Non-invasive neurally adjusted ventilatory assist in rabbits with acute lung injury

OBJECTIVE: Neurally adjusted ventilatory assist uses the electrical activity of the diaphragm (EAdi)-a pneumatically-independent signal-to control the timing and pressure of the ventilation delivered, and should not be affected by leaks. The aim of this study was to evaluate whether NAVA can deliver assist in synchrony and proportionally to EAdi after extubation, with a leaky non-invasive interface. DESIGN AND SETTING: Prospective, controlled experimental study in an animal laboratory. ANIMALS: Ten rabbits, anesthetized, mechanically ventilated. INTERVENTIONS: Following lung injury, the following was performed in sequential order: (1) NAVA delivered via oral endotracheal tube with PEEP; (2) same as (1) without PEEP; (3) non-invasive NAVA at unchanged NAVA level and no PEEP via a single nasal prong; (4) no assist; (5) non-invasive NAVA at progressively increasing NAVA levels. MEASUREMENTS AND RESULTS: EAdi, esophageal pressure, blood gases and hemodynamics were measured during each condition. For the same NAVA level, the mean delivered pressure above PEEP increased from 3.9[Symbol: see text]+/-[Symbol: see text]1.4[Symbol: see text]cmH(2)O (intubated) to 7.5[Symbol: see text]+/-[Symbol: see text]3.8[Symbol: see text]cmH(2)O (non-invasive) (p[Symbol: see text]<[Symbol: see text]0.05) because of increased EAdi. No changes were observed in PaO(2) and PaCO(2). Increasing the NAVA level fourfold during non-invasive NAVA restored EAdi and esophageal pressure swings to pre-extubation levels. Triggering (106[Symbol: see text]+/-[Symbol: see text]20[Symbol: see text]ms) and cycling-off delays (40[Symbol: see text]+/-[Symbol: see text]21[Symbol: see text]ms) during intubation were minimal and not worsened by the leak (95[Symbol: see text]+/-[Symbol: see text]13[Symbol: see text]ms and 33[Symbol: see text]+/-[Symbol: see text]9[Symbol: see text]ms, respectively). CONCLUSION: NAVA can be effective in delivering non-invasive ventilation even when the interface with the patient is excessively leaky, and can unload the respiratory muscles while maintaining synchrony with the subject's demand.

[Of calabash gourds and other patient histories]

In the culture of primal peoples, the dumbbell-shaped bottle gourd or calabash is a symbol for the universe, two equal halves inextricably linked. They represent heaven and earth, Yin and Yang--balance and harmony. This essay reflects personal memories, where case histories, patient stories and a doctor's story are intertwined.

Unprecedented Trapping of Difluorooctamolybdate Anions within an α-Polonium Type Coordination Network

New fluorinated hybrid solids [Mo2F2O5(tr2pr)] (1), [Co3(tr2pr)2(MoO4)2F2]·7H2O (2), and [Co3(H2O)2(tr2pr)3(Mo8O26F2)]·3H2O (3) (tr2pr = 1,3-bis(1,2,4-triazol-4-yl)propane) were prepared from the reaction systems consisting of Co(OAc)2/CoF2 and MoO3/(NH4)6Mo7O24, as CoII and MoVI sources, in water (2) or in aqueous HF (1, 3) employing mild hydrothermal conditions. The tr2pr ligand serves as a conformationally flexible tetradentate donor. In complex 1, the octahedrally coordinated Mo atoms are linked in the discrete corner-sharing {Mo2(μ2-O)F2O4N4} unit in which a pair of tr-heterocycles (tr = 1,2,4-triazole) is arranged in cis-positions opposite to “molybdenyl” oxygen atoms. The anti−anti conformation type of tr2pr facilitates the tight zigzag chain packing motif. The crystal structure of the mixed-anion complex salt 2 consists of trinuclear [Co3(μ3-MoO4)2(μ2-F)2] units self-assembling in CoII-undulating chains (Co···Co 3.0709(15) and 3.3596(7) Å), which are cross-linked by tr2pr in layers. In 3, containing condensed oxyfluoromolybdate species, linear centrosymmetric [Co3(μ2-tr)6]6+ SBUs are organized at distances of 10.72−12.45 Å in an α-Po-like network using bitopic tr-linkers. The octahedral {N6} and {N3O3} environments of the central and peripheral cobalt atoms, respectively, are filled by triazole N atoms, water molecules, and coordinating [Mo8O26F2]6− anions. Acting as a tetradentate O-donor, each difluorooctamolybdate anion anchors four [Co3(μ2-tr)6]6+ units through their peripheral Co-sites, which consequently leads to a novel type of a two-nodal 4,10-c net with the Schläfli symbol {32.43.5}{34.420.516.65}. The 2D and 3D coordination networks of 2 and 3, respectively, are characterized by significant overall antiferromagnetic exchange interactions (J/k) between the CoII spin centers on the order of −8 and −4 K. The [Mo8O26F2]6− anion is investigated in detail by quantum chemical calculations.

A Stratified Model for Psychosis Prediction in Clinical Practice

Objective: Impaired cognition is an important dimension in psychosis and its at-risk states. Research on the value of impaired cognition for psychosis prediction in at-risk samples, however, mainly relies on study-specific sample means of neurocognitive tests, which unlike widely available general test norms are difficult to translate into clinical practice. The aim of this study was to explore the combined predictive value of at-risk criteria and neurocognitive deficits according to test norms with a risk stratification approach. Method: Potential predictors of psychosis (neurocognitive deficits and at-risk criteria) over 24 months were investigated in 97 at-risk patients. Results: The final prediction model included (1) at-risk criteria (attenuated psychotic symptoms plus subjective cognitive disturbances) and (2) a processing speed deficit (digit symbol test). The model was stratified into 4 risk classes with hazard rates between 0.0 (both predictors absent) and 1.29 (both predictors present). Conclusions: The combination of a processing speed deficit and at-risk criteria provides an optimized stratified risk assessment. Based on neurocognitive test norms, the validity of our proposed 3 risk classes could easily be examined in independent at-risk samples and, pending positive validation results, our approach could easily be applied in clinical practice in the future.

Swiss Shock: Minaret Rejection, European Values, and the Challenge of Tolerant neutrality

In 2009 Switzerland, for long an apparent beacon of European toleration and neutrality, voted to ban the erection of minarets. Internal religious matters are normally dealt with at the regional or local level – not at the level of the Swiss national parliament, although the state does seek to ensure good order and peaceful relations between different faith communities. Indeed, the freedom of these communities to believe and function publicly is enshrined in law. However, as a matter of national policy, now constitutionally embedded, one religious group, the Muslim group, is not permitted to build their distinctive religious edifice, the minaret. Switzerland may have joined the rest of Europe with respect to engaging the challenge of Islamic presence to European identity and values, but the rejection of a symbol of the presence of one faith – in this case, Islamic – by a society that is otherwise predominantly secular, pluralist, and of Christian heritage, poses significant concerns. How and why did this happen? What are the implications? This paper will discuss some of the issues involved, concluding the ban is by no means irreversible. Tolerant neutrality may yet again be a leitmotif of Swiss culture and not just of foreign policy.

Geballte Faust, Doppelaxt, rosa Winkel. Gruppenkonstituierende Symbole der Frauen-, Lesben- und Schwulenbewegung

2008 jährte sich die Zäsur von 1968 zum 40. Mal. Besonders an diesem Jahrestag war, dass nun die nächste Generation in die gesellschaftliche Reflexion eingetreten ist. Das aus Vertretern der nach 1968 Geborenen bestehende Schweizer Ausstellungsbüro Palma3 hat aus diesem Anlass gemeinsam mit dem Historischen Museum in Frankfurt am Main die Ausstellung „Die 68er. Kurzer Sommer – lange Wirkung“ realisiert. Im Rahmen von acht Themenbereichen, die die wichtigsten Aufbrüche von 1968 und ihre Weiterentwicklung in den 1970er Jahren dokumentieren und reflektieren, nahm der Bereich „Geschlechterrollen“ einen besonderen Raum ein. Er präsentierte materialreich die Frauen-, Lesben- und Schwulenbewegung sowie die so genannte sexuelle Revolution der 1960er und 1970er Jahre in der Bundesrepublik Deutschland in ihren spannungsvollen Wechselverhältnissen. Im Zentrum des Beitrages sollen die unterschiedlichen Symbole dieser Bewegungen stehen. Diese dokumentieren anschaulich das Aushandeln gruppenkonstituierender Identitäten, wobei Rückgriffe auf ältere Symbole und deren Transformationen sowie Neukontextualisierungen zu beobachten sind. In der Frauenbewegung war das Venus-/Weiblichkeitszeichen mit geballter Faust im Innern in verschiedenen Versionen als grafische Verbindung von linker Bewegung und Feminismus verbreitet. Zwei ineinander verschlungene Weiblichkeitssymbole stehen in der Lesbenbewegung für weib-weibliche Sexualität. Dass die Frauen- und die Lesbenbewegung teilweise eine enge Allianz eingegangen sind, lässt sich auch an ihren gemeinsamen Symbolen ablesen: Die Labrys (Doppelaxt), eine minoische Kultaxt, repräsentiert die Autonomie und Stärke der Amazonen, als deren Waffe sie gilt. Das alte Zeichen der beiden gegeneinander gestellten Hände stellt eine Vagina dar und wurde ursprünglich von Männern als obszöne Geste für den Geschlechtsverkehr benutzt, wobei die Hände in Höhe ihrer Geschlechtsorgane gehalten wurden. In der Frauen- und Lesbenbewegung wurde dieses Zeichen mit erhobenen Armen über dem Kopf gezeigt, um die sexuelle Selbstbestimmung der Frauen deutlich zu machen. Demgegenüber greift die Schwulenbewegung auf den rosa Winkel als Symbol zurück. Dieser kennzeichnete während des Nationalsozialismus’ männliche Häftlinge in Konzentrationslagern als homosexuell. Er wurde von der deutschen Schwulenbewegung aufgegriffen und in emanzipatorischer Absicht umgewertet, wobei die nationalsozialistische Vergangenheit des Symbols präsent bleiben sollte. Insbesondere in den frühen 1970er Jahren finden sich unterschiedlichste Entwürfe dieser Symbole auf Flugblättern, Broschüren, Zeitschriften, Büchern, Plakaten und Transparenten. An Hand einzelner Gruppierungen wie der Homosexuellen Aktion Westberlin, die als Schwulen- und Lesbenorganisation gegründet worden war, sich jedoch schnell in die HAW und das LAZ (LesbenAktionsZentrum) aufsplittete, der Frauenorganisation Brot und Rosen und der Roten Zelle Schwul (ROTZSCHWUL) soll der Aushandlungsprozess innerhalb der Gruppierungen sowie das Verhandeln von Gruppenidentität und -inszenierung nach innen und außen nachgezeichnet werden. Zugleich lässt sich das Weiterexistieren bzw. Verschwinden der jeweiligen Symbole wie auch das Entstehen neuer Symbole – beispielsweise der Regenbogenfahne – als Indiz für die Veränderungen innerhalb der Bewegungen und deren Selbstwahrnehmung und Selbstinszenierung lesen.

Getting the big picture: Development of spatial scaling abilities

Spatial scaling is an integral aspect of many spatial tasks that involve symbol-to-referent correspondences (e.g., map reading, drawing). In this study, we asked 3–6-year-olds and adults to locate objects in a two-dimensional spatial layout using information from a second spatial representation (map). We examined how scaling factor and reference features, such as the shape of the layout or the presence of landmarks, affect performance. Results showed that spatial scaling on this simple task undergoes considerable development, especially between 3 and 5 years of age. Furthermore, the youngest children showed large individual variability and profited from landmark information. Accuracy differed between scaled and un-scaled items, but not between items using different scaling factors (1:2 vs. 1:4), suggesting that participants encoded relative rather than absolute distances.

From Similes to Allegory: The Deconstruction of Chariot Imagery in Early Buddhist Texts, Analyzed with Cognitive Metaphor Theory

The presentation will start by unfolding the various layers of chariot imagery in early Indian sources, namely, chariots as vehicles of gods such as the sun (sūrya), i.e. as symbol of cosmic stability; chariots as symbols of royal power and social prestige e.g. of Brahmins; and, finally, chariots as metaphors for the “person”, the “mind” and the “way to liberation” (e.g., Kaṭ.-Up. III.3; Maitr.-Up. II. 6). In Buddhist and non-Buddhist sources, chariots are in certain aspects used as a metaphor for the (old) human body (e.g., Caraka-S., Vi.3.37-38; D II.100; D II.107); apart from that, there is, of course, mention of the “real” use of chariots in sports, cults, journey, and combat. The most prominent example of the Buddhist use of chariot imagery is its application as a model for the person (S I.134 f.; Milindapañha, ed. Trenckner, 26), i.e., for highlighting the “non-substantial self”. There are, however, other significant examples of the usage of chariot imagery in early Buddhist texts. Of special interest are those cases in which chariot metaphors were applied in order to explain how the ‘self’ may proceed on the way to salvation – with ‘mindfulness’ or the ‘self’ as charioteer, with ‘wisdom’ and ‘confidence’ as horses etc. (e.g. S I. 33; S V.7; Dhp 94; or the Nārada-Jātaka, No. 545, verses 181-190). One might be tempted to say that these instances reaffirm the traditional soteriology of a substantial “progressing soul”. Taking conceptual metaphor analysis as a tool, I will, in contrast, argue that there is a special Buddhist use of this metaphor. Indeed, at first sight, it seems to presuppose a non-Buddhist understanding (the “self” as charioteer; the chariot as vehicle to liberation, etc.). Yet, it will be argued that in these cases the chariot imagery is no longer fully “functional”. The Buddhist usage may, therefore, best be described as a final allegorical phase of the chariot-imagery, which results in a thorough deconstruction of the “chariot” itself.

Classes of multichannel EEG microstates in light and deep hypnotic conditions

The study assessed the brain electric mechanisms of light and deep hypnotic conditions in the framework of EEG temporal microstates. Multichannel EEG of healthy volunteers during initial resting, light hypnosis, deep hypnosis, and eventual recovery was analyzed into temporal EEG microstates of four classes. Microstates are defined by the spatial configuration of their potential distribution maps ([Symbol: see text]potential landscapes') on the head surface. Because different potential landscapes must have been generated by different active neural assemblies, it is reasonable to assume that they also incorporate different brain functions. The observed four microstate classes were very similar to the four standard microstate classes A, B, C, D [Koenig, T. et al. Neuroimage, 2002;16: 41-8] and were labeled correspondingly. We expected a progression of microstate characteristics from initial resting to light to deep hypnosis. But, all three microstate parameters (duration, occurrence/second and %time coverage) yielded values for initial resting and final recovery that were between those of the two hypnotic conditions of light and deep hypnosis. Microstates of the classes B and D showed decreased duration, occurrence/second and %time coverage in deep hypnosis compared to light hypnosis; this was contrary to microstates of classes A and C which showed increased values of all three parameters. Reviewing the available information about microstates in other conditions, the changes from resting to light hypnosis in certain respects are reminiscent of changes to meditation states, and changes to deep hypnosis of those in schizophrenic states.

A community-based geological reconstruction of Antarctic Ice Sheet deglaciation since the Last Glacial Maximum

A robust understanding of Antarctic Ice Sheet deglacial history since the Last Glacial Maximum is important in order to constrain ice sheet and glacial-isostatic adjustment models, and to explore the forcing mechanisms responsible for ice sheet retreat. Such understanding can be derived from a broad range of geological and glaciological datasets and recent decades have seen an upsurge in such data gathering around the continent and Sub-Antarctic islands. Here, we report a new synthesis of those datasets, based on an accompanying series of reviews of the geological data, organised by sector. We present a series of timeslice maps for 20 ka, 15 ka, 10 ka and 5 ka, including grounding line position and ice sheet thickness changes, along with a clear assessment of levels of confidence. The reconstruction shows that the Antarctic Ice sheet did not everywhere reach the continental shelf edge at its maximum, that initial retreat was asynchronous, and that the spatial pattern of deglaciation was highly variable, particularly on the inner shelf. The deglacial reconstruction is consistent with a moderate overall excess ice volume and with a relatively small Antarctic contribution to meltwater pulse 1a. We discuss key areas of uncertainty both around the continent and by time interval, and we highlight potential priorities for future work. The synthesis is intended to be a resource for the modelling and glacial geological community.

Ethics, Interrupted: Community and Impersonality in Levinas

Despite the influence of Emmanuel Levinas’s ethics on the rethinking of community in post-identitarian terms (most prominently in the work of Maurice Blanchot, Alphonso Lingis, and, to a lesser extent, Jean-Luc Nancy), the question of community remains a problematic spot in Levinas’s own philosophy. I would argue that, instead of grounding a new thinking of community, the dyadic relation of Same and Other poses a structural problem when trying to open the ethical relation to the wider realm of others while keeping radical difference in place. As external observer and guarantor of justice, for instance, is the Third excluded a priori from the ethical relation? Is community always only another term for the political? Or, as Levinas himself puts it in Otherwise Than Being: “What meaning can community take on in difference without reducing difference?” Identifying in the notion of impersonality a way to access Levinas’s thought on community, this paper aims at rethinking the scene of address and the ethical relation in terms of displacement, dislocation and interruption.

Computable Diagonalizations and Turing’s Cardinality Paradox

A. N. Turing’s 1936 concept of computability, computing machines, and computable binary digital sequences, is subject to Turing’s Cardinality Paradox. The paradox conjoins two opposed but comparably powerful lines of argument, supporting the propositions that the cardinality of dedicated Turing machines outputting all and only the computable binary digital sequences can only be denumerable, and yet must also be nondenumerable. Turing’s objections to a similar kind of diagonalization are answered, and the implications of the paradox for the concept of a Turing machine, computability, computable sequences, and Turing’s effort to prove the unsolvability of the Entscheidungsproblem, are explained in light of the paradox. A solution to Turing’s Cardinality Paradox is proposed, positing a higher geometrical dimensionality of machine symbol-editing information processing and storage media than is available to canonical Turing machine tapes. The suggestion is to add volume to Turing’s discrete two-dimensional machine tape squares, considering them instead as similarly ideally connected massive three-dimensional machine information cells. Three-dimensional computing machine symbol-editing information processing cells, as opposed to Turing’s two-dimensional machine tape squares, can take advantage of a denumerably infinite potential for parallel digital sequence computing, by which to accommodate denumerably infinitely many computable diagonalizations. A three-dimensional model of machine information storage and processing cells is recommended on independent grounds as better representing the biological realities of digital information processing isomorphisms in the three-dimensional neural networks of living computers.

Weiss auf Rot. Das Schweizer Kreuz zwischen nationaler Identität und Corporate Identity

Das Schweizer Kreuz hat als Zeichen ausserordentliche Qualitäten und ein enormes Potenzial. Seine Verwendung geht weit über den unmittelbaren Bereich von Staat und Nation hinaus. Die Publikation der Hochschule der Künste Bern HKB erschliesst dieses Phänomen mit illustrierten Beiträgen von Fachleuten aus verschiedenen wissenschaftlichen Fachrichtungen. Für Nation, Staat, Politik und im Sport steht es als Symbol, im Kontext Wirtschaft ist es Teil von Logos, im Zusammenhang von Lifestyle und Zeitgeist tritt es als modisches Ornament auf. Das Schweizer Kreuz macht TrägerInnen und AbsenderInnen identifizierbar: Abstimmungsunterlagen als staatliche Dokumente, die Sportlerin als Mitglied des Nationalteams, den Inhaber eines Pas-ses oder einer Identitätskarte als Schweizer Bürger; Post oder SBB als schweizerische Dienstleister; die Besitzerin einer Tasche als Vertreterin einer Lifestyle-Gruppe oder Nachzüglerin eines sinkenden Trends; das Mineralwasser als natürliches, gesundes Produkt; eine Alu-Trinkflasche als flottes Qualitätsprodukt. Interdisziplinärer Zugang «Weiss auf Rot. Das Schweizer Kreuz zwischen nationaler Identität und Corporate Identity» ist eine Textsammlung, die entsprechend der Vielfältigkeit des Themas auch eine Vielfalt von Annäherungen an den Gegenstand bietet. Die 13 wissenschaftlichen Texte werden ergänzt durch fünf Interviews mit VertreterInnen aus Politik, Wirtschaft, Sportwissenschaft und Gestaltung, die in ihrem berufli-chen Alltag einen praktischen Bezug zum Schweizer Kreuz haben.