bluuebunny/crossref_metadata_2025 huggingface dataset:
Therapy of 1,025 Severely Ill Patients with Complicated Infections in a German Multicenter Study: Safety Profile and Efficacy of Tigecycline in Different Treatment Modalities
Authors: Bodmann Klaus-Friedrich , Heizmann Wolfgang R. , von Eiff Christof , Petrik Christian , Löschmann Peter-Andreas , Eckmann Christian
Published: October 2012

This large prospective non-interventional study investigated the effects of tigecycline either as single agent or in combination with other antimicrobial agents in 1,025 patients treated in clinical routine at German hospitals. Sixty-five percent of the patients had APACHE II scores >15, indicating high overall disease severity. Complicated intra-abdominal infections (cIAI) or complicated skin and skin tissue infections (cSSTI) were the most common indications, with Staphylococcus aureus, Enterococcus faecium and Escherichia coli being the most frequently isolated pathogens. Clinical success was reported at the end of tigecycline therapy in 74.2% of the total population, in 75.4% of the cIAI and in 82.2% of the cSSTI patients. The subpopulation (28.0% of the patients) infected with multidrug-resistant pathogens (methicillin-resistant S. aureus, extended-spectrum β-lactamase producers and vancomycin-resistant enterococci) were treated with similar success rates as the overall population. Tigecycline was generally well tolerated. Drug-related adverse events (AEs) were reported in 7.7% of the total population; 2.5% had serious AEs mostly attributable to inefficacy of therapy or deterioration of the disease. Mortality rates were consistent with the types of infection and severity of illness. There was no indication of excessive mortality associated with tigecycline as had been suggested in previously performed meta-analyses. In this large non-interventional study performed in the clinical routine setting, tigecycline achieved favorable clinical success rates in a patient population with high severity of illness and a high prevalence of multidrug-resistant pathogens and showed a good safety and tolerability profile.
Molecular Detection of Nontuberculous Mycobacteria: Advantages and Limits of a Broad-Range Sequencing Approach
Authors: Slany Michal , Pavlik Ivo
Published: October 2012

The isolation of nontuberculous mycobacteria (NTM) from clinical specimens has become very common in recent years. Such organisms are typically environmental and occasionally pathogenic for humans and animals. Standard diagnosis of mycobacterial infections relies on direct examination and culture. However, molecular tools are now available which allow quicker and more accurate diagnosis. Detection of NTM can be performed directly from clinical samples, although identification is mostly carried out after isolation. Sequencing of genomic targets (such as 16S rRNA, ITS, rpoB or hsp65) allows accurate and rapid identification, but has some technical limitations. A brief summary of the molecular methods available for NTM identification and a discussion of the problems associated with the use of sequencing analysis together with a description of available algorithms for NTM identification are the major objectives of this review.
Factors Predicting the Need for Cerebrospinal Fluid Diversion following Posterior Fossa Tumor Surgery in Children
Authors: Gopalakrishnan C.V. , Dhakoji Amit , Menon Girish , Nair Suresh
Published: October 2012

Background: No consensus exists regarding the management of hydrocephalus in children with posterior fossa tumors before, during or after surgery. In the present study we analyze the factors that predispose to persistent hydrocephalus and the need for a postoperative cerebrospinal fluid (CSF) diversion procedure. Methods: Pediatric patients who underwent surgery for posterior fossa tumors with hydrocephalus at our hospital were reviewed to evaluate the need for a postoperative CSF diversion procedure. Patients having undergone CSF diversion preoperatively were excluded from the study group. The case records of 84 patients were reviewed. The factors evaluated included age at diagnosis, duration of symptoms, severity of preoperative hydrocephalus, tumor size, tumor location, tumor histology, extent of tumor resection and postoperative complications that could be related to CSF circulation disorders. Results: At the time of presentation, 80/84 (95.2%) patients had symptomatic hydrocephalus; 25/84 (29.8%) patients required a CSF diversion procedure in the postoperative period. Children presenting with symptom duration of less than 3 months had a significantly higher requirement for postoperative CSF diversion in comparison to those with longer symptomatology (p = 0.016). Evan’s index and frontal and occipital horn ratio on preoperative imaging were found to correlate closely with the need for postoperative shunt (p = 0.001 and p < 0.001, respectively). The requirement for shunt was statistically higher in patients with midline tumors in comparison to laterally placed lesions (p = 0.04) and in children with medulloblastoma (p < 0.001) and ependymoma (p = 0.016) as the tumor subtypes. Children who underwent intraoperative external ventricular drainage (EVD) had a shunt insertion rate of 39.6% compared with 16.7% of those who did not have an EVD (p < 0.001). Patients with meningitis and pseudomeningocele in the postoperative period had a statistically significant higher risk of shunt requirement (p = 0.008 and p = 0.016, respectively). The mean age at diagnosis and the extent of tumor resection did not correlate with the need for CSF diversion. Conclusion: The fact that less than one-third of patients require a CSF diversion after posterior fossa tumor resection refutes the role of prophylactic endoscopic third ventriculostomy. Awareness regarding the factors that can predict persistent postoperative hydrocephalus is essential for the surgeon during patient counseling and surgical planning, and also in deciding the intensity of postoperative clinical and radiological monitoring.
Dipeptidyl Peptidase-4 Modulates Left Ventricular Dysfunction in Chronic Heart Failure via Angiogenesis-Dependent and -Independent Actions
Authors: Shigeta Toshimasa , Aoyama Morihiko , Bando Yasuko K , Monji Akio , Mitsui Toko , Takatsu Miwa , Cheng Xiang-Wu , Okumura Takahiro , Hirashiki Akihiro , Nagata Kohzo , Murohara Toyoaki
Published: October 2012

Background—

The inhibition of dipeptidyl peptidase-4 (DPP4) protects the heart from acute myocardial ischemia. However, the role of DPP4 in chronic heart failure independent of coronary artery disease remains unclear.

Methods and Results—

We first localized the membrane-bound form of DPP4 to the capillary endothelia of rat and human heart tissue. Diabetes mellitus promoted the activation of the membrane-bound form of DPP4, leading to reduced myocardial stromal cell-derived factor-1α concentrations and resultant angiogenic impairment in rats. The diabetic rats exhibited diastolic left ventricular dysfunction (DHF) with enhanced interstitial fibrosis caused partly by the increased ratio of matrix metalloproteinase-2 to tissue inhibitor of metalloproteinase-2 in a DPP4-dependent fashion. Both genetic and pharmacological DPP4 suppression reversed the stromal cell-derived factor-1α–dependent microvasculopathy and DHF associated with diabetes mellitus. Pressure overload induced DHF, which was reversed by DPP4 inhibition via a glucagon-like peptide-1/cAMP-dependent mechanism distinct from that for diabetic heart. In patients with DHF, the circulating DPP4 activity in peripheral veins was associated with that in coronary sinus and with E/e′, an echocardiographic parameter representing DHF. Comorbid diabetes mellitus increased the circulating DPP4 activities in both peripheral veins and coronary sinus.

Conclusions—

DPP4 inhibition reverses DHF via membrane-bound DPP4/stromal cell-derived factor-1α–dependent local actions on angiogenesis and circulating DPP4/glucagon-like peptide-1–mediated inotropic actions. Myocardium-derived DPP4 activity in coronary sinus can be monitored by peripheral vein sampling, which partly correlates with DHF index; thus, circulating DPP4 may potentially serve as a biomarker for monitoring DHF.
Nationwide Improvements in Survival From Out-of-Hospital Cardiac Arrest in Japan
Authors: Kitamura Tetsuhisa , Iwami Taku , Kawamura Takashi , Nitta Masahiko , Nagao Ken , Nonogi Hiroshi , Yonemoto Naohiro , Kimura Takeshi
Published: October 2012

Background—

Little is known about the nationwide trend in the survival of out-of-hospital cardiac arrest (OHCA) in Japan and the differences in incidence and survival by age group and origin of arrest.

Methods and Results—

A nationwide, prospective, population-based observation covering the whole population of Japan and involving consecutive OHCA patients with resuscitation attempts was conducted from January 2005 to December 2009. The main outcome measure was 1-month survival with favorable neurological outcome. The nationwide trends in OHCA incidence and outcome by age and origin of arrest were assessed. Multiple logistic regression analysis for bystander-witnessed OHCA was used to adjust for factors that were potentially associated with favorable neurological outcome. During 5 years, 547 153 overall OHCAs and 169 360 bystander-witnessed OHCAs were enrolled. The annual incidence significantly increased among overall OHCAs and bystander-witnessed OHCAs. Neurologically favorable survival significantly increased from 1.6% (1676/102 737) in 2005 to 2.8% (3280/115 250) in 2009 (
P
<0.001), from 2.1% (638/30 556) to 4.3% (1558/36 361) (
P
<0.001), and from 9.8% (437/4461) to 20.6% (1215/5906) (
P
<0.001) among overall OHCA, bystander-witnessed OHCA, and bystander-witnessed ventricular fibrillation OHCA, respectively. Public-access automated external defibrillator use, either bystander-initiated chest compression–only cardiopulmonary resuscitation or conventional cardiopulmonary resuscitation, and earlier emergency medical services response time were associated with a better neurological outcome. Favorable neurological outcome among adult OHCA subjects significantly improved, but the outcome among younger children and very elderly subjects did not improve and was poor irrespective of origin of OHCA.

Conclusions—

Nationwide improvements of favorable neurological outcome from OHCA were observed in Japan and differed by age group and origin of OHCA.
Homeostatic and Tissue Reparation Defaults in Mice Carrying Selective Genetic Invalidation of CXCL12/Proteoglycan Interactions
Authors: Rueda Patricia , Richart Adèle , Récalde Alice , Gasse Pamela , Vilar José , Guérin Coralie , Lortat-Jacob Hugues , Vieira Paulo , Baleux Frano̧ise , Chretien Fabrice , Arenzana-Seisdedos Fernando , Silvestre Jean-Sébastien
Published: October 2012

Background—

Interaction with heparan sulfate proteoglycans is supposed to provide chemokines with the capacity to immobilize on cell surface and extracellular matrix for accomplishing both tissue homing and signaling of attracted cells. However, the consequences of the exclusive invalidation of such interaction on the roles played by endogenous chemokines in vivo remain unascertained.

Methods and Results—

We engineered a mouse carrying a
Cxcl12
gene (
Cxcl12

Gagtm

) mutation that precludes interactions with heparan sulfate structures while not affecting CXCR4-dependent cell signaling of CXCL12 isoforms (α, β, γ).
Cxcl12

Gagtm/Gagtm

mice develop normally, express normal levels of total and isoform-specific
Cxcl12
mRNA, and show increased counting of circulating CD34
+
hematopoietic precursor cells. After induced acute ischemia, a marked impaired capacity to support revascularization was observed in
Cxcl12

Gagtm/Gagtm

animals associated with a reduced number of infiltrating cells in the ischemic tissue despite the massive expression of CXCL12 isoforms. Importantly, exogenous administration of CXCL12γ, which binds heparan sulfate with the highest affinity ever reported for a cytokine, fully restores vascular growth, whereas heparan sulfate–binding CXCL12γ mutants failed to promote revascularization in
Cxcl12

Gagtm/Gagtm

animals.

Conclusion—

These findings prove the role played by heparan sulfate interactions in the functions of CXCL12 in both homeostasis and physiopathological settings and document for the first time the paradigm of chemokine immobilization in vivo.
Comparing Two Approaches for Assessing Observation Impact
Authors: Todling Ricardo
Published: October 2012

Langland and Baker introduced an approach to assess the impact of observations on the forecasts. In that approach, a state-space aspect of the forecast is defined and a procedure is derived ultimately relating changes in the aspect with changes in the observing system. Some features of the state-space approach are to be noted: the typical choice of forecast aspect is rather subjective and leads to incomplete assessment of the observing system, it requires availability of a verification state that is in practice correlated with the forecast, and it involves the adjoint operator of the entire data assimilation system and is thus constrained by the validity of this operator. This article revisits the topic of observation impacts from the perspective of estimation theory. An observation-space metric is used to allow inferring observation impact on the forecasts without the limitations just mentioned. Using differences of observation-minus-forecast residuals obtained from consecutive forecasts leads to the following advantages: (i) it suggests a rather natural choice of forecast aspect that directly links to the data assimilation procedure, (ii) it avoids introducing undesirable correlations in the forecast aspect since verification is done against the observations, and (iii) it does not involve linearization and use of adjoints. The observation-space approach has the additional advantage of being nearly cost free and very simple to implement. In its simplest form it reduces to evaluating the statistics of observation-minus-background and observation-minus-analysis residuals with traditional methods. Illustrations comparing the approaches are given using the NASA Goddard Earth Observing System.
Preface to the Special Section on Human Factors and Automation in Vehicles
Authors: Merat Natasha , Lee John D.
Published: October 2012

Objective:

This special section brings together diverse research regarding driver interaction with advanced automotive technology to guide design of increasingly automated vehicles.

Background:

Rapidly evolving vehicle automation will likely change cars and trucks more in the next 5 years than the preceding 50, radically redefining what it means to drive.

Method:

This special section includes 10 articles from European and North American researchers reporting simulator and naturalistic driving studies.

Results:

Little research has considered the consequences of fully automated driving, with most focusing on lane-keeping and speed control systems individually. The studies reveal two underlying design philosophies: automate driving versus support driving. Results of several studies, consistent with previous research in other domains, suggest that the automate philosophy can delay driver responses to incidents in which the driver has to intervene and take control from the automation. Understanding how to orchestrate the transfer or sharing of control between the system and the driver, particularly in critical incidents, emerges as a central challenge.

Conclusion:

Designers should not assume that automation can substitute seamlessly for a human driver, nor can they assume that the driver can safely accommodate the limitations of automation. Designers, policy makers, and researchers must give careful consideration to what role the person should have in highly automated vehicles and how to support the driver if the driver is to be responsible for vehicle control. As in other domains, driving safety increasingly depends on the combined performance of the human and automation, and successful designs will depend on recognizing and supporting the new roles of the driver.
Augmented Reality Cues and Elderly Driver Hazard Perception
Authors: Schall Mark C. , Rusch Michelle L. , Lee John D. , Dawson Jeffrey D. , Thomas Geb , Aksan Nazan , Rizzo Matthew
Published: October 2012

Objective:

The aim of this study was to evaluate the effectiveness of augmented reality (AR) cues in improving driving safety among elderly drivers who are at increased crash risk because of cognitive impairments.

Background:

Cognitively challenging driving environments pose a particular crash risk for elderly drivers. AR cuing is a promising technology to mitigate risk by directing driver attention to roadway hazards. We investigate whether AR cues improve or interfere with hazard perception in elderly drivers with age-related cognitive decline.

Method:

A total of 20 elderly ( M = 73 years, SD = 5) licensed drivers with a range of cognitive abilities measured by a speed-of-processing (SOP) composite participated in a 1-hr drive in an interactive, fixed-base driving simulator. Each participant drove through six straight, 6-mile-long, rural roadway scenarios following a lead vehicle. AR cues directed attention to potential roadside hazards in three of the scenarios, and the other three were uncued (baseline) drives. Effects of AR cuing were evaluated with respect to (a) detection of hazardous target objects, (b) interference with detecting nonhazardous secondary objects, and (c) impairment in maintaining safe distance behind a lead vehicle.

Results:

AR cuing improved the detection of hazardous target objects of low visibility. AR cues did not interfere with detection of nonhazardous secondary objects and did not impair ability to maintain safe distance behind a lead vehicle. SOP capacity did not moderate those effects.

Conclusion:

AR cues show promise for improving elderly driver safety by increasing hazard detection likelihood without interfering with other driving tasks, such as maintaining safe headway.
Failure and reliability analysis of pinned-joint composite laminates: Effects of pin–hole clearance
Authors: Khashaba UA , Sebaey TA , Alnefaie KA
Published: October 2012

This study deals with the failure and reliability analysis of cross-ply [0/90]2s glass fiber reinforced epoxy composite pinned-joints. A series of ASTM tests were conducted to study the effect of pin–hole clearance (neat-fit, 50, 100, 200, and 300 µm) on the properties of glass fiber reinforced epoxy composite pinned-joints. Failure analysis was examined using load–displacement diagrams and visual and scanning electron microscope examinations of the fractured specimens. The results showed that the first-peak and ultimate strengths were, respectively, reduced by 33.1% and 15.3% with increase in the pin–hole clearance. The corresponding increase in the ultimate displacement was 10.7% and the reduction of the apparent joint stiffness 27%. Weibull function was used to analyze the scatter in the experimental results and estimate the mean and the 50% survival strengths. Safe design strengths at different reliability levels, characteristic strengths, and the lower bound strengths were estimated using time to first failure concept.
Mechanical and abrasive wear behavior of carbon fabric reinforced epoxy composite with and without fly ash cenospheres
Authors: Arivalagan P , Suresha B , Chandramohan G , Krishnaraj V , Palaniappan N
Published: October 2012

Carbon fabric reinforced epoxy and carbon fabric reinforced epoxy containing different weight fraction of silane-treated fly ash cenospheres filled composites were cast, sectioned, and subjected to three-body abrasive wear tests for evaluating the abrasive wear behavior. Mechanical characterization was done and a comparison was made between the different samples. Abrasive wear tests were performed on a rubber wheel abrasion tester under different loads, abrading distances using quartz and silica sand as abrasives. The results showed that both unfilled carbon fabric reinforced epoxy and fly ash cenospheres filled carbon fabric reinforced epoxy composites exhibit differing magnitudes of wear volume loss, it being highest for unfilled carbon fabric reinforced epoxy composite. The data trends point to the fact that the wear volume and specific wear rate decreases with increasing fly ash cenospheres loading in carbon fabric reinforced epoxy composites. It was found that silane-treated fly ash cenospheres could effectively reduce the wear rate especially under silica sand as abrasives. To explain these differences, the worn surfaces were examined using scanning electron microscope and the features thus observed were correlated with the selected mechanical properties.
On the processing and properties of carbon nanofiber reinforced hybrid structural composites
Authors: Anand Anoop , Harshe Rahul , Joshi Makarand
Published: October 2012

Structural composites based on unidirectional E-glass and epoxy have been fabricated through resin film infusion. Low weight fractions of carbon nanofibers are dispersed in epoxy resin using a solvent-assisted ultrasonication process. Rheological characterization of carbon nanofiber-filled epoxy revealed that viscosity, and in turn processing characteristics of the resin remain almost unaffected as compared to the pristine resin system at elevated temperature of composite processing. Glass transition temperature of epoxy showed a considerable improvement with carbon nanofibers. Local flow of the modified resin through the embedded fabric plies in the resin film infusion process made sure that a uniform distribution of nanoparticles is achieved throughout the composite. Compressive strength of hybrid composites showed over 40% increase while interlaminar shear strength improved by 33% with carbon nanofibers at a loading fraction as low as 0.5 wt%.
Elaboration, characterization, and degradation of composite material: Lignocellulosic/unsaturated polyester
Authors: Siahmed F , Lounis A , Faghi L
Published: October 2012

The present work deals with the valorization of the lignin. The lignin is a by-product of the black liquor of the paper industry, which has a very complex composition structure. In this study, this lignin is obtained from the Alfa grass (Stipa Tenacissima L, also named Esparto grass). A composite material with polymer matrix (unsaturated polyester) reinforced with the lignin at various proportions has been elaborated and a comparison of its mechanical and physico-chemical characteristics to another type of composite material constituted of polymer matrix (unsaturated polyester) reinforced with Alfa fibers has been achieved. The characterization of these composites materials is based on tensile as well as thermal degradation tests under isothermal conditions. In order to explain the deviation from the linear profile (weight losses), a mathematical model has been used to show that the degradation energy is the same for all temperature ranges. This model allowed us to calculate the activation energy (48 kJ/mole.K), which corresponds to the process of off-gassing, break of macromolecular chains and weight loss.
Gas barrier and mechanical properties of crosslinked ethylene vinyl acetate nanocomposites
Authors: SA Ahmad Ramazani , Shafiee M , Abedsoltan H , Shafiee A
Published: October 2012

In this research, the effects of crosslinking agent and clay content on the morphology, barrier and mechanical properties of ethylene vinyl acetate-organoclay nanocomposites prepared by solution method were studied. Dicumyl peroxide has been used as crosslinking agent. The morphology of the prepared nanocomposites was investigated using wide-angle X-ray diffraction and transmission electron microscopy. Wide-angle X-ray diffraction and transmission electron microscopyindicated that the prepared nanocomposites had predominantly intercalated morphologies. The obtained results of permeability tests showed that the permeability of ethylene vinyl acetate films dramatically decreases with addition of organoclay and dicumyl peroxide. Mechanical tests showed that tensile modulus and tensile strength of ethylene vinyl acetate increase with addition of organoclay. Furthermore, the mechanical properties of ethylene vinyl acetate nanocomposites significantly improved in presence of crosslinking agent (dicumyl peroxide).
Governability Framework for the Evaluation and Implementation of Complex Public Health Functions
Authors: Varghese Joe , Kutty V. Raman
Published: October 2012

Background:

The dominant theoretical basis of our public health practice originates from a positivist or reductionist paradigm. It fails to take into account the complexity emerging out of public health’s multiple influences originating from biological and social worlds. A deeper understanding of the interaction of elements that characterize the implementation of public health functions will enhance our ability to generate evidence and learn further.

Objective:

The “interactive governance theory” by Jan Kooiman introduced here offers an analytical framework that uses the concept of “governability.” It is a measure of how governable a particular social system is that takes care of a public function. Assessment is facilitated by breaking down and describing the social system into constituent parts and by exploring the properties, qualities, and the way in which they interact with each other. Further, by deliberating a complex public health function such as immunization services in the context of developing countries, we explore the application of the interactive governance theory and governability.

Conclusion:

The theory offers new insights into how interactive and holistic approaches can be integrated into public health practice. The advantage of the concept of “governability” is that it enables us to explore why some governance systems deliver what they are expected to, while others do not. This might help us to identify areas where governance can be improved.
Practical Guide to Understanding Multivariable Analyses
Authors: Neely J. Gail , Paniello Randal C. , Lieu Judith E. Cho , Voelker Courtney C. J. , Grindler David J. , Sequeira Sunitha M. , Nussenbaum Brian
Published: October 2012

Multivariable analyses are complex statistical methods to evaluate the impact of multiple variables on outcomes of interest. Books have been written on each of these methods detailing the mathematical and statistical objectives and processes. However, we have found very little in the way of brief reports that help the nonstatistically trained physician obtain a basic understanding of multivariable analyses in order to have some understanding of the increasing literature using these methods. This work is organized in 2 parts. This article, Part A, addresses the “big 4” algebraic methods of multivariable analysis. The primary focus of Part A is to present a brief “primer” to help the reader understand the methods and uses; it expressly avoids the many details of statistical assumptions, calculations, and myriad branching alternatives. Part B will concentrate on conjunctive consolidation and will focus on enough information to allow the interested reader to actually perform the analysis. For the statistical scholar, we have included references to several voluminous serious works.
Hearing Outcomes in Stapes Surgery
Authors: Wiet Richard J. , Battista Robert A. , Wiet R. Mark , Sabin Andrew T.
Published: October 2012

Objective

To compare short‐ and long‐term hearing results following stapedectomy using 3 different oval window grafting materials with the same stapes prosthesis.

Study Design

Database review.

Setting

Tertiary referral private practice.

Subjects and Methods

Subjects were ears that underwent stapedectomy for otosclerosis, with placement of fat, fascia, or vein as an oval window seal and reconstruction with a titanium bucket handle prosthesis. A total of 365 procedures met these inclusion criteria: 98 fat grafts, 135 fascia grafts, and 132 vein grafts. Outcome measures included short‐term (<1 year) and long‐term follow‐up air‐bone gap. We compared the preoperative and postoperative amount of change in air‐bone gap and preoperative and postoperative amount of change in the high‐frequency bone conduction average.

Results

Overall median times to short‐term and long‐term follow‐ups were 2.2 months and 36.1 months, respectively. There were no statistically significant differences between the 3 tissue seal groups in the amount of change in air‐bone gap. There was no significant difference in amount of change in high‐frequency bone conduction (representing sensorineural hearing level) between the 3 tissue seal groups. Most patients in all 3 groups had an air‐bone gap at long‐term follow‐up of ≤10 dB (fat, 79.5%; fascia, 78.8%; and vein, 75.6%), with 90.3% of all patients at ≤20 dB.

Conclusions

In both the short‐term postoperative period and long‐term follow‐up, there were no significant differences in hearing results among 3 types of tissue seals of the oval window in stapes surgery. Fat, fascia, and vein grafts all provide satisfactory hearing outcomes in stapedectomy.
Management of Pathologic Fractures of the Mandible Secondary to Osteoradionecrosis
Authors: Sawhney Raja , Ducic Yadranko
Published: October 2012

Objective

To review our experience with late Marx stage III osteoradionecrosis (ORN) of the mandible in patients who present with pathologic fracture.

Study Design

Case series with chart review.

Setting

Tertiary care center.

Subjects and Methods

Thirty‐seven patients were identified from June 1998 to August 2010 who underwent treatment of Marx grade III osteoradionecrosis with pathologic fracture of the mandible. All patients underwent reconstruction with osteocutaneous free tissue transfer and when possible underwent hyperbaric oxygen therapy Marx protocol.

Results

The average time between completion of radiation therapy and presentation of ORN‐induced pathologic fracture was 3.2 years. Sixteen patients developed ORN following tooth extraction. Sixteen patients had no previous documented ORN prior to presenting with pathologic fracture. Follow‐up after surgery averaged 4.5 years with no recurrence of disease. The overall complication rate was 24% with no total flap loss. Of the patients, 95% returned to prefracture dietary intake. Twenty‐six patients underwent a staged protocol, in which after resection and plate reconstruction, they underwent 20 hyperbaric oxygen (HBO) dives. They then underwent free tissue transfer followed by a further 10 HBO dives. There were no flaps lost or nonbony unions. Eleven patients did not receive HBO therapy as part of their surgical treatment plan. Again, there was no total flap loss, but 2 skin paddles were lost and 4 bony nonunions occurred.

Conclusions

Pathologic fracture in conjunction with ORN has a relatively high treatment complication rate. Free tissue transfer and HBO are the treatment of choice for this population.
With Facebook, Blogs, and Fake News, Teens Reject Journalistic “Objectivity”
Authors: Marchi Regina
Published: October 2012

This article examines the news behaviors and attitudes of teenagers, an understudied demographic in the research on youth and news media. Based on interviews with 61 racially diverse high school students, it discusses how adolescents become informed about current events and why they prefer certain news formats to others. The results reveal changing ways news information is being accessed, new attitudes about what it means to be informed, and a youth preference for opinionated rather than objective news. This does not indicate that young people disregard the basic ideals of professional journalism but, rather, that they desire more authentic renderings of them.
Between Inclusion and Exclusion: On the Topology of Global Space and Borders
Authors: Mezzadra Sandro , Neilson Brett
Published: October 2012

The research hypothesis that we call border as method offers a fertile ground upon which to test the potentiality and the limits of the topological approach. In this article we present our hypothesis and address three questions relevant for topology. First, we ask how the topological approach can be applied within the heterogeneous space of globalization, which we argue does not obey the dialectic of inclusion and exclusion. Second, we address the claim of neutrality that is often linked to the topological approach. Our point is that in mapping a space of flows and porous borders, the topological approach must be grasped in its ambivalence; it can become a tool for control as well as a tool for the expansion of freedom and equality. Finally, we argue that it is useful, perhaps even necessary, to locate the topological approach on the border, investigating concrete practices of border crossing that challenge the very possibility of a neutral mapping.
Topology and Morphogenesis
Authors: Sha Xin Wei
Published: October 2012

One can use mathematics not as an instrument or measure, or a replacement for God, but as a poetic articulation, or perhaps as a stammered experimental approach to cultural dynamics. I choose to start with the simplest symbolic substances that respect the lifeworld’s continuous dynamism, temporality, boundless morphogenesis, superposability, continuity, density and value, and yet are independent of measure, metric, counting, finitude, formal logic, syntax, grammar, digitality and computability – in short, free of the formal structures that would put a cage over all of the lifeworld. I call these substances topological media. This article introduces elementary topological concepts with which we can articulate material and cultural change using notions of proximity, limit, and change, without recourse to number or metric. The motivation is that topology furnishes us with concepts well-adapted for poietically articulating the world as stuff, rather than objects with an a priori schema. With care, it may provide a fruitful approach to morphogenesis and cultural dynamics that is neither reductive nor anthropocentric. I will not pretend any systematic application of the scaffolding concepts introduced in this article. Instead, I would see what fellow students of cultural dynamics and cosmopolitics make of these concepts in their own work.
Topology, Algebra, Diagrams
Authors: Rotman Brian
Published: October 2012

Starting from Poincaré’s assignment of an algebraic object to a topological manifold, namely the fundamental group, this article introduces the concept of categories and their language of arrows that has, since their mid-20th-century inception, altered how large areas of mathematics, from algebra to abstract logic and computer programming, are conceptualized. The assignment of the fundamental group is an example of a functor, an arrow construction central to the notion of a category. The exposition of category theory’s arrows, which operate at three distinct but deeply interconnected levels, is framed by a comparison with the language and outlook of set theory founded on the concept of membership; sets and their theorization having provided, famously through the Bourbaki initiative, the basic ontological and epistemological vocabulary for defining and handling all mathematical entities. The comparison with sets emphasizes how categories offer a form of diagrammatic argument and thought against set theory’s fidelity to syntax-based proofs; how categories invert set theory’s priority of objects and their attributes over relations by making the relations of an object to others of its kin primary; and how categories replace identity, that is, equality, between objects, by the weaker notion of isomorphism, restricting equality to identity between arrows. The article concludes with a return to topology and some remarks about the question of its possible use in articulating/characterizing cultural dynamics.
The Topological Quality of Infrastructural Relation: An Ethnographic Approach
Authors: Harvey Penelope
Published: October 2012

This article seeks to address how topological approaches to cultural change might be combined with ethnographic analysis in order to suggest new ways of thinking empirically about the dynamic political and moral spaces that infrastructural systems create and sustain. The analytical focus is on how diverse notions of relationality and connectivity are mobilized in the production of infrastructural systems that sustain the capacity of ‘state-space’ to simultaneously emerge as closed territorial entity and as open, networked form. The article seeks to establish that the differences and discontinuities inherent in all spatio-temporal relations might productively be considered as ‘intervals’ that both separate and connect across time and space. The notion of an infrastructural system as an interface that conjures both topological and topographical space is the idea that I set out to explore.
Nearness and Da-sein: The Spatiality of Being and Time
Authors: Sloterdijk Peter
Published: October 2012

This paper focuses on the latent spatial philosophy in Heidegger’s ‘Being and Time’, highlighting a key aspect of the Heideggerian oeuvre that has mostly been overlooked by commentators. It outlines the concept of an original spatiality of being that is opposed to the philosophies of space in both physics and Cartesian metaphysics. Through an elaboration of the essentially relational character of Da-sein, it is argued that Heidegger’s vocabulary in ‘Being and Time’ yields an onto-topology that shows Da-sein’s primary spatial embeddedness in the world. Finally, the paper argues that Heidegger’s concept of spatiality remained cursory due to its residual existentialist focus. In this context, it attempts a re-evaluation of its intellectual trajectory within the realm of the Spheres project.
Deforming the Figure: Topology and the Social Imaginary
Authors: Lash Scott
Published: October 2012

Topology is integral to a shift in socio-cultural theory from a linguistic to a mathematical paradigm. This has enabled in Badiou and Žižek a critique of the symbolic register, understood in terms of pure conceptual abstraction. Drawing on topology, this article understands it instead in terms of the figure. The break with the symbolic and language necessitates a break with form, but topologically still preserves a logic of the figure. This becomes a process of figuration, indeed a process of `deformation'. Badiou/Žižek will then presume a break with the symbolic for `the real'. But topology entails the centrality of not the real but the imaginary. With Castoriadis, this imaginary is understood as productive and social, and with Sloterdijk as spatial. In our times this is a self-organizing socio-technical imaginary. For Niklas Luhmann these socio-technical systems engage in coupling. They structurally couple with other social imaginaries. Their self-organization, going beyond pure functionality, operates through semantic excess: an excess that organizes the system and is their structure. Such structural coupling entails semantic exchange, consisting of not just information but also of images.
Digital Infrastructures and the Machinery of Topological Abstraction
Authors: Fuller Matthew , Goffey Andrew
Published: October 2012

Drawing on contemporary pragmatic philosophy and grounded in a reading of techniques associated with digital media as sophist practices of influence and manipulation, this paper proposes an ‘experimental’ reading of key aspects of the topological qualities of the infrastructure of the knowledge economy, with its obsessive attempts at measuring, recording and monitoring, or ‘qualculation’. Taking seriously, albeit with humour, early criticisms of actor-network for its ostensibly Machiavellian proclivities, it offers a series of playful stratagems for the exploration and analysis of power as an emergent property of socio-technical relations. Topology, in this account, becomes relevant to cultural analysis because of the way that it allows us to think together processes constructive of the intensive continua of ‘desiring production’ with the sociotechnical operations of digital media infrastructures. Different elements operative within digital media (the super-hub, the power of small numbers, recursion and relational databases) are read stratagematically – as figures of a praxis (the material practice of immaterial labour), that reveals different facets of the operations of power, while also allowing for counter-tactics to be deployed. Rather than proposing a theoretical account or an empirical analysis, the paper develops what Stengers (2011) calls ‘operative constructs’, which become ingredients for further active exploration of and thinking about the topological qualities of mediatic infrastructure. The paper addresses four different and overlapping areas of digital media from a point of view that considers the plural, compositional quality of media/power relations.
On Some Uses and Abuses of Topology in the Social Analysis of Technology (Or the Problem with Smart Meters)
Authors: Marres Noortje
Published: October 2012

This paper examines the limits and possibilities of topological approaches in the social analysis of technology. It proposes that topology should be considered not just as a theory to be adopted, but equally as a device that is deployed in social life in a variety of ways. Digital technologies help to make clear why: these technologies have facilitated the spread of a topological imagination, but they have also enabled a weak form of topological imagination, one that leaves in place deterministic ideas about technology as the principal driver of social change. This paper examines this situation and alternatives to it through an empirical case, that of smart electricity meters. On the one hand, these technologies enable only a limited ‘expansion of the frame’ on technology, one in which the primacy of technology is maintained. But they are also used to render relations between technology and society more complexly. I explore topological devices deployed in this second way, such as the digital visualization tool of tag clouding and propose that this device enables an empirical mode of critique: here, topology does not just help to foreground the entanglement of the social and the technical, it also helps to dramatize the contingent, non-coherent unfolding of issues.
Introduction: The Becoming Topological of Culture
Authors: Lury Celia , Parisi Luciana , Terranova Tiziana
Published: October 2012

In social and cultural theory, topology has been used to articulate changes in structures and spaces of power. In this introduction, we argue that culture itself is becoming topological. In particular, this ‘becoming topological’ can be identified in the significance of a new order of spatio-temporal continuity for forms of economic, political and cultural life today. This ordering emerges, sometimes without explicit coordination, in practices of sorting, naming, numbering, comparing, listing, and calculating. We show that the effect of these practices is both to introduce new continuities into a discontinuous world by establishing equivalences or similitudes, and to make and mark discontinuities through repeated contrasts. In this multiplication of relations, topological change is established as being constant, normal and immanent, rather than being an exceptional form, which is externally produced; that is, forms of economic, political and cultural life are identified and made legible in terms of their capacities for continuous change. Outlining the contributions to this Special Issue, the introduction discusses the meaning of topological culture and provides an analytic framework through which to understand its implications.
Effects of a single session of whole body vibration on ankle plantarflexion spasticity and gait performance in patients with chronic stroke: a randomized controlled trial
Authors: Chan Kwan-Shan , Liu Chin-Wei , Chen Tien-Wen , Weng Ming-Cheng , Huang Mao-Hsiung , Chen Chia-Hsin
Published: October 2012

Objective:

To investigate the effects of a single session of whole body vibration training on ankle plantarflexion spasticity and gait performance in chronic stroke patients.

Design:

Randomized controlled trial.

Setting:

Rehabilitation unit in university hospital.

Participants:

Thirty subjects with chronic stroke were randomized into either a control group ( n = 15) or a group receiving a single session of whole body vibration ( n = 15).

Intervention:

The intervention group was actually treated with whole body vibration while the control group was treated with placebo treatment.

Main measures:

The spastic changes were measured clinically and neurophysiologically. Subjective evaluation of ankle spasticity was performed via a visual analogue scale. Gait performances were evaluated by the timed up and go test, 10-meter walk test and cadence. A forceplate was used for measuring foot pressure.

Results:

The changes between whole body vibration and control groups were significantly different in Modified Ashworth Scale (1.33, 95% confidence interval (CI) = 1.06~1.60). The Hmax/ Mmax ratio (0.14, 95% CI = 0.01~0.26) and visual analogue scale (1.87, 95% CI = 1.15~2.58) were significantly decreased. Whole body vibration could significantly improve gait velocity, timed up and go test (6.03, 95% CI = 3.17~8.89) and 10-meter walk test (1.99, 95% CI = 0.11~3.87). The uneven body weight posture on bilateral feet was also improved after vibration.

Conclusion:

These results suggest that a single session of whole body vibration training can reduce ankle plantarflexion spasticity in chronic stroke patients, thereby potentially increasing ambulatory capacity.
Multiple antidepressant potential modes of action of curcumin: a review of its anti-inflammatory, monoaminergic, antioxidant, immune-modulating and neuroprotective effects
Authors: Lopresti Adrian L , Hood Sean D , Drummond Peter D
Published: October 2012

Curcumin is the principal curcuminoid of the popular Indian spice turmeric and has attracted increasing attention for the treatment of a range of conditions. Research into its potential as a treatment for depression is still in its infancy, although several potential antidepressant mechanisms of action have been identified. Research completed to date on the multiple effects of curcumin is reviewed in this paper, with a specific emphasis on the biological systems that are compromised in depression. The antidepressant effects of curcumin in animal models of depression are summarised, and its influence on neurotransmitters such as serotonin and dopamine is detailed. The effects of curcumin in moderating hypothalamus–pituitary–adrenal disturbances, lowering inflammation and protecting against oxidative stress, mitochondrial damage, neuroprogression and intestinal hyperpermeability, all of which are compromised in major depressive disorder, are also summarised. With increasing interest in natural treatments for depression, and efforts to enhance current treatment outcomes, curcumin is presented as a promising novel, adjunctive or stand-alone natural antidepressant.
The Usefulness of Group Analysis in the Conceptualization and Treatment of ‘Personality Disorders’ and ‘Complex/Post-Traumatic Stress Disorder’
Authors: Vosmer Susanne
Published: October 2012

Personality disorders are defined in the Diagnostic and Statistical Manual of Mental Disorders as enduring patterns of perceiving, relating to, and thinking about the environment and oneself. Some personality disorders also display features of (Complex) Post-Traumatic Stress Disorder. Attachment disruptions in early childhood may result in physiological and psychological (trauma) difficulties. Attachment theory holds that humans are social beings and need relationships for survival. It explores the impact of early attachment experiences and subsequent interpersonal behaviour. This is in line with group analytic thinking, which holds that psychopathology is social and interactional in nature. This article discusses the application of group analysis for the above disorders. I shall examine dominant conceptualizations of ‘personality pathology’ and ‘mental illness/disorder’ and the implication for treatment. By incorporating neurobiological findings from trauma research, I shall propose ‘severe attachment disruptions’ as alternative and discuss implications for practice, illustrating the therapeutic usefulness of group analysis.