bluuebunny/crossref_metadata_2025 huggingface dataset:
An examination of the effect of different methods of scoring pain after a total knee replacement on the number of patients who report unchanged or worse pain
Authors: W-Dahl A. , Sundberg M. , Lidgren L. , Ranstam J. , Robertsson O.
Published: September 2014

We identified a group of patients from the Swedish Arthroplasty Register who reported no relief of pain or worse pain one year after a total knee replacement (TKR). A total of two different patient-reported pain scores were used during this process. We then evaluated how the instruments used to measure pain affected the number of patients who reported no relief of pain or worse pain, and the relative effect of potential risk factors.

Between 2008 and 2010, 2883 TKRs were performed for osteoarthritis in two Swedish arthroplasty units. After applying exclusion criteria, 2123 primary TKRs (2123 patients) were included in the study. The Knee injury and Osteoarthritis Outcome Score (KOOS) and a Visual Analogue Scale (VAS) for knee pain were used to assess patients pre-operatively and one year post-operatively.

Only 50 of the 220 patients (23%) who reported no pain relief on either the KOOS pain subscale or the VAS for knee pain did so with both of these instruments. Patients who reported no pain relief on either measure tended to have less pain pre-operatively but a higher degree of anxiety. Charnley category C was a predictor for not gaining pain relief as measured on a VAS for knee pain.

The number of patients who are not relieved of pain after a TKR differs considerably depending on the instrument used to measure pain.

Cite this article: Bone Joint J 2014;96-B:1222–6.
Dysplasia of the contralateral hip in patients with unilateral late-detected congenital dislocation of the hip
Authors: Terjesen T.
Published: September 2014

The aim of this study was to investigate the incidence of dysplasia in the ‘normal’ contralateral hip in patients with unilateral developmental dislocation of the hip (DDH) and to evaluate the long-term prognosis of such hips. A total of 48 patients (40 girls and eight boys) were treated for late-detected unilateral DDH between 1958 and 1962. After preliminary skin traction, closed reduction was achieved at a mean age of 17.8 months (4 to 65) in all except one patient who needed open reduction. In 25 patients early derotation femoral osteotomy of the contralateral hip had been undertaken within three years of reduction, and later surgery in ten patients. Radiographs taken during childhood and adulthood were reviewed. The mean age of the patients was 50.9 years (43 to 55) at the time of the latest radiological review.

In all, eight patients (17%) developed dysplasia of the contralateral hip, defined as a centre-edge (CE) angle < 20° during childhood or at skeletal maturity. Six of these patients underwent surgery to improve cover of the femoral head; the dysplasia improved in two after varus femoral osteotomy and in two after an acetabular shelf operation. During long-term follow-up the dysplasia deteriorated to subluxation in two patients (CE angles 4° and 5°, respectively) who both developed osteoarthritis (OA), and one of these underwent total hip replacement at the age of 49 years.

In conclusion, the long-term prognosis for the contralateral hip was relatively good, as OA occurred in only two hips (4%) at a mean follow-up of 50 years. Regular review of the ‘normal’ side is indicated, and corrective surgery should be undertaken in those who develop subluxation.

Cite this article: Bone Joint J 2014; 96-B:1161–6.
Dilemmas in imaging for peri-acetabular osteotomy
Authors: Kosuge D. , Cordier T. , Solomon L. B. , Howie D. W.
Published: September 2014

Peri-acetabular osteotomy is an established surgical treatment for symptomatic acetabular dysplasia in young adults. An anteroposterior radiograph of the pelvis is commonly used to assess the extent of dysplasia as well as to assess post-operative correction. Radiological prognostic factors include the lateral centre-edge angle, acetabular index, extrusion index and the acetabular version. Standing causes a change in the pelvis tilt which can alter certain radiological measurements relative to the supine position. This article discusses the radiological indices used to assess dysplasia and reviews the effects of patient positioning on these indices with a focus on assessment for a peri-acetabular osteotomy. Intra-operatively, fluoroscopy is commonly used and the implications of using fluoroscopy as a modality to assess the various radiological indices along with the effects of using an anteroposterior or posteroanterior fluoroscopic view are examined. Each of these techniques gives rise to a slightly different image of the pelvis as the final image is sensitive to the position of the pelvis and the projection of the x-ray beam.

Cite this article: Bone Joint J 2014;96-B:1155–60.
Carpal tunnel decompression in the super-elderly
Authors: Stone O. D. , Clement N. D. , Duckworth A. D. , Jenkins P. J. , Annan J. D. , McEachan J. E.
Published: September 2014

There is conflicting evidence about the functional outcome and rate of satisfaction of super-elderly patients (≥ 80 years of age) after carpal tunnel decompression.

We compiled outcome data for 756 patients who underwent a carpal tunnel decompression over an eight-year study period, 97 of whom were super-elderly, and 659 patients who formed a younger control group (< 80 years old). There was no significant difference between the super-elderly patients and the younger control group in terms of functional outcome according to the mean (0 to 100) QuickDASH score (adjusted mean difference at one year 1.8; 95% confidence interval (CI) -3.4 to 7.0) and satisfaction rate (odds ratio (OR) 0.78; 95% CI 0.34 to 1.58). Super-elderly patients were, however, more likely to have thenar muscle atrophy at presentation (OR 9.2, 95% CI 5.8 to 14.6). When nerve conduction studies were obtained, super-elderly patients were more likely to have a severe conduction deficit (OR 12.4, 95% CI 3.0 to 51.3).

Super-elderly patients report functional outcome and satisfaction rates equal to those of their younger counterparts. They are more likely to have thenar muscle atrophy and a severe nerve conduction deficit at presentation, and may therefore warrant earlier decompression.

Cite this article: Bone Joint J 2014; 96-B:1234–8.
“Self-prevention”: uma estratégia de prevenção de incêndios florestais na Raia Central Ibérica
Authors: Nunes Adélia , Lourenço Luciano , Vieira António , Bento-Gonçalves António
Published: September 2014

O “Self-Prevention” é um projeto transfronteiriço que visa a reintrodução, a partir de 2012, de 150 mil cabras com o objetivo de limpar os terrenos raianos (dos distritos da Guarda e Bragança e das províncias de Salamanca e Zamora), sobretudo ao nível dos estratos herbáceo e arbustivo, e assim prevenir a ocorrência de incêndios florestais, nesta área. Com o presente trabalho pretendem-se analisar e discutir as consequências ambientais decorrentes da implementação desta estratégia, sobretudo, ao nível do solo, comparando, para esse efeito, a resposta hidrogeomorfológica de solos sob diversos usos e cobertos vegetais, designadamente, com vegetação arbustiva dominante (Cytisus multiflorus), após a ocorrência de incêndios florestais, sob pastagens (na sequência da introdução de pastoreio extensivo) e, por último, solos sujeitos ao controlo, através da roça do mato nas comunidades arbustivas dominantes.
O impacto do ambiente nos níveis de obesidade infantil: quando o território emerge como um fator de diferenciação e risco
Authors: Nogueira H. , Ferrão M. M. , Gama A. , Grespan F. , Mourão I. , Marques V. Rosado , Padez C.
Published: September 2014

Este estudo investiga as associações entre as percepções parentais do ambiente construído e social do local de residência e a prevalência de obesidade infantil segundo o género das crianças. Estuda-se ainda a oferta de modalidades desportivas infantis, verificando a sua potencial contribuição para os valores observados de excesso de peso/obesidade. Numa primeira fase, observaram-se 1885 crianças em idade escolar (3-10 anos) residentes no distrito de Coimbra. Nesta amostra, verificou-se uma associação significativa entre a percepção parental do ambiente construído e social e os valores de obesidade no sexo feminino. Numa segunda fase, verificou-se que a oferta de modalidades desportivas na cidade de Coimbra é desequilibrada, restringindo fortemente as oportunidades de prática desportiva às crianças do sexo feminino. Em 67 oportunidades de prática desportiva observadas na cidade, verificou-se que 32 eram mistas, 23 eram direccionadas para o sexo masculino e 12 para o sexo feminino. Conclui-se que as crianças do sexo feminino sofrem processos de discriminação ambiental cujo impacte na saúde pode ser nefasto. Neste contexto, argumenta-se a necessidade de intervenções ambientais, não só como forma de promoção da saúde, mas também de equidade entre os géneros.
Cartografia de suscetibilidade a deslizamentos e unidades territoriais de risco à escala regional: o caso da região Figueira da Foz – Nazaré
Authors: Ramos Anabela , Cunha Lúcio , Cunha Pedro P. , Freitas M. Isabel Castreghini
Published: September 2014

Este trabalho faz uma análise da suscetibilidade a deslizamentos na área da plataforma litoral entre a Figueira da Foz e a Nazaré. Pretende-se efetuar uma cartografia de suscetibilidade, pelo método de análise hierárquica de pares, que constitua um instrumento para o ordenamento do território e para a gestão de risco, permitindo definir áreas prioritárias para estudos de pormenor. Poderemos enunciar, para a área estudada, diferentes tipos de processos perigosos naturais: sismos, erosão litoral, inundações, incêndios florestais, movimentos de massa (deslizamentos, desabamentos e fluxos). Estes afetam desigualmente as diferentes unidades territoriais, tendo por base as suas características físicas e de uso dos solos: Serras calcárias, Colinas gresosas, Planícies aluviais, Campo dunar eólico, Faixa litoral, Corredores neotectónicos (alinhamentos tectónicos e núcleos diapíricos).
Grandes incêndios florestais em Portugal Continental. Da história recente à atualidade
Authors: Ferreira-Leite Flora , Bento-Gonçalves António , Lourenço Luciano
Published: September 2014

O fogo é um elemento presente nas paisagens dos países do Sul da Europa, tendo acompanhado o pastoreio e os desbastes da floresta, através do tempo, e condicionado o desenvolvimento ou regressão dos ecossistemas florestais (Alves et al., 2006).As mudanças socioeconómicas em curso nos países do Sul da Europa, na segunda metade do seculo XX, refletiram-se no uso tradicional da terra e estilo de vida das populações e traduziram-se no aumento de grandes áreas de terras agrícolas abandonadas, muitas das quais se tornaram paisagens propensas à ocorrência de incêndios de grande intensidade, devido aos elevados níveis de biomassa, acumulados ao longo dos anos e prontos para alimentar fogos catastróficos durante o Verão.Com os grandes incêndios a aumentar em frequência e extensão, tomando, por vezes, dimensões catastróficas, perdeu-se o seu importante papel de renovadores dos ecossistemas (Noss et al., 2006).
Nach der Ironie
Authors: Halfmann Roman
Published: September 2014

Ist es möglich, im Zeitalter der unendlichen Ironie authentische Kunst zu schaffen oder ein sich originell anfühlendes Leben zu führen? - Diese sehr gegenwärtigen Fragen finden sich im Werk von David Foster Wallace immer wieder. In dem postumen Roman »The Pale King« kommt er zu einer überraschenden Antwort - nämlich einer Poetik der Langeweile, die er im Verweis auf Franz Kafka entwickelt. Roman Halfmann zeigt, dass Wallace nicht allein eine poetologische Auseinandersetzung anstrebte, sondern, ähnlich wie Kafka, auch eine völlig neue Lebenshaltung, durch welche das Dilemma der Postmoderne überwunden werden könnte.
Gegenarchive
Authors: Herzberg Julia
Published: September 2014

Gewalttätig, naiv und stumm - nach der Aufhebung der Leibeigenschaft 1861 galt diese Charakterisierung des russischen Bauern nicht mehr. Der Bauer wurde zum Symbol für eine in Bewegung geratene Gesellschaft. In Autobiographien und Tagebüchern erzählten Bauern ihre Leben als Sklaven, Autodidakten oder religiös Erweckte und eroberten eine Leserschaft, die in diesen Texten neben dem vermeintlich ›echten‹ Bauern auch alternative Gesellschaftsentwürfe fand. Julia Herzberg analysiert Entstehungssituationen, Publikation und Überlieferung dieser einzigartigen Quellen bis zur Kollektivierung der 1930er Jahre, die mit der bäuerlichen Autonomie auch das Erzählen über das eigene Leben erstickte.
Schwarz besetzt
Authors: Kilian Cassis
Published: September 2014

Am Tag nach der Wahl von Barack Obama hieß es, dass man James Bond jetzt mit einem Schwarzen besetzen wolle. In Afrika ist man da längst weiter: Der Sheriff kommt aus Ouagadougou, ein Nigerianer spielt George W. Bush, Dürrenmatts »alte Dame« spricht Wolof - und selbst Schwarzenegger wird umbesetzt. Im afrikanischen Film übernehmen schwarze Schauspieler Rollen, die in Europa und den USA weißen Darstellern vorbehalten sind. Die Rollen der Weißen werden zu einem Imaginationsraum, der eine Inszenierung von Planspielen ermöglicht. Cassis Kilian zeigt: Die afrikanischen Regisseure nutzen die Rollen als Verhandlungsplattform, auf der sie den Umgang mit postkolonialen Gegebenheiten, etwa dem kolonialen Erbe, neokolonialen Strukturen oder der Hegemonie westlicher Medien erproben.
Kleine Mädchen und High Heels
Authors: Dangendorf Sarah
Published: September 2014

Enge Kleidung, hohe Schuhe und Make-up sind heute oft schon bei Zehnjährigen alltäglich - eine Schönheitspraxis, die immer wieder auf Kritik stößt. Doch was steckt hinter der »visuellen Sexualisierung« junger Mädchen? Das Buch greift diese Frage auf und zeigt: Entscheidend sind jene Bedeutungen, die die Akteurinnen selbst ihrem Äußeren zuschreiben. Ihre Praktiken repräsentieren nicht etwa sexuelle Frühreife, sondern vielmehr ihren tiefen Wunsch nach Normalität, ihre Konfrontation mit veränderten Anforderungen von außen und die Gewissheit, weit vor dem Erwachsenenalter für sich selbst verantwortlich zu sein.
Procalcitonin in early rule-in/rule-out of sepsis in SIRS patients admitted to a medical ward
Authors: Fiotti Nicola , Mearelli Filippo , Ruscio Maurizio , Altamura Nicola , Vinci Pierandrea , Fernandes Giovanni , De Nardo Margherita , Lombardi Jacopo , Mamolo Lorenza , Chendi Enrico , Breglia Andrea , Peretti Alberto , Peric Daniele , Orso Daniele , Pivetti Giulia , Biolo Gianni
Published: September 2014

A relevant amount of patients with clinical suspect of sepsis is admitted and treated in medical wards (MW). These patients have a better prognosis but are older and with more comorbidities compared to those admitted to intensive care units (ICU). Procalcitonin (PCT) is extensively used in emergency departments for the diagnosis of sepsis, but its accuracy in the setting of a MW has not been thoroughly investigated. Predicted low PCT levels also call for the comparison of immunomagnetic-chemiluminescent (L-PCT) and time-resolved amplified cryptate emission (TRACE, K-PCT) technologies, in PCT determination.

In 80 patients with systemic inflammatory response syndrome (SIRS) diagnostic criteria and suspect of sepsis newly admitted to a MW, PCT was determined with L- and K-PCT method.

Sixty patients were diagnosed as sepsis (20 microbiologically and 40 clinically proven) and 20 with non-infective SIRS. The sepsis group had significantly higher levels of both PCTs, with no differences between the clinically and microbiologically proven subgroups. The areas under ROC curves for L- and K-PCT were 0.72 and 0.78 (p<0.001 for each), respectively. Based on MW customized cut-off values of 0.150 (L-PCT) and 0.143 ng/mL (K-PCT), overall accuracies were 66.8 (95% CI 58.7–78.9) and 78.2% (69.8–87.2), respectively, compared to the 55% (44.2–66) of 0.5 ng/mL canonical cut-off. Neither PCT-L nor -K held prognostic value on survival.

In MW patients, customized PCT cut-off levels provide better accuracy than customary levels adopted from ICU, and TRACE technology seems to offer a wider analysis range.
A new device for the prompt diagnosis of urinary tract infections
Authors: Arienzo Alyexandra , Losito Francesca , Bottini Giorgia , Priolisi Francesca Romana , Mari Alberto , Visca Paolo , Antonini Giovanni
Published: September 2014

Urinary tract infections (UTIs) are among the most common infectious diseases. Results obtained from conventional microbiological analysis of urine and antibiotic susceptibility testing are available only after a few days, delaying precise diagnosis and appropriate therapy. Micro Biological Survey (MBS) srl (a spin-off of Roma Tre University, Rome, Italy) has developed and patented an automated colorimetric test for rapid bacterial counting. In a preliminary validation study it was demonstrated that the results obtained with the MBS method are equivalent to the results obtained with conventional culture-based microbiological analysis.

In this study, sterile urine samples were artificially contaminated with bacterial species that are most frequently responsible for UTIs. The MBS method was used to evaluate the presence of bacteria and their sensitivity to some of the most commonly used antibiotics in UTIs.

The MBS method was able to detect in a few hours the presence or absence of bacteria at clinically significant concentrations (>10

The results obtained demonstrate that the MBS point-of-care testing (POCT) device could be developed into a valuable aid for the management of UTIs, possibly addressing more precise diagnosis and appropriate therapy.
Legumain expression, activity and secretion are increased during monocyte-to-macrophage differentiation and inhibited by atorvastatin
Authors: Solberg Rigmor , Smith Robert , Almlöf Maria , Tewolde Eyassu , Nilsen Hilde , Johansen Harald Thidemann
Published: September 2014

Macrophages express several lysosomal cysteine proteases such as cathepsins and legumain. In this study, we assessed the expression, activity and secretion of legumain in cellular models of monocytes/macrophages. Macrophages were derived from M-CSF- or GM-CSF/IFNγ-stimulated human primary monocytes (M2 and M1, respectively), PMA-treated human THP-1 cells, or murine RAW264.7 macrophages. In both primary monocytes and THP-1 cells, monocyte-to-macrophage differentiation caused highly increased cellular expression and activity of legumain. Also, secretion of legumain from macrophages, but not from monocytes, was observed. Notably, M2 macrophages expressed significantly higher levels of active legumain than M1 macrophages, which are not previously reported. Legumain mRNA has been shown to be down-regulated in monocytes isolated from patients treated with the HMG-CoA reductase inhibitor atorvastatin. Interestingly, in our study, the active legumain produced by M2 macrophages was found to be inhibited by atorvastatin, which was reflected in aberrant cellular expression and processing.
Early epigenetic cancer decisions
Authors: Martín-Lorenzo Alberto , Gonzalez-Herrero Inés , Rodríguez-Hernández Guillermo , García-Ramírez Idoia , Vicente-Dueñas Carolina , Sánchez-García Isidro
Published: September 2014

A cancer dogma states that inactivation of oncogene(s) can cause cancer remission, implying that oncogenes are the Achilles’ heel of cancers. This current model of cancer has kept oncogenes firmly in focus as therapeutic targets and is in agreement with the fact that in human cancers all cancerous cells, with independence of the cellular heterogeneity existing within the tumour, carry the same oncogenic genetic lesions. However, recent studies of the interactions between an oncogene and its target cell have shown that oncogenes contribute to cancer development via developmental reprogramming of the epigenome within the target cell. These results provide the first evidence that carcinogenesis can be initiated by epigenetic stem cell reprogramming, and uncover a new role for oncogenes in the origin of cancer. Here we analyse these evidences and discuss how this vision offers new avenues for developing novel anti-cancer interventions.
Cathepsin B-deficient mice as source of monoclonal anti-cathepsin B antibodies
Authors: Weber Ekkehard , Barbulescu Elena , Medek Rita , Reinheckel Thomas , Sameni Mansoureh , Anbalagan Arulselvi , Moin Kamiar , Sloane Bonnie F.
Published: September 2014

Cathepsin B has been demonstrated to be involved in several proteolytic processes that support tumor progression and metastasis and neurodegeneration. To further clarify its role, defined monoclonal antibodies are needed. As the primary structure of human cathepsin B is almost identical to that of the mouse, cathepsin B-deficient mice were used in a novel approach for generating such antibodies, providing the chance of an increased immune response to the antigen, human cathepsin B. Thirty clones were found to produce cathepsin B-specific antibodies. Seven of these antibodies were used to detect cathepsin B in MCF10-DCIS human breast cancer cells by immunocytochemistry and immunoblotting. Five different binding sites were identified by epitope mapping giving the opportunity to combine these antibodies in oligoclonal antibody mixtures for an improved detection of cathepsin B.
Transcription as a force partitioning the eukaryotic genome
Authors: Zirkel Anne , Papantonis Argyris
Published: September 2014

Eukaryotic genomes – until recently dealt with as if they were a cohort of linear DNA molecules – are perplexed three-dimensional structures, the exact conformation of which profoundly affects genome function. Recent advances in molecular biology and DNA sequencing technologies have led to a new understanding of the folding of chromatin in the nucleus. Changes in chromatin structure underlie deployment of new gene expression programs during development, differentiation, or disease. In this review, we revisit data pointing to, arguably, the major force that shapes genomes: transcription of DNA into RNA.
Performance of Phase Modulation in WDM-PON Transmission System
Authors: Li Li , Zhao Dong
Published: September 2014

The modulation and demodulation methods of the optical Differential Quadrature Phase Shift Keying (DQPSK), Optical Differential Phase Shift Keying (DPSK) and the different modulation formats including nonreturn-to-zero (NRZ), return-to-zero (RZ), carrier-suppressed return-to-zero (CS-RZ) are introduced, studying the ability of anti-dispersion for different optical signals in the 40 Gb/s high speed transmission system. The system is simulated in optical fiber by way of dispersion compensation. And then analyzed the compensation effect of the different dispersion compensation method for different phase modulation formats. It is shown that the ability of anti-dispersion and anti-PMD is better in the CS-RZ-DQPSK modulation format, and this format has the smallest eye-opening penalty (EOP) with a wider range of power into the optical fiber.
On the Paradox of Gestalt Switches: Wittgenstein’s Response to Kohler
Authors: Eilan Naomi
Published: September 2014

Wittgenstein formulates the paradox of gestalt switches thus: ‘What is incomprehensible is that nothing, and yet everything has changed, after all. That is the only way to put it’. In the course of isolating what I take to be the best of the various solutions to the paradox explored by Wittgenstein, the following claims are defended: (a) A significant strand in Wittgenstein’s own formulation of, and solution to, the paradox can best be understood as a response to three specific claims made by the Gestalt psychologist Kohler. (b) The most promising avenue Wittgenstein explored in his many attempts to resolve the paradox gives perceptual attention a constitutive role in the solution (c) This role is best elaborated, partially, by appeal to information processing theories of attention. (d) There are good reasons to think that the kind of solution to the paradox this yields would have been welcomed by Wittgenstein.
Is Off-Pump Coronary Artery Bypass Surgery Superior to On-Pump Coronary Artery Bypass Surgery on Postoperative Paradoxical Ventricular Septal Motion?
Authors: Günday Murat , Alpaslan Mete , Çiftçi Özgür , Özülkü Mehmet , Çopur Gülay , Aslamacı Sait
Published: September 2014

Background: The aims of this study were to investigate the appearance of paradoxical ventricular septal motion (PSM) after coronary artery bypass graft (CABG) surgery and to identify factors that might be related to this abnormality.

Methods: This prospective study included 119 consecutive patients (38 women, 81 men) who underwent CABG. Patients who underwent on-pump surgery (22 women, 45 men) and patients who underwent off-pump surgery (16 women, 36 men) were studied separately. All subjects underwent preoperative angiographic septal perfusion evaluation, pre- and postoperative echocardiography, and standard electrocardiographic and laboratory investigations, including troponin I and CK-MB levels. Multivariate logistic regression analysis was also performed for a variety of related parameters.

Results: Significant differences in EuroSCORE, length of intensive care unit stay, length of hospital stay, PSM (assessed using echocardiography), septal perfusion (observed using preoperative angiography), postoperative pleural effusion, and intensive care unit recidivism were observed between the two groups (P < .05). Moreover, postoperative PSM was correlated with septal perfusion (r = -0.687**, P < .001), type of operation (r = -0.194*, P = .035), diabetes mellitus (r = 0.273**, P = .003), carotid stenosis (r = 0.235*, P = .011), the number of distal anastomoses (r = 0.245**, P = .008), pleural effusion (r = 0.193*, P = .037), and intensive care unit recidivism (r = 0.249**, P = .007). However, multivariate analysis demonstrated that only preoperative septal perfusion (odds ratio: 0.037; 95% confidence interval: 0.011-0.128; P < .05) constitutes an independent risk factor for PSM (P < .05).

Conclusions: This study demonstrated that preoperative septal perfusion deficiency represents an independent risk factor for postoperative PSM in patients undergoing CABG. Further investigations addressing the timing of the appearance of PSM and the correlation of this finding with perfusion imaging studies may provide new details concerning the mechanisms that underlie this abnormality.
Septum Primum Atrial Septal Defect in an Infant with Hypoplastic Left Heart Syndrome
Authors: Loar Robert W. , Burkhart Harold M. , Taggart Nathaniel W.
Published: September 2014

Hypoplastic left heart syndrome (HLHS) is a form of congenital heart disease characterized by severe underdevelopment of the left heart, leading to inadequate systemic blood flow. Several different atrial septal morphologies are observed in HLHS, most commonly a secundum atrial septal defect, patent foramen ovale, intact septum, and leftward displacement of the superior attachment of the septum primum. It has been postulated that atrial septal development is associated with the development of the left heart. We present a case of a newborn infant with HLHS and the unusual finding of a primum ASD.
Totally Thoracoscopic Versus Open Surgery for Closure of Atrial Septal Defect: Propensity-Score Matched Comparison
Authors: Zheng Zhe , Kun Hua , Xuezeng Xu , Yunge Chen , Zengshan Ma , Huiming Guo , Liming Liu , Liang Tiao , Zhiwei Wang , Hansong Sun , Shengshou Hu
Published: September 2014

The purpose of this study is to compare early clinical outcomes of surgical repair for isolated atrial septal defect (ASD) with a totally thoracoscopic approach without robotic assistance versus a conventional open procedure.

Between September 2010 and June 2012, 254 consecutive patients with isolated ASD underwent totally thoracoscopic surgery without robotic assistance in seven institutions participating in the nationwide multi-centered registry in China. During the same period, these patients were matched using propensity score methodology with 254 patients who had accepted conventional open surgery through a median sternotomy. The early in-hospital results between the two groups were analyzed and compared.

The patient age was 26.8 � 14.0 years and weight was 52.9 � 16.9 kg in the totally thoracoscopic group. The totally thoracoscopic surgery required longer aortic clamp time (32.1 � 17.3 minutes versus 28.3 � 16.7 minutes, P = .01); shorter length of stay in the intensive care unit (25.3 � 12.2 hours versus 34.8 � 24.4 hours, P = .001); shorter length of stay in hospital (6.5 � 6.3 days versus 7.9 � 6.4 days, P = .008); and shorter mechanical ventilation time (8.3 � 5.0 hours versus 11.4 � 14.8 hours, P = .04). The cardiopulmonary bypass (CPB) time (62.7 � 29.3 minutes versus 61.5 � 28.0 minutes, P = .64) showed no significant difference between the two groups. The totally thoracoscopic group had significantly less postoperative chest tube drainage (322.1 � 213.7 mL versus 462.8 � 398.4 mL, P = .001). The intraoperative (35.4% versus 38.6%, P = .46) and postoperative blood products usage (20.9% versus 21.3%, P = .91) showed no significant difference between the two groups.

There also was no significant difference in mortality and major in-hospital complications between the two groups. The early outcomes for treatment of isolated ASD were similar between the totally thoracoscopic group conventional open operation performed through median sternotomy, despite a longer aortic clamp time in the totally thoracoscopic group.
Should Left Ventricular Assist Devices be Implanted in Patients Seventy Years of Age and Older: A Comparative Analysis
Authors: Morgan Jeffrey A. , Nemeh Hassan W. , Paone Gaetano
Published: September 2014

Background: We evaluated outcomes in left ventricular assist device (LVAD) recipients aged seventy years and above and compared results to outcomes in LVAD recipients below seventy years of age.

Methods: From March 2006 through June 2012, 130 patients underwent implantation of either a HeartMate II (HM II; Thoratec Corp., Pleasanton, CA) or HeartWare (HeartWare Inc., Framingham, MA) LVAD at our institution. Four patients underwent device exchanges and were excluded. Of the remaining 126 patients, 6 (4.7%) were ?70 years of age. Patients in the age group ?70 years were compared to the group of patients < 70 years for perioperative mortality, long-term survival and incidence of postoperative complications.

Results: Mean age was 72.2 � 2.3 (70-75) years for the older group and 52.8 � 11.4 (18-69) years for the younger group (P < .001). There was no significant difference in the incidence of diabetes, hypertension, chronic renal insufficiency, dialysis, hepatic function, preoperative ventilation or previous cardiac surgery between the groups (P = NS). There was no significant difference in survival between the groups, with survival at 6 months, 1 year, and 2 years of 100%, 100% and 66.7% respectively for the older groups, versus 88.6%, 81.3% and 76.7% for the younger group (P = .634). There was no significant difference in postoperative bleeding requiring re-exploration, driveline infections, strokes, pneumonia, right ventricular failure, gastrointestinal bleeding or readmissions within thirty days (P = NS).

Conclusions: These data demonstrate similar short- and long-term results for the two groups of recipients of LVAD implantation. Results support the use of long-term mechanical circulatory support in carefully selected elderly patients.
International Perspectives: Helping Babies Breathe: Evolution of a Global Neonatal Resuscitation Program for Resource-Limited Areas
Authors: Little George A. , Keenan William J. , Singhal Nalini , Niermeyer Susan
Published: September 2014

Helping Babies Breathe (HBB) is a global neonatal resuscitation program for resource-limited areas. This review of HBB provides readers with insight into the strategic assessment of global neonatal mortality that led to development of the program, how that assessment shaped the educational program as a catalyst for change, and how a global public–private alliance has promoted HBB implementation and continues to strive for sustainable improvement in newborn health.
Chest Compressions and Ventilation in Delivery Room Resuscitation
Authors: Solevåg Anne Lee , Cheung Po-Yin , Schmölzer Georg M.
Published: September 2014

The purpose of chest compressions (CCs) is to generate blood flow to vital organs in a state in which the myocardium is unable to produce forward blood flow by internal pump mechanisms. In newborn infants requiring CCs in the delivery room, the most frequent cause of myocardial compromise is energy depletion due to hypoxia. Hypoxemia and the accompanying hypercarbia and metabolic acidosis (ie, asphyxia) causes systemic vasodilation, further compromising perfusion pressure. Hence, in neonatal cardiopulmonary resuscitation (CPR), the focus is on both reversing hypoxia and enhancing coronary and systemic perfusion pressure. There are limited clinical data to support a recommendation for how CC and ventilation should be optimized for this purpose in the newborn. However, studies in animal models and manikins suggest that using a compression-to-ventilation ratio (C:V) of 3:1 and delivering compressions during a pause in ventilation results in improved ventilation and reversal of hypoxia. Use of the 3:1 ratio, compared with higher C:V ratios, also results in more effective CC during prolonged CPR. A C:V ratio of 3:1 is perceived as more exhausting to perform than higher ratios, and a high CC rate, which may be beneficial, cannot be achieved with pauses in CCs for the delivery of ventilation. Continuous CCs and asynchronous ventilation have been shown to have improved outcomes in adults and older children after cardiac arrest, and current evidence suggests that it is as good as a 3:1 C:V ratio in neonatal resuscitation. Further studies are needed and should focus on the optimal resuscitative approach in neonatal CPR.
A Longitudinal Analysis of Sugar-Sweetened Beverage Intake in Infancy and Obesity at 6 Years
Authors: Pan Liping , Li Ruowei , Park Sohyun , Galuska Deborah A. , Sherry Bettylou , Freedman David S.
Published: September 2014

OBJECTIVE:

To examine whether sugar-sweetened beverage (SSB) intake during infancy predicts obesity at age 6 years.

METHODS:

We included 1189 children who participated in the Infant Feeding Practices Study II in 2005–2007 and were followed up at 6 years in 2012. Children’s weight and height were measured by mothers. Obesity was defined as gender-specific BMI-for-age ≥95th percentile. We used logistic regression to estimate the associations of any SSB intake and age at SSB introduction before 12 months and mean SSB intake during ages 10 to 12 months with obesity at 6 years controlling for baseline characteristics.

RESULTS:

The obesity prevalence at 6 years among children who consumed SSBs during infancy was twice as high as that among non–SSB consumers (17.0% vs 8.6%). The adjusted odds of obesity at 6 years was 71% higher for any SSB intake and 92% higher for SSB introduction before 6 months compared with no SSB intake during infancy. Children who consumed SSBs ≥3 times per week during ages 10 to 12 months had twice the odds of obesity compared with those who consumed no SSBs in this period. However, among children who consumed SSBs, the odds of obesity at 6 years did not differ by age at SSB introduction during infancy or by mean weekly SSB intake during ages 10 to 12 months.

CONCLUSIONS:

Children who consumed SSBs during infancy had higher odds of obesity at 6 years than non–SSB consumers. SSB consumption during infancy may be a risk factor for obesity in early childhood. Whether unmeasured behaviors contributed to the association is unclear.
Breastfeeding and Later Psychosocial Development of Children at 6 Years of Age
Authors: Lind Jennifer N. , Li Ruowei , Perrine Cria G. , Schieve Laura A.
Published: September 2014

OBJECTIVE:

To examine the association of breastfeeding duration with psychosocial development at 6 years of age.

METHODS:

We analyzed data from the 2005–2007 Infant Feeding Practices Study II and its 2012 Year 6 Follow-Up (N = 1442). Our breastfeeding duration variable combined overall and exclusive breastfeeding reported during infancy (never breastfed, breastfed <6 months, breastfed ≥6 months + exclusive breastfeeding <3 months, and breastfed ≥6 months + exclusive breastfeeding ≥3 months). Maternal responses to the Strengths and Difficulties Questionnaire were used to create our child psychosocial outcome domains (emotional symptoms, conduct problems, hyperactivity, peer problems, prosocial behavior, and total difficulties). Separate multivariable logistic regression models controlling for maternal sociodemographic characteristics, maternal mental health, and child characteristics were used to assess the likelihood of having difficulties on the 6 domains based on breastfeeding duration.

RESULTS:

Compared with children who were never breastfed, those who were breastfed for ≥6 months and exclusively breastfed for ≥3 months had decreased odds of difficulties with emotional symptoms (odds ratio [OR]: 0.52; 95% confidence interval [CI]: 0.27–0.99), conduct problems (OR: 0.24; 95% CI: 0.10–0.54), and total difficulties (OR: 0.39; 95% CI: 0.18–0.85) before adjustment. These associations were no longer significant after adjustment.

CONCLUSIONS:

Although in our unadjusted analyses we observed significant associations between breastfeeding duration and later psychosocial development, including decreased odds of emotional, conduct, and total difficulties at 6 years of age, these findings were no longer detectable after adjusting for the many potential confounding factors that play a role in psychosocial development.
Transportes, região e desenvolvimento econômico: a dinâmica da expansão da infra-estrutura viária na província de Minas Gerais, 1840-1889
Authors: Barbosa Lidiany Silva , Godoy Marcelo Magalhães
Published: September 2014

O artigo contempla o quadro geral das obras realizadas na infra-estrutura de transportes tradicionais pelo Governo Provincial de Minas Gerais, entre 1840 e 1889. As fontes principais são os Processos de Construção de Estradas e Pontes, geradas no âmbito da Secretaria de Obras Públicas e que abarcam extensa e complexa documentação sobre todas as fases das intervenções viárias realizadas na província. Os resultados fundamentais afirmam forte correlação entre o nível de desenvolvimento econômico das regiões mineiras e a incidência de obras públicas viárias, a revelar pronunciado desequilíbrio na distribuição dos recursos financeiros provinciais destinados a infra-estrutura de transportes de Minas Gerais.
Do Rio Amazonas à Península Ibérica: viajando com o Barão de Marajó
Authors: Sarges Maria De Nazaré , Coêlho Anna Carolina De Abreu
Published: September 2014

O artigo pretende discutir as viagens do Rio Amazonas à Península Ibérica, realizadas pelo intelectual e político José Coelho da Gama e Abreu, o Barão de Marajó, e descritas em sua obra Do Amazonas ao Sena, Nilo, Bósphoro e Danúbio. Apontamentos de Viagem, publicada em 1874, buscando refletir o quanto as relações desse autor com o exterior eram importantes nesse período para definir a sua própria região, o seu país e a si mesmo, ampliando sua "consciência-mundo".
Advanced numerical modelling of tsunami wave propagation, transformation and run-up
Authors: Dimakopoulos Aggelos S. , Guercio Antonella , Cuomo Giovanni
Published: September 2014

This paper presents a series of numerical models tests performed to assess the ability of the OpenFOAM® modelling system to represent the physics that stands behind the propagation of tsunami waves in coastal regions and in particular their transformation (by means of shoaling, refraction, reflection) over uneven bathymetries and their interaction with the shoreline (run-up, run-down, breaking). A series of tests is selected from the literature to explore the accuracy, applicability and limitations of this particular computational fluid dynamics model solving the three-dimensional Navier–Stokes equations for incompressible multiphase fluids. The range of scenarios tested includes experimental work on wave propagation over shoals, solitary wave run-up and the Monai valley tsunami physical model test recreating the Hokkaido–Nansei–Oki 1993 tsunami that struck Okushiri Island, Japan. This allowed direct comparison with experimental data from physical model tests as well as with other established two-dimensional – that is, depth integrated – and three-dimensional numerical models.
Development of a rig to study model pile behaviour under repeating lateral loads
Authors: Arshad Muhammad , O'Kelly Brendan C.
Published: September 2014

This paper deals with an important problem of the effect of repeating lateral loads on large-diameter monopile foundations for offshore wind turbine (OWT) structures. The cycles of typically low-amplitude repeating lateral loads and moments generated by various environmental factors are resisted by horizontal earth pressures mobilised in the soil surrounding the pile. Laboratory testing on reduced-scale piles is an efficient and economical way to investigate such pile–soil behaviour. This paper presents the development of a new mechanical loading system to apply many thousands of repeating cycles of lateral load in different forms to a 1g model, with full control provided over the loading direction (i.e. one-way or two-way lateral loading), amplitude, frequency and waveform shape (e.g. sinusoidal, square or haversine). Compared with equivalent setups employing pneumatic or hydraulic actuators, the new loading system is able to produce similar performance at lower cost and also provides more control over the waveform shape. A programme of lateral load tests, each involving many thousands of load cycles, was performed on a rigid model pile installed in dry sand beds to demonstrate some of the main capabilities of the new system.
Modelling of projectile penetration using transparent soils
Authors: Chen Zhibo (Chris) , Omidvar Mehdi , Iskander Magued , Bless Stephan
Published: September 2014

This paper presents a novel physical modelling method to study projectile penetration problems. The method employs a recently developed transparent synthetic soil made of oil-saturated fused quartz, which represents the macroscopic behaviour of silica sand. Digital image correlation (DIC, also known as particle image velocimetry (PIV)) techniques were employed to quantify the response of granular soils to high-speed penetration, non-intrusively. A conical nose projectile made of steel was accelerated into a transparent soil target at an impact velocity of 13.6 m/s. Visualisation of the soil deformation was made possible by means of a novel seeded plane within the transparent soil model. The complete penetration event was recorded using a high-speed digital camera. The captured images were analysed using DIC, and further analysis of displacement trajectories and strains were also carried out using in-house algorithms.
Influence mechanism of lightweight aggregate on concrete impermeability: prediction by ANN
Authors: Kong Lijuan , Chen Xiaoyu
Published: September 2014

The influence of lightweight aggregate (LWA) on concrete impermeability is complex, varying according to LWA type, water–cement ratio and curing age. A convenient, quick method to predict impermeability of lightweight concrete is needed. To investigate the influencing mechanism, the microstructure of LWA and the interfacial transition zone are observed, and the water absorbing/releasing character of LWA in cement paste is studied. Chloride diffusion coefficients of concrete with different LWAs and water–cement ratios are also tested at different ages. LWA is found to have both an advantageous and disadvantageous influence on concrete impermeability. Based on 108 experimental datasets collected, an artificial neural network (ANN) model is applied to predict the influence of LWA on chloride diffusivity of concrete. The model is developed, trained and tested using a multi-layer back-propagation method. The predicted values are then compared with actual test results; the average relative error of prediction is found to be 4·14% and coefficient of determination (R2) is 0·97. These results indicate that the developed model has successfully learned the relationship between the different input and output parameters, and can predict the chloride diffusivity with accuracy adequate for practical design purposes. The ANN procedure provides guidelines to select the appropriate LWA for the required chloride diffusivity of concrete, reducing trial and error attempts, and saving both cost and time.
The Collapse Analysis of A Transmission Tower Under Wind Excitation
Authors: Tian Li , Yu Qiqi , Ma Ruisheng , Wang Chengwu
Published: September 2014

The collapse of a transmission tower under wind action is studied in this paper. A three-dimensional finite element model of the transmission tower is established based on a real project. The birth-to-death element technique is adopted in ABAQUS/Explicit. Kaimal fluctuating wind power spectrum and the harmony superposition method are used to simulate the fluctuating wind speed time history. The dynamic behavior and the collapse mechanism of the transmission tower under three different angles of attack α = 0o, 45o and 90o are carried out, respectively. The results show that the collapse of the transmission tower at 45o angle of attack occurs easily, but it is contrary at 90o angle of attack. The fracture position of the transmission tower under wind excitation is obtained, and the initial damage of the members happens simultaneously in the main and the secondary element. The results of the collapse analysis can provide reference to the design of the transmission tower and the reinforcement of this structure to prevent the collapse of the tower.
Evaluation of a Transparent Wall System for Residential Construction
Authors: Standley Joseph A. , Memari Ali M.
Published: September 2014

A new type of transparent panelized wall system for residential construction has recently been developed that can be used as an alternative to typical wood-frame and other light-frame wall systems. The new wall system is a prefabricated wall panel consisting of a structural steel back-up frame, transparent polycarbonate sheathing, and a curtain-wall system that may contain an integrated photovoltaic glazing panel. In this paper, after an introduction to the structural and architectural aspects of system, the thermal and energy performance aspects of this wall system are evaluated based on several criteria. The current configuration of the wall system shows an overall U-factor of 1.585 W/m2k. The material and systems analysis using a combination of life-cycle assessment and embodied energy are discussed as well. The embodied energy of the system turns out to be approximately two and a half times that of conventional wood-frame system. The paper provides some concluding remarks regarding the sustainability aspects.
Study of heat transfer and pressure drop characteristics of air heat exchanger using PCM for free cooling applications
Authors: Kalaiselvam Sivakumar , Sureshkumar Kanchipuram , Sriram Vijeykishoor
Published: September 2014

Free cooling is the process of storing the cool energy available in the night
ambient air and using it during the day. The heat exchanger used in this work
is a modular type which is similar to the shell and tube heat exchanger. The
shell side is filled with Phase Change Materials (PCM) and air flow is
through the tubes in the module. The modules of the heat exchanger are
arranged one over other with air spacers in between each module. The air
space provided in between the module in-creases the retention time of the air
for better heat transfer. Transient Computational Fluid Dynamics modeling is
carried out for single air passage in a modular heat exchanger. It shows that
the PCM phase transition time in the module in which different shape of fins
is adopted. The module with rectangular fins has 17.2 % reduction in
solidification compared with the plain module. Then steady state numerical
analysis is accomplished to the whole module having the fin of high heat
transfer, so that pressure drop, flow and thermal characteristics across the
module and the air spacers are deter-mined for various air inlet velocities
of 0.4 to 1.6 m/s. To validate the computational results, experiments are
carried out and the agreement was found to be good.