bluuebunny/crossref_metadata_2025 huggingface dataset:
Item Bias Analysis of the Young Schema-Questionnaire for Psychopathology, Gender, and Educational Level
Authors: Rijkeboer Marleen M. , van den Bergh Huub , van den Bout Jan
Published: January 2011

This study examines the construct validity of the Young Schema-Questionnaire at the item level in a Dutch population. Possible bias of items in relation to the presence or absence of psychopathology, gender, and educational level was analyzed, using a cross-validation design. None of the items of the YSQ exhibited differential item functioning (DIF) for gender, and only one item showed DIF for educational level. Furthermore, item bias analysis did not identify DIF for the presence or absence of psychopathology in as much as 195 of the 205 items comprising the YSQ. Ten items, however, spread over the questionnaire, were found to yield relatively inconsistent response patterns for patients and nonclinical participants.
Mindfulness or Mindlessness?
Authors: Höfling Volkmar , Moosbrugger Helfried , Schermelleh-Engel Karin , Heidenreich Thomas
Published: January 2011

The 15 items of the Mindful Attention and Awareness Scale (MAAS; Brown & Ryan, 2003 ) are negatively worded and assumed to assess mindfulness. However, there are indications of differences between the original MAAS and a version with the positively rephrased MAAS items (“mirror items”). The present study examines whether the mindfulness facet “mindful attention and awareness” (MAA) can be measured with both positively and negatively worded items if we take method effects due to item wording into account. To this end, the 15 negatively worded items of the MAAS and additionally 13 positively rephrased items were assessed (N = 602). Confirmatory factor analyses (CFA) models with and without regard to method effects were carried out and evaluated by means of model fit. As a result, the positively and negatively worded items should be seen as different methods that influence the construct validity of mindfulness. Furthermore, a modified version of the MAAS (MAAS-Short) with five negatively worded items (taken from the MAAS) and five positively worded items (“mirror items”) was introduced as an alternative to assess MAA. The MAAS-Short appears superior to the original MAAS. The results and the limitations of the present study are discussed.
Functional Analysis in Behavioral Medicine
Authors: O’Brien William H. , Carhart Victoria
Published: January 2011

Behavior therapists must often design treatments for individual patients who present with a wide array of psychophysiological disorders and health problems. The functional analysis and functional analytic causal modeling is a learning-based, empirically focused assessment technique used to systematically gather, integrate, and summarize information about the form and function of a patient’s symptoms. A functional analytic case model can be a critical component of effective treatment design because most interventions attempt to modify relationships between causal factors and symptoms. The objectives of this paper are (a) to present a review of the conceptual foundations and essential procedures in the functional analysis; (b) to outline steps required to generate a functional analytic causal model; (c) to explain simple decisional and statistical procedures that can be used to counter intuitive errors; and (d) to demonstrate how functional analytic case models can be used to guide clinical practice and treatment design for persons presenting with disorders observed in medical settings.
Evaluation of a Therapeutic Concept Diagram
Authors: Müller Jörg M.
Published: January 2011

Documentation used in psychotherapy for quality assurance can be useful, but also time consuming and inflexible. In the process of behavior analysis, therapy planning and conducting therapy, a large amount of clinical data have to be structured and organized. We present an economical documentation method that contains information about the most important causes of problem behavior and expectations about how much certain therapy components will achieve the therapist and client therapy aims. This documentation method can assist therapy planning, serve as a communicative tool for colleagues and supervisors, serve as an educational tool for clients, and be utilized as a self-reflective therapy discourse (quality assurance). The paper describes and pilots the use of a transtheoretical, graphic approach, the therapeutic concept diagram, for the above-mentioned aspects of quality assurance. Four experienced analytic therapists and six experienced cognitive-behavioral therapists documented therapeutic concept diagrams for five clients each. These 50 recorded therapeutic concept diagrams are described. In general, the diagrams were rated as useful for documentation and treatment planning. Ratings of the diagrams as a communicative tool and for a self-reflective therapy discourse were heterogenic, with analytical therapists tending to benefit more. The discussion focuses on application settings and limitations and highlights the heuristic value of assessing idiographic hypotheses.
Prophylactic neuroprotection against stroke: Low-dose, prolonged treatment with deferoxamine or deferasirox establishes prolonged neuroprotection independent of HIF-1 function
Authors: Zhao Yanxin , Rempe David A
Published: January 2011

Prophylactic neuroprotection against stroke could reduce stroke burden in thousands of patients at high risk of stroke, including those with recent transient ischemic attacks (TIAs). Prolyl hydroxylase inhibitors (PHIs), such as deferoxamine (DFO), reduce stroke volume when administered at high doses in the peristroke period, which is largely mediated by the hypoxia-inducible transcription factor (HIF-1). Yet, in vitro experiments suggest that PHIs may also induce neuroprotection independent of HIF-1. In this study, we examine chronic, prophylactic, low-dose treatment with DFO, or another iron chelator deferasirox (DFR), to determine whether they are neuroprotective with this paradigm and mediate their effects through a HIF-1-dependent mechanism. In fact, prophylactic administration of low-dose DFO or DFR significantly reduces stroke volume. Surprisingly, DFO remained neuroprotective in mice haploinsufficient for HIF-1 (HIF-1 +/ –) and transgenic mice with conditional loss of HIF-1 function in neurons and astrocytes. Similarly, DFR was neuroprotective in HIF-1 +/ mice. Neither DFO nor DFR induced expression of HIF-1 targets. Thus, low-dose chronic administration of DFO or DFR induced a prolonged neuroprotective state independent of HIF-1 function. As DFR is an orally administered and well-tolerated medication in clinical use, it has promise for prophylaxis against stroke in patients at high risk of stroke.
Why Do Glucocorticoids Produce Potent and Persistent Diuresis Only in Subjects with Volume Overload Other Than Euvolemia
Authors: Liu Chao , Liu Kunshen
Published: January 2011

Background:

The role of glucocorticoids in body fluid control is full of controversy. It is well documented that glucocorticoids could produce potent and persistent diuresis in congestive heart failure. But, the diuretic effect was not reported in patients with euvolemia.

Objective:

To test the hypothesis that the diuresis induced by glucocorticoids is systemic volume dependent.

Methods:

The diuretic effect of glucocorticoids in rats with various systemic volume statuses (i.e. systemic volume depletion, euvolemia, and systemic volume overload, respectively) was recorded.

Results:

Glucocorticoids only produced potent and persistent diuresis in the rats with systemic volume overload.

Conclusion:

The diuresis induced by glucocorticoids was systemic volume dependent, which explained the phenomenon that glucocorticoids only have potent and persistent diuretic effect in congestive heart failure.
Tractable model for concave flexure hinges
Authors: Tseytlin Yakov
Published: January 2011

In this article we prove that approximate solutions previously developed by us, with inverse conformal mapping, for concave flexure notch hinges rotational compliance in correct applications are accurate enough in comparison with the more complicated “precision” solutions for the conic profiles based on the integration of differential equations, finite element model, and experimental data at uncertainty within 10% or less. This is also true with the developed, in this article, simple computer aided evaluation of the approximating circles and their shift to contiguity even without its analytical expression and estimation of the hinge rotation instantaneous center position on this basis.
Combined quantitative ultrasonic and time-resolved interaction force AFM imaging
Authors: Parlak Z. , Degertekin F. L.
Published: January 2011

The authors describe a method where quantitative ultrasonic atomic force microscopy (UAFM) is achieved during time-resolved interaction force (TRIF) imaging in intermittent contact mode. The method uses a calibration procedure for quantitative UAFM. It improves elasticity measurements of stiff regions of surfaces while retaining the capabilities of the TRIF mode for topography, adhesion, dissipation, and elasticity measurements on soft regions of sample surfaces. This combination is especially advantageous when measuring and imaging samples with broad stiffness range in a nondestructive manner. The experiments utilize an active AFM probe with high bandwidth and the UAFM calibration is performed by measuring the magnitude of the time-resolved UAFM signal at a judiciously chosen frequency for different contact stiffness values during individual taps. Improved sensitivity to stiff surface elasticity is demonstrated on a special sample. The results show that combining UAFM with TRIF provides 2.5 GPa (5%) standard deviation on the silicon surface reduced Young's modulus, representing 5× improvement over using only TRIF mode imaging.
Ultra-high vacuum compatible image furnace
Authors: Neubauer A. , Bœuf J. , Bauer A. , Russ B. , Löhneysen H. v. , Pfleiderer C.
Published: January 2011

We report the design of an optical floating-zone furnace for single-crystal growth under ultra-high vacuum (UHV) compatible conditions. The system is based on a commercial image furnace, which has been refurbished to be all-metal sealed. Major changes concern the use of UHV rotary feedthroughs and bespoke quartz-metal seals with metal-O-rings at the lamp stage. As a consequence, the procedure of assembling the furnace for crystal growth is changed completely. Bespoke heating jackets permit to bake the system. For compounds with elevated vapor pressures, the ultra-high vacuum serves as a precondition for the use of a high-purity argon atmosphere up to 10 bar. In the ferromagnetic Heusler compound Cu \documentclass[12pt]{minimal}\begin{document}$_2$\end{document}2MnAl, the improvements of purity result in an improved stability of the molten zone, grain selection, and, hence, single-crystal growth. Similar improvements are observed in traveling-solvent floating-zone growth of the antiferromagnetic Heusler compound Mn \documentclass[12pt]{minimal}\begin{document}$_3$\end{document}3Si. These improvements underscore the great potential of optical float-zoning for the growth of high-purity single crystals of intermetallic compounds.
Convection-dominated dispersion in channels with fractal cross-section
Authors: Adrover Alessandra
Published: January 2011

We focus on the characterization of dispersion processes in microchannels with fractal boundaries (and translational symmetry in the longitudinal direction) in the presence of laminar axial velocity field. This article extends the theory of laminar dispersion in finite-length channel flows at high Peclet numbers by analyzing the role of the fractal cross-section in the convection-dominated transport regime. In this regime, the properties of the dispersion boundary layer and the values of the scaling exponents controlling the dependence of the moment hierarchy on the Peclet number are determined by the local near-wall behavior of the axial velocity. Specifically, different scaling laws in the behavior of the moment hierarchy occur, depending whether the cross-sectional boundary is smooth or nonsmooth (e.g., presenting corner points or cusps). The limit case of a fractal boundary is analyzed in detail. Analytical and numerical results are presented for two fractal cross-sections (the classical Koch curve and the Koch snowflake) in the Stokes regime.
Linear instability of the horizontal throughflow in a plane porous layer saturated by a power-law fluid
Authors: Barletta A. , Nield D. A.
Published: January 2011

The onset of the convective instability in the horizontal throughflow of a power-law fluid saturating a horizontal porous layer heated from below is studied. A linear stability analysis of the basic flow is carried out and the disturbance equations are solved analytically. The problem examined here is an extension of the classical Prats problem for Newtonian fluids. It is shown that the marginal stability condition, as well as the critical values of the wave number and of the Darcy–Rayleigh number, is affected by the value of the Péclet number associated with the basic flow, except for the special case of a Newtonian fluid. The limit of a vanishingly small Péclet number is considered leading to the special case of the Horton–Rogers–Lapwood (HRL) problem for a power-law fluid, i.e., the Prats problem with a vanishing basic throughflow. It is shown that the generalized HRL problem is always linearly stable for pseudoplastic fluids and always linearly unstable for dilatant fluids.
Hot electrons in wurtzite indium nitride
Authors: Masyukov N. A. , Dmitriev A. V.
Published: January 2011

In this paper we study hot electron transport in bulk wurtzite n-InN using an iterative numerical method. We calculate field dependence of the electron drift velocity using several sets of the material parameters that can be found in the literature, and the results are compared with the available experimental data. Then, we perform more detailed calculations for different lattice temperatures and different carrier concentrations using the material parameters that provide the best fit to the experimental data.
Temperature effect on the submicron AlGaN/GaN Gunn diodes for terahertz frequency
Authors: Yang Lin’an , Mao Wei , Yao Qingyang , Liu Qi , Zhang Xuhu , Zhang Jincheng , Hao Yue
Published: January 2011

The wurtzite AlGaN/GaN Gunn diode with tristep-graded Al composition AlGaN as hot electron injector is simulated by using an improved negative differential mobility model of GaN. The results show that the oscillation mode of Gunn diode gradually shifts from dipole domain mode toward accumulation mode with increase in temperature, and the mode shift closely depends on the injector length. At the temperatures of 300–400 K, 0.6 and 0.4 μm Gunn diodes normally generate the oscillation of dipole domain mode, yielding the fundamental oscillation frequencies of 332–352 GHz and 488–508 GHz, respectively, with the dc/rf conversion efficiencies of 2%–3% and the output power densities of 109–1010 W cm−3. At higher temperatures, the diodes generate the accumulation mode oscillation, and the highest frequency approaches 680 GHz and 977 GHz, respectively, with the dc/rf conversion efficiencies of 0.5%–1%.
Enhanced magnetoelectric effect in a stress-biased lead magnesium niobate-lead titanate single crystal/Terfenol-D alloy magnetoelectric sensor
Authors: Lam K. H. , Lo C. Y. , Dai J. Y. , Chan H. L. W. , Luo H. S.
Published: January 2011

A stress-biased magnetoelectric sensor with a built-in permanent magnet has been fabricated using piezoelectric lead magnesium niobate-lead titanate single crystal and magnetostrictive Terfenol-D alloy. The resonance characteristics and magnetoelectric performance of the sensor have been evaluated under different stress-biased conditions. The resonance of the sensor shifts to higher frequency with increasing preloading stress. Due to the piezoelectric and magnetostrictive enhancements under preload, the device exhibits a giant magnetoelectric voltage coefficient of 0.22 V/Oe at a preloading stress of 2.5 MPa. This compact device has the potential to be used as a standalone sensor without requiring external power input.
A study of start-up flow of thixotropic fluids including inertia effects on an inclined plane
Authors: Liu Wenwen , Zhu Ke-Qin
Published: January 2011

Despite the practical importance of thixotropic fluids, there is no reliable way at present to predict the onset of thixotropic flow. The start-up flow of thixotropic fluids including inertia effects falling down along an inclined plate is studied in this paper. The effects of the unsteady term in the NS equations on the start-up process are clarified and a criterion parameter A is presented to measure this unsteady effect. The parameter A is defined as the ratio of the Reynolds number and generalized Weissenberg number W, where W is the ratio of the characteristic time of microstructure changes and the characteristic time of flow. According to flow characteristics, we classify the motion into three cases. In case 1, avalanche happens and the initial viscosity is big. The start-up process is divided into two stages: creep and flow. Velocity profiles of both stages are discussed. In this case, if A is small enough, the inertia effects could be neglected. Otherwise, the inertial unsteady term will protract the start-up process, decrease the velocity of the free surface, and bring a thicker unyield region. In case 2, the avalanche happens and initial viscosity is small. Similar inertial unsteady effects are observed. Moreover, the unsteady term in the NS equations could delay the critical time at which the flow happens or even prevent the thixotropic material from flowing. In case 3, the avalanche could not happen. The inertial unsteady effect is only present in the start period and has no influence on the later motion.
Investigation of the resonant phenomenon of flow around a vibrating cylinder in a subcritical regime
Authors: Chen Shih-Sheng , Yen Ruey-Hor , Wang An-Bang
Published: January 2011

In this paper, the resonant phenomenon of the flow around a vibrating cylinder in a subcritical regime is numerically investigated by using a two-dimensional Navier–Stokes equation-solver and implementing the spectral-element method. Both velocity and pressure responses are measured for Reynolds numbers, Re, between 10 and 45, and exciting Roshko numbers, between 0.1 and 6. For small vibrating amplitudes, a simplified Stuart–Landau model with a forcing term is used to describe the resonant behavior, and a four-parameter best-fit model is proposed for the regression of the Landau constants. This demonstrates that the proposed model is suitable for describing the flow in the subcritical regime and the linearity of the resonant Roshko number, Ron, with the Reynolds number can be further extended to a Reynolds number as low as 10. As a consequence, the critical Reynolds number of vortex shedding for the flow around a stationary cylinder can also be determined accurately and efficiently from this linear relationship. A study of probe locations reveals that the lower the Reynolds number is, the larger the deviation of resonant frequencies at different locations. Since the effect of probe locations is significant, a novel method to determine the critical condition is proposed by finding the intersection of the linear Ron-Re relationships from any two different locations. Since pressure and velocity have almost the same Ron-Re relationship, a new device for measuring free stream velocity in the regime of a very low Reynolds number has been proposed.
Contributions of turbulence to subsonic cavity flow wall pressures
Authors: Murray Nathan , Raspet Richard , Ukeiley Lawrence
Published: January 2011

Poisson-type pressure sources in the flow over open cavities were examined for several subsonic free stream conditions. Wall-mounted pressure transducers and two-component particle image velocimetry (PIV) were employed synchronously to obtain data at Mach 0.19, 0.29, 0.39, 0.58, and 0.73 for a rectangular cavity with a length-to-depth ratio of 6. The modified quadratic stochastic estimation was used to yield a time-resolved, low-dimensional representation of the velocity field using the PIV and pressure measurements. A conformal transformation was applied to the cavity geometry to allow the integration of Poisson’s equation giving a time-resolved estimate of the surface pressure fluctuations. The use of Poisson’s equation allowed the contribution of the mean-shear and nonlinear velocity sources of the surface pressure loads to be evaluated independently, showing that the resonant features of the cavity flow (Rossiter modes) are dominant in the mean-shear contribution and that nonlinear interactions become increasingly significant above Mach 0.4.
Electromagnetically driven dwarf tornados in turbulent convection
Authors: Kenjereš Saša
Published: January 2011

Motivated by the concept of interdependency of turbulent flow and electromagnetic fields inside the spiraling galaxies, we explored the possibilities of generating a localized Lorentz force that will produce a three-dimensional swirling flow in weakly conductive fluids. Multiple vortical flow patterns were generated by combining arrays of permanent magnets and electrodes with supplied dc current. This concept was numerically simulated and applied to affect natural convection flow, turbulence, and heat transfer inside a rectangular enclosure heated from below and cooled from above over a range of Rayleigh numbers (104≤Ra≤5×109). The large-eddy simulations revealed that for low- and intermediate-values of Ra, the heat transfer was increased more than five times when an electromagnetic forcing was activated. In contrast to the generally accepted view that electromagnetic forcing will suppress velocity fluctuations and will increase anisotropy of turbulence, we demonstrated that localized forcing can enhance turbulence isotropy of thermal convection compared to its neutral state.
Analysis of time-dependent nonlinear dynamics of the axisymmetric liquid film on a vertical circular cylinder: Energy integral model
Authors: Novbari E. , Oron A.
Published: January 2011

The nonlinear dynamics of an axisymmetric liquid film falling on the outer surface of a vertical cylinder is investigated in the framework of the set of two coupled evolution equations derived recently using the energy integral method (EIM). This set of EIM evolution equations is solved numerically and its solutions are compared with the traveling wave solutions derived from it using AUTO. We find that traveling wave solutions of EIM equations can bifurcate either supercritically or subcritically from the base state. The type of bifurcation depends on the parameter set of the problem. The set of EIM equations studied here admits both traveling wave and nonstationary wave flows. We demonstrate that in the case of subcritical primary bifurcation the film dynamics is sensitive to the choice of the initial condition and coexistence of up to five different flows is possible for the same parameter set in the domain of a given periodicity. The case of supercritical primary bifurcation exhibits much lesser dependence on the initial condition, though coexistence of two different flows for the same parameter set is possible. The synergetic approach based on both direct numerical solution of the governing evolution equations and search of traveling wave solutions using AUTO facilitate a discovery of a large variety of flows and help to conclude about stability of the traveling wave flows found using AUTO.
Drop deformation and breakup in polystyrene/high-density polyethylene blends under oscillatory shear flow
Authors: Sirivat Anuvat , Patako Sakchai , Niamlang Sumonman , Lerdwijitjarud Wanchai
Published: January 2011

Drop deformation and breakup in polystyrene/high-density polyethylene viscoelastic melt blends were investigated under the effects of viscosity ratio, the time scale ratio, and droplet elasticity under oscillatory shear flow using an optical flow cell. The deformation was studied in terms of deformation parameters, Def∗=a∗−c/a∗+c, where a∗ and c are the apparent drop principal axes and the minor axes of the droplets as measured from the time series of images. Amplitudes of deformation parameters are defined as the difference between the maximum and minimum values divided by two. The amplitudes increase linearly at small capillary number and nonlinearly at large capillary number, where the capillary is defined as the ratio between the matrix viscous force and the interfacial tension force. The deformation amplitude parameters decrease with increasing viscosity ratio, time scale ratio, and elasticity at any fixed capillary number. Drop breakup patterns observed are the nonsymmetric one-end tearing pattern for the system with a lower viscosity ratio and the two-end stretching and twisting for the system with a higher viscosity ratio. The critical capillary number increases with viscosity ratio but varies slightly with the time scale ratio.
Convoluted shorelines confound diel-range estimates of radio-tracked fish
Authors: Ebner Brendan C. , Lintermans Mark , Jekabsons Mark , Dunford Mark
Published: January 2011

Understanding the spatial ecology of animals is an important part of conserving biodiversity. In this context, manual radio‐tracking is a primary means for understanding the movement of freshwater fish. Our aim was to determine the suitability of using linear or area‐based estimates to quantify diel use of space by Macquarie perch, Macquaria australasica (Percichthyidae), in a reservoir. Area‐based estimates were calculated as minimum convex polygons (MCPs). Four‐hourly radio‐tracking of 23 adults within diel periods resulted in 136 pairs of linear and area‐based estimates. We encountered problems with MCPs that were not associated with outlying radio‐fixes. MCPs were more likely to overlap with land as the extent of an individual’s range increased. Corrections were applied to account for land intersecting with MCPs (33.1% of cases); however, underestimates of diel range occurred in most of these cases. MCPs were also small despite substantial movement along one dimension if individuals occupied only straight‐edged sections of the reservoir and did not traverse bays or peninsulas (8.1% of estimates). Mean (±s.e.) diel‐range length was 516 ± 89 m (n = 23) and records varied from 6 to 1972 m. In waterways with convoluted shorelines, linear estimates of diel range are more reliable than area‐based estimates derived from manual radio‐tracking.
An experimentally anchored map of transcriptional start sites in the model cyanobacterium
Synechocystis
sp. PCC6803
Authors: Mitschke Jan , Georg Jens , Scholz Ingeborg , Sharma Cynthia M. , Dienst Dennis , Bantscheff Jens , Voß Björn , Steglich Claudia , Wilde Annegret , Vogel Jörg , Hess Wolfgang R.
Published: January 2011

There has been an increasing interest in cyanobacteria because these photosynthetic organisms convert solar energy into biomass and because of their potential for the production of biofuels. However, the exploitation of cyanobacteria for bioengineering requires knowledge of their transcriptional organization. Using differential RNA sequencing, we have established a genome-wide map of 3,527 transcriptional start sites (TSS) of the model organism
Synechocystis
sp. PCC6803. One-third of all TSS were located upstream of an annotated gene; another third were on the reverse complementary strand of 866 genes, suggesting massive antisense transcription. Orphan TSS located in intergenic regions led us to predict 314 noncoding RNAs (ncRNAs). Complementary microarray-based RNA profiling verified a high number of noncoding transcripts and identified strong ncRNA regulations. Thus, ∼64% of all TSS give rise to antisense or ncRNAs in a genome that is to 87% protein coding. Our data enhance the information on promoters by a factor of 40, suggest the existence of additional small peptide-encoding mRNAs, and provide corrected 5′ annotations for many genes of this cyanobacterium. The global TSS map will facilitate the use of
Synechocystis
sp. PCC6803 as a model organism for further research on photosynthesis and energy research.
Diversity-oriented synthesis leads to an effective class of bifunctional linchpins uniting anion relay chemistry (ARC) with benzyne reactivity
Authors: Smith Amos B. , Kim Won-Suk
Published: January 2011

In conjunction with the construction of a diversity-oriented synthesis library of 10-membered ring “natural product-like” macrolides, the design, synthesis, and validation of a unique class of bifunctional linchpins, uniting benzyne reactivity initiated by type II anion relay chemistry (ARC) has been achieved, permitting access to diverse [2+2], [3+2], and [4+2] cycloadducts.
Towards ICD 10: The Attitudes of Australian and New Zealand Psychiatrists
Authors: Rey Joseph M. , Andrews William
Published: January 2011

About 15% of practising psychiatrists in Australia and New Zealand responded to a brief postal questionnaire. This sample appears reasonably representative of the various groups within the profession and of the geographical distribution of the clinicians. Ninety-one per cent of the respondents thought it was important to have a reliable classification; 83% thought that ICD 10 should incorporate specific diagnostic criteria; and 78% were of the view that ICD 10 should have a multiaxial system. Overall, DSM-III is used twice as often as ICD 9, and only 12% of psychiatrists do not use DSM-III at all. A very small minority (6%) use some other classification system. The results of this survey are discussed against the background of the intended introduction of ICD 10 in about 1990. Preliminary preparations for it are already In progress.
Bipolar Affective Disorder in Adolescence: A 10-Year Study
Authors: Bashir Marie , Russell Janice , Johnson Gordon
Published: January 2011

A descriptive study of bipolar affective disorder in adolescent patients, conducted over a 10-year period, is presented. The diagnosis of 30 subjects referred to an adolescent treatment facility of a major teaching hospital was reviewed using DSM-III criteria, and antecedent symptomatology and signs were documented. Common diagnostic features included schizophreniform phenomenology, motoric and vegetative changes, suicidal and inappropriate sexual behaviour and a stormy first year of illness. A positive family history was frequently noted, as was the relevance of various forms of loss as a precipitant of the first episode. Timely recognition and multidisciplinary management, including the use of lithium, are discussed. It appears that the prognosis of bipolar affective disorder in adolescence is better than was previously believed, probably as a result of earlier diagnosis and more frequent recognition.
Contamination of Hands with Methicillin-ResistantStaphylococcus aureusafter Contact with Environmental Surfaces and after Contact with the Skin of Colonized Patients
Authors: Stiefel Usha , Cadnum Jennifer L. , Eckstein Brittany C. , Guerrero Dubert M. , Tima Mary Ann , Donskey Curtis J.
Published: January 2011

In a study of 40 methicillin-resistantStaphylococcus aureus(MRSA) carriers, hand contamination was equally likely after contact with commonly examined skin sites and commonly touched environmental surfaces in patient rooms (40% vs 45%). These findings suggest that contaminated surfaces may be an important source of MRSA transmission.
Cavity-Induced Self-Trapping of a Bose Josephson Junction
Authors: Huang Jin-Song , Xie Zheng-Wei , Yang Cong-Hua , Wei Lian-Fu
Published: January 2011

We investigate the self-trapping of a Bose Josephson junction, which is dispersively coupled to a driven optical cavity. The cavity-induced nonlinearity is presented analytically, and its effect results in the appearance of the self-trapping for the Bose-Einstein condensates in the Josephson oscillation regime. In addition, there exists competition between the nonlinearities induced by the interatomic interaction and by the driven cavity for the emergences of self-trapping. Our results show that the driven cavity can be utilized as a possible tool to produce the self-trapping for the condensates with weak interatomic interaction.
Thoracic Epidural Anesthesia for Cardiac Surgery: A Randomized Trial
Authors: Svircevic Vesna , Nierich Arno P. , Moons Karel G. M. , Diephuis Jan C. , Ennema Jacob J. , Brandon Bravo Bruinsma George J. , Kalkman Cor J. , van Dijk Diederik
Published: January 2011

Background

The addition of thoracic epidural anesthesia (TEA) to general anesthesia (GA) during cardiac surgery may have a beneficial effect on clinical outcomes. TEA in cardiac surgery, however, is controversial because the insertion of an epidural catheter in patients requiring full heparinization for cardiopulmonary bypass may lead to an epidural hematoma. The clinical effects of fast-track GA plus TEA were compared with those of with fast-track GA alone.

Methods

A randomized controlled trial was conducted in 654 elective cardiac surgical patients who were randomly assigned to combined GA and TEA versus GA alone. Follow-up was at 30 days and 1 yr after surgery. The primary endpoint was 30-day survival free from myocardial infarction, pulmonary complications, renal failure, and stroke.

Results

Thirty-day survival free from myocardial infarction, pulmonary complications, renal failure, and stroke was 85.2% in the TEA group and 89.7% in the GA group (P = 0.23). At 1 yr follow-up, survival free from myocardial infarction, pulmonary complications, renal failure, and stroke was 84.6% in the TEA group and 87.2% in the GA group (P = 0.42). Postoperative pain scores were low in both groups.

Conclusions

This study was unable to demonstrate a clinically relevant benefit of TEA on the frequency of major complications after elective cardiac surgery, compared with fast-track cardiac anesthesia without epidural anesthesia. Given the potentially devastating complications of an epidural hematoma after insertion of an epidural catheter, it is questionable whether this procedure should be applied routinely in cardiac surgical patients who require full heparinization.
Meta-analysis of Thoracic Epidural Anesthesia versus General Anesthesia for Cardiac Surgery
Authors: Svircevic Vesna , van Dijk Diederik , Nierich Arno P. , Passier Martijn P. , Kalkman Cor J. , van der Heijden Geert J.M.G. , Bax Leon
Published: January 2011

Background

A combination of general anesthesia (GA) with thoracic epidural anesthesia (TEA) may have a beneficial effect on clinical outcomes after cardiac surgery. We have performed a meta-analysis to compare mortality and cardiac, respiratory, and neurologic complications in patients undergoing cardiac surgery with GA alone or a combination of GA with TEA.

Methods

Randomized studies comparing outcomes in patients undergoing cardiac surgery with either GA alone or GA in combination with TEA were retrieved from PubMed, Science Citation index, EMBASE, CINHAL, and Central Cochrane Controlled Trial Register databases.

Results

The search strategy yielded 1,390 studies; 28 studies that included 2,731 patients met the selection criteria. Compared with GA alone, the combined risk ratio for patients receiving GA with TEA was 0.81 (95% CI: 0.40-1.64) for mortality, 0.80 (95% CI: 0.52-1.24) for myocardial infarction, and 0.59 (95% CI: 0.24-1.46) for stroke. The risk ratios for the respiratory complications and supraventricular arrhythmias were 0.53 (95% CI: 0.40-0.69) and 0.68 (95% CI: 0.50-0.93), respectively.

Conclusions

This meta-analysis showed that the use of TEA in patients undergoing cardiac surgery reduces the risk of postoperative supraventricular arrhythmias and respiratory complications. The sparsity of events precludes conclusions about mortality, myocardial infarction, and stroke, but the estimates suggest a reduced risk after TEA. The risk of side effects of TEA, including epidural hematoma, could not be assessed with the current dataset, and therefore TEA should be used with caution until its benefit-harm profile is further elucidated.
Perioperative Nerve Injury after Total Knee Arthroplasty
Authors: Jacob Adam K. , Mantilla Carlos B. , Sviggum Hans P. , Schroeder Darrell R. , Pagnano Mark W. , Hebl James R.
Published: January 2011

Background

Perioperative nerve injury (PNI) is one of the most debilitating complications after total knee arthroplasty (TKA). Although regional anesthesia (RA) techniques reduce pain and improve functional outcomes after TKA, they may also contribute to PNI. The objective of this study was to test the hypothesis that PNI risk differs among patients according to RA use during TKA.

Methods

All patients aged at least 18 yr who underwent elective TKA from January 1988 to July 2007 were retrospectively identified. The primary outcome variable was the presence of a new PNI documented within 3 months of the procedural date. Age, sex, body mass index, type of procedure, tourniquet time, type of anesthesia, and use of peripheral nerve blockade were evaluated as potential risk factors for PNI using multivariable logistic regression.

Results

Ninety-seven cases of PNI were identified among 12,329 patients. Overall incidence of PNI was 0.79% (95% CI, 0.64-0.96%). PNI was not associated with peripheral nerve blockade (odds ratio [OR], 0.97) or type of anesthesia (OR, 1.10 [neuraxial vs. general]; OR, 1.82 [combined vs. general]). Risk for PNI decreased with age (OR, 0.68 [per decade]; P < 0.001) but increased with tourniquet time (OR, 1.28 [per 30-min increase]; P = 0.003) and bilateral procedures (OR, 2.51; P < 0.001). Patients with PNI who underwent peripheral nerve blockade were less likely to have complete neurologic recovery (OR, 0.37; P = 0.03).

Conclusions

Risk for PNI after TKA was unchanged by the use of RA techniques. This finding supports the notion that the known benefits of RA for patients undergoing TKA can be achieved without increasing risk of neurologic injury. However, in rare situations when PNI occurs, complete recovery may be less likely if it develops after peripheral nerve blockade.
Association between Intraoperative Blood Transfusion and Mortality and Morbidity in Patients Undergoing Noncardiac Surgery
Authors: Glance Laurent G. , Dick Andrew W. , Mukamel Dana B. , Fleming Fergal J. , Zollo Raymond A. , Wissler Richard , Salloum Rabih , Meredith U. Wayne , Osler Turner M.
Published: January 2011

Background

The impact of intraoperative erythrocyte transfusion on outcomes of anemic patients undergoing noncardiac surgery has not been well characterized. The objective of this study was to examine the association between blood transfusion and mortality and morbidity in patients with severe anemia (hematocrit less than 30%) who are exposed to one or two units of erythrocytes intraoperatively.

Methods

This was a retrospective analysis of the association of blood transfusion and 30-day mortality and 30-day morbidity in 10,100 patients undergoing general, vascular, or orthopedic surgery. We estimated separate multivariate logistic regression models for 30-day mortality and for 30-day complications.

Results

Intraoperative blood transfusion was associated with an increased risk of death (odds ratio [OR], 1.29; 95% CI, 1.03-1.62). Patients receiving an intraoperative transfusion were more likely to have pulmonary, septic, wound, or thromboembolic complications, compared with patients not receiving an intraoperative transfusion. Compared with patients who were not transfused, patients receiving one or two units of erythrocytes were more likely to have pulmonary complications (OR, 1.76; 95% CI, 1.48-2.09), sepsis (OR, 1.43; 95% CI, 1.21-1.68), thromboembolic complications (OR, 1.77; 95% CI, 1.32-2.38), and wound complications (OR, 1.87; 95% CI, 1.47-2.37).

Conclusions

Intraoperative blood transfusion is associated with a higher risk of mortality and morbidity in surgical patients with severe anemia. It is unknown whether this association is due to the adverse effects of blood transfusion or is, instead, the result of increased blood loss in the patients receiving blood.
Neuroprotective Effect of Orexin-A Is Mediated by an Increase of Hypoxia-inducible Factor-1 Activity in Rat
Authors: Yuan Li-bang , Dong Hai-long , Zhang Hao-Peng , Zhao Rui-ni , Gong Gu , Chen Xiao-mei , Zhang Li-na , Xiong Lize
Published: January 2011

Background

Recent studies suggest that the novel neuropeptide orexin-A may play an essential role during neuronal damage. However, the function of orexin-A during brain ischemia remains unclear. Recently, hypoxia-inducible factor-1α (HIF-1α) was shown to be activated by orexin-A. The aim of the current study is to test the hypothesis that administration of exogenous orexin-A can attenuate ischemia-reperfusion injury through the facilitation of HIF-1α expression.

Methods

Sprague-Dawley rats were subjected to transient middle cerebral artery occlusion for 120 min. Rats were treated with different doses of orexin-A or vehicle before the ischemia and at the onset of reperfusion. To investigate the action of HIF-1α in the neuroprotective effects of orexin-A, the HIF-1α inhibitor YC-1 was used alone or combined with orexin-A. Neurologic deficit scores and infarct volume were assessed. Brains were harvested for immunohistochemical staining and western blot analysis.

Results

Orexin-A significantly ameliorated neurologic deficit scores and reduced infarct volume after cerebral ischemia reperfusion. Administration of 30 μg/kg orexin-A showed optimal neuroprotective effects. This effect was still present 7 days after reperfusion. Furthermore, orexin-A decreased the number of apoptotic cells and significantly enhanced HIF-1α expression after cerebral ischemia reperfusion. Moreover, the facilitation of HIF-1α expression was accompanied with inhibition of von Hippel-Lindau expression. Administration of HIF-1α inhibitor suppressed the increase of HIF-1α and reversed the neuroprotective effects of orexin-A.

Conclusions

Orexin-A has a neuroprotective effect against cerebral ischemia-reperfusion injury. These effects may be mediated through the HIF-1α pathway.
A Biopsy Is Not Always Necessary to Diagnose Celiac Disease
Authors: Mubarak Amani , Wolters Victorien M , Gerritsen Susan AM , Gmelig‐Meyling Frits HJ , Ten Kate Fiebo JW , Houwen Roderick HJ
Published: January 2011

Objectives:

Small intestinal histology is the criterion standard for the diagnosis of celiac disease (CD). However, results of serological tests such as anti‐endomysium antibodies and anti‐tissue transglutaminase antibodies (tTGA) are becoming increasingly reliable. This raises the question of whether a small intestinal biopsy is always necessary. The aim of the present study was, therefore, to investigate whether a small intestinal biopsy can be avoided in a selected group of patients.

Patients and Methods:

Serology and histological slides obtained from 283 pediatric patients suspected of having CD were examined retrospectively. The response to a gluten‐free diet (GFD) in patients with a tTGA level ≥100 U/mL was investigated.

Results:

A tTGA level ≥100 U/mL was found in 128 of the 283 patients. Upon microscopic examination of the small intestinal epithelium, villous atrophy was found in 124 of these patients, confirming the presence of CD. Three patients had crypt hyperplasia or an increased number of intraepithelial lymphocytes. In 1 patient no histological abnormalities were found. This patient did not respond to a GFD.

Conclusions:

Pediatric patients with a tTGA level ≥100 U/mL in whom symptoms improve upon consuming a GFD may not need a small intestinal biopsy to confirm CD.
Colonic Hyperactivity Results in Frequent Fecal Soiling in a Subset of Children After Surgery for Hirschsprung Disease
Authors: Kaul Ajay , Garza Jose M , Connor Frances L , Cocjin Jose T , Flores Alejandro F , Hyman Paul E , Di Lorenzo Carlo
Published: January 2011

Background and Aim:

Fecal soiling is a challenging problem in some children after pull‐through surgery for Hirschsprung disease (HSCR). The prevailing perception is that soiling results from overflow incontinence; however, its treatment with laxatives yields mixed results. Colonic manometry studies are reported to be normal in most patients in this population. The interpretation of these findings does not support the physiology of fecal overflow incontinence in these children. The aim of the present study was to define the physiology underlying daily, frequent fecal soiling in children after surgery for HSCR using manometric techniques.

Patients and Methods:

Four pediatric motility centers in the United States participated in the study; medical records and manometric tracings (anorectal and colonic) of children (n = 59; 6.5 years; 48 boys) who had pull‐through surgery for HSCR and presented with daily, frequent fecal soiling were examined. Children referred for evaluation of constipation who had normal colonic manometry served as controls (n = 25; 6.7 years; 12 boys). The patients with HSCR were divided into 2 groups (Hirschsprung disease groups 1 and 2 [HD1, HD2]) based on the absence or presence of high‐amplitude propagated contractions (HAPCs). A control group that included children with chronic constipation was also studied. We compared the mean HAPC frequency between the HD2 and control groups.

Results:

HD1 included 21 patients who had no HAPCs in fasting or postprandial periods. HD2 included 38 patients who had an average of 0.07 HPACs/min while fasting and 0.13/min in the postprandial state. In this subset the number of HAPCs in the fasting state (P = 0.04) and the postprandial state (P < 0.001) was greater when compared with controls. Additionally, there was a significant increase in HAPCs/min from the fasting to the postprandial state (P = 0.01). In the HD2 group 40% had colonic hyperactivity.

Conclusions:

Daily, frequent fecal soiling after pull‐through surgery for HSCR may be due to colonic hyperactivity in some children. It is imperative that this unique subset be identified because the management strategy would include avoidance of laxatives, contrary to standard current practice.
Evaluations of Psychological Preparation for Children Undergoing Endoscopy
Authors: Tanaka Kyoko , Oikawa Nao , Terao Rieko , Negishi Yoshie , Fujii Toru , Kudo Takahiro , Shimizu Toshiaki
Published: January 2011

We provided psychological preparation to children who were hospitalized for endoscopy. We performed a multifaceted evaluation of the effects of the preparation to identify appropriate methods for individual children. The subjects were 20 children, ages 4 to 15 years (average 9.9 years), who were divided into 3 groups according to the preparation methods. From our study, we suggest that it is important to discuss the preparation methods for medical procedures using methods appropriate to the level of cognitive development of each individual child.