bluuebunny/crossref_metadata_2025 huggingface dataset:
Cardiac Micro–Computed Tomography Imaging of the Aging Coronary Vasculature
Authors: Sangaralingham S. Jeson , Ritman Erik L. , McKie Paul M. , Ichiki Tomoko , Lerman Amir , Scott Christopher G. , Martin Fernando L. , Harders Gerald E. , Bellavia Diego , Burnett John C.
Published: June 2012

Background—

Alterations at the level of the coronary circulation with aging may play an important role in the evolution of age-associated changes in left ventricular (LV) fibrosis and function. However these age-associated changes in the coronary vasculature remain poorly defined primarily due to the lack of high resolution imaging technologies. The current study was designed to utilize cardiac micro–computed tomography (micro-CT) technology as a novel imaging strategy, to define the 3-dimensional coronary circulation in the young and aged heart and its relationship to LV fibrosis and function.

Methods and Results—

Young (2 months old; n=10) and aged (20 months old; n=10) Fischer rats underwent cardiac micro-CT imaging as well as echocardiography, blood pressure, and fibrosis analysis. Importantly, when indexed to LV mass, which increased with age, the total and intramyocardial vessel volumes were lower, whereas the epicardial vessel volume, with and without indexing to LV mass, was significantly higher in the aged hearts compared with the young hearts. Moreover, the aged hearts had a significantly lower percentage of intramyocardial vessel volume and a significantly higher percentage of epicardial vessel volume, when normalized to the total vessel volume, compared with the young hearts. Further, the aged hearts had significant LV fibrosis and mild LV dysfunction compared with the young hearts.

Conclusions—

This micro-CT imaging study reports the reduction in normalized intramyocardial vessel volume within the aged heart, in association with increased epicardial vessel volume, in the setting of increased LV fibrosis, and mild LV dysfunction.
Nonculprit Plaques in Patients With Acute Coronary Syndromes Have More Vulnerable Features Compared With Those With Non–Acute Coronary Syndromes
Authors: Kato Koji , Yonetsu Taishi , Kim Soo-Joong , Xing Lei , Lee Hang , McNulty Iris , Yeh Robert W. , Sakhuja Rahul , Zhang Shaosong , Uemura Shiro , Yu Bo , Mizuno Kyoichi , Jang Ik-Kyung
Published: June 2012

Background—

Patients with acute coronary syndrome (ACS) have a higher incidence of recurrent ischemic events. The aim of this study was to compare the plaque characteristics of nonculprit lesions between ACS and non-ACS patients using optical coherence tomography (OCT) imaging.

Methods and Results—

Patients who had 3-vessel OCT imaging were selected from the Massachusetts General Hospital (MGH) OCT Registry. MGH registry is a multicenter registry of patients undergoing OCT. The prevalence and characteristics of nonculprit plaques were compared between ACS and non-ACS patients. A total of 248 nonculprit plaques were found in 104 patients: 45 plaques in 17 ACS patients and 203 plaques in 87 non-ACS patients. Compared with plaques of non-ACS patients, plaques of ACS patients had a wider lipid arc (147.3 ± 29.5° versus 116.2 ± 33.7°,
P
<0.001), a longer lipid length (10.7 ± 5.9 mm versus 7.0 ± 3.7 mm,
P
=0.002), a larger lipid volume index [averaged lipid arc×lipid length] (1605.5 ± 1013.1 versus 853.4 ± 570.8,
P
<0.001), and a thinner fibrous cap (70.2 ± 20.2 µm versus 103.3 ± 46.8 µm,
P
<0.001). Moreover, thin-cap fibroatheroma (64.7% versus 14.9%,
P
<0.001), macrophage (82.4% versus 37.9%,
P
=0.001), and thrombus (29.4% versus 1.1%,
P
<0.001) were more frequent in ACS patients. Although the prevalence of microchannel did not differ between the groups, the closest distance from the lumen to microchannel was shorter in ACS subjects than in non-ACS (104.6 ± 67.0 µm versus 198.3 ± 133.0 µm,
P
=0.027).

Conclusions—

Nonculprit lesions in patients with ACS have more vulnerable plaque characteristics compared with those with non-ACS. Neovascularization was more frequently located close to the lumen in patients with ACS.
Earlier Blood Pressure-Lowering and Greater Attenuation of Hematoma Growth in Acute Intracerebral Hemorrhage
Authors: Arima Hisatomi , Huang Yining , Wang Ji Guang , Heeley Emma , Delcourt Candice , Parsons Mark , Li Qiang , Neal Bruce , Chalmers John , Anderson Craig ,   for the INTERACT1 Investigators
Published: June 2012

Background and Purpose—

The INTEnsive blood pressure Reduction in Acute Cerebral hemorrhage Trial (INTERACT) pilot study showed that early intensive blood pressure-lowering can attenuate hematoma growth in acute intracerebral hemorrhage. The present analysis aimed to determine the treatment effects on hematoma growth by time from intracerebral hemorrhage onset to randomization.

Methods—

Patients (N=404) with acute intracerebral hemorrhage and elevated systolic blood pressure were randomly assigned to intensive or guideline-based blood pressure management. Baseline and repeat CT (24 and 72 hours) were performed and changes in hematoma volume were assessed using generalized estimating equations.

Results—

Among 296 patients with all 3 CT scans available for analysis, reductions in proportional hematoma growth produced by randomized intensive blood pressure-lowering treatment over 72 hours decreased progressively with delays in initiation of study treatment: 22%, 17%, 9%, and 3% for quartile groups defined by time from onset to randomization of <2.9, 2.9 to 3.6, 3.7 to 4.8, and ≥4.9 hours, respectively (
P
trend=0.001). There were also smaller absolute reductions in hematoma growth with delays in initiation of study treatment (6.5 mL, 3.3 mL, 0.9 mL, and 0.6 mL), although the trend did not reach statistical significance (
P
trend=0.12).

Conclusions—

Earlier initiation of intensive blood pressure-lowering treatment is likely to provide greater protection against hematoma growth in acute intracerebral hemorrhage.

Clinical Trial Registration Information—

http://www.clinicaltrials.gov
, NCT002226096.
Posterior Versus Anterior Circulation Infarction
Authors: Tao Wen-Dan , Liu Ming , Fisher Marc , Wang De-Ren , Li Jie , Furie Karen L , Hao Zi-Long , Lin Sen , Zhang Can-Fei , Zeng Quan-Tao , Wu Bo
Published: June 2012

Background and Purpose—

Distinguishing between symptoms of posterior circulation infarction (PCI) and anterior circulation infarction (ACI) can be challenging. This study evaluated the frequency of symptoms/signs in the 2 vascular territories to determine the diagnostic value of particular symptoms/signs for PCI.

Methods—

Neurological deficits were reviewed and compared from 1174 consecutive patients with a diagnosis of PCI or ACI confirmed by magnetic resonance imaging in the Chengdu Stroke Registry. The diagnostic value of specific symptoms/signs for PCI was determined by measuring their sensitivity, specificity, positive predictive value (PPV), and the OR.

Results—

Homolateral hemiplegia (PCI, 53.6% versus ACI, 74.9%;
P
<0.001), central facial/lingual palsy (PCI, 40.7% versus ACI, 62.2%;
P
<0.001), and hemisensory deficits (PCI, 36.4% versus ACI, 34.2%;
P
=0.479) were the 3 most common symptoms/signs in PCI and ACI. The signs with the highest predictive values favoring a diagnosis of PCI were Horner's syndrome (4.0% versus 0%;
P
<0.001; PPV=100.0%; OR=4.00), crossed sensory deficits (3.0% versus 0%;
P
<0.001; PPV=100.0%; OR=3.98), quadrantanopia (1.3% versus 0%;
P
<0.001; PPV=100.0%; OR=3.93), oculomotor nerve palsy (4.0% versus 0%;
P
<0.001; PPV=100.0%; OR=4.00), and crossed motor deficits (4.0% versus 0.1%;
P
<0.001; PPV=92.3%; OR=36.04); however, all had a very low sensitivity, ranging from 1.3% to 4.0%.

Conclusions—

This study indicates that the symptoms/signs considered typical of PCI occur far less often than was expected. Inaccurate localization would occur commonly if clinicians relied on the clinical neurological deficits alone to differentiate PCI from ACI. Neuroimaging is vital to ensure accurate localization of cerebral infarction.
Distinctive Effects of T Cell Subsets in Neuronal Injury Induced by Cocultured Splenocytes In Vitro and by In Vivo Stroke in Mice
Authors: Gu Lijuan , Xiong Xiaoxing , Zhang Hongfei , Xu Baohui , Steinberg Gary K. , Zhao Heng
Published: June 2012

Background and Purpose—

T cells and their subsets modulate ischemic brain injury. We studied the effects of the absence of T cell subsets on brain infarction after in vivo stroke and then used an in vitro coculture system of splenocytes and neurons to further identify the roles of T cell subsets in neuronal death.

Methods—

Stroke was induced by middle cerebral artery suture occlusion in mice and infarct sizes were measured 2 days poststroke. Splenocytes were cocultured with neurons, and neuronal survival was measured 3 days later.

Results—

A deficiency of both T and B cells (severe combined immunodeficiency) and the paucity of CD4 or CD8 T cells equally resulted in smaller infarct sizes as measured 2 days poststroke. Although a functional deficiency of regulatory T cells had no effect, impaired Th1 immunity reduced infarction and impaired Th2 immunity aggravated brain injury, which may be due to an inhibited and enhanced inflammatory response in mice deficient in Th1 and Th2 immunity, respectively. In the in vitro coculture system, wild-type splenocytes resulted in dose-dependent neuronal death. The neurotoxicity of splenocytes from these immunodeficient mice was consistent with their effects on stroke in vivo, except for the mice with the paucity of CD4 or CD8 T cells, which did not alter the ratio of neuronal death.

Conclusion—

T cell subsets play critical roles in brain injury induced by stroke. The detrimental versus beneficial effects of Th1 cells and Th2 cells both in vivo and in vitro reveal differential therapeutic target strategies for stroke treatment.
Electrocardiographic Changes Predict Angiographic Vasospasm After Aneurysmal Subarachnoid Hemorrhage
Authors: Ibrahim George M. , Macdonald R. Loch
Published: June 2012

Background and Purpose—

Early identification of patients at risk of angiographic vasospasm after aneurysmal subarachnoid hemorrhage (SAH) may mitigate its sequelae. One mechanism that may contribute to angiographic vasospasm is increased central sympathetic activity, which is also thought to cause electrocardiographic (ECG) changes after SAH. Here, we perform the first study to determine the association between ECG changes and angiographic vasospasm after SAH.

Methods—

Exploratory analysis was performed on 413 patients from CONSCIOUS-1, a prospective randomized trial of clazosentan for the prevention of angiographic vasospasm. ECGs were obtained within 24 hours of aneurysm rupture and during the vasospasm risk period. Angiographic vasospasm was assessed using catheter angiography at baseline and 7 to 11 days after SAH. Multivariate logistic regression was used to identify significant associations.

Results—

The most prevalent finding on ECG both immediately following SAH and during the vasospasm risk period was QT prolongation (42% and 25%, respectively). A prolonged QT interval and tachycardia on the baseline ECG were associated with angiographic vasospasm (OR, 1.86; 95% CI, 1.00–3.45; and OR, 10.83; 95% CI, 1.17–100.50, respectively). QT prolongation on ECG during the vasospasm risk period was also associated with angiographic vasospasm (OR, 3.53; 95% CI, 1.67–7.39). No ECG findings were associated with delayed ischemic neurological deficit, but tachycardia and ST changes were associated with worse clinical outcome.

Conclusions—

QT prolongation and tachycardia on ECG were independently associated with angiographic vasospasm after aneurysmal SAH on multivariate analysis.

Clinical Trial Registration—

URL:
http://clinicaltrials.gov
. Unique Identifier: NCT00111085.
Using Cognitive Task Analysis to Identify Critical Decisions in the Laparoscopic Environment
Authors: Craig Curtis , Klein Martina I. , Griswold John , Gaitonde Krishnanath , McGill Thomas , Halldorsson Ari
Published: June 2012

Objective:

The aim of this study was to identify the critical decisions surgeons need to make regarding laparoscopic surgery, the information these decisions are based on, the strategies employed by surgeons to reach their objectives, and the difficulties experienced by novices.

Background:

Laparoscopic training focuses on the development of technical skills. However, successful surgical outcomes are also dependent on appropriate decisions made during surgery, which are influenced by critical cues and the use of appropriate strategies. Novices might not be as adept at cue detection and strategy use.

Method:

Participants were eight attending surgeons. The authors employed task-analytic techniques to identify critical decisions inherent in laparoscopy and the cues, strategies, and novice traps associated with these decisions.

Results:

The authors used decision requirements tables to organize the data into the key decisions made during the preoperative, operative, and postoperative phases as well as the cues, strategies, and novice traps associated with these decisions. Key decisions identified for the preoperative phase included but were not limited to the decision of performing a laparoscopic versus open surgery, necessity to review the literature, practicing the procedure, and trocar placement. Some key decisions identified for the operative phase included converting to open surgery, performing angiograms, cutting tissue or organs, and reevaluation of the approach. Only one key decision was identified for the postoperative phrase: whether the surgeon’s technique needs to be evaluated and revised.

Conclusion:

The laparoscopic environment requires complex decision making, and novices are prone to errors in their decisions.

Application:

The information elicited in this study is applicable to laparoscopic training.
Trends and correlates of post-retirement employment, 1977–2009
Authors: Pleau Robin , Shauman Kimberlee
Published: June 2012

The stereotypical retirement experience – the abrupt ceasing of all paid work and commencement of a life of leisure – is the experience of only half of all workers. Yet, despite the prevalence of combining work and retirement in the US and the implications this work-retirement behavior may have for organizations and individual workers, post-retirement employment behavior is understudied. In this article, we add to the growing literature on retirement and late-life employment processes by examining the trends and correlates of post-retirement employment in the US from 1977 to 2009. We find a modest curvilinear trend in post-retirement employment for both males and females over the last 33 years. However, the modest upward trends in post-retirement employment obscure the countervailing influences of significant changes in behavior and in the macro-level demographic and economic forces that are significant determinants of post-retirement employment.
Turmoil in the Nile River Basin: Back to the Future?
Authors: Yohannes Okbazghi , Yohannes Keren
Published: June 2012

Since the end of the Cold War, the Nile co-basin states have been moving towards constructing a regional water governance regime. The focus has been on how to promote cooperative harmonization of the water needs and growth priorities of all basin countries. Unfortunately, the effort appears to have come to a screeching halt, resuscitating old fears of potential inter-riparian conflicts. This paper examines the evolution of contentious politics of hydrology in the Nile basin in light of the regional and international approaches that have hitherto been employed to bring the co-basin states together on the importance of peaceful utilization of Nile waters.
Reliability-based design optimization analysis of tube hydroforming process
Authors: El Hami A , Radi B , Cherouat A
Published: June 2012

In this paper, we are interested particularly in the tube hydroforming process (THP). This process consists of applying an inner pressure combined with an axial displacement to manufacture the part. During the manufacturing phase, inappropriate choice of the load paths can lead to failure. Deterministic approaches are unable to optimize the process by taking into account the uncertainty. So we introduce the reliability-based design optimization (RBDO) to optimize the process under probabilistic constraints to ensure a high reliability level and stability during the manufacturing phase and avoid the occurrence of such plastic instability. Taking some uncertainties into account the process is very stable and associated with a low failure probability. The definition of the objective function and the probabilistic constraints take advantage of the forming limit diagram (FLD) and the forming limit stress diagram (FLSD) used as a failure criterion to detect the occurrence of wrinkling, severe thinning and necking. To validate the proposed approach, the THP is then introduced as an example. The numerical results show the robustness and efficiency of the RBDO to improve thickness distribution and minimize the risk of potential failure modes.
Toward a Completely Constructivist Critical Terrorism Studies
Authors: Stump Jacob L. , Dixit Priya
Published: June 2012

This paper uses Patrick Thaddeus Jackson’s monism/dualism distinction to clarify ongoing methodological debates among students of critical terrorism studies (CTS). We map the distinction onto the CTS literature and emphasize the distinctive ontological starting points and the distinctive epistemological frameworks entailed by each perspective. Then we critically engage monistic, or interpretivist, CTS research, especially that of Richard Jackson. We argue for a more methodologically explicit and logically consistent interpretivist CTS and we suggest three important steps that researchers can take to achieve this aim: (i) take an explicit ontological stance; (ii) embrace reflexivity; (iii) conceptualize terrorism as a meaning-making practice.
On the Methods of Critical Theory: Advancing the Project of Emancipation beyond the Early Frankfurt School
Authors: Brincat Shannon
Published: June 2012

This article offers a reconstruction of the methodological tools pioneered by the first generation of the Frankfurt School (FS) and how they have been adapted in the contemporary project of emancipation in Critical International Relations Theory (CIRT). It is argued that the praxeological and methodological commitments of the early FS are of continuing utility in the post-positivist turn in IR theory. The paper also argues that CIRT has made significant advances on the original programme of CT developed by Horkheimer in the early 1930s. In particular, it is contended that the alleged pessimism typically associated with the later work of the early FS can be overcome if critical analysis looks beyond the state to those possibilities of emancipation pregnant within the global processes of world politics. Here the work of CIRT is argued to offer a number of advances on the sociology of the early FS, which was problematically confined to the examination of Euro- and state-centric possibilities for emancipation.
Narratives, myths and prejudice in understanding employment systems: The case of rigidities, dismissals and flexibility in Spain
Authors: Rodríguez Carlos Jesús Fernández , Lucio Miguel Martínez
Published: June 2012

This contribution is intended to understand the complex issues that underpin the debate on ‘free labour markets’ and job dismissal that has become very important in the context of the current economic crisis. Irrespective of economic debates and their nuances, the article focuses on the way related debates are shaped and how discussions about industrial relations, the labour market and even the economy are structured. The article discusses this in the context of Spain, where the debate has become a touchstone of national concern and external images of the country. In the case of Spanish industrial relations, the free dismissal discourse has been and still is vital for defining the way policy is prescribed, constructed and constrained.
The experience of post-secondary education for students in recovery from addiction to drugs or alcohol
Authors: Terrion Jenepher Lennox
Published: June 2012

Given the drug and alcohol-friendly nature of most college and university campuses, young people who have struggled with addiction to substances – and who are overcoming these struggles – face many challenges in maintaining their recovery and achieving academic success. Using recovery capital as a theoretical framework, this study explored aspects of the academic experience of students in recovery, including the identity formation process, development of relationships, and use of support services. Thematic analysis of in-depth semi-structured interviews showed the development and mobilization of personal, family/social, and community recovery capital and highlighted areas of difficulty in building these resources. The article points to the importance of social and personal relationships to both abstinence and academic success for students in recovery and discusses the role of policy in facilitating the mobilization of recovery capital.
Inflation and deflation timing of the AutoCAT 2 WAVE intra-aortic balloon pump using the autoPilot mode in a clinical setting
Authors: Bakker EWM , Visser K , van der Wal A , Kuiper MA , Koopmans M , Breedveld R
Published: June 2012

The primary goal of this observational clinical study was to register the occurrence of incorrect inflation and deflation timing of an intra-aortic balloon pump in autoPilot mode. The secondary goal was to identify possible causes of incorrect timing. During IABP assistance of 60 patients, every four hours a strip was printed with the IABP frequency set to 1:2. Strips were examined for timing discrepancies beyond 40 ms from the dicrotic notch (inflation) and the end of the diastolic phase (deflation). In this way, 320 printed strips were examined. A total of 52 strips (16%) showed incorrect timing. On 24 of these strips, the incorrect timing was called incidental, as it showed on only one or a few beats. The other 28 cases of erroneous timing were called consistent, as more than 50% of the beats on the strip showed incorrect timing. We observed arrhythmia in 69% of all cases of incorrect timing. When timing was correct, arrhythmia was found on 13 (5%) of 268 strips. A poor quality electrocardiograph (ECG) signal showed on 37% of all strips with incorrect timing and 11% of all strips with proper timing. We conclude that inflation and deflation timing of the IABP is not always correct when using the autoPilot mode. The quality of the ECG input signal and the occurrence of arrhythmia appear to be related to erroneous timing. Switching from autoPilot mode to operator mode may not always prevent incorrect timing.
The veil under attack
Authors: Chakraborti Neil , Zempi Irene
Published: June 2012

In the current climate, the veil is the key visual symbol of Islam. The veiled female body is central in the construction of discourses on the difference of the Muslim as ‘other’ with the non-Muslim ‘self’. The effect is that the multiple meanings of the veil are erased, and only one stands out: the veil as a symbol of gender inequality. This article explores the ways in which the visibility of the veil in the public gaze marks its wearers as particularly vulnerable to expressions of Islamophobia in a non-Muslim country such as the United Kingdom. Whilst the concept of Islamophobia is often understood in gender-neutral ways, evidence suggests that there are gendered dimensions to manifestations of Islamophobia in the public sphere. Stereotypes about veiled women’s subservience coupled with the assumption that their Muslim identity cannot be mistaken, denied or concealed, renders veiled women ‘ideal subjects’ against whom to enact anti-Muslim hostility. For victims, their families and the wider Muslim community, Islamophobic victimization can have significant and ongoing consequences. The article concludes that increased awareness of the gendered facets of Islamophobia unveils the targeted – yet hidden, often invisible – victimization of veiled Muslim women in public, as this victimization tends to fall under the criminal justice ‘radar’.
An imprisoning gaze
Authors: Pollack Shoshana
Published: June 2012

This article examines how correctional systems absorb feminist-inspired reformist discourses that focus upon women's victimization as a ‘pathway’ to incarceration. Through the absorption process the concept of gender loses its socio-economic and political resonance, centering instead the psychological effects of gender oppression. A psychological notion of gender has been used to individualize and pathologize criminalized women through prison programming and is linked with notions of ‘risk’ to re-offend. I reflect upon the role of evidence-based practice (EBP) in exacerbating epistemic problems related to the subjectivity of the ‘risky victim.’ Moving beyond this conceptualization, I suggest the importance of an analysis which draws connections across spaces of confinement and challenges the very role and practices of prisons as examples of racialized and gendered violence themselves.
Biomechanical Comparison of 3 Methods to Repair Pectoralis Major Ruptures
Authors: Rabuck Stephen J. , Lynch Jamie L. , Guo Xin , Zhang Li-Qun , Edwards Sara L. , Nuber Gordon W. , Saltzman Matthew D.
Published: June 2012

Background:

Pectoralis major ruptures are closely associated with weight lifting and participation in sports. The anatomy of the pectoralis major tendon is unique with an elongated thin footprint requiring multiple points of fixation to restore the native anatomy. Multiple options exist for tendon repairs, but the strongest construct has yet to be identified.

Purpose:

The intent of this study was to compare the load to failure of bone trough, cortical button, and suture anchor repairs of the pectoralis major tendon in the extended and abducted position.

Study Design:

Controlled laboratory study.

Methods:

Thirty fresh-frozen cadaveric shoulders were divided equally into 3 groups based on the repair technique to be performed. Bone mineral density of the surgical neck of the proximal humerus was assessed before each repair. Bone trough, suture anchor, and cortical button repairs were performed as dictated by computerized randomization. Each specimen was loaded to failure and mode of failure was noted.

Results:

The majority of failures occurred through the suture used for tendon repair. One specimen in the bone trough group failed via fracture of the proximal humerus. The suture anchor group failed at the implant in 5 of 9 specimens and through the suture in 4 of 9 specimens. Load to failure was greatest in bone trough repairs at 596 N, followed by cortical button at 494 N, and finally suture anchor repairs with 383 N. Load to failure was significantly greater in the bone trough group when compared with suture anchor repairs ( P = .007). No correlation was found between bone mineral density and load to failure.

Conclusion:

Bone trough repair of the pectoralis major tendon was stronger than suture anchor repair.

Clinical Relevance:

Identification of the strongest repair may help guide surgical repair.
Properties of municipal solid waste incineration ashes with respect to their separation temperature
Authors: Keppert Martin , Pavlík Zbyšek , Tydlitát Vratislav , Volfová Petra , Švarcová Silvie , Šyc Michal , Černý Robert
Published: June 2012

Fly ashes generated by power and heating plants are commonly used in the production of building materials in some countries, mainly as partial replacement of cement or aggregates in concrete. The ashes from municipal solid waste incinerators can be applied in a similar way. However, their chemical and mineralogical composition, granulometry and toxic constituents have to be taken into account. In this paper, four types of municipal solid waste incinerator (MSWI) ashes produced by the modern MSWI facility in Liberec, Czech Republic, were investigated. The relationship between the particular ash properties (morphology, chemical composition) and its separation temperature in the incinerator line is discussed. A coal fly ash (class F) is characterized as well, for a comparison because its utilization in building industry is more developed. The studied MSWI ashes exhibit high concentration of chlorides and sulfates which is an unfavourable feature for a potential concrete admixture. On the other hand, three of four ashes are found to be pozzolanic active and certain hydration reactions are indicated.
The Challenge of Developing a New Predictive Formula to Estimate Energy Requirements in Ventilated Critically Ill Children
Authors: Meyer Rosan , Kulinskaya Elena , Briassoulis George , Taylor Rachel M. , Cooper Mehrengise , Pathan Nazima , Habibi Parviz
Published: June 2012

Background: Traditionally, energy requirements have been calculated using predictive equations. These methods have failed to calculate energy expenditure accurately. Routine indirect calorimetry has been suggested, but this method is technically demanding and costly. This study aimed to develop a new predictive equation to estimate energy requirements for critically ill children. Methods: This prospective, observational study on ventilated children included patients with an endotracheal tube leak of <10% and fractional inspired oxygen of <60%. An indirect calorimetry energy expenditure measurement was performed and polynomial regression analysis was used to develop new predictive equations. The new formulas were then compared with existing prediction equations. Results: Data from 369 measurements were included in the formula design. Only weight and diagnosis influenced energy expenditure significantly. Three formulas (A, B, C) with an R2 > 0.8 were developed. When we compared the new formulas with commonly used equations (Schofield, Food and Agriculture Organization/World Health Organization/United Nations University, and White equation), all formulas performed very similar, but the Schofield equation seemed to have the lowest SD. Conclusions: All 3 new pediatric intensive care unit equations have R2 values of >0.8; however, the Schofield equation still performed better than other predictive methods in predicting energy expenditure in these patients. Still, none of the predictive equations, including the new equations, predicted energy expenditure within a clinically accepted range, and further research is required, particularly for patients outside the technical scope of indirect calorimetry.
Validity of the Five-Word Test for the Evaluation of Verbal Episodic Memory and Dementia in a Memory Clinic Setting
Authors: Mormont Eric , Jamart Jacques , Robaye Laurence
Published: June 2012

Background: The five-word test (FWT) uses semantic clues to optimize the encoding and retrieval of 5 items. Our objective was to assess the validity of the FWT as a measure of episodic memory when compared with the Free and Cued Selective Reminding Test (FCSRT), and its ability to distinguish participants with any dementia and especially Alzheimer disease (AD) from those with only subjective complaints. Methods: Two hundred participants with Mini-Mental State Examination (MMSE) >15 were prospectively evaluated. The sum of the immediate and delayed free recalls of the FWT is called the free recall score (FRS). The sum of the immediate free, immediate cued, delayed free, and delayed cued recalls is called the total recall score (TRS). A total weighted score (TWS) is calculated using this formula: (free recalls × 2) + cued recalls. Results: The correlation between FRS and the free recall scores of the FCSRT and between TRS and the total recall scores of the FCSRT was significant ( rs ranges from .74-.84, P < .001). Area under the receiver–operating characteristic (ROC) curves of the MMSE, FRS, TRS, and TWS were not statistically different. A TWS at a cutoff value ≤15 could discriminate any dementia from subjective complaints with a sensitivity of 75% and a specificity of 95.9% or AD from subjective complaints with a sensitivity of 90.2% and a specificity of 95.9%. Conclusion: The FWT is a valid test of verbal episodic memory. It is useful to discriminate dementia especially AD from isolated subjective complaints.
Using Latent Class Analysis to Identify Sophistication Categories of Electronic Medical Record Systems in U.S. Acute Care Hospitals
Authors: Shea Christopher M. , Weiner Bryan J. , Belden Charles M.
Published: June 2012

Many believe that electronic medical record (EMR) systems hold promise for improving the quality of health care services. The body of research on this topic is still in the early stages, however, in part because of the challenge of measuring the capabilities of EMR systems. The purpose of this study was to identify classes of EMR system sophistication in hospitals as well as hospital characteristics associated with the sophistication categories. The data used were from the American Hospital Association (AHA) and the Health Information Management and Systems Society (HIMSS). The sample included acute care hospitals in the United States with 50 beds or more. We used latent class analysis to identify the sophistication classes and logistic regression to identify the relationships between these classes and hospital characteristics. Our study identifies cumulative categories of EMR sophistication: ancillary-based, ancillary/data aggregation, and ancillary-to-bedside. Rural hospital EMRs are likely to be ancillary based, while hospitals in a network are likely to have either ancillary-based or ancillary-to-bedside EMRs. Future research should explore the effect of network membership on EMR system development.
An efficient fusion approach to rule extraction based on rough set theory and particle swarm optimization and its application
Authors: Deng Wu , Yang Xinhua , Zou Li , Zhao Huimin , Li Wen
Published: June 2012

Rule extraction is viewed as an important pretreatment step for machine learning and data mining. In allusion to the shortcomings of the rough set method for rule extraction in systems with incomplete fault diagnosis, in this paper we propose a novel fusion approach based on rough set theory and particle swarm optimization for rule extraction (RSTPSORE) in order to improve the diagnostic robustness and accuracy. In the proposed method, first, an iterative linear subsection interpolation completion method is used to achieve completion of the fault diagnosis process. Then rough set theory is used to find a subset which can preserve the meaning of the attributes. Particle swarm optimization is used to discover the best rule within the flying subset space. To verify the efficiency of the proposed method, experiments are carried out on the collected data in a centralized control substation incomplete fault diagnosis system. The results indicate that the proposed method can provide an efficient solution to finding a minimal subset.
Decoupling and levitation control of a six-degree-of-freedom magnetically levitated stage with moving coils based on commutation of coil array
Authors: Zhang Shengguo , Zhu Yu , Mu Haihua , Yang Kaiming , Yin Wensheng
Published: June 2012

The research in the present paper focuses on decoupling the six-degrees-of-freedom motions of a magnetically levitated stage with moving coils and controlling the levitation motion. The decoupling is based on commutation of coil array, which is obtained reversely from the electromagnetic force/torque model of the stage. The control of levitation motion is carried out by a phase lead-lag controller designed on the criterion of minimum integral of time-weighted absolute error after gravity compensation modeling of the plant dynamics. Comprehensive simulations of the control system in MATLAB/Simulink and real levitation experiments on a digital signal processor-centered test platform are made to verify the six-degrees-of-freedom decoupling effect and the closed-loop control performances of the levitation degree of freedom. The results indicate that the six-degrees-of-freedom motions of the stage can be decoupled through coil array commutation and the levitation motion can be controlled by the phase lead-lag controller based on the gravity compensation model and designed on the criterion of minimum integral of time-weighted absolute error.
Stamping the message: psychiatric themes in philately
Authors: Rodrigo Asiri , Majoor Jennifer
Published: June 2012

Objective:

The objective of this article is to examine the representation of psychiatric themes within medical philately (stamps) over a recent seven-year period.

Method:

Examination of all stamps issued from 1 January 2002 to 31 December 2009 worldwide took place using the World Association for the Development of Philately Numbering System (WNS) on the Universal Postal Union website.

Results:

During the study period, 596 stamps with medical themes were issued around the world. Common psychiatric themes included: psychoactive substance use, recreational drug messages, ‘anti-tobacco’ and human emotions. Notable people, the World Psychiatry Congress and intellectual disability also featured prominently.

Conclusions:

Philately may have a role in anti-stigma campaigns within psychiatry. The highest number of medical stamps have psychiatric themes, yet this potential resource may not be currently utilised to maximal benefit. Philately is being adapted to the electronic age of communication.
A multiple-degree-of-freedom piezoelectric energy harvesting model
Authors: Tang Lihua , Yang Yaowen
Published: June 2012

Conventional vibration energy harvesters have been usually studied as single-degree-of-freedom models. The fact that such harvesters are only efficient near sole resonance limits their applicability in frequency-variant or random vibration scenarios. In this article, a novel multiple-degree-of-freedom piezoelectric energy harvesting model is presented. First, a two-degree-of-freedom model is analyzed, and its two configurations are characterized. In the first configuration, the piezoelectric element is placed between one mass and the base, and in the second configuration, it is placed between the two masses. It is shown that the former is advantageous over the latter since with a slight increase of overall weight to the single-degree-of-freedom model, we can achieve two close and effective peaks in power response or one effective peak with significantly enhanced magnitude. The first configuration is then generalized to an n-degree-of-freedom model, and its analytical solution is derived. This solution provides a convenient tool for parametric study and design of a multiple-degree-of-freedom piezoelectric energy harvesting model. Finally, the equivalent circuit model of the proposed n-degree-of-freedom piezoelectric energy harvesting model is developed via the analogy between the mechanical and electric domains. With the equivalent circuit model, system-level electric simulation can be performed to evaluate the system performance when sophisticated interface circuits are attached.
Serum Antibodies to the Heparin/Platelet Factor 4 Complex Are an Independent Predictor of Thrombotic Complications Following Pediatric Fontan Surgery
Authors: Zhang Ruidong , Huang Yue , Zhang Mazhong , Bai Jie , Liu Jinfen
Published: June 2012

Antibodies to the heparin/platelet factor 4 complex (heparin/PF4) are linked to the pathogenesis of heparin-induced thrombocytopenia (HIT) and to the thrombotic complications. We investigated thrombotic events during early follow-up in a pediatric cardiac surgical population to ascertain whether there is a relation between heparin/PF4 antibody concentration and post-surgical thrombotic complications. One hundred and five consecutive pediatric patients treated by Fontan surgery were studied. The presence of serum heparin/PF4 immunoglobulins IgG, IgA, and IgM (collectively termed HIT antibodies) were measured in preoperative and postoperative blood samples by enzyme-linked immunosorbent assay. On day six after Fontan surgery, HIT-related thromboses was identified in total of 11 patients (10.5%). HIT antibodies were detected in 34 of 105 patients (32.4%). The post-surgical nadir platelet count was significantly lower in patients who developed antibodies ( p < 0.001). We found the odds ratio (OR) for this composite endpoint was 4.06 ( p < 0.001). Seropositive status for heparin/PF4 antibodies was an independent predictor of thrombotic events (OR 2.28; p < 0.001). Quintile analysis revealed that the median nadir platelet value was significantly lower in patients with higher HIT antibody titers. Patients in the highest quintile of HIT antibody titer all experienced thrombotic events, while only two thrombotic events occurred in patients in the lowest quintile ( p < 0.001). Heparin-induced thrombocytopenia is a rare occurrence in pediatric cardiac surgical patients. Patients who develop antibodies to the heparin/PF4 complex have a significantly higher rate of postoperative thrombotic events than patients who lack these antibodies. Within the seropositive group, the risk of developing thrombosis increased with the plasma antibody concentration.
Depression in Australian women: The varied roles of spirituality and social support
Authors: Bennett Kellie S , Shepherd Julie M
Published: June 2012

This study investigated the influence of spirituality on depression in Western Australian women. Two hundred and seventy-eight women (aged 18–78) completed an online survey about factors relating to daily spiritual experience, depression, anxiety and social support. Significant correlations were found between spiritual experience and depression, whereby individuals who reported higher spirituality also reported higher rates of social support and lower levels of depression. A major finding from this study was that spirituality accounted for a significant proportion of variance in depressive symptoms beyond the mediating effect of social support.
Cultural studies and social movements: A crucial nexus in the American case
Authors: Cruz Jon D.
Published: June 2012

Cultural studies took hold in the USA in the context of politics fronted by youth, multi-racial, and gender movements that emerged in the wake of the much larger Civil Rights Movement of the 1960s. With a full-blown academic legitimation crisis well under way, cultural studies resonated strongly with social struggles that shaped both its reception as well as its capacity to augment new intellectual academic formations. Retrieving the historical nexus questions views that treat and limit British cultural studies to being mainly an intellectual import-export phenomenon. The overlooked historical nexus fosters trivialization anad caricature of cultural studies’ incorporation in the American academia, resulting in both conservative antipathy and left disappointments feeding into the common binary narratives of the ‘failure’ of cultural studies for being too Marxist and not Marxist enough. Restoring the historical nexus underscores the value of cultural formations and projects Williams proposed, while cautioning theoreticist and methodological enclosures.
Gender difference in QT interval in patients with primary aldosteronism
Authors: Kurisu Satoshi , Kato Yasuko , Mitsuba Naoya , Ishibashi Ken , Dohi Yoshihiro , Nishioka Kenji , Kihara Yasuki
Published: June 2012

Introduction:

We assessed whether QT interval was still different between male and female patients with primary aldosteronism. We also assessed the gender difference in the relation between serum potassium level and QT interval.

Materials and methods:

The study population consisted of 80 patients with newly diagnosed primary aldosteronism. There were 39 male and 41 female patients.

Results:

There were no significant (ns) differences in serum potassium (3.6±0.7 mEq/l vs 3.8±0.5mEq/l, p=ns) and QTc interval (423±26 msec vs 427±23 msec, p=ns) between male and female patients. In overall patients, serum potassium level was inversely associated with QTc interval significantly ( r=−0.36, p<0.01). In male patients, there was still a significant inverse correlation ( r=−0.42, p<0.01). However, this correlation was lost in female patients ( r=−0.30, p=ns).

Conclusions:

Our data suggested that QTc interval was inversely associated with serum potassium level in male patients, but was not in female patients with primary aldosteronism.
Universities Gone Wild
Authors: Giroux Henry A. , Giroux Susan Searls
Published: June 2012

This article argues that the Penn State scandal both symbolizes the corruption of higher education by big money, big sports, and corporate power and points to what we describe as a symptom of the war on youth. Penn State, like many of its counterparts, has become a corporate university caught in the grip of the military-industrial-academic complex rather than an institution driven by public values and ethical considerations. We argue that the Penn State scandal reveals a hidden order of politics that is a paradigmatic example of mission drift, one largely marked by a retreat from its role as a vital democratic public sphere to an institution willing to subordinate educational values to market values. Stuck in what might be called “an output fundamentalism,” Penn State like many other universities now prioritizes market mechanisms that emphasize performance measures that subordinate and tarnish scholarship with an emphasis on bringing in bigger grants, expanding profits, and narrating itself through the celebrity culture of sports. One consequence is that young people are increasingly defined primarily in market terms and subject to modes of education run like factory assembly lines and shaped in the image of shopping malls and high end entertainment complexes. And as the case of serial abuse that took place on the Penn State campus reveals, they are also considered disposable. We examine this scandal within a wide range of registers and argue that the scandal itself cannot be viewed simply through as a narrative about sexual abuse, a fall from grace for the university, or as a tragic commentary on the career of Coach Joe Paterno.
Missing Pieces, Repetitive Practices
Authors: Staller Karen M.
Published: June 2012

The sexual abuse and exploitation of children is a serious problem. Adult sexual predators often use strategies known as grooming to entice their victims. These include targeting particularly vulnerable youth, gift giving, and systematically engaging in desensitizing sexual behaviors. Less commonly discussed is the notion of institutional grooming, the practice of strategically placing themselves in positions of public trust where they have access to children yet appear beyond reproach. Once situated, they can abuse children for decades without deterrence in spite of the fact that individuals around them may be aware–or partially aware–of their behavior. This article examines three cases, one involving a priest, another a football coach, and the third a pediatrician and considers the institutional practices and cultures that permit (or potentially permit) abuse and exploitation to flourish. Among other things it finds: confidentiality mandates and other codes of silence and secrecy impede information sharing; departmental or programmatic silos exist each with their own independent and competing agendas; confused reporting lines within the institution often end in the hands of powerful individuals who have an interest in non-disclosure; barriers exist to investing within the institution and reporting outside the institution often including mistrust and disempowerment of law enforcement and child protective services; extreme power differences exist between and among victims, predators, reporters, and other institutional players; and finally, intense loyalties personal, professional, and institutional are present. These factors produce institutional cultures that protect pedophiles and conspire against their vulnerable, individual, child victims.