bluuebunny/crossref_metadata_2025 huggingface dataset:
Criteria for the ethical conduct of psychiatric neurosurgery clinical trials
Authors: Lipsman Nir , Bernstein Mark , Lozano Andres M.
Published: July 2010

There is an urgent need for an effective therapy for treatment-refractory mental illness. Trials ongoing globally that explore surgical treatment, such as deep brain stimulation, for refractory psychiatric disease have produced some promising early results. However, diverse inclusion criteria and variable methodological and ethical standards, combined with the sordid past of neuromodulation, confound trial interpretation and threaten the integrity of a new and emerging science. What is required is a standard of ethical practice, globally applied, for neurosurgical trials in psychiatry that protects patients and maintains a high ethical benchmark for clinicians and researchers to meet. With mental illness, as well as treatment resistance, reaching epidemic proportions, ethically and scientifically sound clinical trials will lead to effective and safe surgical treatments that will become vital components of the clinicians' armamentarium. Ethical criteria, such as the ones proposed here, need to be established now and applied in earnest if the field is to move forward and if patients with no other therapeutic options are to receive much-needed treatment.
Disrupting abnormal electrical activity with deep brain stimulation: is epilepsy the next frontier?
Authors: Rahman Maryam , Abd-El-Barr Muhammad M. , Vedam-Mai Vinata , Foote Kelly D. , Murad Gregory J. A. , Okun Michael S. , Roper Steven N.
Published: July 2010

Given the tremendous success of deep brain stimulation (DBS) for the treatment of movement and neuropsychiatric disorders, clinicians have begun to open up to the possible use of electrical stimulation for the treatment of patients with uncontrolled seizures. This process has resulted in the discovery of a wide array of DBS targets, including the cerebellum, hypothalamus, hippocampus, basal ganglia, and various thalamic nuclei. Despite the ambiguity of the mechanism of action and the unknowns surrounding potentially ideal stimulation settings, several recent trials have empirically demonstrated reasonable efficacy in selected cases of medication-refractory seizures. These exciting results have fueled a number of studies aimed at firmly establishing DBS as an effective treatment for selected cases of intractable epilepsy, and many companies are aiming at Food and Drug Administration approval. We endeavor to review the studies in the context of the various DBS targets and their relevant circuitry for epilepsy. Based on the unfolding research, DBS has the potential to play an important role in treating refractory epilepsy. The challenge, as in movement disorders, is to assemble interdisciplinary teams to screen, implant, and follow patients, and to clarify patient selection. The future will undoubtedly be filled with optimization of targets and stimulation parameters and the development of best practices. With tailored therapeutic approaches, epilepsy patients have the potential to improve with DBS.
Deep brain stimulation of the nucleus accumbens reduces alcohol intake in alcohol-preferring rats
Authors: Henderson Michael B. , Green Alan I. , Bradford Perry S. , Chau David T. , Roberts David W. , Leiter James C.
Published: July 2010

Object

The authors tested the hypothesis that deep brain stimulation (DBS) in the nucleus accumbens (NAcc) decreases alcohol intake in alcohol-preferring (P) rats after each animal has established a stable, large alcohol intake and after P rats with an established intake have been deprived of alcohol for 4–6 weeks.

Methods

Bipolar stimulating electrodes were bilaterally placed in the NAcc using stereotactic coordinates. In the first study, P rats (9 animals) were allowed to establish a stable pattern of alcohol intake (about 5–7 g/day) over approximately 2 weeks, and the acute effects of DBS in the NAcc (140–150 Hz, 60-μsec pulse width, and 200-μA current intensity) on alcohol intake and alcohol preference were studied. Each animal acted as its own control and received 1 hour of DBS followed by 1 hour of sham-DBS or vice versa on each of 2 sequential days. The order of testing (sham-DBS vs DBS) was randomized. In the second study, each animal was allowed to establish a stable alcohol intake and then the animal was deprived of alcohol for 4–6 weeks. Animals received DBS (6 rats) or sham-DBS (5 rats) in the NAcc for 24 hours starting when alcohol was reintroduced to each animal.

Results

Deep brain stimulation in the NAcc, as compared with a period of sham-DBS treatment in the same animals, acutely decreased alcohol preference. Furthermore, alcohol consumption and preference were significantly reduced in the DBS group compared with the sham treatment group during the first 24 hours that alcohol was made available after a period of forced abstinence.

Conclusions

The NAcc plays a key role in the rewarding and subsequent addictive properties of drugs of abuse in general and of alcohol in particular. Deep brain stimulation in the NAcc reduced alcohol consumption in P rats both acutely and after a period of alcohol deprivation. Therefore, DBS in the NAcc coupled with other neurophysiological measurements may be a useful tool in determining the role of the NAcc in the mesocorticolimbic reward circuit. Deep brain stimulation in the NAcc may also be an effective treatment for reducing alcohol consumption in patients who abuse alcohol and have not responded to other forms of therapy.
Deep brain stimulation compared with bariatric surgery for the treatment of morbid obesity: a decision analysis study
Authors: Pisapia Jared M. , Halpern Casey H. , Williams Noel N. , Wadden Thomas A. , Baltuch Gordon H. , Stein Sherman C.
Published: July 2010

Object

Roux-en-Y gastric bypass is the gold standard treatment for morbid obesity, although failure rates may be high, particularly in patients with a BMI > 50 kg/m2. With improved understanding of the neuropsychiatric basis of obesity, deep brain stimulation (DBS) offers a less invasive and reversible alternative to available surgical treatments. In this decision analysis, the authors determined the success rate at which DBS would be equivalent to the two most common bariatric surgeries.

Methods

Medline searches were performed for studies of laparoscopic adjustable gastric banding (LAGB), laparoscopic Roux-en-Y gastric bypass (LRYGB), and DBS for movement disorders. Bariatric surgery was considered successful if postoperative excess weight loss exceeded 45% at 1-year follow-up. Using complication and success rates from the literature, the authors constructed a decision analysis model for treatment by LAGB, LRYGB, DBS, or no surgical treatment. A sensitivity analysis in which major parameters were systematically varied within their 95% CIs was used.

Results

Fifteen studies involving 3489 and 3306 cases of LAGB and LRYGB, respectively, and 45 studies involving 2937 cases treated with DBS were included. The operative successes were 0.30 (95% CI 0.247–0.358) for LAGB and 0.968 (95% CI 0.967–0.969) for LRYGB. Sensitivity analysis revealed utility of surgical complications in LRYGB, probability of surgical complications in DBS, and success rate of DBS as having the greatest influence on outcomes. At no values did LAGB result in superior outcomes compared with other treatments.

Conclusions

Deep brain stimulation must achieve a success rate of 83% to be equivalent to bariatric surgery. This high-threshold success rate is probably due to the reported success rate of LRYGB, despite its higher complication rate (33.4%) compared with DBS (19.4%). The results support further research into the role of DBS for the treatment of obesity.
Surgical management of primary central nervous system germ cell tumors
Authors: Souweidane Mark M. , Krieger Mark D. , Weiner Howard L. , Finlay Jonathan L.
Published: July 2010

The successful treatment of children with a primary CNS germ cell tumor can be greatly influenced by the neurosurgeon involved in the diagnostic and therapeutic care of these children. Variability in surgical philosophies no doubt exists due to the relatively infrequent incidence of these tumors, a lack of consensus regarding diagnostic and therapeutic approaches, and the advent of recent surgical innovations. Many of these issues were discussed at the Second International Symposium on Central Nervous System Germ Cell Tumors through presented abstracts and invited presentations. The neurosurgical aspects of these proceedings are summarized here in an effort to present the agreed-upon and debated issues that may confront the pediatric neurosurgeon.
Alterations of pulsation absorber characteristics in experimental hydrocephalus
Authors: Park Eun-Hyoung , Dombrowski Stephen , Luciano Mark , Zurakowski David , Madsen Joseph R.
Published: July 2010

Object

Analysis of waveform data in previous studies suggests that the pulsatile movement of CSF may play a role in attenuating strong arterial pulsations entering the cranium, and its effectiveness in attenuating these pulsations may be altered by changes in intracranial pressure (ICP). These findings were obtained in studies performed in canines with normal anatomy of the CSF spaces. How then would pulsation absorbance respond to changes in CSF movement under obstructive conditions such as the development of hydrocephalus? In the present study, chronic obstructive hydrocephalus was induced by the injection of cyanoacrylate gel into the fourth ventricle of canines, and pulsation absorbance was compared before and after hydrocephalus induction.

Methods

Five animals were evaluated with simultaneous recordings of ICP and arterial blood pressure (ABP) before and at 4 and 12 weeks after fourth ventricle obstruction by cyanoacrylate. To assess how the intracranial system responds to the arterial pulsatile component, ABP and ICP waveforms recorded in a time domain had to be analyzed in a frequency domain. In an earlier study the authors introduced a particular technique that allows characterization of the intracranial system in the frequency domain with sufficient accuracy and efficiency. This same method was used to analyze the relationship between ABP and ICP waveforms recorded during several acute states including hyperventilation as well as CSF withdrawal and infusion under conditions before and after inducing chronic obstructive hydrocephalus. Such a relationship is reflected in terms of a gain, which is a function of frequency. The cardiac pulsation absorbance (CPA) index, which is simply derived from a gain evaluated at the cardiac frequency, was used to quantitatively evaluate the changes in pulsation absorber function associated with the development of hydrocephalus within each of the animals, which did become hydrocephalic. To account for normal and hydrocephalic conditions within the same animal and at multiple time points, statistical analysis was performed by repeated-measures ANOVA.

Results

The performance of the pulsation absorber as assessed by CPA significantly deteriorated after the development of chronic hydrocephalus. In these animals the decrement in CPA was far more significant than other anticipated changes including those in ICP, compliance, or ICP pulse amplitude.

Conclusions

To the extent that the free CSF movement acts as a buffer of arterial pulsation input to flow in microvessels, alterations in the pulsation absorber may play a pathophysiological role. One measure of alterations in the way the brain deals with pulsatile input—the CPA measurement—changes dramatically with the imposition of hydrocephalus. Results in the present study suggest that CPA may serve as a complementary metric to the conventional static measure of intracranial compliance in other experimental and clinical studies.
A ruptured middle cerebral artery aneurysm in a 13-month-old boy with Kawasaki disease
Authors: Ahn Jun Hyong , Phi Ji Hoon , Kang Hyun-Seung , Wang Kyu-Chang , Cho Byung-Kyu , Lee Ji Yeoun , Kim Gi Beom , Kim Seung-Ki
Published: July 2010

This 13-month-old boy, in whom Kawasaki disease had been diagnosed at the age of 6 months, presented with subarachnoid hemorrhage caused by the rupture of a middle cerebral artery aneurysm. The authors performed an emergency craniectomy and clip occlusion of the aneurysm, which was found to be partially thrombosed. The patient was discharged 4 weeks postoperatively without apparent neurological deficit.

Intracranial saccular aneurysms in the pediatric population are rare, and are occasionally associated with various systemic disorders. Kawasaki disease is a systemic vasculopathy of unknown origin, but cerebral arteries are usually spared from the disease process. This is the second case report of a ruptured cerebral aneurysm in a patient with Kawasaki disease, providing a novel clinical feature that the authors call Kawasaki syndrome.
Effects of sodium selenite and amiloride on calvarial calcification in closing small cranial defects
Authors: Yιlmaz Derviş Mansuri , Hacιyakupoğlu Ersin , Hacιyakupoğlu Sebahattin , Polat Sait , Özgür Hülya , Sencar Leman , Dağlιoğlu Kenan
Published: July 2010

Object

Fresh autogenous bone graft is the most preferred osteoplastic material, whether the purpose is cosmetic, psychological, or for the protection of the brain. These grafts are not rejected and do not react immunologically. The aim of this study was to evaluate the efficacy of autogenous fat rolled with bone dust derived from the bur hole in closing small cranial defects. Additionally, the authors examined the morphological and biochemical effects of Na selenite and amiloride on calvarial calcification.

Methods

The study group consisted of 20 domestic pigs. These animals were randomly divided into 4 groups. A bur hole with a diameter of 10 mm was made at the right parietal region in all animals, and then the periosteum around the bur hole was cauterized following exposure of the dura mater. The dura was coagulated with bipolar cautery. Group 1 (controls): only a bur hole was opened, and it was then closed with a mixture of the bone dust that had been created during the opening of the bur hole and fat tissue that was taken from the animal's neck. Group 2 (amiloride): 1 nmol/g body weight of amiloride was applied subcutaneously within 15 minutes after closure of the bur hole with bone dust and fat, and then amiloride was applied once a day for 4 weeks. Group 3 (Na selenite): 30 nmol/g body weight of Na selenite was applied subcutaneously within 30 minutes after closure of the bur hole with bone dust and fat, and then Na selenite was applied once a day for 4 weeks. Group 4 (amiloride and Na selenite): 1 nmol/g body weight of amiloride was applied subcutaneously at 15 minutes, and 30 nmol/g body weight of Na selenite was applied subcutaneously at 30 minutes after closure of the bur hole with bone dust and fat, and these 2 injections were repeated once a day for 4 weeks. At the end of 4 weeks, the animals were anesthetized to evaluate the closure of the bur hole. Tissue samples were obtained for ultrastructural and biochemical examination.

Results

The defect was covered with diffuse connective tissue in the control group. Although multiple capillary vessels were present, the authors did not observe osteogenic differentiation. Histological examination of the second group revealed osteogenic changes. Although new matrix was formed, calcification was not detected. The authors observed fibroblast, collagen fibers, and dense connective tissue filled with capillary in the third group of pigs, which had undergone Na selenite application. Calcification was not detected in this group. Both connective and osteogenic tissue were observed in specimens obtained in the fourth group, which had undergone amiloride and Na selenite application.

Conclusions

The authors experimentally evaluated the supplementary osteogenic effects of Na selenite and amiloride by using them separately and together. The findings seem promising as a lead-in to new studies in restoring cranial defects.
Use of lumboperitoneal shunts with the Strata NSC valve: a single-center experience
Authors: Toma Ahmed K. , Dherijha Muhammad , Kitchen Neil D. , Watkins Laurence D.
Published: July 2010

Object

The lumboperitoneal (LP) shunt with the adjustable PS Medical Strata NSC LP valve and small lumen peritoneal catheter was introduced in the authors' unit in 2007. The object of this study was to audit the unit's experience with this new shunt system.

Methods

The authors performed a retrospective review of the clinical records of patients who underwent Strata NSC LP shunt insertion. Demographic and clinical data as well as information about complications and revisions were reported.

Results

Between August 2007 and November 2009, 20 patients underwent placement of an LP shunt with an adjustable Strata NSC valve and small lumen peritoneal catheter at the authors' institution. Their mean age was 40.3 years and the mean duration of follow-up was 12 months. Preoperatively, 18 patients had headache and 15 patients had visual signs and symptoms. Fourteen of the 18 patients with preoperative headache did not complain of headache postoperatively, and 4 had headache that was found not to be related to shunt function. Two of the patients with preoperative visual complaints had ongoing visual problems postoperatively. None of the patients had infection or subdural hematoma. The only overdrainage symptoms occurred in association with spontaneous readjustment of the valve and resolved when the valve was reset.

Thirteen patients (65%) did not require shunt revision. Seven patients (35%) required 13 shunt exploration or revision procedures, mainly due to distal obstruction. Placement of an LP shunt failed to completely resolve the raised intracranial pressure problem in 2 patients.

Conclusions

The use of the Strata NSC valve and small lumen peritoneal catheter is effective in treating pseudotumor cerebri and is beneficial in terms of markedly reducing overdrainage complications compared with other reported series of cases in which an LP shunt has been placed. However, the use of the Strata NSC valve and small lumen peritoneal catheter did not have a marked impact on other causes of shunt failure, particularly distal obstruction.
Diagnostic value of magnetic resonance imaging in perimesencephalic and nonperimesencephalic subarachnoid hemorrhage of unknown origin
Authors: Maslehaty Homajoun , Petridis Athanassios K. , Barth Harald , Mehdorn Hubertus Maximilian
Published: July 2010

Object

The aim of this study was to evaluate the diagnostic value of MR imaging in perimesencephalic (PM) and nonperimesencephalic (non-PM) subarachnoid hemorrhage (SAH) of unknown origin.

Methods

The authors conducted a retrospective review of all patients with SAH (1226 patients) in their department between January 1991 and December 2008. Included in the study were cases of spontaneous SAH diagnosed using CT scans obtained within 24 hours of the initial symptoms and initially negative digital subtraction (DS) angiograms. Patients with traumatic SAH and an unknown history were excluded from the study. Patients with initially negative DS angiograms were divided into 2 groups: Group 1, a typically PM bleeding pattern (PM SAH); and Group 2, a non-PM bleeding pattern (non-PM SAH) such as hemorrhage in the sylvian or interhemispheric fissure. Cranial MR imaging including the craniocervical region was performed within 72 hours after SAH was diagnosed in all patients in Groups 1 and 2.

Results

One thousand sixty-eight patients underwent DS angiography, and among them were 179 (16.7%) with negative angiograms—47 patients (26.3%) from Group 1 and 132 patients (73.7%) from Group 2. Magnetic resonance imaging demonstrated no bleeding sources in any case (100% negative). Thirty-four patients in Group 1 and 120 patients in Group 2 underwent a second DS angiography study. Digital subtraction angiography revealed an aneurysm as the bleeding source in 1 case in Group 1 and in 13 cases in Group 2.

Conclusions

Magnetic resonance imaging of the brain and craniocervical region did not produce additional benefit for the detection of a bleeding source and the therapy administered for PM SAH and non-PM SAH (100% negative). The costs of this examination exceeded the clinical value. Despite the results of this study, MR imaging should be discussed on a case-by-case basis because rare bleeding sources are periodically diagnosed in cases of non-PM SAH. A second-look DS angiogram is necessary because aneurysmal hemorrhage occasionally produces PM SAH as well as non-PM SAH. Further prospective studies are needed to verify the authors' results in the future.
Vacuum-assisted en bloc resection of large convexity meningiomas
Authors: Fox Benjamin D. , Mitchell Bartley D. , Patel Akash J. , Relyea Katherine , Gopinath Shankar P. , Tatsui Claudio , Ehni Bruce L.
Published: July 2010

Convexity meningiomas are common tumors encountered by neurosurgeons. Retracting, grasping, and mobilizing large convexity meningiomas can be difficult and awkward as well as place unwanted forces on surrounding neurovascular structures. The authors present a safe alternative to traditional retraction and manipulation methods by using a modified bulb syringe connected to standard surgical suction to function as a vacuum retractor. This technique allows for rapid, safe, en bloc resection of large convexity meningiomas with little to no pressure on the surrounding brain. The authors present an illustrative case and describe and discuss the technique.
A Forest Management Process to Incorporate Multiple Objectives: a Framework for Systematic Public Input
Authors: Hossain Shaik Md. Yousuf , Robak E.W.
Published: July 2010

A multi-objective forest management process employing mathematical programming and the analytic hierarchy process has been developed for systematically incorporating public input. The process was tested as a “proof of concept” for four values and five stakeholders in Crown License 5 in New Brunswick. The impacts of tradeoffs among various weighting schemes were evaluated. Analyses of stakeholders’ expected satisfaction were conducted for each scenario. The forest management implications of different weighting methods are discussed.
Characterization of the Exopolysaccharide Produced by Salipiger mucosus A3T, a Halophilic Species Belonging to the Alphaproteobacteria, Isolated on the Spanish Mediterranean Seaboard
Authors: Llamas Inmaculada , Mata Juan Antonio , Tallon Richard , Bressollier Philippe , Urdaci María C. , Quesada Emilia , Béjar Victoria
Published: July 2010

We have studied the exopolysaccharide produced by the type strain of Salipiger mucosus, a species of halophilic, EPS-producing (exopolysaccharide-producing) bacterium belonging to the Alphaproteobacteria. The strain, isolated on the Mediterranean seaboard, produced a polysaccharide, mainly during its exponential growth phase but also to a lesser extent during the stationary phase. Culture parameters influenced bacterial growth and EPS production. Yield was always directly related to the quantity of biomass in the culture. The polymer is a heteropolysaccharide with a molecular mass of 250 kDa and its components are glucose (19.7%, w/w), mannose (34%, w/w), galactose (32.9%, w/w) and fucose (13.4%, w/w). Fucose and fucose-rich oligosaccharides have applications in the fields of medicine and cosmetics. The chemical or enzymatic hydrolysis of fucose-rich polysaccharides offers a new efficient way to process fucose. The exopolysaccharide in question produces a solution of very low viscosity that shows pseudoplastic behavior and emulsifying activity on several hydrophobic substrates. It also has a high capacity for binding cations and incorporating considerable quantities of sulfates, this latter feature being very unusual in bacterial polysaccharides.
Synthesis and Antimicrobial Activity of Some New Quinoxaline Derivatives
Authors: Singh Dharmchand Prasad , Deivedi Sanjay Kumar , Hashim Syed Riaz , Singhal Ram Gopal
Published: July 2010

2-Chloro-3-methylquinoxaline was selected as a nucleus around which various molecular transformations were performed to obtain new compounds expected to possess optimized antimicrobial activity. As very little work regarding attachment of ether linkages replacing chlorine at C-2 has been reported, it was thought worthwhile to synthesize various quinoxaline derivatives by replacing the C2 chlorine with an ether linkage attached to a benzene ring possessing an aldehyde or a free amino group which can be further reacted with aromatic amines and aromatic aldehydes, respectively, to yield new Schiff bases containing quinoxaline moieties. Thus the compounds 4-(2-methylquinoxalinyloxy) benzaldehyde (4), 2-[4-(substituted-benziminomethyl)-phenoxy]-3-methyl quinoxalines 5a–e, 4-(2-methyl-quinoxaline-3-yloxy)benzamine (6) and 4-(2-methylquinoxalin-3-yloxy)-N-substituted benzylidine benzamines 7a–e were synthesized and tested for their antimicrobial activity. The structures of the compounds were confirmed on the basis of their elemental and spectral data.
Extending the Influence of Scenario Development in Sustainability Planning and Strategy
Authors: Mulvihill Peter R. , Kramkowski Victoria
Published: July 2010

There is wide agreement that a transition toward deeper forms of sustainability would require transformational changes at many levels, transcending current patterns of incremental progress. Transformational changes might only occur, in many instances, over time frames that extend well beyond those of mainstream approaches to planning. The need for more explicit attention to longer term futures is reflected in the increasing use of scenario-based processes applied to sustainability challenges. The full potential of scenario development remains, however, largely untapped; many audiences have yet to be engaged, intrigued and influenced by them. This review article explores key barriers to more effective use of scenario development in relation to sustainability challenges, including: (1) the persistent predictive orientation of sustainability planning exercises; (2) the relatively low level of interest in weak signals and their implications; (3) institutionalized aversion to long term planning; and (4) the predominance of an essentialist perspective.
The Influence of Bicarbonate/Lactate-Buffered PD Fluids on Nε-(Carboxyethyl)Lysine and Nε-(Carboxymethyl)Lysine in Peritoneal Effluent
Authors: Cnossen Trijntje T. , Gladziwa Ulrich , Van De Kerkhof Jos J. , Schalkwijk Casper G. , Scheijen Jean , Van Amersfoort Jolanda , Moret Karin , Beerenhout Charles H. , Kooman Jeroen P.
Published: July 2010

Objective

Accumulation of advanced glycation end products (AGEs) may be involved in the pathogenesis of peritoneal membrane dysfunction. As glycoxidation may play an important role in AGE formation, peritoneal dialysis fluids with low levels of glucose degradation products (GDPs) might result in a reduction in AGE concentration in the peritoneal effluent. The aim of this study was to compare the effects of conventional glucose-containing dialysis solutions and low GDP level fluids on the concentration of the AGEs Nε-(carboxymethyl)lysine (CML) and Nε-(carboxyethyl)lysine (CEL) in peritoneal effluent.

Design

Prospective randomized control study.

Methods

23 patients were treated with either conventional glucose-containing fluid ( n = 11, group A) or low level GDP fluid ( n = 12, group B) during a period of 12 weeks. Before and after this period, CML and CEL were measured in peritoneal effluent.

Results

In groups A and B there were changes in CML concentrations [respectively 13.7 ± 17.0 and -16.0 ± 46.0 nmol/L (NS)] and CEL concentrations (respectively 20.3 ± 26.6 and -8.8 ± 18.9 nmol/L, p = 0.015). Residual renal function (RRF) in groups A and B was, respectively, 6.8 and 6.1 mL/min (NS). CML, but not CEL, in the peritoneal effluent was inversely related to RRF ( r = -0.67, p < 0.05).

Conclusion

CEL, but not CML, in the peritoneal effluent appears to be influenced by the prescription of low GDP level fluid, probably due to the highly reduced concentration of methylglyoxal, which is needed for formation of CEL. CML is primarily influenced by RRF.
Academic Integrity in an Online Registered Nurse to Baccalaureate in Nursing Program
Authors: Hart Leigh , Morgan Lesley
Published: July 2010

Background:

The number of nursing programs offering online courses continues to expand. This is a relatively new method of instruction that has not been extensively evaluated. Academic integrity in the online classroom is one area of concern. This study compared academic integrity in both an online and a traditional classroom registered nurse to baccalaureate in nursing (RN-BSN) program.

Methods:

A comparative descriptive design was used to evaluate academic integrity in the two RN-BSN cohorts.

Results:

The traditional classroom RN-BSN students reported higher levels of cheating compared with the online students. Self-reported cheating behaviors were higher among younger students in the traditional classroom.

Conclusion:

This study did not support contemporary concerns that cheating is more prevalent in online courses.
Continued Competency and Board Regulation: One State Expands Options
Authors: Thomas Mary Beth , Benbow Denise A. , Ayars Virginia D.
Published: July 2010

State boards of nursing are mandated by state statutes to ensure the ongoing safe and competent practice of licensees. However, nursing practice is characterized by diversity in educational backgrounds, scope of practice, and variety of settings. As a result, regulatory agencies face many challenges. After years of study, the Texas Board of Nursing has identified two areas for change to the current regulatory model. The first area is a recommendation that nurses obtain continuing education credit in the individual nurse’s area of practice. The second area is an acknowledgment of national specialty nursing certification as one method of demonstrating continuing competency in the nurse’s specialty or area of practice. Both professional and vocational/practical nurses are affected by the rule changes.
Alice Through the Looking Glass: The Influence of Self and Student Understanding on Role Actualization Among Novice Clinical Nurse Educators
Authors: Janzen Katherine J.
Published: July 2010

In response to a shortage of qualified academicians, the past decade has seen nurses who are expert practitioners move into the role of clinical faculty. Although the literature on this transition is emerging, little is known about how expert practitioners actualize that transition or the prescribed paths to follow. This article describes how the understanding of self and student assists in actualizing the role of clinical nurse educator. The author uses a metaphor of Alice stepping through the looking glass to present three dimensions that expert practitioners pass through in their journey to clinical nurse educator. A conceptual model is provided to enhance clarity.
Expanding Simulation to Teach Family Nursing
Authors: Eggenberger Sandra K. , Regan Mary
Published: July 2010

Caring for families during an illness experience is increasingly recognized as a core of nursing practice. Yet research reports deficiencies in the current state of family nursing care. It is possible that these deficiencies are rooted in a lack of integrating family care throughout nursing education and a focus on the biomedical science paradigm. As a relational skill, family care requires different pedagogical approaches to effectively teach family nursing. Simulation is one such approach. Even though simulation is rapidly moving into nursing education, the primary focus is teaching psychomotor nursing skills, rather than caring and family nursing.
Measurement of Intraocular Pressure with Pressure Phosphene Tonometry in Children
Authors: Fan Dorothy S. P. , Chiu Thomas Y. H. , Congdon Nathan , Chan Jeffrey C. W. , Cheung Eva Y. Y. , Lam Dennis S. C.
Published: July 2010

Purpose:

To study the accuracy and acceptability of intraocular pressure (IOP) measurement by the pressure phosphene tonometer, non-contact tonometer, and Goldmann tonometer in children.

Methods:

Fifty children (5 to 14 years old) participated in this prospective comparative study. IOP was measured with the pressure phosphene tonometer, non-contact tonometer, and Goldmann tonometer by three different examiners who were masked to the results. The children were also asked to grade the degree of discomfort from 0 to 5 (0 = no discomfort; 5 = most discomfort).

Results:

The mean IOPs measured by the Goldmann tonometer, pressure phosphene tonometer, and non-contact tonometer were 15.9 mm Hg (standard deviation [SD]: = 5.5 mm Hg; range: 10 to 36 mm Hg), 16.0 mm Hg (SD: 2.9 mm Hg; range: 12 to 25 mm Hg), and 15.7 mm Hg (SD = 5.1 mm Hg; range: 8 to 32 mm Hg), respectively (
P
= .722). The mean difference between pressure phosphene tonometer and Goldmann tonometer readings was 2.9 mm Hg and that between non-contact tonometer and Goldmann tonometer readings was 2.1 mm Hg. The 95% confidence interval of the mean difference between pressure phosphene tonometer and Goldmann tonometer readings was −1.07 and 1.19, and that between non-contact tonometer and Goldmann tonometer readings was −1.07 and 0.53. The mean discomfort ratings for the pressure phosphene tonometer, non-contact tonometer, and Goldmann tonometer were 0.6, 2.0, and 2.3, respectively (
P
< .001).

Conclusion:

Although the pressure phosphene tonometer was less accurate than the non-contact tonometer compared with Goldmann tonometer, it gave a reasonably close estimate and had a high specificity of raised IOP. In addition, measurement by the pressure phosphene tonometer is most acceptable to children. The pressure phosphene tonometer can be considered as an alternative method of IOP measurement in children.
Glaucoma Following Infantile Cataract Surgery
Authors: Saltzmann Robert M. , Weakley David R. , Aggarwal Nalini K. , Whitson Jess T.
Published: July 2010

Purpose:

To examine incidence, risk factors, and outcomes of glaucoma following infantile cataract extraction.

Methods:

A retrospective chart review of all patients who underwent cataract extraction between January 1, 1993, and December 31, 2006, at the Children’s Medical Center in Dallas.

Results:

Sixty-four eyes met inclusion criteria, of which 11 eyes (17.2%) developed glaucoma during a mean follow-up of 65.1 ± 4.3 months. Age younger than 3 months at cataract diagnosis (odds ratio 4.89,
P
= .05) or cataract extraction (odds ratio 4.4,
P
= .047) and the presence of anterior chamber anomalies (odds ratio 8.0,
P
= .01) were the only risk factors found to have statistical significance for the development of glaucoma. Eight of 11 eyes with glaucoma (72.2%) required at least one surgical intervention. Three of 10 eyes (30%) had a final best-corrected visual acuity below 20/400 and another 4 eyes (40%) demonstrated some degree of amblyopia.

Conclusion:

Despite modern microsurgical techniques, infantile cataract surgery continues to pose a risk of secondary glaucoma. This was particularly true when cataract was diagnosed and/or extracted in patients younger than 3 months of age. Most eyes that developed glaucoma required surgical management and visual outcomes continue to be poor in this group.
Intraocular Gas Associated Pressure-Induced Interface Keratopathy 8 Years After Laser in Situ Keratomileusis
Authors: Wu Yu-Kai , Cheng Cheng-Kuo , Lin Hui-Chen
Published: July 2010

The authors report a clinically distinctive form of elevated intraocular pressure-induced interface keratopathy that occurred after a pars plana vitrectomy with intraocular gas tamponade for a macular hole in the right eye in a 35-year-old woman who had laser in situ keratomileusis in both eyes 8 years previously. The intraocular pressure was increased to 37 mm Hg after surgery. Diffuse lamellar keratitis-like interface infiltration was found with concurrent elevated intraocular pressure. The interface infiltration did not respond to steroids but resolved after the intraocular pressure was controlled. This case suggests that interface keratopathy is associated with increased intraocular pressure. Assessment of intraocular pressure is essential in patients presenting with interface keratopathy, especially in those who have undergone posterior segment operations with gas tamponade.
Study of the moisture content gradient in a cementitious material by measuring its impedance and gamma-densitometry
Authors: Guilbaud J. P. , Carvalho H. , Baroghel-Bouny V. , Raharinaivo A.
Published: July 2010

The local water content in cementitious material depends on the equilibrium between its atmospheric environment and its bulk properties. So, the moisture profile in material can vary with time. The object of this study is to follow the change of this profile by measuring the electrical impedance of the material with pairs of small wires embedded at different depths.
This method was applied to young cement paste specimens. The results obtained show that this method is quite satisfactory. The best frequency to be applied, is about 50 or 100 Hz. These results were compared with those obtained with gamma-densitometry.
Consolidating and water repellent treatments applied to wet and salt contaminated granite
Authors: Silva B. , Rivas T. , Prieto B.
Published: July 2010

A comparison was made of the efficacy of two consolidants and two water repellents applied to samples of granite under optimum conditions, with the efficacy of the same products applied to the granite in the presence of soluble salts or water. The amount of product absorbed and the amount of dry polymer remaining after treatment were compared. The results show that the presence of water and soluble salts in the stone significantly modifies the consumption of the products (in particular the water repellents) and also the level of dry polymer retained. The water repellents were found to be much less effective when the substrate contained salts, whereas the presence of water did not appear to influence their efficacy. The lack of correlation between uptake, active dry polymer, and efficacy led to the conclusion that the presence of salts or water markedly changes the kinetics of the polymerization of the products.
Reproducción en cámara climática de las formas de alteración más frecuentes detectadas en materiales graníticos, en clima de tendencia continental
Authors: Íñigo A. C. , Vicente M. A. , Rives V.
Published: July 2010

This present work tries to reproduce, through test of controlled conditions in accelerate aging, reproducing the most frequent ambients in places affected by a clime of continental tendency, the more common forms of deterioration in historical interesting buildings, constructed with granitic rocks in those places.
We analyze the changes in the rocks nature and properties (intensity and rapidity), produced in different experiences.
In this study, realized on "sensu lato" granites, we come to the conclusion that the deterioration due to cold/hot and frost/defrosting processes is quite slow and not much appreciable within a short time, whereas if the phenomena of salts crystallization in the rocks occurs, the deterioration is rapid and intense.
Rheology of cement mixtures with dolomite filler
Authors: Martínez de la Cuesta P. J. , Rus Martínez E. , Díaz Molina F. , Luna Blanco S.
Published: July 2010

This experimental program has studied the behavior of fresh paste made up from cements mixed with dolomite filler. Through prior experiments the starting point is obtained for the designs 22 and 23 factorials. With these designs the governing equations are established that influence the specific surface of the filler, the filler percentage and the ratio water/(cement + filler), used as objective functions: test probe penetration, flow on table and shear stress in viscometer.
Also the type of rheological conduct is determined and the influence over initial and final setting is observed.
Mortars and treatments in the restoration of the Altarpiece of the High Altar of the Pilar Basilica
Authors: Luxán M. P. , Dorrego F. , Sotolongo R.
Published: July 2010

The altarpiece of the Assumption of Mary is located in the High Altar of the Pilar Basilica in Zaragoza and is one of the most important works of the Spanish Artistic Heritage.
The work, sculptured in alabaster, was carried out between 1509 and 1518 by Damián Forment.
The present paper covers the guidelines for the design of repair mortars used to restore the altarpiece. They are based on compatibility criteria with the existing materials and treatments in the altarpiece, according to research carried out during the recent works of cleaning and restoration.
During the previous research, the composition of the original mortars was tested, the aggregate granulometry, and the composition of the organic additives used. The patina of the altarpiece was also analyzed and identified.
The original mortars were made up of a mixture of gypsum and lime with the addition of oil or fats. In many cases various types of fibre were detected in the mortar, used to improve its mechanical characteristics.
The repair mortars were designed with a composition similar to the originals, with a mixture of gypsum and lime, and their compatibility with the alabaster was studied, while also optimizing the granulometry of the aggregates used.
Los finos del árido calizo de machaqueo en la fabricación de hormigones de altas prestaciones: datos para un tema en discusión
Authors: Etxebarría A. , Ramírez J. L. , Urreta J. I. , Gorbeña J.
Published: July 2010

This paper deals with the use of crushed limestone aggregate, fine and coarse, in High Performance Concrete (H.P.C.) manufacturing. Firstly, different international research projects about this subject are presented and following, a focus on the Spanish experience is made. In addition the paper provides a list of works made in Spain with H PC from crushed limestone aggregates and a complete bibliography section about the subject in discussion.
External radiation as element of improvement infrared thermography measurements
Authors: Palomo A. , Gayo E. , Massa M.
Published: July 2010

Infrared thermography is a very versatile non destructive technique which among other uses, can be applied to the study of moisture in buildings. However, this particular application can present some problems strictly related to the characteristics of the thermocamera device. In this case the available equipment works in the IR range of 2.5 to 5.6 μm.
In this part of the spectrum, there exists a small and not very intense band of emission of the water molecules (approximately centered at 2.7 μm), in such a way that detection can be difficult through thermovision.
In the present paper, a complementary technique to the IR thermography being able of favouring the emission of water on the mentioned band, has been developed. It enhances the capacity of detection of the instrument.
Likewise, the process which takes place in the material has been numerically modelled.
Study of the medieval lead cames used in the stained glass windows of the Monastery of Pedralbes (Barcelona)
Authors: Cortés Pizano F.
Published: July 2010

This work includes an study of the glass windows of the "Monasterio de Pedralbes", in Barcelona, concerning lead as their main element.
A new pozzolan for high performance cementitious materials
Authors: De Gutiérrez R. M. , Delvasto S. , Talero R.
Published: July 2010

This paper presents results on the physical and chemical properties of metakaolinite, MK which is prepared by dehydroxylation of high quality kaolinite. The properties of Portland cement mortars blended with MK additions up to 50% are investigated. These properties are compressive strength, pore size distribution, resistance to the penetration of water and chloride ions and corrosion performance of steels embedded in the mortar. The optimum replacement of ordinary Portland cement (OPC) with MK to obtain high strength concrete is about 20%, but it is possible to use a higher percent in order to achieve the best durability properties and strength similar to the control mixture. There is a significant decrease in average pore size with an increase in MK replacement. Metakaolinite is able to bind chloride ions to produce Friedel's salt (SF), which can be considered as the main cause of the lower chloride penetration in portland cement mortars blended with MK addition. This chemical binding capacity was proved by XRD. In general, the test results indicate that the MK is a highly pozzolanic material and can be used as a supplementary cementing material in order to produce a high-performance concrete especially for use in aggressive environments. Such as, thawing salts and dew of the sea.
Basis and classification of efflorescences in construction bricks
Authors: Rincón J. M. , Romero M.
Published: July 2010

The efflorescence problem in clay products and more specifically in construction bricks is a pathology which produce a decrease in the aesthetic quality of buildings. Their types and causes are very different and only a review of all the variables and classification can allow to start the understanding of this phenomenon. Basically, the migration of soluble salts from different sources is the responsible of this pathology. Here is shown directly and briefly the main principles of efflorescece formation with some of the most frequent examples.
Dispersebility degree influence of glass fibre E in the mechanical behaviour and workability of plaster
Authors: Del Río Merino M. , Comino P.
Published: July 2010

Although there are many research studies about plaster strengthened with glass fibre E in Spain, there are no publications which advise the users (plasterers, manufacturers of prefabricated blocks or suspended ceilings, etc) about the most appropriated types of fibre E in respect to its dispersebility degree in the matrix, its lengths, the percentage, or even the type of strengthening, etc. The study of the use of this strengthener is to achieve an improvement in the mechanical behaviour of plaster as well as better conditions in the paste workability.
The company Vetrotex, with the technical personnel and together with the Department of Architectural Constructions and their control (E. U. A. T. M.) have started a serious research on plaster strengthened with E fibre.
Conclusions shown in this first article are about the influence of the dispersebility degree of glass fibres in the mechanical behaviour of the compound as well as its workability.
The degree of dispersibility of the fibres in the matrix is closely related to the type of covering used in the production of the strengthening fibres.
The Civil Palaces in Gravina street, Alicante: building stones and salt weathering
Authors: Louis M. , García del Cura M. A. , Spairani Y. , De Blas D.
Published: July 2010

This paper presents a study into the architecture and construction of the 18th Century Civil Palaces located in Gravina street (Provincial Museum of Fine Arts of Alicante), the building stones used and the mineral related decay processes that these materials have suffered.
The original building stones and other stones used in subsequent restorations in these Civil Palaces are bioclastic limestones and/or calcarenites (San Julian Stone and Bateig Stone). Campello stone and other limestones are also present.
Granular disintegration and alveolar weathering are the main forms of deterioration developed on the exterior of these Civil Palaces. These stone decay types are related to salt crystallisation, caused by sea spray salts and/or soil capillary waters. Halite is the most common salt found, probably due to the buildings' proximity to the coast.
The halite is also present in indoor efflorescences. Gypsum is present in some efflorescences and ettringite on the inner face of the outdoor cladding stone. The cladding has been destroyed and replaced in the last restoration process.