bluuebunny/crossref_metadata_2025 huggingface dataset:
Unbalanced PCC voltage regulation with positive‐ and negative‐sequence compensation tactics for MMC‐DSTATCOM
Authors: Xu Chen , Dai Ke , Chen Xinwen , Kang Yong
Published: September 2016

Unbalanced voltage fluctuation at the point of common coupling (PCC) is a challenging power quality problem in power distribution system. This study presents an unbalanced PCC voltage regulation scheme with positive‐ and negative‐sequence control for modular multilevel converter (MMC) in medium‐voltage distribution static synchronous compensator (DSTATCOM) application. The proposed positive‐sequence control is utilised to regulate the positive‐sequence component of PCC voltage to rated value, while the negative‐sequence control aims to cancel out the negative‐sequence component of PCC voltage completely. Compensation commands whether in positive‐ or negative‐sequence control are generated from unbalanced PCC voltage without utilisation of unbalanced load currents. DC circulating currents transferring active power among three phases of MMC are also analysed to illustrate power balance issue resulting from negative‐sequence control. Then comparison of negative‐sequence compensation capacity between MMC and full‐bridge cascaded converter with delta‐connection is illustrated. Experiment results acquired from a downscaled 85 V/1.5 kVA apparatus validate the effectiveness of the proposed control scheme.
Adaptive estimation of the transformer stray capacitances for DC–DC converter modelling
Authors: Musznicki Piotr , Chrzan Piotr J. , Rucinski Marcin , Kolincio Maciej
Published: September 2016

New low cost and accurate estimation method of transformer stray capacitances for wide band DC–DC converter modelling and design is proposed. The Wiener filter (WF) method is applied to estimate the transformer impedance – referred to the selected transformer winding configurations. Laboratory tests are used to adapt the filter, that is to find optimal impedance which minimises mean square error between measured, noise perturbed current and reconstructed current. Transformer transfer function peaks indicate internal LC resonances. Stray capacitances are extracted based on resonant frequencies determination. The method validation is carried out by simulation and experimental analysis, where estimated stray capacitances by WF are compared with measurements of an impedance analyser.
Beam‐space reduced‐dimension space‐time adaptive processing for airborne radar in sample starved heterogeneous environments
Authors: Wei Zhang , Zishu He , Huiyong Li , Jun Li , Xiang Duan
Published: September 2016

A method for selecting auxiliary channels in reduced‐dimension space‐time adaptive processing (STAP) is proposed for airborne multiple‐input multiple‐output radar. The auxiliary channel selection of the proposed approach is data dependent. Based on maximum cross‐correlation energy metric, the significance of each spatial‐Doppler channel is evaluated, and the auxiliary channels are selected step‐by‐step through utilising iteration. For the sake of achieving better performance as much as possible, the proposed approach will select two auxiliary channels at the first step, and select one channel at the next each step. Due to that the explicit physical meaning is very important for a STAP algorithm, the physical meaning of the maximum cross‐correlation energy metric is discussed, and the fact that the local optimal output signal‐to‐interference‐noise (SINR) performance can be assured by the maximum cross‐correlation energy metric is proved theoretically. The simulations demonstrated that the output SINR loss of the proposed approach is about −1.9 dB when only two auxiliary channels are selected. Consequently, the proposed approach can reduce the requirement of the sample support dramatically. This will be more obvious advantage for the practical application in heterogeneous clutter environments where the number of secondary samples is extremely limited.
Light backscattering (e.g. reflectance) by ZnO nanorods on tips of plastic optical fibres with application for humidity and alcohol vapour sensing
Authors: Lokman Muhammad Quisar , Bin Abdul Rahim Hazli Rafis , Harun Sulaiman Wadi , Hornyak G. Louis , Mohammed Waleed Soliman
Published: September 2016

Relative humidity and alcohol vapour sensing by light backscattering was demonstrated by zinc oxide (ZnO) nanorods grown on tips of plastic optical fibres. Synthesis of ZnO nanostructures was accomplished by the hydrothermal method. A new technique was proposed to extract the backscattered light by ZnO nanostructures. The system was shown experimentally to sense moisture and alcohol vapours. Three ranges of the visible spectrum blue (450–500 nm), green (500–570 nm) and red (610–700 nm) were studied in experiments. Spectral reflectance based on backscattering from ZnO surface structures was used to measure the amount of light backscattered by ZnO nanorods. Results showed that light in the red visible range of the spectrum had higher sensitivity and reflectivity compared with blue and green spectral ranges.
Abgucken Erlaubt!
Authors: Kohrs Jens
Published: September 2016

Daten sind ein wertvolles Gut in unserer Welt. Und Krankenhäuser haben sich zu wahren Datensammlern entwickelt. Wie sie mit diesem Schatz umgehen, welchen Gewinn sie daraus schlagen, ohne das Vertrauen ihrer Patienten zu enttäuschen und deren Rechte zu verletzen, ist eine echte Bewährungsprobe.

Bisher zögern viele deutsche Kliniken noch, konsequent auf den Digitalisierungszug aufzuspringen. Doch genau dieses Zögern könnte sich im Nachhinein als cleverer Schachzug erweisen. Mittlerweile gibt es diverse Beispiele, wie sich die Schlagwörter Digitalisierung und Vernetzung mit Leben füllen lassen – etwa im dänischen Aarhus, wie Wolfgang Deiters beschreibt (Seite 13). Es lohnt sich, dort und andernorts genau hinzuschauen und den Vorteil des Spätzünders auszunutzen. Die deutschen Klinikmanager und ihre Teams können aus den Fehlern der Vorreiter lernen und sich das Erfolgreiche ohne schlechtes Gewissen abgucken.

Skepsis in Anbetracht der neuen Möglichkeiten ist verständlich, Blauäugigkeit gefährlich – nur weiteres Zögern ist jetzt nicht mehr angebracht. Das Neue grundsätzlich zu verteufeln, sollte unbedingt tabu sein. Dafür sind die Perspektiven zu vielversprechend.
Effect of van der Waals interactions on the chemisorption and physisorption of phenol and phenoxy on metal surfaces
Authors: Peköz Rengin , Donadio Davide
Published: September 2016

The adsorption of phenol and phenoxy on the (111) surface of Au and Pt has been investigated by density functional theory calculations with the conventional PBE functional and three different non-local van der Waals (vdW) exchange and correlation functionals. It is found that both phenol and phenoxy on Au(111) are physisorbed. In contrast, phenol on Pt(111) presents an adsorption energy profile with a stable chemisorption state and a weakly metastable physisorbed precursor. While the use of vdW functionals is essential to determine the correct binding energy of both chemisorption and physisorption states, the relative stability and existence of an energy barrier between them depend on the semi-local approximations in the functionals. The first dissociation mechanism of phenol, yielding phenoxy and atomic hydrogen, has been also investigated, and the reaction and activation energies of the resulting phenoxy on the flat surfaces of Au and Pt were discussed.
Increasing the stability of nanofluids with cavitating flows in micro orifices
Authors: Karimzadehkhouei Mehrdad , Ghorbani Morteza , Sezen Meltem , Şendur Kürşat , Pınar Mengüç M. , Leblebici Yusuf , Koşar Ali
Published: September 2016

One of the most critical challenges for nanofluids in practical applications is related to their stability and reusability since a gradual agglomeration of nanoparticles in nanofluids occurs with time and is accelerated by heating. In this study, we propose a technique to maintain the performance and stability of nanofluids with the use of cavitating flows through micro orifices to prevent agglomeration and sedimentation of nanoparticles, which will increase the durability of the nanofluids. γ-Al2O3 (gamma-alumina) nanoparticles with a mean diameter of 20 nm suspended in water were utilized. In the current approach, a flow restrictive element induces sudden pressure, which leads to cavitation bubbles downstream from the orifice. The emerging bubbles interact with the agglomerated structure of nanoparticles and decrease its size through hitting or shock waves generated by their collapse, thereby increasing the stability and reusability of nanofluids. The method does not involve any use of expensive surfactants or surface modifiers, which might alter the thermophysical properties of nanofluids, may adversely influence their performance and biocompatibility, and may limit their effectiveness.
Spin wave absorber generated by artificial surface anisotropy for spin wave device network
Authors: Kanazawa Naoki , Goto Taichi , Sekiguchi Koji , Granovsky Alexander B. , Takagi Hiroyuki , Nakamura Yuichi , Inoue Mitsuteru
Published: September 2016

Spin waves (SWs) have the potential to reduce the electric energy loss in signal processing networks. The SWs called magnetostatic forward volume waves (MSFVWs) are advantageous for networking due to their isotropic dispersion in the plane of a device. To control the MSFVW flow in a processing network based on yttrium iron garnet, we developed a SW absorber using artificial structures. The mechanical surface polishing method presented in this work can well control extrinsic damping without changing the SW dispersion of the host material. Furthermore, enhancement of the ferromagnetic resonance linewidth over 3 Oe was demonstrated.
Empirical exploration of brilliance in health care: perceptions of health professionals
Authors: Karimi Leila , Dadich Ann , Fulop Liz , Leggat Sandra G. , Rada Jiri , Hayes Kathryn J. , Kippist Louise , Eljiz Kathy , Smyth Anne , Fitzgerald Janna Anneke
Published: September 2016

Objective The aim of the present study was to develop a positive organisational scholarship in health care approach to health management, informed by health managers and health professionals’ experiences of brilliance in health care delivery. Methods A sample of postgraduate students with professional and/or management experience within a health service was invited to share their experiences of brilliant health services via online discussions and a survey running on the SurveyMonkey platform. A lexical analysis of student contributions was conducted using the individual as the unit of analysis. Results Using lexical analysis, the examination of themes in the concept map, the relationships between themes and the relationships between concepts identified ‘care’ as the most important concept in recognising brilliance in health care, followed by the concepts of ‘staff’ and ‘patient’. Conclusions The research presents empirical material to support the emergence of an evidence-based health professional perspective of brilliance in health management. The findings support other studies that have drawn on both quantitative and qualitative materials to explore brilliance in health care. Pockets of brilliance have been previously identified as catalysts for changing health care systems. Both quality, seen as driven from the outside, and excellence, driven from within individuals, are necessary to produce brilliance. What is known about the topic? The quest for brilliance in health care is not easy but essential to reinvigorating and energising health professionals to pursue the highest possible standards of health care delivery. What does this paper add? Using an innovative methodology, the present study identified the key drivers that health care professionals believe are vital to moving in the direction of identifying brilliant performance. What are the implications for practitioners? This work presents evidence on the perceptions of leadership and management practices associated with brilliant health management. Lessons learned from exceptionally well-delivered services contain different templates for change than those dealing with failures, errors, misconduct and the resulting negativity.
The emergence of integrated approaches to worker health, safety and wellbeing in Australia
Authors: Joss Nerida , Dupré-Husser Eliette , Cooklin Amanda , Oldenburg Brian
Published: September 2016

Integrated approaches to worker health, safety and wellbeing have been progressively developed and implemented internationally for over a decade; however, implementation in the Australian context is still in the early stages. Integrated workplace interventions recognise the interaction between health protection and health promotion to create a workplace culture in which health, safety and wellbeing are valued and managed efficiently, together with a view to improve organisational productivity. The present paper describes the progress of integrated approaches in six Victorian workplaces considered early adopters and identifies the drivers for further policy and program development in this area. Using a qualitative exploratory multiple case study design, organisational documents were systematically analysed and semi-structured interviews were conducted in six organisations that met criteria for an integrated approach. Key mechanisms to support this approach were observed, including active leadership, the development of an integrated committee for activities, clear strategies to engage employees and an existing commitment to safety practices. The prioritisation within a workplace to integrate health, safety and wellbeing, and ensure sustainability of these approaches, was detected as a gap for future development.
Talent development of high performance coaches in team sports in Ireland
Authors: Sherwin Ian , Campbell Mark J. , Macintyre Tadhg Eoghan
Published: September 2016

Background: Coaches are central to the development of the expert performer and similarly to continued lifelong participation in sport. Coaches are uniquely positioned to deliver specific technical and tactical instruction and mentoring programmes that support the psychological and social development of athletes in a challenging, goal‐oriented and motivational environment. The current study aimed to qualitatively investigate current coach learning sources and coaches’ educational backgrounds in team sports in Ireland. Methods: Coaches from five team sports in Ireland were asked to complete an online questionnaire. Subsequently male coaches (n = 19) from five team sports who completed the questionnaire and met the inclusion criteria were invited to attend a follow‐up semi‐structured interview. Inclusion criteria for coaches were that they possess at least 10 years’ experience coaching their sport and were coaching more than 4 hours per week. Results/Discussion: Formal coach education does not meet the needs of high performance coaches who rely more on self‐directed learning and coaching experience as their main sources of CPD. Although prior playing experience at a high level is both valuable and desirable, there are concerns about fast‐tracking of ex‐players into high performance coaching roles. Conclusions: Preferred sources of education and the best learning environment for coaches of team sports in Ireland are more informal than formal. Further research is needed to examine how this learning is applied in a practical manner by examining coaching behaviours and the impact it has on the athlete development process.
Entropy formula for random ℤ^{𝕜}-actions
Authors: Zhu Yujun
Published: September 2016

In this paper, entropies, including measure-theoretic entropy and topological entropy, are considered for random

Z

k

\mathbb {Z}^k

-actions which are generated by random compositions of the generators of

Z

k

\mathbb {Z}^k

-actions. Applying Pesin’s theory for commutative diffeomorphisms we obtain a measure-theoretic entropy formula of

C

2

C^{2}

random

Z

k

\mathbb {Z}^k

-actions via the Lyapunov spectra of the generators. Some formulas and bounds of topological entropy for certain random

Z

k

\mathbb {Z}^k

(or

Z

+
k

)

\mathbb {Z}_+^k)

-actions generated by more general maps, such as Lipschitz maps, continuous maps on finite graphs and

C

1

C^{1}

expanding maps, are also obtained. Moreover, as an application, we give a formula of Friedland’s entropy for certain

C

2

C^{2}

Z

k

\mathbb {Z}^k

-actions.
Spinor pairs and the concentration principle for Dirac operators
Authors: Maridakis Manousos
Published: September 2016

We study perturbed Dirac operators of the form

D
s

=
D
+
s

A

:
Γ
(
E
)
→
Γ
(
F
)

D_s= D + s\mathcal {A} :\Gamma (E)\rightarrow \Gamma (F)

over a compact Riemannian manifold

(
X
,
g
)

(X, g)

with symbol

c
c

and special bundle maps

A

:
E
→
F

\mathcal {A} : E\rightarrow F

for

s
≫
0

s \gg 0

. Under a simple algebraic criterion on the pair

(
c
,

A

)

(c, \mathcal {A})

, solutions of

D
s

ψ
=
0

D_s\psi =0

concentrate as

s
→
∞

s\to \infty

around the singular set

Z

A

⊂
X

Z_{\mathcal {A}}\subset X

of

A

\mathcal {A}

. We give many examples, the most interesting ones arising from a general “spinor pair” construction.
The Gysin triangle via localization and 𝐴¹-homotopy invariance
Authors: Tabuada Gonçalo , Van den Bergh Michel
Published: September 2016

Let

X
X

be a smooth scheme,

Z
Z

a smooth closed subscheme, and

U
U

the open complement. Given any localizing and

A

1

\mathbb {A}^1

-homotopy invariant of dg categories 

E
E

, we construct an associated Gysin triangle relating the value of 

E
E

at the dg categories of perfect complexes of

X
X

,

Z
Z

, and

U
U

. In the particular case where 

E
E

is homotopy

K
K

-theory, this Gysin triangle yields a new proof of Quillen’s localization theorem, which avoids the use of devissage. As a first application, we prove that the value of 

E
E

at a smooth scheme belongs to the smallest (thick) triangulated subcategory generated by the values of 

E
E

at the smooth projective schemes. As a second application, we compute the additive invariants of relative cellular spaces in terms of the bases of the corresponding cells. Finally, as a third application, we construct explicit bridges relating motivic homotopy theory and mixed motives on the one side with noncommutative mixed motives on the other side. This leads to a comparison between different motivic Gysin triangles as well as to an étale descent result concerning noncommutative mixed motives with rational coefficients.
Vertex algebraic intertwining operators among generalized Verma modules for ̂𝔰𝔩(2,ℂ)
Authors: McRae Robert , Yang Jinwei
Published: September 2016

We construct vertex algebraic intertwining operators among certain generalized Verma modules for

s
l

(
2
,

C

)

^

\widehat {\mathfrak {sl}(2,\mathbb {C})}

and calculate the corresponding fusion rules. Additionally, we show that under some conditions these intertwining operators descend to intertwining operators among one generalized Verma module and two (generally non-standard) irreducible modules. Our construction relies on the irreducibility of the maximal proper submodules of generalized Verma modules appearing in the Garland-Lepowsky resolutions of standard

s
l

(
2
,

C

)

^

\widehat {\mathfrak {sl}(2,\mathbb {C})}

-modules. We prove this irreducibility using the composition factor multiplicities of irreducible modules in Verma modules for symmetrizable Kac-Moody Lie algebras of rank

2
2

, given by Rocha-Caridi and Wallach.
Tame pro-2 Galois groups and the basic ℤ₂-extension
Authors: Mizusawa Yasushi
Published: September 2016

For a number field, we consider the Galois group of the maximal tamely ramified pro-2-extension with restricted ramification. Providing a general criterion for the metacyclicity of such Galois groups in terms of 2-ranks and 4-ranks of ray class groups, we classify all finite sets of odd prime numbers such that the maximal pro-2-extension unramified outside the set has prometacyclic Galois group over the

Z

2

\mathbb Z_2

-extension of the rationals. The list of such sets yields new affirmative examples of Greenberg’s conjecture.
Moesin and cortactin control actin-dependent multivesicular endosome biogenesis
Authors: Muriel Olivia , Tomas Alejandra , Scott Cameron C. , Gruenberg Jean
Published: September 2016

We used in vivo and in vitro strategies to study the mechanisms of multivesicular endosome biogenesis. We found that, whereas annexinA2 and ARP2/3 mediate F-actin nucleation and branching, respectively, the ERM protein moesin supports the formation of F-actin networks on early endosomes. We also found that moesin plays no role during endocytosis and recycling to the plasma membrane but is absolutely required, much like actin, for early-to-late-endosome transport and multivesicular endosome formation. Both actin network formation in vitro and early-to-late endosome transport in vivo also depend on the F-actin–binding protein cortactin. Our data thus show that moesin and cortactin are necessary for formation of F-actin networks that mediate endosome biogenesis or maturation and transport through the degradative pathway. We propose that the primary function of endosomal F-actin is to control the membrane remodeling that accompanies endosome biogenesis. We also speculate that this mechanism helps segregate tubular and multivesicular membranes along the recycling and degradation pathways, respectively.
Regulation of Ca2+channels by SNAP-25 via recruitment of syntaxin-1 from plasma membrane clusters
Authors: Toft-Bertelsen Trine Lisberg , Ziomkiewicz Iwona , Houy Sébastien , Pinheiro Paulo S. , Sørensen Jakob B.
Published: September 2016

SNAP-25 regulates Ca2+channels, with potentially important consequences for diseases involving an aberrant SNAP-25 expression level. How this regulation is executed mechanistically remains unknown. We investigated this question in mouse adrenal chromaffin cells and found that SNAP-25 inhibits Ca2+currents, with the B-isoform being more potent than the A-isoform, but not when syntaxin-1 is cleaved by botulinum neurotoxin C. In contrast, syntaxin-1 inhibits Ca2+currents independently of SNAP-25. Further experiments using immunostaining showed that endogenous or exogenous SNAP-25 expression recruits syntaxin-1 from clusters on the plasma membrane, thereby increasing the immunoavailability of syntaxin-1 and leading indirectly to Ca2+current inhibition. Expression of Munc18-1, which recruits syntaxin-1 within the exocytotic pathway, does not modulate Ca2+channels, whereas overexpression of the syntaxin-binding protein Doc2B or ubMunc13-2 increases syntaxin-1 immunoavailability and concomitantly down-regulates Ca2+currents. Similar findings were obtained upon chemical cholesterol depletion, leading directly to syntaxin-1 cluster dispersal and Ca2+current inhibition. We conclude that clustering of syntaxin-1 allows the cell to maintain a high syntaxin-1 expression level without compromising Ca2+influx, and recruitment of syntaxin-1 from clusters by SNAP-25 expression makes it available for regulating Ca2+channels. This mechanism potentially allows the cell to regulate Ca2+influx by expanding or contracting syntaxin-1 clusters.
Spastin, atlastin, and ER relocalization are involved in axon but not dendrite regeneration
Authors: Rao Kavitha , Stone Michelle C. , Weiner Alexis T. , Gheres Kyle W. , Zhou Chaoming , Deitcher David L. , Levitan Edwin S. , Rolls Melissa M.
Published: September 2016

Mutations in >50 genes, including spastin and atlastin, lead to hereditary spastic paraplegia (HSP). We previously demonstrated that reduction of spastin leads to a deficit in axon regeneration in a Drosophila model. Axon regeneration was similarly impaired in neurons when HSP proteins atlastin, seipin, and spichthyin were reduced. Impaired regeneration was dependent on genetic background and was observed when partial reduction of HSP proteins was combined with expression of dominant-negative microtubule regulators, suggesting that HSP proteins work with microtubules to promote regeneration. Microtubule rearrangements triggered by axon injury were, however, normal in all genotypes. We examined other markers to identify additional changes associated with regeneration. Whereas mitochondria, endosomes, and ribosomes did not exhibit dramatic repatterning during regeneration, the endoplasmic reticulum (ER) was frequently concentrated near the tip of the growing axon. In atlastin RNAi and spastin mutant animals, ER accumulation near single growing axon tips was impaired. ER tip concentration was observed only during axon regeneration and not during dendrite regeneration. In addition, dendrite regeneration was unaffected by reduction of spastin or atlastin. We propose that the HSP proteins spastin and atlastin promote axon regeneration by coordinating concentration of the ER and microtubules at the growing axon tip.
MPRAnator: a web-based tool for the design of massively parallel reporter assay experiments
Authors: Georgakopoulos-Soares Ilias , Jain Naman , Gray Jesse M , Hemberg Martin
Published: September 2016

Motivation

With the rapid advances in DNA synthesis and sequencing technologies and the continuing decline in the associated costs, high-throughput experiments can be performed to investigate the regulatory role of thousands of oligonucleotide sequences simultaneously. Nevertheless, designing high-throughput reporter assay experiments such as massively parallel reporter assays (MPRAs) and similar methods remains challenging.

Results

We introduce MPRAnator, a set of tools that facilitate rapid design of MPRA experiments. With MPRA Motif design, a set of variables provides fine control of how motifs are placed into sequences, thereby allowing the investigation of the rules that govern transcription factor (TF) occupancy. MPRA single-nucleotide polymorphism design can be used to systematically examine the functional effects of single or combinations of single-nucleotide polymorphisms at regulatory sequences. Finally, the Transmutation tool allows for the design of negative controls by permitting scrambling, reversing, complementing or introducing multiple random mutations in the input sequences or motifs.

Availability and implementation

MPRAnator tool set is implemented in Python, Perl and Javascript and is freely available at www.genomegeek.com and www.sanger.ac.uk/science/tools/mpranator. The source code is available on www.github.com/hemberg-lab/MPRAnator/ under the MIT license. The REST API allows programmatic access to MPRAnator using simple URLs.

Supplementary information

Supplementary data are available at Bioinformatics online.
Genetic characterization of wild and farmed European seabass in the Adriatic sea: assessment of farmed escapees using a Bayesian approach
Authors: Šegvić-Bubić Tanja , Grubišić Leon , Trumbić Željka , Stanić Rino , Ljubković Jelena , Maršić-Lučić Jasna , Katavić Ivan
Published: September 2016

Hybridizations between domesticated escaped farmed fish and wild conspecifics may increase genetic diversity or break down locally adapted gene complexes, thus reducing competitive ability and overall fitness. We examined the genetic structure of six farmed populations of European seabass, Dicentrarchus labrax, of different geographical origin, and ten neighbouring wild populations in the Adriatic Sea using 10 microsatellite loci. All loci were polymorphic, with mean expected heterozygosity >74% in all 16 populations. Overall number of alleles as well as short-term effective population size were smaller in farmed (A = 18.7; Ne = 56.1) than in wild populations (A = 21.2; Ne = 180.6). The global FST of 0.0672 across loci showed significant population subdivision. Strong genetic differences between farmed fish and their wild conspecifics enabled the identification of seabass escapees back to their origins and the estimation of the extent of hybridization. Bayesian assignment analyses clustered wild populations together, whereas each farmed populations was assigned to a separate cluster. Intraspecific hybridization was highest in wild populations in areas impacted by fish farms, where highly admixed populations had decreased genetic diversity. The results of this study represent a solid foundation required to establish a genetic register of European seabass wild and farmed populations in the eastern Adriatic Sea that are required to establish a seabass DNA register.
Dosimetric impact of an air passage on intraluminal brachytherapy for bronchus cancer
Authors: Okamoto Hiroyuki , Wakita Akihisa , Nakamura Satoshi , Nishioka Shie , Aikawa Ako , Kato Toru , Abe Yoshihisa , Kobayashi Kazuma , Inaba Koji , Murakami Naoya , Itami Jun
Published: September 2016

The brachytherapy dose calculations used in treatment planning systems (TPSs) have conventionally been performed assuming homogeneous water. Using measurements and a Monte Carlo simulation, we evaluated the dosimetric impact of an air passage on brachytherapy for bronchus cancer. To obtain the geometrical characteristics of an air passage, we analyzed the anatomical information from CT images of patients who underwent intraluminal brachytherapy using a high-dose-rate 192Ir source (MicroSelectron V2r®, Nucletron). Using an ionization chamber, we developed a measurement system capable of measuring the peripheral dose with or without an air cavity surrounding the catheter. Air cavities of five different radii (0.3, 0.5, 0.75, 1.25 and 1.5 cm) were modeled by cylindrical tubes surrounding the catheter. A Monte Carlo code (GEANT4) was also used to evaluate the dosimetric impact of the air cavity. Compared with dose calculations in homogeneous water, the measurements and GEANT4 indicated a maximum overdose of 5–8% near the surface of the air cavity (with the maximum radius of 1.5 cm). Conversely, they indicated a minimum overdose of ~1% in the region 3–5 cm from the cavity surface for the smallest radius of 0.3 cm. The dosimetric impact depended on the size and the distance of the air passage, as well as the length of the treatment region. Based on dose calculations in water, the TPS for intraluminal brachytherapy for bronchus cancer had an unexpected overdose of 3–5% for a mean radius of 0.75 cm. This study indicates the need for improvement in dose calculation accuracy with respect to intraluminal brachytherapy for bronchus cancer.
AtMYB44 Positively Regulates the Enhanced Elongation of Primary Roots Induced by N-3-Oxo-Hexanoyl-Homoserine Lactone in Arabidopsis thaliana
Authors: Zhao Qian , Li Man , Jia Zhenhua , Liu Fang , Ma Hong , Huang Yali , Song Shuishan
Published: September 2016

N-acyl-homoserine lactones (AHL) are the quorum-sensing (QS) signal molecules used by many gram-negative bacteria to coordinate their collective behavior in a population. Recent evidence demonstrates their roles in plant root growth and defense responses. AtMYB44 is a multifaceted transcriptional factor that functions in many physiological processes in plants but whether AtMYB44 modulates the plant response to AHL with aspects of primary root elongation remains unknown. Here, we show that the expression of AtMYB44 was upregulated upon treatment with N-3-oxo-hexanoyl-homoserine lactone (3OC6-HSL). The stimulatory effect of 3OC6-HSL on primary root elongation was abolished in the AtMYB44 functional-deficiency mutant atmby44. In contrast, an enhanced promoting-impact of 3OC6-HSL on primary root growth was observed in AtMYB44-overexpressing plant MYB44OTA. Cellular analysis indicated that the prolonged primary root elicited by 3OC6-HSL is the consequence of increased cell division in the meristem zone and enhanced cell elongation in the elongation zone, and AtMYB44 may act as a positive regulator in this process. Furthermore, we demonstrated that AtMYB44 might participate in the 3OC6-HSL-mediated primary root growth via regulating the expression of cytokinin- and auxin-related genes. The data establish a genetic connection between the regulatory role of AtMYB44 in phytohormones-related gene expression and plant response to the bacterial QS signal.
Reference Values for Noninvasive Blood Pressure in Children during Anesthesia
Authors: de Graaff Jurgen C. , Pasma Wietze , van Buuren Stef , Duijghuisen Jesse J. , Nafiu Olubukola O. , Kheterpal Sachin , van Klei Wilton A.
Published: September 2016

Background

Although noninvasive blood pressure (NIBP) monitoring during anesthesia is a standard of care, reference ranges for blood pressure in anesthetized children are not available. We developed sex- and age-specific reference ranges for NIBP in children during anesthesia and surgery.

Methods

In this retrospective observational cohort study, we included NIBP data of children with no or mild comorbidity younger than 18 yr old from the Multicenter Perioperative Outcomes Group data set. Sex-specific percentiles of the NIBP values for age were developed and extrapolated into diagrams and reference tables representing the 50th percentile (0 SD), +1 SD, −1 SD, and the upper (+2 SD) and lower reference ranges (−2 SD).

Results

In total, 116,362 cases from 10 centers were available for the construction of NIBP age- and sex-specific reference curves. The 0 SD of the mean NIBP during anesthesia varied from 33 mmHg at birth to 67 mmHg at 18 yr. The low cutoff NIBP (2 SD below the 50th percentile) varied from 17 mmHg at birth to 47 mmHg at 18 yr old.

Conclusions

This is the first study to present reference ranges for blood pressure in children during anesthesia. These reference ranges based on the variation of values obtained in daily care in children during anesthesia could be used for rapid screening of changes in blood pressure during anesthesia and may provide a consistent reference for future blood pressure–related pediatric anesthesia research.
Finding a Focus for Nursing
Authors: Cook Laura Beth , Peden Ann
Published: September 2016

Many nursing theorists claim caring as the aspect of nursing that differentiates it from other health care professions. Newman et al defined the focus of nursing as “the study of caring in the human health experience,” yet there is little consensus among nurses about the validity of this statement. The purpose of this article is to explore the concept of caring as it has been defined by various nursing scholars and to determine whether the focus of nursing knowledge development can appropriately be defined as “the study of caring in the human health experience.”
Death Is a Social Justice Issue
Authors: Reimer-Kirkham Sheryl , Stajduhar Kelli , Pauly Bernie , Giesbrecht Melissa , Mollison Ashley , McNeil Ryan , Wallace Bruce
Published: September 2016

All too often, palliative care services are not responsive to the needs of those who are doubly vulnerable, being that they are both in need of palliative care services and experiencing deficits in the social determinants of health that result in complex, intersecting health and social concerns. In this article, we argue for a reorientation of palliative care to explicitly integrate the premises of health equity. We articulate the philosophical, theoretical, and empirical scaffolding required for equity-informed palliative care and draw on a current study to illustrate such an approach to the care of people who experience structural vulnerabilities.
Exercising Nursing Essential and Effective Freedom in Behalf of Social Justice
Authors: Perry Donna J. , Willis Danny G. , Peterson Kenneth S. , Grace Pamela J.
Published: September 2016

This article expands upon previous work by the authors to develop a model of nursing essential and effective freedom to facilitate nursing action in behalf of social justice. The article proposes that while social justice is rooted in nursing's ontological, epistemological, and moral foundations, the discipline's social justice mandate is constrained by its historical and contemporary location within an institutionalized medical paradigm. We present a model of nursing “essential” and “effective” freedom based on the philosophy of Bernard Lonergan to illustrate how nursing can transcend these barriers. This humanizing model is illustrated through personal narratives of the authors.
Femoral Medialization, Fixation Failures, and Functional Outcome in Trochanteric Hip Fractures Treated With Either a Sliding Hip Screw or an Intramedullary Nail From Within a Randomized Trial
Authors: Bretherton Christopher P. , Parker Martyn J.
Published: September 2016

Objectives:

The aim of this study was to determine if femoral medialization influences residual pain and mobility and to determine if fixation method or fracture pattern influences the tendency to medialize.

Design:

This study used data from within a randomized controlled trial.

Setting:

Peterborough City Hospital, UK.

Patient/Participants:

Eight hundred forty-four patients presenting with a trochanteric hip fracture were randomized. Five hundred thirty-eight were available for 1-year follow-up. Fractures were classified according to OTA/AO classification as 31 A1, A2, and A3.

Intervention:

Randomized to fixation with a Targon proximal femoral nail or sliding hip screw (SHS).

Outcome Measures:

Femoral medialization was calculated from follow-up x-rays at a minimum of 28 days post-fixation. Pain and mobility scores were assessed at 1 year by an independent blinded observer. Fixation failure and revision procedures were assessed at a minimum of 1 year from injury.

Results:

Patients with >50% medialization had worse pain (P = 0.012) and mobility scores (P = 0.013) at 1 year. They also had more fracture healing complications (P = 0.021) and required more revision procedures (P = 0.014). Fractures treated with SHS were more likely to medialize >50% compared with intramedullary nail (P < 0.001). A2 and A3 fractures were more likely to medialize, and A3 fractures were more likely to undergo >50% medialization (P < 0.001).

Conclusions:

Our study demonstrates the previously theoretical predisposition for unstable hip fractures treated with SHS to undergo femoral medialization and correlates this with worse functional outcomes. It supports the use of intramedullary nails for A3 fractures, which have a significant tendency to medialize.

Level of Evidence:

Prognostic level II. See Instructions for Authors for a complete description of levels of evidence.
A Review of Local Anesthetics: Minimizing Risk and Side Effects in Cutaneous Surgery
Authors: Park Kelly K. , Sharon Victoria R.
Published: September 2016

BACKGROUND

The specialty of dermatology relies heavily on local anesthesia for diagnosis and management of skin disease. The appropriate selection, preparation, administration, and monitoring of these medications affect surgical outcome and patient safety and satisfaction.

OBJECTIVE

To perform a comprehensive literature review of the side effects and risks associated with local anesthetics used in cutaneous surgery. Current recommendations to reduce risk and minimize side effects are reviewed.

MATERIALS AND METHODS

A comprehensive review of the English-language medical literature search was performed.

RESULTS

No current review articles of the side effects and risks of local anesthetics were identified. This review serves to discuss local anesthetics commonly used in dermatology and cutaneous surgery along with practical information regarding prevention of adverse outcomes and addressing local and systemic reactions when they arise.

CONCLUSION

Local anesthetics commonly used in cutaneous surgery have potential risks and side effects. Appropriate selection and utilization of local anesthetics and knowledge of the means to prevent and address these risks can impact surgical outcomes, patient satisfaction and safety, and ultimately patient experience in the dermatology clinic.
Reconstruction Approach to a Rare Case of Acquired Scrotal Giant Muscular Hamartoma
Authors: Bogetti Paolo , Rolle Luigi , Baglioni Elisabetta Adelaide , Parisi Andrea , Spaziante Luca , Ruka Erind , Rivarossa Filippo , Ceruti Carlo , Preto Mirko , Bocchiotti Maria Alessandra
Published: September 2016

Acquired scrotal giant muscular hamartoma is an uncommon benign lesion with fewer than 10 documented cases all over the world. It is characterized by a proliferation of dermal smooth muscle bundles of scrotum dartos fascia. The authors report a rare case of acquired scrotal giant muscular hamartoma, which occurred in a 70-year-old severely obese and diabetic man presenting with a progressive scrotal enlargement and swelling in the last year, causing marked reduction in quality of life and cosmetic problems. The patient underwent a wide excision of the hamartomatous lesion, and then, a reductive scrotoplasty and autologous skin grafting of penis were performed. Anatomopathological examination showed an acquired scrotal giant muscular hamartoma arising from muscular fascia of dartos. This surgical technique is a valid, safe, effective, and minimally invasive option to treat this pathology, achieving both excellent functional and aesthetic results, with a marked improvement of the patient’s quality of life.
Influence of periampullary diverticulum on the occurrence of pancreaticobiliary diseases and outcomes of endoscopic retrograde cholangiopancreatography
Authors: Chen Lu , Xia Lu , Lu Yi , Bie Like , Gong Biao
Published: September 2016

Background and aim

Periampullary diverticulum (PAD) is frequently encountered in patients undergoing endoscopic retrograde cholangiopancreatography (ERCP). The aim of this study was to investigate the association of PAD with pancreaticobiliary diseases as well as the impact of PAD on the technical success of ERCP and different methods of bile duct stone extraction.

Patients and methods

A total of 1489 cases of patients with PAD were identified from 6390 patients who underwent ERCP. These patients were compared with 1500 controls without PAD in terms of biliary stone formation, technical success, and complications of ERCP.

Results

Patients with PAD had increased prevalence of bile duct stones, gallstones, and cholangitis (P<0.01). Successful cannulation rates were similar in the PAD and the control group (98.59 vs. 99.07%, P=0.225). The incidence of complications did not differ between the PAD and the control group. Successful stone removal rate of endoscopic sphincterotomy (EST) was lower in the PAD group than in the control group (83.53 vs. 94.31%, P=0.005). In patients with PAD, the rate of successful stone removal was lower in the EST group than in the endoscopic papillary balloon dilation (EPBD) and EPBD combined with limited EST (ESBD) group. The rates of complications were similar among different treatments (EST, EPBD, or ESBD) in patients with PAD.

Conclusion

PAD is associated with bile duct stones, gallstones, and cholangitis. In addition, PAD should not be considered a barrier to a successful cannulation. Moreover, EST is less effective than EPBD and ESBD in patients with PAD, whereas EST, EPBD, and ESBD are equally safe in patients with PAD.
Vitamin D Receptor (VDR) Polymorphisms in Pediatric Patients Presenting With Hodgkin’s Lymphoma
Authors: Tekgündüz Sibel A. , Yeşil Şule , Ören Ayşe C. , Tanyildiz Hikmet G. , Çandir Mehmet O. , Bozkurt Ceyhun , Şahin Gürses
Published: September 2016

Vitamin D receptor (VDR) polymorphisms are found more commonly in some tumor types than in healthy individuals, suggesting that some polymorphisms (Cdx2, Fok1, Bsm1, Apa1, Taq1) contribute to tumor development. There is no previous report on VDR polymorphism in Hodgkin’s lymphoma (HL) patients. VDR polymorphism patterns in 95 pediatric HL cases with 100 healthy controls were compared. No statistically significant difference was found between the patient group and control group in terms of Cdx2, Fok1, Bsm1, Apa1, and Taq1 polymorphisms (P>0.5). Our findings suggest that VDR polymorphisms may not play a role in HL development.
Depression as Measured by PHQ-9 Versus Clinical Diagnosis as an Independent Predictor of Long-Term Mortality in a Prospective Cohort of Medical Inpatients
Authors: Martin-Subero Marta , Kroenke Kurt , Diez-Quevedo Crisanto , Rangil Teresa , de Antonio Marta , Morillas Rosa Maria , Lorán Maria Eulalia , Mateu Cristina , Lupon Josep , Planas Ramon , Navarro Ruth
Published: September 2016

Background

Depression has been associated with higher rates of mortality in medical patients. The aim of the study was to evaluate the impact of depression in medical inpatients on the rate of mortality during a prolonged follow-up period.

Method

This is a prospective follow-up study of a cohort of medical inpatients assessed during 1997–1998 in medical and surgical units at a tertiary university hospital in Spain and followed-up for a period ranging between 16.5 and 18 years. Eight hundred three patients were included; 420 (52.3%) were male, and the mean (SD) age was 41.7 (13.8) years. Main outcome was death for any cause during follow-up. The original full Patient Health Questionnaire (PHQ) was administered at baseline as self-report from which the PHQ-9 was derived. Depressive disorders were assessed using PHQ-9 and a structured clinical interview (Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition).

Results

Depressive disorders as defined by PHQ-9 were detected in 206 patients (25.7%), 122 (15.2%) of them fulfilling criteria for major depression. During follow-up, 152 patients (18.9%) died. A PHQ score indicating the presence of major depressive disorder predicted increased mortality (hazard ratio [HR], 2.44; 95% CI, 1.39–4.29), even after adjusting for important demographic and clinical variables. Similarly, the PHQ-9 score as a continuous measure of depression severity predicted increased mortality (HR, 1.06; 95% CI, 1.02–1.10). Results were similar for clinical interview diagnoses of major depression (HR, 2.07; 95% CI, 1.04–4.09).

Conclusions

Medical inpatients with a PHQ depressive disorder had a nearly 2-fold higher risk of long-term mortality, even after adjustment for several confounders. Depression severity as represented by the PHQ-9 score was also a risk factor.
Reluctance to Accept Alcohol Treatment by Alcoholic Liver Disease Transplant Patients: A Qualitative Study
Authors: Heyes Cathy M. , Schofield Toni , Gribble Robert , Day Carolyn A. , Haber Paul S.
Published: September 2016

Background

Liver transplantation (LT) is the optimum treatment for patients with end-stage alcoholic liver disease (ALD). However, despite a recognized risk of relapse to harmful drinking, ALD transplant patients are reluctant to use speciality alcohol treatment to support their abstinence, even when offered within the LT context. This study aimed to understand and identify factors contributing to alcohol treatment reluctance by ALD patients undergoing transplantation.

Methods

We conducted an in-depth qualitative study of ALD transplant patients. Minimally structured face-to-face interviews explored participants' alcohol-related experiences and their reasons for not using alcohol treatment during the course of their transplantation. Thematic analysis was used to analyze and interpret interview data to understand treatment reluctance based on participants' experiences.

Results

Five major themes were identified among 3 subgroups of patients (pretransplant and posttransplant abstainers and posttransplant relapsers): (i) the “contract” of mandatory abstinence, (ii) the “gap in the program” involving the lack of candour between patient and staff about alcohol-related matters and the lack of addiction services, (iii) a preference by participants to self-manage their alcohol use disorder, (iv) social support as a facilitator of abstinence and the risk of relapse when social support is diminished, and (v) the fear of stigmatization. Each of these factors were dynamically interrelated and differed slightly for each subgroup.

Conclusions

The LT services may benefit from the inclusion of integrated specialist addiction services in their model of care. Such an approach may enhance the acceptability of alcohol treatment and reduce the risk of relapse among ALD transplant participants, especially for those whose social supports have diminished.