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At least 73 records · Page 4Linked to original sources
PubMed2000

Freedom from endoleak after endovascular aneurysm repair does not equal treatment success.

OBJECTIVE: To determine whether freedom from endoleak after endovascular repair of abdominal aortic aneurysm (EVAR) is a reliable guide to freedom from persistent or recurrent pressurisation of the aneurysm sac (endotension) and therefore freedom from risk of rupture. PATIENTS AND METHODS: The records of 55 patients followed for more than 3 months after EVAR were reviewed to correlate the presence or absence of endoleak on contrast-enhanced CT and/or angiography with changes in maximum aneurysm diameter (DMAX). RESULTS: in 22 (40%) patients there was no significant change in DMAX during follow-up. In 21 of these no endoleak was observed on CT or angiography. One patient developed a secondary side-branch endoleak which remains under observation. In 18 (33%) patients, DMAX decreased during follow-up. Thirteen of these remained free of endoleak. Four patients developed secondary endoleaks which were treated by secondary intervention. One patient with persistent primary endoleak suffered fatal aneurysm rupture three days before planned intervention. DMAX increased in 15 (27%) patients. In only five of these could an endoleak be identified on CT and/or angiography. One primary side-branch endoleak persists following failed embolisation. Four secondary endoleaks have been corrected by secondary intervention. Four of the remaining 10 patients died suddenly from unknown cause. All had DMAX greater than 65 mm at last follow-up. One patient underwent late conversion, which suggested continued pressurisation through thrombus at the site of a "sealed" primary proximal endoleak. Two patients are scheduled to undergo embolisation of patent side-branches revealed only by Levovist enhanced Duplex scanning and three patients remain under observation. CONCLUSION: Freedom from endoleak on conventional imaging incorrectly suggested freedom from endotension in 10 (18%) of our patients. Follow-up after endovascular repair must include regular measurement of DMAX and/or aneurysm sac volume to identify those patients who remain at risk of rupture.

Aged↗
PubMed1989

Self-serving biases in the perception of freedom: the impact of previously experienced failure.

The purpose of five experiments was to investigate the use by Israeli students of a perceived lack of freedom as a self-protective device against the negative implications of poor performance in an achievement task. I hypothesized that a reduction in perceived freedom might be used to protect self-esteem following failure. A reduction in perceived freedom would weaken a person's sense of responsibility for failure and thereby protect self-esteem. Experiments 1 and 2 showed that subjects exposed to failure retrospectively reported having had less freedom during the experimental sessions than those who experienced success or no feedback at all. Experiments 3, 4, and 5 demonstrated that failure reduces the perception of freedom when other external rationalizations for failure (high consensus, high distinctiveness, low consistency) are unavailable. The results are interpreted in the light of self-protective strategies.

Achievement↗
PubMedDate not supplied

Photosensitive epilepsy beyond adolescence: is freedom from photosensitivity age-dependent?

Patients with photosensitive epilepsy (PSE) are said to lose photosensitivity with age. That is, they do not suffer from photosensitive epileptic seizures after the third decade of life. This claim seems to be an over generalised statement and does not take into account all other important confounding factors that determine the duration and process of neurological illnesses. Hence, there are contradictions pertaining to age of freedom of photosensitivity in epilepsy and in epilepsy with photosensitivity. Often patients are declared free from epileptic activity; however, some of these patients are still found to have seizures a few years later. This paper assesses the freedom photosensitivity in 58 PSE patients to ascertain validity of the claim that patients lose their photosensitivity with age. Thirty-nine of the 58 patients (67%) were female whilst (33%) were male, giving a female/male ratio of 3:1. The average age of onset of photosensitivity was 7 years. Of all the cases studied forty-one (71%) had a family history of photosensitive epilepsy, while seventeen (29%) had no family history of photosensitive epilepsy. Proof of photosensitivity in all the patients was determined by persistent EEG abnormalities including occipital spike and wave discharges. Results show that photosensitivity persisted beyond adolescence; hence, there was no specific age limit of freedom from photosensitivity in patients, especially in those with family history of photosensitive epilepsy. However, those patients who were having regular antiepileptic medication and/or were taking adequate preventive measures had a temporary period of freedom from sensitivity which lasted 1-4 years. These findings suggest that freedom from photosensitivity is not age-dependent, especially in those patients with family history of photosensitive epilepsy.

Adolescent↗
PubMed2001

Compound spatial sonography of the thyroid gland: evaluation of freedom from artifacts and of nodule conspicuity.

OBJECTIVE: The purpose of this study was to compare compound spatial sonography with conventional sonography of the thyroid gland with respect to freedom from sonographic artifacts and conspicuity of thyroid nodules. SUBJECTS AND METHODS: A prospective study was performed on 50 thyroid nodules (in 43 patients). Each nodule was examined using compound spatial sonography and conventional sonography. The sonographic techniques were then compared with respect to freedom from sonographic artifacts and thyroid nodule conspicuity. RESULTS: For freedom from artifacts, compound spatial sonography was superior in 45 cases (90%), and conventional sonography was superior in five cases (10%). Statistical analysis showed that compound spatial sonography was superior to conventional sonography for freedom from artifacts (p < 0.001). For thyroid nodule conspicuity, compound spatial sonography was superior in 37 cases (74%), and conventional sonography was superior in 13 cases (26%). Statistical analysis showed that compound spatial sonography was superior to conventional sonography for thyroid nodule conspicuity (p < 0.001). CONCLUSION: Compound spatial sonography of the thyroid displays greater freedom from artifacts and better nodule conspicuity than does conventional sonography.

Adult↗
PubMed2006

Health promotion and the freedom of the individual.

This article considers the extent to which health promotion strategies pose a threat to individual freedom. It begins by taking a look at health promotion strategies and at the historical development of health promotion in Britain. A theoretical context is then developed in which Berlin's distinction between negative and positive liberty is used alongside the ideas of John Stuart Mill, Charles Taylor and T.H. Green to discuss the politics of health promotion and to identify the implications of conflicting perspectives on freedom. The final section looks at current health promotion policy in Britain and beyond and argues that, if freedom is seen in terms of empowerment, health promotion can enhance individual freedom.

Choice Behavior↗
PubMed2003

Discounting of money, health, and freedom in substance abusers and controls.

Impulsivity is implicated in drug dependence, and discounting of delayed events may be an objective indicator of impulsiveness. This study evaluated the manner in which outcomes are devalued over time in drug abusers (n=101) and non-substance abusing controls (n=40). Four conditions were presented in which participants chose between hypothetical outcomes available after various delays or immediately. Two were monetary outcomes, and the other two were non-monetary-months of health or freedom. In all conditions, hyperbolic discounting functions provided a good fit of the data. One hundred dollars were discounted more rapidly than $1000, and freedom was discounted more rapidly than health. Drug abusers discounted all types of delayed outcomes at higher rates than controls, even though they placed equivalent subjective monetary values on freedom and health. Rates of discounting were not correlated across domains. These results replicate prior studies showing that drug abusers discount delayed monetary outcomes more rapidly than controls, and they extend these findings to new domains. The rapid discounting of freedom and health may provide a theoretical framework for understanding illegal and risky health behaviors in drug abusers.

Adult↗
PubMed2006

Reproductive freedom and risk.

It is widely recognized that one person's freedom may be limited to prevent harm to another (non-consenting) person. It is curious, therefore, that where a right to reproductive freedom is recognized, there is considerable reticence to limit or override it in cases where reproduction harms those people who are brought into existence. I argue that this is inappropriate. If there should be no right to inflict a harm in non-reproductive contexts then there should be no right to inflict an equivalent harm in reproductive contexts. Because of the long history of bias and arbitrary discrimination in curtailments of reproductive freedom, I suggest how bias might be avoided in deciding how severe a harm must be to defeat a right to reproductive freedom.

Behavior↗
PubMed2006

Academic freedom and academic-industry relationships in biotechnology.

Commercial academic-industry relationships (AIRs) are widespread in biotechnology and have resulted in a wide array of restrictions on academic research. Objections to such restrictions have centered on the charge that they violate academic freedom. I argue that these objections are almost invariably unsuccessful. On a consequentialist understanding of the value of academic freedom, they rely on unfounded empirical claims about the overall effects that AIRs have on academic research. And on a rights-based understanding of the value of academic freedom, they rely on excessively lavish assumptions about the kinds of activities that academic freedom protects.

Access to Information↗
PubMed2004

Using collision-induced dissociation with corrections for the ion number of degrees of freedom for quick comparisons of relative bonding strength.

The number of degrees of freedom-dependent stability of ions and ion-neutral non-covalent complexes under collision-induced dissociation (CID) conditions was studied in a quadrupole ion trap mass spectrometer. It was found that the stability of ions as probed by energy-variable CID has a linear dependence on the total number of degrees of freedom for the ions (or ion-neutral complexes) with the same (or nearly the same) bonding energy. The slope of such a stability vs number of degrees of freedom dependence correlates with the binding energy. Proton-bound amine dimers display the lowest slope as they have weak bonds. Breaking covalent bonds will result in much greater slopes. In addition to the binding energy, the vibrational frequencies of the ion also affect the stability vs number of degrees of freedom behavior. Studying such a dependence of the CID stability in a system paves the way for direct relative binding energy comparisons. The application of this approach is demonstrated by testing the relative heme affinities of anti-malaria drugs and related compounds.

Amines↗
PubMed1994

Comparison of perceived and actual rates of survival and freedom from handicap in premature infants.

OBJECTIVE: Our goal was to learn whether physicians delivering obstetric care accurately estimated rates of survival and freedom from handicap in premature infants. STUDY DESIGN: We surveyed by mail 409 obstetricians and general and family physicians reported to perform deliveries in Alabama to identify their perceptions regarding survival and handicap-free rates of infants born at gestational ages between 23 and 36 weeks, inclusive. Responses were compared with published national rates of survival and freedom from handicap by means of unpaired t tests. RESULTS: A total of 224 physicians responded (55%), and 183 were still practicing obstetrics. They significantly underestimated survival rates from 23 through 34 weeks' gestation (p < 0.05) and freedom from serious handicap from 23 through 36 weeks' gestation (p < 0.05). They advocated early treatment of preterm labor, but < 50% would perform cesarean delivery for fetal distress before 26 weeks' gestation. CONCLUSION: We conclude that physicians delivering obstetric care significantly underestimate survival and freedom from handicap in preterm infants. Perinatal care may be adversely affected by these misperceptions.

Persons with Disabilities↗
PubMed2005

Estimating the probability of freedom of classical swine fever virus of the East-Belgium wild-boar population.

A report of the Scientific Committee on Animal Health and Animal Welfare of the European Commission (CEC, 1999.) includes recommendations for setting up monitoring programmes for classical swine fever (CSF) infection in a wild-boar population, based on the assumption that one would detect at least 5% prevalence in a CSF-infected wild-boar population. This assumption, however, is not science based. We propose an alternative method to provide evidence for a wild-boar population being free of CSF and evaluate the efficiency of a surveillance programme that was implemented in Belgium in 1998. In our study, the probability of freedom of CSF-virus was estimated based on 789 samples; these were collected from wild-boars within the surveillance programme (within the three provinces which include 95% of the Belgian wild-boar population) and examined by three diagnostics methods (antibody detection, virus detection and virus RNA detection). A Bayesian framework was used for the estimation, accounting for the diagnostic test characteristics without the assumption of the presence of a gold standard. The median probability of freedom of CSF-virus was estimated at 0.970, with a 95% credibility interval of 0.149-1.000. Independent on the choice of the prior information, the posterior distributions for the probability of freedom of CSF-virus were always skewed close to the upper boundary of 1. This represents a big gain of knowledge since we did not use any prior information for the probability of freedom of CSF-virus and took the uncertainty about the accuracy of the diagnostic methods into account.

Animals↗
PubMed2000

Analytic analysis of the force sharing among synergistic muscles in one- and two-degree-of-freedom models.

Mathematical optimization of specific cost functions has been used in theoretical models to calculate individual muscle forces. Measurements of individual muscle forces and force sharing among individual muscles show an intensity-dependent, non-linear behavior. It has been demonstrated that the force sharing between the cat Gastrocnemius, Plantaris and Soleus shows distinct loops that change orientation systematically depending on the intensity of the movement. The purpose of this study was to prove whether or not static, non-linear optimization could inherently predict force sharing loops between agonistic muscles. Using joint moment data from a step cycle of cat locomotion, the forces in three cat ankle plantar flexors (Gastrocnemius, Plantaris and Soleus) were calculated using two popular optimization algorithms and two musculo-skeletal models. The two musculo-skeletal models included a one-degree-of-freedom model that considered the ankle joint exclusively and a two-degree-of-freedom model that included the ankle and the knee joint. The main conclusion of this study was that solutions of the one-degree-of-freedom model do not guarantee force-sharing loops, but the two-degree-of-freedom model predicts force-sharing loops independent of the specific values of the input parameters for the muscles and the musculo-skeletal geometry. The predicted force-sharing loops were found to be a direct result of the loops formed by the knee and ankle moments in a moment-moment graph.

Algorithms↗
PubMed2000

Freedom from congestion predicts good survival despite previous class IV symptoms of heart failure.

BACKGROUND: This study determined whether evidence of congestion after 4 to 6 weeks of heart failure management predicted outcome for patients hospitalized with chronic New York Heart Association class IV symptoms. Class IV symptoms predict high mortality rates, but outcome is not known for patients who improve to establish freedom from congestion. Revised estimates at 1 month could facilitate decisions regarding transplantation and other high-risk interventions. METHODS: At 4 to 6 weeks after hospital discharge, 146 patients were evaluated for congestion by 5 criteria (orthopnea, jugular venous distention, edema, weight gain, and new increase in baseline diuretics). Heart failure management included inpatient therapy tailored to relieve congestion, followed by adjustments to maintain fluid balance during the next 4 weeks. RESULTS: Freedom from congestion was demonstrated at 4 to 6 weeks in 80 (54%) patients, who had 87% subsequent 2-year survival compared with 67% in 40 patients with 1 or 2 criteria of congestion and 41% in 26 patients with 3 to 5 criteria. The Cox proportional hazards model identified left ventricular dimension, pulmonary wedge pressure on therapy, and freedom from congestion as independent predictors of survival. Persistence of orthopnea itself predicted 38% 2-year survival (without urgent transplantation) versus 77% in 113 without orthopnea. Serum sodium was lower and blood urea nitrogen and heart rate higher when orthopnea persisted. CONCLUSIONS: The ability to maintain freedom from congestion identifies a population with good survival despite previous class IV symptoms. At 4 to 6 weeks, patients with persistent congestion may be considered for high-risk intervention.

Disease Progression↗
PubMed1993

Control of Three- and Four-Joint Arm Movement: Strategies for a Manipulator With Redundant Degrees of Freedom.

Control of arm movements when the number of joints exceeds the degrees of freedom necessary for the task requires a strategy for selecting specific arm configurations out of an infinite number of possibilities. This report reviews strategies used by human subjects to control the shoulder, elbow, and wrist (three degrees of freedom) while moving a pointer to positions in a horizontal plane (two degrees of freedom). Analysis of final arm configurations assumed when the pointer was at the target showed the following: (a) Final arm configurations were virtually independent of the configuration at the start of the pointing movement, (b) subjects avoided configurations subjectively felt to be uncomfortable (e.g., those with extreme flexion or extension of the wrist), and (c) the results could be simulated by assigning hypothetical cost functions to each joint and selecting the arm configuration that minimized the sum of the costs. The fitted cost functions qualitatively agreed with psychophysically determined comfort; they appeared to depend on joint angle and on muscular effort. Simple neural networks can learn implicit representations of these cost functions and use them to specify final arm configurations. The minimum cost principle can be extended to movements that use the fingers as a fourth movable segment. For this condition, however, experiments showed that final configurations of the arm depended upon initial configurations. Analysis of movement trajectories for arms with three degrees of freedom led to a control model in which the minimum cost principle is augmented by a mechanism that distributes required joint movements economically among the three joints and a mechanism that implements a degree of mass-spring control.

Journal Article↗
PubMed2005

Freedom in responsibility: a response.

This paper is a critical response to Elisabeth Gräb-Schmidt's article "Freedom in responsibility: On the relevance of 'sin' as hermeneutic guiding principle in bioethical decision making." Gräb-Schmidt's chief contention is that ethics begins with anthropology, and that moral responsibility is thereby grounded within a set of given limits. Freedom is distorted into sin when these limits are transgressed. My principal complaint is that her account of the relationship between freedom and sin is grounded in a tragic ontology. Alternatively, I contend that anthropology is grounded in Christology in which freedom is a gift of the Spirit. Consequently, sin is not so much tragic as it marks a refusal of humans to accept their divine election. The issues of human cloning and embryonic stem-cell research are used to exemplify what difference these respective differences might make in a process of moral deliberation.

Bioethics↗
PubMed1995

Adolescents' and young adults' conceptions of civil liberties: freedom of speech and religion.

This study examined adolescents' and young adults' conceptions of freedom of speech and religion (civil liberties). 48 adolescents and young adults in 3 grade levels (mean ages 12-8, 16-10, and 19-6) were administered a structured interview containing assessments of civil liberties in general, in straightforward (unconflicted) applications, and in conflict with other social and moral concerns, including law, physical and psychological harm, and equality of opportunity. Freedom of speech and religion were conceptualized as universal rights and applied to social events in unconflicted contexts at all ages. A diverse array of rationales, differentiated according to type of freedom, were used at all ages to ground conceptions of universal freedoms. Judgments of civil liberties in conflicts exhibited several sources of variation, including developmental differences, situational or contextual variation determined by the particular types of issues in conflict, and individual differences. Results are consistent with the proposition that judgments of civil liberties reflect age-related patterns of coordination of delimited social and moral concepts rather than general orientations.

Adolescent↗
PubMed2005

A light weight compliant hand mechanism with high degrees of freedom.

This paper presents the design and prototyping of an inherently compliant lightweight hand mechanism. The hand mechanism itself has 15 degrees of freedom and five fingers. Although the degrees of freedom in each finger are coupled, reducing the number of independent degrees of freedom to 5, the 15 degrees of freedom of the hand could potentially be individually actuated. Each joint consists of a novel flexing mechanism that is based on the loading of a compression spring in the axial and transverse direction via a cable and conduit system. Currently, a bench top version of the prototype is being developed; the three joints of each finger are coupled together to simplify the control system. The current control scheme under investigation simulates a control scheme where myoelectric signals in the wrist flexor and extensor muscles are converted in to x and y coordinates on a control scheme chart. Static load-deformation analysis of finger segments is studied based on a 3-dimensional model without taking the stiffener into account, and the experiment validates the simulation.

Biomimetics↗
PubMed2005

False dichotomies: EBM, clinical freedom, and the art of medicine.

According to numerous commentators, clinical freedom, the art of medicine, and, by implication, a degree of patient welfare, are threatened by evidence based medicine (EBM). As EBM has developed over the last fifteen years, claims about better evidence for medical treatments, and improvements in healthcare delivery, have been matched by critiques of EBM's reductionism and uniformity, its problematic application to individual patients, and its alleged denial of the continuing need for clinical interpretation, insight, and judgment. Most of these attacks on EBM and defences of clinical freedom fail. They are based on erroneous understandings of the relationships between inductive knowledge, clinical uncertainty, and action. Evidence based medicine is a necessary condition for clinical freedom, not a threat to it, and EBM is not something to be balanced with either clinical experience or patient preferences. The art and science of medicine are more conceptually and practically connected than the defenders of clinical freedom, whatever they conceive that to be, are willing to admit.

Biomedical Research↗