bluuebunny/crossref_metadata_2025 huggingface dataset:
The Potential for Mesoscale Visibility Predictions with a Multimodel Ensemble
Authors: Ryerson William R. , Hacker Joshua P.
Published: January 2014

This work examines the viability of producing short-range (<20 h) probabilistic fog predictions in remote locations, absent an observational history, using an uncalibrated 4-km, 10-member Weather Research and Forecasting Model (WRF) ensemble configured to closely match the Air Force Weather Agency Mesoscale Ensemble Forecast Suite. Three distinct sources of error in the final predictions are considered separately to facilitate a better understanding of the total error and appropriate mitigation strategies. These include initial condition error, parameterization of subgrid-scale processes, and error in the visibility parameterization used to convert NWP model output variables to visibility. The raw WRF predictions are generally not skillful in valley and coastal regions, where they produce a shortage of light fog predictions with visibilities of 1–7 mi (1.6–11.3 km) in favor of excessive forecasts of zero cloud water, corresponding to no fog. Initial condition error and visibility parameterization error are shown to play a relatively minor role compared to error in the parameterization of subgrid-scale processes. This deficiency is caused by a negative relative humidity bias, which results from a warm overnight bias. A second-order source of error arises from an inconsistent delineation of fog and haze in the NWP model compared to the verifying observations. Results show that under most conditions it is necessary to deviate from the perfect-prog assumption, and to introduce some method of statistical postprocessing to obtain skillful visibility predictions from the ensemble.
Comparison of LDL-cholesterol estimate using the Friedewald formula and the newly proposed de Cordova formula with a directly measured LDL-cholesterol in a healthy South African population
Authors: Onyenekwu Chinelo P , Hoffmann Mariza , Smit Francois , Matsha Tandi E , Erasmus Rajiv T
Published: January 2014

Background

The accurate determination of low density lipoprotein cholesterol (LDL-c) is pertinent in clinical practice. Most laboratories employ the Friedewald formula, for convenient estimation of LDL-c, despite its shortfalls. Different formulae have been proposed for use, for more accurate but convenient estimation of LDL-c. Here, we compare a new formula recently proposed by de Cordova et al., with that of Friedewald and LDL-c determined by a homogeneous assay. We also assess its performance at very low TG levels against the modified Friedewald formula recommended by Ahmadi et al.

Methods

A database of 587 adults from the ‘Establishing Reference Intervals for Selected Analytes in South Africa’ study was utilized. Fasting samples were assayed for lipids. LDL-c was determined by the Daiichi method. Performance of the Friedewald and the de Cordova formulae was compared. This was exclusively repeated at very low TG levels (<1.13 mmol/L), this time, including the Ahmadi formula.

Results

The Friedewald formula and the de Cordova formula both had high correlations with the direct LDL-c ( r = 0.98 and r = 0.97, respectively), although the latter showed an inconsistent bias at different LDL-c levels. The two formulae had a higher correlation ( r = 0.98) than the Ahmadi formula ( r = 0.92) at very low TG levels.

Conclusions

The Friedewald formula showed better agreement with the direct LDL-c than the de Cordova formula, at various LDL-c levels, in our population. It also performed better than the Ahmadi formula at very low TG levels. We therefore advise that it remains the formula of choice for LDL-c estimation in South Africa.
Porter le chapelet. Formes religieuses dans une prison pour femmes
Authors: Thériault Barbara
Published: January 2014

While I was doing fieldwork in a Montreal women’s jail an unexpected detail emerged that intrigued me as a sociologist: the striking presence of the rosary. This detail is at the core of the present article. Conspicuous and discreet, exotic and trivial, the white plastic rosary given by volunteers to incarcerated women was everywhere. Without assuming an inherently religious character, and resisting the temptation to make of it something profound or curious, I ask in this article two simple questions: What is the rosary as an artefact? And how much about chaplaincy at the women’s jail and Catholicism in contemporary Quebec is condensed in this detail? The answers to these questions instruct us on the context of the jail, the study of religion today, and the importance of artefacts.
A Comprehensive Approach for Assessing Person Fit With Test–Retest Data
Authors: Ferrando Pere J.
Published: January 2014

Item response theory (IRT) models allow model–data fit to be assessed at the individual level by using person-fit indices. This assessment is also feasible when IRT is used to model test–retest data. However, person-fit developments for this type of modeling are virtually nonexistent. This article proposes a general person-fit approach for test–retest data, which is based on practical likelihood-based indices. The approach is intended for two types of assumption regarding trait levels—stability and change—and can be used with a variety of IRT models. It consists of two groups of indices: (a) overall indices based on the full test–retest pattern, which are more powerful and are intended to flag a respondent as potentially inconsistent; and (b) partial indices intended to provide additional information about the location and sources of misfit. Furthermore, because the overall procedures assume local independence under repetition, a statistic for assessing the presence of retest effects at the individual level is also proposed. The functioning of the procedures was assessed by using simulation and is illustrated with two empirical studies: a stability study based on graded-response items and a change study based on binary items. Finally, limitations and further lines of research are discussed.
Sizing Firefighters
Authors: Hsiao Hongwei , Whitestone Jennifer , Kau Tsui-Ying , Whisler Richard , Routley J. Gordon , Wilbur Michael
Published: January 2014

Objective:

This article reports new anthropometric information of U.S. firefighters for fire apparatus design applications (Study 1) and presents a data method to assist in firefighter anthropometric data usage for research-to-practice propositions (Study 2).

Background:

Up-to-date anthropometric information of the U.S. firefighter population is needed for updating ergonomic and safety specifications for fire apparatus.

Method:

A stratified sampling plan of three-age by three-race/ethnicity combinations was used to collect anthropometric data of 863 male and 88 female firefighters across the U.S. regions; 71 anthropometric dimensions were measured (Study 1). Differences among original, weighted, and normality transformed data from Study 1 were compared to allowable observer errors (Study 2).

Results:

On average, male firefighters were 9.8 kg heavier and female firefighters were 29 mm taller than their counterparts in the general U.S. population. They also have larger upper-body builds than those of the general U.S. population. The data in weighted, unweighted, and normality transformed modes were compatible among each other with a few exceptions.

Conclusion:

The data obtained in this study provide the first available U.S. national firefighter anthropometric information for fire apparatus designs. The data represent the demographic characteristics of the current firefighter population and, except for a few dimensions, can be directly employed into fire apparatus design applications without major weighting or nonnormality concerns.

Application:

The up-to-date firefighter anthropometric data and data method will benefit the design of future fire apparatus and protective equipment, such as seats, body restraints, cabs, gloves, and bunker gear.
Composites from chicken feathers quill and recycled polypropylene
Authors: Amieva E Jiménez-Cervantes , Velasco-Santos C , Martínez-Hernández AL , Rivera-Armenta JL , Mendoza-Martínez AM , Castaño VM
Published: January 2014

Recycled polypropylene composites reinforced with quill from chicken feathers were prepared by extrusion process. Chicken feathers, a worldwide waste without any relevant application, may potentially replace nonrenewable reinforcements in composites. The effects of quill reinforcement on the density, as well as the thermal, thermo-mechanical and morphological properties of the composites, were evaluated. Quill showed an excellent compatibility with the polypropylene matrix, revealed by the good dispersion that was confirmed by the physical appearance observed with aid of scanning electron microscopy. This fact is due to the hydrophobic nature of keratin in quill. All of the composites showed higher storage modulus than simple polymer, particularly for the lowest quill content. In addition, the composite materials also had a lower density. The transition temperature remained almost unaltered compared with polypropylene. However, the thermal stability was observed to be strongly related to the quill content. Thus, this study reports a successful industrial process applied to a new natural reinforcement material: quill, used to synthesize composites with an amply used polymer: polypropylene; which can open an important gate towards the extended exploitation of keratin quill as a novel and renewable reinforcement material.
Modelling of concentration-dependent moisture diffusion in hybrid fibre-reinforced polymer composites
Authors: Huo Z , Bheemreddy V , Chandrashekhara K , Brack RA
Published: January 2014

Hybrid fibre-reinforced polymer composites have extensive applications due to their high strength, cost effectiveness, improved product performance, low maintenance and design flexibility. However, moisture absorbed by composite components plays a detrimental role in both the integrity and durability of hybrid structure because it can degrade the mechanical properties and induce interfacial delamination failures. In this study, the moisture diffusion characteristics in two-phase hybrid composites using moisture concentration-dependent diffusion method have been investigated. The two phases are unidirectional S-glass fibre-reinforced epoxy matrix and unidirectional graphite fibre-reinforced epoxy matrix. In the moisture concentration-dependent diffusion method, the diffusion coefficients are not only dependent on the environmental temperature but also dependent on the nodal moisture concentration due to the internal swelling stress built during the diffusion process. A user-defined subroutine was developed to implement this method into commercial finite element code. Three-dimensional finite element models were developed to investigate the moisture diffusion in hybrid composites. A normalization approach was also integrated in the model to remove the moisture concentration discontinuity at the interface of different material components. The moisture diffusion in the three-layer hybrid composite exposed to 45℃/84% relative humidity for 70 days was simulated and validated by comparing the simulation results with experimental findings. The developed model was extended to simulate the moisture diffusion behaviour in an adhesive-bonded four-layer thick hybrid composite exposed to 45℃/84% relative humidity for 1.5 years. The results indicated that thin adhesive layers (0.12-mm thick) did not significantly affect the overall moisture uptake as compared with thick adhesive layers (0.76-mm thick).
Effects of microstructural variability on thermo-mechanical properties of a woven ceramic matrix composite
Authors: Goldsmith Marlana B , Sankar Bhavani V , Haftka Raphael T , Goldberg Robert K
Published: January 2014

The objectives of this paper include identifying important architectural parameters that describe the SiC/SiC five-harness satin weave composite and characterizing the statistical distributions and correlations of those parameters from photomicrographs of various cross sections. In addition, realistic artificial cross sections of a 2D representative volume element (RVE) are generated reflecting the variability found in the photomicrographs and include explicitly modeled voids (something not routinely done for woven CMCs). These models are used to make preliminary observation of the effects of architectural variability on the thermo-mechanical properties (material constants). Lastly, information is obtained on the sensitivity of linear thermo-mechanical properties to architectural variations. Two-dimensional finite element analysis is used in combination with a response surface and it is shown that the present method is effective in determining the effects of architectural variability on thermo-mechanical properties and their variability.
Basalt fibre-reinforced PA1012 composites: Morphology, mechanical properties, crystallization behaviours, structure and water contact angle
Authors: Song Jianbin , Liu Jianxun , Zhang Yanhua , Chen Lihong , Zhong Yumei , Yang Wenbin
Published: January 2014

The influences of basalt fibre on morphology, mechanical properties, structure, contact angle, melting and crystallization behaviours of polyamide 1012 were studied using scanning electron microscopy, material testing machine, X-ray diffractometer, differential scanning calorimeters and static contact angle measuring instrument. It was found that interface properties between basalt fibre and polyamide 1012 were improved effectively by silane coupling agent. Also, the tensile and flexural strength of treated basalt fibre-reinforced composites were found to be higher than untreated ones at the same fibre content. The best tensile and flexural strength of polyamide 1012/treated basalt fibre composites with 30 wt% basalt fibre were determined to be 84.4 and 120 MPa. Although basalt fibre did not change polyamide 1012 crystal structure, it altered the melting temperature and degree of crystallinity of polyamide 1012. In addition, by virtue of the changes in crystallization temperature, the nucleation ability of polyamide 1012 in composites was confirmed to be enhanced. The strong interaction between epoxy groups of silane coupling agent and amide groups of polyamide 1012 elevates the hydrophobic properties of composites. The results from nonisothermal crystallization kinetics testified that crystallization ability of polyamide 1012 in composite containing 30 wt% basalt fibre was strengthened, compared with neat polyamide 1012.
Immigrant Families
Authors: Gorodzeisky Anastasia , Sarid Orly , Mirsky Julia , Slonim-Nevo Vered
Published: January 2014

The study examined the association between immigrants’ adaptation—as reflected by host-country language proficiency (based on self-ratings)—and their children’s psychological well-being in two countries: Germany and Israel. The findings stressed the importance of children’s gender in the study of parent–child dyads. Our separate analyses of boys’ and girls’ subsamples revealed results that were undetected when we analyzed the subsamples of both genders together. Specifically, we found that self-reported paternal proficiency in the German language was positively associated with their daughters’ psychological well-being, whereas maternal proficiency in German was positively associated with their sons’ well-being. No association was found in our Israeli sample between immigrant language proficiency and their children’s psychological well-being during the first 3.5 years following migration. Further analyses demonstrated that in Germany, the quality of father–daughter communication mainly accounted for the association between paternal language proficiency and their daughters’ psychological well-being, while maternal psychological well-being mediated at least partially the association between maternal language proficiency and sons’ psychological well-being. The results are discussed in light of the differences and similarities in the settings of the two countries.
Small bowel intussusception in a pregnant woman with Peutz–Jeghers Syndrome
Authors: Tutar Onur , Kocak Burak , Velidedeoglu Mehmet , Baca Bilgi , Dikici Suleyman , Nurili Fuad , Kantarci Fatih
Published: January 2014

Intussusception is the most frequent complication of Peutz–Jeghers Syndrome (PJS), but usually seen in child age. It is a predictable, but infrequent complication in adults with PJS. However, there is no report about intussusception in pregnancy period secondary to Peutz–Jeghers (PJ) polyps in the literature. In this paper, we present a rare intussusception case in a pregnant woman with PJS, which was diagnosed with magnetic resonance imaging, and discuss this condition with a brief literature review.
The relationship between structural barriers to adherence to antiretroviral therapy, psychological distress, and health-related quality of life
Authors: Kagee Ashraf , Steel Henry , Coetzee Bronwyne
Published: January 2014

We examined the relationship between structural barriers to antiretroviral therapy and quality of life among 291 antiretroviral therapy users in South Africa. We found significant relationships between structural barriers to clinical attendance and pill taking and various dimensions of quality of life. Psychological distress was not found to be a mediator between structural barriers to clinic attendance and indicators of health-related quality of life, although it was a potential mediator between structural barriers to pill taking and some dimensions of quality of life. Psychological distress partially mediated the relationship between structural barriers to pill taking and physical well-being and between structural barriers to pill taking and emotional well-being.
Vascular Origin of Vildagliptin-induced Skin Effects in Cynomolgus Monkeys
Authors: Hoffmann Peter , Bentley Phil , Sahota Pritam , Schoenfeld Heidi , Martin Lori , Longo Linda , Spaet Robert , Moulin Pierre , Pantano Serafino , Dubost Valerie , Lapadula Dan , Burkey Bryan , Kaushik Virendar , Zhou Wei , Hayes Michael , Flavahan Nick , Chibout Salah-Dine , Busch Steve
Published: January 2014

The purpose of this article is to characterize skin lesions in cynomolgus monkeys following vildagliptin (dipeptidyl peptidase-4 inhibitor) treatment. Oral vildagliptin administration caused dose-dependent and reversible blister formation, peeling and flaking skin, erosions, ulcerations, scabs, and sores involving the extremities at ≥5 mg/kg/day and necrosis of the tail and the pinnae at ≥80 mg/kg/day after 3 weeks of treatment. At the affected sites, the media and the endothelium of dermal arterioles showed hypertrophy/hyperplasia. Skin lesion formation was prevented by elevating ambient temperature. Vildagliptin treatment also produced an increase in blood pressure and heart rate likely via increased sympathetic tone. Following treatment with vildagliptin at 80 mg/kg/day, the recovery time after lowering the temperature in the feet of monkeys and inducing cold stress was prolonged. Ex vivo investigations showed that small digital arteries from skin biopsies of vildagliptin-treated monkeys exhibited an increase in neuropeptide Y–induced vasoconstriction. This finding correlated with a specific increase in NPY and in NPY1 receptors observed in the skin of vildagliptin-treated monkeys. Present data provide evidence that skin effects in monkeys are of vascular origin and that the effects on the NPY system in combination with increased peripheral sympathetic tone play an important pathomechanistic role in the pathogenesis of cutaneous toxicity.
Mediastinal sarcoid-like reaction after colon adenocarcinoma resection
Authors: Fiorelli Alfonso , Accardo Marina , Orditura Michele , Santini Mario
Published: January 2014

We report a rare case of mediastinal sarcoid-like reaction presenting 5 years after colon adenocarcinoma resection. The lack of clinical and biochemical features suggestive of sarcoidosis and the high 18F-fluorodeoxyglucose uptake in mediastinal adenopathy, not seen previously, led us to suspect cancer recurrence. Pathological diagnosis obtained with a thoracoscopic biopsy confirmed sarcoidosis. Mediastinal adenopathies need to be confirmed pathologically to avoid potential interpretative pitfalls leading to toxic overtreatment.
Radiofrequency ablation of atrial fibrillation during mitral valve surgery
Authors: Oueida Farouk , Elawady Mohamed Ahmed , Eskander Khalid
Published: January 2014

Objectives

Atrial fibrillation is the most common form of arrhythmia in mitral valve disease. Radiofrequency ablation is most commonly used for atrial fibrillation ablation during mitral valve surgery.

Methods

This prospective study evaluated the midterm outcomes of intraoperative radiofrequency atrial fibrillation ablation during mitral valve surgery.

Results

52 patients were eligible for the study. Fifteen (28.8%) had a transseptal approach and 37 had a left atriotomy. Mitral valve replacement was performed in 16 patients, mitral valve repair in 31, and tricuspid repair in 8. Mean crossclamp time was 58.14. ± 20.08 min, and mean cardiopulmonary bypass time was 71.28 ± 20.31 min. The mean ablation time was 6.41 ± 0.21 min. There was no postoperative mortality. Sinus rhythm was documented in 44 (84.6%) patients on discharge, and 8 (15.4%) were discharged with atrial fibrillation; 2 of them returned to sinus rhythm after 3 months. After 12 months of follow-up, 46 (88.5%) patients were in sinus rhythm.

Conclusion

Left atrial monopolar radiofrequency ablation during mitral valve surgery is a safe procedure with a high success rate.
Long-term results of an open flexible prosthetic band for mitral insufficiency
Authors: Pragliola Claudio , Chello Massimo , Gaudino Mario , Mazza Andrea , Cellini Carlo , Spadaccio Cristiano , Covino Elvio
Published: January 2014

Background

use of a prosthetic ring is an integral part of any mitral valve repair and can influence the long-term stability of the results. We evaluated the long-term results of the AnnuloFlex ring implanted as an open flexible band in patients affected by degenerative mitral disease.

Methods

between 2001 and 2010, 82 patients (52 women, 30 men) with a mean age of 62 years, underwent repair of a prolapsing mitral valve with an AnnuloFlex band. One patient was reoperated on for a technical error and received a mechanical prosthesis, 3 were missing at follow-up, and the other 78 were prospectively followed up with clinical interviews and transthoracic echocardiography.

Results

the mean follow-up was 7.0 ± 1.8 years. Six patients died; 2 deaths were considered valve-related. The overall survival estimate at 10 years was 88.6% (95% confidence interval: 76.1%–94.8%). Freedom from endocarditis was 97.1% (95% confidence interval: 89.1%–98.5%). Freedom from thrombosis or hemorrhage was 93.7% (95% confidence interval: 81.6%–97.9%). Freedom from new or increased regurgitation was 93.1% (95% confidence interval: 87.3%–97.3%). The cumulative freedom from any valve-related event was 78.6% (95% confidence interval: 69.7%–97.1%). A single case of systolic anterior motion occurred before hospital discharge.

Conclusion

the long-term results of the AnnuloFlex band are excellent and stable.
A new way to play music together: The Continuator in the classroom
Authors: Ferrari Laura , Addessi Anna Rita
Published: January 2014

This article describes a didactic experience concerning the interaction between young children and the Continuator, an Interactive Reflexive Musical System (IRMS) elaborated at SONY- Computer Science Laboratory in Paris. The general aim was to analyse whether and how the Continuator can be used in the kindergartner during the daily school activities and the role of the teacher in the context of free play and in guided activities with the system. The experience took place in Bologna (Italy) and involved 18 children aged 3–5 years. The children learned to dialogue musically with the system and to manage various kinds of collaborative play. These factors gave rise to some particularly attentive and prolonged bouts of listening, stimulating the children to think in terms of sound and developing a genuine desire to “play” with music. This experience shows how the Continuator could represent a versatile device capable of enhancing musical creativity and exploration in a classroom setting.
The Image after Strathern: Art and Persuasive Relationality in India’s Sanguinary Politics
Authors: Copeman Jacob , Street Alice
Published: January 2014

Publicly-enacted blood extractions (principally blood donation events and petitions or paintings in blood) in mass Indian political contexts (for instance, protest or political memorial events and election rallies) are a noteworthy present-day form of political enunciation in India, for such extractions – made to speak as and on behalf of political subject positions – are intensely communicative. Somewhat akin to the transformative fasts undertaken by Gandhi, such blood extractions seek to persuade from the moral high ground of political asceticism. This essay seeks to shed light on how and why these extractions have become such a means, with a particular focus on blood-based portraiture. What makes such portraits – chiefly of politicians and ‘freedom fighter’ martyrs – interesting from a Strathernian point of view is their immanent persuasive relationality. The insights of Strathern can help us to explicate these objects’ dynamic relational features, while reciprocally, the portraits may help us to illuminate and clarify the very particular and interesting nature of the way Strathern treats (and creates) images.
Unexpected Properties: Strathern on the Relation of Law and Culture
Authors: Greenhouse Carol J.
Published: January 2014

This article takes up Marilyn Strathern’s formulation of a law/culture ‘duplex’ – her term for the complementarity of anthropology and law as means to each other’s ends. She draws attention to the limitations of the duplex, and urges us to consider ethnography as (in part) a project of unwinding its entwinement. As a step toward that end, the article returns to classic texts by Emile Durkheim and Bronislaw Malinowski – texts that were foundational to the emergence of anthropology, and to the establishment of law as an object of study for the social sciences. Re-read in light of Strathern’s insight, what has been widely taken as their relativism emerges instead as their defense of political community as a subject for ethnography, and (accordingly) the basis for a theoretical check on law conceived globally – within states or as colonial overrule. The article concludes with a discussion of the contemporary relevance of that position.
Law after Anthropology: Object and Technique in Roman Law
Authors: Pottage Alain
Published: January 2014

Anthropological scholarship after Marilyn Strathern does something that might surprise lawyers schooled in the tradition of ‘law and society’, or ‘law in context’. Instead of construing law as an instrument of social forces, or as an expression of processes by which society maintains and reproduces itself, a new mode of anthropological enquiry focuses sharply on ‘law itself’, on what Annelise Riles calls the ‘technicalities’ of law. How might the legal scholar be inspired by this approach? In this article, I explore one possible way of approaching law after anthropology, which is to find within law’s own archive a set of resources for an analogous representation of law itself. Drawing on the historical scholarship of Yan Thomas, I suggest that the Roman conception of law as object offers an engaging counterpart to the anthropological take on law as a specific set of tools or, technicalities, or as a particular art of making relations.
Afterword: Struck Dumb? Marilyn Strathern and Social Science
Authors: Thrift Nigel
Published: January 2014

Marilyn Strathern has produced a remarkable body of work that not only demonstrates range and tenacity but also has produced a host of inspirations that have made their way into the world. This Afterword to the special issue ‘Social Theory After Strathern’ dwells on the subject of the modesty of what Strathern is proposing and how it relates to space, noting that her work enables us to forge new practico-theoretical combinations and works of diplomacy between incompatibles which show up the limitations of each party even as they forge new understandings – an approach that chimes with a move towards a more spatial view of knowledge. Theory, to echo Strathern’s gardening metaphor, needs to leave room not just to prune but to grow, the two being inter-related, as she points out. This Afterword also proposes that the extraordinary ability of anthropology to be inside and outside at once might serve as a model for what the social sciences need to become if they are to stay relevant in a world which cannot be reduced to a cipher for theory but still needs to learn from theory – theory which is precarious but spreadable, theory which establishes a rapport, but a rapport with friction built into it.
Unpaid work in the UK television and film industries: Resistance and changing attitudes
Authors: Percival Neil , Hesmondhalgh David
Published: January 2014

This article concerns resistance to unpaid work in the television and film industries. It outlines one notable and successful campaign against unpaid labour which was conducted in the UK television industry and discusses how a similar campaign in the film industry met much greater opposition. It then reports on a survey that was conducted in order to investigate the seeming differences in attitudes in the two industries observed during these campaigns. While confirming that workers in the film industry are more prepared to accept unpaid labour than television workers, the survey also revealed a more striking characteristic: those who have worked longer in either sector view unpaid labour considerably less favourably than relative newcomers. The article discusses possible reasons for this, such as self-interest and altruistic attitudes towards younger workers; it also explores some implications for future working conditions, and for the role of activism and solidarity in resisting the worst aspects of existing labour relations in the cultural industries.
Clinical experience with Affinity Pixie™ oxygenation system in paediatric and infant patients
Authors: Issitt R , Robertson A , Cross N , Crook R , Molyneux V , Shaw M , Walton N , Tsang V
Published: January 2014

Introduction:

Great Ormond Street Children’s Hospital undertakes over 500 open heart cardiothoracic procedures requiring cardiopulmonary bypass per year. Data from our centre show that many of our neonatal/paediatric patients require higher cardiac indexes than previously thought. We evaluated the new Pixie™ oxygenation system, rated from 0.1 L/min to 2 L/min, to determine if it could be used for these patients.

Methods:

Between 2010 and 2012, 250 Pixie™ oxygenators were used on consecutive patients requiring correction of congenital cardiac defects. Data were collected on FiO2 requirements, oxygenator pressure drop and gaseous microemboli handling. Retrospective analysis was also undertaken on the procedures and demographics of all patients during 2011-2012 to determine the percentage of patients on whom the Pixie™ could be used.

Results:

Analysis of the procedures undertaken at Great Ormond Street Hospital (GOSH) showed that 89% were in patients under 20 kg, requiring a flow rate of <2 L/min (at a base cardiac index of 2.8 L/min/m2). The maximum FiO2 required at 2.5 L/min was 85%. Gaseous microemboli were reduced by 82.5±9.9% and bubble volume was decreased by 94.3±8.4% from the ‘venous’ pre-oxygenator to the ‘arterial’ post-oxygenator.

Discussion:

The Pixie™ oxygenator proved effective at flows up to 2.5 L/min, with air-handling capabilities comparable with other oxygenators. This represents a single oxygenator that could potentially be used to cover 89% of our surgical procedures. However, we believe that, for the smallest patients (i.e. < 2kg), a smaller priming oxygenator should be used in order to limit unnecessary haemodilution in this vulnerable group.
Experiences of sexuality and intimacy in terminal illness: A phenomenological study
Authors: Taylor Bridget
Published: January 2014

Background:

There is a paucity of research considering sexuality and intimacy in palliative care. It is therefore unclear whether palliative care professionals have a role in addressing these issues with patients and their partners.

Aim:

To understand people’s experiences of sexuality and intimacy when living with a terminal illness.

Design:

A Heideggerian hermeneutic (interpretive) phenomenological study was undertaken. Data were collected using one-to-one conversational interviews. An iterative approach to analysing the narratives was used to reveal shared meanings.

Setting/participants:

A total of 27 patients and 14 partners of patients with either cancer or motor neuron disease were recruited from outpatient, community and hospice inpatient units. All participants were aware that the illness was life-limiting.

Findings:

When someone is living with a life-limiting illness, their coupled relationship is also dying. In their being-towards-death-of-the-couple, patients and partners of patients with motor neuron disease and terminal cancer experienced connecting and disconnecting within their coupled relationship. Becoming-apart-as-a-couple was experienced as loss of spontaneity, as lack of reciprocity and as rejection. This was influenced by a range of factors including medical treatments, disfigurement and the disabling effects of equipment. Some participants experienced re-connecting through becoming-closer-as-a-couple, although this was not always sustained.

Conclusions:

This study sheds new light on people’s experiences of sexuality and intimacy when living with a terminal illness. The ethos of holistic care requires palliative care professionals to provide opportunities for patients and their partners to discuss any concerns they might have about their coupled relationship and to understand the meanings symptoms have for them.
Methods for Performing Survival Curve Quality-of-Life Assessments
Authors: Sumner Walton , Ding Eric , Fischer Irene D. , Hagen Michael D.
Published: January 2014

Background. Many medical decisions involve an implied choice between alternative survival curves, typically with differing quality of life. Common preference assessment methods neglect this structure, creating some risk of distortions. Methods. Survival curve quality-of-life assessments (SQLA) were developed from Gompertz survival curves fitting the general population’s survival. An algorithm was developed to generate relative discount rate-utility (DRU) functions from a standard survival curve and health state and an equally attractive alternative curve and state. A least means squared distance algorithm was developed to describe how nearly 3 or more DRU functions intersect. These techniques were implemented in a program called X-Trade and tested. Results. SQLA scenarios can portray realistic treatment choices. A side effect scenario portrays one prototypical choice, to extend life while experiencing some loss, such as an amputation. A risky treatment scenario portrays procedures with an initial mortality risk. A time trade scenario mimics conventional time tradeoffs. Each SQLA scenario yields DRU functions with distinctive shapes, such as sigmoid curves or vertical lines. One SQLA can imply a discount rate or utility if the other value is known and both values are temporally stable. Two SQLA exercises imply a unique discount rate and utility if the inferred DRU functions intersect. Three or more SQLA results can quantify uncertainty or inconsistency in discount rate and utility estimates. Pilot studies suggested that many subjects could learn to interpret survival curves and do SQLA. Limitations. SQLA confuse some people. Compared with SQLA, standard gambles quantify very low utilities more easily, and time tradeoffs are simpler for high utilities. When discount rates approach zero, time tradeoffs are as informative and easier to do than SQLA. Conclusions. SQLA may complement conventional utility assessment methods.
Adjusting Survival Time Estimates to Account for Treatment Switching in Randomized Controlled Trials—an Economic Evaluation Context
Authors: Latimer Nicholas R. , Abrams Keith R. , Lambert Paul C. , Crowther Michael J. , Wailoo Allan J. , Morden James P. , Akehurst Ron L. , Campbell Michael J.
Published: January 2014

Background. Treatment switching commonly occurs in clinical trials of novel interventions in the advanced or metastatic cancer setting. However, methods to adjust for switching have been used inconsistently and potentially inappropriately in health technology assessments (HTAs). Objective. We present recommendations on the use of methods to adjust survival estimates in the presence of treatment switching in the context of economic evaluations. Methods. We provide background on the treatment switching issue and summarize methods used to adjust for it in HTAs. We discuss the assumptions and limitations associated with adjustment methods and draw on results of a simulation study to make recommendations on their use. Results. We demonstrate that methods used to adjust for treatment switching have important limitations and often produce bias in realistic scenarios. We present an analysis framework that aims to increase the probability that suitable adjustment methods can be identified on a case-by-case basis. We recommend that the characteristics of clinical trials, and the treatment switching mechanism observed within them, should be considered alongside the key assumptions of the adjustment methods. Key assumptions include the “no unmeasured confounders” assumption associated with the inverse probability of censoring weights (IPCW) method and the “common treatment effect” assumption associated with the rank preserving structural failure time model (RPSFTM). Conclusions. The limitations associated with switching adjustment methods such as the RPSFTM and IPCW mean that they are appropriate in different scenarios. In some scenarios, both methods may be prone to bias; “2-stage” methods should be considered, and intention-to-treat analyses may sometimes produce the least bias. The data requirements of adjustment methods also have important implications for clinical trialists.
Differences in Indicators of Malignancy Between Luminal Epithelial Cell Type and Myoepithelial Cell Type of Simple Solid Carcinoma in the Canine Mammary Gland
Authors: Yoshimura H. , Nakahira R. , Kishimoto T. E. , Michishita M. , Ohkusu-Tsukada K. , Takahashi K.
Published: January 2014

Routinely diagnosed simple solid carcinoma (SSC) of the canine mammary gland comprises a heterogeneous group of tumors. Seventy-two cases that had been diagnosed as SSC based on hematoxylin and eosin–stained tissue sections were reclassified immunohistochemically on the basis of myoepithelial markers p63 and α-smooth muscle actin, as well as a luminal epithelial marker cytokeratin 8. Only 23 cases (32%) were true SSC, composed only of luminal epithelial cells, whereas 11 cases (15%) were malignant myoepithelioma (MM), composed predominantly of myoepithelial cells, and 38 cases (53%) were biphasic carcinoma (BC), characterized by biphasic proliferation of luminal epithelial and basal/myoepithelial components. As the pathological parameters were compared between the reclassified tumor types, infiltrative potential, vascular/lymphatic invasion, lymph node metastasis, and Ki-67 labeling index were higher in true SSC compared with MM and BC, suggesting that the former may exhibit a poorer prognosis compared with the latter two.
Brain functional connectivity and morphology changes in medication-overuse headache: Clue for dependence-related processes?
Authors: Chanraud S , Di Scala G , Dilharreguy B , Schoenen J , Allard M , Radat F
Published: January 2014

Background

Several imaging studies have identified localized anatomical and functional brain changes in medication-overuse headache (MOH).

Objective

The objective of this article is to evaluate whole-brain functional connectivity at rest together with voxel-based morphometry in MOH patients, in comparison with episodic migraine (EM) patients and healthy controls (HCs).

Methods

Anatomical MRI and resting-state functional MRI scans were obtained in MOH patients ( n = 17 and 9, respectively), EM patients ( n = 18 and 15, respectively) and HCs ( n = 17 and 17). SPM8 was used to analyze voxel-based morphometry and seed (left precuneus) to voxel connectivity data in the whole brain.

Results

Functional connectivity at rest was altered in MOH patients. Connectivity was decreased between precuneus and regions of the default-mode network (frontal and parietal cortices), but increased between precuneus and hippocampal/temporal areas. These functional modifications were not accompanied by significant gross morphological changes. Furthermore, connectivity between precuneus and frontal areas in MOH was negatively correlated with migraine duration and positively correlated with self-evaluation of medication dependence. Gray matter volumes of frontal regions, precuneus and hippocampus were also negatively related to migraine duration. Functional connectivity within the default-mode network appeared to predict anxiety scores of MOH patients while gray matter volumes in this network predicted their depression scores.

Conclusions

Our data suggest that MOH is associated with functional alterations within intrinsic brain networks rather than with macrostructural changes. They also support the view that dependence-related processes might play a prominent role in its development and maintenance.
She Stoops to Conquer? How Posture Interacts With Self-Objectification and Status to Impact Women’s Affect and Performance
Authors: Kozak Megan N. , Roberts Tomi-Ann , Patterson Kelsey E.
Published: January 2014

Research suggests that posture exerts powerful affective and cognitive influences, although recent studies have indicated that these embodiment effects are moderated by gender. We examined two sociocultural factors that may contribute to the effects of postural feedback in women: self-objectification and power. Across a 2 × 2 × 2 between-subjects design, 80 female undergraduates completed various cognitive tasks and self-report measures after having been in an upright or slouched posture, seated in either a (powerful) throne or child’s chair, and wearing either a formfitting (objectifying) tank top or loose sweatshirt. The results showed that posture had the predicted influence on mood, with those seated upright reporting more positive mood than those seated in a slouched position. For the cognitive tasks, our findings were more complex and, due to low power, are best considered preliminary. Participants who were seated upright in a child’s chair while wearing a sweatshirt attempted the highest number of math items compared to those in the other conditions, supporting our prediction that postural benefits would be greatest in a context where power cues were gender-appropriate and self-objectification effects were attenuated. On a measure of satisfaction with performance, our findings suggest that self-objectification outweighed the power manipulation, leading to poorer outcomes when a seated position emphasized sexualized features of the body. Taken together, our results suggest that embodiment effects appear to be impacted by contextual cues, perhaps particularly for women.
Sexual Minority Stressors and Psychological Aggression in Lesbian Women’s Intimate Relationships
Authors: Lewis Robin J. , Milletich Robert J. , Derlega Valerian J. , Padilla Miguel A.
Published: January 2014

Our study examined how two sexual minority stressors (internalized homophobia and social constraints in talking with others about one’s minority sexual identity) are related to psychological aggression (PA) in lesbian women’s relationships. PA includes a range of methods to hurt, coerce, control, and intimidate intimate partners. Rumination (i.e., brooding about one’s self and life situation) and relationship satisfaction were examined as potential mediating variables. Self-identified lesbian women in a same-sex relationship ( N = 220) were recruited from a market research firm’s online panel. Participants completed measures of internalized homophobia, social constraints, rumination, relationship satisfaction, and frequency of past year PA victimization and perpetration. Internalized homophobia and social constraints in talking to friends about sexual identity yielded a positive indirect link with PA via a sequential path through rumination and relationship satisfaction. There was an additional indirect positive association of minority stressors with PA via a unique path through rumination. These results demonstrate the importance of continued efforts toward reducing minority stress, where possible, as well as enhancing coping. Given the importance of rumination and relationship satisfaction in the link between minority stressors and PA, it is imperative to improve adaptive coping responses to sexual minority stressors. Development and validation of individual- and couples-based interventions that address coping with sexual minority stressors using methods that decrease rumination and brooding and increase relationship satisfaction are certainly warranted.
Early Enteral Nutrition in Critically Ill Patients With Hemodynamic Instability
Authors: Yang Shuofei , Wu Xingjiang , Yu Wenkui , Li Jieshou
Published: January 2014

Early enteral nutrition (EEN) in critically ill patients is associated with significant benefit as well as elevated risk of complications. Concomitant use of EEN with vasopressors has been associated with nonocclusive bowel necrosis in critically ill patients with hemodynamic instability. The decision when to initiate enteral nutrition in hemodynamically unstable patients that require vasoactive substances remains a clinical dilemma. This review summarizes the effect of EEN and vasoactive agents on gastrointestinal blood flow and perfusion in critically ill patients, based on current evidence. Animal and clinical data involving simultaneous administration of EEN and vasoactive agents for hemodynamic instability are reviewed, and the factors related to the safety and effectiveness of EEN support in this patient population are analyzed. Moreover, practical recommendations are provided. Additional randomized clinical trials are warranted to provide cutting‐edge evidence‐based guidance about this issue for practitioners of critical care.
Acoustic emission-based study to characterize the initiation of delamination in composite materials
Authors: Fotouhi Mohamad , Najafabadi Mehdi Ahmadi
Published: January 2014

Among the failure modes of composite materials, delamination is the most striking one. It may result in the reduction of stiffness and long-term performance of composite materials. The initiation stage is very crucial in delamination. This is because initiation stage requires higher amount of force, and after this stage, there is a stable propagation of delamination that requires little force and causes the failure of the structure. Initiation of delamination consists of two main stages including minor initiation and major initiation. These two stages are vital stages in the delamination process. Understanding the delamination behavior and their internal micro events in these stages may lead to better design and result in enhanced strength against crack initiation. This article proposes a combined method to discriminate various fracture mechanisms in the initiation of delamination. The combination of sentry function analysis and frequency analysis of acoustic emission (AE) waveforms are used to analyze crack initiation and to discriminate its internal micro failures during mode I delamination. Discrimination process is derived from the power spectrum density of AE waveform in distinct frequency intervals. Scanning electron microscopy (SEM) observation was used to determine different fracture mechanisms and associate these observed fracture mechanisms and their equivalent AE signal frequency range. It is shown that this combined method is a powerful device to study the behavior of the initiation of delamination.