bluuebunny/crossref_metadata_2025 huggingface dataset:
Theoretical Background
Authors: Bentein Klaas
Published: March 2016

This chapter discusses some crucial theoretical concepts. First, the factors motivating the use of periphrasis are outlined, whereby a distinction is made between ‘morphological’, ‘syntactic’, ‘semantic’, and ‘pragmatic’ factors. Second, following up on the pragmatic factors, it is specified how the notions of ‘genre’ and ‘register’ can be conceived of, how they can be applied to the corpus used in the study, and what impact they may have on the use of periphrasis. Third, the much-discussed notion of ‘aspect’ is treated, whereby a distinction is made between three main types, that is, ‘perfective’, ‘imperfective’, and ‘perfect’ aspect. While each of these can be conceived of in terms of temporality, it is argued that such an analysis is not entirely satisfactory; aspect is therefore additionally related to transitivity. Fourth, an overview is given of recent theories of language change; focus lies on one particular framework, Grammaticalization Theory.
‘Verbal’ and ‘Adjectival’ Periphrasis
Authors: Bentein Klaas
Published: March 2016

This chapter discusses the notions of ‘verbal periphrasis’ and ‘adjectival periphrasis’ from a theoretical point of view. At present, there is no consensus as to which constructions can be classified as ‘periphrastic’. After a critical discussion of some recent proposals, a new approach is suggested, based on the view that categories are ‘prototypically’ organized. It is argued that the criteria adopted to identify prototypical periphrastic constructions can be derived from Grammaticalization Theory, which, while being a theory of language change, also has its synchronic relevance. In the second part of the chapter, the notion of ‘adjectival periphrasis’ is treated. This notion is used by some scholars to distinguish constructions of the type πρέπον ἐστί ‘it is fitting’ or ἀνεῳγμένον ἐστί ‘it is open(ed)’ from ‘truly’ periphrastic constructions. It is argued that such a binary distinction cannot be maintained: adjectival periphrasis too is a prototypically organized notion, some participles being more ‘adjectival’ than others.
Do European Elections Create a European Public Sphere?
Authors: Boomgaarden Hajo G. , de Vreese Claes H.
Published: March 2016

This chapter answers the question whether the news coverage of European Parliament (EP) elections across time has helped create a European public sphere. The focus is on the salience of European Union affairs in the mass media during EP election campaigns and on the Europeanness of such coverage, two central aspects of a European public sphere. While the EP elections are more visible in the news media across the EU than previously, the campaign and coverage leading up to the elections have not become European in nature and are still, even increasingly so, dominated by national political actors. Explanatory models show that tabloid newspapers, in particular, show less signs of a European public sphere, while in countries with political parties that are strongly polarized about EU politics, there appears to be more Europeanization of mass media coverage.
The New ABCs of Research
Authors: Shneiderman Ben
Published: March 2016

The immense problems of the twenty-first century invite innovative thinking from students, academic researchers, business research managers, and government policymakers. Hopes for raising quality in healthcare delivery, securing community safety, expanding food production, improving environmental sustainability, and much more depend on pervasive application of research solutions. This book recognizes the unbounded nature of human creativity, the multiplicative power of teamwork, and the catalytic effects of innovation. Contemporary science, engineering, and design research teams get a further boost from fresh ways of using the Web, social media, and visual communications tools that amplify collaborations. The applied and basic research heroes who take on the immense problems of the present time face bigger-than-ever challenges, but if they adopt potent guiding principles and effective research life cycle strategies, they can produce the advances that will enhance the lives of many people. These inspirational research leaders will break free from traditional thinking, disciplinary boundaries, and narrow aspirations. They will be bold innovators and engaged collaborators who are ready to lead yet open to new ideas, and self-confident yet empathetic to others. This book reports on the growing number of initiatives to promote integrated approaches to research and the expansion of these efforts.
Superfluid 4He
Authors: Pitaevskii Lev , Stringari Sandro
Published: March 2016

This chapter summarizes some key features exhibited by superfluid 4He. These include the structure of the elementary excitations exhibiting the typical phonon–maxon–roton dispersion, the pair correlation function, the nature of quantized vortices, and some key thermodynamic properties like the behaviour of the specific heat and the temperature dependence of the normal density. Emphasis is also given to the behaviour of the momentum distribution, extracted from the analysis of the dynamic structure factor at high wave vectors and the experimental evidence for the condensate fraction as a function of temperature and pressure. A comparison between experiments and theoretical predictions based on Monte Carlo simulations is also presented.
Ground State of a Trapped Condensate
Authors: Pitaevskii Lev , Stringari Sandro
Published: March 2016

This chapter uses Gross–Pitaevskii theory in order to calculate the order parameter relative to the ground state of a weakly interacting Bose gas confined by an external harmonic potential. Both the density and the momentum distribution are calculated and an explicit derivation of the virial theorem is presented. The chapter discusses the Thomas–Fermi limit, where the effects of quantum pressure are neglected. The importance of both finite-size and beyond-mean-field effects are discussed. The chapter finally derives solutions for the Gross–Pitaevskii equation in the case of attractive interactions and show that the quantum pressure plays a crucial role in preventing collapse when the number of atoms is small.
Nemertea (Nemertini)
Authors: Beckers Patrick , von Döhren Jörn
Published: March 2016

Nemertea is a spiralian phylum comprising approximately 1300 species of mostly marine, nocturnal predators. Prey is captured with an eversible proboscis housed in a dorsally located fluid filled secondary body cavity, called rhynchocoel. Three major clades are recognized: Hoplonemertea, Pilidiophora, and Palaeonemertea. The main components of the nemertean nervous system are a ring-shaped brain around the rhynchocoel, and paired lateral, longitudinal medullary cords that are confluent with the ventral brain lobes. Additional, variable components of the nervous system are longitudinal cephalic, oesophageal, and proboscis nerves and various plexuses. Sensory organs comprise eyes, cerebral organs, frontal organs, and various epidermal sensory structures. Most of the canonic spiralian neurotransmitters have been detected, with FMRFamide-like neuropeptides being the most prevalent. Larvae of palaeo- and hoplonemertean species show virtually no transitory nervous elements, while the pilidium-larva of Pilidiophora possesses an extensive transitory larval nervous system. Among the first definite neural elements to develop in all species is the brain ring, followed by the lateral medullary cords. Data on neural development and morphology of other spiralian clades, as well as molecular data, support the scenario that a frontal brain with paired lateral medullary cords as present in Nemertea represents the ancestral spiralian nervous system architecture.
Mollusca: Gastropoda
Authors: Voronezhskaya Elena E. , Croll Roger P.
Published: March 2016

Gastropods comprise the second largest metazoan taxon, with about 60,000 to 80,000 living species occupying ecological niches covering the globe. Anatomy, behaviour, and development vary significantly between Patellogastropoda, Vetigastropoda, Neritimorpha, Caenogastropoda, and Heterobranchia. Generally, the central nervous system consists of paired cerebral, buccal, pleural, and pedal ganglia and five ganglia of the visceral loop, but the ganglia demonstrate various degrees of asymmetry (chiastoneury, euthyneury) and fusion due to the combined processes of centralization and torsion, which is an 180° rotation of the posterior portion of the body, occurring early in larval development. Giant, identifiable neurons with characteristic locations, axonal morphology, and physiological properties have led to the adoption of some heterobranchs as ‘model organisms’ for investigation of motor and central pattern generation activity, molecular basis of learning and memory, and single cell transcriptomes. Gastropods possess extensive peripheral nervous systems containing axons efferent and afferent to the central ganglia, and also large numbers of peripheral neurons located within different organs. Most of the classical, small molecule neurotransmitters are also found in the central and peripheral neurons of gastropods, together with numerous neuropeptides. The first neural elements (cells of the apical organ, posterior pioneer neurons, peripheral sensory neurons) and also many central neurons appear during trochophore-veliger larval stages, although many more neurons are added during metamorphosis and postlarval development. Gastropods thus provide a unique diversity of form, function, and development of the nervous system, offering the opportunity to investigate adaptive evolution of the nervous system ranging from behaviour to its molecular underpinnings.
Mollusca: Cephalopoda
Authors: Wollesen Tim
Published: March 2016

Recent cephalopods are a comparatively small molluscan group with body plans that considerably differ from those of their molluscan allies. Coleoids, i.e. all cephalopods but nautiluses, exhibit cognitive and behavioural abilities that rival those of vertebrates and they possess highly centralized and complex central nervous systems (CNS) composed of individual lobes. In contrast, the CNS of nautiluses is less centralized and consists of medullary nerve cords. Studies on the giant squid axons unravelled the ionic basis underlying action potentials, and a number of seminal publications have led to a better understanding of the precise organization of the CNS and putative functions of individuals brain regions. Sensory organs are manifold and some evolved convergently with those of other bilaterians. Organ systems, as well as corresponding brain regions, may vary in structure and size among cephalopod species, which is probably due to ecological and physiological adaptations. Cephalopods are direct developers and the anlagen of their brains are established in a cord-like arrangement which subsequently develops into the medullary cord-like CNS of nautiluses or the centralized CNS of coleoids. Neurotransmitters and neuropeptides, such as the small cardioactive peptide, are abundant and distributed throughout the developing and adult nervous system and are probably involved in neurogenesis and cognition. Modern developmental studies employing gene expression analyses, gene knockdown experiments, as well as electrophysiological analyses, will lead to a better understanding of the evolution, physiology, and function of cephalopod brains.
Cycloneuralia (Nematoda, Nematomorpha, Priapulida, Kinorhyncha, Loricifera)
Authors: Schmidt-Rhaesa Andreas , Henne Stephan
Published: March 2016

The taxon Cycloneuralia includes Nematoda, Nematomorpha, Priapulida, Kinorhyncha and Loricifera. The name-giving autapomorphy of this taxon is the so-called cycloneuralian brain. In this type of brain the neuropil forms a ring around the anterior intestinal system, while the somata of the brain nerve cells form clusters anterior and posterior of this ring neuropil. In the ventral region of the brain, a paired or unpaired ventral nerve cord arises. Further longitudinal neurites or neurite bundles, as well as entire or partial circular neurites connecting the longitudinal ones, are present in most taxa. This can be interpreted as a remnant of an orthogonal pattern in the trunk region. In nematodes, the nervous system is postulated to express little variation throughout the taxon, but there is an extreme heterogeneity in the intensity, with which nervous systems are known. For the ‘model nematode’ Caenorhabditis elegans, each single neuron is known, while data especially from free-living nematodes are lacking. Available data support nematodes having a comparable general architecture of the nervous system, but some variation in detail. Nematomorphs show the greatest differences in the nervous system, probably due to their parasitic mode of life during most of the life cycle. Although available data do not correspond with any one particular shape of the brain, it certainly does not form a ring of equal thickness and is therefore not cycloneuralian. Scalidophora (Priapulida, Kinorhyncha, Loricifera) have a cycloneuralian brain and correspond in the innervation of the scalids representing cuticular structures on the introvert that include receptor cells.
Hemichordata
Authors: Stach Thomas
Published: March 2016

Hemichordates consist of the two exclusively marine taxa, Pterobranchia (angelwings) and Enteropneusta (acorn worms). All hemichordates feature three body parts: the prosome, the mesosome, and the metasome. The major part of the nervous system in both hemichordate groups comprises a plexus. In acorn worms, there is a dorsal collar cord beneath the epidermis in the mesosome. This includes mainly neurites, but also some neuron somata and giant neurons. It has a fluid-filled central canal. In pterobranchs the basiepidermal plexus is ubiquitous with local differences in density, notably the brain, a more prominent ventral nerve cord in the trunk extending into the stalk, a denser area on the dorsal side of the cephalic shield just anterior of the brain, and a considerably less dense area in the dorsal part. Differentiated sensory organs have not been described in adult hemichordates, although eyes are present in tornaria larvae.
Drivers of predatory behavior and extreme size in house mice
Mus musculus
on Gough Island
Authors: Cuthbert Richard J. , Wanless Ross M. , Angel Andrea , Burle Marie-Helene , Hilton Geoff M. , Louw Henk , Visser Paul , Wilson John W. , Ryan Peter G.
Published: March 2016

In comparison to the mainland, populations of rodents on islands are often characterized by a suite of life history characteristics termed the “island syndrome.” Populations of rodents introduced to islands are also well known for their impacts on native species that have evolved in the absence of mammalian predators. We studied the ecology and behavior of introduced house mice Mus musculus on Gough Island where they are the only terrestrial mammal and where their predatory behavior is having a devastating impact on the island’s burrowing petrel (order Procellariiformes ) population and the Critically Endangered Tristan albatross Diomedea dabbenena . Mice on Gough exhibit extreme features of the island syndrome, including: a body mass 50–60% greater than any other island mouse population, peak densities among the highest recorded for island populations, and low seasonal variation in numbers compared to other studied islands. Seasonal patterns of breeding and survival were linked to body condition and mass, and mice in areas with high chick predation rates were able to maintain higher mass and condition during the winter when mouse mortality rates peak. Within-site patterns of chick predation indicate that proximity to neighboring predated nests and nesting densities are important factors in determining the likelihood of predation. We conclude that selection for extreme body mass and predatory behavior of mice result from enhanced overwinter survival. Small mammal populations at temperate and high latitudes are normally limited by high mortality during the winter, but on Gough Island mice avoid that by exploiting the island’s abundant seabird chicks.
Clumpy tori around type II active galactic nuclei as revealed by X-ray fluorescent lines
Authors: Liu Jiren , Liu Yuan , Li Xiaobo , Xu Weiwei , Gou Lijun , Cheng Cheng
Published: March 2016

The reflection spectrum of a torus around an active galactic nucleus (AGN) is characterized by X-ray fluorescent lines, which are most prominent for type II AGNs. A clumpy torus allows photons reflected from the back-side of the torus to leak through the front regions that are free of obscuration. The observed X-ray fluorescent lines are therefore sensitive to the clumpiness of the torus. We analysed a sample of type II AGNs observed with the Chandra High Energy Transmission Grating Spectrometer (HETGS), and measured the fluxes for the Si Kα and Fe Kα lines. The measured Fe Kα/Si Kα ratios, spanning a range between 5 and 60, are far smaller than the ratios predicted from simulations of smooth tori, indicating that the tori of the studied sources have clumpy distributions rather than smooth ones. We compared the measured Fe Kα/Si Kα ratios with simulation results of clumpy tori. The Circinus galaxy has a Fe Kα/Si Kα ratio of ∼60, which is close to the simulation results for N = 5, where N is the average number of clumps along the line of sight. The Fe Kα/Si Kα ratios of the other sources are all below the simulation results for N = 2. Overall, this shows that the non-Fe fluorescent lines in the soft X-ray band are a potentially powerful probe of the clumpiness of tori around AGNs.
MEGA7: Molecular Evolutionary Genetics Analysis Version 7.0 for Bigger Datasets
Authors: Kumar Sudhir , Stecher Glen , Tamura Koichiro
Published: March 2016

We present the latest version of the Molecular Evolutionary Genetics Analysis (M ega ) software, which contains many sophisticated methods and tools for phylogenomics and phylomedicine. In this major upgrade, M ega has been optimized for use on 64-bit computing systems for analyzing larger datasets. Researchers can now explore and analyze tens of thousands of sequences in M ega . The new version also provides an advanced wizard for building timetrees and includes a new functionality to automatically predict gene duplication events in gene family trees. The 64-bit M ega is made available in two interfaces: graphical and command line. The graphical user interface (GUI) is a native Microsoft Windows application that can also be used on Mac OS X. The command line M ega is available as native applications for Windows, Linux, and Mac OS X. They are intended for use in high-throughput and scripted analysis. Both versions are available from www.megasoftware.net free of charge.
Interprofessional Care Conferences for High-Risk Primary Care Patients
Authors: Weppner William G. , Davis Kyle , Sordahl Jeffrey , Willis Janet , Fisher Amber , Brotman Adam , Tivis Rick , Gordon Tim , Smith C. Scott
Published: March 2016

Problem

As health care systems convert to team-based care, the need to improve interprofessional education is tremendous. In addition to formal instruction, trainees need authentic team-based workplace learning experiences.

Approach

The authors designed the PACT-ICU (Patient-Aligned Care Team Interprofessional Care Update) conference to provide team-based care to high-risk patients while teaching trainees principles of interprofessionalism and modeling relevant behaviors. Trainees, supervisors, and affiliated support staff from the fields of internal medicine, nurse practitioner, pharmacy, psychology, and nursing all participate in this conference. During the conference, each participant focuses on the narrative of the patient’s illness from his/her own professional perspective. A multifaceted care plan with specific action items is the product of the conference. To evaluate this workplace learning opportunity, the authors recorded patient characteristics, plus trainees’ participation and satisfaction.

Outcomes

Over the first 16 months (2013–2014) of the PACT-ICU, 33 trainees presented 79 patients. Each trainee presented two or three times each academic year. Patients were 90% male; their mean age was 64.5 years (SD 9.3, range 28–92), and their mean calculated 90-day risk of death or hospitalization was 22% (SD 14%, range 1%–45%).

Overall, all surveyed trainees (n = 32; 97% response rate) expressed satisfaction, reporting that the conference was “helpful” or “very helpful” in developing treatment plans.

Next Steps

Further assessment of change in trainee behavior related to interprofessional team care, patient-level outcomes (e.g., quality of care and utilization), and factors facilitating dissemination of the model to other academic clinic settings is necessary.
Where Do Soldiers Really Come From? A Faculty Development Workshop on Veteran-Centered Care
Authors: Lypson Monica L. , Ross Paula T. , Zimmerman Natalie , Goldrath Kathryn E. , Ravindranath Divy
Published: March 2016

Problem

Addressing the medical concerns of veterans in both civilian health care systems and the Veterans Affairs (VA) health care system, where staff are familiar with issues of military reintegration, remains difficult but is increasingly important.

Approach

In 2013, the authors developed and implemented a faculty development workshop for practicing clinicians using the documentary Where Soldiers Come From. The workshop included topics on unconscious bias, the service member trajectory, health care disparities, and strategies for overcoming barriers to treating veterans with posttraumatic stress disorder and traumatic brain injury. The workshop engaged faculty in the following active-learning techniques: images in education; trigger video; critical thinking and reflective writing; think–pair–share; and large-group discussion. The workshop has been conducted at three locations with 46 health care professionals.

Outcomes

Thirty-one of 37 (84%) participants who completed the workshop evaluation were VA employees. The evaluation results show 25/32 (78.1%) participants indicated the workshop activities changed their knowledge, attitudes, and/or skills; 22/34 (64.7%) stated they had a better understanding of how to develop a care plan for veterans; and 27/34 (79.4%) stated they gained a better understanding of how to prepare for issues around returning veterans.

Next Steps

To address the issue of veteran-centered care education more broadly, the authors have developed a massive open online course for health professionals, using most of the content from this workshop, which will be offered in spring 2016. Another important next step will be to deliver this workshop to and collect evaluation data from non-VA providers.
Changing Physician Behavior With Implementation Intentions: Closing the Gap Between Intentions and Actions
Authors: Saddawi-Konefka Daniel , Schumacher Daniel J. , Baker Keith H. , Charnin Jonathan E. , Gollwitzer Peter M.
Published: March 2016

In medical education, even well-intentioned learners struggle to change their practice. This intention–action gap is a well-described phenomenon. Strong commitment to changing behaviors is important, but by itself it is only a modest predictor of goal attainment.

Implementation intentions are an extensively studied strategy from cognitive psychology that have been shown to close the intention–action gap and increase goal attainment across myriad domains. Implementation intentions are “if–then” plans that specify an anticipated future situation and a planned response—“If I encounter situation X, then I will respond with action Y.” They differ from simple goals, which specify only a desired behavior or outcome—“I intend to perform action Z.” Despite this subtle difference, they have shown substantial effectiveness over goals alone in increasing goal attainment.

In this article, the authors first describe implementation intentions, review the substantial body of evidence demonstrating their effectiveness, and explain the underlying psychological mechanisms. They then illustrate the connections between implementation intentions and established learning theory. The final section focuses on forming effective implementation intentions in medical education. The authors provide concrete examples across the continuum of learners (from medical students to attending physicians) and competencies, and make recommendations for when and how to employ implementation intentions.
A Simple Dual-Planar Osteotomy to Correct Cubitus Varus Deformity in Children
Authors: Liddell Travis R. , Hennrikus William L. , Bresnahan James J.
Published: March 2016

Objectives:

To report the outcomes when performing a dual-planar osteotomy of the distal humerus via a posterior approach for gunstock deformity in children.

Design:

A retrospective review.

Setting:

Penn State Hershey Pediatric Bone and Joint Institute.

Patients/Participants:

Sixteen patients were reviewed. The average patient age was 8 years (range, 5–13 years).

Intervention:

A complete dual-planar closing wedge osteotomy was performed with the patient in the prone position via a posterior triceps-splitting approach. Fixation with buried smooth K wires was utilized.

Main Outcome Measurements:

Valgus correction obtained, final elbow range of motion, radiographic and clinical correction of the deformity, the patient's satisfaction, and elbow function were evaluated.

Results:

Preoperative radiographs showed the average humeral-ulnar angle (HUA) was 17 degrees of varus (range, 10–26 degrees varus). The average wedge removed wallow-up clinical exam demonstrated that the carrying angle was in valgus in 15 cases and neutral in 1 case. The average carrying angle was 5 degrees of valgus (range, 0–11 degrees valgus). The average hyperextenss 25 degrees (range, 20–40 degrees). Duration of follow-up averaged 51 months (range, 12–126 months). Final foion deformity improved from 9 degrees preoperatively to 1 degree postoperatively. Outcomes were classified by the grading scale described by Oppenheim: 14 cases had excellent results and 2 cases had good results.

Conclusions:

This method provides clear visualization and excellent correction of the deformities. The posterior scar is cosmetically acceptable. We recommend this technique for the treatment of gunstock deformity in children.

Level of Evidence:

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Economic Benefit of Calcium and Vitamin D Supplementation: Does It Outweigh the Cost of Nonunions?
Authors: Childs Benjamin R. , Andres Brendan A. , Vallier Heather A.
Published: March 2016

Objectives:

The purpose was to evaluate economic benefit of calcium and vitamin D supplementation in orthopaedic trauma patients. We hypothesized that reduced nonunion rates could justify the cost of supplementing every orthopaedic trauma patient.

Design:

Retrospective, economic model.

Setting:

Level 1 trauma center.

Patients/Participants:

Adult patients over 3 consecutive years presenting with acute fracture.

Intervention:

Operative or nonoperative fracture management.

Main Outcome Measurements:

Electronic medical records were queried for ICD-9 code for diagnosis of nonunion and for treatment records of nonunion for fractures initially treated within our institution.

Results:

In our hospital, a mean of 92 (3.9%) fractures develop nonunion annually. A 5% reduction in nonunion risk from 8 weeks of vitamin D supplementation would result in 4.6 fewer nonunions per year. The mean estimate of cost for nonunion care is $16,941. Thus, the projected reduction in nonunions after supplementation with vitamin D and calcium would save $78,030 in treatment costs per year. The resulting savings outweigh the $12,164 cost of supplementing all fracture patients during the first 8 weeks of fracture healing resulting in a net savings of $65,866 per year.

Conclusions:

Vitamin D and calcium supplementation of orthopaedic trauma patients for 8 weeks after fracture seems to be cost effective. Supplementation may also reduce the number of subsequent fractures, enhance muscular strength, improve balance in the elderly, elevate mood leading to higher functional outcome scores, and diminish hospital tort liability by reducing the number of nonunions.

Level of Evidence:

Economic Level V. See Instructions for Authors for a complete description of levels of evidence.
Treatment Efficacy of Combined Sertraline and Guanfacine in Comorbid Obsessive–Compulsive Disorder and Attention Deficit/Hyperactivity Disorder: Two Case Studies
Authors: Taormina Shibany P. , Galloway Matthew P. , Rosenberg David R.
Published: March 2016

Objective:

Treatment of obsessive–compulsive disorder (OCD) is complicated by comorbid psychiatric disorders. Successful treatment of 2 pediatric patients with severe OCD and comorbid attention deficit/hyperactivity disorder (ADHD) is described.

Method:

A report on 2 pediatric clinical cases (Ages 9 and 10) with comorbid OCD and ADHD was used to describe response to medication management through the serotonin transporter inhibitor, sertraline, and the noradrenergic α2A receptor agonist, guanfacine, along with cognitive behavioral therapy.

Results:

Cognitive behavioral therapy combined with titrated doses of the serotonin transporter inhibitor, sertraline, and the noradrenergic α2A receptor agonist, guanfacine resolved OCD symptoms and the underlying ADHD.

Conclusion:

The novel observations support a focused psychological and pharmacological approach to successful treatment of complex symptoms in patients with comorbid OCD and ADHD. Limitations to generalizability are discussed.
Strengths and weaknesses in team communication processes in a UK emergency department setting: findings using the Communication Assessment Tool-Team
Authors: Graham Blair , Smith Jason E. , Enki Doyo
Published: March 2016

Introduction

Identifying weaknesses in emergency department (ED) communication may highlight areas where quality improvement may be beneficial. This study explores whether the Communication Assessment Tool-Team (CAT-T) survey can identify communication strengths and weaknesses in a UK setting.

Objectives

This study aimed to determine the frequency of patient responses for each item on the CAT-T survey and to compare the proportion of responses according to patient and operational characteristics.

Methods

Adults presenting to the minors area of a semi-urban ED between April and May 2015 were included. Those lacking capacity or in custody were excluded. Multivariate analysis identified associations between responses and demographic/operational characteristics.

Results

A total of 407/526 eligible patients responded (77.3%). Respondents were mostly White British (93.9%), with a median age of 45 years. Most responses were obtained during daytime hours (84.2% between 08 : 00 and 18 : 00). The median reported times to triage, assessment and disposition were 15, 35 and 90 min, respectively. Items most frequently rated as ‘very good’/‘excellent’ (strengths) were ‘ambulance staff treated me with respect’ (86.7%), ED staff ‘let me talk without interruptions’ (85%) and ‘paid attention to me’ (83.7%). Items most frequently rated as ‘poor’/‘fair’ (weaknesses) were ‘encouraged me to ask questions’, ‘reception treated me with respect’ (10.4%) and ‘staff showed an interest in my health’ (6.8%). Arrival time, analgesia at triage and time to assessment were associated with significantly increased odds of positive perception of team communication for a range of items.

Conclusion

The CAT-T survey may be used within a UK setting to identify discrete strengths and weaknesses in ED team communication.
The Effect of Acute Exercise on Affect and Arousal in Inpatient Mental Health Consumers
Authors: Stanton Robert , Reaburn Peter , Happell Brenda
Published: March 2016

Acute exercise performed at a self-selected intensity improves affect and may improve long-term adherence. Similarly, in people with severe depression, acute aerobic exercise performed at self-selected intensity improves affect and arousal. However, the relationship between changes in affect and arousal and perceived exercise intensity in people with mental illness has not been evaluated. Affect and arousal were assessed immediately prior to, and immediately following, a group exercise program performed at a self-selected intensity in 40 inpatient mental health consumers who received a diagnosis of anxiety or bipolar or depressive disorders. Exercise intensity was assessed immediately after exercise. Postexercise affect was significantly improved for people with bipolar and depressive disorders but not for people with anxiety disorders. For the group as a whole, results showed a significant curvilinear relationship between ratings of perceived exertion and postexercise affect. These data will inform the development and delivery of future exercise interventions for inpatient mental health consumers.
Ankle Movements During Supine Kicking in Infants Born Preterm
Authors: Grant-Beuttler Marybeth , Heriza Carolyn B. , Palisano Robert J. , Wagner Barbara Reddien , Miller Debra P. , Karduna Andrew
Published: March 2016

Background:

Knowledge of musculoskeletal factors that influence supine kicking of infants born preterm has implications for early intervention.

Hypotheses:

Differences exist between infants born preterm and full-term in ankle kinematics during supine kicking, which are attributable to passive measures of the gastrocnemius/soleus (g/s) muscle tendon unit (MTU).

Subjects:

Twenty infants born full-term and 22 born preterm were measured at term, 6 weeks, and 12 weeks of age.

Outcome Measures:

Ankle kinematics during supine kicking and g/s MTU length.

Results:

Infants born preterm demonstrated less dorsiflexion, more plantar flexion, and more total ankle range during supine kicking. Gestational age explained 69% to 85% of the variability in MTU length from term to 12 weeks of age. MTU lengths explained 0% to 42% of the variance in ankle kinematics.

Conclusions:

Passive measures of the g/s MTU may inform clinicians about ankle kinematics in newborns to 12-week infants during supine kicking.
Differences Between Methods of Detecting Medication Errors: A Secondary Analysis of Medication Administration Errors Using Incident Reports, the Global Trigger Tool Method, and Observations
Authors: Härkänen Marja , Turunen Hannele , Vehviläinen-Julkunen Katri
Published: March 2016

Objectives

This study aimed to compare medication administration errors detected by 3 different methods in terms of severity, type, and contributing factors.

Methods

The study was performed in one university hospital in Finland. A convenience sample of medication administration errors (n = 451) reported on incident reports or detected by reviewing randomly selected patient records via the Global Trigger Tool method and direct observations of patient record reviews were collected for reanalysis. The severity of the medication administration errors, the types thereof, and factors contributing to such errors were reclassified using the National Coordinating Council for Medication Error Reporting and Prevention’s taxonomy of medication errors.

Results

The observational method revealed fewer medication errors that were more likely to cause harm to patients than did the incident reports or the Global Trigger Tool method. The incident reports and the Global Trigger Tool method mainly revealed wrong doses, whereas most medication administration errors in the observational data were errors involving the use of the incorrect technique. In addition, each method produced different information regarding the factors contributing to medication administration errors.

Conclusions

Based on the study’s findings and the limitations of each method, a combination of different methods should be used to discover representative information concerning medication administration errors. To increase medication administration safety, advanced multiprofessional collaboration, effective communication, adequate skills, more systematic medication processes, and distraction-free work environments are needed.
Magnetic Resonance Imaging Applications on Infiltrative Cardiomyopathies
Authors: Muehlberg Fabian , Toepper Agnieszka , Fritschi Simone , Prothmann Marcel , Schulz-Menger Jeanette
Published: March 2016

Infiltrative cardiomyopathies are a heterogenous group of diseases that typically lead to restrictive cardiac dysfunction. Due to similar phenotypes, accurate diagnosis is challenging without invasive endomyocardial biopsy which has historically been considered mandatory. Cardiac magnetic resonance (CMR) has been well established in the diagnostic workup of patients with suspected cardiomyopathies due to its unique capability for tissue differentiation and its unsurpassed accuracy in defining cardiac morphology and function. The increasing variety of CMR techniques has generated both excitement and uncertainty with regard to their potential clinical use and its role vis-à-vis conventional noninvasive imaging techniques. The purpose of this review is to give an overview of established and emerging CMR techniques and typical image characteristics of the most commonly encountered infiltrative cardiomyopathies.
Evaluation of High-Pitch Ungated Pediatric Cardiovascular Computed Tomography for the Assessment of Cardiac Structures in Neonates
Authors: Sriharan Mona , Lazoura Olga , Pavitt Christopher W. , Castellano Isabel , Owens Catherine M. , Rubens Michael B. , Padley Simon P.G. , Nicol Edward D.
Published: March 2016

Purpose:

We evaluated a high-pitch, non–electrocardiogram-gated cardiac computed tomographic protocol, designed to image both cardiac and extracardiac structures, including coronary arteries, in a neonatal population (less than 1 year old) that was referred for congenital heart disease assessment and compared it with an optimized standard-pitch protocol in an equivalent cohort.

Materials and Methods:

Twenty-nine high-pitch scans were compared with 31 age-matched, sex-matched, and weight-matched standard-pitch, dosimetrically equivalent scans. The visualization and subjective quality of both cardiac and extracardiac structures were scored by consensus between 2 trained blinded observers. Image noise, signal-to-noise and contrast-to-noise ratios, and radiation doses were also compared.

Results:

The high-pitch protocol better demonstrated the pulmonary veins (P=0.03) and all coronary segments (all P<0.05), except the distal right coronary artery (P=0.10), with no significant difference in the visualization of the remaining cardiac or extracardiac structures. Both contrast-to-noise and signal-to-noise ratios improved due to greater vessel opacity, with significantly fewer streak (P<0.01) and motion (P<0.01) artifacts. Image noise and computed tomographic dose index were comparable across the 2 techniques; however, the high-pitch acquisition resulted in a small, but statistically significant, increase in dose-length product [13.0 mGy.cm (9.0 to 17.3) vs. 11.0 mGy.cm (9.0 to 13.0), P=0.05] due to greater z-overscanning.

Conclusions:

In neonates, a high-pitch protocol improves coronary artery and pulmonary vein delineation compared with the standard-pitch protocol, allowing a more comprehensive assessment of cardiovascular anatomy while obviating the need for either patient sedation or heart rate control.
Ketamine Anesthesia, Efficacy of Electroconvulsive Therapy, and Cognitive Functions in Treatment-Resistant Depression
Authors: Rybakowski Janusz K. , Bodnar Anna , Krzywotulski Milosz , Chlopocka-Wozniak Maria , Michalak Michal , Rosada-Kurasinska Jowita , Bartkowska-Sniatkowska Alicja
Published: March 2016

Objectives

Electroconvulsive therapy (ECT) is the most effective treatment for drug-resistant depression (DRD). Because a single infusion of ketamine may exert both a rapid antidepressant effect and a quick improvement of cognition, the aim of the present study was to assess whether ketamine, as an anesthetic drug for ECT, can augment the antidepressant activity of the procedure and/or exert a beneficial effect on cognition.

Methods

A total of 11 male and 34 female patients with DRD, aged 21 to 75 years, were included in the study. Fifteen patients (group 1) received only thiopental anesthesia, 15 patients (group 2) had their second and third ECT sessions with ketamine, and 15 patients (group 3) had ketamine for the second, fourth, sixth, eighth, and tenth sessions. Depression intensity was measured by the 17-item Hamilton Depression Rating Scale. Cognitive functions were measured before and after ECT, assessing visual-spatial abilities, verbal auditory memory, working memory, and executive functions.

Results

Before the ECT, the mean (SD) intensity of depression was 32 (6) points on the Hamilton Depression Rating Scale and the mean number of ECT sessions was 10.8 (1.5), with no difference between groups. After the last ECT session, the intensity of depression was significantly lower in group 3, compared with group 1. Cognitive assessments after ECT showed a more marked worsening in verbal memory in patients with added ketamine anesthesia.

Conclusions

The addition of ketamine may be connected with better antidepressant efficacy of ECT, compared with only thiopental anesthesia. However, patients with added ketamine had worse results on some of the indices measuring verbal memory.
Mutualistic association of rotifer
Philodina roseola
with the branchiuran fish ectoparasite
Argulus bengalensis
at its embryonic stage
Authors: Banerjee Anirban , Poddar Soumabrota , Manna Subha , Saha Samar Kumar
Published: March 2016

Several rotifers including
Philodina
spp. are well known to make commensal and parasitic associations with different animals. The present investigation was carried out to decipher the relationship of
Philodina roseola
with a piscine ectoparasite
Argulus bengalensis
in its embryonic stage. Mechanical removal of the symbiont
P. roseola
from the argulid egg strips resulted in the complete (100%) failure in hatching. Several
P. roseola
individuals were found to feed on the solidified jelly coat of the eggs enabling the larvae to emerge under both laboratory and field conditions. Under the laboratory condition, the experimental removal of
P. roseola
did not affect the embryonic development, but it rendered the jelly coat intact; therefore, the larvae were unable to make hatching furrow and subsequently died. The results of our experiments thus prove this service–resource relationship to be a mutualism. Although the association is facultative for
P. roseola
, it is obligatory for
Argulus
spp. An act of intervention in this relationship thus offers a promising control of argulosis.
Potential impact of spatially targeted adult tuberculosis vaccine in Gujarat, India
Authors: Shrestha Sourya , Chatterjee Susmita , Rao Krishna D. , Dowdy David W.
Published: March 2016

Some of the most promising vaccines in the pipeline for tuberculosis (TB) target adolescents and adults. Unlike for childhood vaccines, high-coverage population-wide vaccination is significantly more challenging for adult vaccines. Here, we aimed to estimate the impact of vaccine delivery strategies that were targeted to high-incidence geographical ‘hotspots’ compared with randomly allocated vaccination. We developed a spatially explicit mathematical model of TB transmission that distinguished these hotspots from the general population. We evaluated the impact of targeted and untargeted vaccine delivery strategies in India—a country that bears more than 25% of global TB burden, and may be a potential early adopter of the vaccine. We collected TB notification data and conducted a demonstration study in the state of Gujarat to validate our estimates of heterogeneity in TB incidence. We then projected the impact of randomly vaccinating 8% of adults in a single mass campaign to a spatially targeted vaccination preferentially delivered to 80% of adults in the hotspots, with both strategies augmented by continuous adolescent vaccination. In consultation with vaccine developers, we considered a vaccine efficacy of 60%, and evaluated the population-level impact after 10 years of vaccination. Spatial heterogeneity in TB notification (per 100 000/year) was modest in Gujarat: 190 in the hotspots versus 125 in the remaining population. At this level of heterogeneity, the spatially targeted vaccination was projected to reduce TB incidence by 28% after 10 years, compared with a 24% reduction projected to achieve via untargeted vaccination—a 1.17-fold augmentation in the impact of vaccination by spatially targeting. The degree of the augmentation was robust to reasonable variation in natural history assumptions, but depended strongly on the extent of spatial heterogeneity and mixing between the hotspot and general population. Identifying high-incidence hotspots and quantifying spatial mixing patterns are critical to accurate estimation of the value of targeted intervention strategies.
Error and bias in size estimates of whale sharks: implications for understanding demography
Authors: Sequeira Ana M. M. , Thums Michele , Brooks Kim , Meekan Mark G.
Published: March 2016

Body size and age at maturity are indicative of the vulnerability of a species to extinction. However, they are both difficult to estimate for large animals that cannot be restrained for measurement. For very large species such as whale sharks, body size is commonly estimated visually, potentially resulting in the addition of errors and bias. Here, we investigate the errors and bias associated with total lengths of whale sharks estimated visually by comparing them with measurements collected using a stereo-video camera system at Ningaloo Reef, Western Australia. Using linear mixed-effects models, we found that visual lengths were biased towards underestimation with increasing size of the shark. When using the stereo-video camera, the number of larger individuals that were possibly mature (or close to maturity) that were detected increased by approximately 10%. Mean lengths calculated by each method were, however, comparable (5.002 ± 1.194 and 6.128 ± 1.609 m, s.d.), confirming that the population at Ningaloo is mostly composed of immature sharks based on published lengths at maturity. We then collated data sets of total lengths sampled from aggregations of whale sharks worldwide between 1995 and 2013. Except for locations in the East Pacific where large females have been reported, these aggregations also largely consisted of juveniles (mean lengths less than 7 m). Sightings of the largest individuals were limited and occurred mostly prior to 2006. This result highlights the urgent need to locate and quantify the numbers of mature male and female whale sharks in order to ascertain the conservation status and ensure persistence of the species.
Dynamic analysis of submerged microscale plates: the effects of acoustic radiation and viscous dissipation
Authors: Wu Zhangming , Ma Xianghong
Published: March 2016

The aim of this paper is to study the dynamic characteristics of micromechanical rectangular plates used as sensing elements in a viscous compressible fluid. A novel modelling procedure for the plate–fluid interaction problem is developed on the basis of linearized Navier–Stokes equations and no-slip conditions. Analytical expression for the fluid-loading impedance is obtained using a double Fourier transform approach. This modelling work provides us an analytical means to study the effects of inertial loading, acoustic radiation and viscous dissipation of the fluid acting on the vibration of microplates. The numerical simulation is conducted on microplates with different boundary conditions and fluids with different viscosities. The simulation results reveal that the acoustic radiation dominates the damping mechanism of the submerged microplates. It is also proved that microplates offer better sensitivities (Q-factors) than the conventional beam type microcantilevers being mass sensing platforms in a viscous fluid environment. The frequency response features of microplates under highly viscous fluid loading are studied using the present model. The dynamics of the microplates with all edges clamped are less influenced by the highly viscous dissipation of the fluid than the microplates with other types of boundary conditions.