This study aimed to investigate the status and risk factors of post-traumatic stress disorder in patients with acute myocardial infarction after emergency percutaneous coronary intervention in acute and convalescence phases. A longitudinal study design was used. Two questionnaire surveys were conducted in the acute stage of hospitalization, and 3 months after onset in patients. Logistic regression was used to analyze the risk factors for PTSD in AMI patients. The incidence of PTSD was 33.1 and 20.4% in acute and convalescent (...) patients, respectively. The risk factors related to PTSD were door-to-balloon time, left ventricular ejection fraction, smoking, anxiety, and depression. AMI patients after PCI had PTSD in the acute and convalescent stage. The findings indicate that tailored measures should be developed and carried out to prevent PTSD and improve the mental health of patients with AMI after undergoing PCI. (shrink)

A number of recent articles attribute the origin of the use of cervical balloon dilation in the induction of labor to either Barnes in the 1860s or Embrey and Mollison in the 1960s. This review examines the historical record and reveals that, based on current practice attribution should rather be made to two contemporaries of Barnes: the Storer and Mattei. More importantly, Storer’s warning about the rubber used in dilators was ignored, leading to decades of possibly unnecessary deaths following (...) childbirth. To conduct this study key search terms for PubMed, Google Scholar and the website of the University of Ryerson were utilized as “Barnes”, “Woodman”, “balloon dilation”, “balloon catheter”, “foley”, “colpeurynter”, “cervix uteri” and “induction.” Subsequent analysis was done on downloaded articles using BibDesk. (shrink)

What has moral theory to do with practical judgment? The practical ethicist can move by analogy from case to case, saying of most new cases, “Oh, I think I've been here before.” Theory, ascending to a broader view, can provide directions when the ethicist finds herself in unfamiliar territory.

Summary The balloon mania between 1783 and 1785 put an extraordinary strain on the Paris Academy of Sciences, threatening its status as the highest tribunal of European science. Faced with repeated royal directives and public frenzy, the Academy manoeuvred carefully to steer the research toward the hydrogen balloon and thereby to maintain its scientific superiority. Antoine-Laurent Lavoisier seized this moment when the promise of ?the empire of airs? brought science to the centre of public attention to push his (...) theoretical reform for chemistry. He utilized the established protocol of the Academy and the resources of the Republic of Letters to broadly publicize his first decomposition of water in April 1784. Once he attained the publicity and the balloon fever began to cool, he staged a much more elaborate experiment for the experts in February 1785. Although this second, large-scale experiment cost much expense and effort, Lavoisier never published a full account. The differential care given to the two experiments can only be understood in their divergent rhetorical contexts. The written accounts in 1784 addressed the court of public opinion, while the exclusive performance in 1785 aimed at the court of experts to inaugurate the collaborative phase of the Chemical Revolution. (shrink)

(1983). Hydrogen production for ballooning during the French Revolution: An early example of chemical process development. Annals of Science: Vol. 40, No. 6, pp. 531-558.

Our examination of universal origins and fine-tuning will begin with a discussion of infl ationary scenarios grafted onto Big Bang cosmology and the proof that all infl ationary spacetimes are past-incomplete. After diverting into a lengthy critical examination of the “different physics” offered by quantum cosmologists at the past-boundary of the universe, we will proceed to dissect the inadequacies of infl ationary explanations and string-theoretic constructs in the context of three cosmological models that have received much attention: the Steinhardt-Turok cyclic (...) ekpyrotic model (which does not invoke inflation), the Gasperini-Veneziano pre-Big Bang infl ationary model, and the inflationary string landscape model advanced by Susskind, Polchinski, Bousso, and Linde. We will argue that none of these highly speculative string cosmologies removes the necessity of a beginning to the process of universe generation, and we will emphasize the implications of this fact. Then, since the inflationary “mechanism” only really addresses the fi ne-tuning of the initial conditions of the universe and not the conditions embodied in its finely tuned laws and constants, we will analyze the adequacy of the string multiverse in its three versions (cyclic ekpyrotic, pre-Big Bang, and landscape) for explaining the nomological structure and values of these precisely tuned life-compatible universal parameters. When all is said and done, it will be clear that transcendent intelligent agency is not just the only causally suffi cient and therefore metaphysically sound explanation for universal origins and fine-tuning, but it is also much more parsimonious, elegant, and resonant with meaning than all of the ad hoc machinations of multiverse cosmology. (shrink)

Summary The balloon mania between 1783 and 1785 put an extraordinary strain on the Paris Academy of Sciences, threatening its status as the highest tribunal of European science. Faced with repeated royal directives and public frenzy, the Academy manoeuvred carefully to steer the research toward the hydrogen balloon and thereby to maintain its scientific superiority. Antoine-Laurent Lavoisier seized this moment when the promise of ‘the empire of airs’ brought science to the centre of public attention to push his (...) theoretical reform for chemistry. He utilized the established protocol of the Academy and the resources of the Republic of Letters to broadly publicize his first decomposition of water in April 1784. Once he attained the publicity and the balloon fever began to cool, he staged a much more elaborate experiment for the experts in February 1785. Although this second, large-scale experiment cost much expense and effort, Lavoisier never published a full account. The differential care given to the two experiments can only be understood in their divergent rhetorical contexts. The written accounts in 1784 addressed the court of public opinion, while the exclusive performance in 1785 aimed at the court of experts to inaugurate the collaborative phase of the Chemical Revolution. (shrink)

Name der Zeitschrift: Semiotica - Journal of the International Association for Semiotic Studies / Revue de l'Association Internationale de Sémiotique Jahrgang: 2013 Heft: 197 Seiten: 35-63.

Radio Free Europe used balloons to drop leaflets in an attempt to supplement radio with printed words in the 1950s—a historical moment when closing borders, censoring the press, jamming foreign radios, tapping telephone lines, and tracking letters from abroad created an almost hermetically sealed space without many means for exchanging information across the Iron Curtain. This article traces how distorted and limited information shaped Cold War propaganda and practices of information-gathering. The article further examines unpredictable environmental factors that were transformed (...) into persuasive political rhetoric. A comparative analysis of communist media shows similarities of imagination in a visual propaganda campaign across five communist countries. Fantasies evolved into an object of public interest when propaganda strategies embraced a language of facts. (shrink)

ArgumentThe history of ballooning has received considerable attention from historians examining the technological innovations behind it as well as from scholars interested in aeronautical anecdotes concerning launches and disasters. The cultural importance of this new machine, however, remains less fully analyzed. This essay explores one facet of that history through a discussion of the commodification of launches in France and Great Britain. These two countries, which have larger middling classes as well as a higher degree of commercialization in general, provided (...) a fertile environment for aeronauts seeking to instruct and entertain an audience willing to fund ballooning. Balloonists had to invent ways to market this scientific discovery and determine how best to attract paying customers. The audience was entertained while simultaneously empowered to act as witnesses to what balloonists presented as a scientific experiment. (shrink)

Mrs. Duong had coronary artery disease, ischemic cardiomyopathy, and mildly altered mental status when her case was presented before an advanced heart therapy medical review board. She was accepted for left ventricular assist device placement pending additional insight into her cognitive state. Before the LVAD could be implanted, however, Mrs. Duong went into cardiogenic shock, and her heart failure team placed an intra‐aortic balloon pump in her subclavian artery. Within two weeks, Mrs. Duong became IABP dependent and deconditioned. The (...) attending deemed her as lacking capacity to make complex medical decisions, and the medical review board officially declined her for LVAD placement. The heart failure and CICU teams feel that Mrs. Duong is not being helped by the care they are giving her. They recommend terminal weaning of the IABP and initiation of comfort care. Her family disagrees, pointing to activities like continued eating and interacting with family. At an impasse after yet another family meeting, the attending for the heart failure team asks the clinical ethics consultant, “Do we have to replace the balloon pump when it fails?”. (shrink)

Definition of the problem: In 1997, Percutaneous Transluminal Coronary Angioplasty (PTCA) was performed in 138.001 cases in Germany. The standard indications, single vessel disease and badly controlled angina, are more and more extended to multivessel disease with and without severe angina, unstable or preinfarction angina, and acute myocardial infarction (AMI) itself. Dilating asymptomatic stenoses of more than 70–80% is a widely used indication, intending prophylaxis of complete occlusion and AMI. Actually there is no generally accepted guideline for the different (...) new indications, conservative versus invasive treatment schedule. It is difficult for the patient to get appropriate information before his decision between mechanical procedures and conservative methods; authentic informed consent actually seems to be in a very bad position. In 1992 the working group called ”Arbeitsgemeinschaft leitender kardiologischer Krankenhausärzte (ALKK)” decided to start a registry of all PTCA procedures, in order to gain knowledge about the present status of PTCA in Germany. Up to March 1999, 198.608 PTCA are logged.Arguments: Each PTCA was included on an intention-to-treat basis. The registry succeeded in a nearly complete recording with 98,6% of all PTCA procedures complete on March 17th, 1999. 93,5% of stenosed and 72,2% of the total occluded vessels were successfully dilated. In 4.729 cases (2,63%) the PTCA caused severe complications. The overall in-hospital mortality was only 0,5%, if the procedures done for AMI were excluded (including AMI it was 1,1%). The calculation of complications should be an essential part of the patients informed consent.Conclusion: Complete recording of all PTCA procedures is feasible even on a nationwide basis. Some results of the registry, as the indication control and the complication rate may help to realize a better doctor-patient-conversation on risks and benefits of either concept. The trend of many CHD patients is ”modern”: It should be done what can be done (mechanically), with results at once. Although said somehow paternalistic, this point of view cannot be tolerated: Proper informed consent today includes the realistic alternative of modern medicaments, especially those with an aggressive cholesterol lowering potency. (shrink)

Many recovering dualists find that the old Cartesian demons are hard to exorcise. Dual substance abuse manifests itself not only as metaphysical dualism, but as a pervasive epistemological framework that creates an unhealthy codependent relationship between scientific realism and phenomenology. Daniel Dennett has led philosophers to recognize many of the symptoms of creeping crypto Cartesianism. In this paper, I try to take Dennett to the limit: Descartes lives on, I argue, in the very heart of cognitive science, in the concept (...) of representation. I outline a five-step program for overcoming this lingering, fundamental, allegiance to Cartesianism, and discuss Dennett's own progress along this path. (shrink)

The essay offers a thought experiment to try to clarify our distinction between our naïve ancestors and our sophisticated moderns. The effect of the thought experiment is to cast doubt upon the distinction and examine further our own myths about our ancestors. And to wonder at what it means to be truly modern.

Beginning with the first series of flights by the French Montgolfier brothers in 1783, hot air ballooning quickly metamorphosed from a dangerous scientific experiment with potential military uses into a widespread cultural craze with deep social implications. Using the lens of the idea of “wonder,” I examine the word-image interactions in a selection of engraved representations of the first Montgolfier demonstration for Louis XVI at Versailles. Such a collective close reading first exposes techniques that aim at encouraging admiration in readers (...) for both the new technology and the French state that produced it. However, visual cues in the images indicate a persistent suggestion of doubt and uncertainty—and even fear—as they take readers “up and away” from the confines and comforts of everyday life. The word-image nexus surrounding this spectacle generates an altered textual world in which traditional social and sexual hierarchies lose stability and the future is full of possibility. (shrink)

Members of the Student Clinical Ethics Committee discussed whether tube feeding should be instigated for a man who had indicated through his actions that he may be refusing it, although his family stated that he would have wanted to be kept alive in such a situation. The Committee considered the key issues of capacity and best interests, which in this case were confounded by lack of clarity about whether the patient’s actions amounted to a valid refusal of life sustaining treatment, (...) and if his previous views still pertained to his current, yet unforeseen, circumstances. As the discussion progressed, it became apparent that some members were reluctant to accept that non-insertion of clinically assisted feeding could ever be in a patient’s best interests. (shrink)

Semantics traditionally focuses on linguistic meaning. In recent years, the Super Linguistics movement has tried to broaden the scope of inquiry in various directions, including an extension of semantics to talk about the meaning of pictures. There are close similarities between the interpretation of language and of pictures. Most fundamentally, pictures, like utterances, can be either true or false of a given state of affairs, and hence both express propositions (Zimmermann, 2016; Greenberg, 2013; Abusch, 2015). Moreover, sequences of pictures, like (...) sequences of utterances, can be used to tell stories. Wordless picture books, comics, and film are cases in point. In this paper I pick up the project of providing a dynamic semantic account of pictorial story-telling, started by Abusch (2012) and continued by Abusch & Rooth (2017); Maier & Bimpikou (2019); Fernando (2020). More specifically, I propose here a semantics of speech and thought bubbles by adding event reference to PicDRT. To get there I first review the projection-based semantics for pictures (section 1), noting the fundamental distinction between symbolic and iconic meaning that makes speech bubbles especially interesting (section 2). I then review the dynamic PicDRT framework for pictorial narratives (section 3), add events (section 4), and propose an account of speech bubbles as quotational event modification (section 5). I end with a brief look at other conventional, symbolic enrichments in comics (section 6). (shrink)

Many studies claim to measure decision-making under risk by employing the Domain-Specific Risk-Taking (DOSPERT) scale, a self-report measure, or the Balloon Analogue Risk Task (BART), a behavioural task. However, these tasks do not measure decision-making under risk but decision-making under uncertainty, a related but distinct concept. The present commentary discusses both the theoretical and empirical basis of the distinction between uncertainty and risk from the viewpoint of several scientific disciplines and reports how many studies wrongfully employ the DOSPERT scale (...) and BART as risk-taking measures. Importantly, we call for proper distinguishing between (tasks measuring) decision-making under uncertainty and decision-making under risk in psychology and related fields. We believe this is vital as research has shown that people’s attitudes, behaviour, and brain activity differ between both concepts, indicating that confusing the concepts may lead researchers to erroneous conclusions. (shrink)

We study the wisdom of the crowd in three sequential decision‐making tasks: the Balloon Analogue Risk Task (BART), optimal stopping problems, and bandit problems. We consider a behavior‐based approach, using majority decisions to determine crowd behavior and show that this approach performs poorly in the BART and bandit tasks. The key problem is that the crowd becomes progressively more extreme as the decision sequence progresses, because the diversity of opinion that underlies the wisdom of the crowd is lost. We (...) also consider model‐based approaches to each task. This involves inferring cognitive models for each individual based on their observed behavior, and using these models to predict what each individual would do in any possible task situation. We show that this approach performs robustly well for all three tasks and has the additional advantage of being able to generalize to new problems for which there are no behavioral data. We discuss potential applications of the model‐based approach to real‐world sequential decision problems and discuss how our approach contributes to the understanding of collective intelligence. (shrink)

An almost unbelievable amount of false philosophy has arisen through not realizing what ‘existence’ means…. [It] rests upon the notion that existence is, so to speak, a property that you can attribute to things, and that the things that exist have the property of existence and the things that do not exist do not. That is rubbish . I have dared to puncture several metaphysical balloons and nothing came out of them but hot air.

The left ventricular assist device was originally designed to be surgically implanted as a bridge to transplantation for patients with chronic end-stage heart failure. On the basis of the REMATCH trial, the US Food and Drug Administration and the US Centers for Medicare & Medicaid Services approved permanent implantation of the left ventricular assist device as a destination therapy in Medicare beneficiaries who are not candidates for heart transplantation. The use of the left ventricular assist device as a destination therapy (...) raises certain ethical challenges. Left ventricular assist devices can prolong the survival of average recipients compared with optimal medical management of chronic end-stage heart failure. However, the overall quality of life can be adversely affected in some recipients because of serious infections, neurologic complications, and device malfunction. Left ventricular assist devices alter end-of-life trajectories. The caregivers of recipients may experience significant burden (e.g., poor physical health, depression, anxiety, and posttraumatic stress disorder) from destination therapy with left ventricular assist devices. There are also social and financial ramifications for recipients and their families. We advocate early utilization of a palliative care approach and outline prerequisite conditions so that consenting for the use of a left ventricular assist device as a destination therapy is a well informed process. These conditions include: (1) direct participation of a multidisciplinary care team, including palliative care specialists, (2) a concise plan of care for anticipated device-related complications, (3) careful surveillance and counseling for caregiver burden, (4) advance-care planning for anticipated end-of-life trajectories and timing of device deactivation, and (5) a plan to address the long-term financial burden on patients, families, and caregivers. Short-term mechanical circulatory devices (e.g. percutaneous cardiopulmonary bypass, percutaneous ventricular assist devices, etc.) can be initiated in emergency situations as a bridge to permanent implantation of ventricular assist devices in chronic end-stage heart failure. In the absence of first-person (patient) consent, presumed consent or surrogate consent should be used cautiously for the initiation of short-term mechanical circulatory devices in emergency situations as a bridge to permanent implantation of left ventricular assist devices. Future clinical studies of destination therapy with left ventricular assist devices should include measures of recipients' quality of end-of-life care and caregivers' burden. (shrink)

Provision of adequate nutrition to elderly patients who develop dysphagia after a stroke can be quite challenging, often leading to the placement of a percutaneous entero‐gastrostomy (PEG) tube for nutritional support. This hypothetical case describes the additional challenge of cross‐cultural belief that leads a daughter to provide oral feeding to her mother, an act that the medical team believes is dangerous and the daughter sees as salubrious. In this case, what is the proper balance between patient safety and deference (...) to cultural traditions and norms? Where are the limits? Two commentaries offer insights for conflict resolution, including recommending that the medical team seek to understand the cultural motivations of the family, balancing safety and respect for cultural norms. The second commentary also disagrees with the team's presumption that the daughter's feeding of her mother is a greater threat to the patient than the PEG tube feeding is. (shrink)

Respecting and encouraging autonomy in the elderly is basic to the practice of geriatrics. In this paper, we examine the practice of cardiopulmonary resuscitation (CPR) and "artificial" feeding in a geriatric unit in a general hospital subscribing to jewish orthodox religious principles, in which the sanctity of life is a fundamental ethical guideline. The literature on the administration of food and water in terminal stages of illness, including dementia, still shows division of opinion on the morality of withdrawing nutrition. We (...) uphold the principle that as long as feeding by naso-gastric (N-G) or percutaneous endoscopic gastrostomy (PEG) does not constitute undue danger or arouse serious opposition it should be given, without causing suffering to the patient. This is part of basic care, and the doctor has no mandate to withdraw this. The question of CPR still shows much discrepancy regarding elderly patients' wishes, and doctors' opinions about its worthwhileness, although up to 10 percent survive. Our geriatric patients rarely discuss the subject, but it is openly ventilated with families who ask about it, who are then involved in the decision-making, and the decision about CPR or "do-not-resuscitate" (DNR) is based on clinical and prognostic considerations. (shrink)

During the phony war that preceded the invasion of France, between late 1939 and the summer of 1940, the young Jean-Paul Sartre was stationed in his native Alsace as part of a meteorological unit. He used his considerable periods of spare time, between mundane duties like watching weather balloons, to make a series of notes on philosophy, literature, politics, history and autobiography that anticipate the themes of his later masterpieces, and often surpass them in literary verve and directness. These War (...) Diaries form a portrait of Sartre in his most intense and brilliant phase. With them the twentieth century's most remarkable and public philosopher has provided us with a fitting posthumous monument to his honest and creativity. (shrink)

ON DECEMBER 10, 1991 Charles Shonubi, a Nigerian citizen but a resident of the USA, was arrested at John F. Kennedy International Airport for the importation of heroin into the United States.1 Shonubi's modus operandi was ``balloon swallowing.'' That is, heroin was mixed with another substance to form a paste and this paste was sealed in balloons which were then swallowed. The idea was that once the illegal substance was safely inside the USA, the smuggler would pass the balloons (...) and recover the heroin. On the date of his arrest, Shonubi was found to have swallowed 103 balloons containing a total of 427.4 grams of heroin. There was little doubt about Shonubi's guilt. In fact, there was considerable evidence that he had made at least seven prior heroin-smuggling trips to the USA (although he was not tried for these). In October 1992 Shonubi was convicted in a United States District Court for possessing and importing heroin. Although the conviction was only for crimes associated with Shonubi's arrest date of December 10, 1991, the sentencing judge, Jack B. Weinstein, also made a ®nding that Shonubi had indeed made seven prior drug-smuggling trips to the USA. The interesting part of this case was in the sentencing. According to the federal sentencing guidelines, the sentence in cases such as this should depend on the total quantity of heroin involved. This instruction was interpreted rather broadly.. (shrink)

Gliomas can display marked changes in the concentrations of energy metabolism molecules such as creatine (Cr), phosphocreatine (PCr) and lactate, as measured using magnetic resonance spectroscopy (MRS). Moreover, the BOLD (blood oxygen level dependent) contrast enhancement in functional magnetic resonance imaging (fMRI) can be reduced or missing within or near gliomas, while neural activity is not significantly reduced (so-called neurovascular decoupling), so that the location of functionally eloquent areas using fMRI can be erroneous. In this paper, we adapt a previously (...) developed model of the coupling between neural activation, energy metabolism and hemodynamics, by including the venous dilatation Balloon model of Buxton and Frank. We show that decreasing the cerebral blood flow (CBF) baseline value, or the CBF increase fraction, results in a decrease of the BOLD signal and an increase of the lactate peak during a sustained activation. Baseline lactate and PCr levels are not significantly affected by CBF baseline reduction, but are altered even by a moderate decrease of mitochondrial respiration. Decreasing the total Cr and PCr concentration reduces the BOLD signal after the initial overshoot. In conclusion, we suggest that the coupled use of BOLD fMRI and MRS could contribute to a better understanding of the neurovascular and metabolic decoupling in gliomas. (shrink)

The Aerial Photo Sourcebook is an illustrated reference for the novice. It has a complete bibliography of over 800 books and articles for those looking for more details on aerial photography. Collins provides the most comprehensive listing available of federal government sources, state and regional sources, and commercial sources and collections. All contact information is included. The sourcebook begins with an overview of the field and with basic instruction in photographic interpretation. The fundamentals section explores the variety of aerial photography: (...) color infrared, black and white, and color. It also explains the difference between oblique and vertical views. Collins discusses formats, tools, and map skills in clear, non-technical terms. She summarizes the traditional roles of aerial photography, as well as the new customers that aerial photography will serve in the future. A bibliography of more than 800 items from over 40 subject areas is included. The bibliography consists primarily of English or English-translated works related to aerial photography in the United States, augmented by a few international perspectives are included.The bibliography lists information and research in aerial photography in the fields of agriculture, balloon and kite photography, geology, history, intelligence, mapping and cartography, aerial photo interpretation, remote sensing, transportation, soil studies, urban problems, wetlands, and more. The Aerial Photo Sourcebook offers numerous ideas for using aerial photography to solve a wide range of problems, to enhance presentations, and to facilitate research. (shrink)