bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessing Near Surface Hydrologic Processes and Plant Response over a 1600 m Mountain Valley Gradient in the Great Basin, NV, U.S.A.
Authors: Devitt Dale , Bird Brian , Lyles Brad , Fenstermaker Lynn , Jasoni Richard , Strachan Scotty , Arnone lll Jay , Biondi Franco , Mensing Scott , Saito Laurel
Published: April 2018

This study investigated near surface hydrologic processes and plant response over a 1600 m mountain-valley gradient located in the Great Basin of North America (Nevada, U.S.A.) as part of a long-term climate assessment study. The goal was to assess shifts in precipitation, soil water status and associated drainage with elevation and how this influenced evapotranspiration and plant cover/health estimated by a satellite-derived Normalized Difference Vegetation Index (NDVI), all to better understand how water is partitioned in a mountain valley system. Data were acquired during a three-year period from meteorological stations located in five plant communities ranging in elevation from 1756 m (salt desert shrubland zone) to 3355 m (subalpine zone). The analysis also included groundwater depths measured at the Salt Desert Shrub West site, mine water flow near the Pinyon-Juniper West site and drainage estimates using drainage flux meters at the four higher elevation sites. Annual precipitation increased with elevation in a linear fashion (R2 = 0.93, p < 0.001) with an average increase of 2.9 cm for every 100 m in elevation. Reference evapotranspiration (ETref) declined in a highly linear fashion with elevation (R2 = 0.95, p < 0.001) with an average 4.0 cm decline for every 100 m rise in elevation. Drainage occurred only at the Montane West and Subalpine West sites and not at the lower elevations. No drainage occurred after Julian day 160. Growing degree days were found to be negatively associated with the time of peak drainage (R2 = 0.97, p < 0.001), the date drainage first occurred (R2 = 0.90, p < 0.001), drainage duration (R2 = 0.79, p < 0.001) and total drainage volume (R2 = 0.59, p < 0.001). It was estimated that 27% of precipitation at the Montane West site (years 1, 2 and 3) and 66 % at the Subalpine West site (40% without year 1) contributed to drainage at the local site level, indicating possible strong recharge contribution from the higher elevation plant communities. Percent vegetation cover and ETref accounted for 94% of the variation in NDVI and 90% of the variation in ET totals when data from all sites were combined. Such data will be extremely valuable to collect and compare over time to assess shifts associated with potential climate warming and/or basin water diversion.
Hydrological Process Simulation of Inland River Watershed: A Case Study of the Heihe River Basin with Multiple Hydrological Models
Authors: Wang Lili , Wang Zhonggen , Yu Jingjie , Zhang Yichi , Dang Suzhen
Published: April 2018

Simulating the hydrological processes of an inland river basin can help provide the scientific guidance to the policies of water allocation among different subbasins and water resource management groups within the subbasins. However, it is difficult to simulate the hydrological processes of an inland river basin with hydrological models due to the non-consistent hydrological characteristics of the entire basin. This study presents a solution to this problem with a case study about the hydrological process simulation in an inland river basin in China, Heihe River basin. It is divided into the upper, middle, and lower reaches based on the distinctive hydrological characteristics in the Heihe River basin, and three hydrological models are selected, applied, and tested to simulate the hydrological cycling processes for each reach. The upper reach is the contributing area with the complex runoff generation processes, therefore, the hydrological informatic modeling system (HIMS) is utilized due to its combined runoff generation mechanisms. The middle reach has strong impacts of intensive human activities on the interactions of surface and subsurface flows, so a conceptual water balance model is applied to simulate the water balance process. For the lower reach, as the dissipative area with groundwater dominating the hydrological process, a groundwater modeling system with the embedment of MODFLOW model is applied to simulate the groundwater dynamics. Statistical parameters and water balance analysis prove that the three models have excellent performances in simulating the hydrological process of the three reaches. Therefore, it is an effective way to simulate the hydrological process of inland river basin with multiple hydrological models according to the characteristics of each subbasin.
Zinc(II) Adsorption by Low-Carbon Shungite: The Effect of pH
Authors: Fischer Axel , Sgolik Luisa , Kreller André , Dornack Christina
Published: April 2018

Shungite is a carbonaceous rock which is abundant in Karelia (Russian Federation). Large deposits of shungite with low levels of carbon (approx. 10% C) are also found in Kazakhstan, where it is mined under the trade name Taurit (Koksu Mining Company). Although Taurit has been reported to be used as an adsorbent for hazardous compounds in water treatment, there is very little precise data about its adsorption capacity or the compounds adsorbed. In this study, the ability of Taurit to adsorb Zn(II) was investigated and Freundlich isotherms were determined for both distilled water and tap water. Taurit was found to have a high buffer capacity leading to pH values > 7.0 in aqueous solution. Because dissolved zinc precipitates as Zn(OH)2 under alkaline conditions, the pH must be carefully controlled and kept ≤7.0. Despite the small inner surface area (BET) of Taurit (13.4 m2 g−1), Freundlich coefficients for distilled water (Kf = 2.4, n = 4.0) and tap water (Kf = 1.5, n = 2.5) were similar to other adsorbents. Our results indicate that Taurit could provide a cheap alternative to activated carbon since both substances have a similar adsorption capacity (at least for Zn(II)).
BAT AGN Spectroscopic Survey. VIII. Type 1 AGN with Massive Absorbing Columns
Authors: Shimizu T. Taro , Davies Richard I. , Koss Michael , Ricci Claudio , Lamperti Isabella , Oh Kyuseok , Schawinski Kevin , Trakhtenbrot Benny , Burtscher Leonard , Genzel Reinhard , Lin Ming-yi , Lutz Dieter , Rosario David , Sturm Eckhard , Tacconi Linda
Published: April 2018

We explore the relationship between X-ray absorption and optical obscuration within the BAT AGN Spectroscopic Survey (BASS), which has been collecting and analyzing the optical and X-ray spectra for 641 hard X-ray selected (E > 14 keV) active galactic nuclei (AGNs). We use the deviation from a linear broad Hα-to-X-ray relationship as an estimate of the maximum optical obscuration toward the broad line region (BLR) and compare the A
V to the hydrogen column densities (

) found through systematic modeling of their X-ray spectra. We find that the inferred columns implied by A
V toward the BLR are often orders of magnitude less than the columns measured toward the X-ray emitting region, indicating a small-scale origin for the X-ray absorbing gas. After removing 30% of Sy 1.9s that potentially have been misclassified due to outflows, we find that 86% (164/190) of the Type 1 population (Sy 1–1.9) are X-ray unabsorbed as expected based on a single obscuring structure. However, 14% (26/190), of which 70% (18/26) are classified as Sy 1.9, are X-ray absorbed, suggesting that the BLR itself is providing extra obscuration toward the X-ray corona. The fraction of X-ray absorbed Type 1 AGNs remains relatively constant with AGN luminosity and Eddington ratio, indicating a stable BLR covering fraction.
Stability Limits of Circumbinary Planets: Is There a Pile-up in the Kepler CBPs?
Authors: Quarles B. , Satyal S. , Kostov V. , Kaib N. , Haghighipour N.
Published: April 2018

The stability limit for circumbinary planets (CBPs) is not well defined and can depend on initial parameters defining either the planetary orbit and/or the inner binary orbit. We expand on the work of Holman & Wiegert (1999) to develop numerical tools for quick, easy, and accurate determination of the stability limit. The results of our simulations, as well as our numerical tools, are available to the community through Zenodo and GitHub, respectively. We employ a grid interpolation method based on ∼150 million full N-body simulations of initially circular, coplanar systems and compare to the nine known Kepler CBP systems. Using a formalism from planet packing studies, we find that 55% of the Kepler CBP systems allow for an additional equal-mass planet to potentially exist on an interior orbit relative to the observed planet. Therefore, we do not find strong evidence for a pile-up in the Kepler CBP systems and more detections are needed to adequately characterize the formation mechanisms for the CBP population. Observations from the Transiting Exoplanet Survey Satellite are expected to substantially increase the number of detections using the unique geometry of CBP systems, where multiple transits can occur during a single conjunction.
Deep JVLA Imaging of GOODS-N at 20 cm
Authors: Owen Frazer N.
Published: April 2018

New wideband continuum observations in the 1–2 GHz band of the GOODS-N field using NSF’s Karl G. Jansky Very Large Array (VLA) are presented. The best image with an effective frequency of 1525 MHz reaches an rms noise in the field center of 2.2 μJy, with 1.″6 resolution. A catalog of 795 sources is presented covering a radius of 9 arcminutes centered near the nominal center for the GOODS-N field, very near the nominal VLA pointing center for the observations. Optical/NIR identifications and redshift estimates both from ground-based and HST observations are discussed. Using these optical/NIR data, it is most likely that fewer than 2% of the sources without confusion problems do not have a correct identification. A large subset of the detected sources have radio sizes >1″. It is shown that the radio orientations for such sources correlate well with the HST source orientations, especially for z < 1. This suggests that a least a large subset of the 10 kpc-scale disks of luminous infrared/ultraluminous infrared galaxies (LIRG/ULIRG) have strong star formation, not just in the nucleus. For the half of the objects with z > 1, the sample must be some mixture of very high star formation rates, typically 300 M
⊙ yr−1, assuming pure star formation, and an active galactic nucleus (AGN) or a mixed AGN/star formation population.
Technology, Educator Intention, and Relationships in Virtual Learning Spaces: A Qualitative Metasynthesis
Authors: Gdanetz Lorraine M. , Hamer Mika K. , Thomas Eileen , Tarasenko Lindsey M. , Horton-Deutsch Sara , Jones Jacqueline
Published: April 2018

Background:

A main concern that remains with the continued growth of online nursing education programs is the way educator and student relationships can be affected by new technologies. This interpretive study aims to gain an understanding of how technology influences the development of interpersonal relationships between the student and faculty in a virtual learning environment.

Method:

Using an established structured approach to qualitative metasynthesis, a search was conducted using PubMed, EBSCO, CINAHL, Medline, ProQuest, Ovid Nursing databases, and Google Scholar, focused on caring and relational aspects of online nursing education.

Results:

Technology alters communication, thereby positioning the intentionality of the educator at the heart of interpersonal relationship development in virtual learning spaces.

Conclusion:

This interpretive synthesis of prior qualitative research supports the development of a framework for online nursing courses, the need for continuing education of nursing faculty, the value of caring intentions, and enhancement of the educator's technological proficiency. [
J Nurs Educ.
2018;57(4):197–202.]
Diagnostic Reasoning and Cognitive Biases of Nurse Practitioners
Authors: Lawson Thomas N.
Published: April 2018

Background:

Diagnostic reasoning is often used colloquially to describe the process by which nurse practitioners and physicians come to the correct diagnosis, but a rich definition and description of this process has been lacking in the nursing literature.

Method:

A literature review was conducted with theoretical sampling seeking conceptual insight into diagnostic reasoning.

Results:

Four common themes emerged: Cognitive Biases and Debiasing Strategies, the Dual Process Theory, Diagnostic Error, and Patient Harm. Relevant cognitive biases are discussed, followed by debiasing strategies and application of the dual process theory to reduce diagnostic error and harm.

Conclusion:

The accuracy of diagnostic reasoning of nurse practitioners may be improved by incorporating these items into nurse practitioner education and practice. [
J Nurs Educ.
2018;57(4):203–208.]
Learning About Conflict and Conflict Management Through Drama in Nursing Education
Authors: Arveklev Susanna H. , Berg Linda , Wigert Helena , Morrison-Helme Morag , Lepp Margret
Published: April 2018

Background:

In the health care settings in which nurses work, involvement in some form of conflict is inevitable. The ability to manage conflicts is therefore necessary for nursing students to learn during their education.

Method:

A qualitative analysis of 43 written group assignments was undertaken using a content analysis approach.

Results:

Three main categories emerged in the analysis—to approach and integrate with the theoretical content, to step back and get an overview, and to concretize and practice—together with the overall theme, to learn by oscillating between closeness and distance.

Conclusion:

Learning about conflict and conflict management through drama enables nursing students to form new knowledge by oscillating between closeness and distance, to engage in both the fictional world and the real world at the same time. This helps students to form a personal understanding of theoretical concepts and a readiness about how to manage future conflicts. [
J Nurs Educ.
2018;57(4):209–216.]
Standardized Patient Simulation to Facilitate Learning in Evidence-Based Oncology Symptom Management
Authors: Ross Jennifer Gunberg , Burrell Sherry A.
Published: April 2018

Background:

New graduate nurses lack the specialty knowledge and skills necessary to provide effective symptom management to oncology patients. The purpose of this article is to describe the development of a simulation-based learning experience using standardized patients to enhance undergraduate nursing students' ability to apply evidence-based principles learned in the classroom to oncology symptom management practice.

Method:

Faculty developed two standardized patient simulations for a 7-week senior seminar in evidence-based oncology symptom management.

Results:

Faculty, students, and standardized patients provided positive feedback. Students appreciated the realism and innovation of using simulation in a seminar-style course. Faculty and students identified that more time was needed for the simulations, and revisions are planned for the next offering of the seminar to address this concern.

Conclusion:

The integration of standardized patients is a feasible learning strategy to facilitate learning of evidence-based oncology symptom management principles among undergraduate nursing students. [
J Nurs Educ.
2018;57(4):250–253.]
Ommatissus lybicus(Hemiptera: Tropiduchidae), an economically important pest of date palm (Arecaceae) with highly divergent populations
Authors: Bagheri Abdoolnabi , Fathipour Yaghoub , Askari-Seyahooei Majeed , Zeinalabedini Mehrshad
Published: April 2018

Ommatissus lybicusde Bergevin (Hemiptera: Tropiduchidae) is a key pest of date palm (Phoenix dactyliferaLinnaeus; Arecaceae) with worldwide distribution and various management strategies. To study genetic diversity of date palm hopper, a series of experiments was conducted on genetic structure and genetic diversity of 15 geographic populations ofO.lybicus(Abu Musa, Bam, Bushehr, Behbahan, Tezerj, Fin, Jiroft, Shahdad, Jahrom, Ghire Karzin, Ghasre Shirin, Iran; Pakistan; Oman; Egypt; and Tunisia) by amplified fragment length polymorphism, cytochromecoxidase subunit I (COI), and 28S rRNA markers. Analysis of molecular variance analysis of amplified fragment length polymorphism data and COI sequences revealed a significant variation amongO.lybicuspopulations (94.12% and 65.08% similarities for amplified fragment length polymorphism and COI, respectively). The 28S rDNA sequences from different populations were identical. Phylogenetic network inferred from amplified fragment length polymorphism data and COI sequences grouped two geographically close populations (Tezerj and Bam) in the two distinct clades while far apart geographical populations bunched in the same or close clades. These two populations experience repeated exposure to heavy pesticide applications annually. In conclusion, study of the genetic structure revealed a considerable variation betweenO.lybicuspopulations under intensive chemical strategies.
Distribution of non-myelinating Schwann cells and their associations with leukocytes in mouse spleen revealed by immunofluorescence staining
Authors: Ma Bin , Yin Changfu , Hu Dailun , Newman Mark , Nicholls Philip K. , Wu Zhanjun , Greene Wayne K. , Shi Zhongli
Published: April 2018

The nervous system and the immune system communicate extensively with each other in order to maintain homeostasis and to regulate the immune response. The peripheral nervous system (PNS) communicates specifically with the immune system according to local interactions, including the “hardwiring” of sympathetic/parasympathetic (efferent) and sensory nerves (afferent) to lymphoid tissue and organs. To reveal this type of bidirectional neuroimmune interaction at the microscopic level, we used immunofluorescent staining of glial fibrillary acidic protein (GFAP) coupled with confocal microscopy/3D reconstruction to reveal the distribution of non-myelinating Schwann cells (NMSCs) and their interactions with immune cells inside mouse spleen. Our results demonstrate i) the presence of  an extensive network of  NMSC processes in all splenic compartments including the splenic nodules, periarteriolar lymphoid sheath (PALS), marginal zone,  trabecula, and red pulp; ii) the close association of  NMSC processes with blood vessels (including central artries and their branches, marginal sinuses, penicillar arterioles and splenic sinuses); iii) the close “synapse-like” interaction/association of NMSC processes with various subsets of dendritic cells (DCs; e.g., CD4+CD11c+ DCs, B220+CD11c+ DCs, and F4/80+ CD11c+ DCs), macrophages (F4/80+), and lymphocytes (B cells, CD4+ T helper cells). Our novel findings concerning the distribution of NMSCs and NMSC-leukocytes interactions inside mouse spleen should improve our understanding of the mechanisms through which the PNS affects cellular- and humoral-mediated immune responses in a variety of health conditions and infectious/non-infectious diseases.
Autophagic processes increase during senescence in cultured sheep neurons and astrocytes
Authors: Farina Vittorio , Lepore Gianluca , Biagi Francesca , Carcupino Marcella , Zedda Marco
Published: April 2018

A possible response to aging is autophagy, a self-digestion process in which portions of cytoplasm are encapsulated by double-membrane-bound structures and delivered to lysosome for degradation. A previous work of our group showed that astrocytes under starving conditions are characterized by a higher upregulation of the marker of autophagy LC3 II than neurons. Aim of the present work was to evaluate LC3 II expression in an aging model consisting in fetal sheep neurons and astrocytes at 10, 20 and 30 days of culture. Such model has been validated by a remarkable activity of β-galactosidase, commonly used to reveal cell aging. LC3 II immunoreactivity in neurons and astrocytes progressively increased with time but differences were observed on the basis of cell density. Indeed, LC3 II immunoreactivity is higher in clusters of neurons and astrocytes and this may be due to the fact that cell-cell contact would represent a second stress in addition to aging itself. Both cell types displayed a reduction in LC3 II signal in nuclei, and a corresponding strengthening in the cytoplasm with time. This may be due to the need of aged cells to remove damaged cytoplasmic components through autophagic processes. Such variation in LC3 II localization could be caused by migration from the nucleus to cytoplasm as well as possible de novo intracytoplasmic production. The present work based on sheep neural cells in vitro may represent a helpful tool in the studies on aging processes in which autophagy plays a remarkable role.
Congenital Methemoglobinemia Misdiagnosed as Polycythemia Vera: Case Report and Review of Literature
Authors: Soliman Dina Sameh , Yassin Mohamed
Published: April 2018

Methemoglobinemia is a rare overlooked differential diagnosis in patients presented with cyanosis and dyspnea unrelated to cardiopulmonary causes. Our patient is 29 year old Indian non-smoker male, his story started 6 months prior to presentation to our center when he had generalized fatigue and discoloration of hands. He presented with persistent polycythemia with elevated hemoglobin level. The patient was misdiagnosed in another center as polycythemia and treated with Imatinib. The diagnosis of PV was revisited and ruled out in view of negative JAK2, normal erythropoietin level and absence of features of panmyelosis. Clinical cyanosis and lowoxygen saturation in the presence of normal arterial oxygen tension was highly suggestive of methemoglobinemia. Arterial blood gas revealed a methemoglobin level of 38% (normal: 0–1.5%). Cytochrome B5 reductase (Methemoglobin reductase B) was deficient at level of <2.6 U/g Hb) (normal: 6.6–13.3), consistent with methemoglobin reductase (cytochrome b5) deficiency and hence the diagnosis of congenital methemoglobinemia was established. The role of Imatinib in provoking methemoglobinemia is questionable and association between Imatinib and methemoglobinemia never described before. In our case, there were no other offending drugs in aggravating the patients’ symptoms and cyanosis. The patient started on Vitamin C 500 mg once daily for which he responded well with less cyanosis and significant reduction of methemoglobin level. Congenital methemoglobinemia is a rare underreported hemoglobin disease and often clinically missed. Upon extensive review of English literature for cases of congenital methemoglobinemia due to deficiency of cytochrome b5 reductase, we found 23 cases diagnosed as type I (including the case reported here). 17 cases (~74%) of type I and 6 cases (27%) of type II. There is male predominance 73% versus 26% in females. Almost half of reported cases 12 cases (52%) are Indian, 2 Japanese, 3 English, 2 Arabic, one case Spanish and one case Italian. For type I, the median calculated age is 31 years with cyanosis and shortness of breath being the most common sign and symptoms. For type II: Six cases were reported in English literature, all in pediatric age group with median calculated age at presentation is 6 years with neurologic manifestations and mental retardation are the most common type II associated symptoms. Due to lack of systematic epidemiological studies, congenital methemoglobinemia is under diagnosed as it is under investigated and usually overlooked especially when presenting in adulthood and in absence of obvious acquired agents.
Acute monocytic leukemia diagnosed by flow cytometry includes acute myeloid leukemias with weakly or faintly positive non-specific esterase staining
Authors: Zushi Yuriko , Sasaki Miho , Mori Ayano , Saitoh Toshiharu , Goka Takae , Aoyama Yumi , Goto Yuta , Tsunemine Hiroko , Kodaka Taiichi , Takahashi Takayuki
Published: April 2018

A diagnosis of acute monocytic leukemia(AML-M5) based on α-naphthyl butyrateesterase (α-NB) staining has some problems,because AML-M5 leukemic cells often showweak or faint positivity on α-NB staining. Inthese situations, some cases of AML-M5tend to be misdiagnosed as AML-M0. Therefore, we evaluated the significance ofweak or faint α-NB staining in AML-M5diagnosed by flow cytometry (FCM). Nineteen AML cases in which leukemic cellswere negative for naphthol AS-D chloroac-etate esterase staining were studied. ForFCM, we defined leukemic cells as having amonocytic nature when more than 10% ofthe leukemic cells were positive for at leastone of the following antigens: CD4, CD11c,CD14, and CD64. The monocytic naturedetermined by FCM was consistent with pos-itive or weak positivity on α-NB staining. Five of 6 cases in which leukemic cellsexhibited faint positivity for α-NB stainingcould be diagnosed as AML-M5 by FCM,while negative α-NB staining was consistentwith a diagnosis of AML-M0. These resultssuggest that AML-M5 should be taken intoconsideration even when leukemic cells arefaintly positive for α-NB staining.
Abdominal Rectus Muscle Pyomyositis: Report of a Case and Review of the Literature
Authors: Fountoukis Tilemachos , Tsatsanidis Nikolaos , Tilkeridou Maria , Konstantinou Ioannis , Fytas Pantelis , Skandalos Ioannis
Published: April 2018

Pyomyositis is an uncommon primary bacterial infection of skeletal muscles, usually caused by Staphylococcus aureus. Predisposing factors for pyomyositisinclude immunodeficiency, trauma, injection drug use, concurrent infection and malnutrition. The diagnosis, staging of the disease and differential diagnosis are established by ultrasound, CT and MRI. Treatment involves surgical drainage and antibiotic therapy. We report a case of abdominal rectus muscle pyomyositis, which constitutes, as far as we know, thesecond reported in bibliography, while Prevotella disiens is firstly reported as causative agent.
Epidemiology of Vertebral Fractures in Pediatric and Adolescent Patients
Authors: Saul Dominik , Dresing Klaus
Published: April 2018

Spinal injuries in children and adolescents are rare injuries, but consequences for the growing skeleton can be devastating. Knowledge of accident causes, clinical symptoms and diagnostics should be part of every trauma department treating the sepatients. We retrospectively analyzed patients with radiographically proven vertebral fractures of the spine. After clinical examination and tentative diagnosis the fractures and injuries were proven with conventional X-ray, computed tomography(CT) scans or magnetic resonance imaging (MRI). The study included 890 fractures in 546 patients with an average age of 12.8±6.2 (6.6-19.4) years. Females had anaverage age of 13.7±6.3 (7.4-20.0) years, whereas males were on average 12.0 (6.0-18.0) years old. Fall from height (58%) wasthe main cause of accident and the most common region of fracture was the thoracolumbar spine with a shift towards the thoracic spine the more fractures occurred. Merely 3.7% of all patients required operative treatment. If a vertebral fracture is found in children and adolescents, it is highly recommended to exclude synchronous additional spine fractures in other levels; prevention should concentrate on fall and traffic accidents.
Acute Encephalopathy with Biphasic Seizures and Late Reduced Diffusion Associated with Streptococcus sanguinis Sepsis
Authors: Awaguni Hitoshi , Shinozuka Jun , Tanaka Shin-ichiro , Kadowaki Sayaka , Makino Shigeru , Maruyama Rikken , Shigematsu Yosuke , Hamaoka Kenji , Imashuku Shinsaku
Published: April 2018

Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) develops in association with systemic as well as central nervous system (CNS) viral or bacterial infections. AESD is most often noted with influenza or human herpesvirus 6 infection in previously healthy infants. However, AESD has also been reported in an infant with developmental retardation and in a mentally and motor-disabled adolescent. Here, we report the case of a 4-year-old female with significant development delay due to spinal muscular atrophy, who developed AESD during Streptococcus sanguinis sepsis with no apparent CNS infection. Although the patient had extremely high serum procalcitonin (45.84 ng/mL, reference; <0.4) on admission indicating a poor prognosis, she was successfully managed for sepsis and AESD.
Investigating a new wealth tax in South Africa: Lessons from international experience
Authors: Arendse Jackie , Stack Lilla
Published: April 2018

In recent years, there has been an increasing focus on new sources of taxation, including wealth tax. In South Africa, two phenomena have driven the focus on wealth tax. Firstly, the need for additional tax revenue to fund an ongoing and growing budget deficit, exacerbated by a prolonged period of low economic growth, rising government debt and a very small base of individual taxpayers. Secondly, the fact that South Africa has one of the most unequal societies in the world. The dual demands of increased tax revenue and economic inequality have converged around wealth tax as a possible panacea to both problems. Although South Africa has a long history of wealth transfer tax in the form of estate duty and donations tax, there has never been a tax on the net wealth holdings of individuals during their lifetime. Internationally, numerous countries have used wealth tax in various forms, including inheritance tax, gift tax, recurrent wealth tax and non-recurrent wealth tax. This study examines some of the international experiences with these three categories of wealth tax, seeking lessons and experiences that can inform the debate around the viability of a new wealth tax in South Africa.
Algorithm and Formal Model of Recovering Network Connectivity in Battlefield Surveillance
Authors: Ahmad Zafar Nazir , Afzaal Hamra
Published: April 2018

Battlefield surveillance requires mission-critical operations and tasks which can effectively be performed using Wireless Sensor and Actor Networks (WSANs). We have used clustering approach for deployment of WSAN to minimize energy consumption and to limit the processing cost. The adverse environment conditions in battlefield may cause a loss of connectivity but there is a need of continuous flow of information in this application. Therefore an algorithm for network recovering is proposed. Firstly, graphical model of the system is presented using graph theory which is then transformed into a formal model by developing formal specification using Vienna Development Method-Specification Language (VDM-SL). Invariants and pre/post-conditions are defined for its validation. The correctness of the formal specification is assured by an analysis through VDM-SL toolbox.
Offshore Outsourcing Risk Management for Pakistan
Authors: Latif Maria , Azim Niaz Iftikhar , Ibrahim Jawwad
Published: April 2018

Software offshore outsourcing is strong pillar of software development. Software offshore outsourcing involves many risks, due to internal or external factors, that must be recognized and managed. Each organization that deals with the offshore outsourcing must be well aware of all the risk factors and barriers in the offshore outsourcing to maintain the quality of their product. It is very important for the Pakistan’s software industry to improve and maintain the quality of the products with minimal risk and compete with other countries in offshore outsourcing. The problem addressed in this research article is to minimize the risks occurring in offshore software outsourcing. For that purpose, we propose some offshore outsourcing risk mitigation guidelines for the software industry of Pakistan. We use empirical analysis and the qualitative method. A comprehensive literature review is carried out. The risk factors related to offshore outsourcing specifically for Pakistan’s software industry are generated empirically.
Epidemiological and Clinical Features of Melioidosis: A Report of Seven Cases from Southern Inland China
Authors: Tang Yanping , Deng Jingmin , Zhang Jianquan , Zhong Xiaoning , Qiu Ye , Zhang Hui , Xu Haiguang
Published: April 2018

Some subtropical regions with similar climatic conditions to melioidosis-endemic areas, such as southern Guangxi, may be new endemic zones for melioidosis. We retrospectively reviewed seven culture-proven melioidosis patients from October 2006 to March 2015. Their clinical characteristics, diagnosis, and treatment, and the geographical and environmental factors were analyzed. Seven male patients lived at latitudes of 21–23°N in Beihai, Nanning, Chongzuo City of the Guangxi Province. Symptom onset occurred during the rainy season. All patients had pneumonia, six patients had diabetes, five patients had a history of wounds or exposure to soil or water, and two patients had liver and spleen abscesses. Most patients were misdiagnosed before the confirmatory laboratory testing. The final diagnosis was confirmed as melioidosis by isolation of Burkholderia pseudomallei in a culture of blood or pus. The 6- to 17-month treatment included carbapenems, ceftazidime, or other antibiotics active against the organism in vitro. All patients initially appeared cured, but two subsequently had recurrent melioidosis. In non-highly endemic areas, there is often a lack of awareness of melioidosis, and this leads to misdiagnoses. Other subtropical regions with climatic conditions similar to the highly melioidosis-endemic areas such as southern Guangxi may also be melioidosis endemic.
Environmental Enteropathy in Undernourished Pakistani Children: Clinical and Histomorphometric Analyses
Authors: Syed Sana , Yeruva Sunil , Herrmann Jeremy , Sailer Anne , Sadiq Kamran , Iqbal Najeeha , Kabir Furqan , Ahmed Kumail , Qureshi Shahida , Moore Sean R. , Turner Jerrold , Ali S. Asad
Published: April 2018

Despite nutrition interventions, stunting thought to be secondary to underlying environmental enteropathy (EE) remains pervasive among infants residing in resource-poor countries and remains poorly characterized. From a birth cohort of 380 children, 65 malnourished infants received 12 weeks of nutritional supplementation with ready-to-use therapeutic food (RUTF). Eleven children with insufficient response to RUTF underwent upper endoscopy with duodenal biopsies, which were compared with U.S., age-matched specimens for healthy, celiac disease, non-celiac villous atrophy, non-celiac intraepithelial lymphocytosis, and graft-versus-host disease patients. Of the 11 children biopsied, EE was found in 10 (91%) with one subject with celiac disease. Morphometry demonstrated decreased villus-to-crypt (V:C) ratios in EE relative to healthy and non-celiac lymphocytosis patients. Environmental enteropathy villus volumes were significantly decreased relative to healthy controls. In EE, average CD3+ cells per 100 epithelial cells and per 1,000 µm2 of lamina propria and the number of lamina propria CD20+ B-cell aggregates were increased relative to all other groups. Our results indicate that V:C ratios are reduced in EE but are less severe than in celiac disease. Environmental enteropathy intraepithelial and lamina propria T lymphocytosis is of greater magnitude than that in celiac disease. The increases in lamina propria B and T lymphocytes suggest that non-cytolytic lymphocytic activation may be a more prominent feature of EE relative to celiac disease. These results provide new insights into shared yet distinct histological and immunological features of EE and celiac disease in children.
Albendazole Treatment Improves Work Capacity in Women Smallholder Farmers Infected with Hookworm: A Double-Blind Randomized Control Trial
Authors: Salmon Margaret , Salmon Christian , Masoda Maurice , Salumu Jean-Maurice , Bozzi Carmine , Nieburg Phil , Harrison Lisa M. , Humphries Debbie , Abaca Uvon Naomi , Wendel Sarah K. , Trout Clint , Cappello Michael
Published: April 2018

An estimated 4.7 billion people live in regions exposed to soil-transmitted helminths, intestinal parasites that have significant impacts on the health of women smallholder farmers. The goal of this trial was to determine whether treatment with albendazole impacts the work capacity of these farmers. This is a prospective double-blind, randomized effectiveness trial. Participants (N = 250) were randomly selected from safe motherhood groups in the Democratic Republic of Congo. Prevalence/intensity of hookworm infection, hemoglobin, and demographics was obtained. At study (Time = 0), participants were randomized into treatment (albendazole 400 mg) and placebo (similar placebo tablet) groups. A step test was administered as a proxy metric for work capacity. Work capacity was defined as ∆heart rate before and after 3 minutes of step testing, in beats per minute. At study (time = 7 months), the step test was repeated and work capacity remeasured. The ∆work capacity (time = 0 minus time = 7 months) was the primary outcome. Investigators/field assistants were blinded to who was enrolled in groups, hookworm status, and step test results. Regression showed highly significant interactive effects of hookworm status and treatment group relative to ∆work capacity after controlling for resting pulse rate and age (P < 0.002). Estimated marginal means for work capacity (WC) for each of four groups (hookworm positive plus placebo, hookworm positive plus treatment, hookworm negative plus placebo, and hookworm negative plus treatment) showed women who were hookworm positive and received treatment decreased heart rate by 9.744 (95% confidence interval [CI]: 6.42, 13.07) beats per minute (increased WC), whereas women who were hookworm positive and received placebo saw a nonsignificant decrease of 0.034 (95% CI: −3.16, 3.84) beats per minute. Treatment with albendazole was associated with improved aerobic work capacity posttreatment. Given modest costs of drug distributions, risk benefits of periodic deworming warrants further study in larger controlled trials.
A Randomized Controlled Trial to Assess the Impact of Ceramic Water Filters on Prevention of Diarrhea and Cryptosporidiosis in Infants and Young Children—Western Kenya, 2013
Authors: Morris Jamae Fontain , Murphy Jennifer , Fagerli Kirsten , Schneeberger Chandra , Jaron Peter , Moke Fenny , Juma Jane , Ochieng John B. , Omore Richard , Roellig Dawn , Xiao Lihua , Priest Jeffrey W. , Narayanan Jothikumar , Montgomery Joel M. , Hill Vince , Mintz Eric , Ayers Tracy L. , O’Reilly Ciara E.
Published: April 2018

Cryptosporidium is a leading cause of diarrhea among Kenyan infants. Ceramic water filters (CWFs) are used for household water treatment. We assessed the impact of CWFs on diarrhea, cryptosporidiosis prevention, and water quality in rural western Kenya. A randomized, controlled intervention trial was conducted in 240 households with infants 4–10 months old. Twenty-six weekly household surveys assessed infant diarrhea and health facility visits. Stool specimens from infants with diarrhea were examined for Cryptosporidium. Source water, filtered water, and filter retentate were tested for Cryptosporidium and/or microbial indicators. To estimate the effect of CWFs on health outcomes, logistic regression models using generalized estimating equations were performed; odds ratios (ORs) and 95% confidence intervals (CIs) are reported. Households reported using surface water (36%), public taps (29%), or rainwater (17%) as their primary drinking water sources, with no differences in treatment groups. Intervention households reported less diarrhea (7.6% versus 8.9%; OR: 0.86 [0.64–1.16]) and significantly fewer health facility visits for diarrhea (1.0% versus 1.9%; OR: 0.50 [0.30–0.83]). In total, 15% of intervention and 12% of control stools yielded Cryptosporidium (P = 0.26). Escherichia coli was detected in 93% of source water samples; 71% of filtered water samples met World Health Organization recommendations of < 1 E. coli/100 mL. Cryptosporidium was not detected in source water and was detected in just 2% of filter rinses following passage of large volumes of source water. Water quality was improved among CWF users; however, the short study duration and small sample size limited our ability to observe reductions in cryptosporidiosis.
Validity of Time to Sputum Culture Conversion to Predict Cure in Patients with Multidrug-Resistant Tuberculosis: A Retrospective Single-Center Study
Authors: Javaid Arshad , Ahmad Nafees , Afridi Afsar Khan , Basit Anila , Khan Amer Hayat , Ahmad Izaz , Atif Muhammad
Published: April 2018

To evaluate the predictive value of time to sputum culture conversion (SCC) in predicting cure and factors associated with time to SCC and cure in multidrug-resistant tuberculosis (MDR-TB) patients, a retrospective study was conducted at programmatic management unit of drug resistant tuberculosis (TB), Peshawar. A total of 428 pulmonary MDR-TB patients enrolled at the study site from January 1, 2012 to August 31, 2014 were followed until treatment outcome was recorded. Survival analysis using Cox proportional hazards model and multivariate binary logistic regression were, respectively, used to identify factors associated with time to SCC and cure. A P value < 0.05 was considered statistically significant. Overall, 90.9% patients achieved SCC, and 76.9% were cured. Previous use of second-line drugs (SLDs) (hazard ratio [HR] = 0.637; 95% confidence interval [CI] = 0.429–0.947), ofloxacin resistance (HR = 0.656; 95% CI = 0.522–0.825) and lung cavitation (HR = 0.744; 95% CI = 0.595–0.931) were significantly associated with time to SCC. In predicting cure, sensitivities of SCC at 2, 4, and 6 months were 64.1% (95% CI = 58.69–69.32), 93.0% (95% CI = 89.69–95.52), and 97.6% (95% CI = 95.27–98.94), respectively, whereas specificities were 67.7% (95% CI = 57.53–76.73), 51.5% (95% CI = 41.25–61.68), and 44.4% (95% CI = 34.45–54.78), respectively. Furthermore, patients’ age of 41–60 (odds ratio [OR] = 0.202; 95% CI = 0.067–0.605) and > 60 years (OR = 0.051; 95% CI = 0.011–0.224), body weight > 40 kg (OR = 2.950; 95% CI = 1.462–5.952), previous SLD use (OR = 0.277; 95% CI = 0.097–0.789), lung cavitation (OR = 0.196; 95% CI = 0.103–0.371) and ofloxacin resistance (OR = 0.386; 95% CI = 0.198–0.749) were significantly associated with cure. Association of SCC with cure was substantially stronger at 6 months (OR = 32.10; 95% CI = 14.34–71.85) than at 4 months (OR = 14.13; 95% CI = 7.92–25.21). However in predicting treatment outcomes, the combined sensitivity and specificity of SCC at 4 months was comparable to SCC at 6 months. Patients with risk factors for delayed SCC were also at high risk of unsuccessful outcomes.
Case Report: Paederus Dermatitis in the Returning Traveler
Authors: Pierce Jacob W. , Rittman Barry , Raybould Jillian E.
Published: April 2018

Rash in the returned traveler can provide a diagnostic dilemma for clinicians, but a detailed history including epidemiologic exposures can allow prompt diagnosis of etiologies uncommon in the United States. One such disease is Paederus dermatitis, an irritant contact dermatitis related to exposure to the rove beetle characterized by bullous lesions with surrounding erythema. Although cases and outbreaks have commonly been reported throughout the world, they are rarely reported in travelers returning to the United States. Here, we describe a patient who presented to an academic medical center in Virginia after travel to Sierra Leone with clinical presentation including exposure history and histopathology consistent with Paederus dermatitis. Our patient’s clinic course is described in detail including treatment. Usual treatment includes antihistamines, topical steroids, and oral antibiotics, particularly with antimicrobials with activity against Pseudomonas sp. In addition, this case suggests a potential role for oral steroids in the treatment of this condition but further investigation is required. This case demonstrates the importance of considering a patient’s travel and exposure history, as well as having familiarity with disease processes common in other parts of the world that are rarely seen in the United States.
Accuracy of the Lee–White Clotting Time Performed in the Hospital Routine to Detect Coagulopathy in Bothrops atrox Envenomation
Authors: de Brito Sousa Jose Diego , Sachett Jacqueline Almeida Gonçalves , de Oliveira Sâmella Silva , Mendonça-da-Silva Iran , Marques Hedylamar Oliveira , de Lacerda Marcus Vinicius Guimarães , Fan Hui Wen , Monteiro Wuelton Marcelo
Published: April 2018

Snake envenomation is a major public health problem in Brazil. Systemic complications that may arise from snakebites are mainly related to coagulopathy. The Lee–White clotting time (LWCT) is a simple and inexpensive test and available even in remote health facilities. However, the diagnostic value of such test needs to be evaluated to accurately diagnose coagulopathy in the clinical practice. This study aimed to assess the reliability of the LWCT performed in hospital routine to diagnose venom-induced coagulopathy. We studied 186 patients admitted at the Tropical Medicine Foundation Dr. Heitor Vieira Dourado in Manaus, Amazonas, Brazil, with Bothrops envenomation diagnosis. At admission, blood samples were collected for performing LWCT and the concentration of fibrinogen. Sensitivity, specificity, positive predictive value, negative predictive value, likelihood ratios, diagnostic odds ratio, and accuracy were calculated with 95% confidence intervals. From the total, 85.5% had hypofibrinogenemia. The sensitivity of the LWCT to the diagnosis of hypofibrinogenemia was 78.0% and the specificity 40.7%. The accuracy of the test was 72.6%, and patients with a prolonged LWCT had 2.4 higher odds of developing hypofibrinogenemia. In addition, the LWCT was also compared with venom antigen levels and systemic hemorrhage. The LWCT showed moderate sensitivity to detect consumption coagulopathy and constitutes a valuable tool for the diagnosis of Bothrops snake envenomation and indication of antivenom therapy.
Optimisation of machining parameters on milling of GFRP composites by desirability function analysis using Taguchi method
Authors: Jenarthanan M.P. , Jeyapaul R
Published: April 2018

Milling of GFRP composite materials is a rather complex task owing to its heterogeneity and the number of problems, such as surface delamination, which appear during the machining process, associated with the characteristics of the material and the cutting parameters. Optimization of machining parameters is an important step in machining. This paper presents a new approach for optimizing the machining parameters on milling glass-fibre reinforced plastic (GFRP) composites. Optimization of machining parameters was done by an analysis called desirability function analysis (DFA), which is a useful tool for optimizing multi-response problems. In this work, based on Taguchi’s L27 orthogonal array, milling experiments were conducted for GFRP composite plates using solid carbide end mills with different helix angles. The machining parameters such as, spindle speed, feed rate, helix angle and fibre orientation angle are optimized by multi-response considerations namely surface roughness, delamination factor and machining force. A composite desirability value is obtained for the multi-responses using individual desirability values from the desirability function analysis. Based on composite desirability value, the optimum levels of parameters have been identified, and significant contribution of parameters is determined by analysis of variance.Keywords: GFRP composites; Taguchi; Desirability function analysis; ANOVA; Solid carbide end mill