bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessment of a University of California, Los Angeles 4‐Variable Risk Score for Advanced Heart Failure
Authors: Sartipy Ulrik , Goda Ayumi , Mancini Donna M. , Lund Lars H.
Published: June 2014

Background

The 4‐variable risk score from University of California, Los Angeles (
UCLA)
demonstrated superior discrimination in advanced heart failure, compared to established risk scores. However, the model has not been externally validated, and its suitability as a selection tool for heart transplantation (HT) and left ventricular assist device (LVAD) is unknown.

Methods and Results

We calculated the
UCLA
risk score (based on B‐type natriuretic peptide, peak
VO
2
, New York Heart Association class, and use of angiotensin‐converting enzyme inhibitor or angiotensin receptor blocker) in 180 patients referred for HT. The outcome was survival free from urgent transplantation or LVAD. The model‐predicted survival was compared to Kaplan‐Meier's estimated survival at 1, 2, and 3 years. Model discrimination and calibration were assessed. During a mean follow‐up of 2.1 years, 37 (21%) events occurred. One‐, 2‐ and 3‐year observed event‐free survival was 88%, 81%, and 75%, and the observed/predicted ratio was 0.97, 0.96, and 0.97, respectively. Time‐dependent receiver operating characteristic curve analyses demonstrated good discrimination overall (1‐year area under curve, 0.801; 2‐year, 0.774; 3‐year, 0.837), but discrimination between the 2 highest risk groups was poor. The difference between observed and predicted survival ranged from −14 to +17 percentage points, suggesting poor model calibration. Fairly similar results were found when the analyses were repeated in 715 patients after multivariate imputation of missing data.

Conclusions

The
UCLA
4‐variable risk model calibration was inconsistent and high‐risk discrimination was poor in an external validation cohort. Further model assessment is warranted before widespread use.
Living in the Eye of the Storm
Authors: Flores René D.
Published: June 2014

As Hispanic immigrants have moved beyond traditional immigrant gateways in recent years, local restrictive immigrant ordinances have proliferated. Although scholars have studied the determinants of these policies, we still know little about their social consequences. Drawing on ethnographic and interview data with 103 white, black, and Hispanic residents, collected in 2007 and 2011 in Hazleton, Pennsylvania, which passed an anti-immigrant ordinance in 2006, the author found that the law motivated anti-immigrant activism, hardened native views of Hispanics (regardless of documentation status), and increased native whites’ fears of lawlessness and crime. By 2011, however, locals reported significantly lower ethnic animosity, and the Latino population, led by Dominicans, continued to grow. This research reveals the unintended consequences of symbolic exclusionary laws and also highlights their limitations. It also demonstrates the capacity that microlevel political factors have to affect immigrant incorporation and intergroup relations and shows that the recent spread of local and state immigrant restrictionist policies may negatively affect immigrants’ ability to incorporate in new destinations of settlement at least in the short term.
A viscoelastic damage model for hysteresis in PVC H100 foam under cyclic loading
Authors: Hoo Fatt Michelle S , Chen Linling
Published: June 2014

A phenomenological constitutive model for Divinycell PVC H100 foam undergoing crushing and hysteresis under cyclic compression loading was developed. Cyclic compression tests were done with strain amplitudes from 0.02 to 0.1 and strain rates ranging from 0.0005 s−1 to 5 s−1. Within this test range, the PVC H100 foam exhibited strain rate-dependency, damage, and hysteresis. Damage that occurred in the foam after yielding followed the pattern of Mullins damage, i.e. the damage was essentially fixed at a given strain amplitude, and more damage occurred with increasing the strain amplitude. A constitutive model based on damage initiation and viscoelastic damage evolution of the foam was proposed. A simple damage initiation criterion based on critical compressive strain was proposed to separate undamaged and damaged foam response. A standard model, an elastic spring in parallel with Maxwell element, was used to describe viscoelastic behavior before and after damage. Before damage, spring and damper constants were evaluated from the test data. The rate-dependent undamaged stress–strain response and flow stress were found to be in good agreement with the test results. After damage, the spring and dashpot resistances were found to be the functions of strain amplitude and flow stress, which depended on strain rate. These viscoelastic damage functions were shown to give very good predictions of the hysteresis and strain rate-dependent behavior of the foam after damage.
Effects of enhanced compatibility by transesterification on the cell morphology of poly(lactic acid)/ polycarbonate blends using supercritical carbon dioxide
Authors: Bao Daofei , Liao Xia , He Guangjian , Huang Erbo , Yang Qi , Li Guangxian
Published: June 2014

Poly(lactic acid)/polycarbonate blends were prepared by melt mixing. The transesterification reaction between poly(lactic acid) and polycarbonate was promoted by using tetrabutyl titanate as a catalyst. For poly(lactic acid)/polycarbonate (weight ratio of 75/25) blend with catalyst content up to 0.5 wt%, polycarbonate particles finely dispersed in the poly(lactic acid) matrix and the adhesion between the phases were improved, due to the enhanced compatibility by transesterification reaction. The blends were foamed by using batch-foaming process with CO2 as the blowing agent. Cell density of poly(lactic acid)/polycarbonate blend increased at low-catalyst content, while decreased at high-catalyst content, which was due to the changes of interfacial properties of blend phases through transesterification reaction and crystallinity of polycarbonate component. Cell types of poly(lactic acid)/polycarbonate blends were transferred from submicro-sized and even nanoscale cells to microscale cells by the deceased crystallinity of poly(lactic acid) component, which was caused by the increased degree of transesterification reaction and temperature. The declined viscosity of poly(lactic acid)/polycarbonate blend because of degradation during blend processing led to large cell size and low-cell density. However, the improvement of elasticity and viscosity of poly(lactic acid)/polycarbonate blend by transesterification reaction could decrease the cell size.
Liquid CO2 processing of solid polylactide foam precursors
Authors: Yoon Yonghoon , Plummer Christopher JG , Thoemen Heiko , Månson Jan-Anders E
Published: June 2014

Diffusion of CO2 in polylactide was modelled by assuming the diffusion coefficient to depend on CO2 concentration, c, according to D[ c] =  D[0]exp[ Ac], where D[0] and A are empirical constants, with the aim of optimizing impregnation of nominally amorphous and semicrystalline polylactide/CO2-based precursors for physical foaming. Numerical simulations provided a consistent description of desorption at different temperatures, T, from polylactide impregnated with liquid CO2 at 10℃ and 5 MPa, and D[0,  T] could be represented analytically using Arrhenius or Williams–Landel–Ferry-type expressions, allowing interpolation and extrapolation. Sorption was argued on this basis to involve a step-like diffusion front, such that the CO2 content of a plate of thickness l increased as ( D[0] t)1/2 l−1 F[ Aco], where co is the value of c at saturation and F is a function of Aco only. A major practical concern with polylactide/CO2 precursors is that the glass transition temperature, Tg, decreases strongly with c, so that amorphous polylactide saturated with CO2 at 10℃ and 5 MPa degasses spontaneously at room temperature and pressure. However, it was inferred from the models and confirmed experimentally that partial impregnation in liquid CO2 for relatively short times could provide a relatively rapid means of preparing precursors with a roughly uniform CO2 content of around 0.1 g/g that were stable with respect to rapid CO2 loss on heating to room temperature. The resulting precursors gave satisfactory foam morphologies and densities on foaming at 100℃. Moreover, it was also possible to adapt the impregnation conditions so as to obtain partially foamed structures from semicrystalline polylactide under these conditions, in spite of its tendency to undergo cold crystallization during impregnation in liquid CO2, which suppressed expansion of saturated specimens at 100℃.
Nanometric TiC reinforced AlSi10Mg nanocomposites: Powder preparation by high-energy ball milling and consolidation by selective laser melting
Authors: Wang Hongqiao , Gu Dongdong
Published: June 2014

In this study, TiC/AlSi10Mg nanocomposite powder was prepared by high-energy ball milling of micrometer-scaled AlSi10Mg and TiC powder. The evolution of constitutional phases and microstructural features of the milled powders at various milling times were studied. It showed that the milled powder particles experienced a stage of coarsening at the early 5 h milling and followed by a continuous refinement during 5–15 h milling. The 15-h milled powder had a stable particle morphology with a narrow size distribution. The average crystalline size of the matrix phase experienced a continuous decrease and obtained a steady value of 21.9 nm after 15-h milling. The ball milled products were generally nanocomposite powder featured by nanocrystalline matrix reinforced with the well-dispersed TiC nanoparticles with the average size less than 50 nm. Selective laser melting of as milled nanocomposite powder was performed. The uniformly dispersed nanoscale granular TiC reinforcement was obtained, and the particle size distribution was well within the nanometer scale. The hardness of 185 HV0.1 and tensile strength Rm of 482 MPa of the TiC/AlSi10Mg nanocomposite part were much higher than the unreinforced AlSi10Mg part while the elongation of 10.8% was almost at the same level with unreinforced AlSi10Mg part.
Determination method of stress concentration relief factors for failure prediction of composite multi-bolt joints
Authors: Zhao Libin , Qin Tianliang , Zhang Jianyu , Shan Meijuan , Fei Binjun
Published: June 2014

Stress concentration relief factor, which reflects the linear relationship between the stress concentration factors of composite joint and those of elastic isotropic joint, was proposed by Hart-Smith for the failure prediction of composite multi-bolt joints. It is deemed to be determined by experiments from either unloaded- or loaded-hole laminates and is suitable for investigations of bypass and bearing stress concentration factors. To examine this viewpoint, in this paper, the stress concentration relief factor is determined by tensile tests of open-, filled- and loaded-hole laminates failing in tensile mode, respectively. It can be found that the loaded-hole has obviously high-stress concentration level, while the filled-hole has slightly higher stress concentration than that of open-hole. Detailed 3D-FE analyses are performed to disclose the stress concentration mechanisms of three hole-laminates. Various stress concentration relief factors are combined to calculate bearing and bypass stress concentration factors, which provide the failure envelope for the strength prediction of composite joints. Moreover, both conventional and modified failure envelopes are discussed. Experimental results of two-, three- and four-bolt joints are provided to investigate the suitability of different failure envelopes. It follows that the stress concentration relief factor for bearing stress concentration factor needs to be determined by a loaded-hole laminate, while that for bypass stress concentration factor can be determined by each of open-, filled- and loaded-hole laminates.
Beam analysis of the double cantilever beam specimen with fibre bridging
Authors: Morais AB de
Published: June 2014

The fibre bridging phenomenon commonly seen in double cantilever beam tests is considered an artifact of the standard unidirectional specimen. Therefore, it limits the scope of the test to the measurement of the critical strain energy release rate GI c for crack initiation. This paper presents a beam model based on a linear traction–separation law that has been shown to be a good approximation to the early stages of fibre bridging. The present model enables the evaluation of accurate propagation GI c values through the fitting of experimental load–displacement curves. Furthermore, fairly good fits can be obtained without employing sophisticated optimization algorithms by considering simple relations between model parameters and curve features. Therefore, the present model is able to extract a broader set of results from a single test, thereby increasing the confidence in toughness measurements.
Personality Assessment in the Workplace
Authors: Ho Chia-Lin , Welbourne Jennifer L. , Howard Pierce J.
Published: June 2014

Evidence for an indigenous Interpersonal Relatedness (IR) personality trait that is distinct from the Big Five personality taxonomy has been demonstrated in Chinese culture; however, research has not yet established whether this construct is specific to the Chinese culture or whether it is more universal. The current research extended this personality construct to a workplace context and examined the relevance of the Workplace IR trait within Taiwanese ( n = 573) and U.S. ( n = 155) employees. Results indicated that in both cultural groups the Workplace IR construct emerged and was not subsumed within the workplace Big Five domains; however, the content of the Workplace IR construct varied slightly between Taiwanese and U.S. employees. These findings suggest that this purported indigenous Chinese personality trait has potential relevance for working adults in Western as well as Eastern cultures.
Multicultural Families and Creative Children
Authors: Chang Jen-Ho , Hsu Chin-Chun , Shih Nai-Hua , Chen Hsueh-Chih
Published: June 2014

The link between multicultural experience and creativity is consistently supported by many empirical studies. However, most of these results are limited to adult participants with foreign living experience. The present study extended previous studies and investigated the positive relationship between multicultural experience and creativity in Taiwan young adolescents living in binational families. With more than 700 young adolescents, the results showed that young adolescents from binational families had parents with lower socioeconomic status than monocultural families. However, young adolescents from binational families performed better on creativity tests (fluency, flexibility, and originality) than those from monocultural families. In addition, when variables of family background and young adolescents’ personalities were controlled for, the effect of binational families on creativity remained. The implications for research on multicultural families and young adolescents’ creative performance are discussed.
External territorial threat, state capacity, and civil war
Authors: Gibler Douglas M , Miller Steven V
Published: June 2014

We argue that the regional threat environment a state faces plays a consequential role in its political development and the likelihood of experiencing future intrastate wars. Challenges to a state’s territorial integrity lead governments to increase their military personnel, and the resources that support these increases most often come willingly from a public that seeks security. Territorial threats are unlike other types of threats because they challenge individual lives and livelihoods, which both connects the average citizen with the state and allows for easier government extraction of necessary resources. Thus, external territorial threats increase state capacity by unifying the state and by increasing the repressive power of the central government. We identify territorial threats as both latent and realized claims against state territories and find that the presence of an external threat to territory leads to an increase in the capacity of central governments to connect and extract from its citizens, as well as the capacity to repress potential regime dissidents. We also find that the presence of a claim against a state’s territory from a neighbor corresponds with a substantial decrease in the likelihood of intrastate conflict at both high and low levels of intensity. The effect of territorial threat is observed even in the short term after a territorial threat has been resolved. Our tests, using standard models of state capacity and insurgency models of conflict on a sample of all states from 1946 to 2007, are robust to multiple model specifications.
Attitudes Toward Using Social Networking Sites in Educational Settings With Underperforming Latino Youth
Authors: Howard Keith E. , Curwen Margie Sauceda , Howard Nicol R. , Colón-Muñiz Anaida
Published: June 2014

The researchers examined the online social networking attitudes of underperforming Latino high school students in an alternative education program that uses technology as the prime venue for learning. A sequential explanatory mixed methods study was used to cross-check multiple sources of data explaining students’ levels of comfort with utilizing a social networking site platform as a supplemental communication tool in connection with their schoolwork. Students were found to be significantly less comfortable using social networking sites than other online communication tools in connection with their schoolwork, and females were significantly more uncomfortable than males using such sites in school.
Enhanced Glutamine Availability Exerts Different Effects on Protein and Amino Acid Metabolism in Skeletal Muscle From Healthy and Septic Rats
Authors: Holecek Milan , Sispera Ludek , Skalska Hana
Published: June 2014

Background: Enhanced glutamine (GLN) intake may affect the catabolism of branched‐chain amino acids (BCAAs; valine, leucine, and isoleucine), which play a regulatory role in protein turnover. We examined the effects of enhanced GLN availability on leucine oxidation, amino acid concentrations, and protein metabolism in muscles from healthy and septic rats. Methods: Cecal ligation and puncture were used as a model of sepsis. Twenty‐four hours after surgery, the soleus (SOL, red muscle) and the extensor digitorum longus (EDL, white muscle) were incubated in medium containing 0.5 or 2.0 mM GLN. Protein breakdown, protein synthesis, and leucine oxidation were determined via 3‐methylhistidine release, muscle L‐[1‐14C]leucine radioactivity, and the radioactivity of released 14CO2, respectively. Results: In muscles from septic animals, increased proteolysis and leucine oxidation and decreased protein synthesis were detected. These effects were more pronounced in the EDL. In septic muscles, the addition of GLN decreased leucine oxidation in both muscles and increased protein synthesis in the EDL. In muscles from untreated animals, decreased leucine oxidation after the addition of GLN to the medium was associated with decreased protein synthesis in the SOL and decreased concentrations of serine, glycine, histidine, alanine, arginine, proline, and lysine in both muscles. Conclusions: White muscle fibers are more sensitive to septic stimuli than red fibers are. In sepsis, enhanced GLN intake may ameliorate GLN deficiency, inhibit BCAA catabolism, and stimulate protein synthesis. In the healthy state, surplus of GLN may lead to severe alterations in the intramuscular concentration of several amino acids and impair protein synthesis.
Mothers’ Physical Illness in One- and Two-Parent Families
Authors: Sitnick Stephanie L. , Masyn Katherine , Ontai Lenna L. , Conger Katherine J.
Published: June 2014

Parental physical illness has been associated with a variety of negative child outcomes but the mechanisms explaining this relationship are not fully understood. Additionally, few studies have explored what role, if any, marital status may play in this relationship. This study used prospective longitudinal survey data from 382 two-parent and 182 single-parent families in the Iowa Youth and Families and Single Parents Project to explore the relationship between maternal illness and parenting with depressed affect as a potential mediator. Multiple group structural equation modeling was used to investigate whether the relationships between these indicators were the same for single and married mothers. Analyses revealed associations between mothers’ illness and parenting for both single and married mothers, but mothers’ depressed affect played a meditational role for single mothers, which was not evident with married mothers. Both the empirical and clinical implications of these findings are discussed.
Family Relationships and the Self-Esteem of Hidden Youth
Authors: Chan Gloria Hong-yee , Lo T-Wing
Published: June 2014

The transmission of power requires the presence of an interpersonal network as a medium; however, the nature of the relationship in the effect of power exertion is seldom discussed. In view of this research gap, this study aims to examine whether the degree of the relationship determines the impact of discipline over hidden youth, which subsequently affects young people’s level of subordination. Hidden youth ( N = 363) participated in the quantitative part of this study, whereas 42 participated in the qualitative phase; surveillants included 21 parents, 11 teachers, 16 social workers or counselors, and three police officers. Using hierarchical regression analysis, moderation analysis, and qualitative verbatim accounts, this study shows that the degree of relationships “catalyzed” the effect of power and control. When the degree of relationship was higher, the effect of power exertion would be higher.
Effective and Ineffective Parenting
Authors: McKinney Cliff , Morse Melanie , Pastuszak Joe
Published: June 2014

The current study examined the impact of effective and ineffective parenting on emerging adult psychological adjustment as well as parenting characteristics associated with adjusted and maladjusted emerging adults. Participants were 175 male and 309 female emerging adults who completed questionnaires assessing their perceptions of their parents’ parenting practices, discipline strategies, and psychopathology as well as their own psychological adjustment. Participants reporting effective parenting from two parents experienced the best adjustment, whereas participants reporting ineffective parenting from two parents experienced the worst adjustment, and participants reporting effective parenting from at least one parent appeared to be protected against the particularly harmful effects of ineffective parenting from two parents. Parental psychopathology, harsh discipline, involvement, and regard for parent and child all strongly differentiated adjusted and maladjusted participants.
Marrying Up? Trends in Age and Education Gaps Among Married Couples in Indonesia
Authors: Utomo Ariane J.
Published: June 2014

Using Indonesian National Socioeconomic Surveys, this article outlines the trends in spousal differences in age and educational attainment from a sample of matched husband–wife data in the early 1980s and 2010. The spousal age gap has declined from 6.4 to 4.7 in the three decades. A trend in assortative mating is maintained as 50% of married couples have equal education levels in both 1982 and 2010. The proportion of women marrying someone of higher education is declining, and conversely, the proportion of women “marrying down” is rising. Higher level of wife’s education and increasing age at first marriage are found to be negatively associated with spousal age gap. Along with development, social change, and the recent accomplishment toward gender parity across all education levels in the country, changing patterns in such gaps are bound to transform gender relations and the power dynamics within Indonesian families.
Trends and Determinants of Age at Union of Men and Women in the Philippines
Authors: Abalos Jeofrey B.
Published: June 2014

This article examines changes in the trends and patterns in union formation of men and women in the Philippines, with primary focus on the role of education and urbanization. The study also investigates the determinants of marriage timing of both Filipino men and women to assess whether similar factors are at work in their decision to enter marriage. Data are drawn from the 2003 and 2008 National Demographic and Health Survey, and the Cox proportional hazard models are used for analysis. Results reveal that both Filipino men and women are delaying entry to marriage, as evidenced by their increasing age at marriage. The proportion of Filipinos living together has been increasing over time, compensating for the consistent decline in the proportion of those who are legally married. Education remains an important factor in marriage timing of both genders, although its impact is more substantial among the most recent cohort.
Continuity and Changes in the Timing and Formation of First Marriage Among Postwar Birth Cohorts in Taiwan
Authors: Chen Yu-Hua , Chen Hsinmu
Published: June 2014

This study analyzes trends in the timing of entry into first marriage and the tendency for Taiwanese to choose partners of similar age, educational attainment, and ethnicity. Using pooled data from the 1991, 1996, 2001, and 2006 Taiwan Social Change Surveys, we examine the shift from early and universal marriage toward late and less marriage among postwar birth cohorts. After educational expansion, higher educated Taiwanese are more likely to postpone marriage, but poorly educated men have become most likely to remain single. In 2012, among primary-educated men born in 1968-1972, 42% were never-married. While men still prefer to marry younger women, the age gap between spouses has narrowed significantly, and following the increase in educational attainment of both genders, there is an increase in ethnic intermarriage and educational homogamy. However, if women postpone marriage to older ages, their chances of marrying men with equivalent education decreases significantly.
Marriage in Asia
Authors: Jones Gavin W. , Yeung Wei-Jun Jean
Published: June 2014

This introductory article provides some comparative background on marriage trends in Asia, to show where the countries included in this special issue fit into overall Asian and international patterns. It also notes the contribution of different chapters to our understanding of these issues. This special issue gives readers a taste of the diversity of Asia, by including articles on countries from Turkey in the west to the Philippines in the east, two of Asia’s three largest countries—China and Indonesia—and a country in South Asia—Sri Lanka. The articles examine the trends in marriage and explore the possible factors contributing to these trends in different national circumstances. We explore why, although similar forces continue to shape changes in Asian societies, including the institution of marriage, sharp differences in marriage patterns and systems persist throughout the region. Finally, we note limitations in extant literature and speculate about future marriage trends in Asia.
A 28-day Gavage Toxicity Study in Fischer 344 Rats with 3-methylfuran
Authors: Gill Santokh , Kavanagh Meghan , Cherry Wendy , Barker Michael , Weld Madeline , Cooke Gerard M.
Published: June 2014

3-Methylfuran is produced in foods during food processing and preservation techniques that involve heat treatment such as cooking, jarring, canning, and pasteurization. Currently, there are no studies available on the toxicity of 3-methylfuran. We conducted a 28-day gavage toxicity study (7 days per week) using doses of 0.0, 0.1, 0.3, 1.5, 3.0, 6.0, 12.0, and 25.0 mg/kg bw/day in order to determine the dose range needed to establish a no observed adverse effect level and to better characterize nonneoplastic effects including those affecting hematology, clinical biochemistry, gross morphology, and histopathology. Histological changes of the liver were noted in all treated animals and gross changes were noted beginning at 3.0 mg/kg bw/kg. Alterations in the activity of serum enzymes indicative of effects on the liver were observed, including increases in levels of alanine transaminase and alkaline phosphatase at the highest dose. There was a significant increase in serum thyroxine (T4) and triiodothyronine (T3), which was not accompanied by histological changes in the thyroid. For the most part, statistically significant changes were seen only at the highest dose for hematology and at the 2 highest doses for clinical chemistry parameters. In contrast, mild histological lesions in the liver were observed even at the lowest dose of 0.1 mg/kg bw/day.
An interesting case of straight back syndrome and review of the literature
Authors: Soleti Pavan , Wilson Bivin , Vijayakumar Arani Rajabathar , Ignatius Sudhakar Chakravarthi Paulraj , Reddy Chilakala Gopinath
Published: June 2014

Straight back syndrome is characterized by loss of the normal upper thoracic kyphosis, leading to a reduced anteroposterior diameter and squashing of the heart. Most patients are asymptomatic; if symptomatic, chest pain and palpitations are most common. On examination, the abnormal clinical findings simulate organic heart disease that needs to be ruled out by echocardiography and cardiac catheterization. A lateral chest radiograph is diagnostic. This condition is commonly associated with mitral valve prolapse and bicuspid aortic valve. We describe an interesting case of straight back syndrome with all the classic and rarely reported clinical findings.
Spectroscopic limb monitoring in peripheral extracorporeal membrane oxygenation
Authors: Keshavamurthy Suresh , Shafii Alexis E , Soltesz Edward
Published: June 2014

Limb-related complications are major contributors to extracorporeal membrane oxygenation-associated complications. Early detection of limb ischemia and or compartment syndrome is paramount to minimizing the adverse effects. With the absence of pulsatile flow, bedside Doppler examination of distal arterial waveforms is an impractical and an unreliable method of monitoring limb perfusion. We describe a new application of near-infrared spectroscopy monitoring of tissue oxygenation for the early detection of limb complications in extracorporeal membrane oxygenation.
Single Heartstring aortotomy for multiple off-pump venous bypass grafts
Authors: Niclauss Lars , Colombier Sébastien , Prêtre René
Published: June 2014

Off-pump coronary bypass grafting may decrease the rate of stroke, due to minimal aortic manipulation. For venous grafts, clampless hemostasis when performing the proximal anastomosis can be achieved using the Heartstring device. We describe a technique using a single device to suture two veins to one aortotomy. This technique requires less space and could be advantageous in very short, small, and calcified aortas. In to our experience, this technique is rapid, simple, easy to reproduce, and cost-saving.
Saphenous vein stripping surgical technique and frequency of saphenous nerve injury
Authors: Jaworucka-Kaczorowska Aleksandra , Oszkinis Grzegorz , Huber Juliusz , Wiertel-Krawczuk Agnieszka , Gabor Elżbieta , Kaczorowski Paweł
Published: June 2014

Objectives

Saphenous nerve injury is the most common complication after surgical treatment of varicose veins. The aim of this study was to establish its frequency at great saphenous vein long stripping when four methods of surgery were applied.

Methods

Eighty patients were divided into four groups depending on different stripping methods. Sensory transmission in saphenous nerve and sensory perception of shank were examined before surgery and two weeks, three and six months afterwards with clinical neurophysiology methods.

Results

In 36% of patients, surgeries caused the injury of saphenous nerve mainly by proximal stripping without invagination (65%, group I). Transmission disturbances ceased completely after three months in patients undergoing distal stripping with invagination (group IV), while in group I they persisted for six months in 35%. Group IV patients were the least injured and group I the most.

Conclusion

Neurophysiological findings may suggest that distal stripping with vein invagination gives the best saphenous nerve sparing.
Prevalence of asymptomatic lower limb venous thrombosis in infertile women with thrombophilic disorders
Authors: Costanzo Luca , Di Pino Luigi , Ragusa Mario , Buccheri Sergio , Sole Andrea , Virgilio Vittorio , Tamburino Corrado , Bellanca Salvatore
Published: June 2014

Objective

We sought to assess the prevalence of asymptomatic venous thrombosis in infertile women with thrombophilic disorders (TDs).

Methods and results

A total of 73 infertile women with TDs underwent duplex ultrasound scan to evaluate superficial and deep venous circulation of lower limbs. A control group of 35 infertile women without TDs was included. A single TD was found in 13 (17.8%) subjects, and 40 (54.8%) women presented a combined defect (more than three alterations). No residual mural thrombosis (RT) was noted in any deep veins. We found RT in 48 (65.8%) patients of TD group, while no RT was found in the control group ( p < 0.0001). None of the clinical and prothrombotic factors were predictors of RT (all p > 0.20), and frequency of TD did not correlate with multi-vessel RT ( p = 0.252).

Conclusions

No signs of deep vein thrombosis but high prevalence of superficial RT is present in infertile women with TDs. Further studies are needed to assess the prognostic value of our findings.
Family Voices at Mealtime
Authors: Smyth Catherine A. , Spicer Carol L. , Morgese Zoe L.
Published: June 2014

Infants with visual impairment often require additional interaction from adults to reinforce behaviors that lead to competency at mealtimes, but parental and professional confidence in teaching these skills is often limited. In the following collective case study, the authors, a speech/language pathologist (S/LP), occupational therapist (OT), and a teacher of students with visual impairment (TVI) questioned whether the level of a child’s visual impairment affected child/adult interactions, and if so, how? The authors followed 30 young children with visual impairment from ages 3 months to 3 years. Cases included two groups of participants identified by degree of vision loss. One case had no vision or light perception only and was identified as the Tactual Learners. The other case, identified as the Visual Learners, had some degree of usable vision, but still required some type of adaptation to be successful. Using interpretive observation, semi-structured interviews, and artifacts for triangulation, the authors identified results that indicate young children who have less vision and are Tactual Learners have specific concerns regarding the development of independent eating skills and that a protocol of family-centered mealtime strategies could benefit their parents. The authors independently reviewed and coded the videotapes, interviews, and artifacts to identify four themes to guide additional strategy implementation for families. The research showed improving caretaker confidence, providing adaptations for an individual child’s visual needs, encouraging sensory experiences around food, and teaching developmental expectations can potentially minimize difficulties in establishing good eating habits and promote independence at mealtime.
Clinical and Microscopic Characteristics of Canine Toxic Epidermal Necrolysis
Authors: Banovic F. , Olivry T. , Bazzle L. , Tobias J. R. , Atlee B. , Zabel S. , Hensel N. , Linder K. E.
Published: June 2014

Canine toxic epidermal necrosis (TEN), a rare and life-threatening cutaneous drug reaction, traditionally has been described as full-thickness devitalization of the epidermis with minimal dermal inflammation; however, few reports detail the histologic findings. We characterize the clinical features and histologic variations of 3 canine TEN patients. Clinically, irregular erythematous and purpuric macules evolved into widespread and severely painful erosions. The number of eroded mucosae varied; however, periocular and perilabial mucocutaneous junctions frequently were affected. Thirteen of 17 biopsies were evaluated. Apoptosis at multiple epidermal levels was the most common pattern of epidermal necrosis (12/13 biopsies, 92%). In contrast, full-thickness coagulation necrosis was present less often (7/13 biopsies, 52%). Lymphocytic interface dermatitis was the predominant inflammatory pattern, and intraepidermal lymphocytes, along with fewer histiocytes, were present to some degree in all samples along with lymphocytic satellitosis of apoptotic keratinocytes. The sequence of changes points to lymphocyte-mediated keratinocyte apoptosis as an early step in lesion development with subsequent variation in progression to coagulation necrosis among patients. Histopathologic changes overlapped with those reported for erythema multiforme, in contrast to traditional histologic descriptions of canine TEN. A specific algorithm for assessment of drug causality in epidermal necrolysis (ALDEN) was applied for each patient; carprofen was associated with a probable score for causality in 1 dog. Clinicians should be encouraged to take multiple biopsies in TEN suspect cases as nearly 25% of all biopsies lacked epithelium and were not diagnostic.
Attributing weather extremes to ‘climate change’
Authors: Hulme Mike
Published: June 2014

Over the last 30 years, scientific research has increasingly implicated human activities in contemporary regional- to global-scale climatic change. Over the last decade, this research has extended to the detection of the fingerprint of human activities on individual extreme weather events. Is it possible to say that this or that weather extreme was ‘caused by’ human activities? Pursuing answers to this question raises many difficult philosophical, epistemological and political issues. In this progress report, I survey the nascent science of extreme weather event attribution by examining the field in four stages: motivations for extreme weather attribution, methods of attribution, some example case studies and the politics of weather event attribution. There remain outstanding political dangers and obstacles for extreme weather attribution if it is to be used, as some claim it can and should be, for guiding climate adaptation investments, for servicing the putative loss and damage agenda of the UN Framework Convention on Climate Change or for underpinning legal claims for liability for damages caused by extreme weather.
The Family in Navarre (Spain) Today
Authors: Miguel Begoña Elizalde-San , Sánchez-Barricarte Jesús J.
Published: June 2014

This article examines the development of household structures in the province of Navarre (Spain) between 1910 and 2001. The data show that the traditional coexistence of two family systems (stem and nuclear families) had already become diffuse by 1950 as a result of the spread of neolocal family structures. However, study of household structures within the perspective of the life cycle shows that different family structure models have persisted within the region. The households of elderly people follow two patterns, reflecting the continued existence of different interpretations as to how their care should be organized.
Osteochondral Autologous Transplantation Is Superior to Repeat Arthroscopy for the Treatment of Osteochondral Lesions of the Talus After Failed Primary Arthroscopic Treatment
Authors: Yoon Hang Seob , Park Yoo Jung , Lee Moses , Choi Woo Jin , Lee Jin Woo
Published: June 2014

Background:

Several studies have reported on the outcome of arthroscopic treatment or osteochondral autologous transplantation (OAT) for osteochondral lesions of the talus (OLT), with mixed results. None of these studies has compared the results of repeat arthroscopy and OAT after failed primary arthroscopic treatment.

Purpose:

To compare the outcomes of OAT and repeat arthroscopy for the treatment of OLT after primary arthroscopy

Study Design:

Cohort study; Level of evidence, 3.

Methods:

This study included 22 patients who underwent OAT (group A) and 22 patients who underwent repeat arthroscopy (group B) after failed treatment of OLT among 399 patients who received primary arthroscopic marrow stimulation at single institution between 2001 and 2009. All patients were evaluated clinically using the visual analog scale (VAS) for pain and American Orthopaedic Foot and Ankle Society (AOFAS) Ankle Hindfoot Scale. The cumulative success rates were compared by use of Kaplan-Meier life table analysis.

Results:

The patients’ demographic and clinical characteristics and indications for surgery were comparable between the groups. Both groups showed significantly improved ( P < .001) VAS and AOFAS scores 6 months after surgery. However, group B showed significant deterioration over a mean follow-up period of 50 months. Overall, 18 of 22 (81.8%) patients in group A and 7 of 22 (31.8%) patients in group B achieved an excellent or good (≥80) AOFAS score ( P < .001). No patient in group A and 14 of 22 (63.6%) in group B required further revisions.

Conclusion:

Osteochondral autologous transplantation was significantly superior to repeat arthroscopic treatment of OLT after a mean follow-up period of 48 months. Therefore, repeat arthroscopy should be used judiciously for the treatment of OLT after failed arthroscopic treatment.
Talking With Parents of High School Football Players About Chronic Traumatic Encephalopathy
Authors: Love Shawn , Solomon Gary S.
Published: June 2014

Over the past decade, athletic-related chronic traumatic encephalopathy (CTE) has garnered a great deal of attention in the popular press and, more recently, in the scientific press. With increasing frequency, sports medicine practitioners and providers are faced with questions from the parents of high school football players about CTE and the risk posed to children who participate in this or other contact or collision sports. The purpose of this review was to summarize the research on CTE in an attempt to provide some evidence-based answers to frequently asked questions in clinics from parents. Addressed are (1) the definitions of CTE and its symptoms, (2) the evidence for CTE in football, (3) abnormal tau protein, (4) the use of neuroimaging in CTE diagnosis, (5) risk for CTE, (6) CTE diagnosis in youth, (7) CTE and its relationship to suicide, and (8) contact and collision sports as a risk factor for permanent brain injury or death.
Examination of the Test-Retest Reliability of a Computerized Neurocognitive Test Battery
Authors: Nakayama Yusuke , Covassin Tracey , Schatz Philip , Nogle Sally , Kovan Jeff
Published: June 2014

Background:

Test-retest reliability is a critical issue in the utility of computer-based neurocognitive assessment paradigms employing baseline and postconcussion tests. Researchers have reported low test-retest reliability for the Immediate Post Concussion Assessment and Cognitive Testing (ImPACT) across an interval of 45 and 50 days.

Purpose:

To re-examine the test-retest reliability of the ImPACT between baseline, 45 days, and 50 days.

Study Design:

Descriptive laboratory study.

Methods:

Eighty-five physically active college students (51 male, 34 female) volunteered for this study. Participants completed the ImPACT as well as a 15-item memory test at baseline, 45 days, and 50 days. Intraclass correlation coefficients (ICCs) were calculated for ImPACT composite scores, and change scores were calculated using reliable change indices (RCIs) and regression-based methods (RBMs) at 80% and 95% confidence intervals (CIs).

Results:

The respective ICCs for baseline to day 45, day 45 to day 50, baseline to day 50, and overall were as follows: verbal memory (0.76, 0.69, 0.65, and 0.78), visual memory (0.72, 0.66, 0.60, and 0.74), visual motor (processing) speed (0.87, 0.88, 0.85, and 0.91), and reaction time (0.67, 0.81, 0.71, and 0.80). All ICCs exceeded the threshold value of 0.60 for acceptable test-retest reliability. All cases fell well within the 80% CI for both the RCI and RBM, while 1% to 5% of cases fell outside the 95% CI for the RCI and 1% for the RBM.

Conclusion:

Results suggest that the ImPACT is a reliable neurocognitive test battery at 45 and 50 days after the baseline assessment. The current findings agree with those of other reliability studies that have reported acceptable ICCs across 30-day to 1-year testing intervals, and they support the utility of the ImPACT for the multidisciplinary approach to concussion management.

Clinical Relevance:

This study suggests that the computerized neurocognitive test battery, ImPACT, is a reliable test for postconcussion serial assessments. However, when managing concussed athletes, the ImPACT should not be used as a stand-alone measure.
Prevalence and Incidence of Cartilage Injuries and Meniscus Tears in Patients Who Underwent Both Primary and Revision Anterior Cruciate Ligament Reconstructions
Authors: Wyatt Ronald W.B. , Inacio Maria C.S. , Liddle Kate D. , Maletis Gregory B.
Published: June 2014

Background:

Previous studies have found differences in meniscus and cartilage injury rates between groups of patients after primary and revision anterior cruciate ligament reconstructions (ACLRs). This study examined a cohort of individual patients who underwent primary and subsequent revision ACLR to determine the incidence of cartilage and meniscus disease.

Purpose:

To describe the prevalence and incidence of meniscus and articular cartilage injuries in patients who underwent primary and then subsequent revision ACLR as well as indicate differences in the management of these injuries.

Study Design:

Case series; Level of evidence, 4.

Methods:

Patients who underwent primary and then revision ACLR from February 2005 to September 2011 were identified using a community-based registry. Patient and procedure characteristics were obtained, and descriptive statistics were used to evaluate the study sample.

Results:

There were 261 patients who underwent primary and then subsequent revision ACLR during the study period. The median age was 18 years at primary ACLR and 20 years at revision ACLR. Revision ACLR was performed for instability in 256 patients (98%) and for infection in 5 patients (2%). The prevalence of cartilage injuries increased from 14.9% at primary ACLR to 31.8% at revision ACLR. The prevalence of meniscus tears decreased from 54.8% at primary ACLR to 43.7% at revision ACLR. The prevalence of lateral meniscus tears was 32.2% at primary ACLR but only 18.4% at revision ACLR, while the prevalence of medial meniscus tears was the same at primary and revision ACLRs (32.6%). Patients who underwent meniscus tear treatment at primary ACLR had a 70.8% prevalence of meniscus tears at revision ACLR.

Conclusion:

In this community-based sample followed from primary ACLR to revision ACLR, the prevalence of articular cartilage injuries increased, while the prevalence of meniscus injuries decreased. The higher prevalence of articular cartilage injuries at revision ACLR may represent new injuries. The lower prevalence of meniscus tears at revision ACLR may be caused by susceptible menisci being injured and treated at primary surgery or by changes in knee kinematics or injury exposure patterns.
Late-Onset Epileptic Spasms
Authors: Ronzano Nadia , Valvo Giulia , Ferrari Anna Rita , Guerrini Renzo , Sicca Federico
Published: June 2014

To evaluate the diverse presentation and course of late-onset epileptic spasms in relation to etiology, we analyzed the clinical, electroencephalographic (EEG), and prognostic features in 34 patients. We divided the patient sample into cryptogenic or symptomatic based on etiology. An association emerged between symmetric spasms at onset and focal interictal EEG abnormalities in cryptogenic patients, and onset with focal or generalized seizures before displaying asymmetric spasms, and multifocal or diffuse EEG abnormalities, in the symptomatic group. Despite an overall poor prognosis, symptomatic patients starting with generalized seizures seem to have a relatively more favorable outcome. The high occurrence of intellectual disability, and sometimes psychomotor regression, confirmed this rare and poorly understood heterogeneous clinical condition as a severe form of epileptic encephalopathy that deserves further study.