bluuebunny/crossref_metadata_2025 huggingface dataset:
Basis for a Rainfall Estimation Technique Using IR–VIS Cloud Classification and Parameters over the Life Cycle of Mesoscale Convective Systems
Authors: Delgado G. , Machado Luiz A. T. , Angelis Carlos F. , Bottino Marcus J. , Redaño Á. , Lorente J. , Gimeno L. , Nieto R.
Published: June 2008

This paper discusses the basis for a new rainfall estimation method using geostationary infrared and visible data. The precipitation radar on board the Tropical Rainfall Measuring Mission satellite is used to train the algorithm presented (which is the basis of the estimation method) and the further intercomparison. The algorithm uses daily Geostationary Operational Environmental Satellite infrared–visible (IR–VIS) cloud classifications together with radiative and evolution properties of clouds over the life cycle of mesoscale convective systems (MCSs) in different brightness temperature (Tb) ranges. Despite recognition of the importance of the relationship between the life cycle of MCSs and the rainfall rate they produce, this relationship has not previously been quantified precisely. An empirical relationship is found between the characteristics that describe the MCSs’ life cycle and the magnitude of rainfall rate they produce. Numerous earlier studies focus on this subject using cloud-patch or pixel-based techniques; this work combines the two techniques. The algorithm performs reasonably well in the case of convective systems and also for stratiform clouds, although it tends to overestimate rainfall rates. Despite only using satellite information to initialize the algorithm, satisfactory results were obtained relative to the hydroestimator technique, which in addition to the IR information uses extra satellite data such as moisture and orographic corrections. This shows that the use of IR–VIS cloud classification and MCS properties provides a robust basis for creating a future estimation method incorporating humidity Eta field outputs for a moisture correction, digital elevation models combined with low-level moisture advection for an orographic correction, and a nighttime cloud classification.
Comparison of Synthetic Aperture Radar–Derived Wind Speeds with Buoy Wind Speeds along the Mountainous Alaskan Coast
Authors: Fisher C. M. , Young G. S. , Winstead N. S. , Haqq-Misra J. D.
Published: June 2008

Satellite-borne synthetic aperture radar (SAR) offers the potential for remotely sensing surface wind speed both over the open sea and in close proximity to the coast. The resolution improvement of SAR over scatterometers is of particular advantage near coasts. Thus, there is a need to verify the performance of SAR wind speed retrieval in coastal environments adjacent to very complex terrain and subject to strong synoptic forcing. Mountainous coasts present a challenge because the wind direction values required for SAR wind speed retrieval algorithms cannot be obtained from global model analyses with as much accuracy there as over the open ocean or adjacent to gentle coasts where most previous SAR accuracy studies have been conducted. The performance of SAR wind speed retrieval in this challenging environment is tested using a 7-yr dataset from the mountainous coast of the Gulf of Alaska. SAR-derived wind speeds are compared with direct measurements from three U.S. Navy Oceanographic Meteorological Automatic Device (NOMAD) buoys. Both of the commonly used SAR wind speed retrieval models, CMOD4 and CMOD5, were tested, as was the impact of correcting the buoy-derived wind speed profile for surface-layer stability. Both SAR wind speed retrieval models performed well although there was some wind speed–dependent bias. This may be either a SAR wind speed retrieval issue or a buoy issue because buoys can underestimate winds as wind speed and thus sea state increase. The full set of tests is performed twice, once using wind directions from the U.S. Navy Operational Global Atmospheric Prediction System (NOGAPS) model analyses and once using wind direction observations from the buoys themselves. It is concluded that useful wind speeds can be derived from SAR backscatter and global model wind directions even in proximity to mountainous coastlines.
Rainy-Season Duration Estimated from OLR versus Rain Gauge Data and the 2001 Drought in Southeast Brazil
Authors: Franchito Sergio H. , Rao V. Brahmananda , Barbieri Paulo R. B. , Santo Clovis M. E.
Published: June 2008

Large precipitation deficits observed during the 2001 austral summer over the southeast region of Brazil contributed to the worsening of the energy crisis that was occurring in the country, with unprecedented social and economic consequences. Reliable information on the beginning of the rainy season was essential for the Brazilian government to manage the energy crisis. The purpose of this study is to determine the rainy season in this region and to point out the risk of using outgoing longwave radiation (OLR) data to estimate the beginning of it. The results show that when OLR data are used the beginning and the end dates of the rainy season are wrongly anticipated and delayed, respectively. The present study aims to provide useful information for the management of the impact of adverse climate conditions such as the one in 2001 by basing the analysis on rainfall data instead of on OLR.
Effects of Atmospheric Turbulence on Ballistic Testing
Authors: Frehlich Rod , Sharman Robert , Clough Charles , Padovani Michael , Fling Kelly , Boughers Ward , Walton W. Scott
Published: June 2008

The effects of atmospheric turbulence on munition target scatter are determined from numerical simulations of ballistic trajectories through many realizations of realistic simulated turbulent wind fields. A technique is evaluated for correcting for the effects of turbulence on ballistic testing procedures by using a line of sonic anemometer measurements taken along the trajectory path. The metric used to evaluate the correction is the difference between the target impact scatter produced with and without the use of the anemometers in the trajectory calculations. The improvement in the testing procedure as measured by this metric is determined as a function of the number of sonic anemometers in the line and the sonic averaging time interval. The performance of the simulations is also compared with data from a field test for a standard small-caliber munition, and the predicted and observed target scatter are in good qualitative agreement, supporting the feasibility of the approach.
Robust model following control for a class of second-order dynamical systems subject to parameter uncertainties
Authors: Duan Guang-Ren , Ling Huang
Published: June 2008

A robust model following control for a class of second-order dynamical systems subject to parameter uncertainties is considered in this article. The problem is decomposed into two subproblems: a robust state feedback stabilization problem for second-order dynamical systems subject to parameter uncertainties and a robust compensation problem. The latter concerns solution of three coefficient matrices such that five matrix equations are met and, simultaneously the effect of the uncertainties to the tracking error is minimized. Based on a complete parametric solution to a class of the second-order generalized Sylvester matrix equations, the robust compensation problem is turned into a minimization problem with linear constraints. The set of linear equations is derived that determines the solution to the minimization problem. A numerical example is given to demonstrate the validity of the results.
Autopoiesis and the Cosmology of Postmodern Adult Education
Authors: Ostrom Christopher Sean , Martin William Jay , Zacharakis Jeff
Published: June 2008

From the time adult education emerged as a field of study, it has suffered a crisis of identity by which the field is increasingly defined by a lack of consensus regarding its larger aspirations and operational boundaries. The purpose of this article is to begin deconstructing and reconstructing the field of adult education phenomenologically by (a) exploring the basic historical assumptions and socially constructed, collectivist realities on which adult education founded its theory and practice in the modern era, (b) elucidating the postmodern turn these realities have taken in the past half century, and (c) reconciling adult education's historical mission with new realities facing the field. This article ultimately concludes that any viable conception of adult education must not only make postmodern individuals better competitors in the global marketplace, but must also help them and the organizations they comprise to define themselves within a larger autopoietic web of relations.
Increased Intracranial Pressure in a Case of Pediatric Multiple Sclerosis
Authors: Williams Brice J. , Skinner Holly J. , Maria Bernard L.
Published: June 2008

A 15-year-old girl presented to our emergency department with dizziness, anorexia, nausea, and malaise. Clinical examination and magnetic resonance imaging studies showed characteristic features of multiple sclerosis. Surprisingly, a diagnostic lumbar puncture showed significant intracranial hypertension in addition to numerous oligoclonal bands, elevated immunoglobulin G index and immunoglobulin G/albumin ratio in the cerebrospinal fluid. It is proposed that a large burden of active demyelinating disease may cause increased intracranial pressure, thus providing an additional sound rationale for prompt therapeutic administration of intravenous high-dose steroids.
Ambulatory Electroencephalography (EEG) in Children: Diagnostic Yield and Tolerability
Authors: Wirrell Elaine , Kozlik Silvia , Tellez Jose , Wiebe Samuel , Hamiwka Lorie
Published: June 2008

Sixty-four children, aged 0-17 years, undergoing ambulatory electroencephalography (EEG) were prospectively recruited during a 12-month period. The diagnostic yield of ambulatory electroencephalography was determined for each of the following groups: group 1: differentiation of seizures from nonepileptic events; group 2: determination of seizure/interictal discharge frequency; and group 3: classification of seizure type or localization. The ambulatory electroencephalography answered the clinical question in 61% of group 1 (27/44) and 100% of groups 2 (16/16) and 3 (4/4). Of 44 cases in Group 1, clinical events were recorded in 61%; the ambulatory electroencephalography result changed the diagnosis from epileptic to nonepileptic or vice versa in 27%. When clinicians suspected that events were epileptic, ambulatory electroencephalography changed the clinical impression in 50%, whereas when events were suspected to be nonepileptic, ambulatory electroencephalography confirmed that impression in 83%.
Mystical Experience in the Context of Health Care
Authors: Witte Alison S. , van der Wal Dirk M. , Steyn H. Chrissie
Published: June 2008

Eighteen participants in a rural Appalachian community were interviewed to learn about their mystical experiences in the context of health care. Semistructured interviews addressed factors initiating mystical experience and essential qualities of mystical experience. Nursing process and the nurse's response were examined. Data were analyzed using the immersion/crystallization method and concept mapping. Mystical experience was conceptualized as a process incorporating initiation, occurrence, maturation, and integration of mystical experience. Essential qualities included sensory–motor perception, interaction with the supernatural, interaction with family members, conviction of reality, cognition, dynamic tension and emotional intensity. Nursing interventions included listening and support. Subjective nursing responses included tension, intimacy and empathy, sense of awe, autonomic responses, and appreciation of the mystical in everyday life. Various stressors are associated with mystical experience. Patients having mystical experiences may benefit from nursing support.
Nursing Students' Perceptions of a Holistic Nursing Conference
Authors: Christiaens Glenda , Abegglen JoAnn , Rowley Alanna
Published: June 2008

Purpose: The purpose of the study was to describe nursing students' perceptions of their experiences at the 2007 annual conference of the American Holistic Nurses Association (AHNA), and identify benefits of professional conference attendance as an educational strategy for undergraduate nursing students. Method: Sixteen nursing students attended the 2007 AHNA annual conference and made daily journal entries about their perceptions of the conference. Using a descriptive qualitative approach, researchers analyzed their journal entries for recurring themes. Findings: Themes suggested that nursing students gained knowledge about holistic nursing and felt empowered through personal interactions with national holistic nursing leaders. They felt motivated to incorporate holistic nursing principles into practice and self-care. In addition, they expressed an appreciation for the importance of lifelong learning and maintaining clinical competency through attendance at a professional conference. Implications for Education: Nursing students' attendance at a holistic nursing professional conference is a useful educational strategy that has many benefits.
Special Section: The Skillful Body as a Concernful System of Possible Actions
Authors: Rietveld Erik
Published: June 2008

For Merleau-Ponty, consciousness in skillful coping is a matter of prereflective `I can' and not explicit `I think that.' The body unifies many domain-specific capacities. There exists a direct link between the perceived possibilities for action in the situation (`affordances') and the organism's capacities. From Merleau-Ponty's descriptions it is clear that in a flow of skillful actions, the leading `I can' may change from moment to moment without explicit deliberation. How these transitions occur, however, is less clear. Given that Merleau-Ponty suggested that a better understanding of the self-organization of brain and behavior is important, I will re-read his descriptions of skillful coping in the light of recent ideas on neurodynamics. Affective processes play a crucial role in evaluating the motivational significance of objects and contribute to the individual's prereflective responsiveness to relevant affordances.
Special Section: Mind the Methodology
Authors: van de Laar Tjeerd
Published: June 2008

In this paper I compare heterophenomenology and neurophenomenology as methodologies for a science of consciousness. I give introductions of heterophenomenology (HP) and neurophenomenology (NP), respectively. Than I briefly relate HP and NP to mainstream cognitive science methodology and to each other. I claim that although HP and NP are indeed different methodologies for studying consciousness, in practice it will be very hard to decide on which methodology we should prefer since, given the research that is currently available, both methodologies seem to allow for the same range of experiments. Given the fact that HP excludes the validity of conclusions drawn by means of NP, it seems that we do have to choose between them, nonetheless. My goal is, however, to see whether there currently are reasons for rejecting HP or NP as unreliable or invalid across the board. I conclude that for the time being we had better keep both HP and NP in the running.
Catastrophic antiphospholipid syndrome mimicking a malignant pancreatic tumour – a case report
Authors: van Wissen S , Bastiaansen BAJ , Stroobants AK , van den Dool EJ , Idu MM , Levi M , Stroes ESG
Published: June 2008

Abstract

The catastrophic antiphospholipid syndrome is characterised by rapid onset thromboses, often resistant to conventional anticoagulant treatment, and resulting in life threatening multiple organ dysfunction. The diagnosis of catastrophic antiphospholipid syndrome may be difficult, predominantly due to its frequently atypical presentation. We report a case of a 35-year-old female who presented with a pancreatic tumour and extensive thromboses. Following a storm of ischemic events due to thrombotic occlusions in spite of therapeutic heparin dose, the suspicion of catastrophic antiphospholipid syndrome emerged. The patient was successfully treated with anticoagulants, immunuglobulins, plasmapheresis and rituximab. The present report shows that the use of the diluted Russell’s viper venom time can be helpful in providing additional information on the lupus anticoagulans antibody status, allowing careful monitoring of lupus anticoagulans conversion and hence response to therapy.
Extracellular signal–regulated kinase 1/2 signalling in SLE T cells is influenced by oestrogen and disease activity
Authors: Gorjestani S , Rider V , Kimler BF , Greenwell C , Abdou NI
Published: June 2008

Systemic lupus erythematosus (SLE) is an autoimmune disease that occurs primarily in women of reproductive age. The disease is characterized by exaggerated T-cell activity and abnormal T-cell signalling. The mitogen-activated protein kinase (MAPK) pathway is involved in the maintenance of T-cell tolerance that fails in patients with SLE. Oestrogen is a female sex hormone that binds to nuclear receptors and alters the rate of gene transcription. Oestrogen can also act through the plasma membrane and rapidly stimulate second messengers including calcium flux and kinase activation. In this study, we investigated whether oestrogen influences the activation of MAPK signalling through the phosphorylation of extracellular signal–regulated kinase 1/2 (ERK1/2) in activated SLE T cells. SLE and control T cells were cultured in serum-free medium without and with oestradiol (10−7 M) for 18 h. The T cells were activated with phorbol 12 myristate 13-acetate and ionomycin for various time points (0–60 min), and the amount of phosphorylated ERK1/2 was measured by immunoblotting. There were no differences in ERK1/2 phosphorylation between SLE and control T cells at 5 and 15 min after the activation stimulus. However, comparison between the amount of phosphorylated ERK1/2 in SLE T cells from the same patients cultured without and with oestradiol showed a significant oestrogen-dependent suppression ( P = 0.48) of ERK1/2 in patients with inactive/mild systemic lupus erythematosus disease activity index (SLEDAI) (0–2) compared with patients with moderate (4–6) or active (8–12) SLEDAI scores. These results suggest that the suppression of MAPK through ERK1/2 phosphorylation is sensitive to oestradiol in patients with inactive or mild disease, but the sensitivity is not maintained when disease activity increases. Furthermore, studies are now necessary to understand the mechanisms by which oestrogen influences MAPK activation in SLE T cells.
Promoter polymorphisms in the IRF3 gene confer protection against systemic lupus erythematosus
Authors: Akahoshi M , Nakashima H , Sadanaga A , Miyake K , Obara K , Tamari M , Hirota T , Matsuda A , Shirakawa T
Published: June 2008

In order to identify a novel candidate gene in systemic lupus erythematosus (SLE), we analysed a panel of six genes encoding molecules involved in the type I interferon (IFN) system. We first identified variants in the five genes related to type I IFN pathway by sequencing. Genotyping of a panel of eight selected single-nucleotide polymorphisms (SNPs) in six candidate genes ( TLR9, MYD88, IRF3, IRF7, IFNB1, IFNA17) was performed in 137 patients with SLE and matched with 152 healthy controls using polymerase chain reaction-restriction fragment length polymorphism analysis. In functional assay, quantitative real-time polymerase chain reaction was performed to assess constitutive IRF3 mRNA expression in peripheral blood mononuclear cells from healthy subjects with different IRF3 promoter haplotypes. Among eight SNPs genotyped, an IRF3 SNP at –925 was found to be associated with SLE after correction for multiple tests (corrected P = 0.016). Of total five IRF3 SNPs genotyped, the promoter IRF3 SNPs –925A/G and –776C/T showed the most significant association with SLE. With regard to –925A/G, the frequency of GG genotype was significantly decreased among SLE patients compared with the control group (1.5% vs. 9.9%; χ2 = 10.0, P = 0.0015, odds ratio 0.12, 95% confidence interval 0.027–0.554). Our experimental data indicated that constitutive IRF3 mRNA expression was significantly lower in cells carrying the minor G-T/G-T haplotype pair compared with those carrying the major A-C haplotype. In conclusion, we showed that the promoter SNPs of the IRF3 gene were significantly associated with resistance against SLE.
Resource Disparities in Treating Persons With Disabilities for Four Common Cancers
Authors: Chirikos Thomas N. , Roetzheim Richard , McCarthy Ellen P. , Iezzoni Lisa I.
Published: June 2008

This study explored whether cumulative Medicare outlays on breast, colorectal, lung, and prostate cancer treatment differ between persons with versus without disabilities. The authors used linked Surveillance, Epidemiology and End Results—Medicare data to compute reimbursements between cancer cases originally entitled to Medicare because of Social Security Disability Insurance (SSDI) and those receiving Old Age and Survivors Insurance (OASI) benefits. They examined differential outlays between these two subgroups by Medicare Part A and Part B services and by treatment phase to gauge whether disability-related resource disparities occur. The findings are mixed, with persons with disabilities treated for lung cancer most likely to experience such disparities. The SSDI subgroup had lower Part B outlays in all four cancers, but some of these were canceled out by higher Part A reimbursements.
Alternative Dispute Resolution
Authors: Mueller Tracy Gershwin
Published: June 2008

The number of due process hearings between parents of children with disabilities and school districts is growing nationwide. This litigation costs millions of dollars and destroys the relationships between the home and school envisioned during the creation of the Individuals with Disabilities Education Act. This article provides a discussion of the status of our nation with regard to conflict between families and school districts. Current dispute resolution procedures, such as due process, formal complaints, and mediation, are all discussed as they relate to this growing national problem. Information regarding resolution meetings and alternative dispute resolution strategies are also discussed, as well as recommended structures for practicing appropriate dispute resolution in special education.
Sociodemographic background, lifestyle and psychosocial conditions of Swedish teenage mothers and their perception of health and social support during pregnancy and childbirth
Authors: Wahn Elisabeth Hertfelt , Nissen Eva
Published: June 2008

Aim: Among Swedish pregnant teenage girls it is unusual to continue pregnancy and to choose to have a baby. Swedish teenage mothers can therefore be expected to differ from adult mothers, at a group level. The aim of this study was to describe and compare teenage mothers who were giving birth in hospital with adult mothers as to sociodemographic background, perception of health and social support. Methods: A descriptive comparative study was conducted over one year, in a county in south-western Sweden, which comprised a group of all teenage mothers aged 15—19, who gave birth at hospital (study group n=97) and the same number of adult mothers aged 25—29, matched for parity and birth of a baby closest to the index mother (reference group). Both groups answered a questionnaire regarding sociodemographic variables, lifestyle, health, self-esteem, depressive symptoms, and support. Information on the mothers' pregnancy and delivery was obtained from their maternal health and delivery charts. Results: Teenage mothers had more often been exposed to a difficult family situation, had more often experienced school failure than adult mothers, and showed health-risk behavior. Teenage mothers perceived less support, had lower self-esteem, and more depressive symptoms than adult mothers. Conclusions: Teenage mothers differed from adult mothers regarding family situation and health behavior as well as perception of support, self-esteem, and depressive symptoms, which may negatively influence their ability to cope with parenthood. Efforts should be made early in pregnancy to meet both health and support needs of teenage mothers.
The association between mental health problems and inflammatory conditions across gender and immigrant status: A population-based cross-sectional study among 10th-grade students
Authors: Lien Lars
Published: June 2008

Aim: The aim of this study was to describe the prevalence of and investigate the association between mental health problems, asthma, allergy and eczema in Norwegian and immigrant youths. Methods: A cross-sectional study was performed of all 10th-grade students in Oslo, Norway, in two school years; 1999—2000 and 2000—2001. Of the 8316 eligible students, 7345 (88.3%) participated. Internalized mental problems were measured using the Hopkins Symptom Check List 10-version, and two subscales of the Strength and Difficulties Questionnaire were used to study externalizing mental health problems. All questions are based on self-report, and 25% of the sample had an immigrant background. Results: Immigrant boys had higher scores on internalizing problems than Norwegian boys. First-generation immigrants reported less asthma and eczema than Norwegians. The strongest association between mental health problems and inflammatory conditions was for allergy and internalizing problems for boys (odds ratio (OR)=2.5 for immigrants and OR=1.8 for Norwegians). For girls, it was allergy in Norwegians (OR=1.6) and asthma for immigrants (OR=2.2). For externalizing problems, the association was strongest for asthma in boys and eczema in girls. Immigrant boys had stronger associations between number of inflammatory conditions and internalizing mental health problems than Norwegians (OR=3.2 vs. OR=2.4). Among girls, the figures were 1.7 for Norwegians and 1.8 for immigrants. Conclusions: There is a strong association between number of inflammatory conditions and internalizing mental health problems, especially among boys with an immigrant background. The association with externalizing mental health problems was less prominent.
Multidisciplinary patient education in groups increases knowledge on osteoporosis: A randomized controlled trial
Authors: Nielsen Dorthe , Ryg Jesper , Nissen Nis , Nielsen Winnie , Knold Berit , Brixen Kim
Published: June 2008

Introduction: Specific pharmacological treatment reduces the incidence of fractures significantly in patients with osteoporosis. Unfortunately, compliance with such therapy is low in clinical practice and is inversely related to educational level. We hypothesized that patients' knowledge of osteoporosis may be increased by a group-based multidisciplinary education programme. Methods: Three hundred patients, aged 45—81 years, recently diagnosed with osteoporosis and started on specific treatment, were randomized to either the "school'' or "control'' group. Teaching was performed by nurses, physiotherapists, dieticians, and doctors, and designed to increase the patient's empowerment. The patient's knowledge of osteoporosis was tested at study entry and at 3 months using a validated questionnaire. Results: At study entry, no differences in age or score (22 (18—24) (median (25—75 percentiles)) vs. 22 (18—24)) were seen between the school and control groups. The change in knowledge during the study, however, differed significantly between the two groups (p<0.001). In the school group, the increase in knowledge score correlated inversely with the level of education; that is, the lower the education level, the higher the gain in knowledge during the course (Rho=-0.25, p<0.01). Conclusions: A group-based multidisciplinary education programme significantly increases patients' knowledge of the disease.
Sense of coherence in three cross-sectional studies in Northern Sweden 1994, 1999 and 2004 — patterns among men and women
Authors: Hendrikx Tijn , Nilsson Mats , Westman Göran
Published: June 2008

Aims: To explore changes in sense of coherence (SOC) over a 10-year period in the general population in northern Sweden. Methods: Three cross-sectional surveys from 1994 (n=1802), 1999 (n=1698) and 2004 (n=1777), conducted within the northern Sweden MONICA Project, were compared. Participants answered questions about gender, age, experience of disease, perceived health, psychosocial factors and Antonovsky's SOC scale with 13 items. Results: A small, but significant, decrease in SOC medians and a shift of cumulative distributions towards slightly lower SOC values were seen both in the total study population and in its male and female subgroups between 1994 and 1999. No changes were seen between 1999 and 2004, with the exception of women between 25 and 44 years of age, who showed a continuous decrease. Conclusions: The present study shows that SOC at a population level in northern Sweden, within a 10-year span, is relatively stable, not withstanding minor changes. These small changes might be attributed to societal changes in Sweden during the 1990s and an increase in ``minor'' psychiatric complaints in the Swedish population as a whole during the same period.
Ventilator-associated pneumonia and new airway technologies
Authors: Yarham Sarah , Young Peter
Published: June 2008

Current endotracheal and tracheostomy tubes have high volume low pressure cuffs. These cuffs are ineffective at preventing the ongoing pulmonary aspiration of oropharyngeal and gastric contents. This ubiquitous complication of intubation is the most important cause of ventilator-associated pneumonia (VAP), the commonest and most devastating nosocomial infection in the Intensive Care Unit (ICU). Current tracheal tubes are made of relatively fixed curved PVC, and this produces forces on the airway tissues which is associated with laryngeal and tracheal injury. There is a need for the development of tracheal tube technologies to prevent aspiration injury and the reduce airway injury associated with mechanical ventilation of the critically ill. Given the costs associated with VAP there is currently a massive mismatch in what we spend on prevention.
Fractures of the distal humerus
Authors: Youssef B. , Youssef S. , Ansara S. , Porter K.
Published: June 2008

Fractures of the distal humerus are challenging injuries to treat. They are rare injuries and frequently involve the joint. The advent of modern operative fixation techniques has led to an increasing trend towards open anatomical reduction and internal fixation of these fractures. This review examines the basic anatomy of the distal humerus and the applied anatomy with regards to fracture classification and surgical approach. This is followed by a discussion of the methods and results of treatment.
Rehabilitation in COPD: the long-term effect of a supervised 7-week program succeeded by a self-monitored walking program
Authors: Ringbaek T , Brøndum E , Martinez G , Lange P ,   and Pulmonary Rehabilitation Research Group
Published: June 2008

Pulmonary rehabilitation in chronic obstructive pulmonary disease (COPD) improves exercise tolerance and health status, however, these effects have been shown to decline after termination of the rehabilitation program. This study has examined the long-term effect of a 7-week supervised rehabilitation program combined with daily self-monitored training at home on exercise tolerance and health status. Two hundred and nine consecutive COPD patients who had completed a 7-week pulmonary rehabilitation program were assessed with endurance shuttle walk test (ESWT) and the St George's Respiratory Questionnaire (SGRQ) at baseline, 0, 3, and 12 months after the program. Sixty-eight (32.5%) patients did not attend the 1-year follow-up. Among the 141 patients who competed the 1-year evaluation, the initial improvement after the 7-week program in the ESWT time was 180 s or 101% ( p = 0.001) and in SGRQ 3.4 units ( p = 0.001). These effects were maintained at the 1-year evaluation (ESWT 59% above baseline; p < 0.001 and improved SGRQ 3.0 units compared with baseline; p = 0.011). The 31 patients who attended the 6-month, but not the 12-month evaluation, improved ESWT time by 96 s ( p = 0.02) without any change in SGRQ +2.0 ( p = 0.40). A relative simple and inexpensive 7-week supervised rehabilitation program combined with daily self-monitored training at home was able to maintain significant improvement in exercise tolerance and health status throughout 1 year. Death and hospital admissions due to acute exacerbations were the main reasons for non-attendance in the follow-up period.
Oxygen conserving devices and methodologies
Authors: Tiep B , Carter R
Published: June 2008

Collective experience with pulmonary rehabilitation and disease management has shown that patients with lung diseases including COPD and restrictive lung diseases live a longer and more productive quality of life if they can remain active. Patients who require oxygen supplementation but can otherwise be active should have the most portable and non-encumbering systems possible. Oxygen conserving devices have made a high level of portability possible. Small gas, liquid and even some concentrators have replaced the 20 pound E cylinder with 4 and 5 pound systems. In a parallel physiological development, exercise plus oxygen increases the physiological benefits of exercise and thereby enhances the patient's ability to function in life. This paper examines available options and their mechanical and physiological foundations.
Designing the Process Evaluation for the Collaborative Planning of a Local Turning Point Partnership
Authors: Tolma Eleni L. , Cheney Marshall K. , Troup Pam , Hann Neil
Published: June 2008

This study describes the design of the process evaluation of a collaborative effort among community partners to address health issues in central Oklahoma. The design is an application of a sound process evaluation planning framework that integrates the components of context, reach, dose delivered, dose received, fidelity, implementation, recruitment, barriers, and maintenance. The planning framework also provides guidance regarding the steps of designing and implementing the process evaluation. This planning process was conducted by utilizing a participatory research approach. At the end of the planning phase, the evaluation team accomplished the following: (a) development of an evaluation plan, (b) development of evaluation instruments (i.e., surveys, interview guides, observation forms), and (c) development of evaluation questions and process objectives. The information derived from this study can be valuable to practitioners and researchers involved in the planning of community partnerships or coalitions and interested in process evaluation that takes place in community settings.
Science for all
Authors: Plonczak Irene
Published: June 2008

This article addresses issues that are related to the empowerment of elementary teachers through teaching and learning science in socially and culturally meaningful contexts. It is based on the analysis of the attitudes and relationship to science of 10 elementary school teachers from inner city schools in Caracas, Venezuela. In the context of a workshop, teachers were asked to come up with a scientific explanation of a familiar physical phenomenon observed on a daily basis and related to their everyday tasks. The data were the teachers' discourse and were both written (a description of an ideal science class) and oral (semi-structured interviews). Academic/epistemic, professional, and social dimensions were used to analyze the discourse. These categories were based on two theoretical frameworks: an empirico-realistic one, held by the majority of teachers, and a socioconstructivist one, held by the researcher. The results illustrate how familiar contexts bring meaning and raise teachers' confidence to teach science, which contributes to the development of a more empowering attitude towards science.
A critical approach to researching social justice and school leadership in England
Authors: Taysum Alison , Gunter Helen
Published: June 2008

This article investigates how school leaders in England understand and describe social justice in terms of their own lived lives. By this we mean how they understand equity issues by recognizing the ways in which they themselves have experienced inclusion or exclusion in their lives. We then go on to examine how this way of knowing shapes the way school leaders want to operationalize social justice in their schools. The research is based on semi-structured interviews with 14 school leaders. The empirical evidence was read through Cribb and Gewirtz' (2003) conceptual framework of social justice. Theorizing in this way revealed that handling challenging professional issues, such as the national curriculum, enabled school leaders to work for cultural justice, distributive justice, and associational justice in their school communities. It is argued such activity impacts on dimensions of quality and performance in working for change in educational institutions.
Incorporation of new technique for processing of Al/SiCp composites based on evaporative pattern casting (EPC) method
Authors: Golestanipour M. , Bagheri R. , Sadeghian M. H.
Published: June 2008

A336 Al matrix composites containing different volume fraction and mean mass particle size of SiC particles as the reinforcing phase were synthesised by evaporative pattern casting (EPC) route. The process consisted of fabricating of EPS/SiCp composite pattern followed by EPC of A336 Al alloy. The EPS/SiCp pattern was made by blending SiC particles with expandable polystyrene (EPS) beads and placing them in expanding mould heating with steam until EPS beads expand completely. Uniform distributed SiC particles around the EPS beads and locally movement of them during pouring and degradation leads to homogenous distribution of particles in final Al/SiCp composite. Higher modulus, strength and hardness were observed in the composites than the unreinforced Al alloy part. The fracture surfaces of the composite samples exhibited dimple surfaces and fracture in SiC particles.
Implementation of an NHS First Trimester Screening Clinic
Authors: Taylor Myles J. , Liversedge Helen M. , James Allan
Published: June 2008

We aimed to improve trisomy 21 and maternal screening by introducing a 'one-stop' NHS first trimester screening clinic (FTSC). We offered first trimester ultrasound assessment of nuchal translucency (NT), measurement of serum free βHCG and Papp-A, along with maternal screening tests (full blood count, rubella, hepatitis B, syphilis, HIV and midstream urine culture). We restructured antenatal clinics, developed clear algorithms, provided detailed patient information and consent leaflets, ensured high standards of ultrasound and serum biochemistry measurement. After one year, completion of screening improved (60–91%) whilst maintaining a high trisomy 21 detection rate (89%) along with a 23% reduction in number of invasive procedures. A reliable FTSC can be introduced which complements existing NHS maternity care.
Two Interesting Cases of Placental Accident and the Role of Ultrasound in their Management
Authors: Anev Ivan , Kumar Bidyut
Published: June 2008

Morbid adhesion of the placenta and placental abruption are abnormalities associated with significant maternal and fetal morbidity and mortality. Early recognition and appropriate management of these placental accidents may play a vital role in preventing fetal and maternal complications. The two cases discussed here were recently managed in the setting of a consultant led obstetric unit in a District General Hospital in North Wales, UK.
Russell–Silver Syndrome Presenting as Early Asymmetric IUGR
Authors: Khalil Haroona , Edwards Hazel , Preston Jane
Published: June 2008

We report a case of severe intrauterine growth restriction (IUGR) which was diagnosed as Russell–Silver syndrome (RSS) postnatally. RSS (also known as Silver–Russell syndrome) is one of more than 300 recognised forms of genetic disorder that leads to short stature. Uniparental disomy for chromosome 7 (UPD7), i.e. inheriting two copies of chromosome 7 from the mother, and a change in methylation pattern (biochemical silencing of gene expression) of chromosome 11 are the most frequently associated chromosomal defects. A wide spectrum of appearances and symptoms are associated with the condition. Most characteristics are not easily identifiable with prenatal diagnostic ultrasound. The symptom most likely to be detected sonographically is IUGR. This case seeks to raise awareness of RSS, and encourages clinicians to consider uncommon genetic disorders such as RSS as a possible cause of early asymmetric IUGR.
Results of a Survey of Exposure Conditions used in Ultrasound Scans in the UK, February 2007
Authors: ter Haar Gail
Published: June 2008

The Safety Committee of BMUS (British Medical Ultrasound Society) carried out a survey of the output levels in common usage during normal clinical ultrasound scanning in the UK. The aim of this study was to gain a snapshot view of ultrasound scanning between 14 and 16 February 2007. BMUS members in ultrasound departments were invited to provide information for as many examinations as possible carried out on one of these days. Details about the type and duration of examination, transducer frequency, scan mode and the safety indices (mechanical index, MI, and thermal index, TI) displayed were requested. Users were asked to record the starting and finishing MI and TI, and the highest level that each reached during an examination (MImax and TImax). They were also requested to provide information about the type of TI being displayed (TIB–bone thermal index, TIS–soft tissue thermal index, TIC–cranial thermal index). 309 examinations, carried out on 60 different ultrasound machines, were reported. The longest scan time used was 34 minutes, Mechanical Indices in the range 0·1–1·6 and Thermal Indices up to 2·5 were reported. All examinations, apart from three, fell within the safety guidelines published on the BMUS website.
Investigation of interfacial reaction between eutectic Sn–Pb solder droplet and Au/Ni/Cu pad
Authors: Li F. Q. , Wang C. Q. , Tian Y. H.
Published: June 2008

The basic process of molten droplet solder bumping and interfacial reaction between molten Sn–Pb droplet and Au/Ni/Cu under bump metallurgy (UBM) pad was investigated in the present paper. The morphology of intermetallic compounds was strongly influenced by the initial temperature of the solder droplet. When the initial temperature 350°C was reached, a continuous AuSn2 and needle like AuSn4 were formed at the solder bump/pad interface. When the initial temperature 450°C was reached, all the AuSn2 converted into AuSn4. Rod like AuSn4 grew strongly, some acicular AuSn4 was distributed inside the solder near the interface. Under the condition that the substrate was preheated, interfacial reaction is more intensive at the molten stage. Results of the calculation have shown that compared with the initial height of droplet, the contact temperature is mainly dependent on the initial temperature. To elucidate intermetallic formation mechanism at the interface, the pad/solder temperature field was analysed using finite element method (FEM).
Characterisation of dynamic recovery during hot deformation of spray formed Al–Li alloy (UL40) using processing map approach
Authors: Jagan Reddy G. , Srinivasan N. , Gokhale A. A. , Kashyap B. P.
Published: June 2008

Processing maps, also known as power dissipation maps, for spray formed Al–Li alloy (UL40), encompassing a wide range of hot working temperature (375–575°C) and strain rate (3 × 10−4–101 s−1) have been developed. The constant true strain rate compression tests were carried out under isothermal conditions to generate the stress–strain data required for computing the efficiency of power dissipation η. The maps exhibit three distinct regimes. The two high efficiency (>55%) regimes occur at the low strain rates (<10−3 s&minus1) and at the high strain rates (>1 s−1), and the other with moderate efficiency values (20–23%) occurs at the intermediate strain rate (10−1 s−1). The latter one has been interpreted to be associated with dynamic recovery (DRV) process while the other two regimes have been found to be associated with cracking processes. The DRV regime in the map has been characterised in terms of stress–strain response, microstructure and tensile ductility. The kinetic rate analysis carried out in the DRV regime suggested that the thermally activated cross-slip is the rate controlling mechanism for the DRV process. The effect of Li addition on the optimum deformation condition of DRV in Al has also been discussed qualitatively.
Impact of Mg addition on solidification behaviour of Al–7%Si alloy
Authors: Nafisi S. , Emadi D. , Ghomashchi R.
Published: June 2008

The impact of Mg addition to Al7Si alloy is investigated using thermal and image analyses. It is shown that Mg expands α-Al solidification range and eutectic forms over a thermal range. For alloys containing less than 0·6%Mg, differential scanning calorimetry analysis and thermodynamic calculations are incapable of predicting the formation of Mg2Si phase during solidification. Furthermore, Mg addition leads to the formation of greater percentage of α-Al primary phase which is beneficial during semisolid processing of hypoeutectic Al–Si alloys.
Experimental investigation and modelling of microstructural variables of Al–4Cu–Mg alloy
Authors: Lu Y. L. , Li M. Q. , Li X. C.
Published: June 2008

The effects of process parameters on microstructural evolution, including grain size and shape factor of the α solid particles during semisolid compression of an Al–4Cu–Mg alloy, were investigated. Experiments were conducted at deformation temperatures of 540, 560 and 580°C, strain rates of 0˙001, 0˙01, 0˙1 and 1 s–1, and height reductions of 20, 40 and 60%. All of the optical micrographs and quantitative metallography showed that deformation process parameters significantly affect the microstructure during semisolid compression of Al–4Cu–Mg alloy, which appears to have a fuzzy characteristic. According to the experimental results from the semisolid compression of Al–4Cu–Mg alloy, a model has been established to describe microstructural evolution by applying a fuzzy set and artificial neural network, which integrates the learning power of neural networks with fuzzy inference systems. The model presented in the present paper can be applied to predict the microstructural changes at deformation temperatures of 540–580°C and strain rates of 0˙001–1 s–1. The maximum relative difference of grain size is 9˙34%. The predicted results are in satisfactory agreement with the experimental results.
Theoretical study of Ni–Al nanoalloy clusters using particle swarm optimisation algorithm
Authors: Zhou J. C. , Li W. J. , Zhu J. B.
Published: June 2008

The global structural optimisations for Ni–Al nanoalloy clusters at different compositions have been investigated using particle swarm optimisation combined with simulated annealing method. The second moment approximation of the tight binding potential has been used in describing the interatomic interactions. Some stable structures were obtained for NixAlx( x=1–8), Ni3xAlx( x=1–4) and NixAl3x( x=1–4) nanoalloy clusters. The simulation results show that the lowest energy isomers of nanoalloy clusters with the approximate composition ‘NiAl, Ni3Al and NiAl3‘ generally have structures based on icosahedral packing. It is confirmed that segregation is favoured for Ni–Al nanoalloy clusters, with the surface becoming richer in Al and the core becoming richer in Ni.