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Research on the multidimensionality of hallucination-like experiences (HLEs) can contribute to the study of psychotic risk. The Launay-Slade Hallucinations Scale-Extended (LSHS-E) is one of the most widely used tools for research in HLEs, but the correspondence of its paper and online formats has not been established yet. Therefore, we studied the factorial structure and measurement invariance between online and paper-and-pencil versions of LSHS-E in a Chilean population. Two thousand eighty-six completed the online version, and 578 students completed the original paper-and-pencil version. After matching by sex, age, civil status, alcohol and cannabis consumption, and psychiatric treatment received, we selected 543 students from each group. We conducted a confirmatory factor analysis of a four-factor model and a hierarchical model that included a general predisposition to hallucination, explaining the strong relationship between the different types of hallucinations. Both models showed a good fit to the data and were invariant between paper-and-pencil and online versions. Also, the LSHS-E has good reliability in both online and paper-and-pencil formats. This study shows that the online LSHS-E possesses psychometric properties equivalent to the paper-and-pencil version. It should be considered a valuable tool for research of psychosis determinants in the COVID-19 era., Author(s): Yanet Quijada [sup.1] , Sandra Saldivia [sup.2] , Claudio Bustos [sup.2] , Antonio Preti [sup.3] , Susana Ochoa [sup.4] , Elvis Castro-Alzate [sup.2] [sup.5] , Sara Siddi [sup.4] Author [...]

The purpose of this study was to investigate the impact of mLearning or mobile device practice on the attention and accuracy of student's use of math concepts, specifically, telling time. A single subject, alternating treatment design was used to compare mLearning to paper and pencil practice in four 3rd grade male students. Results were mixed; two children were observed to be more on-task during the mLearning practice, and two children were observed to perform similarly across both conditions. Additionally, two children performed similarly on correctly completed problems across both conditions, and two children performed better using paper and pencil practice. All students completed more math problems during the paper and pencil practice., Author(s): Cynthia F. DiCarlo [sup.1], Aaron R. Deris [sup.2], Thomas P. Deris [sup.3] Author Affiliations: (1) grid.64337.35, 0000 0001 0662 7451, School of Education, Louisiana State University, , 70806, Baton [...]

Author(s): Quassim Cassam [sup.1] Author Affiliations: (1) grid.7372.1, 0000 0000 8809 1613, University of Warwick, , Coventry, UK Watching news coverage of scores of Afghan civilians running alongside an American [...]

The aim of this study is to employ a response surface methodology (RSM) to optimize experimental parameters in microfluidic paper-based analytical devices ([micro]-PADs). The independent parameters include concentrations and volumes of acetylcholinesterase, acetylthiocholine iodide, and 5,5-dithiobis-(2-nitrobenzoic acid). Their effect on mean color intensity was tested and optimized. From the analysis of variance, high regression and fitting values were obtained between the experimental and RSM predicted mean color intensity. Under optimum conditions, satisfactory linearity (R.sup.2 > 0.9990) in the range of 0.25-16 mg/L was obtained for the studied pesticides. The limit of detection (LOD) varies from 0.13 to 0.27 mg/L; high precision (RSD of 3.8-8.0%), reproducibility (RSD of 7.2-11.0%), and recovery (78-97%) were achieved. The RSM approach has been demonstrated to be more efficient than the traditional approach. It resulted in a [micro]-PAD system with less amount of reagent usage and better LOD compared with a univariate approach., Author(s): Sheleme Beshana [sup.1] , Ahmed Hussen [sup.1] , Seyoum Leta [sup.1] , Takashi Kaneta [sup.2] Author Affiliations: (1) grid.7123.7, 0000 0001 1250 5688, Center for Environmental Science, College of [...]

The aim of this research is to gather information regarding the validity of the Student Career Construction Inventory (SCCI) among university students in order to examine the relation between adaptive readiness, adaptability resources, adapting responses and adaptation results. This research is composed of two different studies. Within the scope of Study 1, the validity of the SCCI was analyzed with a sample of Turkish university students (254 participants in total; 190 female, 64 male). On the other hand, within the scope of Study 2, structural equation modelling was utilized to test the career construction model of adaptation empirically. The participants of Study 2 were composed of 553 university students (429 female, 124 male) none of whom participated in Study 1. The first study involved translating SCCI into Turkish and testing the psychometric properties of the scale. The results have demonstrated that SCCI is a valid and reliable scale to be used for Turkish university students. During the second study, the career construction model of adaptation was used to empirically tested. The results of the structural equation modelling supported the career construction model of adaptation showed that adaptation results were affected by adaptive readiness, adaptability resources, and adapting responses sequentially and directly. By examining how Turkish University students construct their career, this investigation advances existing research from a different cultural perspective., Author(s): Elvan Yildiz-Akyol [sup.1] , Kemal Öztemel [sup.1] Author Affiliations: (1) Psychological Counseling and Guidance Program, , Ankara, Turkey Introduction Technological developments accompanied by the continuous change in the world [...]

Technological progress provides health professionals with an excellent opportunity to take advantage of these developments and contribute to the development of efficient ways of diagnosing, monitoring, treating and assisting users. The purpose of this work is to present the results of a study conducted to examine the quantitative equivalence of paper-and-pencil and a voice-based conversational assistant, popularly known as a 'chatbot', as means to administer tests. One hundred and eight undergraduate university students completed both versions of the De Jong Gierveld Loneliness Scale. The interval between the first and second administration was set at four days. Validity, internal structure, internal consistency and equivalence of chatbot administration mode were assessed. A confirmatory factor analysis was used to verify the factor structure and provided a two-factor structure. Validity and internal consistency are adequate. These results support the feasibility of using chatbots for loneliness assessment in a sample of undergraduate university students and other populations in future., Author(s): Antonio Caballer [sup.1] , Oscar Belmonte [sup.2] , Andrea Castillo [sup.3] , Arturo Gasco [sup.3] , Emilio Sansano [sup.4] , Raul Montoliu [sup.5] Author Affiliations: (1) grid.9612.c, 0000 0001 [...]

Objectives Most researchers who study the effects of hormonal contraception on menstrual bleeding rely on self-reported data via paper diaries, for which completeness and timeliness have been shown to be poor. The purpose of this exploratory study was to compare the completeness and timeliness of bleeding data collected via paper diaries, text messages or smartphone application (a.k.a 'app'). Methods This was a sub-study of a double-blinded, placebo-controlled randomized trial comparing the effects of a non-steroidal anti-inflammatory drug, naproxen, with placebo when using a copper IUD. Participants tracked bleeding and symptoms over 112 days. Participants tracked bleeding daily using a paper diary as well as with either text messages or a smartphone app. Participants who used paper and the app were also able to record non-bleeding symptoms. Results Twenty-five participants submitted diaries. Of these participants, 10 completed both paper and app diaries, 7 completed both paper and text messages, 4 completed the paper diary only, 4 completed the app only. Text messages had the most complete data (108 days), followed by the app (96 days) and paper diaries (84 days). The lag time between a bleeding event and the date recording that event was 0.10 days for text, 1.0 days for app, and 4.73 days for paper diaries. Participants using the app reported a median of 33 other symptoms over the study period compared to 7 for the paper diaries. Discussion Our findings suggest texts demonstrated more complete and timely bleeding data than either paper diaries, or the app. Compared to paper diaries, the app delivered more complete, timely data, and also collected a large set of symptoms., Author(s): Tatiana Josephy [sup.1] , Sajal Sanan [sup.2] , Erin Thayer [sup.2] , Emily Godfrey [sup.2] [sup.3] Author Affiliations: (1) grid.170205.1, 0000 0004 1936 7822, Pritzker School of Medicine, University [...]

A test device based on cellulose paper is proposed for the identification and classification of natural mineral waters. It contains indicator zones for determining total hardness, alkalinity, and pH of water, and also concentrations of chlorides and sulfates. The colorimetric parameters of the indicator zones of the test device after its contact with test water are determined using a smartphone. The analytical signal (A.sub.r) is presented by the values of the colorimetric parameters of each indicator zone in the RGB system: [Formula omitted] The data array is processed by principal component analysis and hierarchical cluster analysis using the XLSTAT software. The identification and classification of 33 na-tural mineral waters (eight of which were carbonated) was performed., Author(s): V. G. Amelin [sup.1], Z. A. Ch. Shogah [sup.1] Author Affiliations: (1) grid.171855.f, 0000 0000 9825 6119, Vladimir State University, , 600000, Vladimir, Russia Digital colorimetry is increasingly used [...]

Technopoiesis was previously identified as the juvenile phase of expression of a technique that spontaneously evolves towards technopraxis as soon as the perspectives of practical use of the end-products overcome the cosmological resonance of the process itself. This view is re-examined considering the data and analyses exposed in 'Refining technopoiesis: Measures and Measuring Thinking in Ancient China,' in which a coexistence of the technopoiesis and technopraxis approaches of technics is suggested., Author(s): Nissim Amzallag [sup.1] Author Affiliations: (1) grid.7489.2, 0000 0004 1937 0511, Department of Bible, Archaeology and Ancient Near Eastern Studies, Ben-Gurion University of the Negev, , Beer Sheba, Israel [...]

Recent research has indicated high economic and environmental costs of human paper usage. Technologies have been developed to reduce consumers' paper use behavior, including mechanical dispensers that institute a delay between opportunities to obtain each consecutive unit. However, there is no empirical evidence that these dispensers or delays reduce paper use. In Experiment 1, implementing a delay between paper-unit deliveries using mechanical dispensers in a university cafe resulted in a significant decrease in units per person, material per person, and cost per person, compared to free-access dispensers. In Experiment 2, a relatively long delay was more effective than a short delay in reducing paper consumption in a laboratory experiment using mechanical dispensers. These results indicate that delays could be used to decrease paper use in many contexts on a larger scale. More research is necessary to determine the underlying behavioral mechanisms responsible for the observed reduction and the cost-benefit relationship under different circumstances. Keywords Reinforcement delays * Paper dispensers * Sustainability * Climate change * Behavioral nudges, Sustainability is rooted in human behavior, which is controlled by variables that can be manipulated (Baum, 2005; Skinner, 1953; Ylek & Steg, 2007). Verbal strategies (e.g., requests, education, information) to [...]

A simple and an available method is proposed for the determination of quinolone antibiotics using solid-phase fluorescence digital colorimetry. The intrinsic fluorescence of 17 quinolones and the quinolone-sensitizedfluorescence of europium on cellulose paper (CP) and a thin silica layer are studied. Upon the irradiation of quinolone solutions applied to a matrix with ultraviolet light (365 nm), blue (CP, high-performance thin-layer chromatography (HPTLC)) and pink (CP-Eu, HPTLC-Eu) fluorescence is observed. Measurement of the fluorescence intensity on the surface of matrices is carried out using a smartphone. The values of colorimetric parameters in the RGB system are used as the analytical signal (A.sub.r): A.sub.r = [Formula omitted] The limits of detection and determination are 0.2-4 and 0.6-12 [micro]g/mL, respectively, for all analyzed analytes. The analytical ranges are 0.6-500 [micro]g/mL. A procedure for the determination of fluoroquinolones in medicinal preparations is proposed. The relative standard deviation of the results of analysis does not exceed 5%., Author(s): V. G. Amelin [sup.1] [sup.2], Z. A. Ch. Shogah [sup.1], D. S. Bol'shakov [sup.2] Author Affiliations: (1) grid.171855.f, 0000 0000 9825 6119, Vladimir State University, , 600000, Vladimir, Russia [...]

Author(s): Lesley Rees [sup.1] , Joseph Flynn [sup.2] [sup.3] Author Affiliations: (1) grid.83440.3b, 0000000121901201, Pediatric Nephrology, UCL Great Ormond Street Institute of Child Health, UCL, , London, UK (2) grid.240741.4, [...]

Attenuated total reflectance-Fourier transform infrared (ATR-FTIR) spectroscopy is one of the preferred techniques for the analysis of forensic samples. However, the potential of ATR-FTIR spectroscopy for the classification of papers has not been established and remains unclear. In this work, a total of 150 ATR-FTIR spectra of white copy paper of three different manufacturers were analyzed using two advanced statistical methods, i.e., principal component analysis (PCA) and classification and regression tree (CART). Based on simple visual examination alone, the IR spectra did not allow any definite discrimination. However, the IR spectral differences between the papers were revealed by PCA and CART methods. A region at 1500-1200 cm.sup.-1 was determined to be the most discriminative. In conclusion, coupling of IR spectrum and CART provides a novel and non-destructive alternative for solving classification tasks in forensic context., Author(s): Loong Chuen Lee [sup.1] [sup.2] Author Affiliations: (1) grid.412113.4, 0000 0004 1937 1557, Forensic Science Program, Fakulti Sains Kesihatan, Basemen 1, PTSL, Universiti Kebangsaan Malaysia, , 43600, Bangi, Malaysia [...]

This article discusses the epistemology of design as a process, arguing specifically that sketching and drawing are essential modes of thinking and reasoning. It demonstrates that the commonly accepted notion of a spontaneous and intuitive vision in the mind's eye-encapsulated in the cliché of the napkin sketch-obscures the exploratory inferences that are made while scribbling with a pencil on a sheet of paper. The draughtsperson, along with their work tools (such as the 6B), modes of notation, specific techniques, and epistemic strategies as well as the resulting design artefacts form milieus of reflection that facilitate complex processes of exploration. Case studies, including the genesis of the Mini by Alec Issigonis, samples of work by Alvar Aalto, and a reinterpretation of student sketches from a classical design study by Gabriela Goldschmidt, serve to illustrate how drawing inferences with pencil and paper occurs., Author(s): Sabine Ammon [sup.1] Author Affiliations: (1) grid.6734.6, 0000 0001 2292 8254, Institute of Vocational Education and Work Studies, Technische Universität Berlin, , Secretariat MAR 1-1, Marchstraße 23, 10587, Berlin, [...]

Author(s): Guido Bacciagaluppi [sup.1] Author Affiliations: (1) grid.5477.1, 0000000120346234, Descartes Centre for the History and Philosophy of the Sciences and the Humanities, Utrecht University, , Utrecht, Netherlands After a number [...]

Borax, salicylic acid, nitrite, and nitrate have been used as food additives during processing for preserving, coloring, and stabilizing food. These four chemical food additives impact consumer health, e.g., liver cancer and gastric cancer. To maintain the high quality of food and to comply with food safety, a paper-based analytical device (PAD) coupled with a colorimetric method is proposed to simultaneously determine these four chemical food additives in this work. The Griess reaction can be used for the determination of nitrite, and nitrate was reduced to nitrite on the PAD in the section with a hydrophilic channel coated with zinc dust prior to detection by the Griess reaction. Borax and salicylic acid were determined using the complexation reactions with curcumin and FeCl.sub.3, respectively. This work presents the development of colorimetric methods on a PAD for the simultaneous determination of borax, salicylic acid, nitrite and nitrate in food samples. Limits of detection were (mg/L) 10 for borax, 35 for salicylic acid and 0.4 for nitrite and nitrate. Our PAD with a colorimetric method was also used for the determination of borax, salicylic acid, nitrite and nitrate in real food samples. Our detection limits were 3-5 times lower than those of commercial test kits, and the results from the real food samples were not statistically significantly different from those obtained via UV-Vis spectrophotometry at the 95% confidence level (t-test paired samples). Our proposed PAD can rapidly determine four chemical food additives in food with a high sensitivity and is an instrument-free technique., Author(s): Nalin Ratnarathorn [sup.1] Wijitar Dungchai [sup.1] Author Affiliations: (1) grid.412151.2, 0000 0000 8921 9789, Organic Synthesis, Electrochemistry and Natural Product Research Unit, Department of Chemistry, Faculty of Science, King [...]

Author(s): John Hulland [sup.1] , Mark B. Houston [sup.2] Author Affiliations: (1) grid.213876.9, 0000 0004 1936 738X, Department of Marketing, Terry College of Business, University of Georgia, , Athens, GA, [...]

Introduction Diversity has become a key-strategic element of success in various political and economic fields. The European Society of Intensive Care Medicine (ESICM) decided to make diversity a key strategic priority for the future and appointed a Task-Force on this topic. Methods In a consensus process, three Working-Groups, nominated by Task-Force members, developed statements on strategic future topics. In addition, diversity-related data available from the membership database have been analyzed and reported in aggregated form. Results The Task-Force decided to nominate working groups on (1) 'sex, gender identity and sexual orientation', (2) 'ethnicity, culture and socio-economic status', and (3) 'multiprofessionalism'. These are the first prioritized topics for the near future. The first diversity-report shows targetable items in all three domains. Conclusion The diversity Task-Force defined actionable items for a one- and three-year plan that are especially aiming at the identification of potential gaps and an implementation of concrete projects for members of the ESICM., Author(s): Bjoern Weiss [sup.1] [sup.2], B. Weiss [sup.1], L. Prisco, C. Boulanger, S. Einav, P. Gruber, J. H. Laake, S. Mehta, M. Ostermann, M. Antonelli, M. Ben Nun, B. Bollen [...]

Author(s): Gilles Hilbert [sup.1] [sup.2] , Frédéric Vargas [sup.1] [sup.2] Author Affiliations: (1) 0000 0004 0593 7118, grid.42399.35, Chef de Service de Médecine Intensive Réanimation, Hôpital Pellegrin-Tripode 1° étage, Centre [...]

Extracorporeal membrane oxygenation (ECMO) has been used increasingly for both respiratory and cardiac failure in adult patients. Indications for ECMO use in cardiac failure include severe refractory cardiogenic shock, refractory ventricular arrhythmia, active cardiopulmonary resuscitation for cardiac arrest, and acute or decompensated right heart failure. Evidence is emerging to guide the use of this therapy for some of these indications, but there remains a need for additional evidence to guide best practices. As a result, the use of ECMO may vary widely across centers. The purpose of this document is to highlight key aspects of care delivery, with the goal of codifying the current use of this rapidly growing technology. A major challenge in this field is the need to emergently deploy ECMO for cardiac failure, often with limited time to assess the appropriateness of patients for the intervention. For this reason, we advocate for a multidisciplinary team of experts to guide institutional use of this therapy and the care of patients receiving it. Rigorous patient selection and careful attention to potential complications are key factors in optimizing patient outcomes. Seamless patient transport and clearly defined pathways for transition of care to centers capable of providing heart replacement therapies (e.g., durable ventricular assist device or heart transplantation) are essential to providing the highest level of care for those patients stabilized by ECMO but unable to be weaned from the device. Ultimately, concentration of the most complex care at high-volume centers with advanced cardiac capabilities may be a way to significantly improve the care of this patient population., Author(s): Darryl Abrams [sup.1], A. Reshad Garan [sup.2], Akram Abdelbary [sup.3], Matthew Bacchetta [sup.4], Robert H. Bartlett [sup.5], James Beck [sup.6], Jan Belohlavek [sup.7], Yih-Sharng Chen [sup.8], Eddy Fan [sup.9] [...]

Author(s): Lesley Rees [sup.1] , Michel Baum [sup.2] Author Affiliations: (Aff1) 0000 0004 0581 2008, grid.451052.7, Renal Office, Gt Ormond St Hospital for Children NHS Foundation Trust, , WC1N 3JH, [...]

This comment is analysing the last section of a paper by Piotr Blaszczyk, Mikhail G. Katz, and David Sherry on alleged misconceptions committed by historians of mathematics regarding the history of analysis, published in this journal in the first issue of 2013. Since this section abounds of wrong attributions and denouncing statements regarding my research and a key publication, the comment serves to rectify them and to recall some minimal methodological requirements for historical research., Author(s): Gert Schubring[sup.1] Author Affiliations: Gert Schubring is a retired member of the Institut für Didaktik der Mathematik , a research institute at Bielefeld University, and at present is visiting [...]

Author(s): Shigeru Saito[sup.1] Author Affiliations: (1) Department of Anesthesiology, Gunma University Graduate School of Medicine, 3-39-22, Showa-machi, 371-8511, MaebashiJapan Management of cognition in anesthesiology From the time anesthesia was established [...]

Introduction Although the recent literature contains plenty of studies concerning all aspects of infective endocarditis (IE), very few focus on severe IE requiring admission to the ICU. Results In 2004, we published a report on the clinical spectrum and prognostic factors in 228 consecutive critically ill patients with IE. Septic shock, neurological complications and immunocompromised state were independently associated with in-hospital mortality. Cardiac surgery during the acute phase of EI was associated with better survival. A lot of information has been accumulated during the past 10 years on management of IE. Although three sets of blood cultures allow the identification of about 90 % of cases, culture-negative IE still remains a diagnostic challenge. Blood-polymerase chain reaction in valve tissue may yield a microbiologic diagnosis. New imaging techniques such as positron emission tomography computed tomography (PET-CT) have shown additive value in patients with an intracardiac device or valvular prosthesis. Systematic cerebral magnetic resonance imaging can lead to modification of therapeutic plans. The decision to operate and the timing of cardiac surgery should take into account the presence of congestive heart failure, neurological complications, renal failure and multiorgan dysfunction syndrome. In 2011 and 2013, we published the results of a multicentre prospective observational study of 198 ICU patients with left-sided IE and confirmed that cardiac surgery was associated with better outcome. The strongest independent predictor of post-operative mortality was the pre-operative multiorgan failure score. Neurological failure also represented a major determinant of mortality, regardless of the mechanism of neurological complication. Conclusion In the present paper, we propose algorithms to optimize the medico-surgical approach., Author(s): Michel Wolff [sup.1] [sup.2], Bruno Mourvillier [sup.1] [sup.2], Romain Sonneville [sup.1] [sup.2], Jean-François Timsit [sup.1] [sup.2] [sup.3] Author Affiliations: (1) grid.50550.35, 0000000121754109, Service de Réanimation, Medical Intensive Care Unit, [...]

Demand for wood products is falling and prices are rising; the industry is expected to do better in the future.

Tables provide statistical information for the forest products and paper industries.

The article gives an in-depth analysis of the forest products and paper industries.

Purpose More than 20 years ago we reported an analysis of a case series of elderly critically ill patients with acute kidney injury (AKI)-then termed acute renal failure. At that time, AKI was regarded as a 'simple' complication, but has since undergone a fundamental change and actually has become one of the central syndromes in the critically ill patient. Methods We have analyzed elderly patients above 65 years of age with an AKI defined as serum creatinine above 3 mg/dl corresponding to modern KDIGO stage 3, most of them requiring renal replacement therapy (RRT). Using an extremely complete data set the diagnosis differentiated the underlying disease entity, the dominant cause of AKI, acute and chronic risk factors (comorbidities). Special aspects such as severity of disease, early AKI at admission versus late AKI, early versus later start of RRT, AKI not treated by RRT in spite of indication for RRT, various measures of short-term and long-term prognosis, renal outcome, patients dying with resolved AKI, and causes of death were evaluated. Results Crude mortality was 61 % which corresponds to modern studies with gross variation among the different subgroups. Age per se was not a determinant of survival either within the group of elderly patients or as compared to younger age groups. Despite an increase in mean age and disease severity during the observation period prognosis improved. A total of 17 % of patients developed a chronic kidney disease. Long-term survival as compared to the general population was low. Conclusions A look back at the last two decades illustrates a remarkable evolution or rather metamorphosis of a syndrome. AKI has evolved as a central syndrome in intensive care patients, a systemic disease process associated with multiple systemic sequels and extra-renal organ injury and exerting a pronounced effect on the course of disease and short- and long-term prognosis not only of the patient but also of the kidney. Moreover, the 'non-renal-naïve' elderly patient with multiple comorbidities has become the most frequent ICU patient in industrialized nations., Author(s): Wilfred Druml [sup.1], Kurt Lenz [sup.2], Anton N. Laggner [sup.3] Author Affiliations: (1) grid.22937.3d, 0000000092598492, Department of Internal Medicine III, Division of Nephrology, Medical University of Vienna, , Währinger [...]

Erich Fromm was a highly successful popular author and psychoanalyst who played an important role as a twentieth-century social activist and public intellectual. Friedman's biography reveals Fromm's fascinating 'lives' as a psychoanalyst, social theorist, cosmopolitan activist, and 'prophet' of love who significantly influenced American thought and politics., Author(s): James J. Clark[sup.1] Author Affiliations: James J. Clark PhD, LCSW joined the University of Cincinnati's School of Social Work at the College of Allied Health Sciences as its Director [...]

Author(s): Samir Jaber [sup.1], Giuseppe Citerio [sup.2] [sup.3], Daniel Talmor [sup.4] Author Affiliations: (1) grid.414352.5, Intensive Care Unit and Transplantation, Department of Anesthesia and Critical Care B (DAR B), Hôpital [...]

Introduction In the early 1990s, the in-hospital mortality rate of intensive care unit (ICU) patients dropped, and interest in the quality of life (QOL) of ICU survivors increased. In 1996, we published a study to investigate 1-year survival after hospital discharge and 6-month QOL after intensive care. Now, we compare our previous results with those reported in the recent literature to appraise any changes, and new knowledge in the area. Results The 1-year survival of ICU patients after hospital discharge is substantial, lower than in the general population, and different among subgroups. Some studies showed a reduction in QOL at 6 months, as in our study, while others showed an improvement. Different results seem to be related mainly to the case mix. Studies on different types of patients found long-term cognitive impairment in ICU survivors, possibly not disease specific. The proportions of patients with neuropsychological morbidities such as posttraumatic stress disorder, anxiety, and depression, described after our study, did not show any change over time. Conclusions Differences between studies on long-term survival and QOL do not allow conclusions to be drawn about change over time. No change was found in neuropsychological morbidities. However, a lack of change may not be viewed negatively, because critically ill patients who survive ICU today may be at higher risk for poor long-term outcome than in the past due to the higher severity of their illness and the more aggressive treatments received. Future studies may provide understanding of the relationships between psychiatric symptoms, cognitive impairment, functional disability, and QOL., Author(s): Maurizia Capuzzo [sup.1] [sup.2], Margherita Bianconi [sup.3] Author Affiliations: (1) grid.8484.0, 0000000417572064, c/o Section of Anaesthesia and Intensive Care, Department of Morphology, Surgery and Experimental Medicine, S. Anna Hospital, [...]

Introduction Jugular oxygen saturation monitoring was introduced in neurointensive care after severe traumatic brain injury (TBI) to explore the adequacy of brain perfusion and guide therapeutic interventions. The brain was considered homogeneous, and oxygen saturation was taken as representative of the whole organ. We investigated whether venous outflow from the brain was homogeneous by measuring oxygen saturation simultaneously from the two jugular veins. Methods In 32 comatose TBI patients both internal jugular veins (IJs) were simultaneously explored using intermittent samples; hemoglobin saturation was also recorded continuously by fiber-optic catheters in five patients. In five cases long catheters were inserted bilaterally upstream, up to the sigmoid sinuses. Main findings On average, measurements from the two sides were in agreement (mean and standard deviation of the differences between the saturation of the two IJs were respectively 5.32 and 5.15). However, 15 patients showed differences of more than 15 % in hemoglobin saturation at some point; three others showed differences larger than 10 %. No relationship was found between the computed tomographic scan data and the hemoglobin saturation pattern. Discussion/conclusion Several groups have confirmed differences between oxygen saturation in the two jugular veins. After years of enthusiasm, interest for jugular saturation has decreased and more modern methods, such as tissue oxygenation monitoring, are now available. Jugular saturation monitoring has low sensitivity, with the risk of missing low saturation, but high specificity; moreover it is cheap, when used with intermittent sampling. Monitoring the adequacy of brain perfusion after severe TBI is essential. However the choice of a specific monitor depends on local resources and expertise., Author(s): N. Stocchetti [sup.1] [sup.2], S. Magnoni [sup.2], E. R. Zanier [sup.3] Author Affiliations: (1) grid.4708.b, 0000000417572822, Department of Physiopathology and Transplant, Milan University, , Milan, Italy (2) grid.414818.0, 0000000417578749, [...]

Withdrawal from mechanical ventilation (or weaning) is one of the most common procedures in intensive care units. Almost 20 years ago, we published one of the seminal papers on weaning in which we showed that the best method for withdrawal from mechanical ventilation in difficult-to-wean patients was a once-daily spontaneous breathing trial with a T-piece. Progress has not stood still, and in the intervening years up to the present several other studies, by our group and others, have shaped weaning into an evidence-based technique. The results of these studies have been applied progressively to routine clinical practice. Currently, withdrawal from mechanical ventilation can be summarized as the evaluation of extubation readiness based on the patient's performance during a spontaneous breathing trial. This trial can be performed with a T-piece, which is the most common approach, or with continuous positive airway pressure or low levels of pressure support. Most patients can be disconnected after passing the first spontaneous breathing trial. In patients who fail the first attempt at withdrawal, the use of a once-daily spontaneous breathing trial or a gradual reduction in pressure support are the preferred weaning methods. However, new applications of standard techniques, such as noninvasive positive pressure ventilation, or new methods of mechanical ventilation, such as automatic tube compensation, automated closed-loop systems, and automated knowledge-based weaning systems, can play a role in the management of the patients with difficult or prolonged weaning., Author(s): Fernando Frutos-Vivar [sup.1] [sup.2] , Andrés Esteban [sup.1] [sup.2] Author Affiliations: (1) grid.411244.6, 0000000096916072, Hospital Universitario de Getafe, , Carretera de Toledo Km.12,500, Getafe, Madrid, Spain (2) grid.413448.e, 0000000093141427, [...]

Article History: Registration Date: 30/09/2004

Introduction Oxygen uptake (VO.sub.2) is independent of oxygen delivery (DO.sub.2) over a wide range of values, because O.sub.2 extraction can readily adapt to changes in DO.sub.2. However, VO.sub.2 can become DO.sub.2-dependent in acute circulatory failure. Methods Various methods of evaluating the presence of VO.sub.2/DO.sub.2 dependency were conducted, but criticized because of potential problems with mathematical coupling of data. Some 20 years ago, we proposed using a dobutamine test and showed similar relationships using direct and indirect measurements. Since these studies on the systemic VO.sub.2/DO.sub.2 relationship, investigators have also explored regional alterations. Conclusion The relationship between VO.sub.2 and DO.sub.2 remains an important concept. Abnormal global VO.sub.2/DO.sub.2 dependency does not exist in stable, critically ill patients, but can exist in circulatory shock of all etiologies. It can also occur regionally in septic patients, and microcirculatory alterations may contribute. Patient management should be titrated individually with careful assessment to identify those who will benefit from increased DO.sub.2., Author(s): Jean-Louis Vincent [sup.1], Daniel De Backer [sup.1] Author Affiliations: (1) grid.4989.c, 0000000123480746, Department of Intensive Care, Erasme Hospital, Université libre de Bruxelles, , Route de Lennik 808, 1070, Brussels, [...]

Introduction More than 20 years have passed since we reported our results of treating patients with the acute respiratory distress syndrome (ARDS) with inhaled nitric oxide (iNO). The main finding was that iNO alleviated pulmonary hypertension (PH) by selective vasodilation of pulmonary vessels in ventilated lung areas. This, in turn, improved arterial oxygenation. Methods We now set out to review the time span between the discovery of NO in 1987 and today in order to identify and describe interesting areas of research and clinical practice surrounding the application of iNO. Major Findings Enhancement of ventilation-perfusion matching and alleviation of PH in ARDS, treatment of PH of the newborn, and treatment of perioperative PH in congenital heart disease serve as just a few exciting examples for the successful use of iNO. Breathing NO prevents PH induced by stored blood transfusions or sickle cell disease. Exploiting the anti-inflammatory properties of NO helps to treat malaria. Discussion Regarding the use of iNO in ARDS, there remains the unresolved question of whether important outcome parameters can be positively influenced. At first glance, several randomized controlled trials and meta-analyses seem to send the clear message: 'There is none!' Careful analyses, however, leave sufficient room for doubt that the ideal study to produce the unequivocal proof for the inability of iNO to positively impact on important outcome parameters has, as yet, not been conducted. Conclusion In summary, the discovery of and research on the many positive effects of iNO has improved care of critically ill patients worldwide. It is a noble effort to continue on this path., Author(s): R. Rossaint [sup.1], K. Lewandowski [sup.2], W. M. Zapol [sup.3] Author Affiliations: (1) grid.412301.5, 0000000086531507, Klinik für Anästhesiologie, Universitätsklinikum Aachen, , Pauwelsstraße 30, 52074, Aachen, Germany (2) grid.477277.6, 0000000446730615, [...]

Because the diaphragm is essential for survival, we wondered if it might be less vulnerable to the long-lasting effects of fatigue than limb muscles. Using a recently introduced magnetic probe to activate the phrenic nerves, we followed the evolution of twitch transdiaphragmatic pressure after inducing fatigue in healthy volunteers. Twenty-four hours after its induction, diaphragmatic fatigue had not fully recovered. Findings from this study later served as the foundation for incorporating a once-daily, T-tube-trial arm into a randomized controlled trial of techniques for ventilator weaning in intensive care unit patients and also influenced the design of a controlled trial of the weaning of tracheostomy patients who required prolonged ventilation. The research methodology was later employed to determine whether low-frequency fatigue is responsible for weaning failure. Employing a further modification of the technique-twitch airway pressure-it became evident that respiratory muscle weakness is a greater problem than fatigue in ventilated patients. Twitch airway pressure is now being used to document the prevalence and consequences of ventilator-induced respiratory muscle weakness. Our study-which began with a circumscribed, simple question-has yielded dividends in unforeseen directions, illustrating the fruitfulness of research into basic physiological mechanisms., Author(s): Franco Laghi [sup.1] [sup.2], Nausica D'Alfonso [sup.1] [sup.2], Martin J. Tobin [sup.1] [sup.2] Author Affiliations: (1) grid.280893.8, 0000000404195175, Division of Pulmonary and Critical Care Medicine, Edward Hines, Jr. VA [...]

Introduction In 1992, we published a report on the effect of positive end-expiratory pressure (PEEP) on right ventricular (RV) function in humans. Results We measured RV volumes and pressures and pericardial pressure (Ppc) as PEEP was increased from zero to 15 cm H20 in 12 patients after thoracotomy, using a pulmonary arterial catheter equipped with a rapid responding thermistor that allowed measurement of RV ejection fraction (RVef), while Ppc was measured via a pericardial balloon catheter. RV end-diastolic volume (EDV) was estimated as the ratio of stroke volume (SV) to RVef, whereas RV end-systolic volume (ESV) were estimated as RV EDV-SV. PEEP increased Ppc and Pra, but RVef unaltered. There was no relation between either RV filling pressure (Pra-Ppc) and EDV or the change in RV filling pressure and EDV, although EDV varied significantly with PEEP (p < 0.05). The relations between EDV and both SV and RVef were weak (r = 0.54 and 0.55, respectively). RVef varied inversely with ESV (r = -0.77), although it showed no relation to transmural peak pulmonary artery pressure (r = 0.28). However, both absolute and relative changes in EDV corresponded closely with respective ESV values (r = 0.94). We concluded that EDV varies independently of changes in filling pressure and that changes in ESV occur independently of changes in ejection pressure. These data can be explained by assuming that the RV shape changes can dissociate changes in RV EDV from changes in RV wall stress (preload). Thus, changes in RV EDV may or may not alter SV but should proportionately change ESV to a degree dependent on election pressure and contractility. Conclusions Subsequent studies confirmed our findings which can be summarized as 1) RV filling is independent of Pra; thus central venous pressure cannot be used to estimate RV preload; and 2) for cardiac output to increase by the Starling mechanism the RV must dilate increasing RV ESV. Since the pericardium limits absolute biventricular volume, there is a finite limit to which cardiac output can increase by the Starling mechanism defined not by left ventricular contractility but by RV function. And 3) if fluid loading causes Pra to increase without increasing cardiac output, then resuscitation should stop as the patient is going into acute cor pulmonale. These truths help bedside clinicians understand the echocardiographic and hemodynamic signatures of both RV failure and volume responsiveness., Author(s): Michael R. Pinsky [sup.1] Author Affiliations: (1) grid.21925.3d, 0000000419369000, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, , 606 Scaife Hall, 3550 Terrace Street, 15261, Pittsburgh, [...]

Author(s): Fekri Abroug [sup.1] [sup.2], Fahmi Dachraoui [sup.1] [sup.2], Lamia Ouanes-Besbes [sup.1] [sup.2] Author Affiliations: (1) Intensive Care Unit, CHU Fatouma Bourguiba, , 5000, Monastir, Tunisia (2) grid.411838.7, 0000000405935040, Research [...]

Byline: Wen-Ching Chen (1,2), Jung-Der Wang (1,3), Jing-Shiang Hwang (4), Chiao-Chicy Chen (5), Chia-Huei Wu (6), Grace Yao (6) Keywords: Comparison; Reliability; Validity; Web version; WHOQOL-BREF Abstract: The purpose of this study was to test whether the web version is an alternative to the paper version of the short version of the World Health Organization Quality of Life assessment (WHOQOL-BREF). Two studies were conducted. Study 1 used crossover self-controlled trials with 80 participants to compare the web and paper versions and to determine the test--retest reliability of the web version. Study 2 used data from 1,016 web participants to analyze the internal consistency and concurrent and construct validity of the web version. The correlations of domain scores between the web and paper versions ranged from 0.71 to 0.85. Dependent t tests showed no significant differences in domain scores between these two versions. The intra-class correlation coefficients (ICC) for test--retest reliability of web version ranged from 0.79 to 0.91. The Cronbach's [alpha] for internal consistency reliability ranged from 0.60 to 0.83. Multiple regression models indicated that the web version has good concurrent validity. Confirmatory factor analysis (CFA) for the second-order hierarchical factor model also supported the construct validity of the web version. The web version of the WHOQOL-BREF can be the alternative to the paper version for health-related quality of life (HR-QOL) evaluation. Author Affiliation: (1) Institute of Occupational Medicine and Industrial Hygiene, College of Public Health, National Taiwan University, Taipei, Taiwan (2) Yuli Hospital, Department of Health, Executive Yuan, Taiwan (3) Department of Internal Medicine and Department of Environmental and Occupational Medicine, National Taiwan University Hospital, Taipei, Taiwan (4) Institute of Statistical Science, Academia Sinica, Taipei, Taiwan (5) Song De Branch, Taipei City Hospital, Taipei, Taiwan (6) Department of Psychology, College of Science, National Taiwan University, No. 1, Sect. 4, Roosevelt Road, Taipei, 10617, Taiwan Article History: Registration Date: 20/10/2008 Received Date: 08/01/2008 Accepted Date: 19/10/2008 Online Date: 05/11/2008

Electron backscatter diffraction (EBSD) is a powerful microscopic technique to characterise the crystallography of biomineralisation. Here, we use high-resolution EBSD to characterise one of the least studied shells in the ocean, the female argonaut brood chamber, and to examine the changes in shell microstructure in response to incubation in decreased pH conditions. The thin (225 (µm) shell of Argonauta nodosa is magnesium calcite with an average magnesium content of ca. 5.1 Wt % MgC[O.sub.3]. EBSD and scanning electron microscopy (SEM) revealed that calcification of the shell is bidirectional with formation of irregular crystalline grains. Following a 2 week incubation in a range of pH treatments (pH, 8.1-7.2), shell fragment weight decreased by dissolution in pH ≤ 7.8. EBSD and SEM revealed altered shell crystallography and microstructure at pH [less than or equal to] 7.4 due to preferential etching down crystallite grain boundaries and a change in crystalline orientation on both the inner and outer shell surfaces. Our study highlights the value of EBSD for the detailed examination of biogenic carbonates and its potential use in the field of ocean acidification research., Introduction Altered skeletogenesis due to ocean acidification has been documented for major marine calcifying groups, including corals, bryozoans, echinoderms and molluscs (Orr et al. 2005; Parker et al. 2010; Byrne [...]

We provide an analysis of refereed papers published in the Australian Journal of Outdoor Education, the Journal of Adventure Education and Outdoor Learning, and the Journal of Experiential Education over the last decade. We developed a framework to classify the papers in terms of the authors' affiliations, the type of papers published, the context they address, and the foci of the papers. Authors from the US published most extensively across all three journals followed by authors from Australia, UK, Canada, and New Zealand; the JAEOL had the most balanced mix of author nationalities. All three journals demonstrated a trend towards a higher proportion of research-based papers. Suggestions for the continued development of the emerging research culture are provided. We conclude by offering a table identifying potential areas for future research., Introduction This paper provides an analysis of the refereed publications in three scholarly journals in the related fields of outdoor education, adventure education, and experiential education. The three journals are [...]

We compare Fresco's analysis of the Turing machine-based notion of computation with that of others, in particular with functional programming and with the reversible computing paradigm of Toffoli and others. We conclude that, although much useful philosophical work can be done by the sort of analysis that Fresco proposes, there is, nevertheless, always likely to be a number of individually viable but different accounts of computation. Keywords Analysis of computation * Functional programming * Reversible computing, 1 Introduction Fresco's article asks whether really existing computers can be considered as information processors, and, in order to answer this question, it considers four current notions of information: Shannon's [...]

The oxidation of 1,2,4-triacetoxybenzene (Pyrogallol A) and 3,3',5,5'-tetramethylbenzydine by air oxygen in presence of tris-(2,2'-dipyridyl)ruthenium(II) as a photosensitizer is studied upon irradiation by visible light. The photooxidation of pyrogallol A was inhibited selectively by benzoate at pH 9-11. The rate of the reaction was not affected by other carboxylic acids but was influenced by short-chained aliphatic amines and transition metals. We developed a semiquantitative procedure for the determination of benzoate by paper chromatography. Therein, a common solution of pyrogallol A and a photosensitizer were used for the visualization followed by irradiation with an incandescent bulb. Benzoate was detected as a light spot with [R.sub.f] ~ 0.3 against a brown background. The measurement of reflectance intensity for the spot by reflectometry allowed the determination of 1 x [10.sup.-5]-0.01 M benzoate within a precision of half-order of magnitude. The procedure was validated by comparison to the data of capillary electrophoresis and used to test beverages containing benzoate at levels of [10.sup.-4]-[10.sup.-3] M. DOI: 10.1134/S1061934810010120, Despite the fact that photochemical processes have a broad application in chemical analysis [1, 2], the number of applicable indicatory reactions is rather limited, so there are a limited number [...]

Introduction Despite the best efforts by the public health community, the existence of disparity in African American infant mortality appears to be insurmountable. Eliminating this disparity is the public health [...]

Prejudices against minorities are still a cause of inter-ethnic conflict and violence, although their expression has changed from blatant to more subtle forms. There has been a shortage of valid and reliable German-language scales for the measurement of contemporary racial prejudices. The Racial Argument Scale (RAS; Saucier & Miller Personality and Social Psychology Bulletin 35:433-450, 2003) measures contemporary prejudice indirectly by asking respondents to judge how well given arguments support a conclusion. This scale was adapted to the German context with Turks as the target group. A validation study using a diverse sample of German adults (N = 194) attests to the reliability and construct validity of the German RAS (RAS-G). The adapted instrument is thus suitable for the indirect measurement of prejudice in German-speaking samples. Keywords Indirect measurement, Nonreactive measures, Racial argument scale, Scale development, Prejudice, Introduction Prejudice forms the core of ideologies that support inequality and exploitation (for example, Jones 1997). Prejudice may thus cause the toleration of inter-ethnic violence and even the perpetration of [...]

Byline: Jill Robbins (001) Keywords: children's thinking; constructivism; early childhood contexts; interviewing; natural phenomena; relationships; sociocultural theory Abstract: How do we see young children's thinking in science? Is it, as much previous research has led us to believe, that their ideas can be neatly boxed like 'brown paper packages tied up with strings' -- as the song from The Sound of Music goes? Or are their ideas like 'wild geese that fly with the moon on their wings' (Sound of Music): fluid, complex, rich...? Drawing on the author's research into young children's ideas about natural phenomena such as the rain and clouds, and on Rogoff's three foci of analysis (personal, interpersonal and contextual), this paper illustrates how a consideration of sociocultural theory can be useful in framing research with young children, and allow us to see beyond the boxes. Emphasis is placed on recognising that children's thinking in science is embedded within particular sociocultural contexts, is guided by others and integrated with their use of certain mental and physical cultural tools. Thus, the article aims to present an alternative method for the generation of data on young children's thinking. Specific analysis of this data will, it is intended, be presented in a subsequent article. Author Affiliation: (001) Faculty of Education, Monash University, Peninsula Campus, PO Box 527, Frankston, Victoria, 3199, Australia Article History: Registration Date: 03/01/2005

Byline: Charles Francis (1) Author Affiliation: (1) Agronomy and Horticulture Department, University of Nebraska, Lincoln, 279 Plant Science Bldg., Lincoln, NE, 68583-0915, USA Article History: Registration Date: 11/11/2009 Accepted Date: 04/11/2009 Online Date: 18/11/2009