bluuebunny/crossref_metadata_2025 huggingface dataset:
LO03: Application and usefulness of outpatient cardiac testing among emergency department patients with syncope
Authors: Cook O. , Mukarram M.A. , Kim S. , Arcot K. , Taljaard M. , Sivilotti M. , Rowe B.H. , Thiruganasambandamoorthy V.
Published: May 2017

Introduction: 2.6% of emergency department (ED) syncope patients will have underlying cardiac serious conditions (e.g. arrhythmia, serious structural heart disease) identified within 30-days of disposition. If those at risk are discharged home, outpatient cardiac testing can detect underlying arrhythmias and structural heart disease, and thereby improve patient safety. We describe the frequency of outpatient referrals for cardiac testing and the proportion of cardiac serious adverse events (SAE) among high risk and non-high (low and medium) risk ED syncope patients, as defined by the Canadian Syncope Risk Score (CSRS). Methods: We conducted a multicenter prospective cohort study to enroll adult syncope patients across five large tertiary care EDs. We collected demographics, medical history, disposition, CSRS value, outpatient referrals and testing results (holter, echocardiography), and cardiac SAE. Adjudicated 30-day SAE included death due to unknown cause, myocardial infarction, arrhythmia, and structural heart disease. We used descriptive analysis. Results: Of 4,064 enrolled patients, a total of 955 patients (23%) received an outpatient referral (mean age 57.7 years, 52.1% female). Of the 299 patients (7%) hospitalized, 154 received outpatient cardiac testing after discharge. Among the 3,765 patients discharged home from the ED, 40% of the non-high risk patients (305/756) and 56% of the high risk patients (25/45) received outpatient cardiac testing. Of all patients who received outpatient cardiac testing, 4 patients (0.8%) had serious cardiac conditions identified and all were arrhythmias. Among those with no cardiac testing, 5 patients (0.9%) suffered cardiac SAE (80% arrhythmias) outside the hospital. Of the 20 (44%) high risk patients who did not receive outpatient cardiac testing, 2 (10%) patients suffered arrhythmias outside the hospital. While among the 451 non-high risk patients, only 0.8% suffered arrhythmia outside the hospital. Conclusion: Outpatient cardiac testing among ED syncope patients is largely underutilized, especially among high risk patients. Better guidelines for outpatient cardiac testing are needed, as current practice is highly variable and mismatched with patient risk.
LO04: Very low concentrations of high-sensitivity troponin T at presentation can rapidly exclude acute myocardial infarction in a significant proportion of ED chest pain patients
Authors: Andruchow J. , McRae A. , Abedin T. , Wang D. , Lang E. , Innes G.
Published: May 2017

Introduction: Chest pain is one of the most common presenting complaints to emergency departments (EDs) across the world, and the exclusion of acute myocardial infarction (AMI) using troponin testing is central to the care of many of these patients. Testing strategies using conventional troponin assays require repeat testing over many hours to avoid missed diagnoses. This study aims to validate the ability of very low concentrations of troponin at presentation to exclude AMI in ED chest pain patients. Methods: This prospective cohort study was conducted at a single urban tertiary centre and regional percutaneous coronary intervention site in Calgary, Alberta. Patients were eligible for enrolment if they presented to the ED with chest pain, were 25-years or older and required biomarker testing to rule out AMI at the discretion of the attending emergency physician. Patients were excluded if they had clear acute ischemic ECG changes, new arrhythmia or renal failure requiring hemodialysis. High-sensitivity troponin-T (Roche Elecsys hs-cTnT) results were obtained in all patients at presentation. Relevant outcomes were obtained from administrative data. The primary outcome was AMI within 30-days of ED visit, the secondary outcome was 30-day major adverse cardiac events (MACE). The study was REB approved. Results: A total of 1,016 patients were enrolled from August 2014-September 2016, of which 174 (17.1%) patients had an initial troponin below the limit of blank (<3 ng/L) and 369 (36.3%) had a level below the limit of detection (<5 ng/L). The sensitivity and negative predictive value (NPV) of a troponin below limit of blank (<3 ng/L) for 30-day AMI were 100% (95% CI 89.3%-100%) and 100% (95% CI 97.8-100%), respectively. The sensitivity and NPV of a troponin below limit of detection (<5 ng/L) for 30-day AMI were 93.8% (95% CI 80.0-98.3%) and 99.5% (95% CI 98.1-99.9%) respectively. Sensitivity for 30-day MACE at both cutoffs was lower: 96.1% (95% CI 92.5-98.0%) for <3 ng/L, and 88.4% (95% CI 83.3-92.1%) for <5 ng/L, respectively. Conclusion: A high sensitivity troponin T result below the limit of blank is highly sensitive at excluding AMI and identifies patients at reasonably low risk of 30-day MACE. A result below the limit of detection will identify a larger population of patients as low risk but has a greater risk of missed AMI and MACE.
LO05: In patients presenting to the ED with STEMI, is the provision of morphine associated with worse patient outcomes?
Authors: Barbic D. , Scheuermeyer F.X. , Salehmohamed Q. , Kim B. , Barbic S. , Kawano T. , Grunau B.E. , Christenson J.
Published: May 2017

Introduction: ST-elevation myocardial infarction (STEMI) presenting to the ED is a significant health burden. The provision of IV morphine with doses titrated to provide comfort is recommended in the AHA STEMI Guidelines, yet there is limited evidence of safety in this setting. The primary objective of this study was to measure potential harm associated with the provision of IV morphine in STEMI patients presenting to the ED. Methods: This was a two centre retrospective chart review from an urban, inner city, academic ED with an annual census of 85,000 visits, and an affiliated community hospital with 35,000 annual visits. Consecutive patients from April 2009 to January 2015 presenting to the 2 EDs with a diagnosis of STEMI were identified in the ED database. Eight trained research assistants, blinded to the study hypothesis, used standardized data collection templates. The primary investigator double collected 20% of all data to ensure completeness and accuracy. Results: We included 311 patients with STEMI (124 received morphine [M]; 187 no morphine [nM]). The ages of the two groups were similar (mean 64 yrs [M] & 67 yrs [nM]; median 63 yrs [M] & 66 yrs [nM]; IQR 45-81 [M] and 45.5-86.5 [nM]); as were the proportion of female patients (21.0% [M] & 23.5% [nM]. The pre-STEMI Charlson comorbidity scores (mean 2.6), median time to first ECG (11 min [M] & 16 min [nM]), and mean time-to-needle for PCI (96.8 min [M] & 92.0 min [nM]) were similar between groups. The mean CCU length of stay (LOS) (9.3 days vs 6.3 days) and hospital LOS (7.4 days vs 4.6 days) were longer for patients receiving morphine than those not receiving morphine. Rates of congestive heart failure, acute kidney injury and cardiac arrest in hospital were unchanged between the groups. Unadjusted mortality was similar (10.5% [M] vs 13.3% [nM]) between groups. Binary logistic regression controlling for age, Charlson score, first and peak troponin values demonstrated an association between receiving morphine in the ED and an increased risk of death at 30 days (OR 8.1; 95% CI 7.1.-9.1). Conclusion: The provision of morphine to patients with STEMI in the ED may be associated with increased CCU and hospital LOS. When controlling for age, pre-STEMI Charlson score, first and peak troponin values, receiving morphine was associated with an increased risk of death at 30 days. Further research to elucidate this association is warranted.
LO06: Role of the age adjusted D-dimer in suspected deep venous thrombosis
Authors: Reardon P. , Patrick S. , Taljaard M. , Thavorn K. , Mukarram M.A. , Kim S. , Le Gal G. , Thiruganasambandamoorthy V.
Published: May 2017

Introduction: It is well established that a negative D-dimer will reliably rule out thromboembolism in selected low risk patients. Multiple modified D-dimer cutoffs have been suggested for older patients to improve diagnostic specificity. However, these approaches are better established for pulmonary embolism than for deep venous thrombosis (DVT). This study will evaluate the diagnostic performance of previously suggested D-dimer cutoffs for low risk DVT patients in the ED, and assess for a novel cutoff with improved performance. Methods: This health records review included patients >50 years with suspected DVT who were low-risk and had a D-dimer performed. Our analysis evaluated the diagnostic accuracy of D-dimer cutoffs of 500 and the age adjusted (age x 10) rule for patients >50 years; and 750, and 1,000 cutoffs for patients >60 years. 30-day outcome was a diagnosis of DVT. We also assessed the diagnostic accuracy for a novel cutoff (age x 12.5). Results: 1,000 patients (mean age 68 years; 59% female) were included. Of these, 110 patients (11%) were diagnosed with DVT. The conventional cutoff of <500 µg/L demonstrated a sensitivity of 99.1% (95% CI 95.0-99.9) and a specificity of 36.4% (95% CI 33.2-39.7). For patients >60 years, the absolute cutoffs of 750 and 1,000 showed sensitivity of 98.7% (95% CI, 92.9, 99.9), and the specificity increased to 48.6% (95% CI, 44.5-52.8%) and 62.1% (95% CI, 58.1-66.1%) respectively. For all study patients, age adjusted D-dimer demonstrated a sensitivity of 99.1% (95% CI 95.0-99.9) and a specificity of 51.2% (95% CI, 47.9-54.6). A novel age adjusted cutoff (age x 12.5) for patients >50, demonstrated a sensitivity of 97.3% (95% CI 92.2-99.4) and a specificity of 61.2% (95% CI 58.0-64.5). When compared to conventional cutoff, the age adjusted cutoffs (age x 10 and age x 12.5) would have resulted in an absolute decrease in further investigations of 13.1% and 22.2%, respectively, with false negative rates of 0.1% and 0.3%. Conclusion: Among older patients with suspected DVT and low clinical probability, the age adjusted D-dimer increases the proportion of patients among whom DVT can be ruled out. A novel cutoff (age x 12.5) demonstrated improved specificity. Future large scale prospective studies are needed to confirm this finding and to explore the cost savings of these approaches.
LO13: GridlockED: an emergency medicine game and teaching tool
Authors: Sneath P.E. , Tsoy D. , Rempel J. , Mercuri M. , Pardhan A. , Chan T.M.
Published: May 2017

Introduction/Innovation Concept: In the controlled chaos of the emergency department (ED) it can be difficult for medical trainees similarly recognize that there is definite order to the chaos, and many may never truly appreciate its complexity. How should medical learners develop this skill? Didactic teaching cannot effectively portray the complexities of managing the ED. Much like education in cardiac arrest, trauma, and multi-casualty incident management, it is our belief that the management of patient flow through the ED is best learned through simulation. Thus, we developed GridlockED, a board game that requires players to work cooperatively to manage a simulated ED to win the game. Methods: GridlockED development took place over a six-month period during which iterative cycles of gameplay and redevelopment were used to optimize game mechanics and improve player engagement. The patient cases were created by medical students (PS, DT, JR) and subsequently reviewed for content validity by two attending emergency physicians (TC, AP). Input from attending emergency physicians, residents, medical students, and laypeople was integrated into the game through a Plan-Do-Study-Act (PDSA) model. Curriculum, Tool, or Material: Our game includes: 1) The game board; 2) Patient cards, which describe a patient, their level of acuity, and the tasks that must be completed in order to disposition the patient; 3) Event cards, which cause random positive or negative events to occur-much like random events occur in real life that change the dynamics of the ED; 4) Game Characters, which move around the board to denote where tasks are being completed; 5) A tracking sheet to follow how many tasks each character has performed in each turn; 6) A shift-time clock, which is used to track the ‘hours’ of your shift; 7) A ‘Gridlock counter’, which tracks how many ED backups or adverse patient outcomes occur (‘Gridlocks’). The goal of the game is to work cooperatively with your teammates to complete patient tasks and move patients through the ED to an ultimate disposition (e.g. admission, discharge). The game is won if you finish your shift before reaching the maximum number of ‘Gridlocks’ allowed. Conclusion: Initial responses to GridlockED have been very positive, supporting it as both an engaging board game and potential teaching tool. We are excited to see it validated through research trials and possibly incorporated into emergency medicine training at both student and postgraduate training levels.
LO15: Not a hobby anymore: Establishment of the Global Health Emergency Medicine organization at the University of Toronto to facilitate academic careers in global health for faculty and residents
Authors: Hunchak C. , Puchalski Ritchie L. , Salmon M. , Maskalyk J. , Landes M.
Published: May 2017

Introduction/Innovation Concept: Demand for training in global health emergency medicine (EM) practice and education across Canada is high and increasing. For faculty with advanced global health EM training, EM departments have not traditionally recognized global health as an academic niche warranting support. To address these unmet needs, expert faculty at the University of Toronto (UT) established the Global Health Emergency Medicine (GHEM) organization to provide both quality training opportunities for residents and an academic home for faculty in the field of global health EM. Methods: Six faculty with training and experience in global health EM founded GHEM in 2010 at a UT teaching hospital, supported by the leadership of the ED chief and head of the Divisions of EM. This initial critical mass of faculty formed a governing body, seed funding was granted from the affiliated hospital practice plan and a five-year strategic academic plan was developed. Curriculum, Tool, or Material: GHEM has flourished at UT with growing membership and increasing academic outputs. Five governing members and 9 general faculty members currently run 18 projects engaging over 60 faculty and residents. Formal partnerships have been developed with institutions in Ethiopia, Congo and Malawi, supported by five granting agencies. Fifteen publications have been authored to date with multiple additional manuscripts currently in review. Nineteen FRCP and CCFP-EM residents have been mentored in global health clinical practice, research and education. Finally, GHEM’s activities have become a leading recruitment tool for both EM postgraduate training programs and the EM department. Conclusion: GHEM is the first academic EM organization in Canada to meet the ever-growing demand for quality global health EM training and to harness and support existing expertise among faculty. The productivity from this collaborative framework has established global health EM at UT as a relevant and sustainable academic career. GHEM serves as a model for other faculty and institutions looking to move global health EM practice from the realm of ‘hobby’ to recognized academic endeavor, with proven academic benefits conferring to faculty, trainees and the institution.
LO19: Introduction of a regional interactive group supervision tool to maximize multi-program research project support
Authors: Atkinson P.R. , Magee K. , Carter A. , Hurley K.F. , Sibley A. , Watson M. , Urquhart D. , DeMone C. , Fitzpatrick E. , Fraser J. , French J. , Howlett M. , MacIntyre J. , Petrie D.
Published: May 2017

Introduction/Innovation Concept: University Departments of Emergency Medicine are responsible for the supervision of research and other scholarly projects for fellows, residents and students, though often lack resources to provide adequate input and oversight. Many departments cover large geographical areas and several programs. We piloted new research committee structures and processes to improve oversight and output of research projects. Methods: We created an interactive group supervision tool based around formation of a collaborative research committee, with rotating chairs from each program, to provide supervision and face to face interaction, and direction for research learners. Included were all Dalhousie University adult and pediatric emergency medicine residency and fellowship programs, as well as trauma and EMS programs across Nova Scotia, New Brunswick, and Prince Edward Island. In addition to providing expertise in clinical trial coordination, database management, research administration, grant applications and Research Ethics Board submissions, we have completed a 2-year pilot of our interactive group supervision tool for research projects. Curriculum, Tool, or Material: The interactive tool consists of a structured PICOD form; allocation of topic and research mentors; standardized yearly milestones from project development through presentation and publication; and regular video-conferenced and in-person interactive group sessions involving several project leads, as well as program research directors, researchers, and co-ordinators. To date, all participating program learners have engaged with the tool, with positive feedback from learners, supervisors and program directors. Conclusion: We report our development of a regional collaborative interactive group supervision tool, that maximizes expert resources in the provision of research and scholarly project supervision.
LO31: Identification of high risk factors associated with 30 day serious adverse events among syncope patients transported to the emergency department by emergency medical services
Authors: Yau L. , Mukarram M.A. , Kim S. , Arcot K. , Thavorn K. , Taljaard M. , Sivilotti M. , Rowe B.H. , Thiruganasambandamoorthy V.
Published: May 2017

Introduction: The majority of syncope patients transported to the emergency department (ED) by emergency medical services (EMS) are low-risk with very few suffering serious adverse events (SAE) within 30-days and over 50% are diagnosed with vasovagal syncope. These patients can potentially be diverted by EMS to alternate pathways of care (primary care or syncope clinic) if appropriately identified. We sought to identify high-risk factors associated with SAE within 30-days of ED disposition as a step towards developing an EMS clinical decision tool. Methods: We prospectively enrolled adult syncope patients who were transported to 5 academic EDs by EMS. We collected standardized variables at EMS presentation from history, clinical examination and investigations including ECG and ED disposition. We also collected concerning symptoms identified and EMS interventions. Adjudicated SAE included death, myocardial infarction, arrhythmia, structural heart disease, pulmonary embolism, hemorrhage and procedural interventions. Multivariable logistic regression was used for analysis. Results: 990 adult syncope patients (mean age 58.9 years, 54.9% females and 16.8% hospitalized) were enrolled with 137 (14.6%) patients suffering SAE within 30-days of ED disposition. Of 42 candidate predictors, we identified 5 predictors that were significantly associated with SAE on multivariable analysis: ECG abnormalities [OR=1.77; 95%CI 1.36-2.48] (non-sinus rhythm, high degree atrioventricular block, left bundle branch block, ST-T wave changes or Q waves), cardiac history [OR=2.87; 95%CI 1.86-4.41] (valvular or coronary heart disease, cardiomyopathy, congestive heart failure, arrhythmias or device insertions), EMS interventions or concerning symptoms [OR=4.88; 95%CI 3.13- 7.62], age >50 years [OR=3.18; 95%CI 1.68-6.02], any abnormal vital signs [OR=1.58; 95%CI 1.03-2.42] (any EMS systolic blood pressure >180 or <100 mmHg, heart rate <50 or >100/minute, respiratory rate >25/minute, oxygen saturation <91%). [C-statistic: 0.81; Hosmer Lemeshow p=0.30]. Conclusion: We identified high-risk factors that are associated with 30-day SAE among syncope patients transported to the ED by EMS. This will aid in the development of a clinical decision tool to identify low-risk patients for diversion to alternate pathways of care.
LO36: Out-of-hospital cardiac arrest in British Columbia: Ten years of increasing survival
Authors: Grunau B.E. , Dick W. , Kawano T. , Scheuermeyer F.X. , Fordyce C. , Barbic D. , Straight R. , Schlamp R. , Connolly H. , Christenson J.
Published: May 2017

Introduction: Survival for victims of out-of-hospital cardiac arrest (OHCA) is typically between 8 and 12%. We sought to report the trends in survival in British Columbia (BC) over a 10-year period. Methods: The BC Resuscitation Outcomes Consortium prospectively collected detailed prehospital and hospital data on consecutive non-traumatic OHCAs from 2006 to 2016 within BC’s four metropolitan areas. We included EMS-treated adult patients without DNR orders. To describe baseline characteristics we organized patient characteristics in three time periods: 2006-09, 2010-13, and 2014-16 (first and last periods reported below). The primary and secondary endpoints were survival at hospital discharge and return of spontaneous circulation (ROSC). We tested the significance of year-by-year trends in baseline characteristics, and performed multivariable Poisson regression, using calendar year as an independent variable, to calculate risk-adjusted rates for survival. Results: Between January 1, 2006 and March 31, 2016 there were a total of 26 433 non-traumatic OHCAs, with 15 145 included in this study. There were significant decreases in the proportion with initial shockable cardiac rhythms (28% to 23%) and bystander witnessed arrests (42% to 39%), however significant increases in the proportion with bystander CPR (40% to 49%) and ALS treatment (86% to 97%), and the median chest compression fraction (0.81 to 0.87). There was a significant increase in the median time until termination of resuscitation in those who did not achieve ROSC (27 to 32 minutes), and a significant decrease in the proportion of patients who were transported in absence of ROSC (17% to 6.5%). There was a significant improvement in achieving ROSC (44% to 48%; adjusted rate ratio per year 1.02, 95% CI 1.01 to 1.02) and survival at hospital discharge (10% to 14%; adjusted rate ratio per year 1.05, 95% CI 1.04 to 1.06). Both subgroups of initial shockable (adjusted rate ratio per year 1.04, 95% CI 1.03 to 1.05) and non-shockable (adjusted rate ratio per year 1.08, 95% CI 1.06 to 1.12) cardiac rhythms demonstrated survival improvement. Conclusion: Despite a significant decrease in those with initial shockable rhythms, out-of-hospital cardiac arrest survival in BC’s metropolitan regions increased by approximately 40% over a 10-year period. During this time there were system changes and quality of care improvements as provided by bystanders and professionals.
Wave Propagation Analysis in Beams Using Shear Deformable Beam Theories Considering Second Spectrum
Authors: Gul U. , Aydogdu M.
Published: May 2017

In this study, wave propagation in beams is studied using different beam theories like Euler-Bernoulli, Timoshenko and Reddy beam theories. Dispersion curves obtained for these beam theories are compared with the exact plane elasticity solutions. It is obtained that, there are two branches for Reddy beam theory similar to the Timoshenko beam theory. However, one branch is obtained for Euler-Bernoulli beam theory. The effects of in-plane load on Timoshenko and Reddy beam theories are examined and dispersion curves of the Timoshenko and Reddy beams are compared with exact plane elasticity solution. In Timoshenko beam theory, qualitative difference between the two spectrums has been lost with in-plane loads for some wave numbers.
Effects of Nano-Nozzles Cross-Sectional Geometry on Fluid Flow: Molecular Dynamic Simulation
Authors: Nowruzi H. , Ghassemi H.
Published: May 2017

Nano-nozzles are an essential part of the nano electromechanical systems (NEMS). Cross-sectional geometry of nano-nozzles has a significant role on the fluid flow inside them. So, main purpose of the present study is related to the effects of different symmetrical cross-sections on the fluid flow behavior inside of nano-nozzles. To this accomplishment, five different cross-sectional geometries (equilateral triangle, square, regular hexagon, elliptical and circular) are investigated by using molecular dynamics (MD) simulation. In addition, TIP4P is used for atomistic water model. In order to evaluate the fluid flow behavior, non-dimensional physical parameters such as Fanning friction factor, velocity profile and density number are analyzed. Obtained results are shown that the flow behavior characteristics appreciably depend on the geometry of nano-nozzle's cross-section. Velocity profile and density number for five different cross sections of nano-nozzle at three various measurement gauges are presented and discussed.
The Magneto-Elastic Internal Resonances of Rectangular Conductive Thin Plate With Different Size Ratios
Authors: Li J. , Hu Y. D. , Wang Y. N.
Published: May 2017

Based on the basic equations of electromagnetic elastic motion and the expression of electromagnetic force, the electromagnetic vibration equation of the rectangular thin plate in transverse magnetic field is obtained. For a rectangular plate with one side fixed and three other sides simply supported, its time variable and space variable are separated by the method of Galerkin, and the two-degree-of-freedom nonlinear Duffing vibration differential equations are proposed. The method of multiple scales is adopted to solve the model equations and obtain four first-order ordinary differential equations governing modulation of the amplitudes and phase angles involved via 1:1 or 1:3 internal resonances with different size ratios. With a numerical example, the time history response diagrams, phase portraits and 3-dimension responses of two order modal amplitudes are respectively captured. And the effects of initial values, thickness and magnetic field intensities on internal resonance characteristics are discussed respectively. The results also present obvious characteristics of typical nonlinear internal resonance in this paper.
How work–family enrichment influence innovative work behavior: Role of psychological capital and supervisory support
Authors: Mishra Pavitra , Bhatnagar Jyotsna , Gupta Rajen , Wadsworth Shelley MacDermid
Published: May 2017

This paper examines the relationship between bi-directional work–family enrichment, psychological capital, and supervisor support in promoting innovative work behavior. We hypothesized that work-to-family enrichment and family-to-work enrichment would have a positive relation with psychological capital. Further, we examined that psychological capital would mediate the relationship between (i) work-to-family enrichment and innovative work behavior, and (ii) family-to-work enrichment and innovative work behavior. We also studied the role of supervisor support as a predictor or moderator for catalyzing innovative work behavior. Data were collected through questionnaire survey from 398 service-sector employees. We analyzed the data using structural equation modeling. Building on the theoretical foundation of broaden-and-build theory, we establish that both work-to-family enrichment and family-to-work enrichment were positively related to psychological capital. Psychological capital fully mediated between bi-directional enrichment and innovative work behavior. Supervisor support was directly related to innovative work behavior. We also suggest interventions for facilitating innovative work behavior.
The effect of position on the precision of dual-energy X-ray absorptiometry and correlation with body condition score in dogs and cats
Authors: Bjørnvad Charlotte R. , Nielsen Mie E. , Hansen Susanna E. M. , Nielsen Dorte H.
Published: May 2017

Dual-energy X-ray absorptiometry (DEXA) has been used to assess body composition in dogs and cats in several studies, but studies are difficult to compare for several reasons. The aim of the present study was to evaluate whether positioning of dogs or cats in either dorsal or ventral recumbency during DEXA scanning influences results. Dogs and cats that were brought to the University Hospital for Companion Animals for euthanasia during the period 15 September–6 November 2015 were consecutively recruited if owners signed a written consent. Following euthanasia and before rigor mortis, the animals were body condition scored (BCS, nine-point scale) and DEXA scanned. DEXA measurements of total body mass (TBM), bone mineral content (BMC), bone mineral density (BMD), lean soft tissue mass (LSTM) and body fat (BF) were performed five times in ventral and two times in dorsal recumbency on each animal. Differences between positioning were analysed using Student's t test or Wilcoxon's test depending on normality of the data. A total of thirteen dogs and seven cats of different breeds, size, sexes and age were included. The CV for DEXA parameters in ventral or dorsal recumbency were, for dogs, TBM ≤ 0·1 %, BMC ≤ 1·63 %, BMD ≤ 1·29 %, LSTM ≤ 0·89 % and BF ≤ 1·52 %; and, for cats, TBM ≤ 0·08 %, BMC ≤ 0·61 %, BMD ≤ 0·49 %, LSTM ≤ 0·45 % and BF ≤ 0·88 %. In both positions, a good correlation was found for dogs (r 0·84–0·85; P < 0·0003) and cats (r 0·89–0·90; P < 0·0081) between the nine-point BCS system and BF percentage measured by DEXA. Ventral and dorsal recumbency provides comparable results, except that BMD measures were higher in dorsal recumbency (P < 0·0004).
The impact of time of neutering on weight gain and energy intake in female kittens
Authors: Allaway David , Gilham Matthew , Colyer Alison , Morris Penelope J.
Published: May 2017

Neutering is a risk factor for obesity in companion animals. In a study to determine the total energy requirements of kittens (15–52 weeks) the impact of neutering and age when neutered on intake and body weight (BW) was investigated. Females (n14), neutered when 19 (early neuter; EN) or 31 (conventional neuter; CN) weeks old (n7/group), were individually fed to maintain an ideal body condition score (BCS). EN kittens gained weight gradually whilst CN kittens’ BW gain slowed from week 24, weighing less than EN kittens from week 30 with a reduced energy intake (kcal/kg BW0·67) in weeks 24–32 (P< 0·05). Following neutering, CN cats’ BW and energy intake increased rapidly (energy intake CN > EN in weeks 36–40). Although EN required earlier diet restriction, acute hyperphagia and increased rate of BW gain following neutering were not observed. Earlier neutering may aid healthy weight management through growth when regulating intake to maintain an ideal BCS.
ANALYSIS OF CONTACT CAUCHY–RIEMANN MAPS II: CANONICAL NEIGHBORHOODS AND EXPONENTIAL CONVERGENCE FOR THE MORSE–BOTT CASE
Authors: OH YONG-GEUN , WANG RUI
Published: May 2017

This is a sequel to the papers Oh and Wang (Real and Complex Submanifolds, Springer Proceedings in Mathematics and Statistics 106 (2014), 43–63, eds. by Y.-J. Suh and et al. for ICM-2014 satellite conference, Daejeon, Korea, August 2014; arXiv:1212.4817; Analysis of contact Cauchy–Riemann maps I: a priori$C^{k}$estimates and asymptotic convergence, submitted, preprint, 2012, arXiv:1212.5186v3). In Oh and Wang (Real and Complex Submanifolds, Springer Proceedings in Mathematics and Statistics 106 (2014), 43–63, eds. by Y.-J. Suh and et al. for ICM-2014 satellite conference, Daejeon, Korea, August 2014; arXiv:1212.4817), the authors introduced a canonical affine connection on $M$ associated to the contact triad $(M,\unicode[STIX]{x1D706},J)$. In Oh and Wang (Analysis of contact Cauchy–Riemann maps I: a priori$C^{k}$estimates and asymptotic convergence, submitted, preprint, 2012, arXiv:1212.5186v3), they used the connection to establish a priori$W^{k,p}$-coercive estimates for maps $w:\dot{\unicode[STIX]{x1D6F4}}\rightarrow M$ satisfying $\overline{\unicode[STIX]{x2202}}^{\unicode[STIX]{x1D70B}}w=0$, $d(w^{\ast }\unicode[STIX]{x1D706}\circ j)=0$without involving symplectization. We call such a pair $(w,j)$ a contact instanton. In this paper, we first prove a canonical neighborhood theorem of the locus $Q$ foliated by closed Reeb orbits of a Morse–Bott contact form. Then using a general framework of the three-interval method, we establish exponential decay estimates for contact instantons $(w,j)$ of the triad $(M,\unicode[STIX]{x1D706},J)$, with $\unicode[STIX]{x1D706}$ a Morse–Bott contact form and $J$ a CR-almost complex structure adapted to $Q$, under the condition that the asymptotic charge of $(w,j)$ at the associated puncture vanishes.

We also apply the three-interval method to the symplectization case and provide an alternative approach via tensorial calculations to exponential decay estimates in the Morse–Bott case for the pseudoholomorphic curves on the symplectization of contact manifolds. This was previously established by Bourgeois (A Morse–Bott approach to contact homology, Ph.D. dissertation, Stanford University, 2002) (resp. by Bao (On J-holomorphic curves in almost complex manifolds with asymptotically cylindrical ends, Pacific J. Math. 278(2) (2015), 291–324)), by using special coordinates, for the cylindrical (resp. for the asymptotically cylindrical) ends. The exponential decay result for the Morse–Bott case is an essential ingredient in the setup of the moduli space of pseudoholomorphic curves which plays a central role in contact homology and symplectic field theory (SFT).
Explicit Bayesian Analysis for Process Tracing: Guidelines, Opportunities, and Caveats
Authors: Fairfield Tasha , Charman Andrew E.
Published: May 2017

Bayesian probability holds the potential to serve as an important bridge between qualitative and quantitative methodology. Yet whereas Bayesian statistical techniques have been successfully elaborated for quantitative research, applying Bayesian probability to qualitative research remains an open frontier. This paper advances the burgeoning literature on Bayesian process tracing by drawing on expositions of Bayesian “probability as extended logic” from the physical sciences, where probabilities represent rational degrees of belief in propositions given the inevitably limited information we possess. We provide step-by-step guidelines for explicit Bayesian process tracing, calling attention to technical points that have been overlooked or inadequately addressed, and we illustrate how to apply this approach with the first systematic application to a case study that draws on multiple pieces of detailed evidence. While we caution that efforts to explicitly apply Bayesian learning in qualitative social science will inevitably run up against the difficulty that probabilities cannot be unambiguously specified, we nevertheless envision important roles for explicit Bayesian analysis in pinpointing the locus of contention when scholars disagree on inferences, and in training intuition to follow Bayesian probability more systematically.
Longitudinal Network Centrality Using Incomplete Data
Authors: Steinert-Threlkeld Zachary C.
Published: May 2017

How do individuals’ influence in a large social network change? Social scientists have difficulty answering this question because measuring influence requires frequent observations of a population of individuals’ connections to each other, while sampling that social network removes information in a way that can bias inferences. This paper introduces a method to measure influence over time accurately from sampled network data. Ranking individuals by the sum of their connections’ connections—neighbor cumulative indegree centrality—preserves the rank influence ordering that would be achieved in the presence of complete network data, lowering the barrier to measuring influence accurately. The paper then shows how to measure that variable changes each day, making it possible to analyze when and why an individual’s influence in a network changes. This method is demonstrated and validated on 21 Twitter accounts in Bahrain and Egypt from early 2011. The paper then discusses how to use the method in domains such as voter mobilization and marketing.
Physics moves to the provinces: the Siberian physics community and Soviet power, 1917–1940
Authors: JOSEPHSON PAUL , SOROKIN ALEKSANDR
Published: May 2017

The rich tradition of Siberian science and higher education is little known outside Russian academic circles. Using institutional history, this article focuses on the founding and pre-war period of the Siberian Physical Technical Institute, the establishment of its research focus and its first difficult steps to become a leading centre of R & D in Siberia. Based on archival materials, the article describes how local and national physicists justified the institute's creation by demonstrating ties with industry and building on the presence of a cohort of locally trained physicists, whose numbers were augmented by Leningrad specialists. The strength of local cadres enabled the institute to navigate civil war and cultural revolution successfully. Physicists were able to take advantage of ongoing industrialization campaigns to gain support to create the institute, although local disputes and economic problems slowed its further development. The article describes the circulation of scientific, political and philosophical knowledge between Moscow, Leningrad and the provinces, and the impact of Bolshevik rule and Stalinism on the Siberian physics enterprise.
JUDICIAL UNCERTAINTIES CONCERNING TERRITORIAL SEA DELIMITATION UNDER ARTICLE 15 OF THE UNITED NATIONS CONVENTION ON THE LAW OF THE SEA
Authors: Lando Massimo
Published: May 2017

Recent international jurisprudence has shown considerable uncertainty with regard to the delimitation of the territorial sea. While international tribunals endorse a two-stage approach to territorial sea delimitation, there is a lack of judicial consensus on the practical implementation of such an approach. This article argues that the rule-exception relationship between equidistance and special circumstances, as reflected in the drafting history of LOSC Article 15 and in jurisprudence prior to 2007, should inform the delimitation of the territorial sea. Cases since 2007 which have strayed from the earlier jurisprudence on LOSC Article 15, should be seen as a misconstruction of the law applicable to territorial sea delimitation.
“Mind Forg’d Manacles” and Recent Pathways to “New” Labor Histories
Authors: Palmer Bryan D.
Published: May 2017

Since the 1990s, labor history has been presented as “in crisis”. This negative evaluation is an overstatement. It has nevertheless prodded historians, often productively, to rethink the basic orientations of working-class history. This survey article explores three recent pathways to a “new” labor history: the turn to transnational and global study; the “new” history of capitalism; and the study of slavery as unfree labor. These new approaches to labor history highlight an old dilemma: how the structured determinations of laboring life are balanced alongside dimensions of human agency in understanding the complex experience of the working-class past. It is argued that we need to consider both structureandagency in the researching and writing of labor history. If an older “new” labor history accented agency, new pathways to labor history too often seem constrained by “mind forg’d manacles” that limit understandings of workers’ past lives by emphasizing structure and determination.
Use of acellular dermal matrices in laryngotracheal and pharyngeal reconstruction: systematic review
Authors: Hui A , Hong P , Bezuhly M
Published: May 2017

Background:

Acellular dermal matrices are increasingly used in laryngotracheal and pharyngeal reconstruction, but specific indications and the type of acellular dermal matrix used vary. The authors systematically reviewed outcomes relating to acellular dermal matrix use in head and neck reconstruction.

Methods:

Electronic databases were searched through 1 May 2016 for literature on acellular dermal matrix use in laryngotracheal and pharyngeal reconstruction. Studies were appraised for surgical indications, outcomes and study design.

Results:

Eleven publications with 170 cases were included. Eight articles reported on acellular dermal matrix use in oncological reconstruction. Most studies were case series; no high-level evidence studies were identified. Graft extrusion was more common in non-oncological applications. In general, post-oncological reconstruction with an acellular dermal matrix demonstrated complication rates similar to those reported without an acellular dermal matrix.

Conclusion:

Evidence in support of acellular dermal matrix use in head and neck reconstruction is generally poor. Prospective comparative studies are required to define the indications, safety and effectiveness of acellular dermal matrices in laryngotracheal and pharyngeal reconstruction.
Diet selection by wintering Lesser White-fronted GooseAnser erythropusand the role of food availability
Authors: KARMIRIS ILIAS , KAZANTZIDIS SAVAS , PLATIS PANAGIOTIS , PAPACHRISTOU THOMAS G.
Published: May 2017

The Fennoscandian population of the Lesser White-fronted GooseAnser erythropus(LWfG) is on the verge of extinction and migrates from northern Fennoscandia to Greece on a regular seasonal basis. For the first time, diet selection was investigated during two years at Kerkini Lake, a wintering site in Greece. The relative use of LWfG’s feeding habitats was systematically recorded by visual observations of the LWfG flocks. Food availability was measured by the relative cover of available vegetation types while the diet composition was determined by the microhistological analysis of droppings. In addition, we determined crude protein, neutral detergent fibre, acid detergent fibre and acid detergent lignin content of the most preferred plant species by LWfG and all vegetation categories that contributed to LWfG diet in the middle of the duration of their stay at Kerkini Lake and after their departure from the lake. LWfG feeding habitat was exclusively marshy grassland in water less than 5 cm deep up to 300–400 m away from the shore. LWfG selected a diverse number of plant species (33), however, grass made up the 58% of their diets. The most preferred plant species wereEchinochloa crus-galli,Cyperus esculentus,Scirpus lacustrisandRanunculus sceleratus. LWfG departed from Kerkini Lake in mid-December to the Evros Delta (Thrace, eastern Greece), when either food availability falls in very low levels or flooding occurred in their main feeding habitat. Consequently, as long as food and habitat resources are available for LWfG, it is very likely that the birds will winter mainly at Kerkini Lake and not at the Evros Delta, which will contribute to further minimisation of the theoretical risk of accidental shooting of LWfG at the latter wintering habitat. Thus, future conservation actions should primarily focus on the grassland improvement at Kerkini Lake enhancing the availability of food resources for LWfG (mainly grasses) and the protection of the feeding habitat from flooding.
Spengler’s Prussian Socialism
Authors: Lewis Ben
Published: May 2017

Oswald Spengler (1880–1936) was one of the most significant thinkers of the Weimar Republic, Germany’s first democracy. His work, notably the two-volume, 1200-page Der Untergang des Abendlandes (Decline of the West, 1918/22), had a profound influence on the intellectual discourses of the time in Germany and beyond.1 Yet, despite the high esteem in which he was held by his contemporaries, his thought has been seriously under-researched. In English, only four major studies have appeared in the last 70 years.2 This is all the more surprising in that the historical period in which he wrote has been extensively covered by both English- and German-language scholars and that some of the thinkers who drew critically on his ideas, such as Heidegger and Adorno, have become household names in Germany intellectual history.
Corruption, Reform and the Euro
Authors: Caruana-Galizia Paul
Published: May 2017

Most policymakers and academics predicted that the European monetary union would lead to economic and institutional modernizaon in its least productive members – Greece, Ireland, Italy, Portugal and Spain. In fact, apart from Ireland, these countries became even more corrupt and their governments even less effective. This paper suggests an explanation that links the reluctance of peripheral countries to reform with the increase in their corruption levels. It also argues that their societies were stuck in a collective action problem: individuals have understood that corruption is antithetical to institutional quality and reform, but, as they cannot trust each other to refrain from corrupt practices, they stand to lose individually from not being corrupt themselves. Monetary union was seen as an external authority that would resolve this problem. Yet weak EU and eurozone monitoring and sanctioning discouraged the formation of social norms while making it attractive for formerly non-corrupt actors to engage in corruption, given the low risk of being caught. Survey evidence supports growth in perceptions of corruption and bribery, along with the weakening of social trust, trust in the police and in politicians across the periphery after the euro’s introduction.
Crisis and Inequality in the European Union
Authors: Amate-Fortes Ignacio , Guarnido-Rueda Almudena , Molina-Morales Agustín
Published: May 2017

The objective of this work is to analyse the factors that influence a greater or lesser inequality in income distribution in the 27 EU countries, paying particular attention to the effect that the economic crisis has had. For this purpose we have used panel data covering a period of 16 years (from 1996 to 2011, inclusive), and we have introduced additional variables over and above those normally used, such as the ideology of the governing party, the economic freedom index, as well as the ‘crisis’ variable. The results obtained enable us to conclude that while the economic crisis has not necessarily caused a worsening in inequality, the response of European governments by means of social policy has not so far proved effective in the fight against the lack of equality in income distribution.
Profiles of Executive Function Across Children with Distinct Brain Disorders: Traumatic Brain Injury, Stroke, and Brain Tumor
Authors: Araujo Gabriel C. , Antonini Tanya N. , Anderson Vicki , Vannatta Kathryn A. , Salley Christina G. , Bigler Erin D. , Taylor H. Gerry , Gerhardt Cynthia , Rubin Kenneth , Dennis Maureen , Lo Warren , Mackay Mark T. , Gordon Anne , Hajek Koterba Christine , Gomes Alison , Greenham Mardee , Owen Yeates Keith
Published: May 2017

Objectives:This study examined whether children with distinct brain disorders show different profiles of strengths and weaknesses in executive functions, and differ from children without brain disorder.Methods:Participants were children with traumatic brain injury (N=82; 8–13 years of age), arterial ischemic stroke (N=36; 6–16 years of age), and brain tumor (N=74; 9–18 years of age), each with a corresponding matched comparison group consisting of children with orthopedic injury (N=61), asthma (N=15), and classmates without medical illness (N=68), respectively. Shifting, inhibition, and working memory were assessed, respectively, using three Test of Everyday Attention: Children’s Version (TEA-Ch) subtests: Creature Counting, Walk-Don’t-Walk, and Code Transmission. Comparison groups did not differ in TEA-Ch performance and were merged into a single control group. Profile analysis was used to examine group differences in TEA-Ch subtest scaled scores after controlling for maternal education and age.Results:As a whole, children with brain disorder performed more poorly than controls on measures of executive function. Relative to controls, the three brain injury groups showed significantly different profiles of executive functions. Importantly, post hoc tests revealed that performance on TEA-Ch subtests differed among the brain disorder groups.Conclusions:Results suggest that different childhood brain disorders result in distinct patterns of executive function deficits that differ from children without brain disorder. Implications for clinical practice and future research are discussed. (JINS, 2017,23, 529–538)