bluuebunny/crossref_metadata_2025 huggingface dataset:
Left Ventricular Ejection Fraction Normalization in Cardiac Resynchronization Therapy and Risk of Ventricular Arrhythmias and Clinical Outcomes
Authors: Ruwald Martin H. , Solomon Scott D. , Foster Elyse , Kutyifa Valentina , Ruwald Anne-Christine , Sherazi Saadia , McNitt Scott , Jons Christian , Moss Arthur J. , Zareba Wojciech
Published: October 2014

Background—

Appropriate guideline criteria for use of implantable cardioverter-defibrillators (ICDs) do not take into account potential recovery of left ventricular ejection fraction (LVEF) in patients treated with CRT-defibrillator.

Methods and Results—

Patients randomized to CRT-defibrillator from the Multicenter Automatic Defibrillator Implantation Trial With Cardiac Resynchronization Therapy (MADIT-CRT) trial who survived and had paired echocardiograms at enrollment and at 12 months (n=752) were included. Patients were evaluated by LVEF recovery in 3 groups (LVEF ≤35% [reference], 36%–50%, and >50%) on outcomes of ventricular tachyarrhythmias (VTAs), VTA ≥200 bpm, ICD shock, heart failure or death, and inappropriate ICD therapy by multivariable Cox models. A total of 7.3% achieved LVEF normalization (>50%). The average follow-up was 2.2±0.8 years. The risk of VTA was reduced in patients with LVEF >50% (hazard ratio [HR], 0.24; 95% confidence interval [CI], 0.07–0.82;
P
=0.023) and LVEF of 36% to 50% (HR, 0.44; 95% CI, 0.28–0.68;
P
<0.001). Among patients with LVEF >50%, only 1 patient had VTA ≥200 bpm (HR, 0.16; 95% CI, 0.02–1.51), none were shocked by the ICD, and 2 died of nonarrhythmic causes. The risk of HF or death was reduced with improvements in LVEF (LVEF >50%: HR, 0.29; 95% CI, 0.09–0.97;
P
=0.045; and LVEF of 36%–50%: HR, 0.44; 95% CI, 0.28–0.69;
P
<0.001). For inappropriate ICD therapy, no additional risk reduction for LVEF>50% was seen compared with an LVEF of 36% to 50%. A total of 6 factors were associated with LVEF normalization, and patients with all factors present (n=42) did not experience VTAs (positive predictive value, 100%).

Conclusions—

Patients who achieve LVEF normalization (>50%) have very low absolute and relative risk of VTAs and a favorable clinical course within 2.2 years of follow-up. Risk of inappropriate ICD therapy is still present, and these patients could be considered for downgrade from CRT-defibrillator to CRT-pacemaker at the time of battery depletion if no VTAs have occurred.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00180271.
Relation of Antiphospholipid Antibodies to Postmortem Brain Infarcts in Older People
Authors: Arvanitakis Zoe , Brey Robin L. , Rand Jacob H. , Schneider Julie A. , Capuano Ana W. , Yu Lei , Leurgans Sue E. , Bennett David A. , Levine Steven R.
Published: October 2014

Background—

There are few data on the relationship of antiphospholipid antibodies (aPLs) to pathologically proven brain infarcts. We tested the hypothesis that aPLs are associated with a higher odds of brain infarcts among older, community-dwelling individuals who came to autopsy.

Methods and Results—

Specimens and clinical and pathological data were derived from 607 deceased subjects (mean age at death, 89 years; 66% women) who were participating in 1 of 2 cohort studies of aging (Rush Memory and Aging Project and Religious Orders Study) and had agreed to brain autopsy. Brain infarcts were identified on gross and microscopic examinations, and severity of cerebral vessel disease (atherosclerosis, arteriolosclerosis) was graded. Four clinically used aPLs were measured longitudinally: 3 in serum (anticardiolipin antibodies, β
2-
glycoprotein I, and anti–phosphatidyl-serine) and 1 in plasma (lupus anticoagulant). A quarter of subjects (142 of 607, 23%) had at least 1 aPL present at baseline (median time interval from baseline to death, 4.6 years), and three quarters of these subjects had persistently positive measures over time. In a logistic regression analysis, baseline aPL positivity did not increase the odds of brain infarcts (odds ratio=1.08; 95% confidence interval, 0.74–1.58;
P
=0.19) or of gross or microscopic infarcts separately. Findings were essentially unchanged when considering number of baseline aPLs, aPLs proximate to death, and persistence of aPLs. Associations did not differ among subjects with increased severity of vessel disease.

Conclusion—

Overall, we did not find evidence that aPLs increase the odds of pathological brain infarcts in older people.
Spot Sign on 90-Second Delayed Computed Tomography Angiography Improves Sensitivity for Hematoma Expansion and Mortality
Authors: Ciura Viesha A. , Brouwers H. Bart , Pizzolato Raffaella , Ortiz Claudia J. , Rosand Jonathan , Goldstein Joshua N. , Greenberg Steven M. , Pomerantz Stuart R. , Gonzalez R. Gilberto , Romero Javier M.
Published: October 2014

Background and Purpose—

The computed tomography angiography (CTA) spot sign is a validated biomarker for poor outcome and hematoma expansion in intracerebral hemorrhage. The spot sign has proven to be a dynamic entity, with multimodal imaging proving to be of additional value. We investigated whether the addition of a 90-second delayed CTA acquisition would capture additional intracerebral hemorrhage patients with the spot sign and increase the sensitivity of the spot sign.

Methods—

We prospectively enrolled consecutive intracerebral hemorrhage patients undergoing first pass and 90-second delayed CTA for 18 months at a single academic center. Univariate and multivariate logistic regression were performed to assess clinical and neuroimaging covariates for relationship with hematoma expansion and mortality.

Results—

Sensitivity of the spot sign for hematoma expansion on first pass CTA was 55%, which increased to 64% if the spot sign was present on either CTA acquisition. In multivariate analysis the spot sign presence was associated with significant hematoma expansion: odds ratio, 17.7 (95% confidence interval, 3.7–84.2;
P
=0.0004), 8.3 (95% confidence interval, 2.0–33.4;
P
=0.004), and 12.0 (95% confidence interval, 2.9–50.5;
P
=0.0008) if present on first pass, delayed, or either CTA acquisition, respectively. Spot sign presence on either acquisitions was also significant for mortality.

Conclusions—

We demonstrate improved sensitivity for predicting hematoma expansion and poor outcome by adding a 90-second delayed CTA, which may enhance selection of patients who may benefit from hemostatic therapy.
The status of Crossopalpus obscuripes (Adams), a new junior synonym of Crossopalpus aenescens (Wiedemann) (Diptera: Hybotidae: Tachydromiinae)
Authors: CUMMING JEFFREY M. , SINCLAIR BRADLEY J.
Published: October 2014

Adams (1905) described a new species, Stilpon obscuripes, from two female specimens collected near Salisbury, Rhodesia (now Harare, Zimbabwe) by Frank L. Snow. Although Smith (1969) briefly treated this species under the genus Stilpon Loew in his monograph on the Empididae of southern Africa, it is evident that he had not seen the type material. The species remained little known until Cumming & Cooper (1992) examined the syntypes and transferred the species to Crossopalpus Bigot, indicating that C. obscuripes (Adams) was allied to C. aenescens (Wiedemann). During preparation of the Hybotidae chapter for the Manual of Afrotropical Diptera (Sinclair & Cumming, accepted), C. obscuripes was re-examined and discovered to be identical to C. aenescens, which was originally described from South Africa. The Crossopalpus aenescens-group was previously studied by Collin (1960), who recognized four included species, and Smith (1967), who provided a key to the species and illustrations of the male terminalia (i.e., right surstylus) of this complex.
Rethinking the Default Construction of Multimodel Climate Ensembles
Authors: Rauser Florian , Gleckler Peter , Marotzke Jochem
Published: October 2014

We discuss the current code of practice in the climate sciences to routinely create climate model ensembles as ensembles of opportunity from the newest phase of the Coupled Model Intercomparison Project (CMIP). We give a two-step argument to rethink this process. First, the differences between generations of ensembles corresponding to different CMIP phases in key climate quantities are not large enough to warrant an automatic separation into generational ensembles for CMIP3 and CMIP5. Second, we suggest that climate model ensembles cannot continue to be mere ensembles of opportunity but should always be based on a transparent scientific decision process. If ensembles can be constrained by observation, then they should be constructed as target ensembles that are specifically tailored to a physical question. If model ensembles cannot be constrained by observation, then they should be constructed as cross-generational ensembles, including all available model data to enhance structural model diversity and to better sample the underlying uncertainties. To facilitate this, CMIP should guide the necessarily ongoing process of updating experimental protocols for the evaluation and documentation of coupled models. With an emphasis on easy access to model data and facilitating the filtering of climate model data across all CMIP generations and experiments, our community could return to the underlying idea of using model data ensembles to improve uncertainty quantification, evaluation, and cross-institutional exchange.
An Object-Based Approach for Quantification of GCM Biases of the Simulation of Orographic Precipitation. Part I: Idealized Simulations
Authors: Yorgun M. Soner , Rood Richard B.
Published: October 2014

An object-based evaluation method to quantify biases of general circulation models (GCMs) is introduced using the National Center of Atmospheric Research (NCAR) Community Atmosphere Model (CAM). Idealized experiments with different topography are designed to reproduce the spatial characteristics of precipitation biases that were present in Atmospheric Model Intercomparison Project simulations using the CAM finite volume (FV) and CAM Eulerian spectral dynamical cores. Precipitation features are identified as “objects” to understand the causes of the differences between CAM FV and CAM Eulerian spectral dynamical cores. Three different mechanisms of precipitation were simulated in idealized experiments: stable upslope ascent, local surface fluxes, and resolved downstream waves. The results indicated stronger sensitivity of the CAM Eulerian spectral dynamical core to resolution. The application of spectral filtering to topography is shown to have a large effect on the CAM Eulerian spectral model simulation. The removal of filtering improved the results when the scales of the topography were resolvable. However, it reduced the simulation capability of the CAM Eulerian spectral dynamical core because of Gibbs oscillations, leading to unusable results. A clear perspective about models biases is provided from the quantitative evaluation of objects extracted from these simulations and will be further discussed in part II of this study.
Estimation of Ice Shelf Melt Rate in the Presence of a Thermohaline Staircase
Authors: Kimura Satoshi , Nicholls Keith W. , Venables Emily
Published: October 2014

Diffusive convection–favorable thermohaline staircases are observed directly beneath George VI Ice Shelf, Antarctica. A thermohaline staircase is one of the most pronounced manifestations of double-diffusive convection. Cooling and freshening of the ocean by melting ice produces cool, freshwater above the warmer, saltier water, the water mass distribution favorable to a type of double-diffusive convection known as diffusive convection. While the vertical distribution of water masses can be susceptible to diffusive convection, none of the observations beneath ice shelves so far have shown signals of this process and its effect on melting ice shelves is uncertain. The melt rate of ice shelves is commonly estimated using a parameterization based on a three-equation model, which assumes a fully developed, unstratified turbulent flow over hydraulically smooth surfaces. These prerequisites are clearly not met in the presence of a thermohaline staircase. The basal melt rate is estimated by applying an existing heat flux parameterization for diffusive convection in conjunction with the measurements of oceanic conditions at one site beneath George VI Ice Shelf. These estimates yield a possible range of melt rates between 0.1 and 1.3 m yr−1, where the observed melt rate of this site is ~1.4 m yr−1. Limitations of the formulation and implications of diffusive convection beneath ice shelves are discussed.
Consociational Settlements and Reconstruction
Authors: Stroschein Sherrill
Published: October 2014

Both Bosnia in 1995 and Northern Ireland in 1998 were extremely fragile in the immediate aftermath of brokered peace negotiations. Each instituted a form of consociationalism—a government that institutionalizes a voice for each ethnic group—as an element of brokered peace. In this article, I examine Bosnian postwar governance with comparative insights from Northern Ireland. Bosnia was the recipient of a large amount of international aid. While this aid was crucial to the initial state-building effort, the problems Bosnia now faces are due to its consociational governance structure. Some of the group-based aspects of consociationalism are in tension with individual rights, a problem that cannot be addressed by aid alone.
Aid and Institution-Building in Fragile States
Authors: Gisselquist Rachel M.
Published: October 2014

Why and how some states transition successfully from fragile to more robust—and some do not—are both topical and age-old questions. This volume of The ANNALS addresses these questions with particular attention to the role of foreign aid, offering new traction on theory development on state-building through the use of comparative analysis. Contributions cover selected major cases of aid-supported state-building from the end of the Second World War to the present. Collectively, they highlight the potential for external assistance both to stimulate change and to alter incentives toward institution-building in fragile states. They also show the limits of external assistance by emphasizing the decisive influence of domestic institutional legacies and political dynamics. This article frames the issues addressed in this volume and draws out key findings relevant to current public debates, including the limits to aid, the influence of historical state strength, institutional change through colonial and postcolonial interventions, and political economy incentives to maintain state weakness.
Voice Outcomes After Endoscopic Treatment of Laryngotracheal Stenosis
Authors: Hatcher Jeanne L. , Dao Ashley M. , Simpson C. Blake
Published: October 2014

Objective:

This study aimed to assess vocal disability in patients with laryngotracheal stenosis who are managed with endoscopic surgery, comparing patients with posterior glottic stenosis (PGS) to those with subglottic or tracheal stenosis (SGS/TS).

Methods:

Patients who underwent endoscopic treatment for laryngotracheal stenosis with voice outcomes data from 2005 to 2013 were studied. The mean Voice Handicap Index–10 (VHI-10) was compared over the study period. Of those with SGS/TS, the distance from the vocal folds to the proximal portion of the stenosis was obtained and compared to VHI-10.

Results:

Forty-four patients met inclusion criteria. The mean VHI-10 for all patients was 14.6. Fifty percent were dysphonic (VHI-10 > 11). The mean VHI-10 for PGS patients was 22.4, and for SGS/TS patients, 10.9 ( P = .004). Of those with PGS, 78.6% were dysphonic compared to only 36.7% of those with SGS/TS. Voice Handicap Index–10 improved from 14.1 for those with proximal stenosis to 4 for those with stenosis more than 2 cm distal to the vocal folds.

Conclusion:

Following endoscopic management of stenosis, those with PGS have poorer voice outcomes compared to those with SGS/TS. The majority of those with SGS/TS are not dysphonic. Vocal outcomes are greatest for those with stenosis beginning at least 2 cm distal to the vocal folds.
The rich, the affluent and the top incomes
Authors: Medeiros Marcelo , de Souza Pedro HG Ferreira
Published: October 2014

The article reviews the literature on the rich, the affluent and the top income earners focusing on the determinants of affluence or richness. The review surveys empirical results about the composition of the income and wealth of the rich and its direct determinants, such as individual characteristics, the state and the structure of production. The article covers literature beginning with the early twentieth century but pays special attention to research conducted after the 2000s. It attempts to cover studies from all regions of the world, despite the concentration of current research on developed countries. The main conclusion is that factors not related to productivity are a key determinant of affluence and that this has not changed much over the last century.
Head and Trunk Moments of Inertia of Able-Bodied and Unbraced Scoliotic Girls
Authors: Damavandi Mohsen , Allard Paul , Rivard Charles-Hilaire
Published: October 2014

Objective:

The purposes of this study were to estimate head and trunk’s (HT) radii of gyration (K) and moments of inertia (I) in able-bodied and unbraced scoliotic girls using an angular momentum method, to test if the use of mean ratios calculated in this study and given by de Leva present similar values compared to the experimental data, and to determine how these methods behave in estimation of scoliotic HT’s K and I with variable Cobb angles.

Background:

Scoliotic HT’s I estimated from anthropometric tables can lead to error in joint muscle moment calculations.

Method:

Twenty-one unbraced scoliotic and 20 able-bodied girls participated. HT’s I values were calculated using an angular momentum method.

Results:

Angular momentum method provided greater HT’s I for the scoliotic group compared with the able-bodied girls. HT’s I obtained by the mean ratios calculated from this study were close to the measured values. Compared with the experimental I, de Leva method provided significantly lower I in the scoliotic group. Scoliotic HT’s K and I obtained from angular momentum method showed greater correlations with the Cobb angles.

Conclusion:

The use of mean ratios obtained in this study to estimate HT’s K values in unbraced scoliotic girls could overcome the drawbacks of current anthropometric methods.

Application:

These results can be used to calculate more precise moments of force during daily activities in scoliotic girls with mild scoliosis and to improve the design of corrective flexible body braces prescribed in cases of rapid interventions in young patients of moderate spinal deformities.
Where are patients who have co-occurring mental and physical diseases located?
Authors: Toftegaard Kristian L , Gustafsson Lea Nørgreen , Uwakwe Richard , Andersen Ulla A , Becker Thomas , Bickel Graziella Giacometti , Bork Bernhard , Cordes Joachim , Frasch Karel , Jacobsen Bent Ascanius , Kilian Reinhold , Larsen Jens Ivar , Lauber Christoph , Mogensen Birthe , Rössler Wulf , Tsuchiya Kenji J , Munk-Jørgensen Povl
Published: October 2014

Background:

Patients with a psychiatric illness have a higher prevalence of physical diseases and thus a higher morbidity and mortality.

Aim:

The main aim was to investigate where patients with co-occurring physical diseases and mental disorders (psychotic spectrum or mood) in the health and social service system are identified most frequently before admission into psychiatry. The second aim was to compare the differences in the treatment routes taken by the patients before entry into psychiatric services in all the participating countries (Denmark, Germany, Japan, Nigeria and Switzerland).

Methodology:

On admission to a psychiatric service, patients diagnosed with schizophrenia, schizotypal or delusional disorders (International Classification of Diseases-10 (ICD-10) group F2) or mood (affective) disorders (ICD-10 group F3) and a co-morbid physical condition (cardiovascular disease, diabetes mellitus and overweight) were asked with which institutions or persons they had been in contact with in the previous 6 months.

Results:

Patients from Denmark, Germany and Switzerland with mental disorders had almost the same contact pattern. Their primary contact was to public or private psychiatry, with a contact percentage of 46%–91%; in addition, general practice was a common contact, with a margin of 41%–93%. Similar tendencies are seen in Japan despite the small sample size. With regard to general practice, this is also the case with Nigerian patients. However, religious guidance or healing was rarely sought by patients in Europe and Japan, while in Nigeria about 80% of patients with mental disorders had contacted this type of service.

Conclusion:

Promoting prophylactic work between psychiatry and the general practice sector may be beneficial in diminishing physical conditions such as cardiovascular disease, diabetes mellitus and overweight in patients with mental disorders in European countries and Japan. In Nigeria (a low-to-middle-income country), religious guides or healers, along with general practitioners, are the most frequently contacted, and they therefore seem to be the most obvious partner to collaborate with.
Influence of void microstructure on the effective elastic properties of discontinuous fiber-reinforced composites
Authors: Srinivasulu G , Velmurugan R , Jayasankar S
Published: October 2014

This study investigates the influence of void microstructure on the effective elastic properties of high fiber volume fraction discontinuous fiber-reinforced composites with randomly oriented fibers. A void microstructure is characterized by using parameters such as the number of voids, void volume fraction, void Aspect Ratio and void size distribution. In order to overcome the difficulties associated with the creation of high fiber volume fraction representative volume element models containing voids, a novel automation program called “ArtiComp” is developed. This program is used to generate representative volume element models of discontinuous fiber-reinforced composites containing randomly oriented straight fibers, curved fibers and spheroidal voids. The effective properties of discontinuous fiber-reinforced composites are computed using a finite element-based micromechanics approach. For comparison, the Mori-Tanaka method is used to compute the effective properties of unidirectional discontinuous fiber-reinforced composites and then orientation averaging is performed on these properties to obtain the effective properties of discontinuous fiber-reinforced composites with randomly oriented fibers. The comparison shows that the finite element predicted properties are stiffer than the analytically predicted properties. The results indicate that the finite element predicted properties are dependent on the number of voids used to represent the void volume. It is seen that the effective properties significantly decrease when void volume fraction is increased. The void Aspect Ratio and void size distribution are found to have a negligible influence on the effective properties. Finally, it is observed that straight fiber composites with voids perform better than the corresponding curved fiber composites with voids.
Simulation-based analyses of an evacuation from a metropolis during a bombardment
Authors: Bae Jang Won , Lee SeHoon , Hong Jeong Hee , Moon Il-Chul
Published: October 2014

The bombardment of a metropolis is considered a nightmare scenario. To reduce losses from such an assault, big cities have developed evacuation policies in case of bombardment. However, to build efficient evacuation policies, much footing data is required that considers both military and civilian views. Agent-based modeling and simulation could be utilized as a method to obtain the footing data. In this paper, we develop an evacuation agent-based model that describes a massive evacuation through the road network of a metropolis during a bombardment. In particular, our model took account of bombing strategies (i.e. the military view) as well as the characteristics of roads and evacuation agents (i.e. the civilian view) in order to analyze evacuations from both military and civilian perspectives. Moreover, we applied real data from a target region to calibrate parameters and initial conditions of the evacuation agent-based models, which increased the reliability of simulation results. Using the evacuation agent-based model, we designed and performed virtual experiments with varying military and civilian factors. Through the various analyses on the experiment results, we showed that our model could be a framework that provides footing data to develop efficient evacuation policies and preparations.
Introduction: Geographies of the urban night
Authors: van Liempt Ilse , van Aalst Irina , Schwanen Tim
Published: October 2014

Academic research tends to overlook what happens when night falls. This special issue aims to bring the space–time of the urban night to the fore by asking how nocturnal cities are produced, used, experienced and regulated in different geographical contexts. Despite local variations and specificities important similarities and ongoing transformations are identified regarding the long-term trends in the formation of the space–times of the urban night. We have structured this special issue on the basis of four important focal points of research for studying the night: (1) changing meanings and experiences of urban darkness and nights; (2) the evolution of the night-time economy; (3) the intensification of regulation; and (4) dynamics in practices of going out. By bringing different sets of literature and theoretical perspectives together this special issue provides a relational perspective on the urban night.
Improving Learning With Science and Social Studies Text Using Computer-Based Concept Maps for Students With Disabilities
Authors: Ciullo Stephen , Falcomata Terry S. , Pfannenstiel Kathleen , Billingsley Glenna
Published: October 2014

Concept maps have been used to help students with learning disabilities (LD) improve literacy skills and content learning, predominantly in secondary school. However, despite increased access to classroom technology, no previous studies have examined the efficacy of computer-based concept maps to improve learning from informational text for students with LD in elementary school. In this study, we used a concurrent delayed multiple probe design to evaluate the interactive use of computer-based concept maps on content acquisition with science and social studies texts for Hispanic students with LD in Grades 4 and 5. Findings from this study suggest that students improved content knowledge during intervention relative to a traditional instruction baseline condition. Learning outcomes and social validity information are considered to inform recommendations for future research and the feasibility of classroom implementation.
ECMO support for right main bronchial disruption in multiple trauma patient with brain injury—a case report and literature review
Authors: Zhou R , Liu B , Lin K , Wang R , Qin Z , Liao R , Qiu Y
Published: October 2014

Extracorporeal membrane oxygenation (ECMO) may offer life-saving treatment in severe pulmonary contusion or acute respiratory distress syndrome when conventional treatments have failed. However, because of the bleeding risk of systemic anticoagulation, ECMO should be performed only as a last resort in multiple trauma victims. Here, we report ECMO as a bridge for right main bronchus reconstruction and recovery of traumatic wet lung in a 31-year-old male multi-trauma patient with right main bronchial disruption, bilateral pulmonary contusion, cerebral contusion and long bone fracture. The patient was discharged without any obvious complication. ECMO support in a traumatic brain injured patient with severe hypoxemia caused by lung contusion and/or tracheal bronchus disruption is not an absolute contraindication.
Lower pain and faster treatment with mechanico-chemical endovenous ablation using ClariVein®
Authors: Vun SV , Rashid ST , Blest NC , Spark JI
Published: October 2014

Objectives

To assess the efficacy of the ClariVein® system of mechanico-chemical ablation of superficial vein incompetence.

Method

ClariVein® treatment uses a micropuncture technique and a 4-Fr sheath to allow a catheter to be placed 1.5 cm from the saphenofemoral junction. Unlike laser (endovenous laser treatment (EVLT)) or radiofrequency ablation (RFA), no tumescence is required. The technique depends on a wire rotating at 3500 r/min causing endothelial damage whilst liquid sclerosant (1.5% sodium tetradecyl sulphate) is infused. The wire is pulled back whilst continuously infusing sclerosant along the target vessel’s length. Initially, 8 mL of dilute sclerosant was used, but this was subsequently increased to 12 mL. No routine post-op analgesia was prescribed and specifically no non-steroidal anti-inflammatory drugs. Procedure times and pain scores (visual analogue scale) were recorded and compared to EVLT and RFA. All patients were invited for duplex post-procedure.

Results

Fifty-one great saphenous veins and six short saphenous veins were treated and followed up with duplex in the 10 months from July 2011. No major complications or deep vein thrombosis were reported. Duplex showed patency of three treated veins with two more veins having only a short length of occlusion, giving a technical success rate of 91%. Comparison with 50 RFA and 40 EVLT showed procedure times were significantly less for ClariVein® (23.0 ± 8.3 min) than for either RFA (37.9 ± 8.3 min) or EVLT (44.1 ± 11.4 min). Median pain scores were significantly lower for ClariVein® than RFA and EVLT (1 vs. 5 vs. 6, p < 0.01).

Conclusion

Mechanochemical ablation with the ClariVein® system is safe and effective. After some initial failures, the use of 12 mL of dilute sclerosant results in a very high technical success rate >90% which accords with the limited published literature. Procedure times and pain scores are significantly better than for RFA and EVLT. We await the long-term clinical outcomes.
French sclerotherapy and compression: Practice patterns
Authors: Tripey V , Monsallier J-M , Morello R , Hamel-Desnos C
Published: October 2014

Based on the recommendations of experts, and supported by a low level of proof, compression after sclerotherapy is applied all over the world.

Objective:

Investigating the practice of French vascular physicians for sclerotherapy and the use of post-sclerotherapy compression.

Methods:

A questionnaire concerning their practices was sent to French vascular physicians through their regional vascular medicine professional development associations.

Results:

A total of 366 vascular physicians replied to the questionnaire, of whom 63% (229/366) were in private practice, 6% (21/366) in hospitals and 31% (115/366) had a mixed private–hospital practice. Sclerotherapy was practised by 88% (323/366) of them. Two-thirds of the vascular physicians used sclerosing foam and practised sclerotherapy using ultrasound guidance. Less than one-third of the vascular physicians regularly applied compression after sclerotherapy. When compression was applied, it was usually after treatment of saphenous or accessory saphenous veins and, in most cases, medical compression stockings of 15–20 mm Hg were used. With respect to the period recommended for wearing compression, this ranged from 48 h to 1 week for 65% (193/299) of the vascular physicians questioned.

Conclusion:

The great majority of vascular physicians who answered the questionnaire employ ultrasound guidance to perform sclerotherapy and use sclerosing foam. Compression after sclerotherapy is diversely applied in France and does not comply with the recommendations of the French Health Authorities who recommend wearing a stocking of 15–20 or 20–36 mm Hg for a period of 4–6 weeks. Thus, less than one-third of the vascular physicians regularly used elastic compression and when they did, it was usually a medical compression stocking of 15–20 mm Hg, for 1 week or less.
Maggots as a wound debridement agent for chronic venous leg ulcers under graduated compression bandages: A randomised controlled trial
Authors: Davies CE , Woolfrey G , Hogg N , Dyer J , Cooper A , Waldron J , Bulbulia R , Whyman MR , Poskitt KR
Published: October 2014

Objectives

Slough in chronic venous leg ulcers may be associated with delayed healing. The purpose of this study was to assess larval debridement in chronic venous leg ulcers and to assess subsequent effect on healing.

Methods

All patients with chronic leg ulcers presenting to the leg ulcer service were evaluated for the study. Exclusion criteria were: ankle brachial pressure indices <0.85 or >1.25, no venous reflux on duplex and <20% of ulcer surface covered with slough. Participants were randomly allocated to either 4-layer compression bandaging alone or 4-layer compression bandaging + larvae. Surface areas of ulcer and slough were assessed on day 4; 4-layer compression bandaging was then continued and ulcer size was measured every 2 weeks for up to 12 weeks.

Results

A total of 601 patients with chronic leg ulcers were screened between November 2008 and July 2012. Of these, 20 were randomised to 4-layer compression bandaging and 20 to 4-layer compression bandaging + larvae. Median (range) ulcer size was 10.8 (3–21.3) cm2 and 8.1 (4.3–13.5) cm2 in the 4-layer compression bandaging and 4-layer compression bandaging + larvae groups, respectively (Mann–Whitney U test, P = 0.184). On day 4, median reduction in slough area was 3.7 cm2 in the 4-layer compression bandaging group ( P < 0.05) and 4.2 cm2 ( P < 0.001) in the 4-layer compression bandaging + larvae group. Median percentage area reduction of slough was 50% in the 4-layer compression bandaging group and 84% in the 4-layer compression bandaging + larvae group (Mann–Whitney U test, P < 0.05). The 12-week healing rate was 73% and 68% in the 4-layer compression bandaging and 4-layer compression bandaging + larvae groups, respectively (Kaplan–Meier analysis, P = 0.664).

Conclusions

Larval debridement therapy improves wound debridement in chronic venous leg ulcers treated with multilayer compression bandages. However, no subsequent improvement in ulcer healing was demonstrated.
Clutchable series-elastic actuator: Implications for prosthetic knee design
Authors: Rouse Elliott J. , Mooney Luke M. , Herr Hugh M.
Published: October 2014

Currently, the mobility of above-knee amputees is limited by the lack of available prostheses that can efficiently replicate biologically accurate movements. In this study, a powered knee prosthesis was designed utilizing a novel mechanism, known as a clutchable series-elastic actuator (CSEA).The CSEA includes a low-power clutch in parallel with an electric motor within a traditional series-elastic actuator. The stiffness of the series elasticity was tuned to match the elastically conservative region of the knee’s torque-angle relationship during the stance phase of locomotion. During this region, the clutch was used to efficiently store energy in the series elasticity. The fully autonomous knee prosthesis design utilized a brushless electric motor, ballscrew transmission and cable drive, as well as commercial electrical components. The knee was lighter than the eighth percentile and shorter than the first percentile male shank segment. The CSEA Knee was tested in a unilateral above-knee amputee walking at 1.3 m/s. During walking, the CSEA Knee provided biomechanically accurate torque-angle behavior, agreeing within 17% of the net work and 27% of the stance flexion angle produced by the biological knee. In addition, the process of locomotion reduced the net electrical energy consumption of the CSEA Knee. The knee’s motor generated 1.8 J/stride, and the net energy consumption was 3.6 J/stride, an order of magnitude less energy than previously published powered knee prostheses.
Randomized path planning on vector fields
Authors: Ko Inyoung , Kim Beobkyoon , Park Frank Chongwoo
Published: October 2014

Given a vector field defined on a robot’s configuration space, in which the vector field represents the system drift, e.g. a wind velocity field, water current flow, or gradient field for some potential function, we present a randomized path planning algorithm for reaching a desired goal configuration. Taking the premise that moving against the vector field requires greater control effort, and that minimizing the control effort is both physically meaningful and desirable, we propose an integral functional for control effort, called the upstream criterion, that measures the extent to which a path goes against the given vector field. The integrand of the upstream criterion is then used to construct a rapidly exploring random tree (RRT) in the configuration space, in a way such that random nodes are generated with an a priori specified bias that favors directions indicated by the vector field. The resulting planning algorithm produces better quality paths while preserving many of the desirable features of RRT-based planning, e.g. the Voronoi bias property, computational efficiency, algorithmic simplicity, and straightforward extension to constrained and nonholonomic problems. Extensive numerical experiments demonstrate the advantages of our algorithm vis-à-vis existing optimality criterion-based planning algorithms.
Critical Practice Analysis of Special Education Policy
Authors: Thorius Kathleen A. King , Maxcy Brendan D.
Published: October 2014

Since 1997, revisions to the Individuals With Disabilities Education Act (IDEA) have shown promise for addressing special education equity concerns: For example, states have the option to use response to intervention (RTI) for determining and thus reducing inappropriate disability determination, and states and districts are required to assess and address disproportionality in special education eligibility and placement. Yet, despite policy revisions, equity concerns endure. Apparent policy inadequacies necessitate that special education research explores policy as a process whereby it is appropriated by local actors. Accordingly, we draw from critical policy scholarship to propose a framework for study of special education policy appropriation. The approach centers equity and attention to actors’ agency and structural forces. We discuss relevance of this framework and its theoretical tools for special education research concerned with how local actors enact federal special education policy. Finally, we provide suggestions for RTI policy research as a case-in-point.
Measuring Opportunity to Learn and Achievement Growth
Authors: Elliott Stephen N.
Published: October 2014

The related constructs of opportunity to learn (OTL) and achievement growth are fundamental aspects of the current large-scale assessment and accountability system in operation in the United States. For purposes of this article, OTL is defined as the degree to which a teacher dedicates instructional time and content coverage to the intended curriculum objectives emphasizing high-order cognitive processes, evidence-based instructional practices, and alternative grouping formats. Both OTL and achievement growth, although frequently talked about by education policy makers and teachers, are actually difficult to measure. Much of my research, in collaboration with other colleagues, over the past decade has concerned the measurement of these constructs in ways that facilitate teachers’ understanding of them and to advance sound policies regarding the instruction and assessment of students with disabilities (SWDs). In this article, I examine both the measurement of OTL and achievement growth, share recent research on them, and outline an agenda for future research on these two important aspects of standards-based accountability systems for all students.
Trajectoires perçues - Une approche quantitative des perceptions de bien-être
Authors: Lelièvre Éva , Robette Nicolas
Published: October 2014

Perceived Trajectories - A Quantitative Approach to Perceptions of Well-being - In INED's Biographies and Entourage (2001) survey, the life-event histories of 2,830 respondents were collected. In addition to their family, residential and occupational histories, each respondent was asked to identify and explain the successive significant periods, turning points and general tone of their life course and what they viewed as landmark events. We therefore deal with a well-being trajectory made of the successive perceived tones of each period. We undertake a descriptive analysis of these trajectories and turning points: the division of life into periods reveals patterns in terms of the age distribution of turning points and of their coincidence with factual events. From a methodological point of view, taking such an approach which combines facts and perceptions contributes to the questioning of the boundaries between qualitative and quantitative approaches.
Emergence d’une spécialité scientifique dans l’espace - La réparation de l’ADN
Authors: Maisonobe Marion
Published: October 2014

The Spatial Emergence of a Scientific Specialty - DNA Repair: In the study of science, the specialty is seen as the ideal level of analysis to understand the genesis and development of scientific communities. This article uses bibliometric data to analyze the emergence of DNA repair by testing a hybrid method to identify the specialty’s appearance in geographical space by focusing on the geographical trajectories of the pioneers in this field. We try to identify the professional mobility of researchers using these bibliometric data, and if possible to highlight the structural networks of places during the emergence stage of the specialty. These networks determine places as much as they are built by individual trajectories. In this way, we try to make a place for the geography of science in the field of social studies of science.
Sudden Infant Death Syndrome, Sleep, and Seizures
Authors: Hoppenbrouwers Toke
Published: October 2014

Working hypothesis: benign febrile seizures seen in 7% of infants before 6 months play a role in the terminal pathway in a subset of sudden infant death syndrome victims. Supporting evidence: (1) lack of 5-hydroxitryptamine, one consistent finding in sudden infant death syndrome that Kinney et al coined a developmental serotonopathy, is consistent with risk for seizures. (2) Non–rapid eye movement sleep increasing during the age of highest risk for sudden infant death syndrome facilitates some seizures (seizure gate). (3) Sudden unexpected death in epilepsy is associated with severe hypoxemia and hypercapnia during postictal generalized electroencephalographic (EEG) suppression. In toddlers, sudden unexplained deaths are associated with hippocampal abnormalities and some seizures. (4) The sudden nature of both deaths warrants an exploration of similarities in the terminal pathway. Moreover, sudden infant death syndrome, febrile seizures, sudden unexplained death in childhood, and sudden unexpected death in epilepsy share some of the following risk factors: prone sleeping, infections, hyperthermia, preterm birth, male gender, maternal smoking, and mutations in genes that regulate sodium channels. State-of-the-art molecular studies can be exploited to test this hypothesis.
Congenital Segmental Spinal Muscular Atrophy
Authors: Savaş Tülin , Erol Ilknur , Özkale Yasemin , Saygi Semra
Published: October 2014

Spinal muscular atrophies are genetic disorders in which anterior horn cells in the spinal cord and motor nuclei of the brainstem are progressively lost. We present a patient with arthrogryposis due to congenital spinal muscular atrophy predominantly affecting the upper limbs. Spinal muscular atrophies with onset at birth may be a cause of arthrogryposis. Localized forms of neurogenic arthrogryposis have been divided into cervical and caudal forms. Our case is similar to the cases described by Hageman et al ( J Neurol Neurosurg Psychiatry 1993;56:365-368): severe symmetric lower motor neuron deficit in the upper extremities at the time of birth, no history of injury to the cervical spinal cord or the brachial plexus during delivery, and severe muscle wasting suggesting chronic denervation in utero. Because there was improvement of our patient’s situation, her disease was also possibly nonprogressive and sporadic. To our knowledge, this is the first reported case of a Turkish patient with congenital cervical spinal muscular atrophy. Congenital cervical spinal muscular atrophy affecting predominantly the upper limbs is a relatively rare form of motor neuron disease and should be considered in the differential diagnosis of infants with congenital contractures and severe muscle weakness by wasting mainly confined to the upper limbs.
Subclinical deterioration of left ventricular function in patients with juvenile-onset systemic lupus erythematosus
Authors: Chung H-T , Huang Y-L , Yeh K-W , Huang J-L
Published: October 2014

Objectives: Patients with systemic lupus erythematosus (SLE) have a higher risk of myocardial involvement, which can result in ventricular dysfunction. Little is known about the chronic influence of SLE on heart function in children and adolescents. This is the first study to demonstrate long-term changes in left ventricular function in patients with juvenile-onset SLE. Methods: This was a longitudinal study of 92 patients with juvenile-onset SLE. Two-dimensional echocardiography was performed by a single pediatric cardiologist at baseline, with follow-up at six-month intervals. Clinical and laboratory parameters, disease activity, treatment, nailfold capillaroscopy, and the traditional risk factors for atherosclerosis were evaluated. The baseline comparison of ventricular function was performed against 50 age-matched controls, and the follow-up results were analyzed using generalized estimating equations. Results: The patients’ mean age at baseline was 15.9 ± 4.3 years, the mean disease duration was 3.6 ± 3.2 years, and the mean follow-up duration was 4.5 ± 1.6 years. At baseline, the mean left ventricular ejection fraction (LVEF) was 74.7 ± 5.6% and the mean E/A ratio of left ventricular diastolic filling was 1.7 ± 0.3 (E: the peak velocity at rapid left ventricular filling; A: the peak velocity during left atrial contraction). The LVEF of the SLE patients was similar to the healthy controls and it did not change during the follow-up period. In contrast, the E/A ratio was lower in the SLE patients than in the healthy controls (1.7 ± 0.3 versus 1.88 ± 0.37; p = 0.002), and it decreased significantly with time (B ± SE, −0.013 ± 0.006, p = 0.023). In multiple analyses, abnormal microvasculature in nailfold capillaroscopy had a negative effect on LVEF progression ( p = 0.039). Disease duration of SLE and proteinuria were risk factors associated with the descent of E/A ratio ( p = 0.014 and p = 0.015, respectively). Conclusion: In patients with juvenile-onset SLE who were free of cardiac symptoms, there was evidence of declining ventricular diastolic function with time. Abnormal nailfold microvasculature, proteinuria and longer disease duration were the main risk factors for worsening of ventricular function.