bluuebunny/crossref_metadata_2025 huggingface dataset:
Hybrid Syntactic Foams of Metal – Fly Ash Cenosphere – Clay
Authors: Shishkin Andrej , Mironov Viktor , Zemchenkov Vjacheslav , Antonov Maksim , Hussainova Irina
Published: January 2016

This paper addresses an innovative syntactic foam produced out of metal powder (Fe), fly ash cenospheres (CS) and clay ceramic syntactic foams composite material (CM). Due to the low density of CS (bulk density - 0.38 g/cm3), the average density of these foams is about 2.6-2.9 g/cm3. It was found that CS undergoes phase transformation during thermal treatment at a temperature of 1200°C. Microstructural observations reveal a uniform distribution of CS and Fe particles in the composite. Compressive strength, and friction coefficient of obtained Fe/CS CM are in the range between 149 - 344 MPa and 0.15 - 1.1, respectively. Dependence of compressive strength on firing temperature is demonstrated exhibiting the maximum at 344 MPa; however, dependence of coefficient of friction on a material properties, obtained at different firing temperature exhibits the minimum value of 0.15 at the firing temperature of 1150 °C. The obtained syntactic form was shown to be a candidate for wear resistant applications.
Pultruding of Metal Powder Filled Glass Fiber Reinforced Polymer Composites
Authors: Rummo Henri , Veinthal Renno , Aruniit Aare
Published: January 2016

The present article focuses on manufacturing of metal powder filled pultrusion profiles for electro-technical applications. Herein a set of test material has been reviewed, which was prepared with the aim to present an optimized composite structure with high metal powder content for magnetic slot wedge production, outperforming the products currently available by alternative technology – compression moulding.This article gives a short overview of incorporating fine metal powders as fillers into pultrusion process (including the technical challenges) and the experimental work done in the project. The selection and analysis of components have been briefly discussed along with the results of material tests conducted on prepared composite samples. Mechanical, dielectric and magnetic properties of the samples were studied at different filler loadings and compared to the properties of iron powder filled compressed laminates.Several application specific material properties were determined, including flexural strength according to ISO 178, volume and surface resistivity similarly to IEC 93, and relative permeability using vibrating sample magnetometer (VSM). Scanning Electron Microscope (SEM) and various image processing software were used to analyse the composition and microstructure of the material samples. Material test results are presented at different iron powder loadings from 20 to 55 wt% and recommendations given for optimal materials selection.
Comparative Study of the VARTM, VAP and MTI Vacuum Infusion Processes
Authors: Aruniit Aare , Herranen Hendrik , Miller Kristen
Published: January 2016

The vacuum infusion process is widely used for the manufacture of fiber reinforced polymer composites. Current research concentrates on the comparison of three alternative methods. The aim is to determine if the Membrane Tube Infusion (MTI) and the Vacuum Assisted Process (VAP) that both use membrane fabric are able to produce higher quality laminate compared to the more established Vacuum Assisted Resin Transfer Moulding (VARTM). The laminate quality was evaluated by the void content, fiber volume fraction and mechanical properties. In addition, the thickness was measured in different segments of the laminate in order to determine if the thickness changes along the laminate. The MTI and VAP process did not give a significant improvement of the measured properties, on the contrary, the VARTM outran the aforementioned in many aspects.
Influence of Casting Velocity on Mechanical Properties and Macro-Structure of Tin Bronzes
Authors: Sergejevs Andrejs , Kromanis Artis , Ozolins Janis , Gerins Eriks
Published: January 2016

Continuous casting is the most productive method of casting. Manufacturers often tend to increase casting velocity without taking into account the fact that it can cause latent defects within the casting and accordingly lead to a deterioration of the mechanical properties of product. The casting process of tin bronzes encumbers high shrinkage and high segregation in the cross section of the castings. The research was performed on three types of tin bronze alloys CuSn12-C, CuSn5Zn5Pb2-C, and CuSn7Zn3Pb7-C (EN 1982:2008). Influence of casting velocity on mechanical properties and macrostructure was studied and optimal velocity parameters were given. The following study revealed a significant effect of the velocity of continuous casting on the mechanical properties of tin bronze, which was also reflected in the macrostructure of the selected samples. Based on the results of the study the recommendations about the optimal casting parameters to increase a quality of end-product were given. The recommendations were later implemented in the manufacturing confirming the value of this study.
Recycling of PA-12 in Additive Manufacturing and the Improvement of its Mechanical Properties
Authors: Mägi Piret , Krumme Andres , Pohlak Meelis
Published: January 2016

This study explores possible ways to make Additive Manufacturing (AM) a cradle-to-cradle process, that is, use the leftover from one process as the raw material for another process. The main goal of this study is to develop a set of new polymeric blends with innovative properties, suitable for using in 3-D printing of prosthetic limbs using Fused Deposition Modeling (FDM) technology. Sustainable acting is achieved by reusing polymeric material left over from Selective Laser Sintering (SLS) processes for making raw material for FDM processes. Test specimens of polyamide 12 (PA-12) in its virgin form and used- , un-sintered form alongside specimens of used PA blended with TPU, aramid, or graphite, were produced in a micro-injection moulding machine and then tested for their mechanical properties. This paper provides information about the differences in mechanical characteristics of these different material blends. An unexpected but positive finding was that the differences between virgin and recycled PA-12 are insignificant. The aforementioned additives influenced PA-12 by producing specimens that responded with predictable characteristics which is a significant accomplishment as it lays the groundwork for the next stages of the project.
Aneurysmal Subarachnoid Hemorrhage: Neurosurgical Frontiers and Nursing Challenges
Authors: Cook Helen A.
Published: January 2016

Despite increases in survival beyond the initial hemorrhage, the devastating consequences of subarachnoid hemorrhage persist. Ruptured intracranial aneurysms are the most likely cause of subarachnoid hemorrhage, with morbidity and mortality rates approaching 75%. Complications arising from aneurysmal subarachnoid hemorrhage include rebleeding, delayed cerebral ischemia, hydrocephalus, hypothalamic dysfunction, and seizure activity. In order to positively influence outcome after subarachnoid hemorrhage, preservation of an adequate cerebral blood flow and prevention of secondary aneurysmal rupture is essential. This article reviews aneurysmal subarachnoid hemorrhage, relating the management of complications to currently accepted treatment strategies
Pain and Analgesia: Considerations for the Elderly in Critical Care
Authors: Greenlee Kay Knox
Published: January 2016

A large percentage of patients in critical care are older than 65 years old. Pain is a problem common to the elderly receiving critical care. Effective management of pain is accomplished through collaboration between nursing and medicine. Understanding physiologic changes experienced with aging and anticipated changes in functional abilities is necessary to the development of a pain-management plan and to providing comprehensive nursing care. Pharmacologic analgesia will be a part of the pain-management plan, with consideration given to the effects on the elderly
The Dying Patient in the Intensive Care Unit: Assisting the Family in Crisis
Authors: Mendyka Brian E.
Published: January 2016

Critically ill patients belong to larger phenomenologic systems, their families. What affects one member affects other system members. Nursing care requires meticulous observation and assessment of family concerns, understanding of clinical events, and practical experience to achieve positive outcomes even if a death occurs. It seems easy to dismiss the family from the clinical and technical matters of the critical care unit, especially when much nursing energy goes into operating peripheral machinery, performing tasks, and pursuing ever-changing patient-centered goals. The following case study attempts to redefine and redirect the focus of what “patient-centered” means to include the nurse, the patient, and the family in the meaning of the core of family-centered care
Consequences of Perinatal Asphyxia
Authors: Thompson Debbie Gearner
Published: January 2016

Perinatal asphyxia occurs in 3–9 of every 1,000 births. The risk for perinatal asphyxia is present in every pregnancy. When asphyxia is diagnosed in a newborn, the effects on the infant are potentially life-threatening. Management of the asphyxia focuses on initial stabilization and support based on identified organ system dysfunction as well as support for the infant’s family. Long-term outcome for the asphyxiated infant is related to the degree, duration, and resolution of organ system dysfunction
Current Controversies in Pediatric Transplantation
Authors: Cipriani Lynne , Martin Sarah A.
Published: January 2016

Transplantation in children has become a therapeutic option for several end stage organ diseases. The kidney, liver, and heart are the most common organs transplanted; however, an increasing number of children are undergoing successful intestine, lung, and multiple organ transplant combinations. Through case study reports, emerging transplant options for the child experiencing end stage liver, intestine, heart, and lung failure are described. Critical care nurses play a crucial role in the postoperative recovery of these patients. An understanding of the transplant process and consequences of immunosuppression will help the critical care nurse identify signs of rejection, infection, and posttransplant lymphoprolifcrative disease
Pharmacologic Treatment Related to Severe Sepsis
Authors: Powers Jan , Jacobi Judith
Published: January 2016

Severe sepsis is a complex syndrome often resulting in multiple organ dysfunction. This is an extremely challenging problem to manage in the intensive care unit, with mortality rates remaining at unacceptably high levels. Death of patients afflicted by this condition generally results from organ dysfunction syndromes related to hypoperfusion abnormalities. Management of patients with severe sepsis or septic shock can be very complex and challenging, utilizing a significant amount of resources. Pharmacologic support of patients with severe sepsis or septic shock primarily involves agents to support and improve perfusion at the microvascular level. It is important to understand the pharmacologic properties of the medications utilized to manage patients with these conditions. The information presented in this article is based on the best evidence currently available in order to assist the critical care nurse in understanding the pharmacologic therapy related to treatment of severe sepsis and septic shock.
Building Trustworthy Relationships With Critically Ill Patients and Families
Authors: Rushton Cynda Hylton , Reina Michelle L. , Reina Dennis S.
Published: January 2016

A difficult case study involving repeated health crises and irreversible organ dysfunction illustrates the challenges critical care professionals face in caring for patients and their families. In such cases, trust is especially fragile, and coexists with its counterpart, betrayal. The Reina Trust & Betrayal Model defines 3 types of Transactional Trust. The first, Competence Trust, or the Trust of Capability, requires that clinicians practice humility, engage in inquiry, honor the patient’s choices, and express compassion. The second, Contractual Trust, or the Trust of Character, demands that clinicians keep agreements, manage expectations, establish boundaries, and encourage mutually serving expectations. The third, Communication Trust, or the Trust of Disclosure, must be rooted in respect and based on truth-telling. Particularly in life-and-death situations, communication requires honesty and clarity. Each type of trust involves specific behaviors that build trust and can guide critical care professionals as they interact with patients and their families.
Diarrhea
Authors: Sabol Valerie K. , Carlson Karen K.
Published: January 2016

Diarrhea is one of many symptoms that may complicate the hospitalization of a critically ill patient. Diarrhea is caused by a variety of etiologies; identifying the etiology aids in the appropriate selection of interventions. Care of the patient with diarrhea should be guided by the evidence and best practices available in the literature. This article defines and describes diarrhea and its pathophysiology. An evidence-based plan of care for the assessment, planning, intervention, and evaluation of the patient with diarrhea is presented, using levels of recommendation based on the strength of the available evidence. A case study is presented to illustrate application to clinical practice. Commentary about the case is provided to review salient points of care.
How to Withdraw Mechanical Ventilation
Authors: Campbell Margaret L.
Published: January 2016

Eight published accounts about ventilator withdrawal spanning 1992–2004 were selected for review. Articles were selected if they contained data that described the processes comprising the withdrawal of mechanical ventilation as a terminal illness event. The purpose of this article is to synthesize the existing evidence about processes for the compassionate withdrawal of mechanical ventilation from intensive care unit patients, including measures of distress, premedication, medication during withdrawal, withdrawal methods, extubation considerations, duration of survival, and relationship of opioids or benzodiazepines to duration of survival. Practice recommendations will be suggested.
Measurement of Thoracic Fluid Content in Heart Failure
Authors: Folan Lynn , Funk Marjorie
Published: January 2016

Current guidelines for assessing the fluid status of patients with heart failure include subjective physical findings, which often occur late in decompensation, and objective pulmonary artery catheter measurements, whose use is controversial in patients with heart failure. Impedance cardiography, which assesses cardiac function by measuring the opposition to an alternating electric current in the thorax, indicates the amount of fluid in the thorax. It is used externally by employing electrodes on the thorax but can also be used internally by electrodes within a cardiac pacemaker. Recent studies have suggested that one of its direct measurements, thoracic impedance, may identify patients at risk for decompensation of heart failure, but because these measurements inconsistently correlate with pulmonary artery catheter measurements and study sample sizes are small, further research is required before its use can be recommended.
Interpretation and Use of Statistics in Nursing Research
Authors: Giuliano Karen K. , Polanowicz Michelle
Published: January 2016

A working understanding of the major fundamentals of statistical analysis is required to incorporate the findings of empirical research into nursing practice. The primary focus of this article is to describe common statistical terms, present some common statistical tests, and explain the interpretation of results from inferential statistics in nursing research. An overview of major concepts in statistics, including the distinction between parametric and nonparametric statistics, different types of data, and the interpretation of statistical significance, is reviewed. Examples of some of the most common statistical techniques used in nursing research, such as the Student independent t test, analysis of variance, and regression, are also discussed. Nursing knowledge based on empirical research plays a fundamental role in the development of evidence-based nursing practice. The ability to interpret and use quantitative findings from nursing research is an essential skill for advanced practice nurses to ensure provision of the best care possible for our patients.
Practical Steps for Evidence-Based Practice
Authors: Granger Bradi B.
Published: January 2016

Evidence-based practice is a goal for all institutions and often an accreditation requirement. However, moving forward to “just do it” poses a problem for nurses in most patient care units. In spite of increased focus on evidence-based practice initiatives, creation of a systematic approach that effectively integrates the evidence for our practice into the minute-by-minute activities of patient care is still needed. In this article, the steps for accomplishing evidence-based practice in the clinical area are described, beginning with establishing a system to identify, evaluate, and prioritize clinical questions and existing research. Although conducting new, unit-based nursing research may seem a distant goal, beginning with initiatives to increase the use of existing evidence in practice is a first step to this goal, one that contributes to professional development and improved patient outcomes.
High-Frequency Oscillatory Ventilation in Adults
Authors: Rose Louise
Published: January 2016

Recently, there has been renewed interest in high-frequency oscillatory ventilation (HFOV) as a lung-protective strategy in adults. It limits overdistension and prevents cyclic collapse by maintaining end-expiratory lung volume. Studies have shown that HFOV is safely tolerated in the adult population and may offer more benefit if applied early in the course of disease. These findings have implications for clinicians as the use of HFOV may increase in the coming decade. Gas transport mechanisms, ventilator settings, patient monitoring, and clinical considerations for HFOV are substantially different from conventional mechanical ventilation. This article reviews management strategies and monitoring priorities currently recommended for management of adults receiving HFOV.
Chest Radiograph Evaluation and Interpretation
Authors: Siela Debra
Published: January 2016

Chest imaging is an important tool in managing critically ill patients. Basic chest radiology is still used to quickly detect abnormalities in the chest. Critical care nurses are often the ones who first read the radiologist’s report of chest radiograph results and provide their interpretation to a physician. Oftentimes, chest radiographs are obtained routinely on a daily basis for every critical care patient, with the goal of effective clinical management. Critical care nurses can confirm cardiopulmonary assessment findings by also evaluating their patient’s chest radiographs and reviewing the radiologist’s report. By learning some basic skills in interpreting and evaluating chest radiographs, nurses can recognize and localize gross pathologic changes visible on a chest radiograph. This article provides basic chest radiograph interpretation information that allows readers to review relevant anatomy and physiology, summarize normal and abnormal findings on chest radiographs, and describe radiographic findings in common pulmonary and cardiac disorders.
Update on Ventricular Assist Device Technology
Authors: Stahl Mary A. , Richards Nancy M.
Published: January 2016

Ventricular assist devices are an important component in the arsenal of therapies to support the failing heart. This article provides an update on the variety of pulsatile, centrifugal, and axial-flow devices available in the United States. Common indications such as Bridge to Recovery and Bridge to Transplant are explored, as are the emerging indications Destination Therapy, Bridge to Decision, and Bridge to Bridge. Ventricular assist devices as support during high-risk percutaneous coronary intervention and the devices that can be rapidly deployed for this support are included. Clinical aspects of patient care including common complications, psychosocial concerns, and ethical considerations are reviewed.
Argatroban Therapy in Heparin-Induced Thrombocytopenia
Authors: Sparks Melanie L.
Published: January 2016

Patients who develop heparin-induced thrombocytopenia (HIT) are at increased risk for morbidity and mortality if the disorder is not recognized and treated early. Upon initial suspicion of HIT, providers should promptly discontinue all heparin products and initiate an alternative form of anticoagulation without waiting for diagnostic test results confirming the presence of HIT antibodies. The direct thrombin inhibitor, argatroban (Argatroban), is a reasonable alternative anticoagulant in patients with HIT, based on its proven safety and efficacy, ease of use, and consistent response rate between individuals. Further clinical trials are warranted to evaluate and expand the use of argatroban in other thrombotic states.
Clinical Faculty
Authors: Ziehm Scott , Fontaine Dorrie K.
Published: January 2016

There has never been a more urgent time for clinically expert nurses to consider the clinical faculty role. Whether they are making a full-time “leap” into academia or combining a successful staff nurse role with a part-time clinical teaching position, nurses should consider teaching as a good career move. Practical tips and resources are described for making the transition into a clinical faculty role a smooth one.
Blood Transfusion
Authors: Katz Elizabeth A.
Published: January 2016

The effectiveness of transfusions is often compromised by adverse reactions. Common transfusion reactions (hemolytic transfusion reactions, transfusion-related acute lung injury, transfusion-associated circulatory overload, transfusion-related immunomodulation) are reviewed, including pathogenesis, clinical and laboratory manifestations, and treatment. In addition, artificial blood substitutes are discussed as a way to mitigate the risk of transfusion-related morbidity and mortality.
Death by Clot
Authors: Dressler Diane K.
Published: January 2016

Blood clotting is a complex process that controls bleeding when tissues are injured. Unfortunately, this same process is capable of producing life-threatening thrombi in response to pathophysiological events. Blood clots may form in large and small vessels in response to triggers from disrupted vessel walls, inflammatory cells, cytokines, and other pathology. Platelet-rich clots can impair circulation to the myocardium and brain, leading to acute coronary syndromes and stroke. Erythrocyte-rich clots can embolize from the deep veins and threaten the lungs with pulmonary emboli. Microthrombi can block the circulation to tissues and organs in disseminated intravascular coagulation. An understanding of the pathogenesis of these various clotting syndromes directs effective intervention and preventive measures, minimizing the number of deaths by clot.
Bed Rest in Health and Critical Illness
Authors: Winkelman Chris
Published: January 2016

Bed rest is a common intervention for critically ill adults. Associated with both benefits and adverse effects, bed rest is undergoing increasing scrutiny as a therapeutic option in the intensive care unit. Bed rest has molecular and systemic effects, ultimately affecting functional outcomes in healthy individuals as well as in those with acute and critical illnesses. Using empirical sources, the purpose of this article was to describe the consequences of bed rest and immobility, especially consequences with implications for critically ill adults in the intensive care unit. This review uses body systems to cluster classic and current results of bed rest studies, beginning with cardiovascular and including pulmonary, renal, skin, nervous, immune, gastrointestinal/metabolic, and skeletal systems. It concludes with effects on muscles, a system profoundly affected by immobility and bed rest.
Chronic Critical Illness
Authors: Wiencek Clareen , Winkelman Chris
Published: January 2016

The syndrome of chronic critical illness has well-documented emotional, social, and financial burdens for individuals, caregivers, and the health care system. The purpose of this article is to provide experienced acute and critical care clinicians with essential information about the prevalence and profile of the chronically critically ill patient needed for comprehensive care. In addition, pathophysiology contributing to chronic critical illness is addressed, though the exact mechanism underlying the conversion of acute critical illness to chronic critical illness is unknown. Clinicians can use this information to identify at-risk intensive care unit patients and to institute proactive care to minimize burden and distress experienced by patients and their caregivers.
Adjunctive Therapies for the Chronically Critically Ill
Authors: Lee Debra , Higgins Patricia A.
Published: January 2016

Along with the well-known pharmacological and technological advances in the treatment of the critically ill, nurses have made significant contributions in the realm of more holistic approaches to care, advancing well-known nursing therapies such as physical activity, music, and relationship-based care. The purpose of this article is to review current literature regarding adjunctive therapies used for the care for the critically ill, and, by extension, the chronically critically ill. The review describes the application of interventions using physical activity, spirituality, music, complementary and alternate therapies, relationship-focused care, and pet visitation. The authors conducted a multidisciplinary review of literature published between 1990 and 2009, using the Cochrane Database system and PubMed. The main focus was intervention studies; articles in which authors reviewed evidence and made suggestions for practice or further research were also examined.
Nurse-Driven Intravenous Heparin Protocol
Authors: Williams Tanya D. , Sullivan Katherine , Lacey Christopher , Adoryan Steve , Watts Brook
Published: January 2016

Background

Safe use of intravenous heparin is an important safety goal.

Objective

To improve the quality of intravenous heparin use.

Methods

A pre-post intervention design assessed the number of patients who reached a therapeutic activated partial thromboplastin time (aPTT), time to aPTT goal, and complications. Fifty traditional care patients were compared with 50 nurse-driven intravenous heparin protocol patients. The data were used to assess the effectiveness of a developed intervention package to improve the quality of intravenous heparin use.

Results

Sixteen percent of the preintervention group never reached the therapeutic goal compared with 8% in the postintervention group (P < .05). Mean time to achieve first therapeutic aPTT was 18.6 hours in the preintervention group compared with 15.2 hours in the postintervention group (P = .33). Neither group noted complications.

Conclusions

The multidisciplinary team approach produced improved patient care outcomes and important lessons for improving the quality of intravenous heparin use.
MEDEVAC
Authors: Higgins R. A.
Published: January 2016

In current military operations, the survival rates of critically injured casualties are unprecedented. An often hidden aspect of casualty care is safe transport from the point of injury to a field hospital and subsequently on to higher levels of care. This en route critical care, which is provided by flight medics under the most austere and rigorous conditions, is a crucial link in the care continuum. This article introduces the role and capabilities of US Army MEDEVAC and reflects the author’s recent experience in Afghanistan as a flight medic. This article provides an assessment of the operational issues, medical capabilities, and transport experiences to provide a real-world view of critical care transport from the battlefield. The MEDEVAC helicopter environment is one of the most difficult, if not the most demanding, critical care environments. This overview brings to light a small but important piece of the care continuum.
7000 Miles and 7 Days From the Battlefield
Authors: McNeill Margaret M.
Published: January 2016

Critically injured combat casualties are rapidly evacuated from the battlefield, and within hours of their injuries they begin a 7000-mile journey home, often arriving in the United States within 7 days. National Naval Medical Center in Bethesda, Maryland, is a major facility for wounded warrior care in the Military Health System. Throughout the facility, the staff from a variety of disciplines and all military services provides care for military personnel with injuries and illnesses, with the goal of optimizing recovery and quality of life. The foundational evidence for select aspects of this care is discussed. Innovations in training and care delivery include the Air Force Nurse Corps’ Critical Care Fellowship, the new inpatient Traumatic Brain Injury Unit, and the National Intrepid Center for Excellence for Traumatic Brain Injury and Psychological Health. The future of the Medical Center includes a new name, expanded staff, and newly constructed space by Department of Defense Base Realignment and Closure activities.
Early cardiovascular involvement in Chronic Obstructive Pulmonary Disease
Authors: Malerba M. , Romanelli G.
Published: January 2016

Cardiovascular (CV) disease represents a considerable risk factor in terms of both morbidity and mortality in elderly patients with chronic obstructive pulmonary disease (COPD). In fact, there is a considerable evidence of this association: for only 20 years forced expiratory volume in 1 second (FEV1) has been considered as predictive of cardiovascular mortality especially in elderly patients. At present, the emerging evidence suggests that hypoxia, systemic inflammation, oxidative stress may cause an early sub-clinical cardiovascular involvement in patients with COPD. Aging is a selective process dramatically affecting certain portions of the cardiovascular system for example: diminished beta-adrenergic responsiveness, increased myocardial and vascular stiffness, decreased arterial baroreflex, vagal outflow and compromission of diastolic function. The nature of these interactions is complex and involves not only mechanisms of aging but also multiple defined and undefined (e.g., genetic) risk factors. Cardiovascular diseases are the main causes of mortality among the subjects with impaired lung function. Even mild reductions in expiratory flow volumes amplify the risk of ischemic heart diseases, strokes, and sudden cardiac deaths 2-to 3-fold, independent of other risk factors. The mechanism or mechanisms responsible for this association, however, remain largely unknown.
Managing venous thromboembolic events in daily practise: ‘‘time is never enough’’
Authors: Anyfantakis D. , Symvoulakis E.K. , Mitrouska I.
Published: January 2016

Pulmonary embolism is an insidious life-threatening condition. Its diagnosis represents a challenging topic in daily clinical practice since the recognition and the appropriate management of the condition can lead to the decrease of potentially fatal consequences. We present a clinical case which highlights the necessity for an increased level of ‘surveillance’ from the involved physicians since features of thromboembolic events may be elusive or vague.
Pulmonary consolidation and inflammation: inflammatory pseudotumour in young children
Authors: Lindemans C.A. , Bruinsma R.A. , Nikkels P.G.J. , Bröker F.H.L. , Arets H.G.M.
Published: January 2016

Here we report two children with a pulmonary inflammatory pseudotumour; a rare entity in children, that often initially presents as a pneumonia, but with the possibility of serious consequences if unrecognised and untreated. One of the children presented is 6 months which is extremely young for this tumour. Difficulties in presentation, management strategies and prognosis are described. Certainly, this is a condition that should be considered even in a very young child with an inflammatory condition presenting as a solid lesion in the lung which does not resolve or even progresses.
Correlation between extreme rainfall and insurance claims due to urban flooding – case study Fredrikstad, Norway
Authors: Torgersen Geir
Published: January 2016

During the last decades an increase in extreme rainfall has led to more urban flooding. This study is based on insurance claims of damages caused by heavy rain during 2006-2012 in Fredrikstad, Norway. Data are analysed using Principal Component Analysis. The purpose has been to find characteristics of extreme rainfall and its influence on the extent of urban flooding. The number of claims seems to be peaked in the late summer period. Furthermore, the precipitation depth the week before an extreme rainfall seems to have significantly influence for the pay out from insurers, and thus the changing in runoff factor due to soil wetness is of importance. Compared to 25-year frequency rainfall with 30 min duration, relatively less intensive, but more stable and long-lasting rain seems to lead to more claims. Experiences from previous events may help to determine the level of flood risk when extreme rainfall is forecasted.
18F-sodium fluoride PET-CT hybrid imaging of the lumbar facet joints: Tracer uptake and degree of correlation to CT-graded arthropathy
Authors: Mabray Marc , Brus-Ramer Marcel , Behr Spencer , Pampaloni Miguel , Majumdar Sharmila , Dillon William , Talbott Jason
Published: January 2016

We aim to evaluate 18F-NaF uptake by facet joints with hybrid PET-CT technique. Specifically, we evaluate NaF uptake in the facet joints of the lower lumbar spine, and correlate with the morphologic grade of facet arthropathy on CT. 30 consecutive patients who underwent standard vertex to toes NaF PET-CT for re-staging of primary neoplastic disease without measurable or documented bony metastases were identified. Maximum (SUVmax) and average (SUVavg) standardized uptake values were calculated for each L3-4, L4-5, and L5-S1 facet joint (n = 180) and normalized to average uptake in the non-diseased femur. A Pathria grade (0-3) was assigned to each facet based upon the CT morphology. Spearman′s rank correlation was performed for normalized SUVmax and SUVavg with Pathria grade. ANOVA was performed with Tukey-Kramer pairwise tests to evaluate differences in uptake between Pathria groups. Facet normalized SUVmax (r = 0.31, P < 0.001) and SUVavg (r = 0.28, P < 0.001) demonstrated a mild positive correlation with CT Pathria grade. There was a wide range of uptake values within each Pathria grade subgroup with statistically significant differences in uptake only between Pathria grade 3 as compared to grades 0, 1, and 2. In conclusion, NaF uptake and morphologic changes of the facet joint on CT are weakly correlated. Physiologic information provided by NaF uptake is often discrepant with structural findings on CT suggesting NaF PET may supplement conventional structural imaging for identification of pain generating facet joints. Prospective investigation into the relationship of facet joint NaF uptake with pain and response to pain interventions is warranted.
Central pontine myelinolysis and localized fluorodeoxyglucose uptake seen on 18 f-FDG PET/CT
Authors: Rønne Frederik , Tfelt-Hansen Peer , Rørdam Lene
Published: January 2016

Case report describing the finding of central pontine myelinolysis (CPM) using combined fluorine-18 ( 18 F)-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT). The patient was a known alcoholic who, during admission was under treatment for hyponatremia, showed a significant decline in both motor and cognitive function. Combined 18 F-FDG PET/CT showed localized FDG uptake in the pons, consistent with the finding of CPM observed on magnetic resonance imaging (MRI). CPM is a demyelinating lesion of the pons, resulting in several neurological symptoms. The exact cause of CPM is not clear, but a strong relations between loss of myelin and osmotic stress exists, especially during rapid correction of hyponatremia. The osmotic stress is thought to induce disruption of the blood-brain barrier, allowing access for inflammatory mediators in extravascular brain tissue, which most likely attracts glial cells of the brain, attracts macrophages and activates astocytes. We suggest that metabolism in these activated cells could be responsible for the localized FDG uptake during active CPM.
Antithyroglobulin antibody as a marker of successful ablation therapy in differentiated thyroid cancer
Authors: Dewi Ayu , Darmawan Budi , Kartamihadja Achmad , Hidayat Basuki , Masjhur Johan
Published: January 2016

The aim of this study was to determine the role of antithyroglobulin antibody (ATA) serum as a marker of successful I-131 ablation therapy in differentiated thyroid cancer (DTC) patients with low serum thyroglobulin (Tg). A retrospective study was conducted on 60 patients (10 males and 50 females). All patients underwent posttotal thyroidectomy and received 2.96 to 3 GBq I-131 ablation. Subjects were divided into two groups with succesful and unsuccessful I-131 ablation therapies. The data of age, gender, histopathologic type, tumor size, and metastasis were collected. Preablation serum Tg and ATA level (Tg1 and ATA1) 6-12 months after ablation (Tg2 and ATA2) were measured. The success of ablation therapy was evaluated by diagnostic whole body scan (DxWBS) 6-12 months after ablation. There were no significant differences in age, gender, type of histopathology, tumor size, and nodal metastasis between the two groups. ATA2 ≤30 kIU/L were found in 23 (62.2%) subjects with successful ablation therapy, and ATA2 >30 kIU/L in 16 (69.6%) subjects belonged to the unsuccessful group (P = 0.017). Changes between ATA1 and ATA2 levels did not differ significantly in both the groups (P = 0.062). Tg1 <10 mg/L was found in 26 (57.8%) subjects with successful therapy (P = 0.037). Multivariate analysis showed ATA2 and Tg1 as the independent factors for the success of ablation therapy (P = 0.007 and 0.015). Adjusted odds ratio of postablation ATA was 5.379 [95% confidence interval (CI) 1.590 to 18.203] and preablation Tg was 5.822 (95% CI 1.418 to 23.902). ATA levels at 6-12 months after ablation, by considering the preablation Tg levels, is a useful marker to determine successful ablation therapy in WDTC patients with low serum Tg. Changes in serum ATA levels, although not statistically significant, can provide additional information about the course of the disease.
Transcriptomic Sequencing Reveals a Set of Unique Genes Activated by Butyrate-Induced Histone Modification
Authors: Li Cong-Jun , Li Robert W. , Baldwin Ransom L. , Blomberg Le Ann , Wu Sitao , Li Weizhong
Published: January 2016

Butyrate is a nutritional element with strong epigenetic regulatory activity as a histone deacetylase inhibitor. Based on the analysis of differentially expressed genes in the bovine epithelial cells using RNA sequencing technology, a set of unique genes that are activated only after butyrate treatment were revealed. A complementary bioinformatics analysis of the functional category, pathway, and integrated network, using Ingenuity Pathways Analysis, indicated that these genes activated by butyrate treatment are related to major cellular functions, including cell morphological changes, cell cycle arrest, and apoptosis. Our results offered insight into the butyrate-induced transcriptomic changes and will accelerate our discerning of the molecular fundamentals of epigenomic regulation.
Reciprocal Effects of Internalizing and Oppositional Defiance Symptoms on Heavy Drinking and Alcohol-Related Harms in Young Adulthood
Authors: Thompson Kara D. , Leadbeater Bonnie J. , Ames Megan E.
Published: January 2016

There is a need for longitudinal research to understand how psychopathology relates to the onset and maintenance of substance use from adolescence into young adulthood. Hence, we investigate the longitudinal, reciprocal influences of internalizing (anxiety and depression) and externalizing (oppositional defiance) symptoms on heavy episodic drinking (HED; ≥5 drinks per occasion) and alcohol-related harms in a community-based sample of youth aged 12–27 years. Participants were chosen from the Victoria Healthy Youth Survey, followed six times, biennially between 2003 and 2013 ( N = 662). Analyses used cross-lagged panel models to examine reciprocal relations over time. Differences across age and sex were also tested. Defiance symptoms predicted increases in HED, which reciprocally predicted increases in defiance symptoms for females. Internalizing symptoms were related to HED within time for females. Alcohol-related harms had reciprocal positive associations with internalizing and defiance symptoms for both males and females. Associations were largely invariant across age groups, suggesting that the presence and strength of associations persisted across development. While psychopathology preceded the onset of HED and harms, the overall findings suggest that these risk processes are mutually reinforcing across development and that youth may become entrenched in an interdependent cycle that significantly increases their risk of comorbid disorders in adulthood.
A Métrica Servqual na Avaliação da Satisfação dos Usuários da Biblioteca Central da Universidade Federal de Santa Catarina
Authors: Rocha Rudimar Antunes da , Silva Andrea Aparecida
Published: January 2016

http://dx.doi.org/10.5007/1518-2924.2015v21n45p35

O artigo trata da satisfação dos alunos da UFSC, avaliada pela Métrica Servqual, sobre os serviços oferecidos pela Biblioteca Central (BC-UFSC) - Campus Trindade – Florianópolis (Brasil). Da população de 31.436 matriculados em 2013 (PROPLAN/UFSC, 2013), obteve-se a amostra de 381 alunos. Utilizou-se o questionário Estilo Likert e o tipo de estudo probabilístico-sistemático. A coleta foi de 1º até 16 de abril de 2013 e o tratamento pelo SPSS®. Os resultados revelaram insatisfação dos entrevistados sobre os serviços da BC-UFSC, principalmente em relação: a segurança no campus, as vagas de estacionamento, a higienização dos banheiros e o excesso de ruído na BC-UFSC.
Liberdade e religião: reflexões kantianas sobre a não coercitividade, a veracidade e a publicidade na relação entre religião e política
Authors: Klein Joel Thiago
Published: January 2016

http://dx.doi.org/10.5007/1677-2954.2015v14n2p222De acordo com a filosofia kantiana existem três princípios que deveriam regular a forma como a política se relaciona com a religião, quais sejam, o princípio da não coercitividade da crença religiosa; a exigência moral da veracidade nas profissões de crença e a incapacidade de máximas com conteúdo religioso se conformarem com o princípio político-jurídico da publicidade. O objetivo deste artigo é apresentar, explicar e justificar a aplicação desses três princípios com relação à religião e indicar como eles poderiam ajudar a resolver problemas políticos e morais com respeito à intolerância religiosa que continua a assolar a sociedade contemporânea.
Charlie hebdo: sobre a democracia francesa
Authors: Muniz Jordan Michel
Published: January 2016

http://dx.doi.org/10.5007/1677-2954.2015v14n2p252

Discutirei os assassinatos no jornal Charlie Hebdo a partir de questões ligadas à religião, à democracia e à liberdade, nesta ordem. Primeiro, irei apresentar aspectos sociais e econômicos da vida dos imigrantes na França, seguidos por fatos da história da dominação imposta aos países abandonados pelos imigrantes. Depois, vou recorrer a Judith Butler e à teoria do discurso para mostrar como a exclusão social foi materializada na França, e defender que uma grave desigualdade política cinde a sociedade francesa, originando revoltas. Problemas de caráter racial foram convertidos em contenda religiosa, fixando identidades antagônicas que barram a interação. Por último, irei apontar a necessidade de transformação da democracia francesa, de modo a dar cidadania efetiva a todos os imigrantes. Converter o conflito religioso atual em embate político permitirá estender os direitos sociais e humanos a todos e valorizar as liberdades democráticas. Talvez por este caminho venha a ser possível a França e outros países europeus construírem uma sociedade realmente igualitária em termos sociais e políticos, com liberdades plenas para todos.

 
Estado laico e interferência religiosa
Authors: Pinzani Alessandro
Published: January 2016

http://dx.doi.org/10.5007/1677-2954.2015v14n2p279O artigo analisa diferentes discursos que, neste momento, estão sendo formulados sobre a religião na esfera pública. Não se falará nele da religião ou das religiões, mas da maneira na qual esses temas são percebidos e discutidos na opinião pública ocidental, em particular europeia, pois essa discussão tem algo relevante para a discussão sobre o papel da religião na sociedade brasileira. Serão considerados três discursos que serão denominados respectivamente de (1) “determinismo cultural”, (2) “anti-religiosidade seletiva” e (3) “laicismo estatal”. A intenção do artigo é apontar para os erros lógicos e categoriais e para as incoerências presentes nesses discursos que dominam o atual debate sobre o lugar da religião em geral e do Islã em particular nas sociedades ocidentais.
Direito à vida e a personalidade do feto, aborto e religião no contexto brasileiro:Mulheres entre a vida e a morte
Authors: Rosendo Daniela , Gonçalves Tamara Amoroso
Published: January 2016

http://dx.doi.org/10.5007/1677-2954.2015v14n2p300A discussão sobre aborto no Brasil é frequentemente permeada por argumentos religiosos travestidos de argumentos jurídicos. Em um Estado guiado pelo princípio da laicidade, moralidades religiosas não devem interferir em políticas públicas e nem mesmo na formulação de leis. Este artigo busca investigar o arcabouço normativo brasileiro, verificando se há subsídios suficientes, do ponto de uma ética pautada em direitos humanos, para proibir a realização do aborto eletivo com base na preservação do direito à vida e à personalidade dos fetos. Mais especificamente, analisa o direito à vida e à personalidade no direito brasileiro, percorrendo também um pouco do histórico das variações relacionadas ao posicionamento da Igreja Católica sobre o tema do aborto e seu consequente impacto no direito brasileiro. Percebe-se que têm sido utilizados argumentos religiosos para impedir o reconhecimento do direito à interrupção voluntária da gravidez, com pleno exercício da autonomia da mulher e do reconhecimento dos seus direitos como sujeito histórico e político. Essa proibição tem acarretado a morte de milhares de mulheres em todo o mundo, razão pela qual é fundamental refletir sobre os argumentos que obstam o avanço legislativo, mantidos pelo discurso masculinista antiabortista (Tiburi), que torna as mulheres referentes ausentes (Adams).
Radicalização da liberdade negativa: Hegel, pós-secularismo e fanatismo
Authors: Campello Filipe
Published: January 2016

http://dx.doi.org/10.5007/1677-2954.2015v14n2p320

O presente artigo tem como objetivo encontrar em Hegel uma contribuição teórica para a debate recente sobre pós-secularismo e a relação entre religião e esfera pública, em particular em torno do conceito de fanatismo. Em primeiro lugar, como veremos, o que se sobressai na abordagem hegeliana é o modo em que o conceito de fanatismo é desenvolvido a partir de uma teoria da liberdade e suas patologias; e, em segundo lugar, como este modelo de liberdade vincula-se a uma teoria de formação da vontade livre em que as instituições cumprem um papel central. Em vista desta proposta interpretativa, apresento meu argumento em dois passos. Primeiramente, discuto brevemente em que medida o conceito hegeliano de fanatismo, ao vincular-se a um modelo de liberdade, pode contribuir para o debate contemporâneo (1). E, em segundo lugar, apresento como a intuição original de Hegel pode ser atualizada a partir de um modelo normativo de processos de aprendizagem (2). 