bluuebunny/crossref_metadata_2025 huggingface dataset:
Change within institutional theory: towards a framework of coping with change
Authors: Börner Tjandra , Verstegen Bernard
Published: August 2013

Purpose

In accounting literature, there is a strand of thought that is founded on the old institutional economics. One of the problems is that institutional theory can demonstrate resistance to change, not the formation of change. The purpose of this paper is to contribute to theory formation, in particular to enrich the institutional framework for understanding change, by showing how medical specialists in hospitals, in particular urologists, shape change processes in organizations as reflected in behavioral routines. The results will also contribute to the empirical understanding of medical specialists' behavior. This could generate dynamic accounts of organizational change and help to find a way towards an enhanced framework.

Design/methodology/approach

In Dutch hospitals a new management control tool is implemented, which is the diagnose treatment combinations (DTC) system. A DTC is a way to describe the required medical procedures for a specific illness in a hospital. Here, an investigation is carried out on how and if the behavior of medical specialists changes because of this introduction.

Findings

After analyzing interviews with urologists, four common themes are distinguished and scripted behavior is described. The individual tracks in scripts can be distinguished, but there is more. This is the story that gives coherence to the various behaviors and shows how the arrangement of behavioral routines in an organizational context forms organizational change through time.

Research limitations/implications

This research was based on the institutional perspective. Another view on management control would emphasize other aspects of behavior. In addition, this was only based on one specialism in three hospitals, so generalizability of the results will be low.

Practical implications

The results contribute to empirical understanding of medical specialists' behavior.

Originality/value

The results will contribute to the empirical understanding of medical specialists' behavior and it will contribute to theory formation in management control literature, in particular by enriching the institutional framework for understanding change.
Strategic management accounting practices in hospitals
Authors: Lachmann Maik , Knauer Thorsten , Trapp Rouven
Published: August 2013

Purpose

The purpose of this paper is to give an overview of the use of strategic management accounting (SMA) techniques in hospitals under competitive market environments. The paper analyses the dissemination of SMA techniques in consideration of structural characteristics and perform a cluster analysis in order to investigate performance differences between various groups of hospitals.

Design/methodology/approach

The paper collected empirical data in a nationwide survey of German general hospitals. Analyses are based on questionnaires from 116 hospitals.

Findings

Results show that strategies are applied and regularly adjusted in most hospitals. However, SMA techniques are not in widespread use. The paper explores performance differences between the clusters comprised. The paper finds evidence that the use of SMA techniques varies among hospitals based on their structural characteristics.

Research limitations/implications

The authors' exploratory analysis suggest that further study exploring both the determinants and effects of the use of SMA techniques in hospitals represents an interesting path for future research. This study is subject to limitations, particularly concerning the limited number of contextual variables and performance measures taken into consideration.

Practical implications

Considering the limited use of SMA techniques, this paper conclude that hospitals should consider the adoption of additional practices. The paper identifies particular potential for development in the areas of risk management and capital budgeting methods.

Originality/value

This study provides the first comprehensive overview of SMA techniques used in hospitals and advances the literature, which primarily includes case study evidence on single SMA techniques or analyses of the impact of strategies and health reforms on “conventional” management accounting practices. This paper, then, constitutes a useful starting point for further research on SMA practices in hospitals.
Is Social Anxiety in the Child or in the Anxiety‐Provoking Nature of the Child's Interpersonal Environment?
Authors: Gazelle Heidi
Published: August 2013

Guided by an interactionist Child × Environment perspective on social development, my research indicates that anxious solitary children show both elements of consistency and change in their social behavior across interpersonal environments. This pattern suggests that social anxiety is in part in the child and in part in the interpersonal environment. Anxious solitary children respond to relatively better treatment from unfamiliar versus familiar peers with improved social behavior, which is encouraging from the standpoint of intervention. I discuss the need for further research on the social anxiety as a Child × Environment phenomenon.
Adaptive response in stress granule formation and bulk translational repression upon a combined stress of mild heat shock and mild ethanol stress in yeast
Authors: Yamamoto Yosuke , Izawa Shingo
Published: August 2013

The formation of cytoplasmic mRNA–protein complex granules termed ‘processing bodies and stress granules’ is often induced in the stress responses of eukaryotic cells. Most previous studies on stress granules have focused on the response to a single type of stress, and little information is available about the response to combined stress. Additionally, the effects of adaptation on stress granule formation and bulk translation activity are poorly understood. We investigated the formation of stress granules upon combined exposure to mild heat shock (37 °C) and mild ethanol stress (5% v/v) in Saccharomyces cerevisiae. Although neither stress alone induced stress granule formation, their combination caused a pronounced repression of translation activity and the formation of stress granules. Pretreatment with each mild stress significantly attenuated the formation of stress granules and caused changes in the composition of stress granules upon the subsequent combined stress and facilitated stress granule disassembly accompanied by smooth translational resurrection during the recovery process, indicating that yeast cells can induce adaptations in stress granule formation. However, the pretreated cells still exhibited a severe repression of translation activity. These findings provide novel and fundamental insight into the regulation of yeast stress granules.
Changing Lenses: Conflict Analysis and Mexico’s “Drug War”
Authors: Carpenter Ami C.
Published: August 2013

U.S. policy toward Mexico has been influenced by a “drug war” frame that has left little rhetorical and operational room for creative multisectoral strategies to stem the violence and address its causes. This article proposes conflict analysis, a lens for viewing conflict that brings into focus a multilevel, integrative diagnosis of the violence in Mexico and supports recent evolutions in Plan Mérida toward a more holistic peacebuilding approach.
Polymorphisms in the promoter region ofmyostatingene are associated with carcass traits in pigs
Authors: Tu P.‐A. , Lo L.‐L. , Chen Y.‐C. , Hsu C.‐C. , Shiau J.‐W. , Lin E.‐C. , Lin R.‐S. , Wang P.‐H.
Published: August 2013

Higher average daily gain, more lean meat yield and less fat yield of porcine carcass increase selling profits for animal producers. Myostatin (MSTN), previously calledGDF8, is a member of transforming growth factor‐β (TGF‐β) superfamily. It is a negative regulator for both embryonic development and adult homeostasis of skeletal muscle. In this study, the genotypes of the previously describedSNPsMSTNg.435G>Aand g.447A>G SNPs in 66Duroc pigs, 33Landrace pigs, 180Duroc × Landrace (DL) pigs and 155Duroc × Yorkshire × Landrace (DYL) pigs were determined byTaqmanSNP GenotypingAssays. ForDuroc andLandrace pigs,MSTNg.435GG/g.447AAindividual had greater backfat thickness (p < 0.05) than g.435AA/g.447GGindividual, whereasMSTNg.435AA/g.447GGhad greater meat (p < 0.05) and meat percentage (p < 0.05) than g.435GA/g.447AGindividual. ForDLandDYLpigs, theMSTNg.435GG/g.447AAanimals were greater in backfat at ultrasound 10th rib (p < 0.05) and carcass 10th rib (p < 0.01) than g.435AA/g.447GGindividual. TheMSTNg.435AA/g.447GGindividual also had higher values than g.435GG/g.447AAfor anterior‐end meat (p < 0.05), posterior‐end meat (p < 0.01), total meat weight (p < 0.01) and meat percentage (p < 0.01). This study confirmed evidence thatMSTNg.435G>Aand g.447A>Gaffected carcass traits in pigs. The effects of the mutated alleles were additive with the maximal effects resulting from two copies of the mutated allele. Selection forMSTNg.435A/g.447Gallele is expected to increase muscle of limb and total meat production and decrease backfat thickness.
Two new species ofLeporinus(Characiformes: Anostomidae) from the Brazilian Amazon, and redescription ofLeporinus striatusKner 1858
Authors: Birindelli J. L. O. , Britski H. A.
Published: August 2013

Two new species ofLeporinusare described from tributaries of the Rio Amazonas in Brazil. One species is known from the Jari and Tapajós River basins, and is identified on the basis of a gas bladder reduced in size, a dark midlateral stripe on the body, dark transverse bars on the dorsum, a subinferior mouth, three teeth on the premaxilla, four teeth on the dentary and 16 scale rows around the caudal peduncle. The second new species is known from the Tocantins, Xingu and Tapajós River basins, and is identified on the basis of three dark longitudinal stripes on the body, a subinferior mouth, three teeth on the premaxilla, four teeth on the dentary and 12 scale rows around the caudal peduncle. In addition,Leporinus striatusis redescribed based on type and additional specimens from the Río de La Plata, Amazonas, Orinoco, Atrato, Magdalena and Sinu River basins.Leporinus striatusis identified on the basis of four dark longitudinal stripes on the body, a subterminal mouth, three teeth on the premaxilla, four teeth on the dentary and 16 scale rows around the caudal peduncle.
Magnitudes of departures from equilibrium during regional metamorphism of porphyroblastic rocks
Authors: Kelly E. D. , Carlson W. D. , Ketcham R. A.
Published: August 2013

Numerical models of diffusion‐controlled nucleation and growth of garnet crystals, which successfully replicate diverse textures in 13 porphyroblastic rocks, yield quantitative estimates of the magnitudes of departures from equilibrium during crystallization. These estimates are derived from differences in chemical potential between subvolumes containing stable product assemblages and those containing persistent but metastable reactant assemblages. The magnitude of disequilibrium is evaluated in terms of the thermal overstepping, which is commonly referenced to the garnet‐in isograd; the reaction affinity in the intergranular fluid at the site and time of each nucleation event, and on average throughout the rock, and the ‘latent energy of reaction’ per unit volume, a measure of the average unreacted capacity of the bulk rock, which describes its overall metastability. Across all of the models, the first crystals nucleate after 5–67 °C of thermal overstepping (correspondingly, 0.7–5.8 kJ mol−1 of 12‐oxygen garnet); the maximum reaction affinity averaged across the intergranular fluid is between 4.7 and 16.0 kJ mol−1 of 12‐oxygen garnet; and the maximum latent energy of reaction ranges from 7.3 to 51.7 J cm−3. These results demonstrate that impediments to crystallization significantly delay nucleation and retard reaction, with the consequence that nucleation of new crystals extends throughout nearly the entire crystallization interval. This potential for protracted reaction during prograde metamorphism, with reactions continuing to temperatures and pressures well beyond equilibrium conditions, suggests the likelihood of overstepping of multiple – possibly competing – reactions that can progress simultaneously. Isograds and ranges of stability for metamorphic assemblages along a metamorphic field gradient may therefore be significantly offset from the positions predicted from calculations based on equilibrium assumptions, which poses a substantial challenge to accurate interpretations of metamorphic conditions and processes.
What Chance‐Credence Norms Should Not Be
Authors: Pettigrew Richard
Published: August 2013

A chance‐credence norm states how an agent's credences in propositions concerning objective chances ought to relate to her credences in other propositions. The most famous such norm is the Principal Principle (PP), due to David Lewis. However, Lewis noticed that PP is too strong when combined with many accounts of chance that attempt to reduce chance facts to non‐modal facts. Those who defend such accounts of chance have offered two alternative chance‐credence norms: the first is Hall's and Thau's New Principle (NP); the second is Ismael's General Recipe (IP). Thus, the question arises: Should we adopt NP or IP or both? In this paper, I argue that IP has unacceptable consequences when coupled with reductionism, so we must accept NP alone.
Fuel-Flexible Engine Control of Biodiesel Blends During Mixing-Controlled Combustion
Authors: Adi Gayatri H. , Hall Carrie M. , Snyder David B. , Belt Bryan W. D. , Shaver Gregory M.
Published: August 2013

The use of biodiesel blends has the potential to result in many benefits including decreased reliance on imported petroleum, increased sustainability, decreased net carbon dioxide emissions, and decreased particulate matter emissions. There are, however, two major combustion-related challenges to the use of biodiesel blends: (1) decreased torque/power capacity and (2) increased emissions of nitrogen oxides. The work presented in this paper demonstrates that both of these challenges can be met through the use of a physically based fuel-flexible combustion control strategy. The approach consists of two parts: estimation, whereby the engine control module (ECM) detects the biodiesel blend fraction being supplied to the engine, and accommodation, whereby the ECM dynamically changes the control setpoints in order to improve the combustion performance. The proposed control method utilizes only stock engine hardware and does not require the creation of new ECM lookup maps. The proposed framework is incorporated into an already complex engine control system, and as such, it must be ensured that the stability of the overall system is not detrimentally affected. A formal stability analysis is outlined which demonstrates that the engine control system will remain stable. Experimental validation of this control strategy on a 2007 6.7 liter Cummins ISB series engine at several very different operating modes shows that this fuel-flexible control strategy greatly reduced or completely eliminated increases in emissions of nitrogen oxides of up to 30% while largely maintaining the torque/power capacity of the engine when operating with biodiesel.
High Performance Continuously Variable Transmission Control Through Robust Control-Relevant Model Validation
Authors: Oomen Tom , van der Meulen Stan
Published: August 2013

Optimal operation of continuously variable transmissions (CVTs) is essential to meet tightening emission and fuel consumption requirements. This is achieved by accurately tracking a prescribed transmission ratio reference and simultaneously optimizing the internal efficiency of the CVT. To reduce the power losses in a CVT, the absolute pressure levels are lowered, which increases the sensitivity to torque disturbances and increases the importance of disturbance feedforwards. This requires a high performance feedback controller for the hydraulic actuation system in a CVT. The aim of this paper is to develop a multivariable feedback controller for the hydraulic actuation system that is robust with respect to the varying system dynamics that are induced by the varying operating conditions, including transmission ratio changes. Hereto, new connections between system identification and robust control are exploited to achieve high performance. As a result, the varying system dynamics are directly evaluated in terms of closed-loop performance objectives. Subsequent robust control design reveals an increase of the control performance of almost a factor two in terms of the criterion value. This leads to improved simulated and measured closed-loop step responses, including a decrease in settling time from 0.4 s to 0.2 s. Finally, the designed robust controller is successfully validated in a standardized driving cycle experiment.
Reduced Order Modeling Based on Complex Nonlinear Modal Analysis and Its Application to Bladed Disks With Shroud Contact
Authors: Krack Malte , Panning-von Scheidt Lars , Wallaschek Jörg , Siewert Christian , Hartung Andreas
Published: August 2013

The design of bladed disks with contact interfaces typically requires analyses of the resonant forced response and flutter-induced limit cycle oscillations. The steady-state vibration behavior can efficiently be calculated using the multiharmonic balance method. The dimension of the arising algebraic systems of equations is essentially proportional to the number of harmonics and the number of degrees of freedom (DOFs) retained in the model. Extensive parametric studies necessary, e.g., for robust design optimization are often not possible in practice due to the resulting computational effort. In this paper, a two-step nonlinear reduced order modeling approach is proposed. First, the autonomous nonlinear system is analyzed using the generalized Fourier-Galerkin method. In order to efficiently study localized nonlinearities in large-scale systems, an exact condensation approach as well as analytically calculated gradients are employed. Moreover, a continuation method is employed in order to predict nonlinear modal interactions. Modal properties such as eigenfrequency and modal damping are directly calculated with respect to the kinetic energy in the system. In a second step, a reduced order model is built based on the single nonlinear resonant mode theory. It is shown that linear damping and harmonic forcing can be superimposed. Moreover, similarity properties can be exploited to vary normal preload or gap values in contact interfaces. Thus, a large parameter space can be covered without the need for recomputation of nonlinear modal properties. The computational effort for evaluating the reduced order model is almost negligible since it contains a single DOF only, independent of the original system. The methodology is applied to both a simplified and a large-scale model of a bladed disk with shroud contact interfaces. Forced response functions, backbone curves for varying normal preload, and excitation level as well as flutter-induced limit cycle oscillations are analyzed and compared to conventional methods. The limits of the proposed methodology are indicated and discussed.
Evaluation of Gas Turbine Outboard Bleed Air on Overall Engine Efficiency and CO2e Emission in Natural Gas Compressor Stations
Authors: Botros K. K. , Golshan H. , Rogers D. , Sloof B.
Published: August 2013

Gas turbine (GT) engines employed in natural gas compressor stations operate in different modes depending on the power, turbine inlet temperature, and shaft speeds. These modes apply different sequencing of bleed valve opening on the air compressor side of the engine. Improper selection of the GT and the driven centrifugal gas compressor operating conditions can lead to larger bleed losses due to wider bleed valve openings. The bleed loss inevitably manifests itself in the form of higher overall heat rate of the GT and greater engine emission. It is, therefore, imperative to determine and understand the engine and process conditions that drive the GT to operate in these different modes. The ultimate objective is to operate the engine away from the inefficient modes by adjusting the driven gas compressor parameters as well as the overall station operating conditions (i.e., load sharing, control set points, etc.). This paper describes a methodology to couple the operating conditions of the gas compressor to the modes of GT bleed valve opening (and the subsequent air bleed rates) leading to identification of the operating parameters for optimal performance (i.e., best overall efficiency and minimum CO2e emission). A predictive tool is developed to quantify the overall efficiency loss as a result of the different bleed opening modes and map out the condition on the gas compressor characteristics. One year's worth of operating data taken from two different compressor stations on TransCanada Pipelines' Alberta system were used to demonstrate the methodology. The first station employs a GE-LM1600 gas turbine driving a Cooper Rolls-RFBB-30 centrifugal compressor. The second station employs a GE-LM-2500+ gas turbine driving NP PCL-800/N compressor. The analysis conclusively indicates that there are operating regions on the gas compressor maps where losses due to bleed valves are reduced and, hence, CO2 emissions are lowered, which presents an opportunity for operation optimization.
What, Where, and When?
Authors: Knapp Sandra
Published: August 2013

Alfred Russel Wallace's science of distribution provided the foundation of biogeography.
REVIEW OF RECENT NEUTRINO PHYSICS RESEARCH
Authors: KISSLINGER LEONARD S.
Published: August 2013

We review recent research in neutrino physics, including neutrino oscillations to test time reversal and CP symmetry violations, the measurement of parameters in the U matrix, sterile neutrino emission causing pulsar kicks, and neutrino energies in the neutrinosphere.
THE PARAMETRIZATION OF FUSION BARRIER CHARACTERISTICS AND PROXIMITY FORMALISM
Authors: GHODSI O. N. , LARI F.
Published: August 2013

The barrier characteristics, barrier height and position, are systematically studied using Prox. 2010 potential for wide range of fusion systems with mass numbers from 6 to 238. We present a pocket formula which reproduces the exact values of the barrier height and its position within the accuracy of ±1%.
A THERMO-DAMAGE STRENGTH MODEL FOR THE SiC-DEPLETED LAYER OF ULTRA-HIGH-TEMPERATURE CERAMICS ON HIGH TEMPERATURE OXIDATION
Authors: WANG RUZHUAN , LI WEIGUO , FANG DAINING
Published: August 2013

At high temperatures above 1650°C, the SiC -depleted layer of ultra-high-temperature ceramics which has high porosity appears during the oxidation process. In this present paper, based on the studies of the oxidative mechanisms and the fracture mechanisms of ultra-high-temperature ceramics under normal and high temperatures, a thermo-damage strength model for the SiC -depleted layer on high temperature oxidation was proposed. Using the model, the phase transformation, microstructure development and fracture performance in the SiC -depleted layer on high temperature oxidation were studied in detail. The study showed that the porosity is mainly related to the oxidation of SiC . And while the SiC is substantially completely oxidized, only a very small part of matrix is oxidized. The fracture strength of the SiC -depleted layer degrades seriously during the high temperature oxidation process. And the bigger the initial volume fraction of SiC , the lower the fracture strength of the SiC -depleted layer is. This layer may become the origin of failure of material, thus the further researches should be undertaken to improve the oxidation behavior for the ultra-high-temperature ceramics in a wider temperature range.
A DIRECT SIMULATION METHOD FOR THE EFFECTIVE IN-PLANE STIFFNESS OF CELLULAR MATERIALS
Authors: KARAKOÇ ALP , FREUND JOUNI
Published: August 2013

A simulation model is presented in order to provide the near-exact geometrical description of the actual cellular materials and to determine the effective in-plane stiffness of them. The model consists of a geometric input generator and a micromechanical model. The input generator is used to describe the cellular material geometry including the cell wall thicknesses, cell connectivity, vertex and center coordinates through the in situ specimen images while the micromechanical model is used to incorporate the geometrical description and the mechanical behavior of the cell walls. For model validation, a case study is performed on Nomex honeycomb specimens, the results of which are expressed in terms of the effective in-plane stiffness properties and compared to the measured values provided in the literature.
Koffein - Wirkmechanismen und kosmetische Verwendung
Authors: Herman A. , Herman A.P.
Published: August 2013

Koffein findet in der Kosmetik zunehmend breite Anwendung, da es hohe biologische Aktivität zeigt und die Hautbarriere zu durchdringen vermag. Das Alkaloid wird häufig als hydrophile Modellsubstanz in Versuchen zur Penetration von Menschen- und Tierhaut sowie verschiedenen synthetischen Membranen im Rahmen von Versuchen mit Franz-Diffusionszellen verwendet. Die im Handel erhältlichen topischen Koffein-Formulierungen enthalten in der Regel 3% Koffein. Für kosmetische Zwecke wird Koffein als Wirkstoff in Produkten gegen Cellulite verwendet, weil es der überschüssigen Fetteinlagerung in den Zellen entgegenwirkt. Das Alkaloid stimuliert den Abbau von Fetten im Rahmen der Lipolyse, indem es die Aktivität der Phosphodiesterase hemmt. Koffein hat ausgeprägte antioxidative Eigenschaften. Es schützt die Zellen vor UV-Strahlen und verzögert die lichtbedingte Hautalterung. Darüber hinaus regt das in Kosmetika enthaltene Koffein die Mikrozirkulation in der Haut an und stimuliert auch das Haarwachstum, indem es die Aktivität der 5-α-Reduktase inhibiert.
Rabbi Ben-Tzion Abba Shaul and the Ideology of the Haredi-Sefardi Scholar-Society in Israel
Authors: Leon Nissim
Published: August 2013

Abstract

This article focuses on Rabbi Ben-Tzion Abba Shaul, one of the most prominent ideologues of the Mizrahi-haredi scholar-society and among the most prominent rabbinical figures of the haredi-Mizrahi stream. The article addresses the ideological heritage that he bequeathed to his students concerning the purpose of the scholar-society and, at its center, the institution of the yeshiva and the Torah scholars who study there. Rabbi Ben-Tzion Abba Shaul occupies an important place in our understanding of the ideological depth of the haredizing trends among contemporary Mizrahi Judaism in Israel and the development of its scholar-society, as well as in analyzing the complex relations among the leaders of the haredi-Mizrahi stream themselves, and between this stream and its broader reference group: the Lithuanian-Ashkenazi stream.
The New Egyptian Constitution of 2012
Authors: Bammarny Bawar
Published: August 2013

Abstract

Nearly 64% of eligible Egyptians had approved the new Egyptian constitution in a referendum. However, the new Egyptian constitution is very controversial. Some Egyptian politicians see this constitution as a major threat to democracy and call for a solution to reintroduce the Egyptian Constitution of 1971, although in the new constitution as opposed to the old constitution the way to absolutism and autocracy is blocked, mainly due to the limitation of power of the President. In particular the president is now elected for four years instead of six years and may be re-elected only once. The experience in Egypt and other Arab countries since their independence shows that the rulers never want to step down and wish to bequeath the Republics to their children. But there are several contentious issues in the new Egyptian constitution, in particular, about the role of religion.
Football, Politics and Europe
Authors: Gaillard William
Published: August 2013

Summary

This article examines the place of sports and football in European society and the complex interaction of the sports field and the football sub-field, which has its own codes of behaviour, its own institutional governance, its own ethics, its own judicial culture and its own language. Charting the history of European football and the Union of European Football Associations (UEFA), the author argues that unless one understands how the football habitus interact with the rest of European society, it is difficult to examine the role of sports and, in particular, football in international relations and diplomacy.
1064 nm Nd:YAG long pulse laser after polidocanol microfoam injection dramatically improves the result of leg vein treatment: A randomized controlled trial on 517 legs with a three-year follow-up
Authors: Moreno-Moraga Javier , Smarandache Adriana , Pascu Mihail L , Royo Josefina , Trelles Mario A
Published: August 2013

Objective

To assess the efficacy and safety of a new method of clearing varicose veins in the long term. It consists of applying the long-pulsed Nd:YAG laser following the injection of polidocanol microfoam, in two consecutive sessions, treating both legs in full in each session.

Method

Randomized, Polidocanol-controlled, blind evaluation clinical trial comparing the results between 79 legs treated with Polidocanol and 517 treated with Polidocanol + Laser. Photographs were taken preoperatively and at three months, two years and three years after treatment, as well as patient self-assessments.

Results

Polidocanol + Laser is much more effective than polidocanol microfoam in clearing venulectasias with a diameter under 4 mm ( p < 0.001). After three years, clearing percentages of 89% (Class I veins), 94% (Class II veins) and 95% (Class III veins) are observed, in comparison to 15%, 18% and 17%, respectively when only polidocanol was applied. No unexpected adverse effects were found and 86% of patients stated they were Satisfied or Very Satisfied.

Conclusion

The method leads to safe, fast and apparently permanent results. The treatment session lasts less than 1 h, and could become a first-choice treatment for the removal of all types of varicose veins with a diameter under 4 mm.
Manual lymphatic drainage in chronic venous disease: A duplex ultrasound study
Authors: dos Santos Crisóstomo Rute Sofia , Candeias Miguel Sandu , Ribeiro Ana Margarida Martins , da Luz Belo Martins Catarina , Armada-da-Silva Paulo AS
Published: August 2013

Objectives

To compare the effect of call-up and reabsorption maneuvers of manual lymphatic drainage on blood flow in femoral vein and great saphenous vein in patients with chronic venous disease and healthy controls.

Methods

Forty-one subjects participated in this study (mean age: 42.68(15.23)), 23 with chronic venous disease (chronic venous disease group) with clinical classification C1–5 of clinical-etiological-anatomical-pathological (CEAP) and 18 healthy subjects (control group). Call-up and reabsorption maneuvers were randomly applied in the medial aspect of the thigh. The cross-sectional areas, as well as the peak and the mean blood flow velocity at femoral vein and great saphenous vein, were assessed by Duplex ultrasound at the baseline and during maneuvers. The venous flow volume changes were calculated.

Results

The venous flow volume in femoral vein and great saphenous vein increased during both manual lymphatic drainage maneuvers and in both groups ( P < 0.05). The two maneuvers had a similar effect on femoral vein and great saphenous vein hemodynamics, and in both the chronic venous disease and control groups. As a result of the call-up maneuver, the flow volume augmentations, as a result of call-up maneuver, decreased with the severity of chronic venous disease in those patients measured by the clinical classification of CEAP ( r = −0.64; P = 0.03).

Conclusions

Manual lymphatic drainage increases the venous blood flow in the lower extremity with a magnitude that is independent from the specific maneuver employed or the presence of chronic venous disease. Therefore, manual lymphatic drainage may be an alternative strategy for the treatment and prevention of venous stasis complications in chronic venous disease.
Fatal Arrhythmogenic Right Ventricular Cardiomyopathy in 2 Related Subadult Chimpanzees (Pan troglodytes)
Authors: Tong L. J. , Flach E. J. , Sheppard M. N. , Pocknell A. , Banerjee A. A. , Boswood A. , Bouts T. , Routh A. , Feltrer Y.
Published: August 2013

Cardiovascular disease is increasingly recognized as an important cause of morbidity and mortality in captive chimpanzees ( Pan troglodytes). This report records 2 cases of sudden cardiac death in closely related subadult captive chimpanzees with marked replacement fibrosis and adipocyte infiltration of the myocardium, which resemble specific atypical forms of the familial human disease arrhythmogenic right ventricular cardiomyopathy. Changes were consistent with left-dominant and biventricular subtypes, which are both phenotypic variants found within human families with familial arrhythmogenic right ventricular cardiomyopathy. Previously reported fibrosing cardiomyopathies in chimpanzees were characterized by nonspecific interstitial fibrosis, in contrast to the replacement fibrofatty infiltration with predilection for the outer myocardium seen in these 2 cases. To the authors’ knowledge, this case report is the first to describe cardiomyopathy resembling arrhythmogenic right ventricular cardiomyopathy in nonhuman primates and the first to describe left-dominant arrhythmogenic cardiomyopathy-type lesions in an animal.
Rapid loss of vaccine-acquired hepatitis B surface antibody after three doses of hepatitis B vaccination in HIV-infected persons
Authors: Mizusawa Masako , Perlman David C , Lucido David , Salomon Nadim
Published: August 2013

HIV-infected individuals have poor responses to hepatitis B vaccine and may have decreased durability of post-vaccination immunity. Retrospective chart review was conducted for HIV-1 positive individuals aged ≥18 years who received hepatitis B vaccine at an urban HIV clinic. A total of 309 patients completed three doses and 178 had post-vaccine serology testing after the third dose. In multivariate analysis, time between the third dose and the first post-vaccine serology testing at 180–359 days (OR = 0.077, p = 0.049) and at ≥360 days (OR = 0.065, p = 0.019) were associated with poor vaccine responses. A significant decrease in seropositivity appeared as early as 180 days after the third vaccine dose, suggesting a rapid loss of vaccine-acquired hepatitis B surface antibody in HIV-infected persons. Our findings suggest that hepatitis B surface antibody should be tested at 6 to 12 months after completing primary vaccine series in order to detect early secondary vaccine failure.
Embodied imitation-enhanced reinforcement learning in multi-agent systems
Authors: Erbas Mehmet D , Winfield Alan FT , Bull Larry
Published: August 2013

Imitation is an example of social learning in which an individual observes and copies another’s actions. This paper presents a new method for using imitation as a way of enhancing the learning speed of individual agents that employ a well-known reinforcement learning algorithm, namely Q-learning. Compared with other research that uses imitation with reinforcement learning, our method uses imitation of purely observed behaviours to enhance learning, with no internal state access or sharing of experiences between agents. The paper evaluates our imitation-enhanced reinforcement learning approach in both simulation and with real robots in continuous space. Both simulation and real robot experimental results show that the learning speed of the group is improved.
‘Soft and fluffy’: Medical students’ attitudes towards psychology in medical education
Authors: Gallagher Stephen , Wallace Sarah , Nathan Yoga , McGrath Deirdre
Published: August 2013

Psychology is viewed by medical students in a negative light. In order to understand this phenomenon, we interviewed 19 medical students about their experiences of psychology in medical education. Interviews were transcribed verbatim and analysed using thematic analysis. Four main themes were generated: attitudes, teaching culture, curriculum factors and future career path; negative attitudes were transmitted by teachers to students and psychology was associated with students opting for a career in general practice. In summary, appreciation of psychology in medical education will only happen if all educators involved in medical education value and respect each other’s speciality and expertise.
In defense of danger: Sex, schools and the politics of discourse
Authors: Miller Sarah A
Published: August 2013

In 2004, Ashbourne High School1 staged the first school-sponsored student performance of The Vagina Monologues, sparking a community controversy covered in the local and national media about the sexuality of minors. Through a content analysis of archival documents and media coverage, this study examines the discursive politics of this community debate over sex, youth, and schools. The author finds that underlying this community’s abundant and atypical support for sexual speech in school was a pervasive gendered discourse of sexual risk, one that transposed teen talk about sex into culturally defensible, protective social action.
Wikisexuality: Rethinking sexuality in cyberspace
Authors: Saraswati L Ayu
Published: August 2013

Scholarship in cyberculture studies often frames the “real” world as the epistemic point of reference in thinking about identities in the virtual world. This article, however, considers cyberspace as its own epistemic point of reference and proposes “wikisexuality,” a new category of sexuality in cyberspace that takes into account the fluidity of sexuality, highlights the constant formation of sexual identities, and reflects the non-linear, postmodern, and chaotic formation of sexuality that moves us beyond the mono versus multiple categories of sexuality and beyond the nature versus nurture debate by evoking the notion of sexuality as constantly shifting with every encounter.
Commenting on pictures: Teens negotiating gender and sexualities on social networking sites
Authors: De Ridder Sander , Van Bauwel Sofie
Published: August 2013

This inquiry shows how youths negotiate sexualities and gender when commenting on profile pictures on a social networking site. Attention is given to (1) how discourses are constituted within heteronormativity, and (2) how the mediated nature of the SNS contributes to resistance. Using insights from cultural media studies, social theory and queer criticism, self-representations in SNSs are viewed as sites of struggle. A textual analysis is used to show how commenting on a picture is a gendered practice, continuously cohering between the biological sex, performative gender and demanded desire. Although significant resignifications are found, they are often accompanied by a recuperation of heteronormativity. Therefore, this inquiry argues for continued attention to current contradictions in self-representations.
Challenging childhood, challenging children: Children’s rights and sexting
Authors: Simpson Brian
Published: August 2013

Concern with children’s online safety dominated the early days of the internet, fuelled by a fear of online predators able to utilise online technologies to manipulate their identities and groom children. Such adults strike at long held notions of childhood innocence and often commit serious offences as a result. However, a possibly unforeseen consequence of new online technologies has been the apparent capacity they afford to children themselves to reconstruct the meaning of childhood and family relationships, especially in the age of mobile (and hence less capable of parental supervision) technology. A recent example of this is the phenomenon of ‘sexting’, which appears to be caught between debates on the sexual rights of children and the role of the state in protecting children from themselves. What I wish to explore, however, is whether such constructions of the debate are themselves static and belong to an older age. Instead, is it possible that online technologies are altering the dynamics of relationships which created romantic notions of childhood innocence in the past, and which now enable children to actively participate in the formation of their own identity? In other words, have new online technologies enabled the creation of new identities of childhood which challenge the order of childhood? If so, does this mean that regulations based on older notions of childhood are doomed to fail, or alternatively lead to such injustices in the eyes of young people that the law’s legitimacy will be open to question?
Dead-baby dreams, transfiguration and recovery from infant death trauma in northeast Brazil
Authors: Nations Marilyn
Published: August 2013

Maternal reactions to infant death in Northeast Brazil have been at the epicenter of anthropological debate since the 1980s. This ethnographic study of 45 death narratives by bereaved mothers collected from 1979–1989 in Pacatuba, Ceará, Brazil, refutes existing claims of mothers’ “selective neglect” and “indifference” towards sick babies and emotionally empty grief response. I argue that through dead-baby dreams—and their imaginary transfiguration—grieving mothers alleviate infant death trauma. Feelings of hopelessness, helplessness, definitive loss, and personal guilt—the social seeds of depression—are reframed to deny death’s finality and exonerate mothers from crippling self-blame. By transfiguring lingering mental images of the tiny cold corpse, mothers remold the irreversibility and definitiveness of death, gaining a sense of control over its unpredictable “jolt.” In the politically oppressive Northeast Brazil—where social justice remains “an illusion”—mothers dream to preserve their own mental sanity and to recover from death’s cruel aftermath. Any interpretation of mourning behavior must be contextualized within the local moral world and its “assumed structure of reality” to avoid demoralizing grieving Brazilian mothers and compounding their suffering. “You see, the only thing a poor woman truly owns that no one can borrow, cheat, steal or rob from her … is her imagination!” ( Dona Chiquinha grieving death of her 10 children, Pacatuba, Ceará, Brazil).
Locke’s Tracts and the anarchy of the religious conscience
Authors: Bou-Habib Paul
Published: August 2013

This article reconstructs the main arguments in John Locke’s first political writings, the highly rhetorical, and often obscure, Two Tracts on Government (1660–1662). The Tracts support the government’s right to impose religious ceremonies on its people, an astonishing fact given Locke’s famous defense of toleration in his later works. The reconstruction of the Tracts developed here allows us to see that rather than a pessimistic view of the prospects for peace under religious diversity, what mainly animates the young Locke is a desire to defend the rule of law against an anarchical conception of religious freedom. The article also argues that the evolution of Locke’s thinking on religious freedom was in large part governed by Locke’s attempt to interpret religious freedom in a way that avoids its having anarchical implications.
Statistical evaluation of surrogate markers: Validity, efficiency, and sensitivity
Authors: Qu Yongming
Published: August 2013

Identification of surrogate markers for a marketed drug is important in monitoring the efficacy or safety after a patient uses the drug. In this article, we clarify the statistical definitions of the surrogate endpoint and surrogate marker and introduce the concept of the validity and efficiency of a surrogate marker. We also review some existing methods and suggest the proportion of information gain is appropriate to be used to evaluate the validity of a surrogate marker.
Evaluation of the thermal performance of a roof-mounted radiant barrier in residential buildings: Experimental study
Authors: Asadi Somayeh , Hassan Marwa M
Published: August 2013

The objective of this study is to examine the reduction in heating and cooling loads that may be attributed to the use of attic radiant barrier and to identify environmental parameters that influence this reduction. To this end, an experimental study was conducted in Zachary, Louisiana for 8 months on two houses built in the same manner and instrumented with thermocouples to measure the temperature in each hour and each layer of the roof. Results showed that an attic radiant barrier can reduce energy loads from 8% to 25% depending on the climatic conditions. Among the evaluated climatic parameters, ambient air temperature had the greatest effect on the ceiling heat flux.
Prediction of relapse after discontinuation of infliximab therapy in severe sarcoidosis
Authors: Vorselaars Adriane D.M. , Verwoerd Anouk , van Moorsel Coline H.M. , Keijsers Ruth G.M. , Rijkers Ger T. , Grutters Jan C.
Published: August 2013

Infliximab is effective as a third-line therapeutic for severe sarcoidosis; however, long-term efficacy is unknown. The aim of this study was to assess the relapse rate after discontinuation of infliximab in sarcoidosis patients and predict relapse by analysis of the activity marker soluble interleukin (IL)-2 receptor (sIL-2R) and maximum standardised uptake value (SUVmax) of18F-fluorodeoxyglucose positron emission tomography (FDG PET).

In this retrospective cohort study, the proportion of relapse was analysed using the Kaplan–Meier method and predicting factors were studied using Cox regression.

47 sarcoidosis patients who started infliximab therapy were included in the risk analysis. Kaplan–Meier analysis revealed a median time to relapse of 11.1 months and showed that 25% of the cohort relapsed within 4 months. Both mediastinal SUVmax≥6.0 on FDG PET (hazard ratio 3.77, p<0.001) and serum sIL-2R ≥4000 pg·mL−1(hazard ratio 2.24, p=0.033) at start of therapy predicted relapse. In multivariate analysis, a mediastinal SUVmax≥6.0 at initiation of therapy was an independent predictor of relapse (hazard ratio 4.33, p<0.001).

The majority of patients that discontinued infliximab therapy relapsed. High serum sIL-2R and high SUVmaxon FDG PET at initiation of therapy were significant predictors of relapse. These results suggest close monitoring of patients in this category when they discontinue infliximab treatment.
Grading the severity of airways obstruction: new wine in new bottles
Authors: Quanjer Philip H. , Pretto Jeffrey J. , Brazzale Danny J. , Boros Piotr W.
Published: August 2013

The objective of this study was to redesign the current grading of obstructive lung disease so that it is clinically relevant and free of biases related to age, height, sex and ethnic group.

Spirometric records from 17 880 subjects (50.4% female) from hospitals in Australia and Poland, and 21 191 records (53.0% female) from two epidemiological studies (age range 18–95 years) were analysed. We adopted the American Thoracic Society(ATS)/European Respiratory Society (ERS) criteria for airways obstruction based on an forced expiratory volume in 1 s (FEV1)/(forced) vital capacity ((F)VC) ratio below the fifth percentile and graded the severity of pulmonary function impairment using z-scores for FEV1, which signify how many standard deviations a result is from the mean predicted value.

Using the lower limit of normal for FEV1/(F)VC and z-scores for FEV1of -2, -2.5, -3 and -4 to delineate severity grades of airflow limitation leads to close agreement with ATS/ERS severity classifications and removes age, sex and height related bias.

The new classification system is simple, easily memorised and clinically valid. It retains previously established associations with clinical outcomes and avoids biases due to the use of per cent predicted FEV1. Combined with the Global Lung Function prediction equations it provides a worldwide diagnostic standard, free of bias due to age, height, sex and ethnic group.