bluuebunny/crossref_metadata_2025 huggingface dataset:
«Sterile» Spondylodiszitis
Authors: Dünkel Jörg , Oestmann Andreas , Jonczy Maciej
Published: September 2013

Wir berichten über eine 81-jährige Patientin mit Fieber und Rückenschmerzen. Aufgrund der Bildgebung der Wirbelsäule wurde trotz fehlendem Erregernachweis initial eine infektiöse Spondylodiszitis vermutet und eine antibiotische Behandlung begonnen. Wegen Symptompersistenz wurde eine erneute, diesmal offen durchgeführte Biopsie vorgenommen, welche die Diagnosestellung einer spinalen Gicht erlaubte. Unter alleiniger symptomatischer Therapie waren die Beschwerden rückläufig.
When a repellent becomes an attractant: harmful saponins are kairomones attracting the symbiotic Harlequin crab
Authors: Caulier Guillaume , Flammang Patrick , Gerbaux Pascal , Eeckhaut Igor
Published: September 2013

Marine organisms have developed a high diversity of chemical defences in order to avoid predators and parasites. In sea cucumbers, saponins function as repellents and many species produce these cytotoxic secondary metabolites. Nonetheless, they are colonized by numerous symbiotic organisms amongst which the Harlequin crab, Lissocarcinus orbicularis, is one of the most familiar in the Indo-Pacific Ocean. We here identify for the first time the nature of the molecules secreted by sea cucumbers and attracting the symbionts: saponins are the kairomones recognized by the crabs and insuring the symbiosis. The success of this symbiosis would be due to the ability that crabs showed during evolution to bypass the sea cucumber chemical defences, their repellents becoming powerful attractants. This study therefore highlights the complexity of chemical communication in the marine environment.
Absolut “copper catalyzation perfected”; robust living polymerization of NIPAM: Guinness is good for SET-LRP
Authors: Waldron Christopher , Zhang Qiang , Li Zaidong , Nikolaou Vasiliki , Nurumbetov Gabit , Godfrey Jamie , McHale Ronan , Yilmaz Gokhan , Randev Rajan K. , Girault Mony , McEwan Kayleigh , Haddleton David M. , Droesbeke Martijn , Haddleton Alice J. , Wilson Paul , Simula Alexandre , Collins Jennifer , Lloyd Danielle J. , Burns James A. , Summers Christopher , Houben Claudia , Anastasaki Athina , Li Muxiu , Becer C. Remzi , Kiviaho Jenny K. , Risangud Nuttapol
Published: September 2013

The controlled polymerization of N-isopropyl acrylamide (NIPAM) is reported in a range of international beers, wine, ciders and spirits utilizing Cu(0)-mediated living radical polymerization (SET-LRP).
Oscillatory and fluctuating terms in energies of assemblies of equicharged particles subject to spherically symmetric power-law confining potentials
Authors: Cioslowski Jerzy , Albin Joanna
Published: September 2013

Energies E(N) of assemblies of equicharged particles subject to spherically symmetric power-law confining potentials vary in a convoluted fashion with the particle totalities N. Accurate rigorous upper bounds to these energies, which are amenable to detailed mathematical analysis, are found to comprise terms with smooth, oscillatory, and fluctuating dependences on N. The smooth energy component is obtained as a power series in N−2/3 with the first two terms corresponding to the bulk and Madelung energies. The oscillatory component possesses the large-N asymptotics given by a product of N1/(λ + 1), where λ is the power-law exponent, and a function periodic in N1/3. The amplitude of the fluctuating component, which originates mostly from the irregular dependence of the Thomson energy ETh(n) on n, also scales like N1/(λ + 1).
Theory of multiple-stage interband photovoltaic devices and ultimate performance limit comparison of multiple-stage and single-stage interband infrared detectors
Authors: Hinkey Robert T. , Yang Rui Q.
Published: September 2013

A theoretical framework for studying signal and noise in multiple-stage interband infrared photovoltaic devices is presented. The theory flows from a general picture of electrons transitioning between thermalized reservoirs. Making the assumption of bulk-like absorbers, we show how the standard semiconductor transport and recombination equations can be extended to the case of multiple-stage devices. The electronic noise arising from thermal fluctuations in the transition rates between reservoirs is derived using the Shockley-Ramo and Wiener-Khinchin theorems. This provides a unified noise treatment accounting for both the Johnson and shot noise. Using a Green's function formalism, we derive consistent analytic expressions for the quantum efficiency and thermal noise in terms of the design parameters and macroscopic material properties of the absorber. The theory is then used to quantify the potential performance improvement from the use of multiple stages. We show that multiple-stage detectors can achieve higher sensitivities for applications requiring a fast temporal response. This is shown by deriving an expression for the optimal number of stages in terms of the absorption coefficient and absorber thicknesses for a multiple-stage detector with short absorbers. The multiple-stage architecture may also be useful for improving the sensitivity of high operating temperature detectors in situations where the quantum efficiency is limited by a short diffusion length. The potential sensitivity improvement offered by a multiple-stage architecture can be judged from the product of the absorption coefficient, α, and diffusion length, Ln, of the absorber material. For detector designs where the absorber lengths in each of the stages are equal, the multiple-stage architecture offers the potential for significant detectivity improvement when αLn ≤ 0.2. We also explore the potential of multiple-stage detectors with photocurrent-matched absorbers. In this architecture, the absorbers are designed to absorb and collect an equal number of carriers in each stage. It is shown that for zero-bias operation, this design has a higher ultimate detectivity than a single-absorber device. Such improvements in detectivity are significant for material with αLn ≤ 0.5. Using the results derived for general values of αLn, we offer an outlook for multiple-stage detectors that utilize InAs/GaSb superlattice absorbers.
Orbital drift of capsules and red blood cells in shear flow
Authors: Cordasco Daniel , Bagchi Prosenjit
Published: September 2013

Many numerical studies have considered the dynamics of capsules and red blood cells in shear flow under the condition that the axis of revolution of such bodies remained aligned in the shear plane. In contrast, several experimental studies have shown that the axis of revolution of red blood cells could drift away from the shear plane in a certain range of controlling parameters. In this article, we present three-dimensional numerical simulations on the orientation dynamics of capsules in simple shear flow with different initial undeformed shapes, namely, prolate, oblate, and biconcave disk. It is observed that unlike rigid ellipsoids in Stokes flow, capsules reorient their axis of revolution either towards the vorticity axis while undergoing a precessing motion or towards the shear plane while undergoing a kayaking-type motion. The specific dynamics are observed to depend on initial shape, capillary number, and the ratio of the internal to external fluid viscosity. Near the physiological values of the viscosity ratio, the biconcave shape performs a rolling motion like a wheel. If the viscosity ratio is reduced below the physiological range, a transition to the kayaking dynamics is observed with increasing capillary number. The critical shear stress at which the rolling-to-kayaking transition occurs is found to be dependent on the viscosity ratio.
Description of electronic excited states using electron correlation operator
Authors: Nichols Bryan , Rassolov Vitaly A.
Published: September 2013

The electron correlation energy in a chemical system is defined as a difference between the energy of an exact energy for a given Hamiltonian, and a mean-field, or single determinant, approximation to it. A promising way to model electron correlation is through the expectation value of a linear two-electron operator for the Kohn-Sham single determinant wavefunction. For practical reasons, it is desirable for such an operator to be universal, i.e., independent of the positions and types of nuclei in a molecule. The correlation operator models the effect of electron correlation on the interaction energy in a electron pair. We choose an operator expanded in a small number of Gaussians as a model for electron correlation, and test it by computing atomic and molecular adiabatic excited states. The computations are performed within the Δ Self-Consistent Field (ΔSCF) formalism, and are compared to the time-dependent density functional theory model with popular density functionals. The simplest form of the correlation operator contains only one parameter derived from the helium atom ground state correlation energy. The correlation operator approach significantly outperforms other methods in computation of atomic excitation energies. The accuracy of molecular excitation energies computed with the correlation operator is limited by the shortcomings of the ΔSCF methodology in describing excited states.
Ertel's vorticity theorem and new flux surfaces in multi-fluid plasmas
Authors: Hameiri Eliezer
Published: September 2013

Dedicated to Professor Harold Weitzner on the occasion of his retirement

“Say to wisdom ‘you are my sister,’ and to insight ‘you are my relative.’”—Proverbs 7:4

Based on an extension to plasmas of Ertel's classical vorticity theorem in fluid dynamics, it is shown that for each species in a multi-fluid plasma there can be constructed a set of nested surfaces that have this species' fluid particles confined within them. Variational formulations for the plasma evolution and its equilibrium states are developed, based on the new surfaces and all of the dynamical conservation laws associated with them. It is shown that in the general equilibrium case, the energy principle lacks a minimum and cannot be used as a stability criterion. A limit of the variational integral yields the two-fluid Hall-magnetohydrodynamic (MHD) model. A further special limit yields MHD equilibria and can be used to approximate the equilibrium state of a Hall-MHD plasma in a perturbative way.
Electron polarization and plasmon effects in anisotropic nanostructures
Authors: Ruda H. E. , Shik A.
Published: September 2013

Properties of nanorods with the length 2 a and radius b (a>b), containing free carriers, in the external d.c. or a.c. electric field are analyzed theoretically. Static polarizability of nanorods depends on their orientation in the field and is determined by the ratio, the nanorod size in the field direction to the screening length of the material rs. When this ratio is very small or very large, the properties of nanorods are similar to those of a dielectric and metallic ellipsoid, respectively. For a≫b, polarization characteristics of nanorods are strongly anisotropic and can be metallic in one direction and dielectric in the other direction. For semiconductor nanorods suspended in a polar liquid, polarizability in different directions may have different signs. For a.c. field, conductivity of nanorods contains plasmon peaks with essentially different frequencies for longitudinal and transverse plasmons. With decreasing a and b, frequencies of both plasmons increase and their amplitudes dramatically decrease. Dynamics of conducting nanorods in external electric fields represents superposition of their angular alignment along the field direction and the drift motion in the field gradient, with the first process being faster. Thus, in non-uniform fields nanorods drift in the field gradient according to the signs and values of their longitudinal and transverse polarizations.
Monte Carlo implementation of a guiding-center Fokker-Planck kinetic equation
Authors: Hirvijoki E. , Brizard A. , Snicker A. , Kurki-Suonio T.
Published: September 2013

A Monte Carlo method for the collisional guiding-center Fokker-Planck kinetic equation is derived in the five-dimensional guiding-center phase space, where the effects of magnetic drifts due to the background magnetic field nonuniformity are included. It is shown that, in the limit of a homogeneous magnetic field, our guiding-center Monte Carlo collision operator reduces to the guiding-center Monte Carlo Coulomb operator previously derived by Xu and Rosenbluth [Phys. Fluids B 3, 627 (1991)]. Applications of the present work will focus on the collisional transport of energetic ions in complex nonuniform magnetized plasmas in the large mean-free-path (collisionless) limit, where magnetic drifts must be retained.
Computational damage mechanics of electromigration and thermomigration
Authors: Yao Wei , Basaran Cemal
Published: September 2013

Reliability of solder joints under Electromigration (EM) and Thermomigration (TM) has drawn increasing attention in recent years, however current understanding regarding degradation physics of solder alloys under time varying current loading is still quite limited. As most integrated circuit (IC) connectors carry Pulse Direct Current/AC signals under normal operating condition instead of DC, investigation of EM/TM failure under time varying current becomes essential. In this paper, detailed formulation is presented to characterize material damage due to electromigration and thermomigration. Entropy based damage model is adopted to characterize the material degradation physics. Thermal gradient is observed to reach 1000 K/cm in current crowding regions, which is high enough to induce TM damage. Most of the time solder joint failure is due to combined action of EM and TM effects, therefore failure under pulsed current loadings due to combined action is investigated. Vacancy accumulation during current on period, and healing during current off period is modeled. In order to simulate EM/TM degradation of solder joints under pulsed current, ABAQUS user defined subroutines (UEL and UMAT) are used.
Chemical and electrical characterization of the HfO2/InAlAs interface
Authors: Brennan B. , Galatage R. V. , Thomas K. , Pelucchi E. , Hurley P. K. , Kim J. , Hinkle C. L. , Vogel E. M. , Wallace R. M.
Published: September 2013

InAlAs has the potential to be used as a barrier layer in buried channel quantum well field effect transistor devices due to favorable lattice-matching and carrier confinement properties with InGaAs. Field effect device structures of this nature may also require a high-k oxide deposited on the InAlAs surface to reduce leakage current. This study investigates the impact of surface preparations and atomic layer deposition of HfO2 on these surfaces using x-ray photoelectron spectroscopy to analyse the chemical interactions taking place, as well as the electrical performance of associated capacitor devices. A large concentration of As related surface features is observed at the InAlAs surface, and is attributed to a large Dit response in electrical measurements.
The role of the Kubo number in two-component turbulence
Authors: Qin G. , Shalchi A.
Published: September 2013

We explore the random walk of magnetic field lines in two-component turbulence by using computer simulations. It is often assumed that the two-component model provides a good approximation for solar wind turbulence. We explore the dependence of the field line diffusion coefficient on the Kubo number which is a fundamental and characteristic quantity in the theory of turbulence. We show that there are two transport regimes. One is the well-known quasilinear regime in which the diffusion coefficient is proportional to the Kubo number squared, and the second one is a nonlinear regime in which the diffusion coefficient is directly proportional to the Kubo number. The so-called percolative transport regime which is often discussed in the literature cannot be found. The numerical results obtained in the present paper confirm analytical theories for random walking field lines developed in the past.
The effects of plasma exposure and vacuum ultraviolet irradiation on photopatternable low-k dielectric materials
Authors: Nichols M. T. , Mavrakakis K. , Lin Q. , Shohet J. L.
Published: September 2013

The effects of plasma exposure and vacuum-ultraviolet (VUV) irradiation on photopatternable low-k (PPLK) dielectric materials are investigated. In order to examine these effects, current-voltage measurements were made on PPLK materials before and after exposure to a variety of inert plasma-exposure conditions. In order to examine the effects of photon irradiation alone, PPLK samples were also exposed to monochromatic synchrotron radiation with 10 eV photon energy. It was found that plasma exposure causes significant degradation in electrical characteristics, resulting in increased leakage-currents and decreased breakdown voltage. X-ray photoelectron spectroscopy measurements also show appreciable carbon loss near the sample surface after plasma exposure. Conversely, VUV exposure was found to increase breakdown voltage and reduce leakage-current magnitudes.
Unusual sevenfold coordination of Ru in complex hydride Na3RuH7: Prospect for formation of [FeH7]3– anion
Authors: Takagi Shigeyuki , Ikeshoji Tamio , Matsuo Motoaki , Sato Toyoto , Saitoh Hiroyuki , Aoki Katsutoshi , Orimo Shin-ichi
Published: September 2013

We used density-functional calculations to clarify the origin of the unusual sevenfold coordination of Ru by H in Na3RuH7. We found that the D5h symmetry of the ligands enables the formation of strong covalent bonds of Ru and H through ligand-field effects, stabilizing the sevenfold coordination. We also examined the possible synthesis of the hypothetical 3d analog, Li3FeH7, which has a gravimetric hydrogen density of 8.4 mass%. The calculated enthalpy change of −16 kJ/mol H2 for the reaction, 3LiH+Fe+2H2→Li3FeH7, reveals a possible route to a stable complex hydride containing [FeH7]3–.
Grazing-incidence x-ray fluorescence analysis for non-destructive determination of In and Ga depth profiles in Cu(In,Ga)Se2 absorber films
Authors: Streeck C. , Brunken S. , Gerlach M. , Herzog C. , Hönicke P. , Kaufmann C. A. , Lubeck J. , Pollakowski B. , Unterumsberger R. , Weber A. , Beckhoff B. , Kanngießer B. , Schock H.-W. , Mainz R.
Published: September 2013

Development of highly efficient thin film solar cells involves band gap engineering by tuning their elemental composition with depth. Here we show that grazing incidence X-ray fluorescence (GIXRF) analysis using monochromatic synchrotron radiation and well-characterized instrumentation is suitable for a non-destructive and reference-free analysis of compositional depth profiles in thin films. Variation of the incidence angle provides quantitative access to the in-depth distribution of the elements, which are retrieved from measured fluorescence intensities by modeling parameterized gradients and fitting calculated to measured fluorescence intensities. Our results show that double Ga gradients in Cu(In1−x,Gax)Se2 can be resolved by GIXRF.
Flicker noise and magnetic resolution of graphene hall sensors at low frequency
Authors: Xu Huilong , Huang Le , Zhang Zhiyong , Chen Bingyan , Zhong Hua , Peng Lian-Mao
Published: September 2013

Hall elements fabricated on chemical vapor deposited graphene exhibited high current- and voltage-related sensitivities due to its low intrinsic carrier density and high mobility about 5000 cm2/V s. Electric noise of the Hall elements was measured at room temperature and found to be largely Flicker noise at low frequency which can be well described by Hooge's empirical relation with a low noise parameter of about 1.8 × 10−4. The combination of high sensitivity and low noise in graphene Hall elements leads to a high room temperature magnetic resolution of about 5 × 10−3 G/Hz0.5 at 3 kHz.
Reconsidering Sound and the City: Asserting the Right to the Deaf-Friendly City
Authors: Harold Gill
Published: September 2013

The sensory turn has made a pronounced attempt to broaden the focus in social and cultural geography to encompass the entire sensory spectrum, with the aim of counterbalancing what is perceived to have been the disproportionate attention granted to visual geographies and the act of seeing. In respect of critically understanding the geographies of difference that characterise Deaf citizens' experience in the contemporary city, this paper calls for a moment in geography to take stock of the signature that visual awareness bears in the social life of the Deaf city, and also to consider the hearingness implicit in geographical commentary on the role of sound in the reproduction of place. Reading urban and public spaces from a Deaf-centred perspective, I draw on parallel discussions from social geography and Deaf Studies to critically deconstruct the phenomena underpinning the aural bias that is deeply embedded in the social fabric, and which finds continuous expression in the intangible aural architectures of modern life. Dispositions and attitudes towards the ‘normal’ hearing body and towards hearing ontological engagements with sound and speech serve to maintain the city's audist and phonocentric inclinations. Here, the manner in which the right to the Deaf-friendly city is jeopardised is made explicit through empirical accounts from Deaf people in Ireland and England whose everyday geographies are characterised by the negotiation of urban spaces that were designed according to the needs of an assumed homogenous hearing public.
The involvement of the mitochondrial peroxiredoxin PRXIIF in defining physiological differences between orthodox and recalcitrant seeds of two Acer species
Authors: Ratajczak Ewelina , Ströher Elke , Oelze Marie-Luise , Kalemba Ewa M. , Pukacka Stanisława , Dietz Karl-Josef
Published: September 2013

Norway maple (Acer platanoides L., orthodox) and sycamore (Acer pseudoplatanus L., recalcitrant) belong to the same genus and grow under similar climatic conditions, but their seeds differ in their tolerance to desiccation. The initial water content (WC) of the seeds used in this study was 50%, and they were dried to 40, 20 and 7%. The mitochondrial peroxiredoxin IIF (PRXIIF) was identified in seeds of both species by immunoblotting. Semiquantitative RT–PCR analyses indicated that the transcript level of PRXIIF in both types of seeds increased during different stages of desiccation and was higher in seeds of Norway maple than in sycamore. General proteome analyses showed important differences between orthodox and recalcitrant seeds. In sycamore seeds that had been desiccated to a 7% WC, the number of protein spots and the levels of those spots were lower than in desiccation-tolerant Norway maple seeds. Post-translational modifications of PRXIIF in seeds at a 50% WC were detected via 2D electrophoresis and subsequent western blot analysis. The detected shift in the pI values (± 0.3) in A. pseudoplatanus was possibly caused by phosphorylation because several potential phosphorylation sites were predicted in silico for that protein. The gene and amino acid sequences were obtained and aligned with known sequences of other plant PRXIIF genes and proteins. High values of sequence identity were noted between the PRXIIF protein sequences of Acer species, Populus trichocarpa Torr. & A. Gray and Arabidopsis thaliana (L.) Heynh. The involvement of PRXIIF in defining the physiological differences between desiccation-tolerant and desiccation-sensitive Acer seeds is discussed in the context of its role in mitochondrial redox homeostasis.
Powers in finite groups and a criterion for solubility
Authors: Liebeck Martin , Shalev Aner
Published: September 2013

We study the set

G

[
k
]

G^{[k]}

of

k

t
h

k^{th}

powers in finite groups

G
G

. We prove that if

G

[
12
]

G^{[12]}

is a subgroup, then

G
G

must be soluble; moreover, 12 is the minimal number with this property. The proof relies on results of independent interest, classifying almost simple groups

G
G

and positive integers

k
k

for which

G

[
k
]

G^{[k]}

contains the socle of

G
G

.
Inhalational Anesthesia
Authors: Adams Jerome , Dorwart Amy
Published: September 2013

Chapter 1 contains 70 questions and answers regarding inhalational anesthesia.
Anesthesia and Disease States, Part II
Authors: Plambeck Christopher , Khatri Vikram , Varadarajan Srinivasan G. , Zainer Christine M.
Published: September 2013

Chapter 4 contains 62 questions and answers regarding anesthesia and disease states.
Vascular Anesthesia
Authors: Eastburn Elizabeth , Bose Ruma
Published: September 2013

Chapter 11 contains 20 questions and answers regarding vascular anesthesia.
Anesthesia Equipment
Authors: Agarwala Aalok , Vazquez Rafael , Vu Cuong
Published: September 2013

Chapter 14 contains 64 questions and answers regarding anesthesia equipment.
Do-Not-Resuscitate Orders in the OR
Authors: Meyer Mark J , Weidner Norbert J
Published: September 2013

A physician signs a do-not-resuscitate order (DNR) when aggressive resuscitation measures will not benefit the patient in the presence of a life-threatening illness. Many children living with a life-threatening illness derive benefit from invasive diagnostic and therapeutic procedures such as tracheostomies, peripherally inserted central lines, gastrostomy tubes, and tumor debulking procedures. These procedures are considered palliative rather than curative in that they improve or preserve quality of life but do not prevent progression of the underlying condition. In children, the presence of a DNR order may not be a harbinger that death is imminent and can be consistent with pursuing life-prolonging interventions aimed at improving quality of life. However, these orders confound pediatric anesthesiologists who, during the conduct of a routine anesthetic, can cause cardiovascular and respiratory compromise.
Anaphylaxis
Authors: Hosu Liana G , Aronson Lori A
Published: September 2013

Anaphylaxis has been defined as a “severe, life-threatening generalized or systemic hypersensitivity reaction” (Johansson et al., 2004). It is rapid in onset and may cause death or permanent disability. Early recognition and optimal management are critical. During anesthesia, recognition of anaphylaxis is often delayed because the clinical presentation can mimic other conditions. Epinephrine is the drug of choice in the treatment of anaphylaxis and should be given as early as possible.
Foreign Body in the Airway
Authors: Chidambaran Vidya , Sadhasivam Senthilkumar
Published: September 2013

Airway foreign body aspiration is associated with significant airway distress that can lead to morbidity and mortality, especially in young children. Children who inhale a foreign body into the airway and require bronchoscopy under general anesthesia present the anesthetist with some of the most difficult and demanding cases in pediatric anesthesia.
Bacterial Tracheitis Versus Epiglottitis
Authors: Wu Junzheng , Kurth C. Dean
Published: September 2013

Both acute epiglottitis and bacterial tracheitis can cause severe airway obstruction, respiratory distress, and sudden respiratory arrest in young children. The early and prompt differential diagnosis between the two is crucial to select the type of airway intervention to ensure a safe outcome.
Cardiac Catheterization
Authors: Lin Erica P , Loepke Andreas W
Published: September 2013

As the management of congenital heart disease evolves, the use of cardiac catheterization, both as a diagnostic and therapeutic tool, has significantly increased. Increasingly complex interventions are being performed on younger and sicker children. Therefore, anesthesia providers in the cardiac catheterization laboratory must have a good understanding of each patient's underlying cardiac physiology, the implications of the anesthetic technique on this physiology, as well as the inherent risks and potential complications of the procedure to be performed.
Cardiac MRI
Authors: Martin Nicholas
Published: September 2013

Magnetic resonance imaging (MRI) is an important tool for investigating congenital cardiac conditions. It provides excellent images of the cardiac anatomy and is unrivalled in its ability to illuminate the pulmonary vessels. Conservation of femoral vessels and absence of ionizing radiation gives it an advantage over cardiac catheterization. Apart from the challenges of anesthetizing a child with an uncorrected congenital heart condition, the MRI environment presents some unique challenges to the anesthesiologist. It is usually remote from the main operating suite, and the permanent strong magnetic field requires specialized equipment and precautions.
Prone Positioning for Posterior Fossa Tumor Resection
Authors: König Matthias W , Mahmoud Mohamed A , McAuliffe John J
Published: September 2013

Brain tumors are the second most common malignancy in children. About one third occur in toddlers under the age of 3, and about two thirds are located in the posterior fossa. Resection of posterior fossa tumors is often a lengthy procedure that is commonly performed in the prone position. The prone position is associated with physiological changes and predisposes the patient to certain types of injuries.
Congenital Diaphragmatic Hernia Repair
Authors: Boat Anne C , Sadhasivam Senthilkumar
Published: September 2013

Congenital diaphragmatic hernia (CDH) affects approximately 1 in 2,500 live births and results from an embryologic defect in diaphragm formation allowing abdominal contents to enter the fetal pleural cavity. Prognosis and treatment options vary depending on the extent and location of the diaphragmatic hernia, but CDH remains a significant cause of neonatal morbidity and mortality. Anesthesia for neonatal repair of CDH can be involved, as patients often have many organ systems affected by their disease process.
Mucopolysaccharidoses
Authors: Frawley Geoff
Published: September 2013

The mucopolysaccharidoses (MPS) are a group of seven chronic progressive diseases caused by deficiencies of 11 different lysosomal enzymes required for the catabolism of glycosaminoglycans (GAGs). Hurler syndrome (MPS IH) is an autosomal recessive storage disorder caused by a deficiency of α‎-L-iduronidase. Hunter syndrome (MPS II) is an X-linked recessive disorder of metabolism involving the enzyme iduronate-2-sulfatase. Many of the MPS clinical manifestations have potential anesthetic implications. Significant airway issues are particularly common due to thickening of the soft tissues, enlarged tongue, short immobile neck, and limited mobility of the cervical spine and temporomandibular joints. Spinal deformities, hepatosplenomegaly, airway granulomatous tissue, and recurrent lung infections may inhibit pulmonary function. Odontoid dysplasia and radiographic subluxation of C1 on C2 is common and may cause anterior dislocation of the atlas and spinal cord compression.
Osteogenesis Imperfecta
Authors: Patino Mario , Varughese Anna M
Published: September 2013

Osteogenesis imperfecta (OI) is a heterogeneous inherited disorder of type I collagen. Although it is most commonly known for the “brittle bones” that lead to multiple and recurrent fractures, OI has manifestations in other tissues where type I collagen is present. Moreover, the brain stem, cervical spine, and lungs can be affected indirectly due to the resultant bone abnormalities. A pre-anesthetic evaluation must review all systems and specific anesthetic considerations are necessary to reduce complications and improve outcomes of patients with OI.
Stridor After Extubation
Authors: Wu Junzheng , Kurth C. Dean
Published: September 2013

Infants and young children who were intubated and mechanically ventilated occasionally present with stridor in the post-anesthesia care unit (PACU) after extubation. In severe cases, respiratory distress and oxygen desaturation accompany the stridor. Prophylactic measures and prompt management help to prevent post-extubation stridor and ameliorate the signs and symptoms should it occur.
Postoperative Nausea and Vomiting in Patients with Prolonged QTc
Authors: Rao Shilpa , Lerman Jerrold
Published: September 2013

A panoply of pharmacological and nonpharmacological strategies are currently employed to attenuate the risk of postoperative nausea and vomiting (PONV) in children, including 5-hydroxytryptamine type 3 (5-HT3) receptor antagonists. 5-HT3 receptor antagonists can prolong the QT interval, which can be a precursor of torsades de pointes (TdP), particularly in children with congenital or acquired prolonged QT interval. This chapter summarizes the causes of prolonged QT interval, the potential interactions of prolonged QT interval with antiemetics and anesthetics, and strategies to prevent PONV.
Disclosure After Complication in the OR
Authors: Meyer Mark J , Weidner Norbert J
Published: September 2013

In matters of medical error and complications, patients and families overwhelmingly want to be informed. Most patients want providers to disclose if a complication or an error has occurred, and want to be informed of any possible adverse outcomes from the event. Most want to be informed immediately following an event and expect an investigation when the cause is not readily identified. When the event is due to an error, patients and families want honest disclosure and a sincere apology from those responsible. Afterward, they want continued emotional and psychological support, and they expect efforts to identify and correct the cause. Historically, physicians and institutions have been slow to fully disclose errors, especially if they were preventable. Patients have frequently not been provided with the support they require and often have felt frightened and alienated. The immediate effects of medical mistakes can be devastating, but the subsequent emotional, personal, and relational consequences can be very distressing. Silence, shame, guilt, and fractured trust disrupt the therapeutic relationship and leave patients, families, and caregivers to suffer alone.
Large-scale phylogenetic analyses reveal the causes of high tropical amphibian diversity
Authors: Pyron R. Alexander , Wiens John J.
Published: September 2013

Many groups show higher species richness in tropical regions but the underlying causes remain unclear. Despite many competing hypotheses to explain latitudinal diversity gradients, only three processes can directly change species richness across regions: speciation, extinction and dispersal. These processes can be addressed most powerfully using large-scale phylogenetic approaches, but most previous studies have focused on small groups and recent time scales, or did not separate speciation and extinction rates. We investigate the origins of high tropical diversity in amphibians, applying new phylogenetic comparative methods to a tree of 2871 species. Our results show that high tropical diversity is explained by higher speciation in the tropics, higher extinction in temperate regions and limited dispersal out of the tropics compared with colonization of the tropics from temperate regions. These patterns are strongly associated with climate-related variables such as temperature, precipitation and ecosystem energy. Results from models of diversity dependence in speciation rate suggest that temperate clades may have lower carrying capacities and may be more saturated (closer to carrying capacity) than tropical clades. Furthermore, we estimate strikingly low tropical extinction rates over geological time scales, in stark contrast to the dramatic losses of diversity occurring in tropical regions presently.
Empirical analysis of the determinants of environmentally sustainable practices in the UK construction industry
Authors: Oluwole Akadiri Peter , Olaniran Fadiya Olusanjo
Published: September 2013

Purpose

– During the last decade, the practice of sustainability has been gradually adopted in the UK construction industry, with the increasing interest in the discourse of sustainable development. This paper therefore aims to investigate the role and ability of sustainable development-based requirements – top management commitment, government regulations and construction stakeholder pressures – as potential determinants of adoption of proactive environmentally sustainable practices, with a view of promoting sustainable innovation in the UK construction industry.

Design/methodology/approach

– The research approach selected for this research comprised of a questionnaire survey of the UK construction industry practitioners – architects and designers, structural engineers, construction managers and quantity surveyors – with the aid of an Adobe Livecycle Designer. Purposive sampling techniques using maximum variation strategy were adopted for selecting the target survey respondents. The Predictive Analysis Software (PASW) Statistics 17.0 (formerly SPSS statistics) was employed to analyse information from the survey.

Findings

– Empirical results indicate a positive effect of government regulations, top management commitment and construction stakeholder pressures on sustainable construction practices. Government regulation was found to be the most important determinants of sustainable practices. In addition, top management commitment appears to be linked with government regulation as the defining factor increasing managers sustainability awareness, helping sustainable practices to be effectively implemented and appealing to firms.

Originality/value

– The research results provide useful information in understanding the determinant factors of sustainable construction innovation and are particularly essential in aiding better decision-making in implementing sustainable practices, thereby facilitating the sustainability of the construction sector.
Geometric modelling of metallic foams
Authors: Carofalo Alessio , De Giorgi Marta , Morabito Anna
Published: September 2013

Purpose

– The aim of this work is the development of a procedure able to model the highly irregular cellular structure of metallic foams on the basis of information obtained by X-ray tomographic analysis.

Design/methodology/approach

– The geometric modelling is based on the feature “pore” characterized by an ellipsoidal shape. The data for the geometric parameters of the instances are obtained with a methodology which is driven by the pore volume distribution curve. This curve shows how much the cells, whose diameter belongs to a given dimensional range, contribute to the reduction of the total volume.

Findings

– The presented methodology has been implemented into a CAD tool consisting of a Matlab routine identifying the instances of the feature “pore” and a CATIA's macro modelling the closed cells foam.

Originality/value

– The presented methodology allows to obtain in an automatic way the CAD model of the complex structure of closed cell aluminium foam approximating by considerable accuracy both the density and the volume distribution of the real foams.
Particle swarm optimization and identification of inelastic material parameters
Authors: Vaz Jr M. , Cardoso E.L. , Stahlschmidt J.
Published: September 2013

Purpose

– Parameter identification is a technique which aims at determining material or other process parameters based on a combination of experimental and numerical techniques. In recent years, heuristic approaches, such as genetic algorithms (GAs), have been proposed as possible alternatives to classical identification procedures. The present work shows that particle swarm optimization (PSO), as an example of such methods, is also appropriate to identification of inelastic parameters. The paper aims to discuss these issues.

Design/methodology/approach

– PSO is a class of swarm intelligence algorithms which attempts to reproduce the social behaviour of a generic population. In parameter identification, each individual particle is associated to hyper-coordinates in the search space, corresponding to a set of material parameters, upon which velocity operators with random components are applied, leading the particles to cluster together at convergence.

Findings

– PSO has proved to be a viable alternative to identification of inelastic parameters owing to its robustness (achieving the global minimum with high tolerance for variations of the population size and control parameters), and, contrasting to GAs, higher convergence rate and small number of control variables.

Originality/value

– PSO has been mostly applied to electrical and industrial engineering. This paper extends the field of application of the method to identification of inelastic material parameters.
Who owns the gap? (Part one): Appreciative Inquiry as a diagnostic tool
Authors: Watson Sally
Published: September 2013

Purpose

– The purpose of this paper is to report on the impact of Appreciative Inquiry on the diagnostic phase of a management development programme. A case study of an organisation delivering both further and higher education will be used to illustrate how the involvement of a management population in the diagnosis and design of the programme resulted in individual, team and organisational learning. The use of Appreciative Inquiry challenges conventional methods of diagnosis and evaluation. One year later a second Appreciative Inquiry was adapted to become an evaluation tool. The outcomes of this work will be reported in part two of this article.

Design/methodology/approach

– Appreciative Inquiry workshops involving 72 managers were used to encourage a collaborative approach to diagnostics prior to the launch of a management development programme. The workshops followed a four-stage structure. Small self-managed teams, with representation from different departments and levels of management, engaged in a diagnostic process with support from Lancaster facilitators.

Findings

– Participants discovered new working practices for exploring and solving organisational issues and challenges. Individuals learned from the teamwork and established new networks and sources of innovation. The benefits of a collaborative approach included greater clarity on strategies, priorities and rigorous alignment of management development needs to the mission of achieving outstanding status.

Research limitations/implications

– Participants of the management development programme were actively engaged in the diagnosis of learning and development needs. The diagnostic phase accelerated engagement with learning across a broad spectrum of managers and key organisational stakeholders.

Practical implications

– The use of Appreciative Inquiry as a diagnostic tool ensures that management development is firmly rooted in strategic priorities of the organisation. The approach ensures that all contributions are respected and this results in a higher quality dialogue across different parts of the organisation.

Originality/value

– The paper is original in presenting a management development programme diagnosed and evaluated by organisational members. The result was practical, cost effective and sustainable development which transferred capability to the organisation. Part two of this article will report on Appreciative Inquiry as an evaluation tool and provide evidence of the sustainability of individual, team and organisational learning.
Assessing obstetric patient experience: a SERVQUAL questionnaire
Authors: Garrard Francesca , Narayan Harini
Published: September 2013

Purpose

– Across health services, there is a drive to respond to patient feedback and to incorporate their views into service improvement. The SERVQUAL method has been used in several clinical settings to quantify whether services meet patient expectations. However, work has been limited in the obstetric population. This paper seeks to address these issues.

Design/methodology/approach

– This study used an adapted SERVQUAL questionnaire to assess a reconfigured antenatal clinic service. The most important care aspects, as rated by patients, were used to construct the SERVQUAL questions. The questionnaire was administered to eligible women in two parts. The first was completed before their first hospital antenatal appointment and the second either at home (a postal-chasing exercise) or while waiting for their next appointment. Only fully completed questionnaires (both parts) were analysed.

Findings

– Service strengths included staff politeness, patient respect and privacy. Areas for improvement included hand cleanliness, women's involvement in decision making and communicating risk. However, the low variability in patient responses makes concrete conclusions difficult and methodological issues complicate evaluating hand cleanliness. The new antenatal clinic service received low negative weighted and un-weighted overall scores. The SERVQUAL measure was developed from patient feedback and used to further improve services.

Practical implications

– The SERVQUAL-based measure allowed an internal evaluation of patient experience and highlighted areas for improvement. However, without validation, the questionnaire cannot be used as an outcome measure and variation between published SERVQUAL questionnaires makes comparisons difficult. This highlights an important balance in patient evaluation measures - between locally responsive and externally comparable.

Originality/value

– The SERVQUAL approach allows healthcare teams to evaluate patient experience, while accounting for variation in their expectations and priorities. The study highlights several areas that are important to obstetric patients, where expectation scores are high. However, the similar means and small samples left little difference between excellence and room for improvement.
Using the Plan-Do-Study-Act model: Pacesetters experiences
Authors: Moule Pam , Evans David , Pollard Katherine
Published: September 2013

Purpose

– This article aims to analytically review the Plan-Do-Study-Act (PDSA) model used in the Pacesetters national programme evaluation.

Design/methodology/approach

– The evaluation team's two-fold role is outlined: supporting project teams to develop PDSA plans and collect evaluation data. Four case studies are used to show the PDSA model's application and effect in a participatory action learning approach. Despite limitations, it is clear that all four case studies illustrate the PDSA model's potential benefits in a participatory evaluation approach, which involves public and patients.

Findings

– The model's effectiveness is premised on several enabling factors such as: teams appreciating the model; a climate that values all learning and open to re-planning; engaging any external evaluators whose role is clearly communicated to all project stakeholders in a timely fashion.

Practical implications

– There are clear intentions to promote evidence-based commissioning in the UK that values patient and public involvement. The PDSA model has the potential to test and implement changes in real work-place settings and to involve the public in evaluation.

Originality/value

– Case study analysis identifies new reflections on the PDSA model's use to support innovative NHS practice development with public involvement in a participatory approach.