bluuebunny/crossref_metadata_2025 huggingface dataset:
Índice de Desenvolvimento como Liberdade: uma proposta teórico-metodológica de análise
Authors: Andrade Sarah Farias , Pires Mônica De Moura , Ferraz Marcelo Inácio Ferreira , Pinheiro Maurício Mota Saboya
Published: June 2016

Este trabalho busca discutir e delinear um índice de desenvolvimento baseado no conceito das liberdades instrumentais de Amartya Sen (2000), denominado aqui de IDL. Como objetivo central, desenvolve-se uma construção teórico-metodológica, sob a ótica das liberdades instrumentais de Amartya Sen para analisar o desenvolvimento. Especificamente, identificam-se as variáveis relevantes e instrumentos de mensuração; propõe-se uma formulação matemática de cálculo do índice de desenvolvimento como liberdade tomando-se como referência a realidade brasileira. As referências teóricas deste trabalho foram estruturadas considerando as abordagens teóricas sobre o desenvolvimento, na perspectiva da escola clássica liberal, e especificamente no pensamento utilitarista. Acrescentam-se também os estudos sobre indicadores de desenvolvimento para subsidiar a proposta metodológica aqui desenvolvida. O IDL está estruturado no conceito das liberdades, sendo construído a partir de cinco indicadores presentes na obra de Amartya Sen: Liberdades Políticas (LP), Disponibilidades Econômicas (DE), Oportunidades Sociais (OS), Garantias de Transparência (GT), e Segurança Protetora (SP). De modo geral, a análise das liberdades instrumentais no contexto brasileiro  constata que a Constituição Federal de 1988 constitui-se em um marco legal relevante no avanço do desenvolvimento regional. No entanto, o parcial descumprimento de alguns dispositivos constitucionais associa-se a uma relativa privação de capacidades humanas.
ISU TERORISME DAN RESPONS AKTIVIS MUDA ACEH
Authors: Amiruddin M. Hasbi
Published: June 2016

This article wants to examine the extent of radical thought in the minds of the younger generation pervasive in Aceh. With the new Aceh conditions experienced several years of post-conflict situation safe again struck by discovered a number of terrorists who make Jalin mountains forest, Aceh Besar, as a military training ground. Also found are also a number of books that have a narrative that can bring inspiration radicalism and terrorism acts. The results of in-depth interviews of young activists in Aceh, can be explained that the concept of terrorism models struggle can not be accepted by young activists in the city of Banda Aceh. They have to understand the teachings of Islam that is relatively comprehensive and proportional. But their ideals in order to uphold Islamic shariah in Aceh is a necessity.

***
Artikel ini ingin melihat sejauhmana pemikiran radikal merasuk dalam pikiran generasi muda di Aceh. Dengan kondisi Aceh yang baru beberapa tahun meng­alami situasi aman pasca terjadi konflik kembali dikejutkan dengan ditemukan sejumlah teroris yang menjadikan hutan pegunungan Jalin, Aceh Besar, sebagai medan latihan militer. Selain itu ditemukan juga sejumlah buku-buku yang memiliki narasi yang dapat memunculkan inspirasi tindakan radikalisme dan terorisme. Hasil wawancara mendalam terhadap para aktivis muda Aceh, dapat dijelaskan bahwa konsep perjuangan model terorisme tidak dapat diterima oleh aktivis muda di Kota Banda Aceh. Mereka telah memahami ajaran Islam yang relatif komprehensif dan proporsional. Namun cita-cita mereka agar tegaknya syariat Islam di Aceh adalah suatu keniscayaan.
RELASI AGAMA DAN NEGARA DALAM PERSPEKTIF ISLAM
Authors: Zaprulkhan Zaprulkhan
Published: June 2016

One discourse that continues to be discussed in the realm of Islamic political philosophy is about the relation between religion and state. Broadly speaking, there are at least three paradigms of thinking about the relationship between religion and state. First, sekularistik paradigm, which says that Islam has nothing to do with the state, because Islam does not regulate state life or reign. Second, formalistic paradigm, which assumes that Islam is a complete religion, which includes everything, including the question of the state or a political system. Third, paradigms substansialistik, which rejects the notion that Islam covers everything and also rejects the notion that Islam is only governs the relationship between man and his Creator alone. This article will take pictures of how the three views of this paradigm by showing some of the characters are representative and critically using the comparative method.

***
Salah satu wacana yang terus diperbincangkan dalam ranah filsafat politik Islam adalah mengenai relasi antara agama dan negara. Secara garis besar paling tidak ada tiga paradigma pemikiran tentang hubungan agama dan negara. Pertama, paradigma sekularistik, yang mengatakan bahwa Islam tidak ada hubungannya dengan negara, karena Islam tidak mengatur kehidupan bernegara atau pemerintahan. Kedua, paradigma formalistik, yang menganggap bahwa Islam adalah agama yang paripurna, yang mencakup segala-galanya, termasuk masalah negara atau sistem politik. Ketiga, paradigma substansialistik, yang menolak pendapat bahwa Islam mencakup segala-galanya dan juga menolak pandangan bahwa Islam hanya mengatur hubungan antara manusia dan Penciptanya semata. Artikel ini akan memotret bagaimana pandangan ketiga paradigma tersebut dengan menampilkan beberapa tokohnya yang representatif dan dengan meng­gunakan metode kritis komparatif.
THE ROLE OF GOVERNMENT IN REVITALIZATION OF ISLAMIC SCHOOL IN TURKEY
Authors: Raharjo Raharjo
Published: June 2016

Selama berabad-abad Islam telah menjadi agama negara di Turki. Tetapi itu berubah saat Turki mendeklarasikan diri sebagai negara Republik pada tahun 1923. Turki menjadi negara sekuler dan membuat Islam tertekan. Namun saat sistem politik Pemerintah Turki mengadopsi multipartai dan partai itu kemudian didukung oleh masyarakat Muslim dan memimpin pemerintahan, perlahan keberadaan Islam kembali tampak. Kondisi ini memengaruhi keberadaan pendidikan dan sekolah-sekolah Islam, yang pada dua dekade terakhir jumlahnya meningkat tajam. Penelitian ini mengumpulkan data tentang kontrol kualitas pendidikan, bentuk-bentuk pendidikan Islam dan peran pemerintah terhadap pendidikan Islam. Melalui teknik dokumentasi, observasi dan interview, peneliti­an ini menunjukkan bahwa: 1) kontrol kualitas pendidikan di Turki dilakukan di bawah kementerian pendidikan nasional; 2) bentuk sekolah dibagi menjadi negeri dan swasta, dan 3) peran pemerintah terhadap sekolah-sekolah Islam tidak dilakukan secara langsung, namun melalui kebijakan Kementerian Pen­didikan Nasional yang diberlakukan secara umum kepada sekolah negeri.

***
Islam had been the religion of the state in Turkey for many centuries, but it was disappeared when the type of the state was changed into republic in 1923. Turkey then has become a secular state and Islam has been depressed. However, when the political system in Turkey adopted multiparty and the party supported by Muslim community run the ruling government, Islam gradually has existed. This affected the Islamic education and schools, which have been sharply increased in number during the last 2 decades. This research was conducted to identify the quality control of education, the types of Islamic education and the role of government towards Islamic schools. By using techniques of documentation, observation and interview, this research indicated that: 1) the quality control of education in Turkey is done under ministry of national education; 2) the types of Islamic education are divided into public and private and  3) the role of government towards Islamic schools is not implemented straight forward, but through the policy in the Ministry of National Education addressed towards the public schools.
DIALEKTIKA RADIKALISME DAN ANTI RADIKALISME DI PESANTREN
Authors: Kusmanto Thohir Yuli , Fauzi Moh. , Jamil M. Mukhsin
Published: June 2016

Any effort opoosing toward any form of radicalism is a part of the reactions to anti-radicalism. The spirit of anti-radicalism emerged as part of the people's resistance. Radicalism and anti-radicalism was dialectically interrelated. Although both are paradoxical, but always be united. Dialectic of radicalism and anti-radicalism interesting is once it was observed in boarding school life. The phenomena of Islamic radicalism is often associated with Islamic boarding schools in Indonesia. Some communities understood that the growing radicalism came from Islamic boarding schools. This view was based on the the many actors of violent Islamic radicalism were the alumni of boarding school. The reality may be true in certain cases, but they may not be generalized. This study explored the data on the perspective of Islamic boarding schools on the discourse and praxis of radicalism and anti radicalism and resistance patterns. The research results showed that the community of Islamic boarding schools rejected, oppossed and actively built the spirit of anti radicalism that was implemented in several patterns. The findings of these research was a synthesis of the thesis which had become the public discourse about radicalism and Islamic boarding school.

***
Upaya menentang segala bentuk radikalisme merupakan bagian dari reaksi anti radikalisme. Semangat anti radikalisme muncul sebagai bagian dari resistensi masyarakat. Radikalisme dan anti radikalisme saling berkaitan secara dialektis. Meski­pun keduanya merupakan sesuatu yang paradoks, namun selalu menyatu. Dialektika radikalisme dan anti radikalisme menarik ketika dilihat dalam kehidupan pesantren. Fenomena radikalisme Islam seringkali dihubungkan dengan masya­ra­kat pesantren di Indonesia. Beberapa kelompok masyarakat memahami radikal­isme tumbuh dari pesantren. Pandangan tersebut didasari oleh banyaknya pelaku radikalisme Islam dalam bentuk kekerasan alumni pesantren. Realitas tersebut bisa jadi benar dalam kasus tertentu, tetapi tidak bisa digeneralisasi. Penelitian ini ber­upaya menggali data pandangan pesantren tentang wacana dan praksis radikalisme dan anti radikalisme serta pola resistensinya. Hasil penelitian menunjukkan bahwa masyarakat pesantren menolak, menentang dan aktif membangun spirit anti radikalisme yang diwujud­kan dalam beberapa pola. Temuan penelitian tersebut merupakan sintesis dari tesis yang selama ini menjadi wacana masyarakat tentang radikalisme dan pesantren.
PENDIDIKAN AGAMA DALAM KULTUR SEKOLAH DEMOKRATIS: POTENSI MEMBUMIKAN DERADIKALISASI AGAMA DI SEKOLAH
Authors: Jannet Herly
Published: June 2016

This study aimed in general to determine and describe the religious education in a democratic school culture is one of potential strategies in disseminating religious de-radicalization in schools. Applying qualitative naturalistic approach with case study, this study focused the location in Christian High School Urimessing Ambon. The object of this research was the all democratic phenomena found in the process of teaching and learning of Christian education. The results of this study can be described as follows: religious education in a democratic school culture has the potential to disseminate de-radicalization because the learning process optimized the attitude of critical thinking on freedom, independence, and accountability that were assumed to build the belief, attitude and norm of student to: (1) deepen and believe their own religious teachings; (2) commit to transform their religious teacgings in their daily life, both individually and socially; and (3) be­come the real who got off from violence and anarchy in realizing their objectives.

***
Penelitian ini bertujuan untuk menemukan dan mendeskripsikan Pendidikan Agama dalam kultur sekolah demokratis sebagai salah satu strategi membumikan deradikalisasi agama di sekolah. Metode penelitian yang digunakan adalah kuali­tatif naturalistik dengan strategi studi kasus dan mengambil tempat penelitian di SMA Kristen Urimessing Ambon. Objek penelitian ini adalah keseluruhan gejala demokratis dalam proses belajar mengajar Pendidikan Agama Kristen. Hasil pe­nelitian dapat dideskripsikan sebagai berikut, Pendidikan Agama dalam kultur sekolah demokratis berpotensi membumikan deradikalisasi, karena dalam pro­ses belajar mengajar mengoptimalkan sikap kebebasan berpikir kritis, ke­mandiri­an, dan akuntabilitas sehingga dapat membentuk keyakinan, sikap dan nor­ma pe­serta didik untuk: (1) mendalami dan meyakini ajaran agamanya sendiri; (2) ber­komitmen mentransformasikan ajar­an agamanya secara baik dalam ke­hidupan pribadi maupun sosial ber­masyarakat; dan (3) memberi teladan secara konkret tidak terjebak menggunakan kekerasan dan anarkisme dalam mewujudkan keinginan.
BINA-DAMAI DALAM KOMUNITAS PESANTREN: SEBUAH UPAYA COUNTER-RADIKALISME
Authors: Mantu Rahman
Published: June 2016

This article discussed about the experience of al-Qodir Boarding School in Sleman Yogyakarta in the effort to counter the radicalism through the approach of peace building. Applying qualitative approach, this research using the methods of observation and deep interview in collecting data. With the theoritical framework of cognitive peace building, three factors of peace building became the focus; the mechanism of internal group, among group and external group. The main research finding here was the essential role of kiai in building participative dialogue with the community out of the boarding school which was imple­mented through social actions. It resulted in the ability of al-Qodir Boarding School in formulating the strategy of radicalism counter which became a typical strategy of pesantren among so many strategies to find out new formulations in avoiding the movement of radicalism in Indonesia.

***
Tulisan ini akan membahas tentang pengalaman Pondok Pesantren Al-Qodir terhadap upaya counter-radikalisme melalui pendekatan bina-damai di Sleman Yogyakarta. Penelitian ini menggunakan metode kualitatif dengan melakukan peng­amat­an serta wawancara mendalam. Kerangka teoritik yang digunakan peneliti adalah teori peace building. Perdamaian menurut teori ini bisa tercipta karena tiga faktor; mekanisme internal, antar kelompok dan eksternal. Temuan dari riset ini adalah adanya peran penting kiai dalam membangun dialog partisipatif dengan masyarakat luar pesantren yang terimplementasi melalui aksi-aksi sosial. Hasilnya Pesantren Al-Qadir mampu merumuskan strategi counter-radikalisme yang khas pesantren ditengah upaya banyak pihak mencari formulasi baru dalam menangkal gerakan radikalisme di Indonesia.
THE PARADIGM OF THEO-ANTHROPO-COSMOCENTRISM: REPOSITION OF THE CLUSTER OF NON-ISLAMIC STUDIES IN INDONESIAN STATE ISLAMIC UNIVERSITIES
Authors: Suharto Toto
Published: June 2016

State Islamic Universities (UIN) in Indonesia nowadays has developed their study courses by opening the faculty of social science and humanities and the faculty of the natural science. This development is constitutionally “has gone beyond” scientific mandate of UIN, which only had the authority to execute the education in the cluster of religious sciences. Applying the approach of philosiphy of knowledge, this paper tried to commit the reposition the sciences of non Islamic studies cluster in UIN so that there is no gap between the two clusters, by offering the application of the paradigm of theo-antropo-cosmosentrism. Applying content analysis on texts related to the theme of the study, this paper offered the integration model of "Triangle of Science" which is based on the paradigm of Theo-anhropo-cosmosentrism. This paradigm tried to integrate the paradigms of theocentrism, anthropocentrism and cosmocentrism.

***
Universitas Islam Negeri (UIN) di Indonesia dewasa ini telah mengembangkan wilayah studi Islamnya dengan membuka fakultas dalam ilmu-ilmu sosial-humaniora dan ilmu-ilmu kealaman. Perkembangan ini secara konstitusional telah “melampaui batas” mandat keilmuan UIN, yang hanya diberi kewenangan untuk menyelenggarakan pendidikan dalam rumpun ilmu agama. Tulisan ini dengan pendekatan filsafat ilmu mencoba mereposisi ilmu-ilmu non-rumpun ilmu agama yang ada di UIN, sehingga tidak terjadi gap antar keduanya, dengan menawarkan penggunaan paradigma teo-antropo-kosmosentrisme. Dengan analisis isi terhadap teks-teks yang terkait dengan tema kajian, tulisan ini menawarkan model integrasi “Segitiga Ilmu” yang berbasiskan pada paradigma teo-antropo-kosmosentrisme. Paradigma ini mencoba mengintegrasikan antara paradigma teosentrisme, antroposentrisme dan kosmosentrisme.
Influence of Jordanian zeolite on the performance of a solar still: experiments and CFD simulation studies
Authors: Taamneh Yazan
Published: June 2016

Computational fluid dynamics (CFD) simulations were performed for experiments carried out with two identical pyramid-shaped solar stills. One was filled with Jordanian zeolite-seawater and the second was filled with seawater only. This work is focused on CFD analysis validation with experimental data conducted using a model of phase change interaction (evaporation-condensation model) inside the solar still. A volume-of-fluid (VOF) model was used to simulate the inter phase change through evaporation-condensation between zeolite-water and water vapor inside the two solar stills. The effect of the volume fraction of the zeolite particles (0 ≤ ϕ ≤ 0.05) on the heat and distillate yield inside the solar still was investigated. Based on the CFD simulation results, the hourly quantity of freshwater showed a good agreement with the corresponding experimental data. The present study has established the utility of using the VOF two phase flow model to provide a reasonable solution to the complicated inter phase mass transfer in a solar still.
Impact of operational parameters on biofiltration performance: organic carbon removal and effluent turbidity
Authors: Nemani Vivek A. , Taylor-Edmonds Lizbeth , Peleato Nicolas M. , Andrews Robert C.
Published: June 2016

The objectives of this pilot-scale study were to optimize backwash frequency and empty bed contact time (EBCT) of biofilters treating ozonated surface water from Lake Ontario. Performance was benchmarked in terms of the reduction of turbidity, dissolved organic carbon (DOC), disinfection by-product (DBP) precursors, and ultrafiltration foulants (biopolymers). Increasing the EBCT from 4 to 8 min resulted in a higher reduction of DOC (5%), trihalomethane (THM4) and haloacetic acid (HAA9) precursors (∼12%) without negatively impacting effluent turbidity (consistently below 0.4 NTU), while biopolymer removal remained unaffected (2%). The impact of varying backwash frequency (5, 10, and 25 day intervals) was also compared for biofilters operated at an EBCT of 4 min. Results showed no impact of extended run times (up to 25 days) on DOC or DBP precursor removal; however turbidity removal was affected beyond 15 days of operation. Backwashing biofilters at 10 vs 5 day intervals would result in a reduction of backwash water, energy consumption and amount to nearly $17,000 in savings for the utility.
Strategies for the reduction of Legionella in biological treatment systems
Authors: Nogueira R. , Utecht K.-U. , Exner M. , Verstraete W. , Rosenwinkel K.-H.
Published: June 2016

A community-wide outbreak of Legionnaire's disease occurred in Warstein, Germany, in August 2013. The epidemic strain, Legionella pneumophila Serogruppe 1, was isolated from an industrial wastewater stream entering the municipal wastewater treatment plant (WWTP) in Wartein, the WWTP itself, the river Wäster and air/water samples from an industrial cooling system 3 km downstream of the WWTP. The present study investigated the effect of physical–chemical disinfection methods on the reduction of the concentration of Legionella in the biological treatment and in the treated effluent entering the river Wäster. Additionally, to gain insight into the factors that promote the growth of Legionella in biological systems, growth experiments were made with different substrates and temperatures. The dosage rates of silver micro-particles, hydrogen peroxide, chlorine dioxide and ozone and pH stress to the activated sludge were not able to decrease the number of culturable Legionella spp. in the effluent. Nevertheless, the UV treatment of secondary treated effluent reduced Legionella spp. on average by 1.6–3.4 log units. Laboratory-scale experiments and full-scale measurements suggested that the aerobic treatment of warm wastewater (30–35 °C) rich in organic nitrogen (protein) is a possible source of Legionella infection.
Densification and Pyrolysis of Lignocellulosic Biomass for Renewable Energy
Authors: Wang Hui , Zhang Bo , Xiu Shuangning , Li Rui , Shi Jian
Published: June 2016

Fast pyrolysis is an attractive platform technology to convert lignocellulosic biomass
into fuels, energy, and other value-added products. However, most of the biomass materials,
e.q., forest waste, agricultural waste, energy crops, and municipal solid waste, have
low bulk and energy density and are difficult to store, transport and convert. Furthermore,
the variations in feedstock composition and particle size among a few other factors all affect
fast pyrolysis performance and product quality. Biomass densification, such as pelleting,
generates a form of biomass feedstock with high mass and energy density and great homogeneity
via blending of different feedstocks, providing unique opportunities to improve feedstock
quality for fast pyrolysis. This paper summarizes the basic principles, processes and
influencing factors, and the recent developments in both densification and fast pyrolysis
fields with special focus on the combination of pelleting and fast pyrolysis. The challenges and perspectives are
also provided for the development of an efficient, cost-effective and scalable fast pyrolysis technologies for generating
fuels and chemicals.
Kinetic Study on Pyrolysis of Biomass Components: A Critical Review
Authors: Wang Shurong , Ru Bin , Lin Haizhou , Dai Gongxin , Wang Yurong , Luo Zhongyang
Published: June 2016

Aiming at promoting the industrial application of biomass pyrolysis technology,
many approaches have been explored to reveal pyrolysis reaction mechanism. Among which
the thermal analysis kinetics based on mechanism scheme receives significant attention. The
kinetic models developed in past decades are classified into five types: one-step global model
based on model-fitting method, global model based on model-free method, multi-step successive
model, semi-global model and distributed activation energy model. In this review, the
computation processes are introduced, and the advantages and disadvantages of these kinetic
models are discussed and compared in detail. To obtain a universal kinetic model and simplify
the intricate behaviors of biomass pyrolysis, the pyrolytic kinetics of the three major components,
namely cellulose, hemicellulose and lignin, have been studied individually. Their
pyrolysis behaviors are dramatically different in view of kinetics. It is recommended that the fundamental theory
progress which has been made in the solid reaction kinetics should be applied in the biomass pyrolysis kinetics,
and a lot of related traditional knowledge in this area needs to be updated urgently.
Mass and Heat Transfer at Different Heat Exchange Surfaces and Their Suitability for Use in Thermal Desalination Plants
Authors: Schwarzer T. , Bart H.J.
Published: June 2016

A new concept for small scale multi-stage distillation (MSD) desalination plants is presented allowing an installation in remote rural areal due to low maintenance, operating and investment costs. It is based on extensive studies on heat and mass transfer using 6 different condensation / heat transfer surfaces or material combinations. Basically all 6 condensation surfaces except glass are of a sheet metal or an expanded metal (to the evaporation side) in combination to an acid- and heat-resistant foil (on the salt water side). The basic experiments were performed in a "lab scale" unit to determine their thermodynamic and structural characteristics and user-friendliness. After validation in a prototype novel oxidic condensation surfaces (AF) and material combinations are in actual use in the new MSD systems, following the requirements, including a good wetting and condensation behavior and a good heat transfer.
Hippo signaling protein MST1 regulates osteoclast differentiation by interacting with integrin linked kinase (ILK) and modulating actin structures
Authors: Huang Xiao-Han , Su Pan , Li Wu-Yin
Published: June 2016

Hippo signaling is implicated in balancing cell proliferation,
differentiation and death in multiple organs. However, its role in specific
bone cell types such as osteoclasts, and its significance in maintaining
overall bone tissue homeostasis remain largely unknown. In this study, we
investigated the role of the Hippo pathway in osteoclast differentiation.
Human primary monocyte cells were treated with receptor activator nuclear
factor kappaB ligand (RANKL) and evaluated for osteoclast differentiation by
marker protein analysis, tartrate-resistant acid phosphate (TRAP) and
resorption assays. Our results showed that Ste20-like kinase 1 (MST1)
underwent the maximum change after RANKL treatments and is negatively
associated with osteoclast differentiation. Furthermore, proteomic approaches
involving coimmunoprecipitation and mass spectrometry identified MST1
interaction with integrin-linked kinase (ILK) which is lost during RANKL
induced differentiation. Finally, using RNAi and ectopic expression
experiments we observed that MST1-ILK interaction negatively inhibits
osteoclast differentiation at the level of actin ring structure formation,
which is facilitated by ILK. Together, our data highlight a role for the
Hippo pathway protein, MST1, in negatively regulating osteoclast
differentiation through its interaction with integrin signaling. Given that
integrin signaling is progressively implicated in pathological osteolysis,
augmenting this pathway could have therapeutic implications.
Kinetics and mechanism of the oxidation of dithiocarbamic acids in the presence of Co(II) phthalocyaninetetacarboxylic acid
Authors: Vashurin Artur , Kuzmin Ilya , Mayzlish Vladimir , Razumov Mikhail , Golubchikov Oleg , Koifman Oscar
Published: June 2016

Present work contains kinetic data of oxidation of sodium
diethyldithiocarbamate in presence of phthalocyanine catalysts. It is shown
that nature of peripheral substituent has a great influence on
self-association of phthalocyanines and on its catalytic activity. Oxidation
mechanism of sodium diethyldithiocarbamate involving formation of triple
complex of substrate, reduced form of catalyst and oxygen is offered. It is
also shown that oxidation mechanism of dithiocarbamic acids is different than
for cysteine.
Physical Therapist–Led Ambulatory Rehabilitation for Patients Receiving CentriMag Short-Term Ventricular Assist Device Support: Retrospective Case Series
Authors: McGarrigle Laura , Caunt Jennifer
Published: June 2016

Background and Purpose

Short-term ventricular assist device (VAD) support is used in the intensive care unit (ICU) to support individuals in end-stage heart failure prior to heart transplantation or implantation of a long-term left VAD. The literature investigating the feasibility, safety, and content of rehabilitation for this patient group is lacking. This report retrospectively describes the rehabilitation strategy, safety measures used, and nature of any adverse events and, therefore, the feasibility of this practice.

Case Series Description

Ten individuals (80% male) admitted to the ICU in critical cardiogenic shock required support via a short-term VAD. A prerehabilitation risk assessment was used to reduce the risk of cannula dislodgement. The therapeutic strategy was a stepwise progression of exercises, mobilization, and ambulation.

Outcomes

Retrospective inspection of the case notes showed 330 rehabilitation sessions (X̅=33, SD=18.1, range=16–72) were performed and progressed to ambulation on 71 occasions (X̅=7.1, SD=7.7, range=1–27). Distance ambulated ranged from 7 to 1,200 m (X̅=157.7, SD=367.3). The Chelsea Critical Care Physical Assessment Tool (CPAx) score for 7 patients improved from a median of 0 (interquartile range=0–1) on day 1 to a median peak score of 39 (interquartile range=37–42). There were 8 episodes of minor adverse events (2.4% incidence rate), including 7 of transient low VAD flows. There were no major adverse events.

Discussion

Early rehabilitation and ambulation of recipients of short-term VAD support was safe and feasible. Recipients demonstrated improvements in physical function (CPAx score) while the VAD was in situ.
Does Developmental Education Improve Labor Market Outcomes? Evidence From Two States
Authors: Hodara Michelle , Xu Di
Published: June 2016

Many community college students start college in developmental education and leave before enrolling in college-level coursework or making much progress toward a degree; thus, developmental education courses represent the primary education these students receive. Using student-unit record data from two large community college systems linked to wage record data, this is the first study to estimate the labor market returns to developmental education. For two cohorts of students who attended community college in North Carolina and Virginia, we find that earning developmental English credits led to an increase in earnings due to an increased likelihood of employment. In contrast, in both states, developmental math credits had negative impacts on earnings, particularly for those assigned to the lowest level of the developmental math sequence.
Figured Worlds of Citizenship
Authors: Mayes Eve , Mitra Dana L. , Serriere Stephanie C.
Published: June 2016

This article explores how two elementary school students responded to their teacher’s invitation in a civic classroom to make a difference to the world. We consider how the teacher framed the construct of civic efficacy and how the students refracted these ideas in their navigation of a civic education project. Closely analyzing these students’ experiences and responses, we question what differences are made when students are encouraged to think of themselves as citizens who can make a difference. Noting dissonances and ambivalences in the students’ responses, the conceptual resources of “figured worlds” enable an analysis of the interplay of discourses, interactions, sensory experiences, and material artifacts as civic identities are constituted. The two students’ differing responses are analyzed in relation to other figured worlds that students and teachers daily negotiate: of compliant citizenship, productive citizenship, and consumer citizenship. The overlaps, dissonances, and/or divergences in discourses and artifacts from various figured worlds of citizenship render some students more recognizable as civically “engaged” and “efficacious” than others.
Accessibility, reliability, and usability of neurosurgical resources
Authors: Agarwal Nitin , Kommana Sumana S. , Hansberry David R. , Kashkoush Ahmed I. , Friedlander Robert M. , Lunsford L. Dade
Published: June 2016

OBJECTIVE

Closing the knowledge gap that exists between patients and health care providers is essential and is facilitated by easy access to patient education materials. Although such information has the potential to be an effective resource, it must be written in a user-friendly and understandable manner, especially when such material pertains to specialized and highly technical fields such as neurological surgery. The authors evaluated the accessibility, usability, and reliability of current educational resources provided by the American Association of Neurological Surgeons (AANS), Healthwise, and the National Institute for Neurological Disorders and Stroke (NINDS).

METHODS

Online neurosurgical patient education information provided by AANS, Healthwise, and NINDS was evaluated using the LIDA scale, a website quality assessment tool, by medical professionals and nonmedical professionals. A high achieving score is regarded as 90% or greater using the LIDA scale.

RESULTS

Accessibility scores were 76.7% (AANS), 83.3% (Healthwise), and 75.0% (NINDS). Average usability scores for the AANS, Healthwise, and NINDS were 73.3%, 82.6%, and 82.9%, respectively, when evaluated by medical professionals and 78.5%, 80.7%, and 75.9%, respectively, for nonmedical professionals, respectively. Average reliability scores were 58.5%, 53.3%, 72.6%, respectively, for medical professionals and 70.4%, 66.7%, and 78.5%, respectively, for nonmedical professionals when evaluating the AANS, Healthwise, and NINDS websites.

CONCLUSIONS

Although organizations like AANS, Healthwise, and NINDS should be commended for their ongoing commitment to provide health care–oriented materials, modification of this material is suggested to improve the patient education value.
Complication avoidance in laser interstitial thermal therapy: lessons learned
Authors: Pruitt Rachel , Gamble Alexander , Black Karen , Schulder Michael , Mehta Ashesh D.
Published: June 2016

OBJECTIVE

Complications of laser interstitial thermal therapy (LITT) are underreported. The authors discuss how they have modified their technique in the context of technical and treatment-related adverse events.

METHODS

The Medtronic Visualase system was used in 49 procedures in 46 patients. Between 1 and 3 cooling catheters/laser fiber assemblies were placed, for a total of 62 implanted devices. Devices were placed using frameless stereotaxy (n = 3), frameless stereotaxy with intraoperative MRI (iMRI) (n = 9), iMRI under direct vision (n = 2), MRI alone (n = 1), or frame-based (n = 47) techniques. LITT was performed while monitoring MRI thermometry. Indications included brain tumors (n = 12), radiation necrosis (n = 2), filum terminale ependymoma (n = 1), mesial temporal lobe epilepsy (n = 21), corpus callosotomy for bifrontal epilepsy (n = 3), cavernoma (n = 1), and hypothalamic hamartomas (n = 6).

RESULTS

Some form of adverse event occurred in 11 (22.4%) of 49 procedures. These included 4 catheter malpositions, 3 intracranial hemorrhages, 3 cases of neurological deficit related to thermal injury, and 1 technical malfunction resulting in an aborted procedure. Of these, direct thermal injury was the only cause of prolonged neurological morbidity and occurred in 3 of 49 procedures. Use of frameless stereotaxy and increased numbers of devices were associated with significantly increased complication rates (p < 0.05). A number of procedural modifications were made to avoid complications, including the use of 1) frame-based catheter placement, a 1.8-mm alignment rod to create a track and titanium skull anchors for long trajectories to improve accuracy; 2) a narrow-gauge instrument for dural puncture and coregistration of contrast MRI with CT angiography to reduce intracranial hemorrhage; 3) general endotracheal anesthesia for posterior-placed skull anchors to reduce the likelihood of damage to the cooling catheter; 4) use of as few probes as possible to reduce complications overall; and 5) dose modification of thermal treatment and use of short (3-mm) diffusing tips to limit treatment when structures to be spared do not have intervening CSF spaces to act as heat sinks.

CONCLUSIONS

Laser ablation treatment may be used for a variety of neurosurgical procedures for patients with tumors and epilepsy. While catheter placement and thermal treatment may be associated with a range of suboptimal operative and postoperative courses, permanent neurological morbidity is less common. The authors' institutional experience illustrates a number of measures that may be taken to improve outcomes using this important new tool in the neurosurgical arsenal.
Stagnation and complex flow in ruptured cerebral aneurysms: a possible association with hemostatic pattern
Authors: Tsuji Masanori , Ishikawa Tatsuya , Ishida Fujimaro , Furukawa Kazuhiro , Miura Yoichi , Shiba Masato , Sano Takanori , Tanemura Hiroshi , Umeda Yasuyuki , Shimosaka Shinichi , Suzuki Hidenori
Published: June 2016

OBJECT

Histopathological examination has revealed that ruptured cerebral aneurysms have different hemostatic patterns depending on the location of the clot formation. In this study, the authors investigated whether the hemostatic patterns had specific hemodynamic features using computational fluid dynamics (CFD) analysis.

METHODS

Twenty-six ruptured middle cerebral artery aneurysms were evaluated by 3D CT angiography and harvested at the time of clipping. The hemostatic patterns at the rupture points were assessed by means of histopathological examination, and morphological parameters were obtained. Transient analysis was performed, and wall shear stress–related hemodynamic parameters and invariant Q (vortex core region) were calculated. The morphological and hemodynamic parameters were compared among the hemostatic patterns.

RESULTS

Hematoxylin and eosin staining of the aneurysm wall showed 13 inside-pattern, 9 outside-pattern, and 4 other-pattern aneurysms. Three of the 26 aneurysms were excluded from further analysis, because their geometry models could not be generated due to low vascular CT values. Mann-Whitney U-tests showed that lower dome volume (0.04 cm3 vs 0.12 cm3, p = 0.014), gradient oscillatory number (0.0234 vs 0.0289, p = 0.023), invariant Q (−0.801 10−2/sec2 vs −0.124 10−2/sec2, p = 0.045) and higher aneurysm formation indicator (0.986 vs 0.963, p = 0.041) were significantly related to inside-pattern aneurysms when compared with outside-pattern aneurysms.

CONCLUSIONS

Inside-pattern aneurysms may have simpler flow patterns and less flow stagnation than outside-pattern aneurysms. CFD may be useful to characterize the hemostatic pattern of ruptured cerebral aneurysms.
Impact of subclinical coronary artery disease on the clinical outcomes of carotid endarterectomy
Authors: Kwon Hyunwook , Moon Dae Hyuk , Han Youngjin , Lee Jong-Young , Kwon Sun U , Kang Dong-Wha , Choo Suk Jung , Kwon Tae-Won , Kim Min-Ju , Cho Yong-Pil
Published: June 2016

OBJECTIVE

Controversy persists regarding the optimal management of subclinical coronary artery disease (CAD) prior to carotid endarterectomy (CEA) and the impact of CAD on clinical outcomes after CEA. This study aimed to evaluate the short-term surgical risks and long-term outcomes of patients with subclinical CAD who underwent CEA.

METHODS

The authors performed a retrospective study of data from a prospective CEA registry. They analyzed a total of 702 cases involving patients without a history of CAD who received preoperative cardiac risk assessment by radionuclide myocardial perfusion imaging (MPI) and underwent CEA over a 10-year period. The management strategy (the necessity, sequence, and treatment modality of coronary revascularization and optimal perioperative medical treatment) was determined according to the presence, severity, and extent of CAD as determined by preoperative MPI and additional coronary computed tomography angiography and/or coronary angiography. Perioperative cardiac damage was defined on the basis of postoperative elevation of the blood level of cardiac troponin I (0.05–0.5 ng/ml) in the absence of myocardial ischemia. The primary endpoint was the composite of any stroke, myocardial infarction, or death during the perioperative period and all-cause mortality within 4 years of CEA. The associations between clinical outcomes after CEA and subclinical CAD were analyzed.

RESULTS

Concomitant subclinical CAD was observed in 81 patients (11.5%). These patients did have a higher incidence of perioperative cardiac damage (13.6% vs 0.5%, p < 0.01), but they had similar primary endpoint incidences during the perioperative period (2.5% vs.1.8%, p = 0.65) and similar estimated 4-year primary endpoint rates (13.6% vs 12.4%, p = 0.76) as the patients without subclinical CAD. Kaplan-Meier survival analysis showed that the 2 groups had similar rates of overall survival (p = 0.75).

CONCLUSIONS

Patients with subclinical CAD can undergo CEA with acceptable short- and long-term outcomes provided they receive selective coronary revascularization and optimal perioperative medical treatment.
High-grade glioma with anterior skull base erosion and intranasal extension: case report
Authors: Stib Matthew T. , Johnson Michael , Siu Alan , Almira-Suarez M. Isabel , Litvack Zachary , Singh Ameet , Sherman Jonathan H.
Published: June 2016

The authors describe the case of a large WHO Grade III anaplastic oligoastrocytoma extending through the anterior skull base and into the right nasal cavity and sinuses. Glial neoplasms are typically confined to the intracranial compartment within the brain parenchyma and rarely extend into the nasal cavity without prior surgical or radiation therapy. This 42-year-old woman presented with progressive headaches and sinus congestion. MR imaging findings revealed a large intracranial lesion with intranasal extension. Endoscopic nasal biopsy revealed pathology consistent with an infiltrating glioma. The patient subsequently underwent a combined transcranial/endonasal endoscopic approach for resection of this lesion. Pathological diagnosis revealed a WHO Grade III oligoastrocytoma. This report reviews the mechanisms of extradural glioma extension. To the authors' knowledge, it is the second report of a high-grade glioma exhibiting nasal extension without prior surgical or radiation treatment.
Mobile spinal enterogenous cyst resulting in intermittent paraplegia in a child: case report
Authors: Kojima Satoko , Yoshimura Junichi , Takao Tetsuro , Tamura Tetsuro , Nishiyama Kenichi , Maruyama Shigeru , Suda Masashi , Fujii Yukihiko
Published: June 2016

The authors report the case of a mobile spinal enterogenous cyst in a 2-year-old boy, who was admitted to the hospital several times for intermittent paraplegia. Magnetic resonance imaging and CT revealed an isolated cyst in the lumbar spinal canal. The symptoms were caused by transient myelopathy of the conus medullaris and radiculopathy of the cauda equina due to the changing size and location of the cyst. The cyst was surgically extirpated, after which the symptoms resolved. The histopathological diagnosis was enterogenous cyst. The clinical history of intraspinal enterogenous cyst is usually progressive. Mobility and changes in size are rare pathophysiological findings. The authors speculate that the cyst wall did not adhere to the surrounding structures and had ruptured and quickly reformed. Enterogenous cyst should be considered in the differential diagnosis of spinal intradural cysts in children with radiculomyelopathy.
Endoscopic third ventriculostomy in children: prospective, multicenter results from the Hydrocephalus Clinical Research Network
Authors: Kulkarni Abhaya V. , Riva-Cambrin Jay , Holubkov Richard , Browd Samuel R. , Cochrane D. Douglas , Drake James M. , Limbrick David D. , Rozzelle Curtis J. , Simon Tamara D. , Tamber Mandeep S. , Wellons John C. , Whitehead William E. , Kestle John R. W. , _ _
Published: June 2016

OBJECTIVE

Endoscopic third ventriculostomy (ETV) is now established as a viable treatment option for a subgroup of children with hydrocephalus. Here, the authors report prospective, multicenter results from the Hydrocephalus Clinical Research Network (HCRN) to provide the most accurate determination of morbidity, complication incidence, and efficacy of ETV in children and to determine if intraoperative predictors of ETV success add substantially to preoperative predictors.

METHODS

All children undergoing a first ETV (without choroid plexus cauterization) at 1 of 7 HCRN centers up to June 2013 were included in the study and followed up for a minimum of 18 months. Data, including detailed intraoperative data, were prospectively collected as part of the HCRN's Core Data Project and included details of patient characteristics, ETV failure (need for repeat hydrocephalus surgery), and, in a subset of patients, postoperative complications up to the time of discharge.

RESULTS

Three hundred thirty-six eligible children underwent initial ETV, 18.8% of whom had undergone shunt placement prior to the ETV. The median age at ETV was 6.9 years (IQR 1.7–12.6), with 15.2% of the study cohort younger than 12 months of age. The most common etiologies were aqueductal stenosis (24.8%) and midbrain or tectal lesions (21.2%). Visible forniceal injury (16.6%) was more common than previously reported, whereas severe bleeding (1.8%), thalamic contusion (1.8%), venous injury (1.5%), hypothalamic contusion (1.5%), and major arterial injury (0.3%) were rare. The most common postoperative complications were CSF leak (4.4%), hyponatremia (3.9%), and pseudomeningocele (3.9%). New neurological deficit occurred in 1.5% cases, with 0.5% being permanent.

One hundred forty-one patients had documented failure of their ETV requiring repeat hydrocephalus surgery during follow-up, 117 of them during the first 6 months postprocedure. Kaplan-Meier rates of 30-day, 90-day, 6-month, 1-year, and 2-year failure-free survival were 73.7%, 66.7%, 64.8%, 61.7%, and 57.8%, respectively. According to multivariate modeling, the preoperative ETV Success Score (ETVSS) was associated with ETV success (p < 0.001), as was the intraoperative ability to visualize a “naked” basilar artery (p = 0.023).

CONCLUSIONS

The authors' documented experience represents the most detailed account of ETV results in North America and provides the most accurate picture to date of ETV success and complications, based on contemporaneously collected prospective data. Serious complications with ETV are low. In addition to the ETVSS, visualization of a naked basilar artery is predictive of ETV success.
Posterior reversible encephalopathy syndrome following a thoracic discectomy–induced dural leak: case report
Authors: Shields Lisa B. E. , Johnson John R. , Shields Christopher B.
Published: June 2016

Posterior reversible encephalopathy syndrome (PRES) is a clinicoradiological syndrome characterized by headaches, altered mental status, seizures, and visual disturbances. Classic MRI findings include white matter changes of the parieto-occipital regions. This syndrome has been encountered in myriad medical illnesses, including hypertension, preeclampsia/eclampsia, and immunosuppressive conditions. While the pathogenesis of the disorder is unclear, vasoconstriction and hypoperfusion leading to brain ischemia and vasogenic edema have been implicated as potential mechanisms. The authors present, to the best of their knowledge, the first case of PRES following a thoracic spinal surgery–induced dural leak noted on resection of the fifth rib during a thoracotomy for a T4–5 discectomy. Brain MRI revealed large areas of increased FLAIR and T2 hyperintensity in the superior posterior frontal lobes, superior and medial parietal lobes, and bilateral occipital lobes. Following repair of the CSF leak, the patient's symptoms resolved. Spinal surgeons should be alert to the potentially life-threatening condition of PRES, especially in a hypertensive patient who experiences surgery-induced dural leakage. The development of a severe positional headache with neurological signs is a red flag that suggests the presence of PRES. Prompt attention to the diagnosis and treatment of this condition by repairing the dural leak via surgery or expeditious blood patch increases the likelihood of a favorable outcome.
A severity-based quantification of data leakages in database systems
Authors: Vavilis Sokratis , Petković Milan , Zannone Nicola
Published: June 2016

The detection and handling of data leakages is becoming a critical issue for organizations. To this end, data leakage solutions are usually employed by organizations to monitor network traffic and the use of portable storage devices. However, these solutions often produce a large number of alerts, whose analysis is time-consuming and costly for organizations. To effectively handle leakage incidents, organizations should be able to focus on the most severe incidents. Therefore, alerts need to be analyzed and prioritized with respect to their severity. This work presents a novel approach for the quantification of data leakages based on their severity. The approach quantifies the severity of leakages with respect to the amount and sensitivity of the leaked information as well as the ability to re-identify the data subjects of the leaked information. To specify and reason on data sensitivity in an application domain, we propose a data model representing the knowledge within the domain. We validate our quantification approach by analyzing data leakages within a healthcare environment. Moreover, we demonstrate that the data model allows for a more accurate characterization of data sensitivity while reducing the efforts for its specification.