bluuebunny/crossref_metadata_2025 huggingface dataset:
Reliability of Noninvasive Assessment of Systolic Pulmonary Artery Pressure by Doppler Echocardiography Compared to Right Heart Catheterization: Analysis in a Large Patient Population
Authors: Greiner Sebastian , Jud Andreas , Aurich Matthias , Hess Alexander , Hilbel Thomas , Hardt Stefan , Katus Hugo A. , Mereles Derliz
Published: August 2014

Background

Pulmonary artery pressure (PAP) is an important marker in cardiovascular disorders, being closely associated with morbidity and mortality. Noninvasive assessment by Doppler echocardiography is recommended by current guidelines. So far, the reliability of this method has been assessed only in small studies with contradictory results. Therefore, the aim of this study was to analyze the reliability of noninvasive PAP assessment by Doppler echocardiography compared to invasive measurements in a large patient population.

Methods and Results

We retrospectively analyzed data from a large tertiary cardiology department over 6 years in order to compare invasively measured PAP to estimated PAP from echocardiography examinations. N=15 516 patients fulfilled inclusion criteria and n=1695 patients with timely matched examinations (within 5 days) were analyzed. In n=1221 (72%) patients, pulmonary hypertension (PH) was diagnosed invasively (postcapillary PH: n=1122 [66%]; precapillary PH: n=99 [6%]). Systolic pulmonary artery pressure (sPAP) was 45.3±15.5 mm Hg by Doppler echocardiography and 47.4±16.4 mm Hg by right heart catheterization. Pearson's correlation coefficient was
r
=0.87 (
P
<0.0001). Mean right atrial pressure (RAP) was 12.0±5.7 mm Hg by right heart catheterization and was estimated to be 12.1±6.6 mm Hg by echocardiography (
r
=0.82,
P
<0.0001). Bland–Altman analysis showed a bias of −2.0 mm Hg for sPAP (95% limits of agreement −18.1 to +14.1 mm Hg) and +1.0 mm Hg for RAP (95% limits of agreement +0.1 to +1.9 mm Hg). Noninvasive diagnosis of pulmonary hypertension with Doppler echocardiography had a good sensitivity (87%) and specificity (79%), positive and negative predictive values (91% and 70%), as well as accuracy (85%) for a sPAP cut‐off value of 36 mm Hg (AUC 0.91,
P
<0.001, CI 0.90 to 0.93).

Conclusions

In this study, Doppler echocardiography proved to be a reliable method for the assessment of sPAP, being well suited to establish the noninvasive diagnosis of pulmonary hypertension in patients with cardiac diseases.
Effect of High-Dose Atorvastatin on Renal Function in Subjects With Stroke or Transient Ischemic Attack in the SPARCL Trial
Authors: Amarenco Pierre , Callahan Alfred , Campese Vito M. , Goldstein Larry B. , Hennerici Michael G. , Messig Michael , Sillesen Henrik , Welch K. Michael A. , Wilson Daniel J. , Zivin Justin A.
Published: August 2014

Background and Purpose—

Higher low-density lipoprotein cholesterol is associated with more rapid chronic kidney disease progression; reduction in cholesterol with statins, in conjunction with statins’ pleiotropic effects, such as decreasing inflammation, may be renoprotective. The Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) trial assessed the effect of statin treatment on the risk of nonfatal and fatal stroke in subjects with a noncardioembolic stroke or transient ischemic attack, no known coronary heart disease, and low-density lipoprotein cholesterol between 2.6 and 4.9 mmol/L (100–190 mg/dL).

Methods—

We explored the effect of randomization to atorvastatin 80 mg/d or placebo on the change in estimated glomerular filtration rate (eGFR; using the 4-component Modification of Diet in Renal Disease Study equation) in SPARCL subjects (n=4731) with (eGFR, <60 mL/min per 1.73 m
2
; n=3119) and without (eGFR, ≥60 mL/min per 1.73 m
2
; n=1600) chronic kidney disease overall and by glycemic status at baseline.

Results—

Mean baseline eGFR was similar between treatment groups (65.5±0.26 versus 65.6±0.26 mL/min per 1.73 m
2
atorvastatin versus placebo; 33% versus 34% had chronic kidney disease, respectively;
P
=0.55). After 60 months, eGFR increased 3.46±0.33 mL/min per 1.73 m
2
in those randomized to atorvastatin versus 1.42±0.34 mL/min per 1.73 m
2
in those randomized to placebo (
P
<0.001) independent of baseline renal function. In the subgroup with diabetes mellitus at randomization, eGFR increased 1.12±0.92 mL/min per 1.73 m
2
in the atorvastatin group and decreased 1.69±0.92 mL/min per 1.73 m
2
in placebo group during a period of 60 months (
P
=0.016).

Conclusions—

This post hoc analysis suggests that atorvastatin treatment may improve renal function in patients with prior stroke or transient ischemic attack with and without chronic kidney disease, and that atorvastatin treatment may prevent eGFR decline in patients with stroke and diabetes mellitus.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00147602.
A brief look at the Odonata from the Páramo ecosystems in Colombia, with the descriptions of Oxyallagma colombianum sp. nov. and Rhionaeschna caligo sp. nov. (Odonata: Coenagrionidae, Aeshnidae, Libellulidae)
Authors: BOTA-SIERRA CORNELIO ANDRÉS
Published: August 2014

Here I present the results of field work and collections of Odonata made in several páramos of Colombia between 2007 and 2014. Two undescribed species, in the genera Oxyallagma Kennedy, 1920, and Rhionaeschna Förster, 1909, respectively, were found, as well as two species not previously recorded from Colombia: Rhionaeschna peralta (Ris, 1918) and Oxyallagma dissidens (Selys, 1876). Descriptions and diagnoses of the new species, photographs, maps, illustrations, natural history notes, and comments on morphological plasticity are presented.
Two new species and a new record of Scale-worms (Polychaeta) from Southwest Atlantic deep-sea coral mounds
Authors: MIRANDA VINÍCIUS DA ROCHA , BRASIL ANA CLAUDIA DOS SANTOS
Published: August 2014

Two new species of scale-worms, Harmothoe ruthae sp. nov. (Polynoidae) and Pholoides sinepapillatus sp. nov. (Sigalionidae) are described. In addition, we expand the description of Harmothoe gilchristi and extend its distribution to the Southwest Atlantic. The three species were found among the species of corals Lophelia pertusa, Solenosmilia variabilis, Enallopsammia rostrata, Madrepora oculata and Errina sp., a total of 257 samples of these corals were taken between 570 m and 1040 m depth, at the North-East coast of Rio de Janeiro, Brazil.
Investigation of Low-Cloud Characteristics Using Mesoscale Numerical Model Data for Improvement of Fog-Detection Performance by Satellite Remote Sensing
Authors: Ishida Haruma , Miura Kentaro , Matsuda Teruaki , Ogawara Kakuji , Goto Azumi , Matsuura Kuniaki , Sato Yoshiko , Nakajima Takashi Y.
Published: August 2014

The comprehensive relationship between meteorological conditions and whether low water cloud touches the surface, particularly at sea, is examined with the goal of improving low-cloud detection by satellite. Gridpoint-value data provided by an operational mesoscale model with integration of Multifunction Transport Satellite-2 data can provide sufficient data for statistical analyses to find general parameters that can discern whether low clouds touch the surface, compensating for uncertainty due to the scarcity of observation sites at sea and the infrequent incidence of fog. The analyses reveal that surface-touching low clouds tend to have lower cloud-top heights than those not touching the surface, although the frequency distribution of cloud-top height differs by season. The bottom of the Γ > Γm layer (where Γ and Γm are the vertical gradient and the moist-adiabatic lapse rate of the potential temperature, respectively) with surface-touching low-cloud layers tends to be very low or almost attached to the surface. In contrast, the tops of low-cloud layers not touching the surface tend to occur near the bottom of the Γ > Γm layer. Mechanisms to correlate these meteorological conditions with whether low clouds touch the surface are inferred from investigations into the vertical structure of equivalent potential temperature. These results indicate that the temperature difference between cloud-top height and the surface can be an appropriate parameter to infer whether low clouds touch the surface. It is also suggested that only a little addition of meteorological ancillary data, such as the forecast sea surface temperature, to satellite data allows successful performance of the discrimination.
A Method to Deconvolve Errors in GPS RO-Derived Water Vapor Histograms
Authors: Kursinski E. Robert , Gebhardt Thomas
Published: August 2014

Water vapor is an important constituent in the earth’s atmosphere that must be understood to predict weather and climate. Water vapor is challenging to measure, and observations of water vapor must be as independent of weather and climate models as possible in order to assess and improve those models. When combined with independent atmospheric temperature estimates, GPS radio occultation (RO) refractivity profiles yield unique, all-weather, high-vertical-resolution, globally distributed profiles of tropospheric water vapor whose vertical extent is maximum at low latitudes. A method for retrieving water vapor, known as the direct method, combines GPS RO-derived refractivity with temperatures from global weather analyses. Unlike variational methods, the direct method does not use the water vapor estimates from analyses because of their potential systematic errors. While utilization of the direct method has been limited because it produces negative values, these unphysical negative values reveal unique information about errors. A deconvolution technique is presented here that uses the negative values to estimate and remove random errors in histograms of water vapor derived via the direct method. Results indicate direct method specific humidity errors at low latitudes range from 0.4 g kg−1 at 725 hPa to 0.14 g kg−1 near 350 hPa, which can be removed via deconvolution. The deconvolved histograms extend to about the 240-K level in the troposphere, corresponding to 10 km at low latitudes. Unlike the limited information of low-order statistical moments like means and variances, histograms capture the full range of variability, which opens a new window into water vapor behavior and increases understanding of processes at work in the hydrological cycle.
On the Mesoscale Structure of Surface Wind and Pressure Fields near Tornadic and Nontornadic Cold Fronts
Authors: Clark Matthew R. , Parker Douglas J.
Published: August 2014

Observations from a mesoscale network of automatic weather stations are analyzed for 15 U.K. cold fronts exhibiting narrow cold frontal rainbands (NCFRs). Seven of the NCFRs produced tornadoes. A time-compositing approach is applied to the minute-resolution data using the radar-observed motion vectors of NCFR precipitation segments. Interpolated onto a 5-km grid, the analyses resolve much of the small-mesoscale structure in surface wind, temperature, and pressure fields. Postfrontal winds varied substantially between cases. Tornadic NCFRs exhibited a near-90° wind veer and little or no reduction in wind speed on NCFR passage; these attributes were generally associated with large vertical vorticity, horizontal convergence, and vorticity stretching at the NCFR. Nontornadic NCFRs exhibited smaller wind veers and/or marked decreases in wind speed across the NCFR, and weaker vorticity, convergence, and vorticity stretching. In at least four tornadic NCFRs, increases in vorticity stretching preceded tornadogenesis. Doppler radar observations of two tornadic NCFRs revealed the development of misocyclones, some tornadic, during the latter stages of vorticity-stretching increase. The presence of cyclonic vortices only, in one case occurring at regular intervals along the NCFR, provides limited circumstantial evidence for horizontal shearing instability (HSI), though other vortex-genesis mechanisms cannot be discounted. Vorticity-stretching increases were associated with coherent mesoscale structures in the postfrontal wind field, which modified the cross-frontal convergence. Where cross-frontal convergence was large, extremely narrow, intense shear zones were observed; results suggest that tornadoes occurred when such shear zones developed in conjunction with conditional instability in the prefrontal environment.
“Do-Live-Well”: A Canadian framework for promoting occupation, health, and well-being
Authors: Moll Sandra E. , Gewurtz Rebecca E. , Krupa Terry M. , Law Mary C. , Larivière Nadine , Levasseur Mélanie
Published: August 2014

Background.

Occupational therapists can bring a unique and valuable perspective to the national dialogue on health promotion. Current approaches have a narrow focus on diet and exercise; a broader focus on occupation has the potential to enrich understanding regarding forces that contribute to health and well-being.

Purpose.

A new “Do-Live-Well” framework will be presented that is grounded in evidence regarding the links between what people do every day and their health and well-being.

Key Issues.

Elements of the framework include eight different dimensions of experience and five key activity patterns that impact health and well-being outcomes. Personal and social forces that shape activity engagement also affect the links to health and well-being.

Implications.

The framework is designed to facilitate individual reflection, community advocacy, and system-level dialogue about the impact of day-to-day occupations on the health and well-being of Canadians.
Uncovering the theoretical underpinnings of an interprofessional preschool intervention program: Tumbling Together
Authors: Eamer Claire R. , Lefebvre Pascal , Ducharme Daphne A.
Published: August 2014

Background.

Intervention programs are rarely tailored for children with self-regulation and communication challenges. Therefore, clinicians develop their own programs as is the case with the preschool program Tumbling Together. This program combines occupational therapy, speech-language therapy, and gymnastics.

Purpose.

The aim of this study was to take an in-depth look at the program to answer the following questions: (a) What are the fundamental concepts of the program? and (b) What is the underlying theoretical model that illustrates the relationships between concepts?

Method.

The qualitative research method of grounded theorizing using situational analysis was employed.

Findings.

Fourteen main concepts of the program were identified and informed the development of a theoretical model.

Implications.

A theoretical model incorporating Tumbling Together’s concepts is a first step in evaluating its efficacy. Although the concepts involved are not novel, their unique combination forms a promising intervention approach for this population.
Diffusion of Diaspora Enfranchisement Norms
Authors: Turcu Anca , Urbatsch R.
Published: August 2014

States have increasingly granted voting rights to their citizens overseas. Traditional accounts of franchise extension suggest that governments’ motivations are either political (new voters are expected to support the incumbent government) or, in the case of citizens abroad, materialist (a fortified link to migrants encourages remittance flows). Although these factors doubtless matter, they overlook the tendency for liberal norms to diffuse through the international system, as competition with and learning from neighbors motivate the adoption of relevant policies and institutions. We use large- N cross-national hazard models to examine whether a similar pattern holds for diaspora enfranchisement and find that neighbors’ recent enactment of overseas voting nearly doubles the chance that a country will enfranchise its own diaspora. This suggests a role for international norms in determining national voting policies.
‘What is wrong with a woman being chief?’ Women Chiefs and Symbolic and Substantive Representation in Botswana
Authors: Bauer Gretchen
Published: August 2014

Across the globe women are accessing national legislatures and executives in unprecedented numbers. Over the last 25 years several African countries have led the way in women’s representation in parliaments and, more recently, in cabinets. At the same time, governments and foreign donors are increasingly focusing on the role of traditional leaders in local-level politics as states democratize and decentralize across the continent. Once considered hopelessly undemocratic and patriarchal, traditional leaders are more recently viewed in many African countries as one half of a viable and effective hybrid system at the local level. In addition, whereas the role of chief has been largely the preserve of African men, African women are increasingly asserting a right to become chief. This article, using Botswana as a case study, suggests that the increased presence of women in national legislatures and executives may be having a symbolic representation effect on African women who are insisting that they too may access political power, even in positions formerly unavailable to them, such as chief. This article further suggests that, like their women counterparts in African parliaments, once they gain access to political office, women chiefs may substantively represent women’s interests, in venues such as a House of Chiefs and in their communities.
Effect of mixing conditions on the morphology and performance of fiber-reinforced polyurethane foam
Authors: Chang Li-Chi , Sain Mohini , Kortschot Mark
Published: August 2014

Polyol derived from soybean oil was used as a natural source preparation to create an environmentally friendly polyurethane foam. In order to stiffen these foams, wood fibers were added to provide reinforcement at low cost, while preserving the environmental friendly nature of the material. Mixing is a crucial step in the manufacture of reinforced foams and determines the fiber distribution and cell structure and hence the performance of the material. In this study, the effect of stirring variables on the mechanical properties of polyurethane foams was investigated and foams made using hand mixing were compared to foams made with a mechanical stirrer. Cell morphologies of the reinforced foams were characterized using scanning electron microscopy, X-ray computed tomography, and 3D stereo microscopy. The mechanical performance of the reinforced foam was essentially independent of stirring time and mainly depended on the variation in stirring rate. For foams made with high fiber fractions using a mechanical stirrer, the fibers were not as effective in increasing the compressive strength and modulus as they were in foams prepared by hand stirring. This suggests that mechanical stirring causes damage to the fibers, particularly at high fiber content.
Why is there so much evil?
Authors: Hasker William
Published: August 2014

The problem of evil is one that perplexes both believers and non-believers. The best approach to the problem is to see evil and suffering as the outcome of general policies God has adopted in creating and governing the world—policies which on the whole are good and beneficial, but which in specific cases lead to suffering for humans and other sentient creatures. Chief among these policies are the policy of allowing human beings to exercise free will in choosing between good and evil, and the policy of creating and sustaining a world of nature that operates according to its inherent laws, with divine interventions into the natural order comparatively infrequent. This approach benefits persons suffering from various evils by releasing them from an often fruitless search for “God’s reasons” for the evil in question, and enabling them to focus on the grace and strength given by Christ to live courageously in spite of their suffering.
DGridSim: a multi-model discrete-event simulator for real-time data grid systems
Authors: Doğan Atakan , Atanak Mustafa Müjdat , Tandoğan Safai , Altuğ Reha Oğuz , Şenel Hakan Güray
Published: August 2014

Data grid systems are utilized to share, manage, and process large data sets. On the other hand, an increasing number of applications with real-time constraints arise in several disciplines of science and engineering. The performance of a data grid system for real-time applications is highly dependent on the underlying job scheduling, data scheduling, and data replication algorithms and advance reservation mechanism. Thus, in the literature, there are numerous studies that propose solutions to the job/data scheduling, data replication, and advance reservation problems. In these studies, a number of simulators, emulators, or test beds have been used to evaluate the proposed algorithms. Furthermore, these simulators/emulators usually adopt fixed-grid models, which in turn dictate specific job/data scheduling and data replication mechanisms. In the literature, there is no unified framework for modeling grid systems with different architectures, which can allow researchers to develop new grid system models and evaluate them in a flexible manner. This paper presents a unique framework for modeling real-time data grid systems that attempts to unify a large class of job scheduling, data scheduling, and data replication algorithms based on several system services. Then, in order to enable the development of these algorithms under different system models, DGridSim is realized to be a multi-model discrete-event simulator, and its capabilities are exemplified by means of a set of simulation results. The main contribution of the research is DGridSim, which can model and simulate a variety of different data grid system models by means of several system services and their interactions.
Evaluation method for yarn diameter unevenness based on image sequence processing
Authors: Zhong Ping , Kang Zhang , Han Sen , Hu Rui , Pang Jiayu , Zhang Xiuyun , Huang Fanxia
Published: August 2014

This article proposes a testing and evaluation method for the unevenness of yarns based on measuring diameters of a series of testing points contained in the image sequence captured from a moving yarn. The address mapping table is used to achieve automatically measuring diameters of all testing points by fast addressing and locating their positions in the image sequence. Measuring the diameter of the testing point is based on the sub-image containing the testing point segmented from the captured image. In the yarn body extraction, according to the distribution character of gray-level projection, the sub-image is firstly divided into the yarn noumenon section, suspected noumenon section and image background section. Then the pixels of the suspected noumenon section are further categorized according to gray-level characters and connectivity to the yarn noumenon section. Finally, the complete yarn body image could be extracted. The diameter of the yarn testing point was represented by the average value of the neighboring point diameters in the axial direction. We compared the proposed method with the traditional measuring method by testing the same kind of yarn and performed an analysis using mathematical statistics methods. It proved that the proposed method can automatically process a continuous yarn image sequence and realize large sample statistics and unevenness evaluation.
Clientelism a Stumbling Block for Democratization?
Authors: Seffer Kristin
Published: August 2014

Clientelism is a form of social conflict management and as such is more than mere vote buying or a way of undermining rational-legal systems. Integrating clientelism into the debate over the transition to democracy makes it possible to explain the outcomes of stagnating political transition processes. Under the condition of labor surplus, clientelism hinders political inclusion by undermining the class-based organizations that might challenge the privileged access of the elite to resources. Consideration of clientelism helps explain the case of Mexico, which has been classified as a deviant case in transition research because two transition processes there, at the beginning and the end of the twentieth century, did not end in complete democratization.

El clientelismo es una forma de gestión del conflicto social y, como tal, es algo más que la mera compra de votos o una manera de socavar los sistemas racional-legales. La integración de clientelismo en el debate sobre la transición a la democracia hace posible explicar los resultados de procesos de transición política estancados. Bajo la condición de mano de obra excedente, el clientelismo dificulta la inclusión política, socavando las organizaciones de clase que podría desafiar el acceso privilegiado de la élite a los recursos. Reflexión sobre el clientelismo ayuda a explicar el caso de México, que ha sido clasificado como un caso anormal en la investigación de transición debido a que dos procesos de transición allí, al principio y al final del siglo XX, no resultaron en la democratización completa.
Identification and cuckoo PI-PD controller design for stable and unstable processes
Authors: Nema Swapnil , Kumar Padhy Prabin
Published: August 2014

In this paper, a method for the identification and control of stable and unstable processes is proposed. Firstly, a second-order plus delay time process model is identified using an ideal relay in the feedforward path and then, a proportional integral–proportional derivative (PI-PD) controller is designed based on the identified process model. The PD controller is designed that stabilizes the process and the PI controller is designed using the cuckoo optimization algorithm. The effectiveness of the proposed identification and control method is illustrated and verified by simulation and experimental results.
The Politics of Intergovernmental Transfers in Northeast Thailand
Authors: Wongpredee Achakorn , Sudhipongpracha Tatchalerm
Published: August 2014

Public finance theory dictates that intergovernmental transfers should help alleviate horizontal fiscal imbalances among local jurisdictions. The amount of intergovernmental fiscal transfers should be inversely related to each local jurisdiction’s revenue-generating capacity. However, intense politicking in many countries turns an intergovernmental fiscal transfer system into a battle of local and particularistic interests. This article illustrates a disjuncture between the theory and practice of intergovernmental equalization transfers with the quantitative and qualitative evidence from 226 local administrative organizations in Khon Kaen province in northeastern Thailand. Findings indicate that Thailand’s current intergovernmental fiscal transfer system is not oriented toward achieving local horizontal equity. In Khon Kaen, local administrative organizations with high fiscal capacity tend to receive more equalization grants than financially disadvantaged jurisdictions. In-depth interviews with selected local government officials in Khon Kaen reveal inconsistency and heavy politicization of the country’s intergovernmental fiscal transfer system.
Capital Accumulation, Profitability, and Crisis
Authors: Bakir Erdogan
Published: August 2014

This paper uses the rate of profit to address the issue of structural changes in class relationships and the process of capital accumulation that occurred under neoliberalism. I take a long-term class perspective and show that changing class relationships along with the financialization of the economy beginning in early 1980s progressively set the stage for the crisis of 2007-2009.
Influences of ammonia contamination on leaching from air-pollution-control residues
Authors: Guan Zhenzhen , Chen Dezhen , Astrup Thomas Fruergaard
Published: August 2014

Application of selective non-catalytic reduction systems at municipal solid waste incinerators (MSWIs) often involves over-stoichiometric injection of ammonia into flue gases. Un-reacted ammonia may be deposited on fly ash particles and can ultimately influence the leaching behaviour of air-pollution-control (APC) residues. Batch tests were conducted to investigate the impacts of ammonia levels on leaching of a range of metals (sodium, potassium, calcium, aluminium, chromium, iron, lead, cadmium, copper, nickel and zinc), as well as chloride and dissolved organic carbon (DOC). Specific conductivity was also identified to reflect the soluble components. The results showed that with ammonia concentrations rising from a background level of 4 to 26,400 mg l−1, the specific conductivity increased by 2–7 times as pH varied from alkaline to acidic values. DOC release was also significantly enhanced with high ammonia levels of 1400 mg l−1 or higher at pH > 9; however at these high ammonia concentrations, the role of DOC in cadmium, copper, nickel and zinc leaching was negligible. Based on the experimental data, chloride, sodium and potassium were leached at high concentrations regardless of pH and ammonia concentrations. For aluminium, chromium, iron and lead, ammonia had little impact on their leaching behaviour. With respect to cadmium, copper, nickel and zinc, high ammonia concentrations significantly increased leaching in the pH range of 8–12 due to the formation of metal-ammonia complexes, which was also proved in the speciation calculations. However, the overall results suggest that typical levels of ammonia injection in MSWIs are not likely to affect metal leaching from APC residues.
Prevention of carbon tetrachloride (CCl4)-induced toxicity in testes of rats treated with Physalis peruviana L. fruit
Authors: Abdel Moneim Ahmed E
Published: August 2014

Treatment of rats with carbon tetrachloride (CCl4; 2 ml/kg body weight) once a week for 12 weeks caused a significant decrease in serum levels of testosterone, luteinizing hormone, and follicle-stimulating hormone. These decreases in sex hormones were reduced with Physalis peruviana L. (Cape gooseberry) juice supplementation. In addition, testicular activity of antioxidant enzymes such as superoxide dismutase, catalase, glutathione peroxidase, glutathione reductase, and glutathione- S-transferase suppressed with CCl4 were elevated after P. peruviana juice supplements. P. peruviana juice supplementation significantly increased the testicular glutathione and significantly decreased the level of lipid peroxidation and the nitric oxide production compared with the CCl4 group. In addition, the decline in the activity of antioxidant enzymes after CCl4 was ameliorated by P. peruviana. Moreover, degeneration of germ and Leydig cells along with deformities in spermatogenesis induced after CCl4 injections were prevented with the supplementation of P. peruviana juice. Furthermore, P. peruviana juice attenuated CCl4-induced apoptosis in testes tissue by inhibition of caspase-3 activity. The results clearly demonstrate that P. peruviana juice augments the antioxidants defense mechanism against CCl4-induced reproductive toxicity and provides evidence that the juice may have a therapeutic role in free radical-mediated diseases and infertility.
A population assessment of mercury exposure from two cities of Pakistan with respect to freshwater and marine fish consumption
Authors: Shah Abdul Qadir , Kazi Tasneem Gul , Afridi Hassan Imran , Arain Mohammad Balal
Published: August 2014

In this study, we aimed to estimate the level of mercury (Hg) in scalp hair samples of human subjects and its association with consumption of sea- and freshwater fish species. The scalp hairs were collected from both genders (male and female) aged between 15 and 50 years ( n = 200), living in coastal areas of Karachi, who mostly consumed sea fish species, referred to as exposed subjects. For comparison purposes, scalp hair samples of both genders ( n = 160) were collected from the inhabitants of Karachi and Hyderabad cities who consumed freshwater fish species termed as referent subjects. The frequently consumed fresh and marine fish species were also collected. The level of Hg was determined in fish and scalp hair samples by cold vapor atomic absorption spectrometry, prior to ultrasonic-assisted acid digestion in a mixture of nitric acid and hydrogen peroxide. The validity of methodology was checked by certified reference material (CRM) BCR 397 (human hair) and DORM-2. The concentrations of Hg in sea- and freshwater fish were found in the range of 1.47–2.09 and 0.402–0.676 μg/g, respectively. The exposed subjects had significantly elevated levels of Hg in scalp hair samples (1.8–4.3 μg/g) as compared to referent subjects (0.87–1.95 μg/g) ( p < 0.001). A significant positive correlation was obtained between the concentration of Hg in hair and age of study population. Exposed and referent female subjects had higher levels of Hg in scalp hair than that in males of both study groups ( p = 0.02–0.031).
Feminist Spirituality as Lived Religion
Authors: Aune Kristin
Published: August 2014

How do feminists in the United Kingdom view spirituality and religion? What are their religious and spiritual attitudes, beliefs, and practices? What role do spirituality and religion play in feminists’ lives? This article presents findings from an interview-based study of 30 feminists in England, Scotland, and Wales. It identifies three characteristics of feminists’ approaches to religion and spirituality: They are de-churched, are relational, and emphasize practice. These features warrant a new approach to feminists’ relationships with religion and spirituality. Rather than, as others have done, equating feminism with secularism, secularization, or alternative spiritualities, the article reveals the complex ways feminists forge religio-spiritual lives. The interview data demonstrate that it is unwise to see “spirituality” and “religion” as analytically distinct. Instead, drawing on the growing field of scholarship on “lived religion,” the article proposes conceptualizing feminist spirituality as lived religion.
Antineoplastic Agents and the Associated Myelosuppressive Effects
Authors: Barreto Jason N. , McCullough Kristen B. , Ice Lauren L. , Smith Judith A.
Published: August 2014

Bone marrow is a complex organ responsible for the regulation of hematopoietic cell distribution throughout the human body. Patients receiving antineoplastic agents as a therapeutic intervention for hematologic malignancy often experience varying degrees of myelotoxicity. Antineoplastic agents cause hypocellularity in marrow resulting in a reduction in hematopoietic tissue activity and a corresponding decline in cell production. Quantifying the adverse effects on hematopoiesis is based on the properties of a single agent, the use of individual drugs within a combination chemotherapy regimen, and the course, or courses, of chemotherapy designed to treat cancer. The direct or indirect suppression of erythrocytes, granulocytes, and megakaryocytes has potential for multiple negative clinical consequences ranging from increased monitoring of blood counts to life-threatening infection and death. This review will provide an overview of the structure and function of competent adult bone marrow, describe the process of hematopoiesis, and characterize the myelotoxicities associated with common antineoplastic agents currently used in the treatment of cancer.
Waiting for Merlot
Authors: Kumar Amit , Killingsworth Matthew A. , Gilovich Thomas
Published: August 2014

Experiential purchases (money spent on doing) tend to provide more enduring happiness than material purchases (money spent on having). Although most research comparing these two types of purchases has focused on their downstream hedonic consequences, the present research investigated hedonic differences that occur before consumption. We argue that waiting for experiences tends to be more positive than waiting for possessions. Four studies demonstrate that people derive more happiness from the anticipation of experiential purchases and that waiting for an experience tends to be more pleasurable and exciting than waiting to receive a material good. We found these effects in studies using questionnaires involving a variety of actual planned purchases, in a large-scale experience-sampling study, and in an archival analysis of news stories about people waiting in line to make a purchase. Consumers derive value from anticipation, and that value tends to be greater for experiential than for material purchases.
Ethical challenges in care for older patients who resist help
Authors: Brodtkorb Kari , Skisland Anne Valen-Sendstad , Slettebø Åshild , Skaar Ragnhild
Published: August 2014

Background:

Situations where patients resist necessary help can be professionally and ethically challenging for health professionals, and the risk of paternalism, abuse and coercion are present.

Research question:

The purpose of this study was to examine ethical challenges in situations where the patient resists healthcare.

Research design:

The method used was clinical application research. Academic staff and clinical co-researchers collaborated in a hermeneutical process to shed light on situations and create a basis for new action.

Participants and research context:

Four research groups were established. Each group consisted of six to eight clinical co-researchers, all employees with different health profession backgrounds and from different parts of the municipal healthcare services, and two scientific researchers.

Ethical considerations:

The study was conducted in compliance with ethical guidelines and principles. Participants were informed that participation was voluntary and that confidentiality would be maintained. They signed a consent form.

Findings:

The findings showed that the situations where patients opposed help related to personal hygiene, detention in an institution and medication associated with dental treatment. The situations were perceived as demanding and emotionally stressful for the clinicians.

Discussion:

The situations can be described as everyday ethics and are more characterised by moral uncertainty and moral distress than by being classic ethical dilemmas.

Conclusion:

Norwegian legislation governing the use of force seems to provide decision guidance with the potential to reduce uncertainty and moral stress if the clinicians’ legal competence had been greater.
A new clinical guideline to improve sedation safety in patients transferred under the Mental Health Act from remote parts of Western Australia
Authors: Balaratnasingam Sivasankaran
Published: August 2014

Objective:

Clinicians dealing with referrals under the Mental Health Act in rural and remote parts of Australia face the difficult task of providing safe sedation whilst transferring the patient to an appropriate authorized facility. This paper reviews the efforts to overcome these challenges in the remote north-west of Australia.

Methods:

Senior medical staff undertook a review of sedation practice in the region. A search was made of the medical literature to determine whether evidence based treatment may exist elsewhere and this information was used in conjunction with consensus opinion to devise a new guideline.

Results:

Scant literature exists in the field of sedation and aeronautical evacuation of patients with acute mental health presentations in remote areas. Issues and challenges were identified and a new clinical guideline based on local expert consensus of good practice was developed.

Conclusions:

Standardizing the approach to managing agitated patients who are transferred under the Mental Health Act is essential in order to mitigate medical morbidity that may arise from sedation related complications. The sedation guideline developed by our service has been well received by staff, seems practical and feasible to implement and has the potential to reduce sedation related morbidity.
Paliperidone: another treatment option for delusional parasitosis
Authors: Altınöz Ali Ercan , Tosun Altınöz Şengül , Küçükkarapınar Melike , Coşar Behçet
Published: August 2014

Objective:

Patients with delusional parasitosis (DP) have a fixed belief of being infested by small pathogens. Typical and atypical antipsychotics are widely used for treating DP. There are limited controlled trials about the treatment of DP and the most useful antipsychotic agent is still unknown. Paliperidone treatment for DP will be demonstrated through two cases. One of these cases had previously used pimozide but had not responded to treatment. Both cases had remission from symptoms with paliperidone. There are only two case reports published about paliperidone treatment for DP.

Conclusion:

Paliperidone appears to have promise in the treatment of DP; however, more case reports and controlled trials are required.
Analysis of the torque characteristic of a magnetorheological clutch using neural networks
Authors: Bucchi F , Forte P , Frendo F
Published: August 2014

In this paper the dependence of the torque characteristic of a magnetorheological clutch on several working parameters is analyzed by means of a feedforward neural network. The clutch was envisaged to have the possibility to disengage the vacuum pump in diesel engine vehicles, in order to increase the overall vehicle efficiency.

A large set of test was carried out following different protocols in order to obtain a detailed characterization of the clutch. Results showed that, due to the characteristics of MR fluids and to the complex mechanism of torque transmission, the torque characteristics (both the yield torque and the torque-slip behavior) are a function of the relative speed between the input and output shafts, of the energy dissipated during the clutch slip and of the rest time between consecutive slippages. The data acquired during all tests were used to train a neural network with five input elements and one output element.

The developed neural network proved to satisfactorily reproduce the actual clutch properties and could be used in the future in an engine-vehicle simulator in order to model the torque characteristic of the clutch subjected to different operating cycles.
Assistive Technology Provision Within the Navajo Nation
Authors: Reisinger Kim D. , Ripat Jacquie D.
Published: August 2014

In this study we explored the factors that affect assistive technology (AT) provision within the Navajo Nation using a qualitative approach to inquiry. Focus groups were held in which AT users discussed their awareness of AT and their need for, use of, and satisfaction with AT devices and services. Twenty-eight individuals who used wheelchairs, orthotics or prosthetics, hearing aids, communication aids, vision aids, and other AT participated in one of seven focus groups. Seven AT providers discussed the facilitators and barriers that affect AT provision. The findings revealed six themes common to both stakeholder groups and two additional themes for AT users. The central theme for AT users centered on (not) feeling understood; the central theme for AT providers revolved around the processes, activities, and roles the providers engaged in at times for different clients. Activities to increase awareness and to promote successful AT provision and satisfaction with AT devices were proposed.
Narrative Transformation Among Military Personnel on an Adventurous Training and Sport Course
Authors: Carless David
Published: August 2014

In the wake of recent wars, some military personnel face considerable physical and mental health problems. In this article I explore the effects of an adapted sport and inclusive adventurous training course for military personnel who have experienced physical injury and/or psychological trauma. Using a dialogical narrative approach, I analyzed stories shared by six soldiers during the course to explore the effects of involvement. Participation in the course seemed to facilitate a narrative transformation or opening corresponding to a broadening identity and sense of self. Story plots progressed from a failing monological narrative, through a chaos narrative, toward a dialogical quest narrative prioritizing immersion in an intense present, a developing self, and a relational orientation. On the basis of narrative theory, I suggest this transformation holds positive consequences for the health and well-being of military personnel who have experienced injury and/or trauma.
Positive Tuberculosis Blood Test as a Predictor of Health Status Among HIV-Infected Persons
Authors: Natad Ashley , Moser Kathleen , Maiden Jeanne , Kim Son Chae
Published: August 2014

This cross-sectional study explored tuberculosis (TB) knowledge, attitudes, practice, and TB interferon-gamma release assay (IGRA) results as the predictor of self-reported poor mental and physical health among HIV-infected persons attending a sexually transmitted diseases clinic ( N = 111). The participants correctly responded to only 56.6% of the TB knowledge questions. Most had positive attitudes and would not be ashamed of TB diagnosis. The TB practice was suboptimal with only half having been tested for TB within the past 2 years. Eight percent of the participants had positive IGRA ( n = 9). Simultaneous multiple regression models showed that positive IGRA, an indicator of latent TB infection, was the only significant predictor of both poor mental health ( p = .006) and physical health days ( p = .016). IGRA screening and treatment of latent TB infection in HIV-infected persons could potentially improve their mental and physical health status in addition to reducing the TB reactivation rate.
A Qualitative Analysis of Parents With Children Diagnosed With Reading Disabilities
Authors: Dipeolu Abiola , Storlie Cassandra , Hargrave Stephanie J. , Cook Robin
Published: August 2014

Semistructured interviews were conducted with nine parents with children diagnosed with reading disability (RD). A phenomenological theoretical tradition was used to explore the meaning, structure, and essence of the shared experiences of these individuals. Results generated a deeper understanding of the lived experiences and challenges of families with children diagnosed with RD. Themes produced a need for a systemic model of home, school, and community collaboration, which may improve interaction and communication among all parties. Implications for research and working with families with children diagnosed with RD are discussed.
Improving Academic Self-Efficacy, School Connectedness, and Identity in Struggling Middle School Girls
Authors: Mann Michael J. , Smith Megan L. , Kristjansson Alfgeir L.
Published: August 2014

Girls struggling to be successful in middle school are often dealing with negative life experiences that affect their ability to achieve academically. Frequently, their academic failures and problem behaviors are associated with feeling overwhelmed by difficult and challenging life circumstances. In the absence of intervention, these patterns may contribute to girls chronically underperforming in school, dropping out of school, and becoming involved in delinquent and high-risk behaviors. This article describes a quasi-experimental, mixed-methods study of the REAL Girls program. REAL Girls was designed to help struggling middle school girls develop resilience—particularly academic self-efficacy, school connectedness, and identity—and achieve successful outcomes in school and life. In this study, using a crossover design, 48 girls identified as experiencing academic failure, school behavior problems, or truancy participated in one of two implementations of this 3-day intervention. Findings based on both quantitative and qualitative data suggest that REAL Girls contributed to positive increases in academic self-efficacy, school connectedness, and identity. Repeated measures analysis of variance and paired t tests suggest significant increases in each outcome variable, both immediately after program delivery and 2 weeks later, and effect size estimates suggest moderate to large program impact. Focus groups conducted 90 days after implementation of the program confirmed the quantitative findings and support the efficacy of the REAL Girls program and approach.