Cooler Heads Research Articles

Cool heads needed

Cool heads needed

Management of Severe Infections: A Time to Keep a Cool Head or a Hot Topic for Clinical Trials?

We believe that the study by Mourvillier et al (6) is an important addition to the infectious diseases literature and serves to guide our management of patients with severe meningitis. Based on this study and others, it is evident that hypothermia is a pathological state and prompt resuscitation to normothermia is warranted in patients with severe infections. In contrast, fever is an adaptive host response to infection and its presence is associated with improved outcome in neurologically intact, infected patients admitted to ICUs. While it may appear ridiculous to the many clinicians who insist on treating all fevers in infected patients, it is our contention that therapeutic hyperthermia requires (re-)exploration as an adjunctive therapy for selected patients with infection (25).

Cooler heads prevail…even when those with a propensity to be “hot heads” are included!*

Cooler heads prevail…even when those with a propensity to be “hot heads” are included!*

A Week Of Avian Flu

Last week saw more questions and, maybe, a few answers about the drawn-out controversy over recent H5N1 avian flu research. After exchanges of letters and a congressional hearing, cooler heads seem...

Constructing Guerrilla Memory: John Newman Edwards and Missouri's Irregular Lost Cause

Constructing Guerrilla Memory:John Newman Edwards and Missouri's Irregular Lost Cause Matthew C. Hulbert (bio) On May 5, 1889, the Kansas City Times eulogized, "It is not derogation to other good and brave men to say that the death of no man in Missouri would cause genuine pain and grief to so many and so different persons as that of John N. Edwards. Nor will the memory of any be so cherished."1 Edwards—a veteran of Gen. Jo Shelby's Iron Brigade, fire-eating conservative pundit, and prolific myth-maker—stood as a pro-Confederate vanguard in Missouri politics and cultural restoration from the end of the Civil War at Appomattox in 1865 until his death in 1889.2 As author of the controversial Noted Guerrillas, Or, The Warfare of the Border (1877), Edwards's area of expertise was anything but official or Reconstructed. Other postwar movements commemorated fallen Confederates from the regular chain of command, but for the guerrilla, Edwards solemnly proclaimed, "there was no funeral."3 By most accounts, these guerrillas—endemic to the border West but particularly raucous in Missouri—had operated under night skies, utilized non-typical backcountry battlegrounds, and ambushed any alleged Unionist, military or civilian, with signature six-guns blazing.4 Thus, while elite ex-Confederate authors scrambled to produce and harness apotheosized imagery of Robert E. Lee and Jefferson Davis to revamp southern culture, John Newman Edwards focused both gaze and pen squarely on the rowdiest, most reviled irregular figure: the Missouri bushwhacker. To aid in the production of a southern identity for Missouri, Edwards sculpted this bushwhacker to accouter the state with an irregular Lost Cause. It is important to note that Edwards was not himself a bushwhacker—nor even a native Missourian, for that matter. John Newman Edwards was born in Warren County, Virginia, in 1838 and migrated to Lexington, Missouri, sometime around 1855.5 Upon arrival, he found brief employment editing the Expositor, until a group of raiding Kansans, displeased with the newspaper's partisan slant, destroyed its printing press. Not too long after settling in Missouri, Edwards also met the aristocratic Joseph [End Page 58] Shelby; the two were avid hunting companions and lifelong friends. In 1862, Edwards joined Shelby's Confederate cavalry unit, best known as the Iron Brigade, and eventually rose to the rank of major and adjutant.6 While raiding with the Iron Brigade in 1863-64, he came into contact with many of the Missouri bushwhackers he would later spin into martyr and myth. Following Lee's surrender at Appomattox, Shelby and Edwards spearheaded a quixotic attempt at colonization south of the border. Initially, Shelby offered the combat services of the Iron Brigade to the puppet monarch Maximilian—then engaged in a bitter war with Benito Juarez and his Mexican guerrilla fighters—but the soon-to-be-executed emperor declined. Rather than arm the ex-Confederates, he instead accorded land for a colony, which the ex-Rebels named after his wife, Carlota. While in self-imposed Mexican exile, Edwards managed a struggling plantation, wrote politically charged letters to his sisters back in Virginia, and edited an English-Spanish newspaper called the Mexican Times. In 1867, after Maximilian's execution, Edwards and Shelby returned to Missouri.7 By 1868, Edwards had cofounded the Kansas City Times, a literary outlet for his fiery brand of anti-Reconstruction politics and a vehicle for his partisan editorials starring bushwhacker-turned-bandit Jesse James.8 Edwards left the Times in 1873 to edit the St. Louis Dispatch—the move marked the beginning of a long, alcoholism-fueled stint of instability and short-term work.9 Two years later, Edwards fought a duel with Col. Emory Foster over inflammatory remarks; neither shooter drew blood. Edwards, however, demanded another shot before cooler heads (and promises of libation) prevailed and his seconds dissuaded him from further gunplay. In 1877, Edwards published his magnum opus, Noted Guerrillas, Or, The Warfare of the Border, which featured William C. Quantrill, William "Bloody Bill" Anderson, Coleman "Cole" Younger, and his former editorial subjects the James brothers, Frank and Jesse. In his later years, Edwards decried the state-sponsored assassination of Jesse James and subsequently negotiated...

The Alien Terrorist Removal Court and Other National Security Measures You May Have Never Heard Of: The Need for Comprehensive National Security Reform

In light of the decade that has passed since 2001, cooler heads have prevailed. Advancements in technology and information-seeking have paved the way to prune unnecessary laws that are archaic, redundant, in many instances contradictory, and which merely frustrate the real policy behind these laws: safeguarding the U.S. and its citizens. To assist in this pruning, this Article presents a comprehensive plan for national security reform, specifically involving immigration, with an emphasis on the agency tasked with its implementation-the Department of Homeland Security. In light of this goal, Section II provides a brief background into the U.S.'s current approach to immigration policy, including a history of the Department of Homeland Security and a highlight of relevant national security legislation. Section III outlines the successes and failures of the current policies with respect to preventing, stopping, and quickly responding to terrorist attacks. Section IV elucidates areas within national security policy capable of augmentation, alteration, or repudiation altogether. Finally, Section V offers additional recommendations to further improve our nation's security.

Cool head, hot brain: cerebral blood flow distribution during exercise

Cool head, hot brain: cerebral blood flow distribution during exercise

The railroad that never was: Vanderbilt, Morgan, and the South Pennsylvania Railroad

Contents Sources and Acknowledgments Introduction 1. Prelude: The Omnipotent Pennsylvania Railroad 2. The Back Story 3. Why? 4. Vanderbilt Takes Charge 5. The Spoilers 6. The Syndicate Forms 7. A Rugged Route 8. Building a Mountain Railroad 9. The Second Front 10. Cooler Heads and Colder Feet Emerge 11. A Summer Cruise on the Hudson 12. Not Quite Dead 13. The End 14. Railroad to Superhighway, More or Less... 15. Epilogue: Ghost Hunting along the South Penn Notes Bibliography Index

The Agrarian Dispute: The Expropriation of American-Owned Rural Land in Postrevolutionary Mexico

The Agrarian Dispute: The Expropriation of American-Owned Rural Land in Postrevolutionary Mexico

Cool heads: ethical issues associated with therapeutic hypothermia for newborns

Hypothermia is the first treatment for newborns with hypoxic-ischaemic encephalopathy (HIE) with consistent evidence of a reduction in the risk of death or severe disability. This paper addresses a number of ethical and practical issues faced by clinicians as cooling moves from an experimental treatment into practice. These issues are not unique to therapeutic hypothermia. They include the extrapolation of evidence from trials to clinical care, as well as the impact of hypothermia on prognosis and withdrawal of life-sustaining treatment. Hypothermia is a promising new therapy, but further research will be necessary to help resolve some of the ethical concerns associated with its use in newborns with HIE .

Cool Heads and Hot Hearts

Cool Heads and Hot Hearts

The Risks of Keeping a Cool Head

The Risks of Keeping a Cool Head

Global initiatives to prevent climate change

Global initiatives to prevent climate change

Going Ballistic Over Missile Defenses: What Matters and Why

Missile defenses have become a source of controversy between the United States and Russia, out of proportion to their technological capabilities and in negligence of strategic and political realities. Cooler heads should prevail. U.S. or other national missile defenses will not abolish mutual deterrence based on assured retaliation. In addition, whether defenses support or undermine deterrence is a question of political intent, not of technology determinism. U.S. missile defenses deployed in Europe, for example, might be provocateurs of Russian distrust or they might be instruments of collaborative research and development under a regime of cooperative security.

India Opens Universities to More Underprivileged Students

HIGHER EDUCATION![Figure][1] Quota quarrels. A plan to boost university enrollment of underprivileged students has sparked weeks of protests. CREDIT: P. BAGLA/ SCIENCE NEW DELHI— Defying countrywide protests, India's government last week approved a radical expansion of affirmative action programs for helping millions of disadvantaged citizens attend university. The changes will spur a “massive expansion” of India's higher education system, promises Prime Minister Manmohan Singh. Experts concur that India's higher education system, with 9.2 million students, includes far too few of the socially disadvantaged. “Many Indian geniuses are still hidden in the dust, and if we can't find them, as a country we won't go really far in our development,” says astronomer Yash Pal, former chair of the University Grants Commission in New Delhi. But that's where the consensus ends. “We can either move forward and create centers of academic excellence, or go along with the demands of identity politics based on caste and community, but we cannot do both,” says Andre Beteille, a sociologist at the University of Delhi, who earlier this week resigned in protest from a panel advising Singh on how to transform India into a knowledge economy. Even Singh's chief science adviser, C.N.R. Rao, claims he was not consulted before the government announced the reforms. It's a “stupendous task,” Rao says, that is “being presented in a highly oversimplified fashion.” Despite its emergence as a regional power, India is still divided along caste lines, with several groups by tradition performing menial jobs and manual labor. To erode this social stratification, India has long set promotion quotas for “scheduled” castes and tribes, including the untouchables, which guarantee them 22.5% of places in higher education and jobs in the public sector. The new amendment to the Indian constitution, approved unanimously by Parliament, will reserve another 27% of placements for the Dalits, or “other backward castes.” The prospect of nearly half of all current university places being set aside for disadvantaged castes has sparked furious protests among young people of privileged castes, who argue that merit will be overlooked to make amends for historical social injustices. Over the past 3 weeks, medical and engineering students have staged strikes across the country, crippling the public health system and sparking several brutal clashes with police. As Science went to press, student leaders were weighing whether to continue the protests. To take the sting out of the quota increase, the government has promised to dramatically expand enrollment at public higher education institutions. Among those included under the new policy, to take effect next year, are the seven Indian Institutes of Technology (IIT), which together enrolled 5444 students in 2006; the Indian Institute of Science (IISc) and its 2000 students; and 18 federally funded universities with an annual enrollment of about 180,000 students. The University of Delhi alone would need to increase from 40,000 students in 2006 to 60,000 next year. To further boost capacity, two new Indian Institutes of Science Education and Research, at a cost of $250 million, are expected to open in Pune and Kolkata by year's end. The government plans to support the expansion by injecting $2 billion this year into the higher education system—almost double the annual expenditure. Some worry whether the money will be well spent. Rao, a former IISc director, says the technology institutes are a case in point. A rapid doubling of enrollment will be “very difficult,” he says. “Where will you get the trained faculty to teach these additional students?” Even today, a quarter of IIT faculty slots are vacant. Staffing decisions, Rao says, require “very careful selection, which can't be done overnight.” There's still time to devise a workable strategy, he says—if cooler heads prevail. [1]: pending:yes

IS: Not exactly the 10th anniversary, but close enough

There has been a lot of puzzled debate and equally puzzling explanations regarding the following question: Will the International Showcase at the upcoming 2004 Annual Meeting in Denver be its 10th anniversary? Well, let's see … the first IS was at the 1995 Annual Meeting in Houston. So, counting on our fingers, … the 2004 showcase is the 10th! Oh, but cooler heads realized that the official, unarguable anniversary will be in 2005.

CAN OSTRICHES KEEP A COOL HEAD?

For any animal that's stood out in the savannah, it's important to keep your cool with the sun beating down on your head. However under some conditions, mammals that are exposed to extreme temperatures seem to be able to cool their brains as the temperature rises; but not always. Could ostriches that roam across South African grasslands protect themselves from the heat by keeping their brains cool? Andrea Fuller and her colleagues at the University of Witwatersrand decided to monitor the brain and body temperatures of free ranging ostriches, to see if the birds selectively cooled their brains(p. 1171).After tracking the birds' temperatures for several months, the team were surprised to discover that the ostriches' brains were slightly warmer than their body temperature, and only occasionally cooled below body temperature during the afternoon. More surprisingly, their brain temperature was higher than their blood temperature by 3°C at night! Fuller believes that instead of using cooling to protect their brains from overheating, mammals cool the hypothalamus to reduce evaporative heat loss and protect themselves from dehydration during the heat of the day; but it seems unlikely that birds use brain cooling in the same way. In fact, she adds that ostriches seem to use selective brain cooling so rarely that it might `serve no current physiological function' for these big birds.

Cryogen-free HTS coil placed in a heat-exchange gas

Poorly cooled regions in cryogen-free superconducting windings represent weak points especially in high-current-density superconducting windings of superconducting magnets with complicated geometry. It is quite natural taking into account the low average heat conductivity of the superconducting winding. In this paper, we propose to cool the winding mainly not by thermal conductivity but by heat exchange with the low-pressure gaseous helium placed in a hermetic envelope around the winding. The envelope is cooled through its thermal contact with a cooler head. The method was experimentally checked and its advantages are discussed.

High-Stakes Testing for Students with Special Needs

A serious concern for Alaskan parents of students with disabilities is the difficulty that their children will almost surely have in qualifying for a diploma that requires them to tests that measure specific skills at levels beyond their reach, the authors point out. IN 1997 the Alaska legislature mandated that the Department of Education and Early Development (DEED) prepare and have administered the High School Graduation Qualifying Examination (HSGQE). The examination would consist of tests in mathematics, reading, and writing -- and only these areas. High school diplomas would be awarded only to those students who succeeded in meeting the minimum required pass scores on all three tests, which soon became referred to as the The genesis of the requirement is interesting. No hard data were gathered or analyzed. The impetus, according to a strong legislative advocate of the tests, came from complaints registered with legislators by parents, students, businesspeople, and university administrators. When questioned about the data gathered to justify the exit exam requirement, the legislator replied that he had acted on anecdotal evidence. This anecdotal evidence overlooked or ignored the fact that Alaska high school graduates have for years been attending and graduating from some of the most prestigious universities in the world. These graduates have returned to Alaska to staff hospitals, law offices, engineering firms, schools, and universities and to engage in any number of other professions requiring postsecondary education. A serious concern for parents of students with disabilities was the difficulty that their children would almost surely have in qualifying for a diploma that required them to tests that spoke only to specific skills at levels beyond their reach. A committee of parents and educators worked with the Department of Education and Early Development to recommend accommodations for students with disabilities. Sadly, the accommodations were to be available to only 2% of the special education population. Parents found this allocation less than munificent. To be fair, it must be noted that some parents of students with disabilities were not in favor of postponing or revising the exit exams for their children. These parents felt that their children should somehow be prepared by the schools to the regular examinations. Others had found unique and very expensive individualized programs that helped their children make greater progress than they had made in their classrooms. While citing such cases, legislators were in no way hastening to make such individualized tutoring available to the general population of students with disabilities. The original legislation set the year 2002 as the time when graduates' diplomas would be determined by test results. When the first administration of the exams proved disastrous for many students, especially in the area of mathematics, educators began to have second thoughts about the reasonableness of the tests. Rewrites were very much the order of the day, causing test zealots to bewail the abandonment of standards and opponents of high-stakes testing to gloat in smug satisfaction. Cooler heads seem to have prevailed, despite the indignation of some members of the Alaska House of Representatives, and the state senate passed a bill (S.B. 133) that both delayed the implementation of the diploma/no diploma provision and offered an alternative route to the diploma for students in special education classes. Under this provision, special education students who cannot the exit exams as they stand can earn a diploma by meeting the standards set down in an individualized education program (IEP). To this point we have made no mention of any data supporting either side in the debate over the exit exams. There is good reason for this, because the DEED has not disaggregated the data so that conclusions can be drawn about whether or not the tests are realistic for students in special education. …

Initial experience with cool head, warm body perfusion in aortic arch surgery.

Hypothermia has been an essential technique in aortic arch surgery for protecting the brain. To reduce the adverse effect caused by hypothermia, we modified the perfusion technique in aortic arch surgery. Initial results using this modified technique are reviewed. Nineteen patients were operated on for aortic aneurysm involving the aortic arch. Fifteen patients had nondissecting aneurysm and four patients had type A dissecting aneurysm including three with acute dissection. While on the hypothermic (25 degrees C to 28 degrees C of nasopharyngeal temperature) antegrade selective cerebral perfusion (SCP) was performed by direct cannulation to the brachiocephalic and left common carotid arteries, visceral perfusion via the femoral artery or graft was performed with tepid or normothermia (34 degrees C to 36 degrees C). Hospital mortality rate was 5.3% (1/19 patients). None of the 19 patients suffered from stroke postoperatively. Duration of total cardiopulmonary bypass and SCP was 144 +/- 36 minutes and 90 +/- 34 minutes, respectively. Eighteen surviving patients were extubated at 9.4 +/- 13.2 hours and stayed in the intensive care unit (ICU) for 3.0 +/- 1.8 days after the surgery. Our initial experience revealed that the modified technique using simultaneous hypothermic cerebral perfusion and tepid or normothermic visceral perfusion can be a useful adjunct during aortic arch surgery providing quick recovery.