bluuebunny/crossref_metadata_2025 huggingface dataset:
Adhesion mechanism of space-climbing robot based on discrete element and dynamics
Authors: Hou Xuyan , Su Yilin , Jiang Shengyuan , Li Long , Chen Tao , Sun Lining , Deng Zongquan
Published: April 2018

According to the on-orbit servicing requirements of spacecraft, this article presents a new type of space-climbing robot that can climb onto the target spacecraft for repairing, rescuing, and removing orbital debris. This robot mobile system is composed of a piezoelectric actuation leg, microadhesive feet, and others. In the environment of zero gravity, the space-climbing robot can cross obstacles through crawling movement and turnover movement. The gripping force of the robot is supplied by the adhesive capacity of the robot feet. The research on its adhesion mechanism is the basis of the robot feet design and motion control. The design of a robot feet microarray structure imitates the adhesion mechanism of gecko seta. Based on the theory of interface micromechanics, we used EDEM software to establish the simulation model of vertical microarrays. This work will simulate the microarray’s attaching and detaching processes with different modes of motion, analyzing each microarray’s adhesive property. In order to make the structure of microarray has ideal adhesive property, microarray parameters including length–diameter ratio and arrangement density of microarray are optimized. By EDEM-ADAMS coupling simulation, the robot can attach to the surface of the spacecraft and verify the adhesion function of the space-climbing robot.
Characterization of a rare variant (c.2635-2A>G) of the MSH2 gene in a family with Lynch syndrome
Authors: Cariola Filomena , Disciglio Vittoria , Valentini Anna M. , Lotesoriere Claudio , Fasano Candida , Forte Giovanna , Russo Luciana , Di Carlo Antonio , Guglielmi Floranna , Manghisi Andrea , Lolli Ivan , Caruso Maria L. , Simone Cristiano
Published: April 2018

Introduction:

Lynch syndrome is caused by germline mutations in one of the mismatch repair genes ( MLH1, MSH2, MSH6, and PMS2) or in the EPCAM gene. Lynch syndrome is defined on the basis of clinical, pathological, and genetic findings. Accordingly, the identification of predisposing genes allows for accurate risk assessment and tailored screening protocols.

Case Description:

Here, we report a family case with three family members manifesting the Lynch syndrome phenotype, all of which harbor the rare variant c.2635-2A>G affecting the splice site consensus sequence of intron 15 of the MSH2 gene. This mutation was previously described only in one family with Lynch syndrome, in which mismatch repair protein expression in tumor tissues was not assessed. In this study, we report for the first time the molecular characterization of the MSH2 c.2635-2A>G variant through in silico prediction analysis, microsatellite instability, and mismatch repair protein expression experiments on tumor tissues of Lynch syndrome patients. The potential effect of the splice site variant was revealed by three splicing prediction bioinformatics tools, which suggested the generation of a new cryptic splicing site. The potential pathogenic role of this variant was also revealed by the presence of microsatellite instability and the absence of MSH2/MSH6 heterodimer protein expression in the tumor cells of cancer tissues of the affected family members.

Conclusions:

We provide compelling evidence in favor of the pathogenic role of the MSH2 variant c.2635-2A>G, which could induce an alteration of the canonical splice site and consequently an aberrant form of the protein product (MSH2).
Vehicle detection framework for challenging lighting driving environment based on feature fusion method using adaptive neuro-fuzzy inference system
Authors: Pae Dong Sung , Choi In Hwan , Kang Tae Koo , Lim Myo Taeg
Published: April 2018

This article proposes a new preceding vehicle detection framework for challenging lighting environments using a novel feature fusion technique based on an adaptive neuro-fuzzy inference system. A combination of two feature descriptors, the histogram of oriented gradients and local binary patterns, is adopted to improve the vehicle detection accuracy of the proposed framework, and the performance of the combination in image transformations is evaluated. Furthermore, we tested the detection performance of the proposed framework in three challenging driving conditions and filmed the test image sequences for each categorized environment of the experiments. The experimental results demonstrate that the proposed framework outperforms the conventional framework under specific driving environments with harsh lighting conditions.
Use of glucocorticoids in patients with COPD exacerbations in China: a retrospective observational study
Authors: Zhang Jing , Zheng Jinping , Huang Kewu , Chen Yahong , Yang Jingping , Yao Wanzhen
Published: April 2018

Background:

Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are common in patients with underlying moderate to severe COPD and are associated with increased health and economic burden. International and Chinese guidelines recommend using glucocorticoids for the management of AECOPD because glucocorticoid therapy has been shown to benefit clinical outcomes. However, only scant data are available for current status of glucocorticoid therapy in hospitalized AECOPD patients in China. The aim of the study was to identify current use of glucocorticoids for the treatment of AECOPD in China.

Methods:

This retrospective, multicenter, noninterventional study evaluated the treatment pattern of AECOPD in patients hospitalized from January 2014 to September 2014 at 43 sites (41 tertiary hospitals and two secondary hospitals) in China. The endpoints of the study were the percentage of patients receiving glucocorticoids by different routes of administration, doses and duration, mortality, and the mean length of hospitalization.

Results:

A total of 4569 patients (90.17%) received glucocorticoids for AECOPD treatment. A combination of nebulized and systemic route was most frequently used (40.51%), followed by using nebulized route alone (38.00%), systemic route alone (15.45%), and inhaled route other than nebulization (6.04%). Furthermore, the most commonly prescribed glucocorticoids of the nebulized, intravenous, inhaled (other than nebulized) and oral route was budesonide (69.4%), methylprednisolone sodium succinate (45.31%), fluticasone propionate (19.54%), and prednisone acetate (11.90%), respectively. The in-hospital mortality rate was 1.24% and the mean length of hospitalization was 12.22 ± 6.20 days (± SD).

Conclusions:

Our study was the first study of the treatment pattern of glucocorticoids in the management of hospitalized AECOPD patients in China. Data indicates that there is a gap in the implementation of international guidelines for the treatment of AECOPD in China. Further studies are warranted to clarify the appropriate glucocorticoids strategy for the management of AECOPD to determine the optimal route of administration, dose and duration, and resulting clinical outcomes.
Factors associated with emotional distress in patients with myocardial infarction: Results from the SWEDEHEART registry
Authors: Norlund Fredrika , Lissåker Claudia , Wallert John , Held Claes , Olsson Erik MG
Published: April 2018

Background

Emotional distress, symptoms of depression and anxiety, is common among patients after a myocardial infarction (MI), and is associated with an increased risk of cardiovascular morbidity. Real world population data on factors associated with emotional distress in MI patients are scarce. The aim was to determine factors associated with incident emotional distress two and 12 months post MI respectively, and with persistent emotional distress, versus remittent, in patients <75 years old.

Design

This was a registry-based observational study.

Methods

Data from the national SWEDEHEART registry on 27,267 consecutive patients with a first-time MI, followed up at two and 12 months post MI ( n = 22,911), were included in the analyses. Emotional distress was assessed with the EuroQol-5D questionnaire. Several candidate sociodemographic and clinical factors were analysed for their association with emotional distress in multivariate models.

Results

Symptoms of emotional distress were prevalent in 38% and 33% at two and 12 months post MI respectively. At both time-points, previous depression and/or anxiety, readmission for new cardiovascular event, female gender, younger age, born outside the neighbouring Nordic countries, smoking and being neither employed nor retired showed the strongest associations with emotional distress. Other factors related to medical history, the MI and its care or were only modestly associated with emotional distress. Persistent emotional distress was associated with younger age, female gender, smoking and being born outside of the Nordic countries.

Conclusion

Previous depression/anxiety, female gender, younger age, smoking, born outside of the Nordic countries, neither employed nor retired and readmission due to cardiovascular events were strongly associated with emotional distress post MI. These factors may be of relevance in tailoring rehabilitation programmes.
Measuring smartphone usage and task switching with log tracking and self-reports
Authors: Deng Tao , Kanthawala Shaheen , Meng Jingbo , Peng Wei , Kononova Anastasia , Hao Qi , Zhang Qinhao , David Prabu
Published: April 2018

Smartphones offer multimedia convergence in a single device, ubiquitous access to media, and constant connections with others. The rapid rise of smartphone use calls for more scholarly attention paid to users’ media usage and time expenditure. This study aims to (a) understand smartphone usage patterns by examining time spent using smartphones and task switching between mobile applications (apps), and (b) test the validity of self-reported measures of these behaviors by comparing self-reports with log data from the smartphone. Data were collected from 50 participants over 1 week. Results show that on average participants spent 2 hours 39 minutes on their smartphone and made 101 app switches per day. Among other findings, social networking was the most used app category, age was a significant demographic factor, and participants, especially heavy smartphone users, overestimated their mobile app usage. Theoretical and practical implications of these findings are discussed.
Cardiopulmonary Bypass Reduces Early Thrombosis of Systemic-to-Pulmonary Artery Shunts
Authors: Patregnani Jason T. , Sochet Anthony A. , Zurakowski David , Klugman Darren , Diab Yaser , Berger John T. , Sinha Pranava
Published: April 2018

Background:

Shunt thrombosis is a significant cause of morbidity and mortality after systemic-to-pulmonary artery shunt (SPS) placement. Concurrent procedures with placement of SPS may require cardiopulmonary bypass (CPB). Cardiopulmonary bypass is known to cause bleeding and platelet dysfunction in infants, which may protect from early shunt thrombosis. We hypothesized that infants undergoing SPS placement on CPB have a lower incidence of early shunt thrombosis.

Methods:

Retrospective cohort study of infants undergoing SPS placement from January 2008 to December 2014 was performed. Patients with and without early shunt thrombosis and on or off CPB were compared using the Mann-Whitney U test or Fisher exact test. Multivariable regression analysis was performed to identify independent predictors of early shunt thrombosis and to assess effect of CPB independent of other factors.

Results:

Seventy-five infants underwent SPS placement during the study period (on CPB, n = 25; off CPB, n = 50). Operative mortality was 11% (8/75). Nine (12%) patients developed early shunt thrombosis, all of whom had shunt placement off CPB. Independent risk factors for early shunt thrombosis were identified to be SPS placement off CPB ( P = .011), prematurity ( P = .034), and competitive antegrade pulmonary blood flow ( P = .038).

Conclusion:

Prematurity, competitive antegrade pulmonary blood flow, and shunt placement off CPB lead to higher risk of early shunt thrombosis. We speculate that the protection offered by use of CPB may be accounted for by the associated complex coagulopathy and platelet dysfunction associated with CPB.
Optimal Use of Z-Scores to Preserve the Pulmonary Valve Annulus During Repair of Tetralogy of Fallot
Authors: Awori Mark Nelson , Mehta Nikita P. , Mitema Frederick O. , Kebba Naomi
Published: April 2018

Objective:

The size of the pulmonary annulus measured as a z-score is often used to determine when to insert a transannular patch (TAP). Multiple “cutoffs” are quoted in the literature; this could lead to inappropriate insertion. We aimed to determine whether the use of z-scores derived from different populations may have contributed to the varied “cutoffs” quoted.

Methods:

PubMed was searched using the terms: “tetralogy,” “Fallot,” “transannular,” “patch,” “mortality,” and “death.” Studies published between January 1, 2005, and October 5, 2017, were included; studies without participants under the age of 18 years and studies that did not describe the operative procedure were excluded.

Results:

Of 52 papers retrieved, 19 were included representing 2,500 repaired patients; 1,371 (54.8%) had a TAP. Five (26.3%) papers representing 638 patients (25.5%) quoted a z-score “cutoff” and what data set was used; “cutoffs” ranged from −2 to −4 and were derived from 2 different data sets. Three studies quoted a data set that has been shown in previous work to be problematic; the only quoted “cutoffs” of −4 were from two of these studies.

Conclusions:

Surprisingly few (26.3%) studies mention what pulmonary annulus size “cutoff” was used to decide when to insert a TAP. Z-scores derived from different populations were used by different studies and it is possible that this may have contributed to the varied “cutoffs’ quoted. Recommendations to perform valve-sparing surgery in pulmonary annuli as small as −4 may not be warranted. Future papers should record “cutoffs” employing recommended z-score data set.
Ping-Pong Ball, Tumor or Thrombus in the Right Atrium? A Case Report
Authors: Ghaleb Stephanie , Roosevelt Bryant , Cnota James
Published: April 2018

Tumors and thrombi are the most common cardiac masses of the right atrium. The use of noninvasive imaging to differentiate between the two can be deceiving, and the clinical judgment of a cardiologist and the emergency of the situation should be partnered to decide on the next step of the management. We present the case of a 29-year-old lady who was receiving neoadjuvant treatment for her rhabdomyosarcoma and was incidentally found to have a very large, very mobile right atrial mass that was protruding in the right ventricle with each cardiac cycle along with findings of a small segmental right lower lobe pulmonary embolism. Along with noninvasive imaging, frozen section analysis procured the wrong diagnosis, and the mass was ultimately found to be a right atrial thrombus on definite pathology review. Exact management of right atrial masses continues to be not well delineated, and when in doubt, final diagnosis might need to be “a posteriori” and based on the treatment response.
Implant Prophylaxis: The Next Best Practice Toward Asepsis in Spine Surgery
Authors: Agarwal Aakash , Schultz Christian , Goel Vijay K. , Agarwal Anand , Anand Neel , Garfin Steve R. , Wang Jeffrey C.
Published: April 2018

Study Design:

A literature review.

Objectives:

An evaluation of the contaminants prevalent on implants used for surgery and the aseptic methods being employed against them.

Methods:

PubMed was searched for articles published between 2000 and 2017 for studies evaluating the contaminants present on spine implants, and associated pre- and intraoperative implant processing and handling methodology suggested to avoid them. Systematic reviews, observational studies, bench-top studies, and expert opinions were included.

Results:

Eleven studies were identified whose major focus was the asepsis of implants to reduce the incidence of surgical site infection incidences during surgery. These studies measured the colony forming units of bacteria on sterilized implants and/or gloves from the surgeon, scrub nurse, and assistants, as well as reductions of surgical site infection rates in spine surgery due to changes in implant handling techniques. Additionally, the search included assessments of endotoxins and carbohydrates present on reprocessed implants. The suggested changes to surgical practice based on these studies included handling implants with only fresh gloves, keeping implants covered until the immediate time of use, reducing operating room traffic, avoiding reprocessing of implants (ie, providing terminally sterilized implants), and avoiding touching the implants altogether.

Conclusions:

Both reprocessing (preoperative) and handling (intraoperative) of implants seem to lead to contamination of sterilized implants. Using a terminally sterilized device may mitigate reprocessing (preoperative implant prophylaxis), whereas the use of fresh gloves for handling each implant and/or a permanent shielding technique (intraoperative implant prophylaxis) could potentially avoid recontamination at the theatre.
Degenerative Lumbar Spine Disease: Estimating Global Incidence and Worldwide Volume
Authors: Ravindra Vijay M. , Senglaub Steven S. , Rattani Abbas , Dewan Michael C. , Härtl Roger , Bisson Erica , Park Kee B. , Shrime Mark G.
Published: April 2018

Study Design:

Meta-analysis-based calculation.

Objectives:

Lumbar degenerative spine disease (DSD) is a common cause of disability, yet a reliable measure of its global burden does not exist. We sought to quantify the incidence of lumbar DSD to determine the overall worldwide burden of symptomatic lumbar DSD across World Health Organization regions and World Bank income groups.

Methods:

We used a meta-analysis to create a single proportion of cases of DSD in patients with low back pain (LBP). Using this information in conjunction with LBP incidence rates, we calculated the global incidence of individuals who have DSD and LBP (ie, their DSD has neurosurgical relevance) based on the Global Burden of Disease 2015 database.

Results:

We found that 266 million individuals (3.63%) worldwide have DSD and LBP each year; the highest and lowest estimated incidences were found in Europe (5.7%) and Africa (2.4%), respectively. Based on population sizes, low- and middle-income countries have 4 times as many cases as high-income countries. Thirty-nine million individuals (0.53%) worldwide were found to have spondylolisthesis, 403 million (5.5%) individuals worldwide with symptomatic disc degeneration, and 103 million (1.41%) individuals worldwide with spinal stenosis annually.

Conclusions:

A total of 266 million individuals (3.63%) worldwide were found to have DSD and LBP annually. Significantly, data quality is higher in high-income countries, making overall quantification in low- and middle-income countries less complete. A global effort to address degenerative conditions of the lumbar spine in regions with high demand is important to reduce disability.
Dog Bites in Children: A Descriptive Analysis
Authors: McGuire Connor , Morzycki Alex , Simpson Andrew , Williams Jason , Bezuhly Michael
Published: April 2018

Objective:

To describe characteristics of dog bites and their treatment in a pediatric population including infection, medical specialties involved, rates of admission, and need for surgery.

Method:

Patients presenting with a dog bite to the emergency department of a tertiary care pediatric hospital between January 1, 2015, and June 30, 2017, were included. Details related to demographics, complications, consultations, and treatment were extracted from the patients’ records. Descriptive statistics were performed and binary logistic regression was used to assess potential predictors of infection.

Results:

One hundred fifty-eight dog bite patients were identified. Most patients were male (53.8%) and less than 5 years of age (50%). Bites occurred most frequently in June (13.3%) and July (16.5%). The face was most commonly involved (42.9%), followed by the hands (12.6%) and the scalp (26.6%). Pit bulls (11.4%), Labrador retrievers (7.0%), and German shepherds (4.4%) were the most common offending breeds. Most bites were superficial (91.1%). Half were treated conservatively with dressings and petrolatum-based ointment, with 41.1% requiring simple primary closure. Ten (6.3%) cases necessitated primary repair in the main operating room under general anesthesia. More than half of patients were treated with prophylactic systemic antibiotics (55.1%). Plastic surgery was the most common service involved (24.7%). Seven (4.4%) patients developed an infection and there were no mortalities or long-term complications. Rates of infection did not differ between patients who did or did not receive prophylactic systemic antibiotics ( P = .88). Regression analysis revealed no significant predictors of infection.

Conclusions:

Most dog bites are superficial and involve the head and hands. Infection rate is low, with no significant difference in infection rates between patients treated with or without prophylactic antibiotics.
Are We Over Treating Hand Fractures? Current Practice of Single Metacarpal Fractures
Authors: Retrouvey Helene , Morzycki Alexander , Wang Annie M. Q. ,   The Canadian Plastic Surgery Research Collaborative, Binhammer Paul
Published: April 2018

Purpose:

We conducted a national survey of Canadian plastic surgeons to assess if inconsistencies in management strategies exist for single metacarpal fractures.

Methods:

A cross-sectional study of Canadian plastic surgeons who perform hand surgeries was conducted. A 15-question survey was distributed to all members of the Canadian Society of Plastic Surgeons. Participants’ demographics, practice settings, and current treatment strategies for patients presenting with single metacarpal fractures were evaluated.

Results:

A total of 113 Canadian plastic surgeons met inclusion criteria. The majority of respondents were male (76%), with 50% in practice for more than 15 years. Canadian surgeons used a wide variety of surgical techniques for the management of single metacarpal fractures, with close reduction (94%), Kirshner wires (94%), and splinting and immobilization (89%) being the most common. The majority of plastic surgeons stated that rotational deformity (81%) was the most important indication for surgery. Surgeons demonstrated a trend toward immobilization after splinting (48%), instead of early mobilization after splinting (21%). When results were stratified by years in practice, no differences in surgical and non-surgical management were found, although surgeons in practice for less than 15 years were more likely to suggest hand therapy.

Conclusion:

These findings demonstrate inconsistencies in management of single metacarpal fractures among Canadian plastic surgeons. Surprisingly, surgeons in the survey tended to favor immobilization, as oppose to the literature that favors mobilization. The study highlights the lack of clear guidelines dictating treatment, possibly leading to these inconsistencies.
Changing Roles, Changing Perspectives—Vulnerability as a Patient
Authors: Schuler Monika
Published: April 2018

As an assistant professor of nursing and nurse in an emergency department, I offer my perspective on being a patient with cancer and the element of feeling vulnerable associated with an “insiders” viewpoint of the health-care system.
Clinical and laboratory profile of juvenile-onset systemic sclerosis in a Brazilian cohort
Authors: Sampaio-Barros Percival D , Bortoluzzo Adriana B , Del Rio Ana Paula T , Luppino-Assad Ana Paula , Andrade Danieli CO , Marques-Neto João Francisco
Published: April 2018

Objective:

To characterize the clinical and laboratory profile of juvenile-onset compared to adult-onset systemic sclerosis in a large Brazilian cohort.

Methods:

Retrospective analysis of a cohort of 1016 systemic sclerosis patients followed at the Scleroderma Outpatient Clinic from two referral university centers in Brazil. Patients were classified as systemic sclerosis according to the 1980 American College of Rhaumatology (ACR) criteria. Juvenile-onset systemic sclerosis was defined if age at onset was <16 years.

Results:

Thirty-one (3.1%) patients were classified as juvenile-onset systemic sclerosis. These patients were predominantly females (90.3%), Caucasians (71.0%), and presented diffuse systemic sclerosis (51.6%), with mean age at onset of 12.71 years. Compared to the adult-onset patients, juvenile onset was associated with diffuse systemic sclerosis (p < 0.001), calcinosis (p < 0.001), myositis (p = 0.050), and lower frequency of interstitial lung disease (p = 0.050), pulmonary hypertension (p = 0.035), and esophageal (p = 0.005) involvement.

Conclusion:

Juvenile-onset systemic sclerosis characterized a distinct clinical pattern in this large series of systemic sclerosis patients, since it was predominantly associated with diffuse systemic sclerosis without significant organ involvement.
Minute Pulsed Electromagnetic Neurostimulation for Mixed Trauma Syndromes
Authors: Nelson David V. , Esty Mary Lee
Published: April 2018

Research regarding noninvasive brain stimulation technologies for the treatment of mild traumatic brain injury (mTBI), posttraumatic stress disorder (PTSD), and mixed (mTBI/PTSD) trauma syndromes has been increasing exponentially. Technologies with the greatest potential thus far include repetitive transcranial magnetic stimulation (rTMS), transcranial direct current stimulation (tDCS), and cranial electrotherapy stimulation (CES). The nature and some of the controversies distinguishing mTBI, PTSD, and mTBI/PTSD are reviewed along with evidence for shared underlying mechanisms. An overview of treatment applications for rTMS, tDCS, and CES are also reviewed. A novel variant of a minute pulsed electromagnetic stimulation technology linked to ongoing electroencephalograph monitoring known as the Flexyx Neurotherapy System is introduced with an overview of the technology and technique, as well as a summary of supportive data to date that explores potential applications for amelioration of these syndromes.
Cardiovascular Risks of Fluphenazine in a Patient With Schizophrenia
Authors: Burton Samantha , Prokop Matthew , Kaakeh Yaman
Published: April 2018

Objective: Patients with psychiatric illnesses are at an increased risk for heart disease, and many antipsychotic medications elicit adverse effects on the heart. This report summarizes conduction abnormalities manifested as chest pain when a patient is treated with fluphenazine decanoate. Case Summary: A 61-year-old male with a history of schizophrenia, coronary artery disease, and atrial fibrillation presented complaining of chest pain and shortness of breath with moderate T-wave abnormality detected on electrocardiogram. The patient recently initiated fluphenazine decanoate intramuscular injection while continuing oral fluphenazine as directed. Discussion: Utilizing the Naranjo algorithm, the cardiac conduction abnormality was determined to be a possible adverse event associated with fluphenazine use. This was based on recent initiation and increasing dose of fluphenazine and documented association of antipsychotics and risk of Torsades de Pointes. Conclusions: While it is known that fluphenazine decanoate can cause extrapyramidal adverse effects, this case demonstrates that it may also play a role in causing or exacerbating cardiovascular adverse events. Continued cardiovascular monitoring after starting fluphenazine decanoate is warranted.
Interface between general adult and old age psychiatry
Authors: Khrypunov Oleksandr , Aziz Raheel , Al-Kaissy Ban , Jethwa Ketan , Joseph Verghese
Published: April 2018

Older people with mental health problems are entitled to the same level and quality of care as younger people. Several factors continue to influence policy and delivery of older adults' mental health services in the UK. Following the introduction of the Equality Act 2010, there has been a drive to create an ‘ageless’ National Health Service. This has opened up the debate about whether such a service is best equipped to meet the specific needs of older adults. In this contribution we consider the concepts of ‘old age’ and ‘frailty’ and their clinical and service provision implications in psychiatry. The management of late-life depression and early-onset dementia, advance care planning and palliation in dementia are also considered.

LEARNING OBJECTIVES

•

Appreciate how old age psychiatric services and the concept of ‘old age’ have evolved over time

•

Gain an understanding of issues at the interface between old age and general adult psychiatry and those specific to old age psychiatry

•

Gain an overview of procedures involved in transferring care between general adult and old age psychiatric services and the need for a separate old age psychiatry subspecialty

DECLARATION OF INTEREST

None.
Liaison psychiatry: heart and lung transplantation
Authors: Sheehan John D.
Published: April 2018

Owing to the continuing shortage of organs, the demand for transplantation outstrips supply. Liaison psychiatrists, as part of a multidisciplinary team, have a key role in the assessment of transplant candidates and participate in the decision-making process regarding ‘listing’ the patient for transplantation. Psychiatric and psychosocial factors affect prognosis post-transplantation and there are absolute and relative contraindications to transplantation. The skills of the liaison psychiatrist are employed throughout the patient's illness journey, in the pre-, peri- and post-transplantation periods.

LEARNING OBJECTIVES

•

Learn the salient factors in a pre-transplantation psychosocial assessment

•

Know the contraindications to transplantation

•

Appreciate the factors associated with a poor outcome post-transplantation

DECLARATION OF INTEREST

None.
Nest box exploration may stimulate breeding physiology and alter mRNA expression in the medial preoptic area of female European starlings
Authors: Spool Jeremy A. , Jay Melannie D. , Riters Lauren V.
Published: April 2018

Environmental resources are proposed to fine-tune the timing of breeding, yet how they may do so remains unclear. In female European starlings (Sturnus vulgaris), nest cavities are limited resources that are necessary for breeding. Females that explore nest cavities, compared to those that do not, readily perform sexually-motivated behaviors. We assigned female starlings to aviaries with 1) no nest boxes, 2) nest boxes, or 3) nest boxes, plants, flowing water, insects and berries to test the hypothesis that environmental resources alter neural systems to stimulate mating behavior. Compared to other females, females that were housed with and explored nest boxes had higher estradiol, higher preproenkephalin (PENK) mRNA, and lower levels of D1 and D2 dopamine receptor mRNA in the medial preoptic area (mPOA), a region in which opioids and dopamine modify female sexual behaviors and sexual motivation. Additionally, in the mPOA, PENK and tyrosine hydroxylase mRNA positively predicted, whereas estrogen receptor beta mRNA negatively predicted nest box exploration. In the ventromedial hypothalamus, a region in which estradiol acts to stimulate sexual behavior, estrogen receptor alpha mRNA was highest in females that had access to but did not explore nest cavities. It is likely that seasonal increases in estradiol modify mRNA in the mPOA to facilitate nest cavity exploration. It is also possible that nest cavity exploration further alters gene expression in the mPOA, functioning to coordinate mating with resource availability. Thus nest cavity exploration may be a form of self-stimulation that alters neural systems to fine-tune sexual behavior.
Berufliche Umweltbildung - wo steckst Du?
Authors: Fichter Klaus , Nitschke Christoph
Published: April 2018

Trotz der verbreiteten Aktivitäten im Bereich beruflicher Umweltbildung ist däs Wissen über den quantitativen und qualitativen Stand der Umweltbildung recht beschränkt. Insbesondere liefern die punktuellen Forschungsarbeiten und Erfahrungsberichte keine fundierte Auskunft darüber, was die berufliche Umweltbildung »gebracht« hat. Vor diesem Hintergrund hat das IÖWin Zusammenarbeit mit dem Institut für Umweltbildung im Beruf, IfUB, eine Untersuchung praktischer Beispiele be-ruflicher Umweltbildung in 28 Unternehmen, Berufsschulen und Bildungseinrichtungen durchgeführt. Mit Abschluß der Untersuchung, die von der Deutschen Bundesstiftung Umwelt gefördert wurde, liegt erstmals ein Bericht über einen größeren »Erfahrungsraum« in der beruflichen Umweltbildung vor. Er stellt zugleich den ersten Vorstoß auf das heikle Gebiet dar, in dem es um grundlegende Ein-schätzungen und Bewertungen bisheriger Aktivitäten der Umweltbildung geht. Der Artikel enthält eine Kurzbeschreibung des Forschungsprojektes, der Ergebnisse und Schlußfolgerungen.
Going Dutch in Environmental Policy
Authors: Tuininga Eric-Jan
Published: April 2018

In many discussions on Environmental Policy the Dutch efforts since 1989 are mentioned as a laud-able example for other governments. But after five years of hard work and three National Environ-mental Policy Plans (nepp), the effectiveness of all these policy plans are still up for debate, most of all in the Netherlands itself. Environmental policy is more than writing plans and as it turns out the implementation of policies is more unruly than expected. OECD's recent 'Environmental Performance Review' of the Dutch policies even wondered if the Dutch planning and agreement approach could backfire and prevent some real solutions.
Engaging Stakeholders: The Next Challenge in Corporate Environmental Reporting
Authors: Andrea Spencer-Cooke
Published: April 2018

SustainAbility has recently embarked on the third phase of its work with the United Nations Envi-ronment Programme (UNEP). Our aim: to focus on >Stage 5< sustainable development reporting and stakeholders. Below, Andrea Spencer-Cooke, SustainAbility's Programme Manager, reviews the progress to date.
Umweltberichte: notwendig, aber nicht hinreichend
Authors: Richert Heiko
Published: April 2018

Kraft Jacobs Suchard Deutschland hat 1994/95 seinen ersten Umweltbericht veröffentlicht (1). Eines der Grundprinzipien des Umweltmanagements bei Kraft Jacobs Suchard und damit erklärtes Ziel des Umweltberichtes ist das »Fordern und Fördern« des umweltpolitischen Dialogs und der umweltpolitischen Kooperation mit allen gesellschaftlichen Gruppen (S. 9,13,19). Die bisherigen Erfahrungen sind positiv bis vielversprechend - mit einer relativ deutlichen Ausnahme: die Umweltund Verbraucherverbände und auch die Wissenschaft. Diese halten sich mit einer Reaktion (noch) spürbar zurück (2).
Ecological Economics: Zur Einführung
Authors: Soete Birgit
Published: April 2018

Die Ecological Economics (ökologische Ökono-mie) hat sich ungefähr vor zehn Jahren zu einer eigenständigen Denkrichtung oder Teildisziplin innerhalb der Ökonomie entwickelt. Die Vertre-terinnen dieser Denkrichtung grenzen sich in ihrem Selbstverständnis von der neoklassischen Umwelt- und Ressourcenökonomie ab, da sie diese in vielerlei Hinsicht als zu reduktionistisch finden. Da inzwischen analytische Erkenntnisse sowie methodische Ansätze vorliegen, deren Er-gebnisse auch zunehmend politischen Einfluß erlangen, ist es an der Zeit, den wissenschaftlichen Erkenntnisfortschritt dieses Forschungsgebietes einmal zusammenfassend im Informationsdienst vorzustellen und zu diskutieren: Was verbirgt sich hinter dem Begriff ökologische Ökonomie, der zur Zeit auch in Deutschland in Mode kommt? Was ist der Unterschied zur Umwelt-und Ressourcenökonomie? Welche neueren Erkenntnisse sind mit diesem Ansatz gewonnen worden?
Die Chancen der Wuppertaler Strategie gegen den postfordistischen Wettbewerbsstaat: Zukunftsfähig trotz globaler Umbrüche?
Authors: Hein Wolfgang
Published: April 2018

Die Wuppertal-Studie definiert zwar ein Ziel, aber nicht den Weg, der zu diesem Ziel führt. Es bleibt ungeklärt, wie es der Kapitalismus schaffen kann, sich gegen die tendenziell selbstzerstörerischen, ökonomischen, sozialen und ökologischen Konsequenzen seiner eigenen Dynamik zu schützen und diese zu wenden.
From Environmental Space to the Ecological Debt: The Ecological Debt is increasing all the time
Authors: Martinez-Alier Juan
Published: April 2018

Die Auswirkungen auf die Länder des Südens gehören zu den stark diskutierten Aspekten eines Zukunftsfähigen Deutschlands. Nach Meinung des Autors ist die Botschaft dieser Studie an diese Länder ungenügend: Es werden weder die "ökologischen Schulden" des Nordens gegenüber dem Süden behandelt noch die "Umwelteinstellungen der Armen" berücksichtigt. Im Gegenteil, die Studie übernehme unkritisch die These von der postmateriellen Werthaltung.
Nachhaltiger Konsum aus der Nord-Süd-Perspektive: Ökologisierung im Norden - Auswirkungen auf den Süden
Authors: Scholz Imme
Published: April 2018

In den Industrieländern werden von den Verbrauchern zunehmend Anforderungen an Produkte gestellt: sie sollen weder die Umwelt noch die Gesundheit belasten. Diese veränderten Ansprüche dürften Auswirkungen auf die Hersteller auch im Ausland haben. Welche positiven und negativen Aspekte sind damit für die Entwicklungsländer verbunden?
Entwicklungsstränge der ökologischen Konsumforschung
Authors: Bodenstein Gerhard , Spiller Achim
Published: April 2018

Die Konsumforschung ist von theoretischen bis hin zu praxisorientierten Ansätzen sehr unterschiedlich angelegt. Dabei wird meist klar zwischen den Forschungsrichtungen getrennt und übergreifende Aspekte kaum berücksichtigt. In einer Studie der Dortmunder Universität wurde versucht sozialpsychologische Umweltbewußtseinsforschung mit einzubeziehen.
Toxic Release Inventory (TRI) - Umweltberichterstattung in den USA: Chance oder Risiko
Authors: Aucott Mike
Published: April 2018

Das in den USA bereits 1987 eingeführte Gefahrstoffemissionskataster, Toxic Release Inventory (TRI), hat eine Verringerung der Emissions- und Abfallmengen von U.S.-Industriebetrieben bewirkt. Dennoch wird eine Ausweitung des TRI kontrovers diskutiert.
Auf dem Weg zum deutschen Umweltplan: Im Konsens zur Nachhaltigkeit?
Authors: Kottmann Heinz
Published: April 2018

Das Bundesumweltministerium hat sich vorgenommen, die nationalen Anstrengungen zur nachhaltigen Entwicklung zielorientiert zu bündeln. Eine Diskussionveranstaltung Anfang Juli bildete den Auftakt zur Erarbeitung des ersten deutschen Umweltplans, woran sich alle gesellschaftlichen Interessengruppen beteiligten.
Eigenständig und integriert
Authors: Fichter Klaus
Published: April 2018

Die Umweltkostenrechnung ist als wesentlicher Bestandteil des Umweltmanagements ein oft noch vernachlässigtes Gebiet. Praxistauglichkeit und eine Ausgestaltung im Sinne eines aktiven und ingetrierten Umweltschutzes sind nur in Ausnahmefällen gegeben, wie ein Gutachten von IÖW und IÖB zeigt. Wie hat sich die Umweltkostenrechnung entwickelt und wie kann sie verbessert werden?
Ist ökologische Mobilität planbar?
Authors: Hesse Markus
Published: April 2018

Die Ansichten über die Verkehrsentwicklungen sind deutlich polarisiert zwischen der Aufrechterhaltung des Status Quo auf der einen und der ge-staltenden Forderung nach einer Verkehrswende auf der anderen Seite. Mit welchen Schwierigkeiten muß die kommunale ökologische Verkehrsplanung kämpfen? Ist das Verkehrsmanagement der richtige Weg?
Schafft Erwerbsarbeit mehr Verkehr?
Authors: Knothe Bettina , Czyganowski Sonja
Published: April 2018

Die Gestaltung der Arbeitsmärkte hat wesentlichen Einfluß auf Art und Ausmaß der Arbeitsmobilität. Dem Wohnstandort, der Verkehrsmittelwahl und der Gestaltung der Gewerbsarbeit kommen daher besondere Bedeutung zu. An den Beispielen Bremen und Halle/Saale zeigt sich, wie eng diese Faktoren mitein-ander verknüpft sind und wo Einflußmöglichkeiten liegen.
Innovation und Nachhaltigkeit
Authors: Meyer-Krahme Frieder
Published: April 2018

Der staatlichen Forschungs- und Entwicklungspolitik kommt eine Schlüsselrolle sowohl für die Attraktivität des Wirtschaftsstandortes als auch für die Handlungsmöglichkeiten zur Förderung einer Politik der Nachhaltigkeit zu. Eine aktuelle Studie zeigt, daß nicht nur die Spitzenforschung sondern auch das Tempo des Lernens und Beherrschens neuer Lösungen entscheidend ist.
Einige Koordinaten auf unbekanntem Te n
Authors: Wiesenthal Helmut
Published: April 2018

Das Thema Globalisierung steht heute im Mittelpunkt der meisten wirtschafts-politischen Diskussionen. Dabei bestehen über die Dimensionen und die zu erwartenden Folgen der Globalisierung sehr unterschiedliche Einschätzungen. Inwieweit sind diese Folgen von den "praktischen" Interessen verschiedener Akteure geprägt? Welche soziokulturellen und politischen Chancen bieten sich und wie können sie genutzt werden?
Reform ökologisch mitprägen
Authors: Mackscheidt Klaus
Published: April 2018

In den letzten Jahren wurde viel über eine ökologische Steuerreform diskutiert. Doch bei den jetzigen Reformvorhaben spielt sie kaum eine Rolle obwohl sie sich gut in deren Zielsetzung einpassen würde.
Ökologie als Leitwissenschaft?
Authors: Beckmann Arnim
Published: April 2018

Ob und welchen Beitrag die Ökologie zur ökonomisch-ökologischen Bewertung liefern kann, dieser Frage geht der Autor in diesem Beitrag nach. Dabei geht es insbesondere darum, ob der Ökologie eine Tendenz zu konservativen Werten immanent ist oder ob Fortschritt ökologisch denkbar ist.
Vorsorgendes Wirtschaften
Authors: Biesecker Adelheid , Jochimsen Maren , Knobloch Ulrike
Published: April 2018

Das Konzept des Vorsorgenden Wirtschaftens wurde vom Arbeitskreis - seit 1996 Netzwerk - "Vorsorgendes Wirtschaften", dem Frauen aus der Schweiz, Osterreich und Deutschland angehören, entwickelt. Die Arbeit an dem Konzept ist ein andauernder Prozeß - die hier dargestellten Grundgedanken und Strukturen sind Ausdruck dieses Prozesses.
Durch Kooperation zu umwelt-verträglicheren Produkten?
Authors: Zundel Stefan
Published: April 2018

Die ökologische Optimierung von Produkten ist bislang vor allem die Angele-genheit einzelner Unternehmen oder bestenfalls Gegenstand einer horizontalen Kooperation mehrerer Unternehmen, die das gleiche Produkt herstellen. Da der ökologische Veränderungswille und die ökologische Veränderungsfähigkeit in der Wertschöpfungskette eher in Ausnahmefällen auf der gleichen Stufe ange-siedelt sind, sollte geprüft werden, ob und wie durch eine Kooperation entlang einer Wertschöpfungskette durch Innovation ökologische Optimierungspoten-tiale freigesetzt werden können.
Von der Ökobilanz zur Umweltleistungsmessung
Authors: Clausen Jens
Published: April 2018

Eine wesentliche Grundlage für Umweltmanagementsysteme sind Informationen über die betrieblichen Stoff- und Energieverbräuche. Der Artikel gibt einen Überblick über die Entwicklung der Instrumente zur Informationserhebung und stellt die Bedeutung des Öko-Controlling für die Umweltleistungsmessung heraus.
Streik gegen die Verschwendung von Zukunft
Authors: Daxner Michael
Published: April 2018

Mehr Geld für die Hochschulen, erweiterte Mitbestimmung und sinn-volle, auch ökologische, Inhalte - dafür lohnt es sich, auf die Straße zu gehen.
Top-down oder Bottom-up?
Authors: Jänicke Martin
Published: April 2018

Die Frage nach den Erfolgsbedingungen von Umweltpolitik ist eine typisch transdisziplinäre Herausforderung. Formal ist sie ein Teil der Policy-Analyse. Um die Erfolgsbedingungen umweltpolitischen Handelns zu verstehen, gilt es, sich von isolierten disziplinaren Top-Down-Ansätzen zu lösen und sich der Fragestellung mit interdisziplinärer Offenheit und empirisch gestützten bottom-up-Ansätzen zu nähern. Der Beitrag geht auf das Wesen und die Möglichkeiten beider Ansätze für die Policy-Analyse ein.
Benzinpreis - der Brotpreis der Moderne?
Authors: Hesse Markus
Published: April 2018

Die Forderung der Bündnisgrünen, den Benzinpreis innerhalb der nächsten zehn Jahre auf 5 Mark/Liter zu erhöhen und die fast schon hysterische Reaktion in der Öffentlichkeit darauf geben in mehrfacher Hinsicht zu denken. Auf der Tagesordnung stehen Grundfragen der politischen Kommunikation, sowie Restriktionen und Spielräume der Umweltpolitik.
Qualitätsunterschiede
Authors: Clausen Jens , Fichter Klaus
Published: April 2018

Schon 1994 und 1995 hotte das IÖW gemeinsam mit future e.V. die Qualität der Umweltberichterstattung deutscher Unternehmen bewertet. Dabei war deutlich geworden, daß nach den Jahren der Avantgardisten mit Einführung der EG-Oko-Audit-Verordnung 1993 eine Phase der qualitativ anspruchsvolleren Umweltberichte begann. Soeben ist das Ranking für 1997 erschienen
Öko-strategische Informationen
Authors: Stahlmann Volker
Published: April 2018

Das herkömmliche betriebliche Rechnungswesen ist in vielfacher Hinsicht überfordert, Umweltwirkungen des Unternehmens umfassend aufzuzeigen. Unternehmen, die ein offensives, proaktives Umweltmanagement anstreben, brauchen daher eine ökologieorientierte Neugestaltung ihres Rechnungswesens. Der Artikel gibt einen Überblick über mögliche Ansätze und Beispiele.
Kein Platz für den Produktbezug?
Authors: Schmidt Mario
Published: April 2018

Die derzeit gültige europäische EG-Öko-Audit-Verordnung ist auf den einzelnen Standort eines Unternehmens ausgerichtet. Damit grenzt sie sich nicht nur von einem möglichen Organisationsbezug der ISO 14001, sondern auch von einem Produktbezug ab. Ein solcher würde eine Berücksichtigung des Lebensweges eines Produktes von der Wiege bis zur Bahre erfordern und müßte damit nicht nur standortübergreifend, sondern sogar organisationsübergreifend sein.
Step by Step
Authors: Rubik Frieder
Published: April 2018

Die Umweltpolitik hot sich Produkten zugewendet, wie die Schlagworte Produktverantwortung, Responsible Care oder Lebenszyklusdenken zeigen. Gleichzeitig erhielten "weiche" Instrumente wie EMAS in der Umweltpolitik eine wachsende Bedeutung. Ist im Sinne einer Verknüpfung ein verbesserter Produktbezug von EMAS angezeigt und wie könnte dieser erfolgen?
Standards im Wettbewerb
Authors: Petschow Ulrich
Published: April 2018

Normen und Standards können zur Senkung der Transaktionskosten von markt liehen Austauschprozessen, vor allem der Senkung des Transaktionsrisikos und der Erhöhung der Vertrauenswürdigkeit, einen wesentlichen Beitrag leisten. Was bedeutet dies für die Weiterentwicklung von EMAS?
Paradigmatische Neuorientierung
Authors: Beckenbach Frank
Published: April 2018

Ökologisch-ökonomische Komplexitätsforschung behandelt die Nutzung ökologischer Ressourcen aus ökonomischer Perspektive als Aufeinanderwirken von zwei Systemen, die jeweils für sich auf unterschiedliche Weise komplex sind. Hieraus ergeben sich sowohl analytisch als auch politisch-programmatisch erhebliche Konsequenzen.
Konzept Nachhaltigkeit
Authors: Lehmann Sabine
Published: April 2018

Nach mehr als drei Jahren Arbeit, Diskussionen, Anhörungen von Expertinnen und diversen Studien hat die Enquete-Kommission "Schutz des Menschen und der Umwelt" Ende Juni ihren Abschlußbericht präsentiert.
Neue Dächer nötig?
Authors: Molitor Reimar
Published: April 2018

Nach der Initiierung vieler kommunaler Lokale Agenda 21-Prozesse rückt die Raumebene Region derzeit stärker in den Blickpunkt. Implementierung und Ausgestaltung Nachhaltiger Regionalentwicklung innerhalb der Regionen gestalten sich vor Ort sehr heterogen. Ohne den vermessenen Anspruch einer starren Kategorisierung versucht dieser Beitrag, die Konzepte zu systematisieren.
Facilitating Autonomy
Authors: Sweeney Gerry
Published: April 2018

Nachhaltige Entwicklung ist ohne regionalen Bezugspunkt nicht vorstellbar. Sie kann nur auf der Ebene einer Region, deren Grenzen von der dort lebenden Bevölkerung definiert werden, in Gang gesetzt werden. Wie kann dies geschehen und welche Rolle spielt dabei die Regierung? Im Kern geht es darum, das soziale Kapital der Region zu stärken und einen eigenständigen Entwicklungsprozeß zu ermöglichen. Die Grundlage dafür bilden gemeinsame Wertvorstellungen und Entrepreneurship vor Ort.
Towards a Holistic Approach
Authors: Regan Sean
Published: April 2018

Wie gestaltet sich Nachhaltige Regionalentwicklung im Europa der Regionen? Beispielhaft werden die Ergebnisse eines Pilotprojekts für ein raumbezogenes Umweltkennzeichen in Irland vorgestellt. Der "Beatha"-Award wird anhand eines Kriterienkatalogs an Regionen vergeben, die eine hochwertige Umwelt mit einer glaubhaften Selbstbindung der lokalen Akteure, diese nachhaltig zu schützen, verknüpfen. Als Grundlage dient ein Umweltressourcenaudit