Incidence and clinical implications of stent fractures of the Xpert self-expanding nitinol stent in infrainguinal arteries

BACKGROUND: Different stents in infrainguinal arteries have recently been associated with stent fractures and unfavorable clinical outcome, although data is limited regarding fractures of the Xpert selfexpanding nitinol stent. Thus, purpose of the present investigation was to evaluate its incidence and clinical implications in lower limb arteries. PATIENTS AND METHODS: Fifty-three consecutive patients (53 limbs) with peripheral arterial disease underwent secondary Xpert stent implantation due to suboptimal primary balloon angioplasty (PTA). Median age was 76 years. Stent fractures were evaluated by plain X-ray at median follow-up of 16 months. Stent patency was assessed by duplex ultrasound and sustained clinical improvement was defined as improvement of the ABI of > or = 0.10 together with improvement of at least one Rutherford class above the baseline finding throughout follow-up. RESULTS: Median length of femoropopliteal and infrapopliteal lesion was 3.0 and 2.3 cm, respectively. Sixtyfive stents were implanted in 43 limbs with femoropopliteal and 10 stents in 10 limbs with infrapopliteal lesion, respectively. Stent fractures occurred in 3 of 43 limbs (7.0%) of patients with femoropopliteal lesion with stent-based fracture rate of 4.6%. All fractured stents showed multiple struts fractures and occurred in the distal and middle superficial femoral artery. No stent fracture was observed in infrapopliteal lesions. The fractured stents were not associated with any clinical deterioration. Sustained clinical improvement was 71.0% and 54.6% for femoropopliteal and infrapopliteal lesions, respectively. Stent patency assessed by duplex was 65.2 and 63.9% for femoropopliteal and infrapopliteal lesions, respectively. CONCLUSIONS: Fractures of the Xpert stent were seldom and not associated with unfavorable clinical outcome at midterm follow-up.

Give me a shilling [videorecording]: phenomenon of the street children

Pictures of the Watoto wa Lwanga project, the efforts of the Brothers of St. Charles Lwanga not only to rehabilitate Nairobi's street children, but to prevent slum children from ending up in the streets. Features life in the slums, the situation of the street children, the efforts of the social workers to involve the children's parents, the various reception centers, the vocational school, the Boy's Town Ruai Residential School, the community of the Brothers of St. Charles Lwanga as well as interviews with former street children and with various directors and benefactors of the project.

Homo Jihadicus. Islam in the former USSR and the phenomenon of the post-Soviet militants in Syria and Iraq. OSW REPORT 2015-09-21

The post-Soviet area, along with the countries of the Middle East, North Africa and Western Europe, have become one of the main global exporters of Islamic militants. Currently on the territory of Syria, and to a lesser extent of Iraq, there are several thousands of foreign fighters from the post-Soviet states. The causes of the war migration from the former USSR states to the Middle East have their roots in the dynamic changes taking place inside Islam in the post-Soviet area: primarily the growth of Salafism and militant Islam, as well as the internationalisation and globalisation of the local Islam. The deep political, economic, social and ideological changes which Muslims underwent after the collapse of the USSR, led to the creation of a specific group within them, for which Islam in its radical form became the main element of their identity. Homo sovieticus, without fully eradicating his Soviet part, became Homo jihadicus who not only identifies himself with the global Ummah, but is also ready to leave his country and join jihad beyond its borders in the name of the professed ideas.

Progress of the non-self-governing territories under the Charter.

"United Nations publication: Sales no.: 60. VI.B.1."

Final report on development of the teenage self-test drinking and driving.

National Highway Traffic Safety Administration, Office of Driver and Pedestrian Programs, Washington, D.C.

Parents of the handicapped; self-organized parents' and relatives' groups for treatment of ill and handicapped children.

Mode of access: Internet.

Mormonism and the Mormons : a historical view of the rise and progress of the sect self-styled Latter-Day Saints /

Mode of access: Internet.

Mormonism and the Mormons; a historical view of the rise and progress of the sect self-styled Latter-day saints.

Mode of access: Internet.

Woodrow Wilson's ''Rhetorical restructuring'': The transformation of the American self and the construction of the German enemy

From a comprehensive study of the public addresses of Woodrow Wilson in the period following the outbreak of the war in Europe in August 1914 to the war's conclusion in June 1919, this essay examines Wilson's transformation of the long-held vision of America as merely a great example of liberty to its embodiment as the self-sacrificing champion of liberty. It will demonstrate how this transformation of the American "self" was inextricably connected to a changing image of the war and the construction of an enemy image of the German government.

An examination of the psychometric properties of the Rosenberg Self-Esteem Scale (RSES) in Chinese acute coronary syndrome (ACS) patients

The psychometric properties of the Rosenberg Self-Esteem Scale (RSES) as a clinical research instrument for acute coronary syndrome (ACS) patients were investigated in a translated Chinese version of the instrument. A confirmatory factor analysis was conducted on the RSES to establish its psychometric properties in 128 ACS patients over two observation points (within 1 week and 6 months post-admission for ACS). Internal and test - retest reliability of the RSES-TOT (all-items) and RSES-POS sub-scale (positively valenced items) were found to be acceptable. The RSES-NEG sub-scale (negatively valenced items) lacked acceptable internal reliability. The underlying factor structure of the RSES comprised two distinct but related factors, though there was inconsistency in best model fit indices at the 1-week observation point. The use of the RSES as two sub-scales (RSES-POS and RSES-NEG) may be clinically useful in evaluating the influence of this important psychological construct on the health outcomes of patients with ACS. Directions for future research are indicated.

Merton's true self and the psychology of the dialogical self

Thomas Merton pursued a life-long quest to grasp the nature of the “true self.” This is the self that lives in and through Christ. Opposed to this is the false self that is expressive of infidelity. It is argued that the interaction between the true and false selves constitutes a dialogical process. The thesis of the essay is that this interaction expresses the dynamics associated with what some psychologists refer to as the “dialogical self.” The dialogical self is a model of the inner life that draws attention to the interpretive process required to deal with the many voices that get internalized in an engagement with the world.

Responsiveness and clinical utility of the geriatric self-efficacy index for urinary incontinence

OBJECTIVES: To report on the responsiveness testing and clinical utility of the 12-item Geriatric Self-Efficacy Index for Urinary Incontinence (GSE-UI). DESIGN: Prospective cohort study. SETTING: Six urinary incontinence (UI) outpatient clinics in Quebec, Canada. PARTICIPANTS: Community-dwelling incontinent adults aged 65 and older. MEASUREMENTS: The abridged 12-item GSE-UI, measuring older adults' level of confidence for preventing urine loss, was administered to all new consecutive incontinent patients 1 week before their initial clinic visit, at baseline, and 3 months posttreatment. At follow-up, a positive rating of improvement in UI was ascertained from patients and their physicians using the Patient's and Clinician's Global Impression of Improvement scales, respectively. Responsiveness of the GSE-UI was calculated using Guyatt's change index. Its clinical utility was determined using receiver operating curves. RESULTS: Eighty-nine of 228 eligible patients (39.0%) participated (mean age 72.6+5.8, range 65–90). At 3-month follow-up, 22.5% of patients were very much better, and 41.6% were a little or much better. Guyatt's change index was 2.6 for patients who changed by a clinically meaningful amount and 1.5 for patients having experienced any level of improvement. An improvement of 14 points on the 12-item GSE-UI had a sensitivity of 75.1% and a specificity of 78.2% for detecting clinically meaningful changes in UI status. Mean GSE-UI scores varied according to improvement status (P<.001) and correlated with changes in quality-of-life scores (r=0.7, P<.001) and reductions in UI episodes (r=0.4, P=.004). CONCLUSION: The GSE-UI is responsive and clinically useful.

Responsiveness and clinical utility of the geriatric self-efficacy index for urinary incontinence

OBJECTIVES: To report on the responsiveness testing and clinical utility of the 12-item Geriatric Self-Efficacy Index for Urinary Incontinence (GSE-UI). DESIGN: Prospective cohort study. SETTING: Six urinary incontinence (UI) outpatient clinics in Quebec, Canada. PARTICIPANTS: Community-dwelling incontinent adults aged 65 and older. MEASUREMENTS: The abridged 12-item GSE-UI, measuring older adults' level of confidence for preventing urine loss, was administered to all new consecutive incontinent patients 1 week before their initial clinic visit, at baseline, and 3 months posttreatment. At follow-up, a positive rating of improvement in UI was ascertained from patients and their physicians using the Patient's and Clinician's Global Impression of Improvement scales, respectively. Responsiveness of the GSE-UI was calculated using Guyatt's change index. Its clinical utility was determined using receiver operating curves. RESULTS: Eighty-nine of 228 eligible patients (39.0%) participated (mean age 72.6+5.8, range 65–90). At 3-month follow-up, 22.5% of patients were very much better, and 41.6% were a little or much better. Guyatt's change index was 2.6 for patients who changed by a clinically meaningful amount and 1.5 for patients having experienced any level of improvement. An improvement of 14 points on the 12-item GSE-UI had a sensitivity of 75.1% and a specificity of 78.2% for detecting clinically meaningful changes in UI status. Mean GSE-UI scores varied according to improvement status (P<.001) and correlated with changes in quality-of-life scores (r=0.7, P<.001) and reductions in UI episodes (r=0.4, P=.004). CONCLUSION: The GSE-UI is responsive and clinically useful.