bluuebunny/crossref_metadata_2025 huggingface dataset:
Fluid-Attenuated Inversion Recovery and Diffusion- and Perfusion-Weighted MRI Abnormalities in 117 Consecutive Patients With Stroke Symptoms
Authors: Perkins Candice J. , Kahya Erkan , Roque Clemente T. , Roche Patricia E. , Newman George C.
Published: October 2007

Background and Purpose

—

Diffusion-weighted MRI (DWI) is highly sensitive to early cerebral ischemia, but its dependence on lesion location, acuity, and etiology remains unknown. Furthermore, although a marked perfusion-weighted MRI (PWI)-DWI mismatch may exist in a subset of acute strokes, the frequency and distribution of these mismatches have never been methodically characterized in an unselected population. To address these 2 issues, we evaluated echo-planar imaging in 117 consecutive patients with signs and symptoms of acute stroke.

Methods

—

Clinical diagnoses were determined by chart review. Fluid-attenuated inversion recovery (FLAIR), DWI, and PWI sequences were scored for lesion acuity, neuroanatomy, and vascular territory. Lesion and PWI-DWI mismatch volumes were determined by image analysis.

Results

—

DWI was more sensitive than was FLAIR for the detection of stroke for all subtypes in all anatomic distributions and at all tested time intervals. Although DWI exhibited its greatest benefit over FLAIR during the first 6 hours, it was still superior to FLAIR even after 24 hours. PWI abnormalities were detected in 49% of patients with DWI abnormalities. In the majority of these cases, the PWI-DWI mismatch was substantially larger than the DWI lesion itself. Both the largest DWI lesion volumes and the largest mismatch volumes occurred in patients with carotid disease.

Conclusions

—

DWI nearly doubles the likelihood of detecting acute ischemic stroke lesions compared with FLAIR for all etiologies and in all anatomic locations. In the hyperacute period (0 to 6 hours), DWI more than triples the likelihood of acute-stroke detection over FLAIR. PWI reveals a measurable mismatch compared with DWI nearly 50% of the time; and in more than half of these patients, the ratio of the volume of the PWI lesion to the DWI lesion is several times larger than the core ischemic lesion itself. In the final analysis, approximately one fourth of all stroke patients present with a large volume of potentially salvageable tissue at risk for infarction.
Educating the Next Generation of Physicians About Stroke
Authors: Billings-Gagliardi Susan , Fontneau Nancy M. , Wolf Merrill K. , Barrett Susan V. , Hademenos George , Mazor Kathleen M.
Published: October 2007

Background and Purpose

—

In response to the need to educate physicians about stroke, we have implemented an educational program on stroke prevention for undergraduate medical students within the first-year neuroscience course. This study investigated whether first-year students learned and retained key information about stroke, and used students’ feedback both to identify effective curricular components and to explore their attitudes regarding stroke prevention.

Methods

—

Stroke knowledge and self-assessed confidence in that knowledge before, immediately after, and 8 months after participation in the stroke curriculum were analyzed and compared for 3 classes, using paired
t
tests and repeated-measures ANOVA. Student feedback about the effectiveness of specific parts of the curriculum and about the importance of stroke prevention was solicited and evaluated.

Results

—

First-year medical students in 3 classes more than doubled their overall stroke knowledge scores (pretest total mean of 8.2; posttest mean 18.0), and retained significant improvement 8 months later (mean 15.7). Subscores in all 4 areas of stroke knowledge tested significantly increased (
P
<0.001). Students’ confidence in their knowledge of stroke risk factors and warning signs, as well as in their knowledge itself, increased (
P
<0.001). Each of the 3 cohorts demonstrated similar improvements. Feedback indicated heightened awareness and interest in stroke prevention, which was maintained after completion of the curriculum.

Conclusions

—

These results demonstrate that when instruction on stroke prevention is incorporated into the first-year curriculum, students learn and retain key information. Because entire classes of medical students are involved, this type of approach has the potential to reach all future physicians and therefore to meaningfully impact future stroke care.
Progression and Clinical Recurrence of Symptomatic Middle Cerebral Artery Stenosis
Authors: Arenillas Juan F. , Molina Carlos A. , Montaner Joan , Abilleira Sònia , González-Sánchez Miguel A. , Álvarez-Sabín José
Published: October 2007

Background and Purpose

—

Patients with symptomatic intracranial atherosclerotic stenosis have a high rate of recurrence. We conducted a prospective study to determine which factors are associated with the progression of symptomatic middle cerebral artery (MCA) stenosis and to evaluate the relationship between progression and clinical recurrence.

Methods

—

Between January 1996 and February 2000, of a total of 2564 consecutive first-ever transient ischemic attack (TIA) or stroke patients admitted to our cerebrovascular unit, 145 showed an MCA stenosis signal on transcranial Doppler (TCD) on admission, and 40 fulfilled all criteria to enter this study, including angiographic confirmation. Patients were prescribed antiplatelet or anticoagulant agents following the criteria of the neurologist in charge. TCD recordings and clinical interviews were performed regularly during follow-up. Progression of MCA stenosis was defined as an increase >30 cm/s in TCD-recorded maximum mean flow velocity. Logistic regression analyses were used to identify predictors of progression and clinical recurrence.

Results

—

With a median follow-up of 26.55 months, 13 (32.5%) MCA stenoses progressed, 3 (7.5%) regressed, and 24 (60%) remained stable. Absence of significant extracranial internal carotid artery (ICA) stenosis (
P
=0.049) and the use of oral anticoagulants (
P
=0.045) were significantly associated with a lower progression rate in univariate analysis, and anticoagulation remained an independent predictor when a logistic regression model was applied (OR 7.25, CI 1.1 to 48.1,
P
=0.019). A new ischemic event during follow-up in the territory supplied by the stenosed MCA occurred in 8 cases (20%), and 13 patients had a major vascular event. Progression of the MCA stenosis detected by TCD was independently associated with a new ipsilateral ischemic event (OR 2.89, CI 1.09 to 7.71,
P
=0.031) and with the occurrence of any major vascular event (OR 7.03, CI 1.6 to 30.9,
P
=0.0071).

Conclusions

—

Progression of symptomatic MCA stenosis detected by means of TCD predicts clinical recurrence. Anticoagulation is independently associated with a lower progression rate of symptomatic MCA stenosis.
Evidence for Excess Long-Term Mortality After Treated Subarachnoid Hemorrhage
Authors: Ronkainen Antti , Niskanen Minna , Rinne Jaakko , Koivisto Timo , Hernesniemi Juha , Vapalahti Matti
Published: October 2007

Background and Purpose

—

The purpose of this study was to examine the long-term mortality rate of patients with aneurysmal subarachnoid hemorrhage (SAH) compared with that of the general population.

Methods

—

Aneurysmal SAH patients who were treated for ruptured aneurysm from 1977 through 1998 in a tertiary referral center (n=1537) were followed up for a median of 7.5 years. Dates and causes of death were determined. Standardized mortality ratios (observed/expected deaths) according to age, sex, and Glasgow Outcome Scale at 12 months after surgery were calculated.

Results

—

The mortality rate among patients with good recovery at 12 months was twice that of the general population. The excess mortality appeared to be most evident in younger age groups. Cerebrovascular and cardiovascular diseases were the principal causes of premature death. The result was similar among patients without preexisting cardiovascular diseases at the time of SAH.

Conclusions

—

Aneurysmal SAH patients have an excess mortality rate even after successful treatment of ruptured aneurysms. Therefore, aneurysmal SAH should be viewed more as one aspect of a chronic general vascular disease, and more attention should be given to treatment of risk factors and long-term follow-up of these patients.
Report of the Substudy Assessing the Impact of Neurocognitive Function on Quality of Life 5 Years After Cardiac Surgery
Authors: Newman Mark F. , Grocott Hilary P. , Mathew Joseph P. , White William D. , Landolfo Kevin , Reves Joseph G. , Laskowitz Daniel T. , Mark Daniel B. , Blumenthal James A.
Published: October 2007

Background and Purpose

—

The importance of perioperative cognitive decline has long been debated. We recently demonstrated a significant correlation between perioperative cognitive decline and long-term cognitive dysfunction. Despite this association, some still question the importance of these changes in cognitive function to the quality of life of patients and their families. The purpose of our investigation was to determine the association between cognitive dysfunction and long-term quality of life after cardiac surgery.

Methods

—

After institutional review board approval and patient informed consent, 261 patients undergoing cardiac surgery with cardiopulmonary bypass were enrolled and followed for 5 years. Cognitive function was measured with a battery of tests at baseline, discharge, and 6 weeks and 5 years postoperatively. Quality of life was assessed with well-validated, standardized assessments at the 5-year end point.

Results

—

Our results demonstrate significant correlations between cognitive function and quality of life in patients after cardiac surgery. Lower 5-year overall cognitive function scores were associated with lower general health and a less productive working status. Multivariable logistic and linear regression controlling for age, sex, education, and diabetes confirmed this strong association in the majority of areas of quality of life.

Conclusions

—

Five years after cardiac surgery, there is a strong relationship between neurocognitive functioning and quality of life. This has important social and financial implications for preoperative evaluation and postoperative care of patients undergoing cardiac surgery.
Mechanisms of Edema Formation After Intracerebral Hemorrhage
Authors: Xi Guohua , Hua Ya , Bhasin R. Rick , Ennis Steven R. , Keep Richard F. , Hoff Julian T.
Published: October 2007

Background and Purpose
—

Red blood cell (RBC) lysis contributes to brain edema formation after intracerebral hemorrhage (ICH), and RBC hemolysate (oxyhemoglobin) has been implicated to be a spasminogen in subarachnoid hemorrhage. Whether cerebral ischemia contributes to brain edema formation after ICH remains unclear, however. The aims of this study were to test whether extravasation of RBCs induces cerebral ischemia and/or blood-brain barrier disruption in a rat ICH model characterized by perihematomal brain edema.

Methods
—

In this study, 87 pentobarbital-anesthetized Sprague-Dawley rats were used. In each animal, saline, packed RBCs, or lysed RBCs were injected into the right caudate nucleus. Sham injections served as controls. Regional cerebral blood flow, brain water and ion contents, blood-brain barrier integrity, and plasma volume were measured.

Results
—

Intraparenchymal infusion of lysed RBCs caused severe brain edema by the first day but did not induce ischemic cerebral blood flows. In contrast, blood-brain barrier permeability increased during the first day after infusion of lysed RBCs (a 3-fold increase) and 3 days after infusion of packed RBCs (a 4-fold increase).

Conclusions
—

These results suggest that ischemia is not present at 24 or 72 hours after hematoma induction by injection of intact or lysed RBCs. RBC constituents that appear after delayed lysis, however, increase blood-brain barrier permeability, which contributes to edema formation.
Current Strategies of Secondary Prevention After a Cerebrovascular Event
Authors: Lalouschek Wolfgang , Lang Wilfried , Müllner Markus
Published: October 2007

Background and Purpose

—

Oral anticoagulation (OAC) and antiplatelet drugs are effective in the secondary prevention of ischemic cerebrovascular events. Only few data exist about the factors influencing the choice of a specific therapy for secondary prevention in patients with a recent stroke or transient ischemic attack (TIA).

Methods

—

Within a cross-sectional study, nested in a cohort we identified 931 patients with a recent ischemic stroke or TIA who were discharged with OAC or with one of the antiplatelet medications aspirin, clopidogrel, or the combination of aspirin and extended-release dipyridamole. By means of multivariate logistic regression analysis, we determined the influence of several clinical variables on the decision between OAC and overall antiplatelet therapy as well as on the decision between different antiplatelet therapies.

Results

—

A cardioembolic etiology of the index event and atrial fibrillation were independently associated with the use of OAC. Age was inversely associated with the use of OAC. Different estimations of contraindications to OAC were the main reason for the considerable variability among the participating centers. The most important factor promoting the use of clopidogrel was therapy with aspirin before the index event. Patients with large- or small-vessel disease received clopidogrel more often than those with an event of undetermined etiology. We found an extremely high interhospital variability for the use of the combination of aspirin with extended-release dipyridamole.

Conclusions

—

Current recommendations are applied in clinical practice, but great variability between different centers remains. More clearly defined guidelines for indications for, as well as contraindications against, a specific therapy are necessary.
Epidemiology of Ischemic Stroke Subtypes According to TOAST Criteria
Authors: Kolominsky-Rabas Peter L. , Weber Margarete , Gefeller Olaf , Neundoerfer Bernhard , Heuschmann Peter U.
Published: October 2007

Background and Purpose

—

The purpose of this study was to determine the incidence, recurrence, and long-term survival rates of ischemic stroke subtypes by a mechanism-based classification scheme (Trial of ORG 10172 in Acute Stroke Treatment, or TOAST).

Methods

—

We identified all 583 residents of the city of Erlangen, Bavaria, Germany, with a first ischemic stroke between 1994 and 1998. Multiple overlapping sources of information were used to ensure completeness of case ascertainment. The cause of ischemic stroke was classified according to the TOAST criteria. Patients were followed up at 3 months and 1 and 2 years after stroke onset.

Results

—

The age-standardized incidence rates for the European population (per 100 000) regarding ischemic stroke subtypes were as follows: cardioembolism, 30.2 (95% CI 25.6 to 35.7); small-artery occlusion, 25.8 (95% CI 21.5 to 30.9); and large-artery atherosclerosis, 15.3 (95% CI 12 to 19.3). When age-adjusted to the European population, the incidence rate for large-artery atherosclerosis was more than twice as high for men than for women (23.6/100 000 versus 9.2/100 000). Two years after onset, patients in the small-artery occlusion subgroup were 3 times more likely to be alive than those with cardioembolism. Ischemic stroke subtype according to the TOAST criteria was a significant predictor for long-term survival, whereas subtype was not a significant predictor of long-term recurrence up to 2 years, both before and after adjustment for age and sex.

Conclusions

—

Epidemiological observational studies that possess wide access to appropriate diagnostic technologies and apply standardized etiologic classifications provide a much better understanding of underlying risk factors for initial stroke, recurrence, and mortality.
Role of Factor XIII Val34Leu Polymorphism in Retinal Artery Occlusion
Authors: Weger Martin , Renner Wilfried , Stanger Olaf , Schmut Otto , Deutschmann Hannes , Wascher Thomas C. , Haas Anton
Published: October 2007

Background and Purpose

—

Factor XIII (FXIII) Val34Leu, a common polymorphism in the gene for factor XIII, has been associated with a lower risk of stroke, myocardial infarction, and deep vein thrombosis. Ineffective fibrin cross-linking has been suggested to be causative. The aim of the present case-control study was to investigate the role of FXIII Val34Leu polymorphism in patients with retinal artery occlusion.

Methods

—

A total of 108 patients with retinal artery occlusion and 313 age- and sex-matched controls were genotyped for the FXIII Val34Leu polymorphism. Factor XIII Val34Leu genotypes were determined by use of allele-specific polymerase chain reaction.

Results

—

Homozygous Leu genotype was found significantly more often in control subjects than in patients with retinal artery occlusion (
P
=0.018), with an odds ratio of 0.22 (95% confidence interval 0.07 to 0.74). Distribution of the Val/Val and Val/Leu genotypes did not differ significantly between groups.

Conclusions

—

Because prevalence of homozygous Leu genotype was significantly higher in controls, we conclude that the Leu/Leu genotype is associated with a protective effect against retinal artery occlusion.
Hate Crime Policy in Western Europe
Authors: Bleich Erik
Published: October 2007

In recent years, the British, German, and French states have increasingly turned their attention to the problem of racist violence. Yet in spite of their common participation in the European Union, each country has pursued a distinctive path in response to such hate crimes. Britain has focused primarily on policing and on the judicial process for prosecuting racially aggravated offenses, Germany has devoted substantial resources to civil society groups dedicated to countering right-wing extremism, and France has taken high-profile symbolic actions and has begun adapting its educational policies to address racist violence. This article argues that developing effective policies depends on learning best practices from other states but that it also requires being responsive to the concerns of domestic actors who face specific problems and who suggest possible solutions.
Hate Crimes Against Immigrants in Sweden and Community Responses
Authors: Bunar Nihad
Published: October 2007

The purpose of this article is to describe and analyze development in Sweden concerning the amount and types of reported hate crimes and entailed community responses. Particular attention is paid to offenses against immigrants. The number of reported xenophobic, anti-Semitic, and homophobic crimes has increased considerably between 1997 and 2003. The most common hate crimes against immigrants are threats, harassment, slander, ethnic agitation, and assault. The broader community (political state and welfare society) responded with new legislation, new orders to the police, a discursive offensive against racism, and in particular, the enactment of huge social programs in impoverished immigrant communities. The author analyzes some of the outcomes of these responses.
Bias-Crime Reporting
Authors: Cronin Shea W. , McDevitt Jack , Farrell Amy , Nolan James J.
Published: October 2007

Over the past two decades, significant efforts have established categories of crimes motivated by bias and so enhanced the quality of information about the prevalence of such crimes in the United States. As part of a national reporting system established by the Hate Crime Statistics Act, local police agencies collect information about the prevalence and characteristics of bias-crime incidents. Although the quality of this program has improved since its inception, local police face several challenges to identifying and accurately classifying bias crimes, including the ambiguity of applying legal definitions to cases, uncertainty regarding bias motivation, and infrequency of reported events to law enforcement. Drawing on information from eight case studies, the article examines how local police identify and record bias crimes through various kinds of reporting procedures and organizational structures. The article concludes with best practice recommendations for bias-crime tracking and reporting of incidents of bias crime within local police agencies.
The Microdynamics of Hate Violence
Authors: Blee Kathleen M.
Published: October 2007

By examining the link between attitudes and actions by perpetrators of hate violence and interpretation of hate violence by its victims, this article demonstrates how interpretive analytic strategies can illuminate aspects of the microdynamics of hate crime violence that are difficult to understand with variable-centered analysis. Data on the relationship between perpetrator motive and actions are from semistructured interviews of female rank-and-file members of organized racist groups in the modern United States. Data on victim interpretations are from ethnographic case studies of victims and victim communities in various settings across the United States. Interpretive analyses of these data suggest new implications for formulating effective responses to hate violence.
How Did Asian Americans Respond to Negative Stereotypes and Hate Crimes?
Authors: Lee Yueh-Ting , Vue Sandy , Seklecki Richard , Yue Ma
Published: October 2007

Stereotypes and hate crimes are complex issues. Stereotypes usually have three dimensions— Evaluation or valence, Potency, and Accuracy (EPA). According to the EPA model of stereotypes and stereotyping, negative and inaccurate stereotypes are more prone to bias and prejudice. This article uses the EPA model to test two assumptions. First, stereotypes would produce a differential impact on Asian Americans, which is contingent on the accuracy and valence of stereotypes to Asian Americans. Inaccurate negative stereotypes may offend Asian Americans more than accurate negative stereotypes. Second, Asian Americans may be more sensitive or responsive to a hate crime situation in which Asian Americans are racially targeted as the only victims than to one in which both Asian Americans and other minority Americans are racially targeted as victims together. The results from the two studies strongly corroborate these two assumptions, which provide more support for the EPA model of stereotypes and stereotyping.
“Hate Torts” to Fight Hate Crimes
Authors: Koenig Thomas H. , Rustad Michael L.
Published: October 2007

This article coins the term hate torts to illustrate the growing role of tort law in defending vulnerable Americans against violence and intimidation by hate groups and hateful individuals. Hate torts give juries the muscle to impose a financial death penalty against organizations that recklessly and intentionally enable racial and gender oppression. In the absence of effective criminal sanctions, tort victims and their lawyers can play the role of private attorneys general by filing civil lawsuits that expose and financially punish organizations that incite the commission of hate crimes.
An Interview With a Persistent Woman
Authors: Farmer Helen , Harmon Lenore W.
Published: October 2007

An interview with Helen Farmer reveals the highlights of her professional life and the unusual road she took to her eventual position as a professor whose theories and mentoring of students have greatly influenced the field of counseling psychology. Also revealed are some of the personal qualities that led to her success.
Pierre de Bérulle's Apostolate of the Incarnate Word
Authors: Rearden Myles
Published: October 2007

Pierre de Bérulle is the originator of the mystical and ascetical movement known as the French School of Spirituality. Although he had strong institutional concerns, the enduring value of his work lies in its radical Christocentricism. While his theology is not original, he uses it to develop the themes of contemplation and intimacy with Christ in writings of rare brilliance. His theology is eclectic, deriving from Augustinian, Thomist and Scotist sources. Some of his key concepts, however, do seem to be original: state, servitude/adherence and non-being. His works are little known in the English-speaking world.
Reinforcing Effect of Carbon Short Fibers Coated with Pyrolytic Carbon in Ceramic Matrix Composites
Authors: Hackl Gerrit , Gerhard Helmut , Schmidt Stephan , Popovska Nadejda
Published: October 2007

Carbon short fibers (6000 filaments) with a length of 6 mm were uniformly coated with pyrolytic carbon (pyC) in continuous CVD process using propane—hydrogen mixture as precursor. The process conditions for the fiber coating were optimized to meet a high deposition rate at minimum soot formation in parameter screening experiments using nonporous graphite substrates. The coated fibers were characterized by SEM and Raman spectroscopy. Their reinforcing effect was investigated in composites with C/SiC matrix. As a result of fiber coating the bending strength of the composites was increased about 30% and elongation at break increased by a factor of nine. The pyC coating modifies the fiber—matrix interface preventing too strong a bonding, resulting in damage tolerant behavior of the composites.
Dynamic Response of Smart Hybrid Composite Plate Subjected to Low-Velocity Impact
Authors: Khalili S.M.R. , Shokuhfar A. , Ashenai Ghasemi F. , Malekzadeh K.
Published: October 2007

In this article, the response of rectangular smart hybrid composite plate subjected to low velocity impact is studied and the effect of some geometrical and material parameters on the response of the composite plate embedded with shape memory alloy (SMA) wires is investigated. The interaction between the impactor and the composite plate is considered in the impact analysis. The SMA wires are embedded within the layers of the composite laminate. The effect of the SMA wires on contact force history, deflection, in-plane strains and stresses of the structure was studied. The classical first-order shear deformation theory (FSDT) as well as the Fourier series method is utilized to solve the governing equations of the composite plate analytically. The interaction between the impactor and the plate is modeled with the help of two degrees-of-freedom system, consisting of springs-masses. The Choi's linearized Hertzian contact model is used in the impact analysis of the laminated hybrid composite plate. The simultaneous application of the FSDT, Fourier series method, springs-masses and Choi's linearized contact model helps to get a complete model and more accurate result and save computational time and effort for the analysis of the composite structures subjected to the transverse impact. The results indicated that some of the geometrical and material parameters like the volume fraction, the orientation and the through thickness location of the SMA wires, the longitudinal to transverse elastic modulus ratio of the plate and the material type of composite medium are some of the important factors affecting the impact process and the design of the structures.
The Effect of Internal Stress on the Thermal Expansion Coefficient of Al/SiC p Composite
Authors: Na Chen  , Hongxiang Zhang  , Guohong Mu  , Mingyuan Gu
Published: October 2007

The effect of internal stress on the coefficient of thermal expansion (CTE) of the high volume fraction Al/SiCp composite was calculated and studied in a temperature range from 298 to 673 K. The results show that the CTE of composite rises slowly to a maximum value at about 530 K and then decreases with temperature because of the microstress induced by thermal mismatch between aluminum matrix and SiC particles. The macrostress in the composite changes the temperature at which the matrix begins to yield. The calculated CTE of the Al/SiCp composite is consistent with the experimental one before the temperature at which the matrix begins to yield. This temperature has been determined through theoretical calculation, which is well in accord with the experimental result.
Effect of Short Glass Fiber Content on Three-Body Abrasive Wear Behaviour of Polyurethane Composites
Authors: Suresha B. , Chandramohan G. , Dayananda Jawali N. , Siddaramaiah
Published: October 2007

Fiber reinforced polymer composites are known to generally possess high strength and attractive wear resistance in dry sliding conditions involving adhesion transfer or fatigue. How such composites perform in abrasive wear situations needs a proper understanding. Hence, in this study, three-body abrasive wear behavior of short glass fiber (SGF) reinforced polyurethane (PU) composite is investigated. Three-body abrasive wear tests are conducted using rubber wheel abrasion tester (RWAT) at two different loads (i.e., 22 and 32 N) and increasing abrading distances (i.e., 150, 300, 450, and 600 m) respectively. The wear results of the SGF/PU composites indicate that the wear volume increased with increase in fiber content for both increased load/abrading distance. However, the specific wear rate decreases with increase in load. The abraded surface features of the composites are studied by using a scanning electron microscope (SEM).
Fatigue Life Prediction of Composite Structures Under Constant Amplitude Loading
Authors: Kassapoglou Christos
Published: October 2007

An approach to construct the stress (or load) vs. cycles curve for composite structures under constant amplitude loading is presented. The approach is based on the assumption that the cycles to failure are a function of the probability of failure during any given cycle. In this first investigation, this probability of failure during any cycle is assumed to be constant and equal to the probability of failure obtained from static test results and the associated statistically quantified scatter. Expressions for the cycles to failure as a function of R ratio are derived. These expressions do not require any curve fitting and do not involve any experimentally determined parameters. The fatigue predictions do not require any fatigue tests for calibration. Comparisons to several test cases found in the literature show this first simple model to be very promising.
Pharmacokinetics, Pharmacodynamics, and Safety of Tolvaptan, a Nonpeptide AVP Antagonist, During Ascending Single‐Dose Studies in Healthy Subjects
Authors: Shoaf Susa E. , Wang Zhao , Bricmont Patricia , Mallikaarjun Suresh
Published: October 2007

Two single‐center, double‐blind, randomized, placebo‐controlled, sequentially enrolled studies were conducted. In study 1, 8 subjects (6 active/2 placebo) received 60‐, 90‐, 120‐, 180‐, or 240‐mg tolvaptan/matching placebo. In study 2, 9 subjects (6 active/3 placebo) received 180‐, 240‐, 300‐, 360‐, 420‐, or 480‐mg tolvaptan/matching placebo. Increases in tolvaptan Cmaxwere less than dose‐proportional and plateaued at doses greater than 240 mg; AUC∞increased proportionally with dose. Changes in serum K+, creatinine clearance, and Na+, K+, and osmolality urinary excretion were similar to the placebo group for the 0‐ to 24‐hour interval following dosing. Changes were observed in plasma arginine vasopressin, serum aldosterone, and plasma renin activity but were not clinically significant. Increases were seen in mean serum Na+concentrations (4–6 mEq/L), plasma osmolality (∼8 mOsm/kg), and free water clearance (∼6 mL/min) throughout 0 to 24 hours; none of these increases was dose dependent. Only total urine volume excretion (0–72 hours postdose) increased linearly with dose. As plasma tolvaptan concentrations increased, the duration that the urine excretion rate remained above baseline rates also increased. The most frequent adverse events—excess thirst, frequent urination, and dry mouth—appeared to be related to the pharmacological action of tolvaptan. No dose‐limiting toxicities were observed.
The Impact of Age, Place, Aging in Place, and Attachment to Place on the Well-Being of the Over 50s in England
Authors: Gilleard Chris , Hyde Martin , Higgs Paul
Published: October 2007

This study uses data from the English Longitudinal Study on Ageing to explore the extent and significance of the influence of “age,” “place,” and “aging in place” on the attachment to place in a large representative population of English adults aged 50 and over. It then examines the contribution of age, place, aging in place, and the attachment to place to scores on the CASP 19, a measure of well-being designed to measure some of the key sentiments and experiences of the “third age.” The results indicate that age, aging in place, place, and the attachment to place interact in complex ways to affect levels of “third age” well-being.
Deriving a Model of the Necessity to Hospitalize Nursing Home Residents
Authors: O'Malley A. James , Marcantonio Edward R. , Murkofsky Rachel L. , Caudry Daryl J. , Buchanan Joan L.
Published: October 2007

Although often important to recover from acute medical problems and exacerbations of chronic illness, hospitalizations can be traumatic for nursing home residents and costly for payers. It is important that unnecessary hospitalizations are avoided wherever possible. The authors derived and validated a diagnosis-based model to estimate the clinical necessity of hospitalizing nursing home residents with common conditions using data from an expert panel survey. Model validation involved a linked minimum data set—hospitalization claims data set. The expert panel of 12 experienced geriatricians rated the necessity of hospitalization for 1,948 clinical scenarios containing diagnoses, cognitive and functional status, age, gender, and advance directives. Primary diagnoses with the highest average necessity scores were respiratory failure, acute myocardial infarction, hip fracture, and brain injury. The secondary diagnosis-primary diagnosis interaction with the greatest impact was gastrointestinal bleed on gastroenteritis. Poor cognitive function and presence of an advance directive lowered the risk of hospitalization.
The Persistence of Hardship Over the Life Course
Authors: Hungerford Thomas L.
Published: October 2007

Status maintenance models have been proposed that suggest stratification of economic status over the life course (e.g., little mobility within the income distribution) and several studies have found evidence to support this, but none have looked at broader measures of well-being. Using 29 years (1968-1996) of the Panel Study of Income Dynamics, hypothesis tests and logistic regression techniques are employed to test the relation between middle-age chronic hardship and adverse old-age outcomes. In many cases, individuals who experience middle-age chronic hardships are significantly (statistically) more likely to experience adverse old-age outcomes.
Nonformaldehyde Flame Retardant Finishing of the Nomex/Cotton Blend Fabric Using a Hydroxy-Functional Organophosphorus Oligomer
Authors: Yang Hui , Yang Charles Q.
Published: October 2007

Multifunctional carboxylic acids, such as 1,2,3,4-butanetetracarboxylic acid (BTCA), have been used as durable press finishing agents to produce wrinkle-resistant cotton. In our previous research, we used BTCA as a nonformaldehyde bonding agent in the flame retardant finishing system based on a hydroxy-functional organophosphorus oligomer (HFPO) for cotton. In this research, we investigate the application of HFPO to the 65%/35% Nomex/cotton blend fabric using BTCA as a bonding agent and triethanolamine (TEA) as a co-reactant. We found that the addition of TEA in the flame retardant finishing system improves the hydrolysis resistance of the HFPO bound to the Nomex/ cotton blend and enhances the flame retardant performance of HFPO by means of phosphorus—nitrogen synergism. Moreover, TEA reduces the deposit of calcium salt on the treated fabric during laundering by esterifying the free carboxylic acid groups on cotton. The Nomex/cotton blend fabric treated with the HFPO/BTCA/TEA system shows high flame retardant performance at relatively low add-on levels. It is a completely nonformaldehyde flame retardant finishing system.
Keep It Cheap, Keep It Local, and Keep It Coming
Authors: Brown Christopher P.
Published: October 2007

Through a multiple perspectives model that incorporates the normative, symbolic, and political perspectives, the author analyzes the emergence of standards-based accountability reform in the state of Wisconsin. His analysis offers insight into the effectiveness of various political actors' attempts to alter the state's education systems. Through this case study, the author contends that these policy makers' attempts to reform Wisconsin's systems of education are kept in check by the principles of cheap and local reform. Thus, to achieve change, these principles of cheap and local reform create a policy environment in which stakeholders must offer a continuous series of reform initiatives in hope that some of their policies might slip through an open policy window.
Teachers' Mathematics Knowledge for Teaching and School Context
Authors: Hill Heather C. , Lubienski Sarah Theule
Published: October 2007

This article examines the relationship between the mathematical knowledge of 438 K-8 California teachers and the demographics of the schools in which they work. To measure mathematical knowledge, we used a series of multiple-choice problems meant to represent both the content teachers teach and the specialized knowledge of mathematics that teachers might possess. Teachers in schools with higher proportions of low-SES and Hispanic students performed more poorly on these measures than did teachers from other schools. Implications for policy and for further research are discussed.
Creating an Effective System of Teacher Preparation and Professional Development
Authors: Lobman Carrie , Ryan Sharon
Published: October 2007

With the expansion in publicly funded prekindergarten programs across the country, a number of policy initiatives are aiming to bring these various providers of preschool services together to create coordinated systems of early care and education. This article reports the findings of a focus group study with stakeholders at all levels of the preschool teacher development system in New Jersey after it had been in operation for 4 years. The reported experiences of these early childhood stakeholders offer insights into what is needed for such a system to work and the barriers preventing coordination of services and how they might be addressed in other states.
Evidence-Based Decision Making in School District Central Offices
Authors: Honig Meredith I. , Coburn Cynthia
Published: October 2007

District central office administrators increasingly face policy demands to use “evidence” in their decision making. These demands up the ante on education policy researchers and policy makers to better understand what evidence use in district central offices entails and the conditions that may support it. To that end, the authors conducted a comprehensive review of research literature on evidence use in district central offices, finding that the process of evidence use is complex, spanning multiple subactivities and requiring administrators to make sense of evidence and its implications for central office operations. These activities have significant political dimensions and involve the use of “local knowledge” as a key evidence source. Evidence use is shaped by features of the evidence itself and various organizational and institutional factors. Policy shapes evidence use, but other factors mediate its impact. The authors conclude with implications for future policy and research on central office evidence-based decision making.
Mchenga — urban poor housing fund in Malawi
Authors: Zeleza Manda Mtafu A.
Published: October 2007

The growth of slums in Malawi is largely attributed to failure by the urban poor to access land for housing. This paper outlines the background to the establishment of a federation of the urban poor in Malawi in 2003, which was formed with the support of a local NGO, the CCODE. The aim was to access land for housing and to build decent houses through savings groups. The paper also describes the operation of the Mchenga Fund for housing, and its progress and challenges over its four years of existence. It is noted that organizations of the urban poor have the potential, when given space, and state and external support, to contribute significantly not only to housing development but also to improving the lives of slum dwellers.
Housing microfinance in post-conflict Angola. Overcoming socioeconomic exclusion through land tenure and access to credit
Authors: Cain Allan
Published: October 2007

Angola's last four decades of near-continuous conflict have resulted in the displacement of over one-third of the population and massive damage to property and infrastructure. Social networks and local institutions were seriously eroded. The war has urbanized Angola, with an estimated 60 per cent of the population now living in the cities, three-quarters of them in informal peri-urban musseque settlements. They have no clear legal title to the land they occupy and suffer increasing social and economic exclusion that inhibits their full participation in a post-war recovery. Development Workshop is a human settlements NGO that has been working in Angola since 1981 and is developing approaches to postconflict shelter challenges. Two linked programmes are discussed in this paper. Development Workshop's KixiCasa housing microfinance model aims to address the issue of economic exclusion through the provision of microcredit. And together with Ministry of Urbanism and Environment, Development Workshop is piloting a land management strategy using upgradeable occupancy rights and land pooling to facilitate the regularization and securing of tenure rights for the poor. These approaches need to be scaled up significantly to begin to meet post-conflict housing and reconstruction needs and to mitigate against the resurgence of local level conflicts.
Shelter finance strategies for the poor: Philippines
Authors: Llanto Gilberto M.
Published: October 2007

In the Philippines, rapid urbanization casts a serious challenge to providing the urban poor with access to decent shelter. The urban poor lack access not only to appropriate housing but also to affordable, tenured, serviced land, shelter financing, targeted and sustainable subsidies and the means to provide their own shelter. This paper focuses on shelter finance strategies for the poor because it is a key instrument for addressing their shelter problem. The paper critiques the current shelter finance innovations that have been developed in the Philippines to provide for poor households, especially those in the informal sector, and identifies possible areas of improvement in shelter finance for them.
The Kuyasa Fund: housing microcredit in South Africa
Authors: Mills Sophie
Published: October 2007

This paper describes the Kuyasa Fund, a South African non-profit microfinance institution (MFI) that focuses solely on the provision of loans for use in housing. Launched in response to the shortfall in finance that is available to low-income state housing subsidy recipients, the Kuyasa Fund has grown rapidly over the past seven years and is poised for national expansion. This paper addresses the housing finance context and discusses some of the challenges facing housing microfinance in South Africa, and presents the Kuyasa methodology as a viable option for improving housing delivery.
The growth of “financial services” provided by Homeless International
Authors: Morris Ian , Mullard Kim , Jack Malcolm
Published: October 2007

For nearly 20 years, Homeless International has supported international partner organizations that work with slum communities to reduce poverty and improve living conditions. Its support has increasingly focused on partner organizations that are members of the Shack/Slum Dwellers International (SDI) network. The support has changed over time in response to the changing demands, but has increasingly been in the form of what Homeless International terms “financial services” — essentially, helping partners to access increased levels of capital to finance slum development projects on a growing scale. Homeless International now has a range of financial services that it provides to partners, depending on their stage of development and consequent needs. These include the Community-Led Infrastructure Finance Facility (CLIFF), which currently provides large-scale venture capital grants to partners in three locations; a guarantee facility that can encourage and persuade local banks to lend to partners for slum development; and a new mechanism that heralds the start of Homeless International lending directly to partners. This profile discusses only the financial services work of Homeless International and not the broader activities of the organization..
An offer of partnership or a promise of conflict in Dharavi, Mumbai?
Authors: Patel Sheela , Arputham Jockin
Published: October 2007

The first part of this paper, by Sheela Patel, provides a backdrop to Jockin's letter about the current government plans to redevelop Dharavi, a large inner-city township within Mumbai with hundreds of thousands of inhabitants and tens of thousands of enterprises. The second part is the text of an open letter by Jockin Arputham from the National Slum Dwellers Federation to the government and private developers that was released to the press in June 2007 and that received widespread coverage in newspapers and other media around the world. This open letter is an offer of partnership in such redevelopments from the organizations and federations of slum dwellers in Mumbai and elsewhere to government agencies and developers. But it is also a warning of the disruptions that the slum dwellers will bring if they are not involved in the planning and implementation of such redevelopments.
Informal mechanisms for accessing and securing urban land rights: the case of Kampala, Uganda
Authors: Nkurunziza Emmanuel
Published: October 2007

There is a growing consensus in research that informal settlements are not as chaotic as often portrayed. The processes through which households in these settlements access housing land are not anarchic but are structured and regulated by some form of social ordering. This paper analyzes and explains the nature of the institutions that actually regulate and underpin land delivery processes in Kampala's informal settlements. Contemporary land access processes are examined in three case study settlements where institutions that are responsive to the local contexts have been developed and utilized. These non-state institutions are shown to be eclectic in nature, drawing on various normative orders including state law, rules of market exchange and customary practices. Their success in delivering large quantities of housing land is attributed to the social legitimacy they command, evidenced by the general acceptance and respect they enjoy from those whose relations they regulate.
Flood risk in unplanned settlements in Lusaka
Authors: Nchito Wilma S.
Published: October 2007

Flooding in unplanned settlements in Lusaka is expected, even in years of normal rainfall. There is always much discussion of needed action when flooding occurs but, as soon as the seasonal rains stop, the incidents are forgotten. Most of the households affected by flooding are poor and the flooding damages or destroys their homes and belongings, which might have taken years to accrue. Poorer groups may be faulted for settling on sites at risk from flooding, but this is usually because they can find no safer alternative. In addition, as this paper shows, reducing flood risks in one settlement can increase flood risks in others. Local authorities need to be vigilant in stopping settlement in unstable zones and they need to increase awareness of the need for action in settlements already built in flood-prone areas. Ways also need to be sought to provide low-income households with alternatives to informal settlements in flood-prone sites. It is hard to stop people from erecting houses where they see vacant land. Since rain in Zambia is seasonal, many marshy areas have been built on during dry periods only to be flooded when the rains come. In the end, it is the poor who lose and a solution needs to be found before more lives and property are lost.