bluuebunny/crossref_metadata_2025 huggingface dataset:
Emergency physician recognition of delirium
Authors: Suffoletto Brian , Miller Thomas , Frisch Adam , Callaway Clifton
Published: June 2013

Objective

To compare the recognition of delirium by emergency physicians based on observations made during routine clinical care with concurrent ratings made by a trained researcher after formal cognitive assessment and to examine each of the four individual features of delirium separately to determine the variation in identification across features.

Methods

In a prospective study, a convenience sample of 259 patients, aged ≥65 years, who presented to two urban, teaching hospital emergency departments (EDs) in Western Pennsylvania between 21 June and 29 August 2011, underwent paired delirium ratings by an emergency physician and a trained researcher. Emergency physicians were asked to use their clinical judgment to decide whether the patient had any of the following delirium features: (1) acute change in mental status, (2) inattention, (3) disorganised thinking and (4) altered level of consciousness. Questions were prompted with examples of delirium features from the Confusion Assessment Method. Concurrently, a trained researcher interviewed surrogates to determine feature 1, conducted a cognitive test for delirium (Confusion Assessment Method for the intensive care unit) to determine delirium features 2 and 3 and used the Richmond Agitation and Sedation Scale to determine feature 4.

Results

In the 2-month study period, trained researchers identified delirium in 24/259 (9%; 95% CI 0.06 to 0.13) older patients admitted to the ED. However, attending emergency physicians recognised delirium in only 8 of the 24 and misidentified delirium in a further seven patients. Emergency physicians were particularly poor at recognising altered level of consciousness but were better at recognising acute change in mental status and inattention.

Conclusions

When emergency physicians use routine clinical observations, they may miss diagnosing up to two-thirds of patients with delirium. Recognition of delirium can be enhanced with standardised cognitive testing.
Risk identification and assessment of modular construction utilizing fuzzy analytic hierarchy process (AHP) and simulation
Authors: Li Hong Xian , Al-Hussein Mohamed , Lei Zhen , Ajweh Ziad
Published: June 2013

Modular construction brings improved safety and mitigates risks of hazard and injury. However, modular construction technology is also challenged with a degree of uncertainty resulting from such internal and external factors as engineering, occupational, cultural, socio-economic, and financial. Since modular construction is by nature distinct from conventional construction, existing risk management research for onsite construction cannot be directly applied to modular construction. This paper describes research on the risk management associated with modular construction, focusing on: (1) identifying risk factors and (2) assessing the impacts of the identified risk factors on project cost and duration. The primary risk factors associated with modular construction are identified, and fuzzy analytic hierarchy process (AHP) is utilized to rank these factors; simulation techniques are employed to assess the risks of projects. The risk identification and ranking are evaluated by a focus group of experts from the modular construction industry; t-distribution and chi-squared distribution are applied to analyze the results. The case of a project in Edmonton, Canada is presented to illustrate application of the proposed methodology.
An increasing trend of diffuse CO
2
emission from Teide volcano (Tenerife, Canary Islands): geochemical evidence of magma degassing episodes
Authors: Pérez Nemesio M. , Hernández Pedro A. , Padrón Eleazar , Melián Gladys , Nolasco Dácil , Barrancos José , Padilla Germán , Calvo David , Rodríguez Fátima , Dionis Samara , Chiodini Giovanni
Published: June 2013

Multiple soil CO
2
efflux surveys have been undertaken at the summit cone of Teide volcano, Tenerife, from 1997 to 2011, to determine the total CO
2
emissions from the summit cone and to evaluate the temporal variations of CO
2
efflux and their relationships with seismic–volcanic activity. Our results reveal significant fluctuations in degassing rate, which do not seem to be masked by atmospheric variations. These geochemical observations provide evidence for the unrest of the volcanic system, as has been suggested previously by anomalous seismic activity recorded in Tenerife during 22–29 April 2004. A new trend of increasing CO
2
efflux and CO
2
/CH
4
ratio in fumarolic gas discharges was observed from 2006 to 2009, suggesting that subsurface magma movement is the cause for the observed changes in the total output of diffuse CO
2
emission at the summit cone of Teide.
Persistent long-term (
c.
24 Ma) exhumation in the Eastern Alaska Range constrained by stacked thermochronology
Authors: Benowitz Jeff A. , Layer Paul W. , Vanlaningham Sam
Published: June 2013

To address Miocene–present episodic v. persistent exhumation, we utilize a simple graphical procedure that vertically stacks spatially diverse K-feldspar
40
Ar/
39
Ar multi-domain diffusion (MDD) models from the length of the approximately 100 km-long high-peak region of the Eastern Alaska Range. We supply additional constraints with
40
Ar/
39
Ar mica dating because the higher closure-temperature-window places limits on the initiation of rapid Eastern Alaska Range exhumation. We also provide a broad
40
Ar/
39
Ar K-feldspar minimum closure age data set to add more detail on spatial patterns in the regional exhumation history for the Eastern Alaska Range. We find that rapid and persistent exhumation has occurred in the Eastern Alaska Range since about 24 Ma at a long-term rate of approximately 0.9 km/Ma, but that this rapid exhumation is spatially variable through time. Onset of rapid Eastern Alaska Range exhumation is coincident with the initiation of rapid exhumation in SW Alaska, the Western Alaska Range and the Chugach–Saint Elias Range at around 25 Ma, implying a region-wide deformational response to a change in tectonic forcing. The initiation of highly coupled flat-slab subduction of the Yakutat microplate is probably responsible for this prolonged period of rapid exhumation in southern Alaska.

Supplementary material:

Sample locations from the Eastern Alaska Range, and
40
Ar/
39
Ar data tables and age spectrum figures are available at
www.geolsoc.org.uk/SUP18603
.
Impaired postprandial fullness in Type 2 diabetic subjects is rescued by acute exercise independently of total and acylated ghrelin
Authors: Knudsen Sine H. , Karstoft Kristian , Solomon Thomas P. J.
Published: June 2013

Ghrelin levels are suppressed in obese subjects and subjects with Type 2 diabetes mellitus (T2DM). Exercise-stimulated decreases in plasma ghrelin are a proposed mediator of exercise-induced satiety in healthy subjects. However, exercise-induced satiety and the impact of impaired ghrelin levels in obesity-related disease are poorly understood. Therefore our objective was to investigate exercise-induced postprandial satiety and ghrelin responses in overweight subjects with T2DM ( N = 8) and healthy controls ( N = 7). Visual analog scale satiety questionnaires (assessing hunger, thirst, food that could be eaten, nausea, and fullness) and circulating levels of glucose, insulin, and total and acylated ghrelin were measured at baseline and in response to a 75 g oral glucose load, provided immediately after an aerobic exercise bout (1 h at 50% Wmax) or no exercise (rest trial), on two separate occasions. Baseline levels of total (284.4 ± 15.9 and 397.6 ± 35.2 pmol/l) and acylated ghrelin (7.9 ± 1.0 and 13.7 ± 1.2 pmol/l) were lower in subjects with T2DM compared with healthy subjects ( P < 0.05). In the rest trial, post- vs. preprandial feeling of fullness increased in healthy subjects but decreased in subjects with T2DM (healthy vs. T2DM; P < 0.05). Exercise increased postprandial fullness in the T2DM group ( P < 0.05), while plasma ghrelin levels were unaffected. Our data suggest that the presence of T2DM likely drives suppressed ghrelin levels and poor appetite regulation, but a single exercise bout is sufficient to restore oral glucose-induced fullness independently of ghrelin.
Elastic ankle exoskeletons reduce soleus muscle force but not work in human hopping
Authors: Farris Dominic James , Robertson Benjamin D. , Sawicki Gregory S.
Published: June 2013

Inspired by elastic energy storage and return in tendons of human leg muscle-tendon units (MTU), exoskeletons often place a spring in parallel with an MTU to assist the MTU. However, this might perturb the normally efficient MTU mechanics and actually increase active muscle mechanical work. This study tested the effects of elastic parallel assistance on MTU mechanics. Participants hopped with and without spring-loaded ankle exoskeletons that assisted plantar flexion. An inverse dynamics analysis, combined with in vivo ultrasound imaging of soleus fascicles and surface electromyography, was used to determine muscle-tendon mechanics and activations. Whole body net metabolic power was obtained from indirect calorimetry. When hopping with spring-loaded exoskeletons, soleus activation was reduced (30–70%) and so was the magnitude of soleus force (peak force reduced by 30%) and the average rate of soleus force generation (by 50%). Although forces were lower, average positive fascicle power remained unchanged, owing to increased fascicle excursion (+4–5 mm). Net metabolic power was reduced with exoskeleton assistance (19%). These findings highlighted that parallel assistance to a muscle with appreciable series elasticity may have some negative consequences, and that the metabolic cost associated with generating force may be more pronounced than the cost of doing work for these muscles.
Improvements in exercise performance with high-intensity interval training coincide with an increase in skeletal muscle mitochondrial content and function
Authors: Jacobs Robert Acton , Flück Daniela , Bonne Thomas Christian , Bürgi Simon , Christensen Peter Møller , Toigo Marco , Lundby Carsten
Published: June 2013

Six sessions of high-intensity interval training (HIT) are sufficient to improve exercise capacity. The mechanisms explaining such improvements are unclear. Accordingly, the aim of this study was to perform a comprehensive evaluation of physiologically relevant adaptations occurring after six sessions of HIT to determine the mechanisms explaining improvements in exercise performance. Sixteen untrained (43 ± 6 ml·kg−1·min−1) subjects completed six sessions of repeated ( 8 – 12 ) 60 s intervals of high-intensity cycling (100% peak power output elicited during incremental maximal exercise test) intermixed with 75 s of recovery cycling at a low intensity (30 W) over a 2-wk period. Potential training-induced alterations in skeletal muscle respiratory capacity, mitochondrial content, skeletal muscle oxygenation, cardiac capacity, blood volumes, and peripheral fatigue resistance were all assessed prior to and again following training. Maximal measures of oxygen uptake (V̇o2peak; ∼8%; P = 0.026) and cycling time to complete a set amount of work (∼5%; P = 0.008) improved. Skeletal muscle respiratory capacities increased, most likely as a result of an expansion of skeletal muscle mitochondria (∼20%, P = 0.026), as assessed by cytochrome c oxidase activity. Skeletal muscle deoxygenation also increased while maximal cardiac output, total hemoglobin, plasma volume, total blood volume, and relative measures of peripheral fatigue resistance were all unaltered with training. These results suggest that increases in mitochondrial content following six HIT sessions may facilitate improvements in respiratory capacity and oxygen extraction, and ultimately are responsible for the improvements in maximal whole body exercise capacity and endurance performance in previously untrained individuals.
Slow V̇o2 off-kinetics in skeletal muscle is associated with fast PCr off-kinetics—and inversely
Authors: Korzeniewski Bernard , Zoladz Jerzy A.
Published: June 2013

The computer model of the bioenergetic system in skeletal muscle, developed previously, was used to study the effect of the characteristic decay time of the parallel activation of oxidative phosphorylation [τ(OFF)] during muscle recovery on the muscle oxygen consumption rate (V̇o2) and phosphocreatine (PCr) work-to-rest transition (off)-kinetics and on the relationship between the V̇o2 and PCr rest-to-work transition (on)- and off-kinetics in moderate and heavy exercise. An increase in τ(OFF) slows down the initial phase of the muscle V̇o2 off-kinetics and accelerates the PCr off-kinetics. As a result, the relationship between the initial phase of the V̇o2 off-kinetics (lasting approximately 3–60 s in computer simulations) and the PCr off-kinetics is inverse: the slower the former, the faster the latter. A faster initial phase of the V̇o2 off-kinetics is associated with a slower late phase of the V̇o2 off-kinetics, and as a result, the integral of V̇o2 above baseline during recovery, representing the oxygen debt, is identical in all cases [values of τ(OFF)] for a given PCr decrease. Depending on τ(OFF), the muscle V̇o2 on-kinetics was either equally fast or slower than the V̇o2 off-kinetics in moderate exercise and always slower in heavy exercise. PCr on-kinetics was always faster than PCr off-kinetics. This study clearly demonstrates that τ(OFF) has a pronounced impact on the mutual relations between the muscle V̇o2 and PCr on- and off-kinetics.
Thrombocytosis as a Response to High Interleukin-6 Levels in cGMP-Dependent Protein Kinase I Mutant Mice
Authors: Zhang Lin , Lukowski Robert , Gaertner Florian , Lorenz Michael , Legate Kyle R. , Domes Katrin , Angermeier Elisabeth , Hofmann Franz , Massberg Steffen
Published: June 2013

Objective—

The purpose of this study was to investigate the influence of cGMP-dependent kinase I (cGKI) on platelet production.

Approach and Results—

We used hematology analyser to measure platelet counts in conventional cGKI-null mutants (cGKI
L1/L1
), gene-targeted cGKIα/β rescue mice (referred to as cGKI-smooth muscle [SM]) in which cGKI expression is specifically restored only in SM, platelet factor 4-Cre
tg/+
; cGKI
L2/L2
mice in which the cGKI protein was specifically deleted in the megakaryocyte/platelet lineage and cGKI-deficient bone marrow–chimeras. Thrombocytosis was detected in cGKI
L1/L1
and in cGKI-SM. In contrast, neither platelet factor 4-Cre
tg/+
; cGKI
L2/L2
nor cGKI-deficient bone marrow–chimeras displayed a thrombocytosis phenotype, indicating that the high platelet count in cGKI
L1/L1
and cGKI-SM mutants is attributable to loss of an extrinsic signal rather than reflecting an intrinsic defect in megakaryopoiesis. Cytometric analyses further showed that stimulation of bone marrow–derived wild-type megakaryocytes in vitro using serum preparations obtained from cGKI-SM mutants strongly accelerated megakaryopoiesis, suggesting that the high platelet count develops in response to serum factors. Indeed, using ELISA assay, we found elevated levels of interleukin-6, a known stimulator of thrombopoiesis, in cGKI-SM mutant serum, whereas interleukin-6 levels were unaltered in platelet factor 4-Cre
tg/+
; cGKI
L2/L2
mice and cGKI-deficient bone marrow–chimeras. Accordingly, antibody-mediated blockade of interleukin-6 normalized platelet counts in cGKI-SM mice.

Conclusions—

Abnormal cGMP/cGKI signaling in nonhematopoietic cells affects thrombopoiesis via elevated interleukin-6 production and results in thrombocytosis in vivo. Dysfunction of cGMP/cGKI signaling in nonhematopoietic cells contributes to a high platelet count, which is potentially associated with thrombosis.
Mitochondrial Oxidative Stress Corrupts Coronary Collateral Growth by Activating Adenosine Monophosphate Activated Kinase-α Signaling
Authors: Pung Yuh Fen , Sam Wai Johnn , Stevanov Kelly , Enrick Molly , Chen Chwen-Lih , Kolz Christopher , Thakker Prashanth , Hardwick James P. , Chen Yeong-Renn , Dyck Jason R.B. , Yin Liya , Chilian William M.
Published: June 2013

Objective—

Our goal was to determine the mechanism by which mitochondrial oxidative stress impairs collateral growth in the heart.

Approach and Results—

Rats were treated with rotenone (mitochondrial complex I inhibitor that increases reactive oxygen species production) or sham-treated with vehicle and subjected to repetitive ischemia protocol for 10 days to induce coronary collateral growth. In control rats, repetitive ischemia increased flow to the collateral-dependent zone; however, rotenone treatment prevented this increase suggesting that mitochondrial oxidative stress compromises coronary collateral growth. In addition, rotenone also attenuated mitochondrial complex I activity and led to excessive mitochondrial aggregation. To further understand the mechanistic pathway(s) involved, human coronary artery endothelial cells were treated with 50 ng/mL vascular endothelial growth factor, 1 µmol/L rotenone, and rotenone/vascular endothelial growth factor for 48 hours. Vascular endothelial growth factor induced robust tube formation; however, rotenone completely inhibited this effect (
P
<0.05 rotenone versus vascular endothelial growth factor treatment). Inhibition of tube formation by rotenone was also associated with significant increase in mitochondrial superoxide generation. Immunoblot analyses of human coronary artery endothelial cells with rotenone treatment showed significant activation of adenosine monophosphate activated kinase (AMPK)-α and inhibition of mammalian target of rapamycin and p70 ribosomal S6 kinase. Activation of AMPK-α suggested impairments in energy production, which was reflected by decrease in O
2
consumption and bioenergetic reserve capacity of cultured cells. Knockdown of AMPK-α (siRNA) also preserved tube formation during rotenone, suggesting the negative effects were mediated by the activation of AMPK-α. Conversely, expression of a constitutively active AMPK-α blocked tube formation.

Conclusions—

We conclude that activation of AMPK-α during mitochondrial oxidative stress inhibits mammalian target of rapamycin signaling, which impairs phenotypic switching necessary for the growth of blood vessels.
Bis(Monoacylglycero)Phosphate Accumulation in Macrophages Induces Intracellular Cholesterol Redistribution, Attenuates Liver-X Receptor/ATP-Binding Cassette Transporter A1/ATP-Binding Cassette Transporter G1 Pathway, and Impairs Cholesterol Efflux
Authors: Luquain-Costaz Céline , Lefai Etienne , Arnal-Levron Maud , Markina Daria , Sakaï Shota , Euthine Vanessa , Makino Asami , Guichardant Michel , Yamashita Shizuya , Kobayashi Toshihide , Lagarde Michel , Moulin Philippe , Delton-Vandenbroucke Isabelle
Published: June 2013

Objective—

Endosomal signature phospholipid bis(monoacylglycero)phosphate (BMP) has been involved in the regulation of cellular cholesterol homeostasis. Accumulation of BMP is a hallmark of lipid storage disorders and was recently reported as a noticeable feature of oxidized low-density lipoprotein–laden macrophages. This study was designed to delineate the consequences of macrophage BMP accumulation on intracellular cholesterol distribution, metabolism, and efflux and to unravel the underlying molecular mechanisms.

Approach and Results—

We have developed an experimental design to specifically increase BMP content in RAW 264.7 macrophages. After BMP accumulation, cell cholesterol distribution was markedly altered, despite no change in low-density lipoprotein uptake and hydrolysis, cholesterol esterification, or total cell cholesterol content. The expression of cholesterol-regulated genes sterol regulatory element–binding protein 2 and hydroxymethylglutaryl-coenzyme A reductase was decreased by 40%, indicative of an increase of endoplasmic reticulum–associated cholesterol. Cholesterol delivery to plasma membrane was reduced as evidenced by the 20% decrease of efflux by cyclodextrin. Functionally, BMP accumulation reduced cholesterol efflux to both apolipoprotein A1 and high-density lipoprotein by 40% and correlated with a 40% decrease in mRNA contents of ATP-binding cassette transporter A1, ATP-binding cassette transporter G1, and liver-X receptor α and β. Foam cell formation induced by oxidized low-density lipoprotein exposure was exacerbated in BMP-enriched cells.

Conclusions—

The present work shows for the first time a strong functional link between BMP and cholesterol-regulating genes involved in both intracellular metabolism and efflux. We propose that accumulation of cellular BMP might contribute to the deregulation of cholesterol homeostasis in atheromatous macrophages.
Emergency Department Bypass for ST-Segment–Elevation Myocardial Infarction Patients Identified With a Prehospital Electrocardiogram
Authors: Bagai Akshay , Jollis James G. , Dauerman Harold L. , Peng S. Andrew , Rokos Ivan C. , Bates Eric R. , French William J. , Granger Christopher B. , Roe Matthew T.
Published: June 2013

Background—

For patients identified before hospital arrival with ST-segment–elevation myocardial infarction, bypassing the emergency department (ED) with direct transport to the catheterization laboratory may shorten reperfusion times.

Methods and Results—

We studied 12 581 ST-segment–elevation myocardial infarction patients identified with a prehospital ECG treated at 371 primary percutaneous coronary intervention–capable US hospitals participating in the Acute Coronary Treatment and Intervention Outcomes Network Registry–Get With The Guidelines, including those participating in the American Heart Association Mission: Lifeline program from 2008 to 2011. Reperfusion times with primary percutaneous coronary intervention and in-hospital mortality rates were compared between patients undergoing ED evaluation and those bypassing the ED. ED bypass occurred in 1316 patients (10.5%). These patients had a lower frequency of heart failure and shock on presentation and nonsystem reasons for delay in percutaneous coronary intervention. ED bypass occurred more frequently during working hours compared with off-hours (18.3% versus 4.3%); ED bypass rate varied significantly across hospitals (median, 3.3%; range, 0%–71%). First medical contact to device activation time was shorter (median, 68 minutes [interquartile range, 54–85 minutes] versus 88 minutes [interquartile range, 73–106 minutes];
P
<0.0001) and achieved within 90 minutes more frequently (80.7% versus 53.7%;
P
<0.0001) with ED bypass. The unadjusted in-hospital mortality rate was lower among ED bypass patients (2.7% versus 4.1%;
P
=0.01), but the adjusted mortality risk was similar (adjusted odds ratio, 0.69; 95% confidence interval, 0.45–1.03;
P
=0.07).

Conclusions—

Among ST-segment–elevation myocardial infarction patients identified with a prehospital ECG, the rate of ED bypass varied significantly across US hospitals, but ED bypass occurred infrequently and was mostly isolated to working hours. Because ED bypass was associated with shorter reperfusion times and numerically lower mortality rates, further exploration of and advocacy for the implementation of this process appear warranted.
Verb Transitivity and Ancient Hebrew מושׁ in Zechariah 3:9
Authors: Rogland Max
Published: June 2013

Abstract

This study argues that the verb מושׁ is used intransitively in Zech 3:9 with the sense of “to depart” and that the particle את is best interpreted as the preposition “with” rather than as the nota accusativi.
An Explanation for the Reading ἐν µέσῳ αὐτῆς in LXX-Jer 29:14 in Light of Dalet-Resh Interchange
Authors: Riley Jason
Published: June 2013

Abstract

This article argues that in LXX-Jer 29, the rendering ἐν µέσῳ αὐτῆς “in her midst” suggests that the Greek translator had before him a true variant which read בצדה rather than בצרה, which the MT reads. The variant בצדה is supported by several other Greek versions. Furthermore, dalet-resh interchange is a common phenomenon exhibited by LXX-Jer 29 and the parallel Hebrew texts.
The Decorated Stone from the Synagogue at Migdal
Authors: Aviam Mordechai
Published: June 2013

Abstract

In the center of the first century CE synagogue which was discovered at ancient Magdala (Migdal), a large decorated stone block was found. It is covered with decorative-symbolic elements on four sides and on the upper face as well, standing on four short legs. As the façade is carrying the Temple’s Menorah, this article will suggest that all other elements are not decorative but rather symbolic and symbolizing the Temple in Jerusalem. Another conclusion is that the block was used as a base for the Torah reading table in the synagogue. These symbols show that there was a very strong connection between Galileans and Jerusalem with the Temple in its center, and that there is an important reflection and relations between Jewish symbolism and Jewish heavenly mysticism as it appears in ancient Jewish sources, both Biblical and non-Biblical.
Three Models of Development: Community Ophthalmology NGOs and the Appropriate Technology Movement
Authors: Williams Logan D. A.
Published: June 2013

Abstract

This paper describes a new shift in the appropriate technology movement in less economically developed countries as seen in a multi-sited ethnography of non-governmental organizations (NGOs) in the scientific field of ophthalmology. This research reveals how Aravind Eye Care System in southern India and Tilganga Institute of Ophthalmology in Nepal are addressing “undone science” for avoidable blindness. They are creating the requisite local hospital and personnel infrastructure while conducting “civil society research.” They are also providing high quality modern care to low-income patients of the global south while charging reduced or no fees. This paper argues that they represent a third model in the appropriate technology movement—contextually appropriate local production of high technology. This third model focuses on socially responsible innovation for purposes of social improvement; it is rooted in nonprofit, social enterprise organizations to include the following four aspects: (1) scientific innovation or the “appropriation” of new science; (2) organizational innovation, including changes in operations management for self-sufficiency through multiple revenue streams; (3) technological innovation or the creation of new products and artifacts; and (4) an underlying ideological orientation that is based on local philosophy (and challenges hegemonic understandings of postcolonial dependency or neoliberalism).
The Market at the Bottom of the Pyramid: Understanding the Culture of Poverty
Authors: Ahmed Fauzia Erfan
Published: June 2013

Abstract

As never before, the private sector can make a difference at the bottom of the pyramid (BOP). But little is known about who the poor really are, the environment in which they live, and how to create value for them. This also means that little is known about how to establish a business at the BOP that meets both development and profit goals. This article presents a segmentation approach embedded in a larger theory of the culture of poverty to help businesses focus on serving the BOP. I focus on examples from my research on the Grameen Bank in Bangladesh and Patrimonio Hoy in Mexico to show examples of applications of segmentation theory to businesses at the BOP.
Fear Control in Media Discourse
Authors: Marko Davor
Published: June 2013

This article deals with how fear is misused in media discourse. Pursuing the claim that it is impossible to eliminate fear from the public sphere, this paper argues that fear control is a technique widely used by certain interest groups to generate and spread uncertainty among people in order to create an atmosphere in which their goals are easily reachable. This paper will discuss the concepts of discourse, hegemony, and power relations in order to show how public language (both written and spoken) in media discourse reflects, creates, and maintains power relations. In this sense, fear, which is a crucial “energizing fuel” of such public language, could be considered and further elaborated as both a contextual variable and as a tool for facilitating power relations by applying various techniques. Aiming to show how media use and control the nature and level of fear in public discourse, I will discuss two techniques – the commercialization of fear and the method of “othering.” While commercialization implies the mass (re)production and (re)appropriation of fear in a public space, “othering” has been applied when the object of reporting is an out-group individual or community and self-group is using the media as a tool for their negative portrayal, thus creating boundaries and provoking discrimination and violence. The case of Serbia will be used to indicate how techniques of “othering,” linked with the regime’s propaganda, may contribute to the creation of an atmosphere of fear, and make a people seek protection and become easy prey for manipulation.
The Constitutional Consequences of the Failure of Intra-religious Accommodation in Pakistan: Implications for Religious Liberty in a Religious Nationalist State
Authors: Tanchum Micha’el M.
Published: June 2013

This article examines how the failure to defend intra-religious accommodation from sectarian challenges in the public sphere creates structures of political opportunity for religious extremist organizations to exert a constraining influence on positive law-making and individual rights. Through a comparison of the government response to Sunni sectarian agitation during the 1950s and the early 1970s in Pakistan, each time conducted by organizations affiliated with the Deobandi movement (the movement that later created the Taliban in 1994), it will be shown how the failure to uphold intra-religious accommodation impacted the Pakistan’s constitutional development and furthered Pakistan’s shift from liberal democracy to Islamism. The article suggests that a religious discourse of intra-religious accommodation, not a prohibition of religious expression in the public sphere (laïcité), can serve as an important foundation for the development of religious liberty and civil society in newly democratizing Muslim societies.
The Art of Hybrid Images: Two for the View of One
Authors: Oliva Aude
Published: June 2013

Hybrid images are static pictures with two interpretations that change depending on the image’s viewing distance or size. The phenomenon of hybrid images arises from the multiscale processing of images in the human visual system. By taking into account perceptual grouping mechanisms, one can build compelling hybrid images with two different stable interpretations: one that appears when the image is viewed up-close, and the other that appears from afar. Hybrid images can be used to create compelling prints and photographs in which the observer experiences different percepts when interacting with the image.
Spatial Gradients in Aerosol-Induced Atmospheric Heating and Surface Dimming over the Oceanic Regions around India: Anthropogenic or Natural?
Authors: Nair Vijayakumar S. , Babu S. Suresh , Moorthy K. Krishna , Prijith S. S.
Published: June 2013

Making use of the extensive shipboard and aircraft measurements of aerosol properties over the oceanic regions surrounding the Indian peninsula, under the Integrated Campaign for Aerosols, gases and Radiation Budget (ICARB) field experiment during the premonsoon season (March–May), supplemented with long-term satellite data and chemical transport model simulations, investigations are made of the east–west and north–south gradients in aerosol properties and estimated radiative forcing, over the oceans around India. An eastward gradient has been noticed in most of the aerosol parameters that persisted both within the marine atmospheric boundary layer and above up to an altitude of ~6 km; the gradients being steeper at higher altitudes. It was also noticed that the north–south gradient has contrasting patterns over the Bay of Bengal and the Arabian Sea on the either side of the Indian peninsula. The aerosol-induced atmospheric heating rate increased from a low value of ≤0.1 K day−1 in the southwestern Arabian Sea to as high as ~0.5 K day−1 over the northeastern Bay of Bengal. The simulations of species-resolved spatial gradients have revealed that the observed gradients are the result of the strong modulations by anthropogenic species over the natural gradients, thereby emphasizing the role of human activities in imparting regional forcing. These large spatial gradients in aerosol forcing induced by mostly anthropogenic aerosols over the oceanic regions around the Indian peninsula can potentially affect the regional circulation patterns.
The Strain Index and ACGIH TLV for HAL
Authors: Kapellusch Jay M. , Garg Arun , Hegmann Kurt T. , Thiese Matthew S. , Malloy Elizabeth J.
Published: June 2013

Objective:

The objective of this study was to investigate the association between job physical exposure (JPE) and incidence of flexor tendon entrapment of the digits (FTED).

Background:

FTED, commonly known as trigger digit, is associated with age, gender, and certain health disorders. Although JPE has been suggested as a risk factor for FTED, there are no prospective cohort studies.

Method:

A cohort of 516 workers was enrolled from 10 diverse manufacturing facilities and followed monthly for 6 years. Worker demographics, medical history, and symptoms of FTED were assessed. JPE was individually measured using the Strain Index (SI) and American Conference of Governmental Industrial Hygienists (ACGIH) threshold limit value for hand activity level (TLV for HAL). Changes in JPE (assessed quarterly) and symptoms (assessed monthly) were recorded during follow-up. FTED was defined as demonstrated triggering on examination.

Results:

Point prevalence of FTED at baseline was 3.6%. During follow-up there were 23 incident FTED cases (left and/or right hands). The incident rate for first occurrence of FTED from enrollment was 1.38 per 100 person-years. Risk factors were JPE, age, gender, diabetes mellitus, carpometacarpal osteoarthrosis, and rheumatoid arthritis. In multivariate models, the SI showed strong association with risk of FTED when treated as a continuous variable and marginal association when dichotomized (SI > 6.1). TLV for HAL showed a statistical trend of increasing risk of FTED using the ACGIH limits, but no association as a continuous variable.

Conclusions:

Both JPE and personal risk factors are associated with FTED development. The SI and TLV for HAL are useful tools for estimating JPE.
Accountability as a policy technology: accounting for education performance in Europe
Authors: Ozga Jenny
Published: June 2013

This article discusses the investigation of accountability in different national contexts in the rapidly developing and increasingly important policy field of education in Europe. It draws on recent and current research to argue for a focus on what changing practices of accountability in education tell us about changes in governing education (and by extension, other public policy areas) within and across shifting policy spaces. The article further argues that accountability in education is increasingly defined as technical accountability through international and national comparative measures of performance, so that political accountability has been displaced, and performativity contributes to growing problems of diminished trust across and within education systems.

Points for practitioners

This article seeks to place the development of comparative measures of performance – in education and in other public sector provision – in a critical frame that draws attention to the reduction in political accountability that accompanies the explosion of performance measurement. The article underlines the extent to which competitive measurement of performance both drives out other, more complex forms of assessment of performance and creates relations of mistrust between education professionals and governments. Professionals working in the education sector are encouraged to scrutinize the operation of technologies like PISA and to be informed about their political effects and assumptions
From civil servants to liberal professionals: an empirical analysis of the reform of Portuguese notaries
Authors: Tavares António F , Rodrigues Miguel A
Published: June 2013

The use of market mechanisms has been progressively introduced as an alternative solution to public service delivery since the 1980s. This work addresses an uncommon public service function – civil law notaries – and seeks to analyse the factors that led to the formation of diverse market structures as a result of the choice of the privatization path over civil service status by public notaries. The Portuguese government gave public notaries the choice of becoming private, and regulated a numerus clausus of notaries by district. Since the reform was completed, a diversity of market structures have prevailed throughout the 278 notarial districts. Our key hypothesis is that markets with multiple agents formed in jurisdictions having a larger and more profitable number of notary and legal acts that provided financial survival and profit. In contrast, monopolies formed as a result of a perceived absence of market opportunities and demand. During the period 2010–11 we collected data from official statistics of the notary system supplemented by data on the economic and demographic features of each jurisdiction. Multinomial logistic regression is used to test the key hypothesis regarding market arrangements in the 278 notarial districts of continental Portugal.

Points for practitioners

The trend in the deregulation of the notary profession is likely to continue to sweep European Union countries. Lessons can be drawn from the Portuguese experience, where the change from civil service status is not yet mandatory for all notaries, but financial constraints and fiscal pressures indicate privatization as the inevitable path.
Analysing the role of ministerial cabinets in Italy: legacy and temporality in the study of administrative reforms
Authors: Di Mascio Fabrizio , Natalini Alessandro
Published: June 2013

The article explores the transformations which have occurred in ministerial cabinets as entrenched advisory structures in the Italian executive since the early 1990s when the party system collapsed and a permanent cycle of public management reforms was introduced. It examines how ministerial advisers have acquired a greater role in executive coordination filling the void of governing capacity left by the failed institutionalization of the new party system. In doing so, the empirical analysis identifies the constellation of actors that reproduced ministerial cabinets as a legacy of the past in the present set-up of the Italian system, eventually hindering the innovation of governance structures according to international standards.

Points for practitioners

This article seeks to contribute to the literature on the development of ministerial staff as a key manifestation of increasing public service politicization. With its more nuanced type of legacy explanation, focused on the identification of causal mechanisms that link institutional arrangements and actor choices in reform processes, the article can also contribute to general debates on the role of time in public management. It also recommends an integrated focus on the different policies of civil service reform in order to map interrelations of administrative changes.
Religion and Interconnection With Zimbabwe
Authors: Machoko Collis Garikai
Published: June 2013

The author argues that the continuous connection between Zimbabwean Diasporic Canadians (ZDC) and their homeland Zimbabwe is facilitated by the ZDC’s ongoing relationship and involvement with Zimbabwean African Indigenous Religion (AIR) and Zimbabwean African Initiated Churches (AICs). The two spiritual institutions are used as vehicles to alleviate cultural and racial discrimination as well as the socioeconomic challenges faced by the ZDC. The methodologies of interviews and participant observation were used. Research indicates that ZDC maintain their ties with Zimbabwe through continued engagement with AIR and AIC, who establish and assert themselves as vehicles of interaction and interdependence between Zimbabwe and the ZDC. In addition to their religious preoccupation, these institutions also play an important economic and social role in the lives of the ZDC. The conclusion is that ZDC did not make a complete break with their homeland.
Vitamin D and Periodontal Health in Older Men
Authors: Alshouibi E.N. , Kaye E.K. , Cabral H.J. , Leone C.W. , Garcia R.I.
Published: June 2013

Vitamin D, an anti-inflammatory mediator, has potential benefits for physical and oral health. Although it is produced endogenously, some individuals have a greater need for dietary and supplemental sources. This repeated-measures cross-sectional study assessed associations between total vitamin D intake and periodontal health in older men. Participants were 562 members of the Department of Veterans Affairs Dental Longitudinal Study, mean age 62.9 years, who were examined 1 to 4 times between 1986 and 1998. A calibrated examiner measured probing pocket depth (PPD) and attachment loss (AL) on each tooth. Alveolar bone loss (ABL) was determined from radiographs. Severe periodontal disease was defined as PPD ≥ 5 mm on ≥ 1 tooth and AL ≥ 6 mm at ≥ 2 sites (not on same tooth), and moderate-to-severe alveolar bone loss as ABL ≥ 40% at ≥ 3 sites. Generalized estimating equations were used to compute the odds ratios (OR) and 95% confidence intervals (95% CI) of having periodontal disease by level of vitamin D intake. Total vitamin D intake ≥ 800 IU was associated with lower odds of severe periodontal disease (OR = 0.67, 95% CI = 0.55-0.81) and moderate-to-severe ABL (OR = 0.54, 95% CI = 0.30-0.96) relative to intake < 400 IU/day. Vitamin D intake may protect against periodontal disease progression.
Thermal comfort and waterproof-breathable performance of aluminum-coated polyurethane nanowebs
Authors: Kim Keum Seo , Park Chung Hee
Published: June 2013

In this study, aluminum (Al) vapor was deposited on the surface of electrospun polyurethane nanowebs in order to improve their thermal comfort while maintaining water vapor permeability. After the deposition, the pore size and air permeability decreased, while the water vapor permeability remained at a level of 5000g/m2·24hr. Because of the reflection of the radiation heat, the thermal resistance increased by 30–40% compared with untreated nanowebs. Evaluation of clothing performance using a thermal sweating manikin demonstrated that the water vapor resistance of the deposited nanowebs was lower and the thermal resistance was higher than existing waterproof–breathable textiles.
Characteristics and outcomes of liver and lung hydatid disease in children
Authors: Çevik Muazez , Eser Irfan , Boleken Mehmet Emin
Published: June 2013

Our study retrospectively evaluates and compares the characteristics of lung and liver hydatid disease (HD) in children. This retrospective study was performed between 2007 and 2012 using the medical records of patients aged ≤17 years of age who had liver and/or lung HD. They were evaluated using the demographic characteristics of the patients, clinical presentation, hospital stay and outcome. A total of 252 cysts were identified in 152 of the patients. The incidence of HD increased with age and the majority of patients were older than 9 years. Overall, lung HD was more complicated and symptomatic than liver HD on initial admission.
Evaluation of visual inspection as the primary screening method in a four-year cervical (pre-) cancer screening program in rural China
Authors: Li Rong , Zhou Qi , Li Ming , Tong Shao-Min , He Mei , Qiu Hui , Zhang Jin-Song , Zhang Qiao-Yu
Published: June 2013

The aim of the study is to evaluate the feasibility of visual inspection with acetic acid/Lugol’s iodine (VIA/VILI) as a primary screening method for cervical lesions in low-resource settings in China. Participants underwent VIA/VILI, and, if positive, received colposcopy and direct biopsy of visible lesions. Women who were negative for VIA/VILI or who were diagnosed with cervical intraepithelial neoplasia (CIN) 1 were re-screened the following year with the same procedure. In total, 10,269 women received VIA/VILI (of whom 8263, twice). Overall test positivity was 8.07% (1495/18532) for VIA/VILI, 33.44% (500/1495) for colposcopy, and the incidence of pathology-confirmed CIN1, CIN2/3 and cervical cancer was 0.85% (87/10,269), 0.53% (54/10,269) and 0.02% (2/10,269), respectively. Women aged 30–39 years at screening had higher rates of CIN2+ (include CIN2, CIN3 and cervical cancer). Our study indicates that VIA/VILI is a simple, feasible, and effective primary cervical cancer screening method in an impoverished, rural community that lacks access to standard medical care.
A diary examination of romantic and sexual partners withholding affectionate messages
Authors: Carton Shannon T. , Horan Sean M.
Published: June 2013

Expressing and receiving affectionate messages have emotional and physiological benefits (Floyd, 2006a). Previously, research has called for an examination of why people withhold affectionate messages that may provide these positive effects (Horan & Booth-Butterfield, 2013). Accordingly, this study examined instances of withholding affection in a variety of romantic relationships. Participants initially completed general scales of deception and affection followed by a 7-day diary detailing what they felt when they withheld affection, what they communicated in place of affection, and their deceptive motives. After inductively developing a coding scheme, 12 themes were identified for what participants felt, the most common of which were liking, a desire for affection, and irritation. Eleven themes emerged for what was communicated in lieu of affection, some of which were moderated affection, rejection, and jealousy-evoking. Eleven themes emerged for reasons why participants withheld affection, including concern for perception, inappropriate circumstances, punishment, and using withholding affection to test a romantic partner. There were no variations in frequency of deception, expressed or received affection based on participant sex or relationship type. Withholding affection is a common and complex process in relationships.
Validation of the Longer-term Unmet Needs after Stroke (LUNS) monitoring tool: a multicentre study
Authors:   LoTS care LUNS study team, Forster Anne , Murray Jenni , Young John , Shannon Rosie , Mellish Kirste , Horton Mike , Tennant Alan , Breen Rachel , Alvarado Natasha , Bhakta Bipin , Bogle Sue , Hewison Jenny , House Allan
Published: June 2013

Objective:

To evaluate the acceptability, test–retest reliability and validity of the Longer-term Unmet Needs after Stroke monitoring tool.

Design:

A questionnaire pack was posted to stroke survivors living at home three or six months after stroke. A second pack was sent two weeks after receipt of the completed first pack.

Setting:

Stroke survivors living at home across England.

Subjects:

Stroke survivors were recruited from 40 hospitals across England, in two phases. The first with an optimal cohort of patients, the second to capture a broader post-stroke population, including those with communication and/or cognitive difficulties. Patients were excluded if they required palliative care or if permanent discharge to a nursing or residential home was planned.

Main measures:

The questionnaire pack included the Longer-term Unmet Needs after Stroke tool, General Health Questionnaire-12, Frenchay Activities Index, and Short Form-12.

Results:

Interim analysis of phase 1 data ( n = 350) indicated that the tool was sufficiently robust to progress to phase 2 ( n = 500). Results are reported on the combined study population. Of 850 patients recruited, 199 (23%) had communication and/or cognitive difficulties. The median age was 73 years (range 28–98). Questionnaire pack return rate was 69%. For the new tool, there was 3.5% missing data and test–retest reliability was moderate to good (percentage item agreement 78–99%, kappa statistic 0.45–0.67). Identification of an unmet need was consistently associated with poorer outcomes on concurrent measures.

Conclusions:

The Longer-term Unmet Needs after Stroke tool is acceptable, reliable, can be self-completed, and used to identify longer-term unmet needs after stroke.