bluuebunny/crossref_metadata_2025 huggingface dataset:
Modification of Outcomes With Aspirin or Apixaban in Relation to Female and Male Sex in Patients With Atrial Fibrillation
Authors: Lip Gregory Y.H. , Eikelboom John , Yusuf Salim , Shestakovska Olga , Hart Robert G. , Connolly Stuart
Published: June 2014

Background and Purpose—

The main objective of the present analysis was to assess the effect of treatment with aspirin compared with apixaban on ischemic stroke and major bleeding in women compared with men. Female patients with atrial fibrillation are at increased stroke risk compared with male patients, and the underlying reasons for higher risk are uncertain.

Methods—

Ancillary analysis of the Apixaban Versus Acetylsalicylic Acid [ASA] to Prevent Stroke in Atrial Fibrillation Patients Who Have Failed or Are Unsuitable for Vitamin K Antagonist Treatment (AVERROES) trial, comparing aspirin and apixaban, focused on sex differences. Mean follow-up was 1.1 years.

Results—

Women compared with men tended to be older (aspirin, 71.8 versus 68.8 years; apixaban, 71.4 versus 68.6 years), with a higher proportion of those aged ≥75 years. Also, women had less peripheral artery disease (aspirin, 2.4% versus 3.7%; apixaban, 1.4% versus 3.0%), more heart failure, and higher mean CHADS
2
(congestive heart failure, hypertension, age of 75 years or older, diabetes [1 point each], stroke or transient ischemic attack [2 points]) scores (aspirin, 2.2 versus 2.0; apixaban, 2.1 versus 2.0). Women compared with men had higher ischemic stroke rates (aspirin, 3.99% versus 2.28%; apixaban, 1.55% versus 0.82%) but similar bleeding rates (aspirin, 1.29% versus 1.22%; apixaban, 1.15% versus 1.36%). The relative effect of apixaban compared with aspirin was similar in men and women for both ischemic stroke (women, 3.99% versus 1.55%; hazard ratio, 0.39; 95% confidence interval, 0.23–0.64; men, 2.28% versus 0.82%; hazard ratio, 0.36; 95% confidence interval, 0.19–0.63;
P
int
=0.84) and major bleeding (women, 1.29% versus 1.15%; hazard ratio, 1.15; 95% confidence interval, 0.59–2.23; men, 1.36% versus 1.22%; hazard ratio, 1.13; 95% confidence interval, 0.64–2.02;
P
int
=0.96).

Conclusions—

Female patients with atrial fibrillation had higher ischemic stroke rates compared with male patients, but the relative effects of apixaban compared with aspirin on both ischemic stroke and bleeding were similar in men and women.
The Challenge of Collective Action for Irrigation Management in India
Authors: Chun Natalie
Published: June 2014

The determinants and impacts of farm household participation in collective action for irrigation management in Chhattisgarh, India, are analyzed. Wealth or land holdings are not factors affecting participation, but minority castes are disproportionately less likely to participate. Participation is found to increase sufficiency of water in the canal, but not land productivity or per capita incomes. This highlights some of the major challenges with collective action that provides greater equality in access, but insufficient incentives to participate.
Begonia intermedia, an illegitimate name and taxonomic synonym of B. wuzhishanensis
Authors: TIAN DAIKE
Published: June 2014

It came to our attention that Begonia ×intermedia Veitch ex van Houtte (1873: 39) was published in Flore des Serres and therefore, B. intermedia D.K. Tian et al. (2014: 116) is a later homonym and not legitimate according to the International code of nomenclature for algae, fungi and plants (McNeill et al. 2012: Art. 53). Furthermore, the article by Tian et al. was published on 24 Apr 2014 in Phytotaxa while B. wuzhishanensis C.I. Peng et al. (2014: 3) was published on 5 Feb 2014 in Botanical Studies for the same species based on type material collected from different locations on Hainan Island of China. In total, extant wild populations of this species have been found in at least the three places belonging to one city (Wuzhishan) and two counties (Qiongzhong and Lingshui), respectively (Fig 1).
Pitcairnia albifolia (Bromeliaceae), a new species from the Talamanca Mountains in Veraguas Province, Panama
Authors: CÁCERES GONZÁLEZ DANIEL ADOLFO , IBÁÑEZ ALICIA
Published: June 2014

Bromeliaceae Juss. comprises 3,348 species and 58 genera (Luther 2012), grouped in subfamilies Brocchinioideae, Bromelioideae, Hechtioideae, Lindmanioideae, Navioideae, Pitcairnioideae, Puyoideae, and Tillandsioideae (Givnish et al. 2007). According to Luther (2012), the genus Pitcairnia Ruiz & Pav. has ca. 342 species and is the most diverse in Pitcairnioideae.
Studies on Megachile Latreille subgenus Callomegachile Michener (Hymenoptera: Megachilidae) from Chandigarh and Haryana plains, India
Authors: KUMARI PRIYANKA , KUMAR NEELIMA R.
Published: June 2014

Floral associations of three species of Megachile (Callomegachile) from NW India are provided: M. (C.) disjuncta, M. (C.) cephalotes and M. (C.) lerma. Morphological characters of both sexes and the male genitalia of each species are presented and illustrated. All three species are new records for Union Territory (Chandigarh) and Haryana in India.
Revision of the cranaid genera Phalangodus, Iquitosa and Aguaytiella (Opiliones: Laniatores: Gonyleptoidea)
Authors: HARA MARCOS RYOTARO , PINTO-DA-ROCHA RICARDO , VILLARREAL M. OSVALDO
Published: June 2014

The monotypic genus Temucus Roewer, 1943, originally placed in Pachylinae (Gonyleptidae) is transferred to the Cranainae (Cranaidae) and synonymized with Phalangodus Gervais, 1842, therefore Phalangodus palpiconus (Roewer, 1943) comb. nov. is proposed. The synonymy is based on the following features: (i) the outline of dorsal scutum type alpha; (ii) the thickened pedipalpal claw in males; (iii) pedipalpal femur with a few ventral enlarged tubercles restricted to the median ventral region, and a conspicuous group of very large and acuminated tubercles basally; (iv) ventral plate of penis with a rather elevated number of cylindrical, straight and sharp distal pairs of setae and a notorious reduction in the number of the basal pairs of setae; (v) penis stylus straight, its distal tip rounded in a mushroom-like shape without stylar caps. The record of P. palpiconus to Chile is doubtful. We also propose the revalidation of Iquitosa Roewer, 1943, hitherto considered a junior synonym of Phalangodus. Iquitosa is revised and the male of its type species, I. poecilis, is reported for the first time. Aguaytiella Goodnight & Goodnight, 1943, a monotypic genus which superficially resembles Iquitosa is also revised. In this article, we report data of male genitalia of Iquitosa and Aguaytiella, providing redescriptions and diagnoses of those genera and species, and a discussion of their relationship with other cranaids.
Synoptic-Scale Dual Structure of Precipitable Water along the Eastern Pacific ITCZ
Authors: Chen Guanghua , Takayabu Yukari N. , Yokoyama Chie
Published: June 2014

Using 10-yr high-resolution satellite and reanalysis data, the synoptic-scale dual structure of precipitable water (PW), in which the southern and northern bands straddled at the ITCZ produce zonally propagating meridional dipoles, is observed over the eastern Pacific (EP) during boreal summer and fall. Composites indicate that the PW dipole, concurrent with the dipole-like filtered divergence, has a shift to the west of the anomalously cyclonic circulation. The vertical structure of filtered meridional wind is characterized by a wavenumber-1 baroclinic mode, and the vertical motion has two peaks situated at 850 and 300 hPa, respectively. To the east of the PW dipole, the shallow convection is embedded within the deep convection, forming a multilevel structure of meridional wind on the ITCZ equatorward side. To the west of the PW dipole, the deep convection tends to be suppressed because of the invasion of midlevel dry air advected by northerly flows. The generation and propagation of the dual PW band can be attributed to the divergence and advection terms related to specific humidity and three-dimensional wind. By comparison, the PW anomalies over the western North Pacific, only exhibiting a single band, coincide with the centers of synoptic disturbances with a barotropic vertical structure. Because of the weakening of lower-level divergence, the vertical motion, and the horizontal gradient of PW, the synoptic-scale PW signal is reduced significantly. The typical cases and statistics confirm that the strong meridional dipoles and westward-propagating disturbances are closely associated with the distortion and breakdown of ITCZ over the EP.
The Intraseasonal Variability of African Easterly Wave Energetics
Authors: Alaka Ghassan J. , Maloney Eric D.
Published: June 2014

African easterly waves (AEWs) and associated perturbation kinetic energy (PKE) exhibit significant intraseasonal variability in tropical North Africa during boreal summer. Consistent with East Africa (e.g., east of Lake Chad) being an initiation region for AEWs, previous studies have shown that increased East African PKE precedes and leads to increased West African AEW activity on intraseasonal time scales. In this study, reanalysis budgets of PKE and perturbation available potential energy (PAPE) are used to understand this behavior. The variability of PKE and PAPE sources is analyzed as a function of Madden–Julian oscillation (MJO) phase and a local 30–90-day West African PKE index to diagnose when and where eddy energy conversions terms are important to periods of increased or decreased intraseasonal AEW activity. In East Africa, an increased meridional temperature gradient locally enhances baroclinic energy conversion anomalies to initiate periods of increased intraseasonal AEW activity. Downstream barotropic and baroclinic energy conversions associated with strong AEWs are important for the maintenance of intraseasonal AEW activity in West Africa. Barotropic energy conversions dominate south of the African easterly jet (AEJ), while baroclinic energy conversions are most important north of the AEJ. In both East and West Africa, diabatic heating does not appear to aid intraseasonal PKE creation. Instead, negative PAPE tendency anomalies due to the diabatic heating–temperature covariance act as a negative feedback to increased baroclinic energy conversion downstream in the AEJ.
Synoptic Flow Patterns and Large-Scale Characteristics Associated with Rapidly Intensifying Tropical Cyclones in the South China Sea
Authors: Chen Xiaomin , Wang Yuqing , Zhao Kun
Published: June 2014

The typical synoptic flow patterns and environmental factors that favor the rapid intensification (RI) of tropical cyclones (TCs) in the South China Sea (SCS) have been identified based on all TCs formed in the SCS between 1981 and 2011. The quantity RI is defined as the 24-h increase in maximum sustained surface wind speed by 15 m s−1 as in previous studies, which is close to the 95th percentile of 24-h intensity change of all SCS samples excluding those after landfall. There are 4.9% (2.3%) of tropical depressions (tropical storms) that experienced RI. No typhoons satisfied the RI threshold.

Six low-level synoptic flow patterns favoring RI have been identified based on 18 RI cases. In the monsoon season very few TCs experience RI due to large vertical wind shear (VWS). Most RI cases occurred in the postmonsoon season when the midlatitude troughs often penetrated into the SCS whereas the southwesterly monsoon flow is still strong in the southern SCS. Compared with those of non-RI cases, the mean initial conditions of RI cases include weak VWS and relatively strong forcing from midlatitude troughs. Several criteria of significant environmental factors for RI are statistically identified based on all TC samples. It is found that 16 non-RI TCs fitted in the RI flow patterns but only two of them satisfy all the criteria, suggesting that a combination of the synoptic flow pattern and the environmental factors can be used to predict RI in the SCS. In addition, two RI cases involving TC–trough interaction are analyzed.
The Influence of Land Surface Heterogeneities on Cloud Size Development
Authors: Rieck Malte , Hohenegger Cathy , van Heerwaarden Chiel C.
Published: June 2014

This study analyzes the effects of land surface heterogeneities at various horizontal scales on the transition from shallow to deep convection and on the cloud size distribution. An idealized case of midlatitude summertime convection is simulated by means of large-eddy simulations coupled to an interactive land surface. The transition is accelerated over heterogeneous surfaces. The simulation with an intermediate patch size of 12.8 km exhibits the fastest transition with a transition time two-thirds that over a homogeneous surface. A similar timing is observed for the precipitation onset whereas the total accumulated rainfall tends to increase with patch size. The cloud size distribution can be approximated by a power law with a scale break. The exponent of the power law is independent of the heterogeneity scale, implying a similar cloud cover between the simulations. In contrast, the scale break varies with patch size. The size of the largest clouds does not scale with the boundary layer height, although their maximum size scales with the patch size. Finally, the idea that larger clouds grow faster, known from homogeneous surface conditions, is not fully valid over heterogeneous surfaces. These various aspects can be understood from the complex interplay between the characteristics of the triggered mesoscale circulations and a cloud development acting in response to the diurnal cycle in surface heating. The results also call for adequate representation of such effects in convective parameterizations.
Analysis of a Destructive Wind Storm on 16 November 2008 in Brisbane, Australia
Authors: Richter Harald , Peter Justin , Collis Scott
Published: June 2014

During the late afternoon on 16 November 2008 the Brisbane (Queensland, Australia) suburb of “The Gap” experienced extensive wind damage caused by an intense local thunderstorm. The CP2 research radar nearby detected near-surface radial velocities exceeding 43 m s−1 above The Gap while hail size reports did not exceed golf ball size, and no tornadoes were reported. The storm environment was characterized by a layer of very moist near-surface air and strong storm-relative low-level flow, whereas the storm-relative winds aloft were weak. While the thermodynamic storm environment contained a range of downdraft-promoting ingredients such as a ~4-km-high melting level above a ~2-km-deep layer with nearly dry-adiabatic lapse rates mostly collocated with dry ambient air, a ~1-km-deep stable layer near the ground would generally lower expectations of destructive surface winds based on the downburst mechanism. Once observed reflectivities exceed 70 dBZ, downdraft cooling due to hail melting and downdraft acceleration based on hail loading are found to likely become nonnegligible forcing mechanisms. The event featured the close proximity of a hydrostatically and dynamically driven mesohigh at the base of the downdraft to a dynamically driven mesolow associated with a low-level circulation. This proximity was instrumental in the anisotropic horizontal acceleration of the near-ground outflow and the ultimate strength of the Gap storm surface winds. Weak storm-relative midlevel winds are speculated to have allowed the downdraft to descend close to the low-level circulation, which set up this strong horizontal perturbation pressure gradient.
Magnetic Resonance Imaging of the Effortful Swallow
Authors: Fritz Mark , Cerrati Eric , Fang Yixin , Verma Avanti , Achlatis Stratos , Lazarus Cathy , Branski Ryan C. , Amin Milan
Published: June 2014

Objective:

The effortful swallow was designed to improve posterior mobility of the tongue base and increase intraoral pressures. We characterized the effects of this maneuver via dynamic magnetic resonance imaging (dMRI) in healthy patients.

Methods:

A 3-T scanner was used to obtain dMRI images of patients swallowing pudding using normal as well as effortful swallows. Ninety sequential images were acquired at the level of the oropharynx in the axial plane for each swallow; 3 series were obtained for each swallow type for each patient. Images were acquired every 113 ms during swallowing. The images were analyzed with respect to oropharyngeal closure duration, anteroposterior and transverse distance between the oropharyngeal walls, and oropharyngeal area before and after closure.

Results:

Preswallow reduced pharyngeal area was observed ( P = .02; mean = 212.61 mm2 for effortful, mean = 261.92 mm2 for normal) as well as prolonged pharyngeal closure during the swallow ( P < .0001; mean = 742.18 ms for effortful, mean = 437.31 ms for normal). No other differences were noted between swallow types. Interrater and intrarater reliability of all measurements was excellent.

Conclusion:

This preliminary investigation is the first to evaluate the effects of effortful swallows via dMRI. In our cohort, consistent physiologic changes were elicited, consistent with clinical dogma regarding this maneuver.
“Good Types” in Authoritarian Elections
Authors: Manion Melanie
Published: June 2014

A new electoral design for subnational congress elections in China allows me to investigate the informational utility of authoritarian elections. Authoritarian regimes are notoriously bad at solving the moral hazard problem in the voter’s agency relationship with politicians. Borrowing from the literature on political selection, I theorize that authoritarian elections can nonetheless solve the adverse selection problem: Chinese voters can use their electoral power to select “good types,” with personal qualities that signal they will reliably represent local interests. I analyze original data from a survey of 4,071 Chinese local congressmen and women, including voter nominees and communist party nominees. I find that voters do in fact overcome coordination difficulties to nominate and elect “good types.” In contacting politicians about local problems after the elections, however, voters hedge their bets by contacting regime insiders too. At these very local levels, congressional representation by means of political selection co-exists with communist party nominating and veto power in the electoral process.
Results of Immersion Service Learning Activism With Peers
Authors: Koch Julie M. , Ross Julie B. , Wendell Joel , Aleksandrova-Howell Maria
Published: June 2014

Despite the emphasis on multicultural counseling competence and social justice in counseling psychology, the mechanisms behind building skills related to effective work remain elusive. This qualitative study explored the experiences of student-participants during a service learning course based on social justice principles in Belize. The researchers sought to inform how a non-traditional teaching methodology—immersion service learning activism—might affect these students’ development. The researchers used Consensual Qualitative Research to analyze interviews and journals through a collaborative and reflective process. Eleven domains emerged from the analysis. Results confirmed past research related to immersion and service learning, including personal and professional development and changes in diversity attitudes. There were also unanticipated themes related to complex interpersonal and group dynamics. These findings demonstrate the influence of immersion, service learning, and group process in intra- as well as interpersonal development and skill building related to cultural competency and social justice activism.
Strategies to improve the mechanical properties of high-density polylactic acid foams
Authors: Geissler Bernd , Feuchter Michael , Laske Stephan , Fasching Michael , Holzer Clemens , Langecker Günter R
Published: June 2014

In this study, different strategies to improve the mechanical properties of physically foamed high-density polylactic acid sheets were examined to produce polylactic acid foam sheets with tailor-made mechanical properties. The first part was the determination of the effect of different blowing agents (CO2 and N2) on the foam morphology. The second part of the study was the modification of the formulation. For this purpose, both a linear and a branching chain extender and a thermoplastic elastomer were used to improve the elongational properties (tensile modulus and strain at break) of the polylactic acid foam sheets. Additionally, the effect of the addition of cellulose fibers on the foam morphology and the mechanical properties was investigated. All experiments were carried out on a laboratory flat-film line. This extrusion line consists of a 30-mm single-screw extruder attached with a 250-mm flat sheet die. The results show a strong influence of the material formulation on the mechanical properties of the high-density foam sheets. Both the mechanical properties and foam morphology could be improved by the right material formulation. The addition of the thermoplastic elastomer leads to a better foam morphology and also to a reduced brittleness of the foam sheets. Furthermore, it could be demonstrated that cellulose fiber can be used as a nucleating agent for polylactic acid but causes a further decrease in the strain at break.
The effect of coupling agents on silicate-based nanofillers/carbon black dual filler systems on the properties of a natural rubber/butadiene rubber compound
Authors: Poikelispää Minna , Das Amit , Dierkes Wilma , Vuorinen Jyrki
Published: June 2014

Nanofillers have been introduced a few years ago, but their application in elastomers is still a challenge. With the existing rubber processing equipment and constraints of rubber mixing, dispersion of nanofillers is difficult. The processability and performance of compounds containing plate- or tube-like silicates in a blend with conventional fillers, such as carbon black (CB), are investigated, and the effect of surface modification of the nanofillers is studied.

Processing is facilitated by the replacement of CB by the nanofillers, but curing efficiency is reduced. The dispersion of the fillers is improved with the addition of nanofillers. The dynamic properties of the cured composite material are affected, giving the composite material lower hysteresis, while the mechanical properties are merely affected by the addition of nanofillers. Additionally, the filler–polymer interaction is increased. The addition of a compatibilizing and coupling agent, a silane, has only a minor effect and does not improve processing and properties significantly for these combined filler systems.
Polymer composites prepared from heat-treated starch and styrene–butadiene latex
Authors: Kim Sanghoon , Adkins Jason , Aglan Heshmat A , Biswas Atanu , Selling Gordon
Published: June 2014

Thermoplastic starch/latex polymer composites were prepared using styrene–butadiene latex and heat-treated cornstarch. The composites were prepared in a compression mold at 130°C, with 20% starch content. An amylose-free cornstarch, waxy maize, was used for this research, and the heat treatment range was from ambient temperature to 170°C. The heat-treated starch (HTS) was characterized by optical microscopy, dynamic light scattering, and size exclusion chromatography. The composites were characterized by mechanical analysis (stress–strain) and by scanning electron microscopy. The mechanical tests of composites revealed a dramatic increase in the modulus and tensile strength when the gelatinized starch was incorporated. When the starch was not gelatinized, starch did not contribute to the increase in the modulus and tensile strength because of its small surface area, thus weak interaction with the matrix. The reinforcing effect of starch as filler was reduced as the heating temperature of starch was increased to higher than 120°C. The variation of reinforcement effect of HTS as filler was explained by the interaction between starch and matrix material, latex.
Method to Estimate the Deviation from Ideal Uniaxial Compression during Freehand Elastography
Authors: Xia Rongmin , Thittai Arun K.
Published: June 2014

Quasi-static ultrasound elastography was introduced in the early 1990s to provide a way to visualize the mechanical properties of target tissue. Most commonly, only the axial strain is imaged and referred to as an Axial Strain Elastogram (ASE) or elastogram for simplicity. It has been shown that one can image the axial-shear strain distributions as well in addition to ASE. The image of the axial-shear strain is referred to as an axial-shear strain elastogram (ASSE). It has also been shown that the presence or absence of non-zero axial-shear strain values inside the inclusion (referred to as fill-in) along with contrasting margin at its boundary may serve as a potential feature from ASSE that can aid in non-invasive breast lesion classification. However, during freehand elastography, deviations from uniaxial compression often occur typically appearing in several of the frames of a cine-loop obtained during compression. It was shown recently that accounting for such deviations would be important for reliable interpretation of the “ fill-in” observed in ASSE. In this article, we describe a method to estimate the angle of iso-displacement contour at a given depth and use this as a measure to quantify the deviation from the desired uniaxial compression during freehand elastography. We validate the estimated angle obtained from the axial-displacement map against the designed values in simulation and tissue-mimicking phantom experiments. The potential of the angle estimate to detect unreliable ASSE frames among the freehand-acquired data cine-loop is demonstrated using example cases of in vivo breast lesion data. Based on the results, we conclude that the angle of the iso-displacement contour from the axial-displacement map can be used as a metric to qualify an ASSE frame as reliable to interpret or not. Importantly, this metric can be obtained in real time and thus can provide operator feedback to guide and improve in vivo freehand elastography data acquisition quality.
How Many More Indians? An Argument for a Representational Ethics of Native Americans
Authors: Merskin Debra
Published: June 2014

This article explores the persistence of stereotypical representations of Native Americans as brand images and situates a call for change within an ethics of representation. American Spirit Cigarettes are used as an illustrative case study to demonstrate that these representations cannot be relegated to less enlightened times, rather endure because naturalization is part of commodified racism. The present essay argues for engagement in representational ethics on the part of communicators to interrupt the contribution of stereotypes to the maintenance of colonial ideologies.
Native speakers’ perceptions of fluency and accent in L2 speech
Authors: Pinget Anne-France , Bosker Hans Rutger , Quené Hugo , de Jong Nivja H.
Published: June 2014

Oral fluency and foreign accent distinguish L2 from L1 speech production. In language testing practices, both fluency and accent are usually assessed by raters. This study investigates what exactly native raters of fluency and accent take into account when judging L2. Our aim is to explore the relationship between objectively measured temporal, segmental and suprasegmental properties of speech on the one hand, and fluency and accent as rated by native raters on the other hand. For 90 speech fragments from Turkish and English L2 learners of Dutch, several acoustic measures of fluency and accent were calculated. In Experiment 1, 20 native speakers of Dutch rated the L2 Dutch samples on fluency. In Experiment 2, 20 different untrained native speakers of Dutch judged the L2 Dutch samples on accentedness. Regression analyses revealed, first, that acoustic measures of fluency were good predictors of fluency ratings. Second, segmental and suprasegmental measures of accent could predict some variance of accent ratings. Third, perceived fluency and perceived accent were only weakly related. In conclusion, this study shows that fluency and perceived foreign accent can be judged as separate constructs.
SLA developmental stages and teachers’ assessment of written French: Exploring Direkt Profil as a diagnostic assessment tool
Authors: Granfeldt Jonas , Ågren Malin
Published: June 2014

One core area of research in Second Language Acquisition is the identification and definition of developmental stages in different L2s. For L2 French, Bartning and Schlyter (2004) presented a model of six morphosyntactic stages of development in the shape of grammatical profiles. The model formed the basis for the computer program Direkt Profil (Granfeldt et al., 2006), which carries out an automated analysis of the developmental stage of a learner text. The aim of the present study was to explore the relevance of Direkt Profil as a diagnostic assessment tool by comparing Direkt Profil’s automated profile analysis with assessment by trained language teachers.

Data for the present study come from the CEFLE corpus of written L2 French (Ågren, 2008). The learner texts were first analysed for developmental stage by the computer program Direkt Profil. In a second step, seven experienced language teachers of French assessed the same texts. The results indicated relatively high degrees of correlation and showed that the analysis of developmental stage by Direkt Profil could explain 73% of the variance in the teachers’ mean assessments ( r2 = 0.735). In addition, we concluded that the teachers were in agreement with each other and with the computer program when assessing texts at low and high proficiency levels respectively. The most important variation in the teachers’ assessments was found in texts at intermediate levels, due to an inconsistent use of grammar and vocabulary. One of the advantages of using Direkt Profil as a diagnostic assessment tool is that it provides immediate and detailed feedback indicating how certain types of linguistic structures, correct or incorrect, are related to different stages of development.
Raters’ decisions, rating procedures and rating scales
Authors: Kuiken Folkert , Vedder Ineke
Published: June 2014

This special issue of Language Testing explores raters’ evaluations of L2 proficiency and possible causes of variability of rater judgments. In addition to the analysis of rater behavior and rater consistency, we investigate the relationship between general measures of oral and written L2 performance concerning complexity, accuracy and fluency of L2 production and overall judgments of oral and written L2 performance by raters, based on holistic rating scales. Finally, the use of rating scales in different contexts and for different types of learners is also examined. In this introduction the three central themes presented in the various contributions are briefly discussed: rater behavior and rater consistency, rater judgments and measures of language performance, and the use of global rating scales.
Use of a single circuit to provide temporary mechanical respiratory and circulatory support in patients with LV apical thrombus and cardiogenic shock
Authors: Mohamedali B , Tatooles A , Bhat G
Published: June 2014

Introduction:

Techniques to support patients with cardiogenic shock continue to improve. Patients with intracardiac thrombi pose a potential for additional complications. Novel methods of biventricular support are necessary to manage these patients.

Methods:

Two patients with refractory cardiogenic shock and left ventricular apical thrombi underwent mechanical circulatory support (MCS) as a bridge to decision, with a left ventricular assist device (LVAD) and extracorporeal mechanical oxygenation (ECMO). Instead of the conventional LV apical cannulation for LVAD, the left atrium (LA) was cannulated. The LA cannula was then integrated with the ECMO circuit via a ‘Y’ connection to a percutaneous right atrial cannula, enabling optimal drainage of both sides into one circuit through a single CentriMag® pump and ECMO into the aorta.

Results:

The first patient was converted to a durable LVAD and transplanted, while the second patient was explanted, after demonstrating significant LV recovery.

Conclusion:

We demonstrated the use of MCS as a bridge to decision in patients with LV thrombi, utilizing biatrial cannulation with a ‘Y’ connection to drain both right- and left-sided circulation through a single circuit and pump.
Grief, anger and despair in relatives of severely brain injured patients: responding without pathologising
Authors: Kitzinger Celia , Kitzinger Jenny
Published: June 2014

The training and expertise of healthcare professionals in diagnosing and treating pathology can mean that every situation is treated as an instance of illness or abnormality requiring treatment. This medicalised perspective is often evident in clinical approaches to family members of people with prolonged disorders of consciousness. This editorial was stimulated by reviewing an article (final version now published in this issue) concerning the distress of families with severely brain injured relatives,2 and by reading the larger body of literature to which that article contributes. It was also prompted by the recent publication of national clinical guidelines in the UK about the management of prolonged disorders of consciousness. In this editorial we highlight the depth and range of emotional reactions commonly experienced by families with a severely brain injured relative. We suggest that clinicians should understand such emotions as normal responses to a terrible situation, and consider the ways in which clinical practice can be adapted to avoid contributing to family trauma.
The ambiguity of the concept of participation in measurement instruments: operationalization of participation influences research outcomes
Authors: Stallinga Hillegonda A , Dijkstra Pieter U , Bos Isaac , Heerkens Yvonne F , Roodbol Petrie F
Published: June 2014

Objective:

This study explores, based on the International Classification of Functioning, Disability and Health, the consequences of different operationalizations of participation in regression models predicting participation in one sample of patients.

Design:

Cross-sectional, comparative study.

Setting:

Department of Neurology of a University Hospital.

Subjects:

A total of 677 patients with a Neuromuscular Disease.

Measures:

Participation was measured using the Neuromuscular Disease Impact Profile questionnaire, the RAND-36 Item Health Survey (social functioning, role limitations—physical, role limitations—emotional) and the Impact on Participation and Autonomy questionnaire (autonomy outdoors, social relations). Potential predictors of participation included type of neuromuscular disease, body functions (measured with Neuromuscular Disease Impact Profile), activities (measured with Neuromuscular Disease Impact Profile), environmental factors (measured with Neuromuscular Disease Impact Profile), and personal factors (measured with the 13-item Sense of Coherence questionnaire). The results were controlled for patient characteristics.

Results:

Participation was statistically predicted by different determinants depending on the operationalization used for participation. Additionally, the regression coefficients differed significantly. Body functions and activities were predictors in five out of six operationalizations of participation. Sense of coherence predicted participation in all of the operationalizations. The explained variance of the different models ranged from 25% (RAND-36 role limitations—emotional) to 65% (Neuromuscular Disease Impact Profile).

Conclusions:

Different operationalizations of participation result in different prediction models. Lack of conceptual consensus makes participation an ambiguous concept in research, and this ambiguity makes evidence-based decisions directed at enhancing participation difficult. Participation needs to be operationalized in an unambiguous and standard way in order to improve the comparability of outcomes.
Adhesive taping vs. daily manual muscle stretching and splinting after botulinum toxin type A injection for wrist and fingers spastic overactivity in stroke patients: a randomized controlled trial
Authors: Santamato Andrea , Micello Maria Francesca , Panza Francesco , Fortunato Francesca , Picelli Alessandro , Smania Nicola , Logroscino Giancarlo , Fiore Pietro , Ranieri Maurizio
Published: June 2014

Objective:

To compare the effectiveness of two procedures increasing the botulinum toxin type A effect for wrist and finger flexor spasticity after stroke.

Design:

A single-blind randomized trial.

Subjects:

Seventy patients with upper limb post-stroke spasticity.

Methods:

Adults with wrist and finger flexor muscles spasticity after stroke were submitted to botulinum toxin type A therapy. After the treatment, the subjects injected were randomly divided into two groups and submitted to adhesive taping (Group A) or daily muscle manual stretching, passive articular mobilization of wrist and fingers, and palmar splint (Group B) for 10 days. We measured spasticity with Modified Ashworth Scale, related disability with Disability Assessment Scale, and fingers position at rest. The measurements were done at baseline, after two weeks, and after one month from the treatment session.

Results:

After two weeks, subjects in Group A reported a significantly greater decrease in spasticity scores (Modified Ashworth Scale fingers: mean (standard deviation) 1.3±0.6 vs. 2.1±0.6; Modified Ashworth Scale wrist: 1.7 ±0.6 vs. 2.3 ±0.8), and after one month in spasticity and disability scores (Modified Ashworth Scale fingers: mean (standard deviation) 1.9 ±0.7 vs. 2.5 ±0.6; Modified Ashworth Scale wrist: 2.0 ±0.7 vs. 2.6 ±0.6; Disability Assessment Scale: 1.6 ±0.7 vs. 2.1 ±0.7) compared with Group B subjects. Subjects in Group A reported also a significantly improved fingers position at rest compared with Group B subjects after two weeks (2.8 ±0.9 vs. 2.1 ±0.7) and one month (2.3 ±0.7 vs. 1.5 ±0.6).

Conclusions:

Adhesive taping of wrist and finger flexor muscles appeared to enhance the effect of botulinum toxin type A therapy more than daily manual muscle stretching combined with passive articular mobilization and palmar splint.
Chest X-ray and CT findings of early H7N9 avian influenza cases
Authors: Lin Zhi Qian , Xu Xue Qin , Zhang Ke Bei , Zhuang Zhi Guo , Liu Xiao Sheng , Zhao Li Qun , Lin Chang Yang , Li Yang , Hua Xiao Lan , Zhao Hui Lin , Hua Jia , Xu Jian Rong
Published: June 2014

Background

The H7N9 strain of bird flu is a new type of avian flu that was identified at the end of March 2013. The disease is concerning because most patients have become severely ill.

Purpose

To study the X-ray and computed tomography (CT) findings of early H7N9 avian influenza cases.

Material and Methods

Chest radiography and CT were performed in six patients with H7N9 avian influenza within 1–20 days after onset. The CT examinations included conventional spiral CT and high-resolution CT. The findings on the radiography and CT images were analyzed.

Results

Abnormal X-ray and CT findings were present in all of the patients. All of the cases had acute onset. In the early stage, the right lung was more commonly affected (particularly in the right upper and middle lobes). The lesions rapidly expanded to the entire lungs and were characterized primarily by ground-glass opacities (GGOs) combined with consolidation. Diffuse GGO was observed in all six cases (1 was symmetric, and 5 were non-symmetric). Local consolidation was found in four cases, and lobar consolidation was found in two cases. Normal lung tissue was observed between the lesions. Pleural thickening was common and was combined with pleural/pericardial effusion or mediastinal lymph node enlargement. Reticular changes, centrilobular nodules, and the tree-in-bud sign were observed in some cases, but reticular changes, bronchial wall thickening, and hyperinflation were not found.

Conclusion

Radiological changes associated with both acute pneumonia and acute interstitial inflammation were observed in early H7N9 avian influenza cases. Serial chest X-rays were useful for the diagnosis and severity assessment of the disease. CT may provide a more accurate assessment of the lung pathology.
SWELA, ethnicity, and democracy in Cameroon’s patrimonial state: An anthropological critique
Authors: Orock Rogers Tabe Egbe
Published: June 2014

Since the importation of liberal democracy by African postcolonial states in the 1990s mainstream political science scholarship has mainly represented the outcome as a pathologically ethnicized disfiguration of a universal model of politics upon which many had invested much hope for political empowerment and accountability. This article draws from a recent anthropological theoretical position on democracy as a work of cultural construction as well as on ethnographic material on an ethno-regional elite organization in Southwestern Cameroon called SWELA to provide an alternative reading of the ethnicity-elite-democracy nexus in postcolonial Africa. I suggest that while ethnicity is a major idiom through which the politics of democracy is practiced in Africa where most states are very patrimonially organized, this need not be seen as unproductive to the democratic ideals or expectations of effective political participation, deliberation (voice), and political accountability. Taking the case of Cameroon, I argue that in complete reversal of the situation under the one-party state, the historical shift from the one-party state to multiparty politics in 1990 and vernacularization of democracy in Cameroon along a cultural politics of ethnic identities have provided political spaces to the elite that were previously inexistent. I explore how South-West political elites successfully articulate personalized and collective interests on the state through various ethno-regional modes of political action that range from lobbying to threatening memoranda to the regime. These successful strategies by South-West elites indicate how ethnic and patrimonial politics by political elites can link up to democratic expectations in quite surprising ways, suggesting the need for a more cautious interpretation of democracy as a culturally enfolded and enfolding formation subject to local political conditions.
Conflict, claim and contradiction in the new ‘indigenous’ state of Bolivia
Authors: Canessa Andrew
Published: June 2014

Recent conflict between indigenous people and a self-styled indigenous state in Bolivia has brought to the fore some of the paradoxes and contradictions within the concept of indigeneity itself. The contemporary politics of state sponsored indigeneity in Bolivia has as much capacity to create new inequalities as it does to address old ones and there is a conceptual deficit in understanding contemporary indigenous rights claims, in particular as they relate to the state. Anthropologists are understandably reluctant to define indigeneity in any objective way, but as indigeneity discourses proliferate, we need some conceptual tools to distinguish between competing rights claims based on indigeneity. I propose a conceptual distinction between inclusive national indigeneity for the majority which seeks to co-opt the state and a concept of indigeneity for a minority which needs protection from the state. Only by looking at the kinds of claims people make through the rhetoric of indigeneity can we make sense of such indigenous conflict in Bolivia and elsewhere.
Women in Lesbian Relations
Authors: Malmquist Anna
Published: June 2014

When a lesbian couple conceives through donor insemination, the partners transform their relations to each other. In this article, I explore how women in lesbian relations depict their parental roles in relation to the notion of equality. Drawing on critical discursive psychology, I conducted and analyzed interviews with 96 Swedish lesbian parents. Findings show how the interviewees draw on three different interpretative repertoires when they talk about their parental roles. In one repertoire, parents describe themselves as being spontaneously equal in relation to the child. In a second repertoire, equality is depicted as a potential result of struggling, where some parents claim to have achieved equality, whereas others describe being frustrated about their unequal situation. Finally, in a third repertoire, inequality is depicted as a given starting point, drawing on a biologistic rhetoric. Although most parents present equality as idealized, most also refer to biology as a reality that sets the benchmark. Findings in the present study could be useful for clinicians working with lesbian couples; rather than assuming that a lesbian couple is more or less equal, it is important to consider the specific couple and their descriptions.
Voluntary Enhanced Cocontraction of Hamstring Muscles During Open Kinetic Chain Leg Extension Exercise
Authors: Biscarini Andrea , Benvenuti Paolo , Botti Fabio M. , Brunetti Antonella , Brunetti Orazio , Pettorossi Vito E.
Published: June 2014

Background:

A number of research studies provide evidence that hamstring cocontraction during open kinetic chain knee extension exercises enhances tibiofemoral (TF) stability and reduces the strain on the anterior cruciate ligament.

Purpose:

To determine the possible increase in hamstring muscle coactivation caused by a voluntary cocontraction effort during open kinetic chain leg-extension exercises, and to assess whether an intentional hamstring cocontraction can completely suppress the anterior TF shear force during these exercises.

Study Design:

Descriptive laboratory study.

Methods:

Knee kinematics as well as electromyographic activity in the semitendinosus (ST), semimembranosus (SM), biceps femoris (BF), and quadriceps femoris muscles were measured in 20 healthy men during isotonic leg extension exercises with resistance ( R) ranging from 10% to 80% of the 1-repetition maximum (1RM). The same exercises were also performed while the participants attempted to enhance hamstring coactivation through a voluntary cocontraction effort. The data served as input parameters for a model to calculate the shear and compressive TF forces in leg extension exercises for any set of coactivation patterns of the different hamstring muscles.

Results:

For R≤ 40% 1RM, the peak coactivation levels obtained with intentional cocontraction ( l) were significantly higher ( P < 10–3) than those obtained without intentional cocontraction ( l0). For each hamstring muscle, maximum level l was reached at R = 30% 1RM, corresponding to 9.2%, 10.5%, and 24.5% maximum voluntary isometric contraction (MVIC) for the BF, ST, and SM, respectively, whereas the ratio l/ l0 reached its maximum at R = 20% 1RM and was approximately 2, 3, and 4 for the BF, SM, and ST, respectively. The voluntary enhanced coactivation level l obtained for R≤ 30% 1RM completely suppressed the anterior TF shear force developed by the quadriceps during the exercise.

Conclusion:

In leg extension exercises with resistance R≤ 40% 1RM, coactivation of the BF, SM, and ST can be significantly enhanced (up to 2, 3, and 4 times, respectively) by a voluntary hamstring cocontraction effort. The enhanced coactivation levels obtained for R≤ 30% 1RM can completely suppress the anterior TF shear force developed by the quadriceps during the exercise.

Clinical Relevance:

This laboratory study suggests that leg extension exercise with intentional hamstring cocontraction may have the potential to be a safe and effective quadriceps-strengthening intervention in the early stages of rehabilitation programs for anterior cruciate ligament injury or reconstruction recovery. Further studies, including clinical trials, are needed to investigate the relevance of this therapeutic exercise in clinical practice.