bluuebunny/crossref_metadata_2025 huggingface dataset:
Demographic and Treatment Variability of Refractory Kawasaki Disease: A Multicenter Analysis From 2005 to 2009
Authors: Ghelani Sunil J. , Pastor William , Parikh Kavita
Published: September 2013

Objective:

Approximately 10% to 15% of Kawasaki disease (KD) is refractory to treatment with initial intravenous immunoglobulin (IVIG). However, there is no consensus on pharmacologic treatment of refractory KD (rKD). Demographic characteristics of patients with rKD and regional variability in their treatment in the United States have not been reported on a large scale. The goal of this study was to describe the demographic and treatment variability in rKD by using a large multi-institutional database.

Methods:

Data were obtained for patients with KD from January 2005 to June 2009 by using the Pediatric Health Information System. Patients who received a single dose of IVIG were labeled as having standard KD (sKD) and those who required additional medications were labeled as having rKD.

Results:

Of the 5633 patients studied, 4818 (85.5%) received 1 dose of IVIG (sKD) and 815 (14.5%) received >1 medication (rKD). Median age was 30 months (interquartile range: 14-53) and 30 months (interquartile range: 15-54) for rKD and sKD patients, respectively (P= .438). No significant change was noted in the gender or ethnic distribution of patients between rKD and sKD groups. Seasonal distribution of rKD was comparable to sKD. IVIG was the most common (64.5%) initial medication chosen to treat rKD, followed by methylprednisolone (27.1%) and infliximab (8.3%); however, there was significant regional variability. Of patients with rKD, 81% required only 1 additional medication (after the initial IVIG) for treatment.

Conclusions:

Patients with rKD have similar age, gender, ethnic, and seasonal distribution as sKD patients. IVIG is the most common initial medication chosen to treat rKD; however, there is regional variation.
Resident Perceptions of Autonomy in a Complex Tertiary Care Environment Improve When Supervised by Hospitalists
Authors: Burgis Jennifer C. , Lockspeiser Tai M. , Stumpf Emily C. , Wilson Stephen D.
Published: September 2013

Background and Objective:

Increasingly, academic hospitals have adopted hospitalist-based systems of inpatient pediatric care. Some studies comparing hospitalists with other attending physicians have suggested trainees are more satisfied with education from hospitalists. However, there are published concerns that the increased presence of hospitalists may reduce residents’ autonomy. The objective of the current study was to evaluate pediatric residents’ perceptions of their own autonomy after a broad ward restructuring to hospitalist-led teams.

Methods:

We analyzed data from standardized attending evaluations before and after a pediatric ward restructuring at an academic tertiary care hospital. Provision of most inpatient pediatric care changed from subspecialist-led teams to hospitalist-led teams. Numerical scores from evaluations before and after the restructuring were compared quantitatively. Comments from the evaluations were analyzed qualitatively to identify key themes.

Results:

Before the restructuring, there were 65 evaluations of 5 hospitalists and 602 evaluations of 32 subspecialists. After the restructuring, there were 188 evaluations of 8 hospitalists. Hospitalists were rated significantly higher on all teaching attributes compared with all attending physicians before the restructuring. The attending role in promoting autonomy was mentioned infrequently and reflected residents’ perceived lack of autonomy before the restructuring. The primary theme after the restructuring was autonomy, specifically emphasizing resident leadership and decision-making and the appropriate balance of resident autonomy and supervision.

Conclusions:

Although patient complexity was unchanged, a comparison of numerical ratings and resident comments before and after the restructuring indicates that hospitalists lead teams differently from subspecialists, with more emphasis on resident decision-making and autonomy.
Career Satisfaction and the Role of Mentorship: A Survey of Pediatric Hospitalists
Authors: Pane Laurie A. , Davis Aisha B. , Ottolini Mary C.
Published: September 2013

Background and Objective:

Attending physicians’ career satisfaction is associated with higher patient satisfaction, better patient care, and even medical student career choice. Previous studies indicate that adequate mentorship improves job satisfaction, but finding mentors may be challenging for some hospitalists. Little is known about pediatric hospitalist career satisfaction or the role of mentorship. The goal of this study was to assess career satisfaction among pediatric hospitalists, determine which interventions may improve satisfaction, and investigate the role of mentorship in satisfaction.

Methods:

This study included the use of an anonymous electronic cross-sectional survey sent to the American Academy of Pediatrics’ Section on Hospital Medicine Listserv between November 2009 and January 2010.

Results:

A total of 222 pediatric hospitalists responded; 92% agreed with the statement, “Overall, I am pleased with my work.” Of the 23 satisfaction statements, “I have adequate mentorship in my career” was rated lowest (P ≤ .001); only 44% agreed. Adequate mentorship was significantly correlated with overall career satisfaction, having sufficient opportunity for promotion, feeling valued by one’s administration, and wishing to remain at one’s current hospital. Adequate mentorship was negatively correlated with planning to change specialty or leave clinical medicine. Mentorship satisfaction did not differ by age, years as a hospitalist, gender, or practice setting. Of the 15 potential interventions, creating a formal mentorship program ranked in the top 5. Only increasing base salary received a significantly higher score.

Conclusions:

Although surveyed hospitalists have substantial overall career satisfaction, lack of mentorship is a significant problem that spans the demographic spectrum. Establishing a mentorship program may be an effective way for hospitalist groups to improve satisfaction.
Validity of Respiratory Scores in Bronchiolitis
Authors: Destino Lauren , Weisgerber Michael C. , Soung Paula , Bakalarski Deborah , Yan Ke , Rehborg Rebecca , Wagner Duke R. , Gorelick Marc H. , Simpson Pippa
Published: September 2013

Objective:

The primary objective of this study was to establish the validity and reliability of 2 respiratory scores, the Respiratory Distress Assessment Instrument (RDAI) and the Children’s Hospital of Wisconsin Respiratory Score (CHWRS), in bronchiolitis. A secondary objective was to identify the respiratory score components that most determine overall respiratory status.

Methods:

This was a prospective cohort study in infants aged <1 year seen at Children’s Hospital of Wisconsin for bronchiolitis. We evaluated: (1) discriminative validity (the score’s ability to discriminate between 2 different outcomes) of the respiratory scores to identify emergency department (ED) disposition by using receiver operating characteristic curves; and (2) construct validity (the score’s ability to measure what it is thought to measure, overall respiratory status) by using length of stay (LOS) as a proxy for disease severity and comparing correlations between changes in respiratory scores and LOS. Interrater reliability was established by using intraclass correlation. The contribution of individual respiratory score components to determine ED disposition was studied by using multivariate logistic regression.

Results:

A total of 195 infants were included. The area under the receiver operating characteristic curve was 0.68 for CHWRS versus 0.51 for RDAI in predicting disposition. There was no correlation between initial respiratory scores or change in respiratory scores over the first 24 hours and LOS. Item analysis revealed that oxygen delivery, subcostal retractions, and respiratory rate were independently correlated with ED disposition. The CHWRS was more reliable than the RDAI.

Conclusions:

The CHWRS had modest discriminative validity in predicting ED disposition. Neither the CHWRS nor the RDAI had good construct validity. Respiratory rate, oxygen need, and presence of retractions were most useful in predicting ED disposition.
A Preliminary Screening Instrument for Early Detection of Medical Child Abuse
Authors: Greiner Mary V. , Palusci Vincent J. , Keeshin Brooks R. , Kearns Stephen C. , Sinal Sara H.
Published: September 2013

Objective:

The goal of this research was to develop a screening instrument for early identification among hospitalized children of medical child abuse (MCA).

Methods:

We developed a preliminary screening instrument for the early identification of MCA. Items were chosen based on published characteristics of MCA, including caregiver, patient, and illness information. Each item in the instrument was scored with 1 point if positive. This instrument was tested by reviewing the hospital charts of child protective services–confirmed MCA patients and comparing the results with charts of children with admissions for apnea, vomiting/diarrhea, and seizures who were not diagnosed with MCA. Nineteen cases and 389 controls were used for analysis. We used receiver operating characteristic curves, starting with items most highly associated with MCA in our sample. Predictive values and strengths of association were assessed by using χ2 and Fisher’s exact tests, as appropriate.

Results:

From an initial 46 questions, we determined that 26 items showed a statistically significant difference between cases and control patients. From these, an instrument with 15 items maximized the area under the receiver operating characteristic curve, and a score of ≥4 had a sensitivity of 0.947 and a specificity of 0.956 (P < .05) in detecting MCA.

Conclusions:

This chart review screening instrument identified differences in characteristics of children, caregivers, and illness during hospitalization that may allow for earlier detection of MCA and referral for further assessment to the multidisciplinary team.
Hospitalization of Early Preterm, Late Preterm, and Term Infants During the First Year of Life by Gestational Age
Authors: Ray Kristin N. , Lorch Scott A.
Published: September 2013

Objectives:

The goal of this study was to describe hospitalizations of infants during the first year of life according to week of gestational age (GA). We hypothesized that odds of any hospitalization would generally decrease with increasing GA, with late preterm infants experiencing additional increased risk of specific hospitalizations, such as hyperbilirubinemia.

Methods:

Birth certificates for >6.6 million infants born in California hospitals between 1993 and 2005 and surviving to discharge were linked to hospital discharge records during the first year of life. Odds of any hospitalization and any hospitalization for specific diagnoses during the first year of life were determined for infants 23 to 44 weeks’ GA. Further analysis determined odds of any hospitalization within 14, 30, and 90 days of birth discharge, and observed odds were compared with expected odds obtained through quadratic modeling.

Results:

Odds of any hospitalization within the first year of life decreased with advancing GA, but observed odds of any hospitalization exceeded expected odds for 35-, 36-, and 37-week GA infants for all time periods after discharge. Odds of any hospitalization for hyperbilirubinemia were greatest for infants 33 to 38 weeks’ GA (peak odds ratio at 36 weeks’ GA: 2.86 [95% confidence interval: 2.73–3.00]), and a relative peak in odds of any hospitalization for specific infections was observed among infants 33 to 36 weeks’ GA.

Conclusions:

Odds of any hospitalization during the first year of life exceeded expected odds of hospitalization for 35-, 36-, and 37-week GA infants. GAs at risk overlapped with, but were not identical to, GAs identified as late preterm infants.
Morphine Is Associated With Acute Chest Syndrome in Children Hospitalized With Sickle Cell Disease
Authors: Birken Catherine S. , Khambalia Amina , Dupuis Annie , Pastor Aimee , Lee Michelle , Padavattan Karen , Mekky Magda , Odame Isaac , Parkin Patricia C.
Published: September 2013

Objective:

To determine if intravenous morphine is associated with acute chest syndrome (ACS) in children with homozygous for hemoglobin S sickle cell disease (SCD) hospitalized with acute pain.

Methods:

Health records of patients with homozygous for hemoglobin S SCD aged 2 to 18 years hospitalized with acute pain were reviewed. Patients developed ACS at least 12 hours after emergency department triage; controls did not develop ACS. Survival analyses were performed.

Results:

There were 38 cases and 45 randomly selected controls. The mean hourly dose of morphine 1, 2, and 3 hours before ACS and cumulative mean morphine dose up to 5 hours before ACS were significantly associated with ACS (P < .05). Adjusted analysis showed that 1 hour before ACS, the mean morphine dose was significantly higher in cases (40 µg/kg) compared with controls (34 µg/kg), and the risk of ACS increased by 23% for each additional 10 µg/kg of morphine received (P = .02).

Conclusions:

We recommend close observation for ACS in hospitalized patients with SCD who are receiving morphine.
The Clinical Management of Preterm Infants With Bronchiolitis
Authors: Alverson Brian , McCulloh Russell J. , Dawson-Hahn Elizabeth , Smitherman Sarah E. , Koehn Kristin L.
Published: September 2013

Objectives:

The goal of this study was to determine physician management choices for hospitalized premature infants with bronchiolitis compared with term infants and to evaluate predictors of steroid use in premature infants.

Methods:

A chart review was conducted of premature and nonpremature infants admitted to 2 children’s hospitals with bronchiolitis. Reviewers selected charts based on International Classification of Diseases, Ninth Revision diagnosis codes and collected demographic and historical information, as well as evaluation, treatment, treatment effectiveness, length of stay, hospital readmission rates, and adverse outcomes. Reviewers compared documented rates of utilization and effectiveness of inhaled racemic epinephrine and albuterol between patients with and without a history of prematurity. Patients with a history of prematurity underwent subgroup analysis of factors relating to steroid use.

Results:

A total of 1223 patients met the study criteria for inclusion. Premature infants represented 19% of all children hospitalized with bronchiolitis. These infants had a longer length of stay (3.8 vs 2.6 days; P < .001) and a more severe hospital course. Rates of inhaled therapy and steroid utilization did not differ between premature and term infants. There was no difference in rates of documented positive response to albuterol, but premature infants were more likely to have a positive response to epinephrine. Steroid use in premature infants was associated with older age, history of wheeze, and albuterol use; documentation of albuterol efficacy did not correlate with steroid use, however.

Conclusions:

Management decisions among term and premature infants with bronchiolitis were similar. Premature infants who received albuterol were more likely to receive steroids; however, the decision regarding steroid use was not associated with documentation of efficacy of albuterol.
High-Fidelity Simulation Enhances Pediatric Residents’ Retention, Knowledge, Procedural Proficiency, Group Resuscitation Performance, and Experience in Pediatric Resuscitation
Authors: Mills David M. , Wu Chang L. , Williams Daniel C. , King Lydia , Dobson Joseph V.
Published: September 2013

Objective:

The goal of this study was to assess the effect of high-fidelity simulation (HFS) pediatric resuscitation training on resident performance and self-reported experience compared with historical controls.

Methods:

In this case-control study, pediatric residents at a tertiary academic children’s hospital participated in a 16-hour HFS resuscitation curriculum. Primary outcome measures included cognitive knowledge, procedural proficiency, retention, and self-reported comfort and procedural experience. The intervention group was compared with matched-pair historical controls.

Results:

Forty-one residents participated in HFS training with 32 matched controls. The HFS group displayed significant initial and overall improvement in knowledge (P < .01), procedural proficiency (P < .05), and group resuscitation performance (P < .01). Significant skill decay occurred in all performance measures (P < .01) with the exception of endotracheal intubation. Compared with controls, the HFS group reported not only greater comfort with most procedures but also performed more than twice the number of successful real-life pediatric intubations (median: 6 vs 3; P = .03).

Conclusions:

Despite significant skill decay, HFS pediatric resuscitation training improved pediatric resident cognitive knowledge, procedural proficiency, and comfort. Residents who completed the course were not only more proficient than historical controls but also reported increased real-life resuscitation experiences and related procedures.
Bevacizumab for Advanced Breast Cancer: Hope, Hype, and Hundreds of Headlines
Authors: Fralick Michael , Ray Monali , Fung Christina , Booth Christopher M. , Mallick Ranjeeta , Clemons Mark J.
Published: September 2013

Learning Objectives

Summarize findings regarding the media's portrayal of bevacizumab with each phase of therapeutic development. Identify media sources of information about bevacizumab in each phase of therapeutic development.
Chemotherapy With Erlotinib or Chemotherapy Alone in Advanced Non-Small Cell Lung Cancer With Acquired Resistance to EGFR Tyrosine Kinase Inhibitors
Authors: Goldberg Sarah B. , Oxnard Geoffrey R. , Digumarthy Subba , Muzikansky Alona , Jackman David M. , Lennes Inga T. , Sequist Lecia V.
Published: September 2013

Purpose.

Epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer has an oncogene-addicted biology that confers sensitivity to EGFR tyrosine kinase inhibitors (TKIs). Published data suggest that EGFR addiction persists after development of TKI acquired resistance, leading many clinicians to continue TKI with subsequent chemotherapy; however, this strategy has not been formally evaluated.

Methods.

We retrospectively reviewed an institutional database to identify patients with advanced EGFR mutation with acquired resistance who subsequently received chemotherapy. Patients were classified as receiving chemotherapy with continued erlotinib or chemotherapy alone. We assessed differences in outcomes between the two strategies.

Results.

Seventy-eight patients were included, 34 treated with chemotherapy and erlotinib and 44 treated with chemotherapy alone. Objective response rate was evaluable in 57 patients and was 41% for those treated with chemotherapy and erlotinib and 18% for those treated with chemotherapy alone. After adjusting for chemotherapy regimen and length of initial TKI course, the odds ratio for the response rate was 0.20 (95% confidence interval: 0.05–0.78; p = .02) favoring treatment with chemotherapy and erlotinib. The median progression-free survival was 4.4 months on chemotherapy and erlotinib and 4.2 months on chemotherapy alone (adjusted hazard ratio = 0.79; 95% confidence interval: 0.48–1.29; p = .34). There was no difference in overall survival.

Conclusion.

This is the first study, to our knowledge, to demonstrate that continuation of EGFR TKI with chemotherapy in patients with acquired resistance improves outcomes compared with chemotherapy alone. We observed an improved response rate but no difference in progression-free survival or overall survival. A larger prospective clinical trial is needed to evaluate this promising strategy further.
Plant genotype, nutrients, and G × E interactions structure floral visitor communities
Authors: Burkle Laura A. , Souza Lara , Genung Mark A. , Crutsinger Gregory M.
Published: September 2013

Intraspecific variation in plants is driven by both genetic and environmental factors and has been shown to play an important role in determining assemblages of herbivores, predators, and pathogens. Yet, the consequences of genetic (G) and environmental (E) factors, as well as potential (G × E) interactions, for floral visitor communities remains poorly explored. In a common garden experiment, we compared the relative effects of host‐plant genotype and genotypic diversity as well as soil nutrient enrichment on floral resource abundance and insect floral visitors associated with tall goldenrod,Solidago altissima. We found that the floral visitor community varied considerably among genotypes, driven predominantly by variation in floral phenology amongS. altissimaclones. Floral visitors also varied among nutrient treatments, though this response was much weaker than to different plant genotypes, and was likely driven by effects of floral rewards rather than of floral phenology. Importantly, we also detected several G × E interactions for both flowering and floral visitors. Taken together, our results suggest that the effects of host‐plant genetic variation, and to a lesser extent G × E interactions, are key agents in structuring the diversity and composition of floral visitors.
Semi-analytical model of Raman generation in silicon-on-insulator rib waveguide with DBR/F-P resonator
Authors: Tyszka-Zawadzka A. , Szczepański P. , Mossakowska-Wyszyńska A. , Karpierz M. , Bugaj M.
Published: September 2013

An approximate method of modelling of Raman generation in silicon-on-insulator (SOI) rib waveguide with DBR/F-P resonator including spatial field distribution and nonlinear effects such as Raman amplification and two photon absorption (TPA), is developed. In threshold analysis of steady-state Raman laser operation, an analytical formula relating threshold pump power to the system parameters is obtained. The analysis of the above threshold operation is based on an energy theorem. In exact energy conservation relation, we approximate the Stokes field distributions by that existing at the threshold, whereas the approximate pump field distributions are obtained by integrating the equations for the pump signal using the linear (threshold) pump field distributions and the threshold Stokes field distributions. An approximate, semi-analytical expression related the Raman output power to the pump power and system parameters is derived. Our calculations remain in a good agreement with the exact numerical solutions.
Scientific realism and philosophical naturalism in Šmajs’ evolutionary ontology
Authors: Melichová Inéz , Burgan Robert
Published: September 2013

J. Šmajs’ concept of evolutionary ontology has attracted much attention in recent years especially in Czech and Slovak academic circles, yet it remains, as some of its proponents claim, undervalued in Britain and the US. Even in the Czech Republic and Slovakia, there are, in addition to its strong supporters, several authors who almost a priori reject the concept, pointing to several questionable, contradictory or even mutually exclusive or self-refuting arguments. In this paper, mainly based on a comprehensive analysis of the first part of Šmajs’ book, Evoluční ontologie kultury a problém podnikání (2012) [Evolutionary Ontology of Culture and The Issues Of Business], we attempt to demonstrate that the opponents of Šmajs’ concept are closer to the truth, since the concept, we believe, is just another variation on the extreme escalation of philosophical naturalism.
Nesting by Hobbies (Falco subbuteo) in the Košice Basin (Eastern Slovakia) from 1996 to 2005
Authors: Lipták Ján
Published: September 2013

In the course of ten nesting seasons from 1996 to 2005 I observed nesting by hobbies in Eastern Slovakia within a territory of 1000 km2 in the Košice Basin. During this ten-year period 218 nestings were recorded. The average population density was two pairs per 100 km2 in the monitored territory. In certain quadrants with better occupation it was from four to seven pairs per 100 km2. The birds nested more frequently on very high tension (VHT) electricity pylons (126 instances) than in trees (92 instances). They prefer the nests of hooded crows (Corvuscorone cornix) (110 cases) and ravens (Corvus corax) (90 cases), and in only 18 cases did they use another nesting solution. When nesting in VHT pylons in the 1980’s they used to make more use of crows’ nests, but at the present time they prefer ravens’ nests to a significant degree.
Disruption Recovery in Passenger Railways
Authors: Pender Brendan , Currie Graham , Delbosc Alexa , Shiwakoti Nirajan
Published: September 2013

This research paper explores the manner in which passenger rail transit organizations plan for and manage unplanned service disruptions through an international survey of practices. The research reported here included semistructured interviews of those staff responsible for service disruption management within 71 international transit agencies. Results suggested that 20% of agencies had parallel transit systems that could be used by commuters whose service was disrupted. Most of these systems existed in inner-city contexts. Track intrusions, medical emergencies, weather extremes, and track and rolling stock failures were common causes of unplanned disruptions. Bus bridging was the most common response to line blockages, while transfer of passengers to the next train was the most common approach to individual rolling stock failures. Track crossovers were widely seen as critical to manage responses to disruptions. A small minority, mostly in cold climates, also saw crossovers as a cause of unplanned failures. Most agencies used spare buses as bus-bridging vehicles. Only 45% actively retracted buses from existing scheduled bus services. Some of these agencies did acknowledge that retraction often was done in extenuating circumstances, however. Rarely did agencies have a strategic reserve of buses for bus-bridging purposes. This paper discusses the implications of the study findings for further research and practice. This paper also documents that all responses to unplanned disruptions can be categorized according to the key disruption characteristics of duration, cause, time, and location, and it provides a typology of response mechanisms on the basis of such characteristics.
Observed Customer Seating and Standing Behavior and Seat Preferences on Board Subway Cars in New York City
Authors: Berkovich Aaron , Lu Alex , Levine Brian , Reddy Alla V.
Published: September 2013

An observational sampling methodology was used to explore seat occupancy patterns in New York City subway cars. The study was performed under uncrowded conditions on the basis of special attributes of what otherwise were highly homogeneous plastic bench seats. Onboard seating patterns, measured as relative seat occupancy probabilities, were explained in terms of interactions between railcar design, layout, customer preferences, and resulting behavior. Earlier research focused in general on passenger distribution between cars within long trains or on the desirability of attributes common to all seats, rather than on passenger seating patterns within a single car. Results of the study reported here had their basis in seating- and standing-room occupancy statistics and showed that customers had a clear preference for seats adjacent to doors, no real preference for seats adjacent to support stanchions, and disdain for bench spots between two other seats. On cars that featured transverse seating, customers preferred window seats, but their preference was almost equal for backward- or forward-facing seats. No gender bias in all seated passengers was detected, but as load factor increased, the chance of standing was higher for men than for women. Use of 90% of the seats was achieved only at a 120% load factor. Customers who stood strongly preferred to crowd vestibule areas between doors (particularly in cars with symmetric door arrangements) and to hold on to vertical poles. These findings were consistent with published anecdotes. In future, cars should be designed with asymmetric doors, 2 1 2 1 2 partitioned, longitudinal seats, and no stanchions or partitions near doorways. To understand customer seating preferences further, research should be conducted in commuter rail vehicles with suburban layouts and booth seating and in the subways of other cities.
Measurement of Subway Service Performance at New York City Transit
Authors: Levine Brian , Lu Alex , Reddy Alla V.
Published: September 2013

A recurring challenge that faces transit managers today is the persistent question of how to do more with less: to maintain and to improve service despite deficits of historic proportions. New York City Transit (NYCT) responded by retooling performance measurement frameworks and procedures to capture the customer's perspective better, to respond to management initiatives, and to incentivize proper operating decisions. NYCT's primary performance measure, Wait Assessment (WA), measured customer maximum wait times to board at stations. A reach and match algorithm was developed; this algorithm was defined as the percentage of headways between trains that did not exceed 125% of scheduled headways. The purpose of the algorithm was to account for NYCT's irregularly scheduled service and to ensure that the way customers experienced headways matched the specific, published scheduled headway in effect at that moment, regardless of which scheduled trip was supposed to arrive. Sample-based methods that gathered limited data manually were upgraded, and track-occupancy data were downloaded from the automated train supervision system for the Number 1 through Number 6 routes. This action provided 100% coverage, which resulted in much lower public reporting of time lags and in the ability to take near-term corrective action. The increase in data availability also allowed NYCT to provide better service through improved consideration of corridor-level and track-level WA standards for internal diagnostic purposes and analysis of train performance in shared-track territory, regardless of route designation.
Cerebellar mutism
Authors: Pitsika Marina , Tsitouras Vassilios
Published: September 2013

Mutism of cerebellar origin is a well-described clinical entity that complicates operations for posterior fossa tumors, especially in children. This review focuses on the current understanding of principal pathophysiological aspects and risk factors, epidemiology, clinical characteristics, treatment strategies, and outcome considerations. The PubMed database was searched using the term cerebellar mutism and relevant definitions to identify publications in the English-language literature. Pertinent publications were selected from the reference lists of the previously identified articles. Over the last few years an increasing number of prospective studies and reviews have provided valuable information regarding the cerebellar mutism syndrome. Importantly, the clarification of principal terminology that surrounds the wide clinical spectrum of the syndrome results in more focused research and more effective identification of this entity. In children who undergo surgery for medulloblastoma the incidence of cerebellar mutism syndrome was reported to be 24%, and significant risk factors so far are brainstem involvement and midline location of the tumor. The dentate-thalamo-cortical tracts and lesions that affect their integrity are considered significant pathophysiological issues, especially the tract that originates in the right cerebellar hemisphere. Moderate and severe forms of the cerebellar mutism syndrome are the most frequent types during the initial presentation, and the overall neurocognitive outcome is not as favorable as thought in the earlier publications. Advanced neuroimaging techniques could contribute to identification of high-risk patients preoperatively and allow for more effective surgical planning that should focus on maximal tumor resection with minimal risk to important neural structures. Properly designed multicenter trials are needed to provide stronger evidence regarding effective prevention of cerebellar mutism and the best therapeutic approaches for such patients with a combination of pharmacological agents and multidisciplinary speech and behavior augmentation.
Alcohol and Violence in the Emergency Room: A Review and Perspectives from Psychological and Social Sciences
Authors: Zerhouni Oulmann , Bègue Laurent , Brousse Georges , Carpentier Françoise , Dematteis Maurice , Pennel Lucie , Swendsen Joel , Cherpitel Cheryl
Published: September 2013

Our objective is to present a focused review of the scientific literature on the effect of alcohol consumption on violence related-injuries assessed in the emergency room (ER) and to show how psychological and behavioral sciences could lead to a better understanding of the factors contributing to alcohol-related injuries in the ER. We retrieved published literature through a detailed search in Academic Search Premier, MEDLINE with Full Text PsycARTICLES, Psychology and Behavioral Sciences Collection, PsycINFO, PUBMed and SocINDEX with Full Text for articles related to emergency rooms, medical problems and sociocognitive models addressing alcohol intoxication articles. The first search was conducted in June 2011 and updated until August 2013. Literature shows that compared to uninjured patients; injured ones have a higher probability of: (i) having an elevated blood-alcohol concentration upon arrival at the ER; (ii) reporting having drunk alcohol during the six hours preceding the event; and (iii) suffering from drinking-related consequences that adversely affect their social life. The main neurocognitive and sociocognitive models on alcohol and aggression are also discussed in order to understand the aetiology of violence-related injuries in emergency rooms. Suggestions are made for future research and prevention.
Integrating Open Access Geospatial Data to Map the Habitat Suitability of the Declining Corn Bunting (Miliaria calandra)
Authors: Abdi Abdulhakim
Published: September 2013

The efficacy of integrating open access geospatial data to produce habitat suitability maps for the corn bunting (Miliaria calandra) was investigated. Landsat Enhanced Thematic Mapper Plus (ETM+), Shuttle Radar Topography Mission (SRTM) and Corine (Coordination of Information on the Environment) land cover data for the year 2000 (CLC2000) were processed to extract explanatory variables and divided into three sets; Satellite (ETM+, SRTM), CLC2000 and Combined (CLC2000 + Satellite). Presence-absence data for M. calandra, collected during structured surveys for the Catalan Breeding Bird Atlas, were provided by the Catalan Ornithological Institute. The dataset was partitioned into an equal number of presence and absence points by dividing it into five groups, each composed of 88 randomly selected presence points to match the number of absences. A logistic regression model was then built for each group. Models were evaluated using area under the curve (AUC) of the receiver operating characteristic (ROC). Results of the five groups were averaged to produce mean Satellite, CLC2000 and Combined models. The mean AUC values were 0.69, 0.81 and 0.90 for the CLC2000, Satellite and the Combined model, respectively. The probability of M. calandra presence had the strongest positive correlation with land surface temperature, modified soil adjusted vegetation index, coefficient of variation for ETM+ band 5 and the fraction of non-irrigated arable land.
Yields, Phenolic Profiles and Antioxidant Activities of Ziziphus jujube Mill. in Response to Different Fertilization Treatments
Authors: Wu Chun-Sen , Gao Qing-Han , Kjelgren Roger , Guo Xu-Dan , Wang Min
Published: September 2013

Increasing demand for more jujube (Ziziphus jujube Mill.) production requires understanding the specific fertilization needs of jujube trees. This study was conducted to compare fruit yields, phenolic profiles and antioxidant activity of jujube in response to different fertilizers. Application of organic fertilizer appeared to enhance the phenolics and antioxidant activity accumulation of jujubes, compared to conventional fertilized jujubes. Amongst inorganic fertilizers, supplemental potassium as an individual nutrient improved the accumulation of phenolics in jujubes. Our results demonstrate that phenolics levels and antioxidant activity of jujube can be manipulated through fertilizer management and tracked by following proanthocyanidin concentrations. In a practical production context, the combination of organic fertilizers and inorganic fertilizers such as more supplemental individual potassium, and less supplemental individual nitrogen and phosphorus, might be the best management combination for achieving higher phenolic concentration, stronger antioxidant activity and a good harvest.
Exploring Knowledge, Attitudes and Abuse Concerning Doping in Sport among Syrian Pharmacy Students
Authors: El-Hammadi Mazen , Hunien Bashar
Published: September 2013

This study aimed to assess pharmacy students’ knowledge about doping substances used in sport, explore their attitudes toward doping and investigate their misuse of doping drugs. A questionnaire was developed and employed to collect data from bachelor of pharmacy (BPharm) students at the International University for Science and Technology (IUST). Two-hundred and eighty students participated in this self-administrated, paper-based survey. Around 90% of the students did not appear to know that narcotics, β-blockers and diuretics were used in sport as doping agents. Additionally, proportions between 60% and 80% considered vitamins, energy drinks and amino acids as substances that possess performance-enhancing effects. The main reason for doping, based on students’ response, was to improve muscular body appearance. The vast majority of students agreed that pharmacists should play a major role in promoting awareness about risks of doping. While students showed negative attitudes toward doping, approximately 15% of them, primarily males, had already tried a doping drug or might do so in the future. More than 60% of the students believed that sports-mates and friends are the most influential in encouraging them to take a doping agent. The study highlights the need to provide pharmacy students with advanced theoretical background and practical training concerning doping. This can be achieved by adopting simple, but essential, changes to the current curricula.
Assessing Outcomes of Online Training in Public Health: Changes in Individual and Organizational Knowledge and Capacity
Authors: Wallace John , Horney Jennifer , Wilfert Rachel , Alexander Lorraine
Published: September 2013

The need for a well-prepared public health workforce to prepare for and respond to threats of terrorism, infectious diseases, and other public health emergencies is well documented, as is the reality that the public health workforce in the United States is under-trained and unprepared to handle public health emergencies. The impact of training on the public health workforce is often measured by the volume of training completed and post-course evaluation data. A survey of current, high-volume users (n = 759) of the University of North Carolina Center for Public Health Preparedness Training Web Site, defined as individuals who had completed 12 or more training modules was conducted in order to determine if measurable changes in preparedness and response knowledge and capacity were brought about by the trainings. Two-hundred and seventy respondents completed the survey (response rate = 36%), with 52% reporting employment in governmental public health. Individual changes reported as a result of training included increased personal satisfaction (71%), increased job satisfaction (38%), and recognition by supervisors for training completion (23%); Organizational changes included updates to training plans (19%), making trainings mandatory (19%), and revising standard operating procedures (13%). Results from this survey indicate that the knowledge learned from completing online trainings led to changes in individuals and, to a lesser extent, changes in organizations.
Religious Observance and Well-Being among Israeli Jewish Adults: Findings from the Israel Social Survey
Authors: Levin Jeff
Published: September 2013

This study reports on analyses of Jewish respondents (N = 6,056) from the 2009 Israel Social Survey. Multivariable methods were used to investigate whether religiously observant Jews have greater physical and psychological well-being. After adjustment for age and other sociodemographic correlates of religion and well-being and for a measure of Israeli Jewish religious identity (i.e., secular, traditional, religious, ultra-Orthodox), two findings stand out. First, greater Jewish religious observance is significantly associated with higher scores on indicators of self-rated health, functional health, and life satisfaction. Second, there is a gradient-like trend such that greater religiousness and life satisfaction are observed as one moves “rightward” across religious identity categories. These findings withstand adjustment for effects of all covariates, including Israeli nativity and Jewish religious identity.
Patient Empowerment by Increasing the Understanding of Medical Language for Lay Users
Authors: Stoicu-Tivadar V. , Topac V.
Published: September 2013

Background: Patient empowerment is important in order to increase the quality of medical care and the life quality of the patients. An important obstacle for empowering patients is the language barrier the lay patient encounter when accessing medical information.

Objectives: To design and develop a service that will help increase the understanding of medical language for lay persons.

Methods: The service identifies and explains medical terminology from a given text by annotating the terms in the original text with the definition. It is based on an original terminology interpretation engine that uses a fuzzy matching dictionary. The service was implemented in two projects: a) into the server of a tele-care system (TELEASIS) with the purpose of adapting medical text assigned by medical personnel for the assisted patients. b) Into a dedicated web site that can adapt the medical language from raw text or from existing web pages.

Result: The output of the service was evaluated by a group of persons, and the results indicate that such a system can increase the understanding of medical texts. Several design decisions were driven from the evaluation, and are being considered for future development. Other tests measuring accuracy and time performance for the fuzzy terminology recognition have been performed. Test results revealed good performance for accuracy and excellent results regarding time performance.

Conclusion: The current version of the service increases the accessibility of medical language by explaining terminology with a good accuracy, while allowing the user to easily identify errors, in order to reduce the risk of incorrect terminology recognition.
AgOTf-catalyzed one-pot reactions of 2-alkynylbenzaldoximes with α,β-unsaturated carbonyl compounds
Authors: Ding Qiuping , Wang Dan , Luo Puying , Liu Meiling , Pu Shouzhi , Zhou Liyun
Published: September 2013

AgOTf-catalyzed one-pot reactions of 2-alkynylbenzaldoximes with various α,β-unsaturated carbonyl compounds under mild conditions are described, which provides a facile and efficient pathway for the synthesis of 1-alkylated isoquinoline derivatives. The method tolerates a wide range of substrates and allows for the preparation of the products of interest in moderate to excellent yields.
IT Infrastructure for Research and Teaching Combining an Online Lab, a UAV and Audio-Visual Communication
Authors: Volkert Thomas , Simon Tobias , Henke Karsten , Ostendorff Steffen
Published: September 2013

From previous experiences with student work, we figured out that an interesting real studying object highly motivates students to understand the theory by hands-on experiments. Based on our former work, this paper introduces a new concept, which combines three of our research topics to one complex infrastructure. We start with our existing online lab â??REALâ? and describe how it can be used in order to provide an experiment environment, which is available independent of laboratory opening times. Based on this, we explain how a new experimental platform can be integrated, which is focused on the stabilization of a gimbal-mounted UAV. In this context, different control techniques from different engineering disciplines such as control theory, fuzzy control, neuronal networks and reinforcement learning can be applied. Furthermore, we describe how the video conferencing tool â??Homer-Conferencingâ? can be used as audio-visual platform to coordinate experiments. This approach enables the teacher to give direct feedback to the students. In general, our approach is intended to provide a flexible infrastructure, which can also be used among different experiment locations.
A Prototype Navigation System for Guiding Blind People Indoors using NXT Mindstorms
Authors: Alhmiedat Tareq Ali , Abutaleb Anas , Samara Gassan
Published: September 2013

People with visual impairment face enormous difficulties in terms of their mobility as they do not have enough information about their location and orientation with respect to traffic and obstacles on their route. Visually impaired people can navigate unknown areas by relying on the assistance of canes, other people, or specially trained guide dogs. The traditional ways of using guide dogs and long-cane only help to avoid obstacles, not to know where they are. The research presented in this paper introduces a mobile assistant navigation prototype to locate and direct blind people indoors. Since most of the existing navigation systems developed so far for blind people employ a complex conjunction of positioning systems, video cameras, location-based and image processing algorithms, we designed an affordable low-cost prototype navigation system for orienting and tracking the position of blind people in complex environments. The prototype system is based on the inertial navigation system and experiments have been performed on NXT Mindstorms platform.
3D Modeling and Visual Simulation of Plain Knitted Structures
Authors: Li Yinglin
Published: September 2013

Weft knitted fabrics are widely used in clothing textiles and technical applications, such as sweater and underwear, etc. The geometrical modeling of weft knitted structures is useful to predict fabrics properties and for creating physical models. How to realize the realistic computer simulation of plain knitted structures, much research is still needed. By measuring the loop structure size of fabrics produced by the circular machine and flat machine, a 3D geometrical model of plain loop with combination of empirical and theoretical was developed. The loop model has a total of 17 data points. Cubic NURBS curve was used to generate central path of yarn in plain loop. The circle was selected as the cross-section of yarn. In Visual C++ and OpenGL environment, then the 3D computer simulation of plain knitted fabric was realized. The simulation results distinctly show the intermeshed loops effects of knitted structures in 3D space.
Automatic Operating Process for Zebrafish Embryo Injection
Authors: Yiliao Wang , Mingzhu Sun , Xizeng Feng , Nan Wang Ya , Baoquan Zhao , Xin Zhao
Published: September 2013

Embryo injection is a significant technique in molecular biology and drug discovery for zebrafish, one of the most popular model organisms. Traditional zebrafish embryo injection is manually conducted under microscope, requiring challenging coordination of hand (to manipulate), eye (to watch) and even foot (to trigger the microinjector), and their respective precise control as well as being labor intensive. An automatic operating process for zebrafish embryo injection is proposed in this paper. Based on a micromanipulation robot system, the operating process integrates computer vision and micromanipulation robot control to realize batch embryo quantitative injection automatically. Successful rate of 93% and survival ratio of 89.5% at operating speed of 6-7 embryos/minute are obtained, verifying the feasibility and effectiveness of the process. Finally, the process is applied to inject a fluorescent material and investigate the toxicity of a dye, both receiving success.