the importance of increasing lifestyle physical activity levels among this population, which requires increased attention in the development of measurement tools and interventions for these activities.
Determination of Nitrogen Concentration in Fresh Pear Leaves by Visible/Near‐Infrared Reflectance Spectroscopy
Authors: Jie Wang , Hua-bing Zhao , Chang-wei Shen , qiao-wei Chen , Cai-xia Dong , Yang-chun Xu
Published: August 2014

A rapid and reliable method is required to determine the N status of pear (Pyrus communis L.) leaves during the growing season for timely fertilization to improve the yields and fruit quality. In the present study, we evaluated visible and near‐infrared reflectance (Vis/NIR) spectra of fresh pear leaves using partial least squares (PLS) regression to determine the N concentration of fresh pear leaves. In addition, we studied the performance of modified spectra generated using different preprocessing techniques. A total of 450 leaf samples were collected from 6‐yr‐old pear trees of two cultivars, and randomly separated into two subsets (calibration subset [294 samples] and validation subset [180 samples]) after excluding outliers by using principle component analysis. Results showed that the model built using full spectra performed better than that developed using characteristic wavelength segments. In addition, we found that original spectral proved to provide better accuracy than derivative spectra. Among the studied preprocessing techniques, moving average smoothing (MAS) technique improved accuracy the most. Overall results suggested that PLS regression with preprocessing of full spectra using MAS is optimal method for modeling N concentration of fresh pear leaves which yielded 0.961 and 0.953 coefficient of determination (R2) for calibration and cross‐validation, respectively. The validation of this method resulted high R2 value (0.847) and low mean relative error (4.48%). In conclusion, this model could provide a rapid and more reliable method to determine the total N concentration in fresh pear leaves and could be useful for fertilization management in pear orchards.
Soybean Maturity Group Choices for Early and Late Plantings in the Midsouth
Authors: Salmeron Montserrat , Gbur Edward E. , Bourland Fred M. , Buehring Normie W. , Earnest Larry , Fritschi Felix B. , Golden Bobby R. , Hathcoat Daniel , Lofton Josh , Miller Travis D. , Neely Clark , Shannon Grover , Udeigwe Theophilus K. , Verbree David A. , Vories Earl D. , Wiebold William J. , Purcell Larry C.
Published: August 2014

Growing conditions in the U.S. Midsouth allow for large soybean [Glycine max L. (Merr.)] yields under irrigation, but there is limited information on planting dates (PD) and maturity group (MG) choices to aid in cultivar selection. Analysis of variance across eight (2012) and 10 (2013) locations, four PD, and 16 cultivars (MG 3–6), revealed that the genotype by environment (G×E) interaction accounted for 38 to 22% of the total yield variability. Stability‐analysis techniques and probability of low yields were used to investigate this interaction. Planting dates were grouped within early‐ and late‐planting systems. Results showed that MG 4 and 5 cultivars in early‐planting systems had the largest average yields, whereas for late‐planting systems, late MG 3 to late MG 4 cultivars had the largest yields. Least square means by MG within planting systems at each environment showed that MG 4 cultivars had the greatest yields or were not significantly different from the MG with the greatest yields in 100% of the environments for both early‐ and late‐planting systems. Yields of MG 5 cultivars were similar to those of MG 4 in 100% of the environments with an early planting but only in 20% of the environments with a late planting. The MG 3 cultivars were the best second choice for late plantings, with similar yields to MG 4 cultivars in 55 to 75% of the environments. These results have profound implications for MG recommendations in irrigated soybean in the U.S. Midsouth and indicate the need to reconsider common MG recommendations.
Dynamic programming approach (DPA) for assessment of water quality network: a case study of the Sefīd-Rūd River
Authors: Asadollahfardi G. , Asadi M. , Nasrinasrabadi M. , Faraji A.
Published: August 2014

Due to financial constraints, water quality monitoring network design is an efficient way to manage water quality. The most crucial part is to find appropriate locations for monitoring stations. Considering the objectives of water usage, we evaluate existing water quality sampling stations of the Sefīd-Rūd River, located in the north of Iran, which has been used for irrigation and drinking water. There are several methods for assessment of existing monitoring stations such as Sanders method, multiple criteria decision making and dynamic programming approach (DPA) which DPA was opted in this study. The results showed that out of 21 existing monitoring stations, eight and seven stations should be retained on the upstream and downstream of the basins, respectively. Although the area of the downstream basin is larger than the upstream basin, the number of stations which was retained was less than upstream. This may mean that water quality of the downstream is more favorable than the upstream. Meanwhile the technique may be also suitable for optimization of the water quality network.
Application of probability graph for understanding nitrate variation in river water: a case study in northern Anhui Province, China
Authors: Sun Linhua , Fu Jinmu , Zhang Sheng
Published: August 2014

Water in river is important for human beings. For better understanding the variations of nitrate concentrations in five main rivers in northern Anhui Province, China, the NH4+-N concentrations of the 168 river water samples collected during 2010 have been analyzed by probability graph. The results indicate that the concentrations of NH4+-N vary significantly, which implying the multi contributions of nitrate in the river. In comparison with the water quality standards of China, most of the samples (76.6%) can be used for agricultural and industrial purpose, and more than half of the samples (53.6%) can be used for drinking purpose. Moreover, probability plots, in combination with quantile and density plots have subdivided the concentrations of NH4+-N into five populations with four thresholds (0.28, 0.70, 1.64 and 6.14 mg/l), the concentrations <0.28 and 1.64 mg/l are considered to be representative of pristine and current environmental background, respectively, and concentrations >1.64 mg/l are considered to be representative of anthropogenic pollution.
Novel sludge management options for a large UK water company
Authors: Pearce P. , Mills N. , Winter P.
Published: August 2014

Thames Water is the largest water company in the UK. The company treats about 400,000 tonnes dry solids (tds) p.a. sewage sludge. The company's current strategic investment plans focus on improving treatment through enhanced digestion and reducing the wet mass of sludge recycled to land. Thames recognises sludge as a resource and is evaluating advanced options to unlock the full energy potential from sludge. Anaerobic digestion has been the foundation of sludge treatment and, in combination with combined heat and power, is the main process for recovering renewable energy in Thames Water and in the UK Water Industry. It is our view that sludge drying is an essential stage for advanced energy recovery process technologies such as pyrolysis or gasification. Efficient use of waste heat is critical to the economic and environmental sustainability of sludge management. Innovative technologies are a key part for the vision to convert a water company into a renewable energy provider.