bluuebunny/crossref_metadata_2025 huggingface dataset:
Reconstruction of post‐traumatic drop foot deformity by the chimeric deep inferior epigastric artery perforator free flap associated with a composite quadriceps osteotendinous graft
Authors: Ayestaray Benoit , Elbaz Matthias , Lelievre Henri , Scharyki Stéphane , Foufa Adnan
Published: June 2015

Dorsiflexor tendons are particularly exposed in crush injury of the foot. Anterior tibialis tendon defects may be responsible for a steppage gait and a drop foot deformity. Drop foot reconstruction is challenging because of the high risk of postoperative adhesions and functional sequelae. In this report, we present the results of the reconstruction of post‐injury anterior tibialis tendon defects with chimeric deep inferior epigatric artery perforator (DIEP) free flap associated with a quadriceps osteotendinous graft in two patients. Two men (32‐year‐old and 19‐year‐old) presented drop foot deformity with defect of the anterior tibialis tendon secondary to a crush injury. The sizes of the soft tissues defects at the foot dorsum were 24 cm × 8 cm and 20 cm × 8 cm, respectively. The quadriceps osteotendinous grafts were used to reconstruct the anterior tibialis tendon in both patients. The chimeric DIEP free flaps with skin paddles (24 cm × 8 cm and 20 cm × 8 cm) and rectus abdominis fascia (24 cm × 4 cm and 20 cm × 4 cm) were used for reconstruction. The skin component based on a musculocutaneous perforator was used for soft tissue reconstruction of the foot dorsum. The fascial component based on a second perforator was used to create a sliding surface around the osteotendinous graft. Postoperative course was uneventful. Rehabilitation lasted 3 months. The range of ankle movement was measured during 12 months. The first patient recovered 10 degree of dorsiflexion. The second patient recovered 25 degree of dorsiflexion. Walk recovery was satisfying in both patients. The single‐stage procedure using the chimeric DIEP free flap may be an option for post‐injury drop foot reanimation. Creating a sliding surface around a composite osteotendinous quadriceps graft with a vascularized fascial component avoid postoperative peritendinous adhesions. This technique may improve foot dorsiflexion and walk recovery. © 2015 Wiley Periodicals, Inc. Microsurgery 36:334–338, 2016.
Reconstruction of posterior compartment of lower extremity using a functional latissimus dorsi free flap: A case report
Authors: Rednam Rukmini S. , Rinker Brian D.
Published: June 2015

We present an unusual case in an 8‐year‐old male that presented with a severe crushing injury to the right lower extremity with grade IIIB open tibia/fibula fracture and composite loss of the majority of the posterior muscle compartments and overlying skin and segmental loss of the tibial nerve. Composite reconstruction was performed with internal fixation, cable autografting of the tibial nerve, and a functional latissimus dorsi musculocutaneous flap. A motor branch of the tibial nerve to the soleus was used as the donor motor nerve. The patient achieved a bony union and began ambulating at 8 weeks postoperatively. At 24 months, the patient was running and jumping with plantar push‐off. Recovery of plantar flexion was to the M5 level. Static and moving 2‐point discrimination of the plantar foot was 8 mm and 6 mm, respectively. Functioning muscle transfer in a child with a severe lower extremity injury with composite tissue loss may provide soft tissue and motor‐unit defect reconstruction with an acceptable functional restoration. © 2015 Wiley Periodicals, Inc. Microsurgery 36:77–80, 2016.
Optimization of arterial spin labeling MRI for quantitative tumor perfusion in a mouse xenograft model
Authors: Rajendran Reshmi , Liang Jieming , Tang Mei Yee Annie , Henry Brian , Chuang Kai‐Hsiang
Published: June 2015

Perfusion is an important biomarker of tissue function and has been associated with tumor pathophysiology such as angiogenesis and hypoxia. Arterial spin labeling (ASL) MRI allows noninvasive and quantitative imaging of perfusion; however, the application in mouse xenograft tumor models has been challenging due to the low sensitivity and high perfusion heterogeneity. In this study, flow‐sensitive alternating inversion recovery (FAIR) ASL was optimized for a mouse xenograft tumor. To assess the sensitivity and reliability for measuring low perfusion, the lumbar muscle was used as a reference region. By optimizing the number of averages and inversion times, muscle perfusion as low as 32.4 ± 4.8 (mean ± standard deviation) ml/100 g/min could be measured in 20 min at 7 T with a quantification error of 14.4 ± 9.1%. Applying the optimized protocol, heterogeneous perfusion ranging from 49.5 to 211.2 ml/100 g/min in a renal carcinoma was observed. To understand the relationship with tumor pathology, global and regional tumor perfusion was compared with histological staining of blood vessels (CD34), hypoxia (CAIX) and apoptosis (TUNEL). No correlation was observed when the global tumor perfusion was compared with these pathological parameters. Regional analysis shows that areas of high perfusion had low microvessel density, which was due to larger vessel area compared with areas of low perfusion. Nonetheless, these were not correlated with hypoxia or apoptosis. The results suggest that tumor perfusion may reflect certain aspect of angiogenesis, but its relationship with other pathologies needs further investigation. Copyright © 2015 John Wiley & Sons, Ltd.
On error estimates of an exponential wave integrator sine pseudospectral method for theKlein–Gordon–Zakharov system
Authors: Zhao Xiaofei
Published: June 2015

In this article, we propose an exponential wave integrator sine pseudospectral (EWI‐SP) method for solving the Klein–Gordon–Zakharov (KGZ) system. The numerical method is based on a Deuflhard‐type exponential wave integrator for temporal integrations and the sine pseudospectral method for spatial discretizations. The scheme is fully explicit, time reversible and very efficient due to the fast algorithm. Rigorous finite time error estimates are established for the EWI‐SP method in energy space with no CFL‐type conditions which show that the method has second order accuracy in time and spectral accuracy in space. Extensive numerical experiments and comparisons are done to confirm the theoretical studies. Numerical results suggest the EWI‐SP allows large time steps and mesh size in practical computing. © 2015 Wiley Periodicals, Inc. Numer Methods Partial Differential Eq 32: 266–291, 2016
Treatment of EBV‐associated nodular sclerosing Hodgkin lymphoma in a patient with ataxia telangiectasia with brentuximab vedotin and reduced COPP plus rituximab
Authors: Meister Michael T. , Voss Sandra , Schwabe Dirk
Published: June 2015

Patients with ataxia telangiectasia (AT) with malignancies face poor prognosis due to increased treatment‐related toxicity. Here, we report a 14‐year‐old male with AT and Hodgkin lymphoma (HL) who received brentuximab vedotin and reduced COPP plus rituximab courses. This treatment resulted in complete remission and showed no severe toxicity. Pediatr Blood Cancer © 2015 Wiley Periodicals, Inc.
Polybenzoxazine nanocomposites containing 3,13‐Diglycidyl double‐decker silsesquioxane
Authors: Zhang Chongyin , Liu Ning , Li Lei , Wang Lei , Zheng Sixun
Published: June 2015

3,13‐Diglycidyloxypropyloctaphenyl double‐decker silsesquioxane (3,13‐diglydidyl DDSQ) was synthesized via hydrosilylation between 3,13‐dihydrooctaphenyl double‐decker silsesquioxane (3,13‐dihydro DDSQ) and allyl glycidyl ether. This novel difunctional polyhedral oligomeric silsesquioxanes (POSS) macromer was incorporated into polybenzoxazine (PBZ) thermosets to obtain the organic–inorganic nanocomposites. Compared to control PBZ, the organic–inorganic nanocomposites displayed the enhanced glass transition temperatures (Tg's). Under the identical condition, the organic–inorganic nanocomposites exhibited the stable rubbery plateaus in the measurements by dynamic mechanical thermal analysis, which was in marked contrast to control PBZ thermoset. The enhanced Tg's and improved dynamic mechanical properties are attributable to the formation of the additional crosslinking between PBZ and the difunctional POSS macromer and the nanoreinforcement of POSS cages on PBZ networks. Thermogravimetric analysis indicates that the organic–inorganic nanocomposites displayed improved thermal stability. POLYM. COMPOS., 38:827–836, 2017. © 2015 Society of Plastics Engineers
Effect of epoxidized soybean oil on mechanical properties of woven jute fabric reinforced aromatic and aliphatic epoxy resin composites
Authors: Niedermann Péter , Szebényi Gábor , Toldy Andrea
Published: June 2015

A systematic study was performed to describe the effect of epoxidized soybean oil (ESO) on storage modulus, glass transition temperature (Tg) and mechanical properties in epoxy resin composites reinforced by jute fabric. In addition to aromatic diglycidylether of bisphenol‐A (DGEBA) resin, a glycerol (GER)‐and a pentaerythritol (PER)‐based aliphatic resin was applied as base resin, which can be also synthesized from renewable feedstock. Based on strip tensile test results, the usual alkali treatment of jute fabric was avoided. By increasing the ESO‐content in aliphatic composites the Tg increases, whereas in case of DGEBA, it decreases. The results indicate that although ESO has a significant softening effect, the jute fiber‐reinforced DGEBA composite can be replaced without significant compromise in mechanical properties by a potentially fully bio‐based composite consisting of 25 mass% ESO‐containing aliphatic PER‐reinforced by jute fibers. POLYM. COMPOS., 38:884–892, 2017. © 2015 Society of Plastics Engineers
Diagnostic accuracy of algorithms to identify hepatitis C status, AIDS status, alcohol consumption and illicit drug use among patients living with HIV in an administrative healthcare database
Authors: Durand Madeleine , Wang Yishu , Venne François , Lelorier Jacques , Tremblay Cécile L. , Abrahamowicz Michal
Published: June 2015

Purpose

This study aims to develop and evaluate diagnostic algorithms for AIDS, hepatitis C status, alcohol abuse and illicit drug use in the administrative healthcare database of the Province of Quebec, Canada (Régie de l'assurance‐maladie du Québec (RAMQ)).

Methods

We selected HIV‐positive patients contributing to both the RAMQ database and a local clinical database, which was used as gold standard. We developed algorithms to identify the diagnoses of interest in RAMQ using data from hospital discharge summaries and medical and pharmaceutical claims databases. We estimated and compared sensitivity, specificity, positive predictive and negative predictive values and area under receiver operating curve for each algorithm.

Results

Four hundred twenty patients contributed to both databases. Prevalence of conditions of interest in the clinical database was as follows: AIDS 233 (55%), hepatitis C infection 105 (25%), alcohol abuse 106 (25%), illicit drug use 144 (34%) and intravenous drug use 107 (25%). Sensitivity to detect AIDS, hepatitis C, alcohol abuse, illicit drug use and intravenous drug use was 46% [95%CI: 39–53], 26% [18–35], 50% [37–57], 64% [55–72] and 70% [61–79], respectively. Specificity to detect these conditions was 91% [86–95], 97% [94–98], 92% [88–95], 95% [92–97] and 90% [87–93], respectively. Positive predictive values were 87% [80–92], 71% [54–85], 68% [56–78], 87% [79–93] and 72% [62–80], respectively. Area under receiver operating curve varied from 0.62 [0.57–0.65] for hepatitis C to 0.80 [0.76–0.85] for intravenous drug use.

Conclusions

Sensitivity was low to detect AIDS, alcohol abuse, illicit drug use and especially hepatitis C in RAMQ. Researchers must be aware of the potential for residual confounding and must consider additional methods to control for confounding. Copyright © 2015 John Wiley & Sons, Ltd.
Mass spectrometric study of the decomposition pathways of canonical amino acids and α‐lactones in the gas phase
Authors: Koirala Damodar , Kodithuwakkuge Sampath Ranasinghe , Wenthold Paul G.
Published: June 2015

The dissociation pathways of a gas‐phase amino acid with a canonical (non‐zwitterionic) α‐amino acid moiety are studied by using mass spectrometry. Investigation of the canonical amino acid moiety is possible because the ionized amino acid, a sulfonated phenylalanine, has a charge center that is separated from the amino acid, and dissociation occurs by charge‐remote fragmentation. The amino acid is found to dissociate only by loss of NH3 upon collision‐induced dissociation to form a substituted α‐lactone. The dissociation is consistent with what has been observed previously upon pyrolysis of other α‐substituted carboxylic acids. Decarboxylation, which has also been reported previously for amino acid pyrolysis, is not observed, likely because the product would be a high‐energy, ammonium ylide. The resulting α‐lactone is found to undergo dissociation by decarbonylation to give an aldehyde, and by loss of CO2. Decarboxylation is calculated to occur through a transition state involving hydride shift coupled with lactone ring‐opening. The transition state is found to be stabilized by the negative charge, and therefore, decarboxylation is more favorable for anions. The results show that remote ionic groups can be used as mostly inert charge carriers to enable mass spectrometry to be used to investigate the gas‐phase physical and chemical properties of different types of functional groups, including amino acids. Copyright © 2015 John Wiley & Sons, Ltd.
A clinically based protein discovery strategy to identify potential biomarkers of response to anti‐TNF‐α treatment of psoriatic arthritis
Authors: Collins Emily S. , Butt Aisha Q. , Gibson David S. , Dunn Michael J. , Fearon Ursula , van Kuijk Arno W. , Gerlag Danielle M. , Pontifex Eliza , Veale Douglas J. , Tak Paul P. , FitzGerald Oliver , Pennington Stephen R.
Published: June 2015

Purpose

Psoriatic arthritis (PsA) can be treated using biologic therapies targeting biomolecules such as tumor necrosis factor alpha, interleukins (IL)‐17 and IL‐23. Although 70% PsA patients respond well to therapy, 30% patients show no or limited clinical improvement. Biomarkers that predict response to therapy would help to avoid unnecessary use of expensive biologics in nonresponding patients and enable alternative treatments to be explored.

Experimental design

Patient synovial tissue samples from two clinical studies were analysed using difference in‐gel electrophoresis‐based proteomics to identify protein expression differences in response to anti‐TNF‐α treatment. Subsequent multiplexed MRM measurements were used to verify potential biomarkers.

Results

A total of 119 proteins were differentially expressed (p<0.05) in response to anti‐TNF‐α treatment and 25 proteins were differentially expressed (p<0.05) between “good responders” and “poor responders”. From these differentially expressed proteins, MRM assays were developed for four proteins to explore their potential as treatment predictive biomarkers.

Conclusion and clinical relevance

Gel‐based proteomics strategy has demonstrated differential protein expression in synovial tissue of PsA patients, in response to anti‐TNF‐α treatment. Development of multiplex MRM assays to these differentially expressed proteins has the potential to predict response to therapy and allow alternative, more effective treatments to be explored sooner.
Chiral topologies for composite morphing structures – Part II: Novel configurations and technological processes
Authors: Airoldi Alessandro , Bettini Paolo , Panichelli Paolo , Sala Giuseppe
Published: June 2015

The article presents the advancements in the technological processes developed to produce chiral honeycombs made of thin composite laminates. An original technological process, which was applied to produce chiral components for aerospace morphing structures, is critically analysed and a new approach is proposed. The objective of such approach is the production of thin‐walled chiral composite structures with enhanced strength properties by using a more feasible technology. According to the new methodology, chiral honeycombs with polygonal nodes are obtained by assembling thin‐walled prismatic composite tubes. Numerical models are developed to investigate the behaviour of such topologies. A comparison with the performances of chiral honeycombs with cylindrical nodes is presented, showing that the new configuration can provide negative Poisson's ratios that tend to the theoretical limit of −1 as the stiffness of the polygonal nodes is increased. Thereafter, a method to fill partially the nodes is proposed and numerically assessed, to enhance at the same time the auxetic behaviour and the mechanical properties of the chiral honeycomb. Finally a complete manufacturing process is developed. Hexa‐chiral structural units are manufactured and subsequently tested to assess the auxetic response. Results are in acceptable agreement with numerical predictions and indicate that the novel technological route provides a significant contribution for the application of composite chiral honeycomb to morphing structures.
Adaptive Motion Planning for Autonomous Rough Terrain Traversal with a Walking Robot
Authors: Belter Dominik , Łabęcki Przemysław , Skrzypczyński Piotr
Published: June 2015

Achieving full autonomy in a mobile robot requires combining robust environment perception with onboard sensors, efficient environment mapping, and real‐time motion planning. All these tasks become more challenging when we consider a natural, outdoor environment and a robot that has many degrees of freedom (DOF). In this paper, we address the issues of motion planning in a legged robot walking over a rough terrain, using only its onboard sensors to gather the necessary environment model. The proposed solution takes the limited perceptual capabilities of the robot into account. A multisensor system is considered for environment perception. The key idea of the motion planner is to use the dual representation concept of the map: (i) a higher‐level planner applies the A* algorithm for coarse path planning on a low‐resolution elevation grid, and (ii) a lower‐level planner applies the guided‐RRT (rapidly exploring random tree) algorithm to find a sequence of feasible motions on a more precise but smaller map. This paper contributes a new method that can identify the terrain traversability cost to the benefit of the A* algorithm. A probabilistic regression technique is applied for the traversability assessment with the typical RRT‐based motion planner used to explore the space of traversability values. The efficiency of our motion planning approach is demonstrated in simulations that provide ground truth data unavailable in field tests. However, the simulation‐verified approach is then thoroughly tested under real‐world conditions in experiments with two six‐legged walking robots having different perception systems.
Towards the algorithmic detection of archetypal structures in system dynamics
Authors: Schoenenberger Lukas , Schmid Alexander , Schwaninger Markus
Published: June 2015

Traditionally, model analysis follows qualitative, heuristic, and trial‐and‐error‐driven approaches for testing dynamic hypotheses. Only recently have other methods like loop dominance analysis or control theory been proposed for this purpose. We advocate complementing established qualitative heuristics with a quantitative method for model analysis. To that end, we propose two algorithms to detect Wolstenholme's four generic problem archetypes within models. We tested these algorithms using the Maintenance and World Dynamics models. The approach presented in this paper is a first important step towards the identification of system archetypes in system dynamics and contributes to improving model analysis and diagnosis. Furthermore, our approach goes beyond diagnosis to eliciting solution archetypes, which foster the design and implementation of effective policies. Copyright © 2015 System Dynamics Society
Does R&D offshoring lead to SME growth? Different governance modes and the mediating role of innovation
Authors: Rodríguez Alicia , Nieto María Jesús
Published: June 2015

Research summary: In this article, we address the role of R&D offshoring strategies in the sales growth of small‐ and medium‐sized enterprises (SMEs). We propose that different governance modes of R&D offshoring—insourcing versus outsourcing—may lead to growth, but that they differ in their effects. In turn, we argue that innovation mediates the relation between international R&D sourcing strategies and sales growth. Based on a large database of SME manufacturing enterprises in Spain, we find that offshore outsourcing positively affects sales growth both directly and indirectly, while offshore insourcing only affects sales growth indirectly via innovation results. The analysis reveals different contributions of each governance mode to sales growth and the mediating role of innovation in the relation between R&D offshoring and firm growth.

Managerial summary: We analyze how different governance modes of international R&D sourcing—offshore insourcing and outsourcing—may contribute to growth in SMEs. Modes of offshore R&D outsourcing positively affect the growth of sales in two ways. One effect is direct, produced by improved efficiency, flexibility, enhanced resources, and access to new markets. And the other effect is indirect as offshore R&D outsourcing favors the achievement of innovations, and this in turn, positively affects firm growth. For their part, captive modes only exert an indirect effect. Offshore R&D insourcing contributes to the achievement of innovations, and thus, ultimately to firm growth in so far as these innovations enable SMEs to increase sales. Therefore, innovation results perform a mediating role in the relation between R&D offshoring and sales growth. Copyright © 2015 John Wiley & Sons, Ltd.
Captive‐rearing of Gunnison sage‐grouse from egg collection to adulthood to foster proactive conservation and recovery of a conservation‐reliant species
Authors: Apa Anthony D. , Wiechman Lief A.
Published: June 2015

Gunnison sage‐grouse (Centrocercus minimus) are distributed across southwestern Colorado and southeastern Utah, United States. Their distribution has decreased over the past century and the species has been listed as threatened by the U.S. Fish and Wildlife Service. Reduced genetic diversity, small population size, and isolation may affect Gunnison sage‐grouse population persistence. Population augmentation can be used to counteract or mitigate these issues, but traditional translocation efforts have yielded mixed, and mostly unsuccessful, results. Captive‐rearing is a viable, although much debated, conservation approach to bolster wild conservation‐reliant species. Although there have been captive‐rearing efforts with greater sage‐grouse (C. urophasianus), to date, no information exists about captive‐rearing methods for Gunnison sage‐grouse. Therefore, we investigated techniques for egg collection, artificial incubation, hatch, and captive‐rearing of chicks, juveniles, subadults, and adults for Gunnison sage‐grouse. In 2009 we established a captive flock that produced viable eggs. From 2009–2011, we collected and artificially incubated 206 Gunnison sage‐grouse eggs from 23 wild and 14 captive females. Our hatchability was 90%. Wild‐produced eggs were heavier than captive‐produced eggs and lost mass similarly during incubation. We produced 148 chicks in captivity and fed them a variety of food sources (e.g. invertebrates to commercial chow). Bacterial infections were the primary cause of chick mortality, but we successfully reduced the overall mortality rate during the course of our study. Conservationists and managers should consider the utility in developing a captive‐rearing program or creating a captive population as part of a proactive conservation effort for the conservation‐reliant Gunnison sage‐grouse. Zoo Biol. 34:438–452, 2015. © 2015 Wiley Periodicals, Inc.
Ketogenic diets in patients with inherited metabolic disorders
Authors: Scholl‐Bürgi S. , Höller A. , Pichler K. , Michel M. , Haberlandt E. , Karall D.
Published: June 2015

Ketogenic diets (KDs) are diets that bring on a metabolic condition comparable to fasting, usually without catabolism. Since the mid‐1990s such diets have been widely used in patients with seizures/epilepsies, mostly children. This review focuses on the use of KDs in patients with various inherited metabolic disorders (IMD). In glucose transporter type 1 deficiency syndrome (GLUT1‐DS) and pyruvate dehydrogenase complex (PDHc) deficiency, KDs are deemed the therapy of choice and directly target the underlying metabolic disorder. Moreover, in other IMD, mainly of intermediary metabolism such as glycogen storage diseases and disorders of mitochondrial energy supply, KDs may ameliorate clinical symptoms and laboratory parameters. KDs have also been used successfully to treat symptoms such as seizures/epilepsy in IMD, e.g. in urea cycle disorders and non‐ketotic hyperglycinemia. As a note of caution, catabolism may cause the condition of patients with IMD to deteriorate and should thus be avoided during KDs. For this reason, careful monitoring (clinical, laboratory and apparatus‐supported) is warranted. In some IMDs specific macronutrient supply is critical. Therefore, in cases of PDHc deficiency the carbohydrate intake tolerated without lactate increase and in urea cycle disorders the protein tolerance should be determined. Considering this, it is particularly important in patients with IMD that the use of KDs be individualized and well documented.
Long-term evolution of highly alkaline steel slag drainage waters
Authors: Riley Alex L. , Mayes William M.
Published: June 2015

The disposal of slag generated by the steel industry can have negative consequences upon the surrounding aquatic environment by the generation of high pH waters, leaching of potentially problematic trace metals, and rapid rates of calcite precipitation which smother benthic habitats. A 36-year dataset was collated from the long-term ambient monitoring of physicochemical parameters and elemental concentrations of samples from two steel slag leachate-affected watercourses in northern England. Waters were typified by elevated pH (>10), high alkalinity, and were rich in dissolved metals (e.g. calcium (Ca), aluminium (Al), and zinc (Zn)). Long-term trend analysis was performed upon pH, alkalinity, and Ca concentration which, in addition to Ca flux calculations, were used to highlight the longevity of pollution arising as a result of the dumping and subsequent leaching of steel slags. Declines in calcium and alkalinity have been modest over the monitoring period and not accompanied by significant declines in water pH. If the monotonic trends of decline in alkalinity and calcium continue in the largest of the receiving streams, it will be in the region of 50–80 years before calcite precipitation would be expected to be close to baseline levels, where ecological impacts would be negligible.
Exceedance of critical loads and of critical limits impacts tree nutrition across Europe
Authors: Waldner Peter , Thimonier Anne , Graf Pannatier Elisabeth , Etzold Sophia , Schmitt Maria , Marchetto Aldo , Rautio Pasi , Derome Kirsti , Nieminen Tiina Maileena , Nevalainen Seppo , Lindroos Antti-Jussi , Merilä Päivi , Kindermann Georg , Neumann Markus , Cools Nathalie , de Vos Bruno , Roskams Peter , Verstraeten Arne , Hansen Karin , Pihl Karlsson Gunilla , Dietrich Hans-Peter , Raspe Stephan , Fischer Richard , Lorenz Martin , Iost Susanne , Granke Oliver , Sanders Tanja G. M. , Michel Alexa , Nagel Hans-Dieter , Scheuschner Thomas , Simončič Primož , von Wilpert Klaus , Meesenburg Henning , Fleck Stefan , Benham Sue , Vanguelova Elena , Clarke Nicholas , Ingerslev Morten , Vesterdal Lars , Gundersen Per , Stupak Inge , Jonard Mathieu , Potočić Nenad , Minaya Mayte
Published: June 2015

Key message

Exceedance of critical limits in soil solution samples was more frequent in intensively monitored forest plots across Europe with critical loads for acidity and eutrophication exceeded compared to other plots from the same network. Elevated inorganic nitrogen concentrations in soil solution tended to be related to less favourable nutritional status.

Context

Forests have been exposed to elevated atmospheric deposition of acidifying and eutrophying sulphur and nitrogen compounds for decades. Critical loads have been identified, below which damage due to acidification and eutrophication are not expected to occur.

Aims

We explored the relationship between the exceedance of critical loads and inorganic nitrogen concentration, the base cation to aluminium ratio in soil solutions, as well as the nutritional status of trees.

Methods

We used recent data describing deposition, elemental concentrations in soil solution and foliage, as well as the level of damage to foliage recorded at forest plots of the ICP Forests intensive monitoring network across Europe.

Results

Critical loads for inorganic nitrogen deposition were exceeded on about a third to half of the forest plots. Elevated inorganic nitrogen concentrations in soil solution occurred more frequently among these plots. Indications of nutrient imbalances, such as low magnesium concentration in foliage or discolouration of needles and leaves, were seldom but appeared more frequently on plots where the critical limits for soil solution were exceeded.

Conclusion

The findings support the hypothesis that elevated nitrogen and sulphur deposition can lead to imbalances in tree nutrition.
Evaluation of a National Online Educational Program in Geriatric Psychiatry
Authors: Law Marcus , Rapoport Mark J. , Seitz Dallas , Davidson Marla , Madan Robert , Wiens Andrew
Published: June 2015

Objective

This study provides evaluation results of an online study group (OSG) for geriatric psychiatry continuing professional development.

Methods

The OSG is an interactive, expert-facilitated, asynchronous educational experience for psychiatrists and residents in Canada. A retrospective web survey assessed self-efficacy, knowledge in geriatric psychiatry, comfort with online learning, and perceived effectiveness of the instructional methods. Wilcoxon signed-rank tests and descriptive statistics were calculated.

Results

Twenty-nine (of 50) participants (58 %) completed the questionnaire. Although only 48 % of respondents reported improved perceived knowledge, 79 % reported improved efficacy beliefs, and 76 % reported improved comfort with online learning. Most (79 %) would consider taking OSG again, and 93 % would recommend it to others.

Conclusions

The OSG was well-received, with greater benefits for self-efficacy with the material and comfort with online learning than for perceived knowledge itself. Further research is needed to ascertain actual knowledge change in the context of online learning in medical education.
Virtual Community, Purchasing Behaviour, and Emotional Well-Being
Authors: Chou Cindy Yunhsin , Sawang Sukanlaya
Published: June 2015

The benefits of virtual communities in increasing firms’ profits, instilling knowledge in consumers, and enhancing consumers’ social experience and enjoyment are widely recognised. However, relatively little is known about how the use of a virtual community could influence consumers’ emotional well-being. This study examines the relationships among virtual community features (structural and experiential routes) as antecedents of virtual community engagement, including quality of use of virtual communities (time spent online and level of information exchange), electronic word-of-mouth (eWOM) purchasing behaviour, and consumers’ emotional experience. Furthermore, by extending the cultural perspective to virtual community engagement, this study examines the role of collectivistic values on the aforementioned relationships. The proposed hypotheses are tested on the basis of data collected from 286 members of different virtual communities in Taiwan. The results partially support the theory that features of virtual communities influenced the quality of use, which then has a subsequent effect on consumer eWOM purchasing and emotional well-being. The results of the empirical analysis add credence to the proposed relationships. The role of collectivistic values is also partially supported. A detailed discussion of the findings and limitations of this study is provided.
Hysteroscopic tubal electrocoagulation versus laparoscopic tubal ligation for patients with hydrosalpinges undergoing in vitro fertilization
Authors: El‐Mazny Akmal , Abou‐Salem Nermeen , Hammam Mohamed , Saber Walid
Published: June 2015

Objective

To investigate the use and success rate of hysteroscopic tubal electrocoagulation for the treatment of hydrosalpinx‐related infertility among patients undergoing in vitro fertilization (IVF) who have laparoscopic contraindications.

Methods

A prospective study was conducted among patients who had unilateral or bilateral hydrosalpinges identified on hysterosalpingography and vaginal ultrasonography, and who were undergoing IVF at a center in Cairo, Egypt, between January 1, 2013, and October 30, 2014. All patients who had contraindications for laparoscopy were scheduled for hysteroscopic tubal electrocoagulation (group 1); the other patients underwent laparoscopic tubal ligation (group 2). For all patients, hysterosalpingography was performed 3 months after their procedure to evaluate proximal tubal occlusion.

Results

Among 85 enrolled patients, 22 underwent hysteroscopic tubal electrocoagulation and 63 underwent laparoscopic tubal ligation. The procedure was successful in terms of tubal occlusion for 25 (93%) of 27 hydrosalpinges in group 1, and 78 (96%) of 81 hydrosalpinges in group 2 (P = 0.597). No intraoperative or postoperative complications were reported.

Conclusion

Hysteroscopic tubal electrocoagulation was found to be a successful treatment for hydrosalpinges before IVF when laparoscopy is contraindicated.
Age, growth, biological and ecological aspects of Remora osteochir (Echeneidae) in the Mediterranean Sea
Authors: Battaglia P. , Potoschi A. , Valastro M. , Andaloro F. , Romeo T.
Published: June 2015

This paper provides for the first time data on age and growth ofRemora osteochir, also describing its sagittal otolith together with other biological and ecological aspects. Overall, 236 individuals of marlin sucker were collected in the southern-central Mediterranean Sea, from 2008 to 2009. All samples were hosted by the Mediterranean spearfish,Tetrapturus belone, caught by surface longline and harpoon. Analysis of gonads identified a reproductive peak during June and July. The estimated growth parameters according to the von Bertalanffy equation were:L∞= 27.37 cm TL,k= 0.248 year−1,t0= −1.36 year. The length-weight relationship, computed by using eviscerate weight, highlighted an isometric growth for both sexes, as supported by the other results: similar sizes, growth curves and disc length-total length relationship.
Toxic Tares: The Poisonous Weeds (ζιζάνια) in Matthew's Parable of the Tares (Matthew 13.24–30, 36–43)
Authors: Cousland J. R. C.
Published: June 2015

This article examines the poisonous characteristics ofLolium TemulentumL., the weed that is generally identified with the tares (zizania) mentioned in Matthew's Parable of the Wheat and the Tares (Matt 13.24–30, 36–43). It identifies the weed, examines its pervasiveness in antiquity, as well as the nature and degree of its toxicity, and establishes that the tares of the Palestine of Jesus' day were likely poisonous. With this in mind, it considers whether the tares' toxicity is a factor in understanding the parable and its interpretation, concluding that it is very likely presupposed by both.
The Jesus' Wife Papyrus in the History of Forgery
Authors: Jones Christopher
Published: June 2015

Many forgeries pass through a cycle of fabrication, acceptance, doubt and final rejection. Consideration of a number of modern forgeries, notably those of Constantinos Simonides, illustrates how forgers exploit prevailing debates, look for persons or institutions on whom to practise their deception, and are often undone by their own errors, especially when manufacturing provenance. This ‘syntax’ of forgery can be applied to the case of the Jesus' Wife papyrus, though the participation of media corporations and the existence of the internet add a new element to the process.
Assessment of the Storm Avoidance Effect on the Wave Climate along the Main North Atlantic Routes
Authors: Vettor Roberto , Soares C. Guedes
Published: June 2015

The wave climate along the main transoceanic routes of the North Atlantic sub basin is determined using three different databases: two derived by numerical models in the HIPOCAS and ERA40 databases and one from Voluntary Observing Ships. For each route the distribution of the mean significant wave height along the path is computed as well as the specific scatter diagram. In addition an assessment of the relative wave heading probability is provided. The results highlight a bias in the visual observations especially in the summer and, more in general, for low sea states. The correction of this bias allows better understanding of rough weather avoidance by ships and to determine a storm avoidance correction.
Impact of a Two-step Emergency Department Triage Model with START, then CTAS, on Patient Flow During a Simulated Mass-casualty Incident
Authors: Lee James S. , Franc Jeffrey M.
Published: June 2015

Introduction

A high influx of patients during a mass-casualty incident (MCI) may disrupt patient flow in an already overcrowded emergency department (ED) that is functioning beyond its operating capacity. This pilot study examined the impact of a two-step ED triage model using Simple Triage and Rapid Treatment (START) for pre-triage, followed by triage with the Canadian Triage and Acuity Scale (CTAS), on patient flow during a MCI simulation exercise.

Hypothesis/Problem

It was hypothesized that there would be no difference in time intervals nor patient volumes at each patient-flow milestone.

Methods

Physicians and nurses participated in a computer-based tabletop disaster simulation exercise. Physicians were randomized into the intervention group using START, then CTAS, or the control group using START alone. Patient-flow milestones including time intervals and patient volumes from ED arrival to triage, ED arrival to bed assignment, ED arrival to physician assessment, and ED arrival to disposition decision were compared. Triage accuracy was compared for secondary purposes.

Results

There were no significant differences in the time interval from ED arrival to triage (mean difference 108 seconds; 95% CI, -353 to 596 seconds; P=1.0), ED arrival to bed assignment (mean difference 362 seconds; 95% CI, -1,269 to 545 seconds; P=1.0), ED arrival to physician assessment (mean difference 31 seconds; 95% CI, -1,104 to 348 seconds; P=0.92), and ED arrival to disposition decision (mean difference 175 seconds; 95% CI, -1,650 to 1,300 seconds; P=1.0) between the two groups. There were no significant differences in the volume of patients to be triaged (32% vs 34%; 95% CI for the difference -16% to 21%; P=1.0), assigned a bed (16% vs 21%; 95% CI for the difference -11% to 20%; P=1.0), assessed by a physician (20% vs 22%; 95% CI for the difference -14% to 19%; P=1.0), and with a disposition decision (20% vs 9%; 95% CI for the difference -25% to 4%; P=.34) between the two groups. The accuracy of triage was similar in both groups (57% vs 70%; 95% CI for the difference -15% to 41%; P=.46).

Conclusion

Experienced triage nurses were able to apply CTAS effectively during a MCI simulation exercise. A two-step ED triage model using START, then CTAS, had similar patient flow and triage accuracy when compared to START alone.

LeeJS, FrancJM. Impact of a two-step emergency department triage model with START, then CTAS, on patient flow during a simulated mass-casualty incident. Prehosp Disaster Med. 2015;30(4):1–7.
Breast-feeding and complementary feeding practices in the first 6 months of life among Norwegian-Somali and Norwegian-Iraqi infants: the InnBaKost survey
Authors: Grewal Navnit Kaur , Andersen Lene Frost , Sellen Daniel , Mosdøl Annhild , Torheim Liv Elin
Published: June 2015

Objective

To examine breast-feeding and complementary feeding practices during the first 6 months of life among Norwegian infants of Somali and Iraqi family origin.

Design

A cross-sectional survey was performed during March 2013–February 2014. Data were collected using a semi-quantitative FFQ adapted from the second Norwegian national dietary survey among infants in 2006–2007.

Setting

Somali-born and Iraqi-born mothers living in eastern Norway were invited to participate.

Subjects

One hundred and seven mothers/infants of Somali origin and eighty mothers/infants of Iraqi origin participated.

Results

Breast-feeding was almost universally initiated after birth. Only 7 % of Norwegian-Somali and 10 % of Norwegian-Iraqi infants were exclusively breast-fed at 4 months of age. By 1 month of age, water had been introduced to 30 % of Norwegian-Somali and 26 % of Norwegian-Iraqi infants, and infant formula to 44 % and 34 %, respectively. Fifty-four per cent of Norwegian-Somali and 68 % of Norwegian-Iraqi infants had been introduced to solid or semi-solid foods at 4 months of age. Breast-feeding at 6 months of age was more common among Norwegian-Somali infants (79 %) compared with Norwegian-Iraqi infants (58 %;P=0·001). Multivariate analyses indicated no significant factors associated with exclusive breast-feeding at 3·5 months of age. Factors positively associated with breast-feeding at 6 months were country of origin (Somalia) and parity (>2).

Conclusions

Breast-feeding initiation was common among Iraqi-born and Somali-born mothers, but the exclusive breast-feeding period was shorter than recommended in both groups. The study suggests that there is a need for new culture-specific approaches to support exclusive breast-feeding and complementary feeding practices among foreign-born mothers living in Norway.
Die stationäre psychiatrische Versorgung Adoleszenter in Deutschland
Authors: Plener Paul L. , Groschwitz Rebecca C. , Franke Cindy , Fegert Jörg M. , Freyberger Harald J.
Published: June 2015

Die Adoleszenz ist häufig die Lebensphase, in der sich psychiatrische Phänomene des Erwachsenenalters erstmals manifestieren. Darüber hinaus stellt sie auch eine Phase des Übergangs zwischen den Versorgungssystemen der Kinder- und Jugendpsychiatrie und dem der Psychiatrie und Psychotherapie des Erwachsenenalters dar. Die vorliegende Arbeit beschäftigt sich mit der stationären psychiatrischen Versorgungssituation der Adoleszenten in Deutschland. Berichtet wird eine Analyse der stationären psychiatrischen Versorgung in der Altersgruppe der 15- bis 25-Jährigen in Deutschland in den Jahren 2003 bis 2012, basierend auf Krankenhaus Entlassdiagnosen. Trotz stagnierender Bevölkerungszahlen in der Altersgruppe der 15- bis 25-Jährigen findet sich eine deutliche Zunahme der stationären Behandlungen im Verlauf der letzten 10 Jahre. Es finden sich deutliche Unterschiede in der Häufigkeit der Behandlung von Störungsbildern der Kategorie F8 und F9 in der Altersgruppe der 15- bis unter 20-Jährigen im Vergleich zu den 20- bis unter 25-Jährigen. Die Brüche in den stationären Behandlungsraten der ICD-10 Kategorien F8 und F9 können als Hinweis auf eine mangelhaft ausgebaute Schnittstelle zwischen der Kinder- und Jugendpsychiatrie und der Psychiatrie und Psychotherapie des Erwachsenenalters gesehen werden. Eine durchgängig über Versorgungssysteme gedachte Adoleszenzpsychiatrie könnte es schaffen diesen Übergang zu erleichtern.
Selective Astrocytic Endothelin-1 Overexpression Contributes to Dementia Associated with Ischemic Stroke by Exaggerating Astrocyte-Derived Amyloid Secretion
Authors: Hung Victor KL , Yeung Patrick KK , Lai Angela KW , Ho Maggie CY , Lo Amy CY , Chan Kevin C , Wu Ed XK , Chung Stephen SM , Cheung Chi W , Chung Sookja K
Published: June 2015

Endothelin-1 (ET-1) is synthesized by endothelial cells and astrocytes in stroke and in brains of Alzheimer's disease patients. Our transgenic mice with ET-1 overexpression in the endothelial cells (TET-1) showed more severe blood–brain barrier (BBB) breakdown, neuronal apoptosis, and glial reactivity after 2-hour transient middle cerebral artery occlusion (tMCAO) with 22-hour reperfusion and more severe cognitive deficits after 30 minutes tMCAO with 5 months reperfusion. However, the role of astrocytic ET-1 in contributing to poststroke cognitive deficits after tMCAO is largely unknown. Therefore, GET-1 mice were challenged with tMCAO to determine its effect on neurologic and cognitive deficit. The GET-1 mice transiently displayed a sensorimotor deficit after reperfusion that recovered shortly, then more severe deficit in spatial learning and memory was observed at 3 months after ischemia compared with that of the controls. Upregulation of TNF- a, cleaved caspase-3, and Thioflavin-S-positive aggregates was observed in the ipsilateral hemispheres of the GET-1 brains as early as 3 days after ischemia. In an in vitro study, ET-1 overexpressing astrocytic cells showed amyloid secretion after hypoxia/ischemia insult, which activated endothelin A (ETA) and endothelin B (ETB) receptors in a PI3K/AKT-dependent manner, suggesting role of astrocytic ET-1 in dementia associated with stroke by astrocyte-derived amyloid production.
Effects of Anesthesia on BOLD Signal and Neuronal Activity in the Somatosensory Cortex
Authors: Aksenov Daniil P , Li Limin , Miller Michael J , Iordanescu Gheorghe , Wyrwicz Alice M
Published: June 2015

Most functional magnetic resonance imaging (fMRI) animal studies rely on anesthesia, which can induce a variety of drug-dependent physiological changes, including depression of neuronal activity and cerebral metabolism as well as direct effects on the vasculature. The goal of this study was to characterize the effects of anesthesia on the BOLD signal and neuronal activity. Simultaneous fMRI and electrophysiology were used to measure changes in single units (SU), multi-unit activity (MUA), local field potentials (LFP), and the blood oxygenation level-dependent (BOLD) response in the somatosensory cortex during whisker stimulation of rabbits before, during and after anesthesia with fentanyl or isoflurane. Our results indicate that anesthesia modulates the BOLD signal as well as both baseline and stimulus-evoked neuronal activity, and, most significantly, that the relationship between the BOLD and electrophysiological signals depends on the type of anesthetic. Specifically, the behavior of LFP observed under isoflurane did not parallel the behavior of BOLD, SU, or MUA. These findings suggest that the relationship between these signals may not be straightforward. BOLD may scale more closely with the best measure of the excitatory subcomponents of the underlying neuronal activity, which may vary according to experimental conditions that alter the excitatory/inhibitory balance in the cortex.