bluuebunny/crossref_metadata_2025 huggingface dataset:
Intravenous acetaminophen vs. ketorolac for postoperative analgesia after ambulatory parathyroidectomy
Authors: Anand Amrat , Sprenker Collin J. , Karlnoski Rachel , Norman James , Miladinovic Branko , Wilburn Bruce , Southall Roger A. , Mangar Devanand , Camporesi Enrico
Published: July 2013

Background and methods

Minimally invasive parathyroidectomy requires limited analgesia and short recovery times. The preferred post-operative analgesic regimen for this patient population has not been established but non-narcotic components would be quite appropriate. The aim of the study was to determine whether intravenous (IV) acetaminophen (1 g) or ketorolac (30 mg) provide better pain control after parathyroidectomy. A parallel, randomized, double blind, comparative study was completed on 180 patients scheduled for outpatient parathyroidectomy utilizing general anesthesia. Patients were randomized to a blinded administration of either intravenous acetaminophen 1 g or ketorolac 30 mg intra-operatively. Upon arrival but before premedication, baseline pain scores were assessed in all patients. A consecutive series of postoperative pain scores were collected every 15 min using a 10 cm visual analog pain scale (VAS) upon arrival to the post anesthesia care unit (PACU) until discharge by blinded study personnel. Other data collected included: anesthesia time, surgical time, time to discharge, supplemental morphine and postoperative side effects.

Results

Overall mean postoperative VAS scores were not significantly different between the two treatment groups (p = 0.07). However, ketorolac produced significantly lower pain scores compared with acetaminophen in the later postoperative periods (3.9 ± 1.9 vs. 4.8 ± 2.4 at 45 min, p = 0.009; 3.4 ± 1.7 vs. 4.5 ± 2.1 at 60min, p = 0.04; and 3.2 ± 2.1 vs. 4.4 ± 2.1 at 75 min, p = 0.03). Supplemental morphine was administered to 3 patients in the ketorolac group and 9 patients in the acetaminophen group but total consumption was not significantly different between groups (p = 0.13). The occurrence of nausea was significantly lower in the ketorolac group compared with the IV acetaminophen group (3.4% vs. 14.6%, respectively; p = 0.02). The overall incidence of morphine supplementation, vomiting, headache, muscular pain, dizziness, and drowsiness were not significantly different when compared between the treatment groups.

Conclusions

Both postoperative regimens provided adequate analgesia but patients receiving ketorolac intraoperatively had significantly lower pain scores at later recovery time points and significantly lower occurrences of nausea.

Implications

The large volume of patients undergoing parathyroidectomies at our facility warranted a study to develop a standardized postoperative analgesic regimen. We conclude both medications can be utilized safely in this patient population, but there is a slight advantage in pain control with the usage of ketorolac for minimally invasive parathyroidectomies.
Resources for Business Continuity in Disaster-Based Hospitals in the Great East Japan Earthquake: Survey of Miyagi Prefecture Disaster Base Hospitals and the Prefectural Disaster Medicine Headquarters
Authors: Kudo Daisuke , Furukawa Hajime , Nakagawa Atsuhiro , Yamanouchi Satoshi , Koido Yuichi , Matsumura Takashi , Abe Yoshiko , Konishi Ryota , Matoba Masaaki , Tominaga Teiji , Kushimoto Shigeki
Published: July 2013

Objective

To clarify advance measures for business continuity taken by disaster base hospitals involved in the Great East Japan Earthquake.

Methods

The predisaster situation regarding stockpiles was abstracted from a 2010 survey. Timing of electricity and water restoration and sufficiency of supplies to continue operations were investigated through materials from Miyagi Prefecture disaster medicine headquarters (prefectural medical headquarters) and disaster base hospitals (14 hospitals) in Miyagi Prefecture after the East Japan earthquake.

Results

The number of hospitals with less than 1 day of stockpiles in reserve before the disaster was 7 (50%) for electricity supplies, 8 (57.1%) for water, 6 (42.9%) for medical goods, and 6 (42.9%) for food. After the disaster, restoration of electricity and water did not occur until the second day or later at 8 of 13 (61.5%) hospitals, respectively. By the fourth postdisaster day, 14 hospitals had requested supplies from the prefectural medical headquarters: 9 (64.3%) for electricity supplies, 2 (14.3%) for water trucks, 9 (64.3%) for medical goods, and 6 (42.9%) for food.

Conclusions

The lack of supplies needed to continue operations in disaster base hospitals following the disaster clearly indicated that current business continuity plans require revision. (Disaster Med Public Health Preparedness. 2013;0:1-6)
RISK REALLOCATION IN DEFINED-CONTRIBUTION FUNDED PENSION SYSTEMS
Authors: Beetsma Roel M. W. J. , Bucciol Alessandro
Published: July 2013

This paper explores the introduction of collective risk-reallocation elements into defined-contribution pension contracts. We consider status-contingent, age-contingent, and asset-contingent arrangements to reallocate risk among participants. Eliminating asset market risk for the retired raises their welfare, whereas it lowers the welfare of the workers, despite the fact that they benefit later from the same arrangement. Overall welfare falls. The welfare effects are largest when personal and pension portfolios are optimally chosen. Allowing for intragenerational heterogeneity, the highest-skilled retirees benefit most, whereas the highest-skilled workers lose most. Our main results are qualitatively robust to a number of model variations and extensions.
Atemnot und Gehunfähigkeit
Authors: Schuster Stefanie , Diethelm Markus
Published: July 2013

Wir berichten über einen 73-jährigen Patienten mit schwerer Exazerbation einer chronisch-obstruktiven Pneumopathie. Unter Therapie mit Glukokortikoiden und sequenziell zwei verschiedenen Chinolonen kam es zu einer beidseitigen Achillessehnenruptur. Wir diskutieren die Häufigkeit dieser Komplikation, die diagnostischen Methoden und die möglichen Therapieoptionen.
Effektivität alltagsintegrierter Sprachförderung bei ein- und zwei- bzw. mehrsprachig aufwachsenden Vorschulkindern
Authors: Jungmann Tanja , Koch Katja , Etzien Maria
Published: July 2013

Kinder mit Migrationshintergrund können aufgrund ihrer mangelnden Sprachbeherrschung Bildungschancen häufig nicht optimal nutzen. Daher kommt der frühen Sprachförderung ein wichtiger Stellenwert zu. Aufgrund der eher enttäuschenden Befunde zur Effektivität spezifischer Sprachförderprogramme hat die Forderung nach alltagsintegrierten Sprachfördermaßnahmen Eingang in die Bildungskonzeptionen aller Länder gefunden. Systematische Überprüfungen ihrer Effektivität und der Wirkfaktoren stehen noch aus. Im Rahmen der Umsetzung der Bildungskonzeption für 0- bis 10-jährige Kinder in Mecklenburg-Vorpommern (M-V) nahmen N = 27 Fachkräfte aus N = 19 Kitas an einer Fortbildungsreihe zur alltagsintegrierten Sprachförderung teil. Zur Erfassung und Sicherung der Umsetzungsqualität der Fortbildungsinhalte wurde vor, während und nach der Fortbildung die sprachförderliche Qualität der ErzieherInnen-Kind-Interaktionen anhand von Videos eingeschätzt. Der Sprachentwicklungsstand der insgesamt N = 263 Kinder, davon n = 23 zwei- oder mehrsprachig aufwachsend, wurde vor Beginn der Fortbildung (Prätest) und sechs Monate später (Posttest) mit dem SETK 3 – 5 erfasst. Im Prätest wurden 19 % der einsprachig deutschen Kinder, aber mehr als die Hälfte der zwei- oder mehrsprachig aufwachsenden Kinder als sprachauffällig identifiziert. Über die Zeit zeigten alle Kinder ein signifikantes Aufholwachstum. Insgesamt profitieren sprachlich auffällige Kinder stärker von der alltagsintegrierten Sprachförderung als sprachlich unauffällige. Implikationen der Ergebnisse und methodische Einschränkungen werden diskutiert.
Effekte kombinierter Förderprogramme zur phonologischen Bewusstheit und zum Sprachverstehen auf die Entwicklung der phonologischen Bewusstheit von Kindergartenkindern mit und ohne Migrationshintergrund
Authors: Pröscholdt Marie Verena , Michalik Annette , Schneider Wolfgang , Duzy Dagmar , Glück Daniela , Souvignier Elmar , Penner Zvi
Published: July 2013

Es werden Befunde einer Langzeitstudie berichtet, in der die kombinierte Wirkung eines für Kinder mit Migrationshintergrund entwickelten sprachlichen Frühförderprogramms und eines phonologischen Bewusstheitstrainings erfasst werden sollte. Insgesamt 439 Kinder nahmen ab Beginn des vorletzten Kindergartenjahrs an der Untersuchung teil. Während in einer Trainingsgruppe (EG1) beide Förderprogramme in einem Zeitraum von etwa zwei Jahren sukzessiv durchgeführt wurden, wurde für die zweite Trainingsgruppe (EG2) eine fusionierte Version beider Programme zusammengestellt und ebenfalls in einem Zeitraum von zwei Jahren erprobt. Als Kontrollgruppe (KG) fungierten 156 Kindergartenkinder, die allesamt das phonologische Bewusstheitstraining absolvierten, jedoch keine spezifische Sprachförderung erhielten. Der Vergleich von Prä- und Posttestwerten ergab für alle Trainingsvarianten insofern positive Effekte, als sich unabhängig vom Migrationsstatus statistisch und praktisch bedeutsame Zugewinne in der phonologischen Bewusstheit fanden. Da sich die KG in allen erfassten Bereichen mindestens ebenso gut entwickelte wie die beiden EGs, ist anzunehmen, dass die zusätzliche Förderung mit dem spezifischen Sprachförderprogramm nur geringe positive Effekt verzeichnete.
Low-temperature water dynamics in an aqueous methanol solution
Authors: Bertrand C. E. , Chiang W.-S. , Tyagi M. , Chen S.-H.
Published: July 2013

An aqueous methanol solution (xMeOH = 0.30) has been studied by quasielastic neutron scattering. The single-particle water dynamics were effectively isolated by employing deuterated methanol. A smooth dynamic transition to a sub-Arrhenius temperature dependence has been observed in the relaxation times. We associate this behavior with the formation of small crystallites in the system. These findings are compared with molecular dynamics simulations and previous nuclear magnetic resonance measurements. We discuss possible dynamic signatures of structuring in the mixture.
Narrow versus broad asymmetric waveguides for single-mode high-power laser diodes
Authors: Ryvkin Boris S. , Avrutin Eugene A. , Kostamovaara Juha T.
Published: July 2013

We investigate numerically the effect of the optical confinement layer thickness on the far field properties (far field shape and input efficiency) and confinement factor of an asymmetric-waveguide high power laser diode. A strong correlation is found between the confinement and input efficiency. It is shown that the far field properties of lasers with narrow asymmetric structures tend to be superior to those of broad waveguide ones with a similar confinement factor.
Simultaneous imaging of surface and magnetic forces
Authors: Forchheimer Daniel , Platz Daniel , Tholén Erik A. , Haviland David B.
Published: July 2013

We demonstrate quantitative force imaging of long-range magnetic forces simultaneously with near-surface van-der-Waals and contact-mechanics forces using intermodulation atomic force microscopy. Magnetic forces at the 200 pN level are separated from near-surface forces at the 30 nN level. Imaging of these forces is performed in both the contact and non-contact regimes of near-surface interactions.
Optical tweezers assisted quantitative phase imaging led to thickness mapping of red blood cells
Authors: Cardenas Nelson , Mohanty Samarendra K.
Published: July 2013

Quantitative phase microscopy (QPM) allows dynamic mapping of optical path length of microscopic samples with high temporal and axial resolution. However, decoupling of the geometric thickness from the refractive index in phase measurements is challenging. Here, we report use of optical tweezers combined with QPM for decoupling geometric thickness from the refractive index. This is demonstrated by orienting the microscopic sample (red blood cell) by optical tweezers and imaging the phase at various orientations. Since optical tweezers can orient wide variety of micro and nanoscopic objects, this integrated method can be employed to accurately determine their physical properties.
Usefulness of a virtual community of practice and Web 2.0 tools for general practice training: experiences and expectations of general practitioner registrars and supervisors
Authors: Barnett Stephen , Jones Sandra C. , Bennett Sue , Iverson Don , Bonney Andrew
Published: July 2013

General practice training is a community of practice in which novices and experts share knowledge. However, there are barriers to knowledge sharing for general practioner (GP) registrars, including geographic and workplace isolation. Virtual communities of practice (VCoP) can be effective in overcoming these barriers using social media tools. The present study examined the perceived usefulness, features and barriers to implementing a VCoP for GP training. Following a survey study of GP registrars and supervisors on VCoP feasibility, a qualitative telephone interview study was undertaken within a regional training provider. Participants with the highest Internet usage in the survey study were selected. Two researchers worked independently conducting thematic analysis using manual coding of transcriptions, later discussing themes until agreement was reached. Seven GP registrars and three GP supervisors participated in the study (average age 38.2 years). Themes emerged regarding professional isolation, potential of social media tools to provide peer support and improve knowledge sharing, and barriers to usage, including time, access and skills. Frequent Internet-using GP registrars and supervisors perceive a VCoP for GP training as a useful tool to overcome professional isolation through improved knowledge sharing. Given that professional isolation can lead to decreased rural work and reduced hours, a successful VCoP may have a positive outcome on the rural medical workforce.
Critiquing circumcision: in search of a new paradigm for conceptualizing genital modification
Authors: Androus Zachary T.
Published: July 2013

In this article, I advance two separate but related critiques of current approaches to classifying and analyzing culturally, socially, and medically motivated genital modifications: first that the widely employed categories of female circumcision and male circumcision separate these practices in gendered terms that are inconsistent with both the reality of these practices and fundamental social scientific principles, and second that the practice of neonatal male circumcision that emerged from Anglophone medical practice to become an entrenched social norm in the United States merits a critical evaluation beyond that which it has heretofore been subjected. These critiques lead me to propose an alternative approach to the conceptual classification of genital modification practices, one in which the extent of the modification, the meanings of the practice to those involved, whether it is motivated by a group or individual desire, and the developmental stage of the individual form a framework for analysis, rather than the geographically and gender-based approaches that have resulted in the profoundly ethnocentric exceptionalism that characterizes most current research, writing, and activism on the matter. The differential attention paid to male and female circumcision fails to reflect the cultural sensibilities of those whose practices are in question and creates a de facto exceptionalism by which US practices are exempted from the same scrutiny afforded by others. I address specifically the gendered approach to African circumcision practices, including the recent attention that male circumcision has received as a potential anti-HIV intervention, and I argue the need for a much more vigorously critical scholarly attention to US circumcision practices. My approach is influenced by critical medical anthropology, which frames its inquiries around a focus on the human body and which does not accept biomedical knowledge as factual a priori, but rather seeks to contextualize it within the socially and culturally relevant system of knowledge that has produced it. I draw also on the history of circumcision, campaigns for both its promulgation and elimination, and my own ethnographic work with US parents on how they make the decision whether to circumcise their newborn sons.
Interaction between AP-5 and the hereditary spastic paraplegia proteins SPG11 and SPG15
Authors: Hirst Jennifer , Borner Georg H. H. , Edgar James , Hein Marco Y. , Mann Matthias , Buchholz Frank , Antrobus Robin , Robinson Margaret S.
Published: July 2013

The AP-5 complex is a recently identified but evolutionarily ancient member of the family of heterotetrameric adaptor proteins (AP complexes). It is associated with two proteins that are mutated in patients with hereditary spastic paraplegia, SPG11 and SPG15. Here we show that the four AP-5 subunits can be coimmunoprecipitated with SPG11 and SPG15, both from cytosol and from detergent-extracted membranes, with a stoichiometry of ∼1:1:1:1:1:1. Knockdowns of SPG11 or SPG15 phenocopy knockdowns of AP-5 subunits: all six knockdowns cause the cation-independent mannose 6-phosphate receptor to become trapped in clusters of early endosomes. In addition, AP-5, SPG11, and SPG15 colocalize on a late endosomal/lysosomal compartment. Both SPG11 and SPG15 have predicted secondary structures containing α-solenoids related to those of clathrin heavy chain and COPI subunits. SPG11 also has an N-terminal, β-propeller–like domain, which interacts in vitro with AP-5. We propose that AP-5, SPG15, and SPG11 form a coat-like complex, with AP-5 involved in protein sorting, SPG15 facilitating the docking of the coat onto membranes by interacting with PI3P via its FYVE domain, and SPG11 (possibly together with SPG15) forming a scaffold.
The Effect of Transpedicular Screw Design on Its Performance in Vertebral Bone Under Tensile Loads
Authors: Alkaly Ron N. , Bader Dan L.
Published: July 2013

Study Design:

A biomechanical study using bovine thoracolumbar spines.

Objective:

To study investigated whether thread design parameters aimed at altering the state of stress at the screw-bone interface increase the screw’s holding power.

Summary and Background Data:

Internal spinal fixators utilizing transpedicular screw fixation are used to achieve early stabilization of the injured spine in a range of clinical conditions. Despite advances in the design of internal spinal fixation systems, implant loosening, and catastrophic failures at the screw-bone interface remains a serious complication in adult spine surgery. Although the performance of the screws in the vertebral bone critically depends on ability of screw thread design to provide and maintain adequate bone purchase, the effect of individual thread design parameters on screw performance and the failure process of the screw-bone interface, remains unclear.

Methods:

On the basis of the AO Schanz thread, this parametric study used 96 lumbar bovine vertebrae instrumented with 19 screw designs to investigate the effects of pitch, ratio of major to minor diameter, screw insertion depth, and major diameter, on screw performance under pure tensile loading. The effect of vertebral morphometry on screw performance and the extent of damage within the failed screw-bone interface were evaluated.

Results:

The increase in screw insertion depth, screw pitch, and the ratio of major to minor diameter, significantly affected screw performance under tensile loads. Complex interactions existed between the major diameter and each of the design variables. Vertebral morphometry had little effect on screw performance while the damage within the failed bone-screw interface confined to the immediate region of the screw threads.

Conclusions:

Design variables, able to reduce shear stresses or modify the complex stress profile at the bone-screw interface, are more effective in preventing early failure of the interface.
Getting it done on time
Authors: Fourie Ina , Fourie Herman
Published: July 2013

Purpose

The purpose of this contribution is to focus on an essential issue in all workplace settings where the emphasis is on productivity, time management and creativity: getting innovative, high quality work completed on time according to tight schedules – often facing serious staff shortages. The intention is not to offer an ultimate answer, but to take a different look at the issues that might bring some answers, or that might inspire research projects in the “own” circles of libraries and information services. What does it take to get quality work completed on time?

Design/methodology/approach

The contribution is written against the background of research from time management, productivity, learning styles, information behaviour and collaborative work.

Findings

There might be simplistic solutions on offer to get work done on time such as the use of productivity and time management tools. When the aim is high quality, creativity and innovative work (done on time), there might be a need to consider more issues such as learning styles and whole brain learning; information seeking skills, writing skills and streamlining cognitive skills; a focus on productivity; brain health and maintaining a balanced life style; perceptions of stimulating creativity; recognition of the need to complement human weaknesses with collaborative strengths; and the need for flow as argued by Csikszentmihalyi.

Originality/value

Although many publications have appeared on time management, productivity, software to support time management and other individual issues noted in this paper, the authors are not aware of work (at least not in the field of library and information science) that combine these with the need to consider learning styles, whole brain learning, acknowledging the limitations of mind and body, and addiction to adrenaline that might stimulate inspiration and creativity – among many things that might impact on time management.
Connecting industry and supply chain management education: exploring challenges faced in a SCM consultancy module
Authors: Bak Ozlem , Boulocher‐Passet Véronique
Published: July 2013

Purpose

Consultancies provide a beneficial teaching tool in linking industry with supply chain education. With the scarcity of supply chain talent and real life experience, there is a real interest in using consultancy modules to bring the two worlds closer. This research paper aims to explore the challenges faced by key stakeholders (clients, lecturers and students) who participate in a supply chain management (SCM) consultancy module.

Design/methodology/approach

Case study methodology is used to describe the challenges faced by the stakeholders in running a SCM consultancy module. Using the existing literature on consultancy module challenges as a point of departure, this paper explores these challenges within a SCM consultancy module. A triangulated research approach allowed capturing the views of the key stakeholders.

Findings

The findings confirmed that the case entailed all initial 13 challenges faced by key stakeholders, as well as four more challenges (health and safety risks; expertise assessment; depicting supply chain management boundaries; and SCM consultancy skills) which were relevant to the SCM field.

Research limitations/implications

The paper offers an insight into the challenges of teaching a supply chain management consultancy module and addresses the issues for academics to bridge the divide between theory and practice.

Practical implications

This paper assists supply chain educators in consultancy module development and helps companies willing to participate in such modules prepare for the challenges that they will encounter. It also contributes to debate on SCM difficulties in building business‐university collaboration.

Originality/value

Consultancy challenges observed in higher education have been based on individual cases and mainly covered in the marketing literature. This paper is the first case study that depicts all consultancy module challenges faced by key stakeholders and within the supply chain management subject; it highlights some subject relevant challenges for supply chain educators.
Impact of environmental scanning on the organisational performance of local authorities in Malaysia
Authors: Fadzli Ahmad Tajuddin Ahmad , Zamberi Ahmad Syed
Published: July 2013

Purpose

Previous studies on scanning behaviour focused mainly on the performance of the private sector, leaving the public sector, especially local authorities (LAs), largely understudied. Primarily, this paper aims to examine the element of strategic management tools associated with the impact of environmental scanning (ES) on organisational performance in the LAs. It explores the above relationship in the context of public sector organisations in Malaysia.

Design/methodology/approach

A quantitative approach has been used for this study where the data were collected through a mail survey (n=75) of local authorities in Malaysia, which consists of four categories – City Council/City Hall, Municipal Council, District Council and organisations that exercise the functions of local authorities.

Findings

Overall, the results show that the scope of general environmental scanning is seen as a prerequisite to the successful alignment of competitive strategies as a result of changing the needs and demands of the larger society, and the diverse nature of businesses. In the context of Malaysian LAs, there is a significant relationship between the environmental scanning (operation) and the overall achievement of the organisation's performance.

Research limitations/implications

This paper is limited to the Malaysian context, and, hence, the findings cannot be applied generally.

Practical implications

This study could be used effectively as a road map to assist the council members, senior staff and stakeholders in evaluating their success and steering the organisation's performance and sustainability.

Originality/value

This paper provides important insights into the performance of local governments in Malaysia. To the authors' knowledge, this study is the first attempt to look at a more holistic perspective in exploring environmental scanning of LAs in the country. Increased understanding in this area is of critical importance in relation to implementing effectively the current and future modernisation and reform initiatives. It is of interest to both researchers and practitioners.
Lemonade from Lemons: The Taphonomic Effect of Lawn Mowers on Skeletal Remains
Authors: Martin DC , Dabbs Gretchen R. , Roberts Lindsey G.
Published: July 2013

This study provides a descriptive analysis of the taphonomic changes produced by passing over skeletonized remains (n = 4, Sus scrofa) with three common lawn mowers. Two skeletons were mowed over with a riding lawn mower set at multiple blade heights (10.16, 7.62, 5.08 cm) and one each with a rotary mower (9.53, 6.35 cm) and a mulching mower (6.35 cm). Results show that different types of common lawn mowers will produce different patterns of bone dispersal and fragmentation rates. Overall, skeletal elements projecting upward from the surface frequently exhibited a sheared morphology characterized by a smooth, flat, cut surface (7.0–7.6% of elements). The push mowers yielded a higher frequency of undamaged bone than the riding mower (54.8–61.2% vs. 17.7%), and the riding mower created more catastrophic damage to skeletal elements. Additionally, each mower produced a distinct dispersal pattern of skeletal fragments. The dispersal patterns have been identified as “bull's‐eye” (riding), circular (mulching), and discontinuous rectangle (rotary).
Raman Spectroscopy as a Simple, Rapid, Nondestructive Screening Test for Methamphetamine in Clandestine Laboratory Liquids
Authors: Triplett Jeremy S. , Hatfield Jennifer A. , Kaeff Tracy L. , Ramsey Christopher R. , Robinson Susan D. , Standifer Allison F.
Published: July 2013

Raman spectroscopy has found increased use in the forensic controlled substances laboratory in recent years due to its rapid and nondestructive analysis capabilities. Here, Raman spectroscopy as a screening test for methamphetamine in clandestine laboratory liquid samples is discussed as a way to improve the efficiency of a laboratory by identifying the most probative samples for further workup among multiple samples submitted for analysis. Solutions of methamphetamine in ethanol, diethyl ether, and Coleman fuel were prepared in concentrations ranging from 0.5% to 10% w/v, and Raman spectra of each were collected. A concentration‐dependant Raman peak was observed at 1003 per cm in each solution in 4% w/v and greater solutions. Case samples were analyzed and also found to reliably contain this diagnostic peak when methamphetamine was present. The use of this diagnostic indicator can save the forensic controlled substances laboratory time and materials when analyzing clandestine laboratory liquid submissions.
Immunoadsorption for Pregnancy‐Associated Severe Acquired Hemophilia
Authors: Zeitler Heike , Ulrich‐Merzenich Gudrun , Marquardt Natascha , Oldenburg Johannes , Goldmann Georg
Published: July 2013

Postpartum hemorrhage is a common cause of maternal mortality. Acquired hemophilia (AH) is a rare, life‐threatening bleeding disorder induced by autoantibodies against coagulation factors (inhibitors). We report about eight patients with postpartum AH (out of 82). Seven AH patients with severe bleeding complications were treated by the “Modified Bonn‐Malmö Protocol (MBMP)” which consists of inhibitor elimination via immunoadsorption (IA) in combination with immunosuppression and high‐dose Factor VIII substitution. One patient was treated only by immunosuppression. Seven out of eight patients with severe AH and mean inhibitor titers (IT) of 118 BU/mL were referred to our center. They were severe cases with a median delay of diagnosis of 30.5 days (range 7–278 days). After a median of 3 IA sessions (range 3–5 days), no inhibitor was detectable. The factor substitution was discontinued after a median of 13 IA sessions (range 8–24 days) and IA was terminated after a median of 15 sessions (range 9–27 days). One less severe affected patient (IT: 2.1 BU/mL) received prednisolone (1.5 mg/kg BW) for 120 days. Complete remission was achieved in all patients with a median follow‐up of 100 months (range 56–126 m). The delayed diagnosis of pregnancy‐associated AH leads to a high bleeding risk with bleeding associated complications. Immunoadsorption offers an important treatment option in severe AH, enabling a fast reconstitution of the blood coagulation with a reduced time for the Factor VIII substitution and for immunosuppressive treatment. In cases of postpartum bleeding the diagnosis of AH should be routinely considered.
Is the extant southern short‐tailed opossum a pigmy sabretooth predator?
Authors: Blanco R. E. , Jones W. W. , Milne N.
Published: July 2013

Hypertrophied canines evolved several times among mammalian carnivores. Several palaeobiological hypotheses related to sabretooth evolution and killing behaviours have been suggested based on biomechanical and functional considerations. However, the lack of well‐studied extant analogues makes it difficult to test these hypotheses. Here we propose the South American short‐tailed opossum Monodelphis dimidiata as a living analogue of extinct sabretooth predators. Our morphological analysis shows that M. dimidiata not only has relatively the largest canines among extant marsupial carnivores, but they are also within the range of those of sabretooth predators. It also has cranial adaptations for a wide gape typical of sabretooth carnivores. The small body size of this species allows further biological studies that can provide useful information to understand the evolution, behaviour and physiology of extinct sabretooth carnivores.
The Uses of Lacan in Recent British Romantic Studies
Authors: Garofalo Daniela
Published: July 2013

The Uses of Lacan examines romantic literary criticism that engages with Lacanian psychoanalytic theory and shows how this approach has offered new ways to engage with important issues of the period.
Humanist Hagiography in England, c. 1480 – c. 1520
Authors: Henry Joni
Published: July 2013

In late medieval and early Tudor England, a handful of humanist writers attempted to combine the traditional religious genre of hagiography with humanist literary style, a style newly fashionable in England, which sought to imitate classical Latin literature. This created a strange hybrid genre: the humanist hagiography. The genre attracted some of the leading literary figures of late fifteenth‐ and early sixteenth‐century England, including the Tudor court poets, Pietro Carmeliano and Bernard André, the prolific humanist translator, Alexander Barclay, and the printer, Richard Pynson. Their humanist saints' lives experimented with classical Latin metres and were among the first works in England to adopt humanist script, printing and publishing practices. Despite this, they have been largely ignored by modern scholars, with the notable exception of David Carlson. This article introduces the most important examples, Carmeliano's Life of St Katherine, André's Hymni Christiani and Barclay's translation of Mantuan's Life of St George, discusses recent studies of these works, and suggests further areas for research in this largely and unjustly neglected field. The humanist hagiographies of England deserve more scholarly attention; they are a fascinating late example of medieval hagiography's rich tradition of reinvention and innovation, as well as important reminders of the centrality of religion in early English humanism.
Global distribution ofRisso's dolphinGrampus griseus: a review and critical evaluation
Authors: Jefferson Thomas A. , Weir Caroline R. , Anderson R. Charles , Ballance Lisa T. , Kenney Robert D. , Kiszka Jeremy J.
Published: July 2013

The global range ofRisso's dolphinGrampus griseusis not well known, and there has been confusion in the literature as to whether the species has a broad, circumglobal range or only occurs along continental margins.

To clarify the species' distribution and habitat preferences, we compiled and reviewed all available (published and unpublished) records of sightings and captures of this species for the past 62 years (1950–2012,n = 8068 records). Stranding records were not included.

The results showed that the species has a range that extends across ocean basins and spans between at least 64°N and 46°S, and is apparently absent from high‐latitude polar waters. Although Risso's dolphins occur in all habitats from coastal to oceanic, they show a strong range‐wide preference for mid‐temperate waters of the continental shelf and slope between 30° and 45° latitude.

Although a number of misconceptions about the distributional ecology of Risso's dolphin have existed, this analysis showed that it is a widespread species. It strongly favours temperate waters and prefers continental shelf and slope waters to oceanic depths. These habitat preferences appear to hold throughout much or all of the species' range.
New Model Introductions, Cannibalization and Market Stealing: Evidence from Shopbot Data
Authors: Haynes Michelle , Thompson Steve , Wright Peter W.
Published: July 2013

Incremental innovation plays an important role in competitive conduct in high‐tech industries. This paper explores the impact of new model introduction by employing a nested logit specification to investigate the determination of market shares across and within submarkets for a panel of 336 digital cameras. Our results confirm the existence of pronounced life cycle effects and the existence of statistically significant market stealing and cannibalization effects, particularly associated with the introduction of a technologically superior entrant into the model's market segment. The paper reveals significant differences in market outcomes, in both elasticity and response to entry, across submarkets.
Early‐onset neonatal sepsis in Dhaka, Bangladesh: risk associated with maternal bacterial colonisation and chorioamnionitis
Authors: Chan Grace J. , Baqui Abdullah H. , Modak Joyanta K. , Murillo‐Chaves Adriana , Mahmud Abdullah A. , Boyd Theonia K. , Black Robert E. , Saha Samir K.
Published: July 2013

Objective

To estimate the risk of early‐onset neonatal sepsis among newborns of mothers with chorioamnionitis and/or bacterial colonisation in Dhaka.

Methods

We conducted a cohort study at a maternity centre following 600 mother–newborn pairs. Women with a positive bacterial vaginal culture or positive Group B streptococcus (GBS) rectal culture during labour were classified as colonised. Women with placental histopathology demonstrating signs of maternal or foetal inflammation were classified as having chorioamnionitis. Newborns were followed over the first 7 days of life. The primary outcome measure was physician or community health worker diagnosis of neonatal sepsis following modified World Health Organization Integrated Management of Childhood Illnesses criteria. Survival analysis was conducted with non‐parametric, parametric and semiparametric models.

Results

Of the 600 mother–newborn pairs, 12.8% of newborns were diagnosed with early‐onset sepsis. Five hundred and forty‐three women had both colonisation and chorioamnionitis data, 55.4% of mothers were non‐exposed, 31.7% were only colonised and 12.9% had chorioamnionitis regardless of colonisation status.

After adjusting for birthweight, sex, maternal characteristics and wealth, newborns of only colonised mothers developed sepsis 63% faster and had a 71% higher risk of developing sepsis than their non‐exposed counterparts (RT = 0.37, 95% CI 0.14–1.03; RH = 1.71, 95% CI 1.00–2.94). Newborns of mothers with chorioamnionitis developed sepsis 74% faster and had a 111% higher risk of developing sepsis (RT = 0.26, 95% CI 0.07–0.94; RH = 2.11, 95% CI 1.06–4.21).

Conclusions

Newborns born to mothers with colonisation or chorioamnionitis developed sepsis faster and were at higher risk of developing sepsis in Dhaka.
Investigation of Streamwise and Transverse Instabilities on Swept Cylinders and Implications for Turbine Blading
Authors: Gostelow J. P. , Rona A. , De Saint Jean M. , Garrett S. J. , McMullan W. A.
Published: June 2013

The starting point for this investigation was the observation of robust streamwise streaks in flow visualization on the suction surfaces of blades in a turbine cascade at subsonic and transonic speeds. The spanwise wavelength of an array of streamwise vortices had been predicted and is here confirmed experimentally. Observations of streaks on unswept turbine blades and on circular cylinders confirmed these earlier predictions, providing a firm basis for referencing the new measurements of vortical behavior. The observations made it clear that the boundary layers are highly three dimensional. In this paper observations of streamwise and transverse instabilities on swept circular cylinders, over a range of inclinations, are presented. The circular cylinder is a canonical case and observations relate the streamwise vorticity of the unswept case to the more aggressive crossflow instability at high sweep angles. Introducing sweep brings consideration of a wide range of instabilities. Prominent is crossflow instability resulting from the inflectional behavior of a three-dimensional boundary layer.
Unsteady Rotor Hub Passage Vortex Behavior in the Presence of Purge Flow in an Axial Low Pressure Turbine
Authors: Jenny P. , Abhari R. S. , Rose M. G. , Brettschneider M. , Engel K. , Gier J.
Published: June 2013

The paper presents an experimental and computational study of the unsteady behavior of the rotor hub passage vortex in an axial low-pressure turbine. Different flow structures are identified as having an effect on the size, strength, shape, position, and the unsteady behavior of the rotor hub passage vortex. The aim of the presented study is to analyze and quantify the sensitivities of the different flow structures and to investigate their combined effects on the rotor hub passage vortex. Particular attention is paid to the effect of the rim seal purge flow and of the unsteady blade row interaction. The rotor under investigation has nonaxisymmetric end walls on both hub and shroud and is tested at three different rim seal purge flow injection rates. The rotor has separated pressure sides at the operating point under investigation. The nondimensional parameters of the tested turbine match real engine conditions. The 2-sensor fast response aerodynamic probe (FRAP) technique and the fast response entropy probe (FENT) systems developed by ETH Zurich are used in this experimental campaign. Time-resolved measurements of the unsteady pressure, temperature and entropy fields between the rotor and stator blade rows are taken and analyzed. Furthermore, the results of URANS simulations are compared to the measurements and the computations are also used to detail the flow field. The experimental results show a 30% increase of the maximum unsteadiness and a 4% increase of the loss in the hub passage vortex per percent of injected rim seal cooling flow. Compared to a free stream particle, the rim seal purge flow was found to do 60% less work on the rotor.
Tip-Shaping for HP Turbine Blade Aerothermal Performance Management
Authors: Zhang Q. , He L.
Published: June 2013

A large portion of the over-tip leakage flow is often transonic for a typical high pressure (HP) turbine blade. It has been observed that the tip heat transfer is noticeably lower in a high speed flow tip region than in a low speed region. The present study therefore investigates the feasibility of controlling blade heat transfer by tip shaping to locally accelerate the flow to a transonic regime. The results show that a significant heat load reduction can be achieved by the local flow acceleration. Such over-tip-shaping provides a great potential as an effective means to control heat load distribution (and hence thermal stress) over the blade tip surface. The feasibility of the concept and flow physics have been demonstrated in detail by CFD analyses, with and without the effect of moving casing. The experimental results obtained from a high speed linear cascade facility have also been presented. The novel tip-shaping concept proposed in this paper could provide a potential for promoting choking inside the tip gap as a new way to control the over-tip leakage mass flow.
Unsteady Interaction Between Annulus and Turbine Rim Seal Flows
Authors: Chilla Martin , Hodson Howard , Newman David
Published: June 2013

In core gas turbines relatively cold air is purged through the hub gap between the stator and rotor in order to seal the disk space against flow ingestion from the main annulus. Although the sealing mass flow rate is commonly very small compared to the main annulus mass flow rate, it can have significant effects on the development of the passage endwall flows and on the overall loss generation. In this paper, the interaction between the annulus and rim sealing flows is investigated using numerical simulations of a generic high-pressure turbine. At first, the numerical approach is validated by comparing the results of calculations to measurement data at the design flow conditions. Following that, results from steady and unsteady calculations are used to describe in detail the aerodynamics in overlap-type rim seals and their effects on the blade passage flow. It is found that the flow interaction at the rim seal interface is strongly influenced by the velocity deficit of the rim sealing flow relative to the annulus flow as well as by the circumferentially nonuniform pressure field imposed by the rotor blades. At typical sealing flow conditions, the flow interaction at the rim seal interface is found to be naturally unsteady, with periodical vortex shedding into the rotor passage. The rim seal geometry, in particular close to the annulus interface, is found to have an effect on the frequency of the shedding process. Finally, it is shown that the rim seal flow interaction can be stabilized by increasing either the sealing mass flow rate or the sealing tangential velocity.
A Multiaxis Programmable Robot for the Study of Multibody Spine Biomechanics Using a Real-Time Trajectory Path Modification Force and Displacement Control Strategy
Authors: Kelly Brian P. , DiAngelo Denis J.
Published: July 2013

Robotic testing offers potential advantages over conventional methods including coordinated control of multiple degrees of freedom (DOF) and enhanced fidelity that to date have not been fully utilized. Previous robotic efforts in spine biomechanics have largely been limited to pure displacement control methods and slow quasi-static hybrid control approaches incorporating only one motion segment unit (MSU). The ability to program and selectively direct single or multibody spinal end loads in real-time would represent a significant step forward in the application of robotic testing methods. The current paper describes the development of a custom programmable robotic testing system and application of a novel force control algorithm. A custom robotic testing system with a single 4 DOF serial manipulator was fabricated and assembled. Feedback via position encoders and a six-axis load sensor were established to develop, program, and evaluate control capabilities. A calibration correction scheme was employed to account for changes in load sensor orientation and determination of spinal loads. A real-time force control algorithm was implemented that employed a real-time trajectory path modification feature of the controller. Pilot tests applied 3 Nm pure bending moments to a human cadaveric C2–T1 specimen in flexion and extension to assess the ability to control spinal end loads, and to compare the resulting motion response to previously published data. Stable accurate position control was achieved to within ±2 times the encoder resolution for each axis. Stable control of spinal end body forces was maintained to within a maximum error of 6.3 N in flexion. Sagittal flexibility data recorded from rostral and caudally placed six-axis load sensors were in good agreement, indicating a pure moment loading condition. Individual MSU rotations were consistent with previously reported data from nonrobotic protocols. The force control algorithm required 5–10 path iterations before converging to programmed end body forces within a targeted tolerance. Commercially available components were integrated to create a fully programmable custom 4 DOF gantry robot. Individual actuator performance was assessed. A real-time force control algorithm based on trajectory path modification was developed and implemented. Within a reasonable number of programmed path iterations, good control of spinal end body forces and moments, as well as a motion response consistent with previous reported data, were obtained throughout a full physiologic flexion-extension range of motion in the human subaxial cervical spine.
Gas-Filled Encapsulated Thermal-Acoustic Transducer
Authors: Tong L. H. , Lim C. W. , Li Y. C.
Published: July 2013

A new model for a gas-filled encapsulated thermal-acoustic transducer, which uses newly devised carbon nanotube (CNT) thin film is developed and the exact and approximate solutions are derived. A comparison between theoretical prediction and experimental data is presented and excellent agreement is reported. The frequency response for this acoustic transducer is investigated and the acoustic response of as a function of window–thin-film distance of the encapsulated transducer is discussed. An optimal distance between window and thin film is successfully derived and used in some practical examples. Resonance takes place for a suitable input frequency, and thus such transducers can be used to either generate acoustic waves of specific frequency or to filter specific resonant frequencies from a wide spectrum of signals. This kind of transducer can be immersed in different liquid media. A gaseous medium shows better performance at lower frequency while it is otherwise for a liquid medium. The conclusions derived in this work could be regarded as effective guidelines and information for enhancing thermal-acoustics efficiency conversion, as well as for the optimal design of a thermal-acoustic transducer.