bluuebunny/crossref_metadata_2025 huggingface dataset:
Aerosol scattering effects on water vapor retrievals over the Los Angeles Basin
Authors: Zeng Zhao-Cheng , Zhang Qiong , Natraj Vijay , Margolis Jack S. , Shia Run-Lie , Newman Sally , Fu Dejian , Pongetti Thomas J. , Wong Kam W. , Sander Stanley P. , Wennberg Paul O. , Yung Yuk L.
Published: February 2017

Abstract. In this study, we propose a novel approach to describe the scattering effects of atmospheric aerosols in a complex urban environment using water vapor (H2O) slant column measurements in the near infrared. This approach is demonstrated using measurements from the California Laboratory for Atmospheric Remote Sensing Fourier Transform Spectrometer on the top of Mt. Wilson, California, and a two-stream-exact single scattering (2S-ESS) radiative transfer (RT) model. From the spectral measurements, we retrieve H2O slant column density (SCD) using 15 different absorption bands between 4000 and 8000 cm−1. Due to the wavelength dependence of aerosol scattering, large variations in H2O SCD retrievals are observed as a function of wavelength. Moreover, the variations are found to be correlated with aerosol optical depths (AODs) measured at the AERONET-Caltech station. Simulation results from the RT model reproduce this correlation and show that the aerosol scattering effect is the primary contributor to the variations in the wavelength dependence of the H2O SCD retrievals. A significant linear correlation is also found between variations in H2O SCD retrievals from different bands and corresponding AOD data; this correlation is associated with the asymmetry parameter, which is a first-order measure of the aerosol scattering phase function. The evidence from both measurements and simulations suggests that wavelength-dependent aerosol scattering effects can be derived using H2O retrievals from multiple bands. This understanding of aerosol scattering effects on H2O retrievals suggests a promising way to quantify the effect of aerosol scattering on greenhouse gas retrievals and could potentially contribute towards reducing biases in greenhouse gas retrievals from space.
Validation of meteorological analyses and trajectories in the Antarctic lower stratosphere using Concordiasi superpressure balloon observations
Authors: Hoffmann Lars , Hertzog Albert , Rößler Thomas , Stein Olaf , Wu Xue
Published: February 2017

Abstract. In this study we validated temperatures and horizontal winds of meteorological analyses in the Antarctic lower stratosphere, a region of the atmosphere that is of major interest regarding chemistry and dynamics of the polar vortex. The validation was performed with long-duration observations from 19 superpressure balloon flights during the Concordiasi field campaign in September 2010 to January 2011. Our intercomparison covers the European Centre for Medium-Range Weather Forecasts (ECMWF) operational analysis, the ERA-Interim reanalysis, the Modern-Era Retrospective analysis for Research and Applications (MERRA), and the National Centers for Environmental Prediction and National Center for Atmospheric Research (NCEP/NCAR) reanalysis. We found that large-scale temperatures of the analyses have a mean precision of 0.4–1.4 K and a warm bias of 0.4–2.1 K at about 17–18.5 km altitude and 60–85° S. Zonal and meridional winds have a mean precision of 0.9–2.3 m/s and a bias below ±0.5 m/s in the same region. Standard deviations related to small-scale fluctuations such as gravity waves are reproduced at levels of 15–60 % for temperature and 30–60 % for the horizontal winds. We also used the balloon observations to validate trajectory calculations, where vertical motions of simulated trajectories were nudged to pressure measurements of the balloons to take into account changes in the overall mass configuration of the balloon-gondola system. We found relative horizontal transport deviations of 4.5–12 % and error growth rates of 60–170 km/day for 15-day trajectories. Dispersion simulations revealed some difficulties with the representation of subgrid-scale wind fluctuations in our Lagrangian transport model, as the spread of air parcels simulated with different analyses was not consistent. Although case studies suggest that the accuracy of trajectory calculations is influenced by meteorological complexity, diffusion generally does not contribute significantly to transport deviations in our analysis. Overall, validation results are satisfactory and compare well to earlier studies using superpressure balloon observations. In most cases, best performance was achieved by the ECMWF operational analysis, having the best spatiotemporal resolution, followed by ERA-Interim, MERRA, and finally NCEP/NCAR, having the lowest spatiotemporal resolution. Future work applying Eulerian or Lagrangian models to study the chemistry and dynamics of the polar vortex may use our validation results as additional guideline for error analyses.
Inorganic Carbon and Water Masses in the Irminger Sea since 1991
Authors: Fröb Friederike , Olsen Are , Pérez Fiz F. , García-Ibáñez Maribel  I. , Jeansson Emil , Omar Abdirahman , Lauvset Siv K.
Published: February 2017

Abstract. The subpolar gyre region in the North Atlantic is a major sink for anthropogenic carbon. While the storage rates show large interannual variability related to atmospheric forcing, less is known about variability in the natural Dissolved Inorganic Carbon (DIC) and the combined impact of variations in the two components on the total DIC inventories. Here, data from 15 cruises in the Irminger Sea covering 1991–2015 were used to determine changes in total DIC and its natural and anthropogenic components in relation to the distribution and evolution of the main water masses. The inventory of DIC increased by 1.43 ± 0.17 mol m−2 yr−1 over the period, mainly driven by the increase in anthropogenic carbon (1.84 ± 0.16 mol m−2 yr −1), but partially offset by a loss of natural DIC (−0.57 ± 0.22 mol m−2 yr−1). Changes in the carbon storage rate can be driven by concentration changes in the water column, for example due to ageing of water masses, or by changes in the distribution of water masses with different concentrations, either by local formation or advection. A decomposition of the trends into their main drivers showed that variations of natural DIC inventories are mainly driven by changes in the layer thickness of the main water masses, while anthropogenic carbon is most affected by concentration changes. The storage rates of anthropogenic carbon are sensitive to data selection, while changes in DIC inventory show a robust signal on short timescales, associated with the strength of convection.
Marginal cost curves for water footprint reduction in irrigated agriculture: guiding a cost-effective reduction of crop water consumption to a benchmark or permit level
Authors: Chukalla Abebe D. , Krol Maarten S. , Hoekstra Arjen Y.
Published: February 2017

Abstract. Reducing the water footprint (WF) of the process of growing irrigated crop is an indispensable element in water management, particularly in water-scarce areas. To achieve this, information on marginal cost curves (MCCs) that rank management packages according to their cost-effectiveness to reduce the WF need to support the decision making. MCCs enable the estimation of the cost associated with a certain WF reduction target, e.g. towards a given WF permit (expressed in m3 per hectare per season) or to a certain WF benchmark (expressed in m3 per tonne of crop). This paper aims to develop MCCs for WF reduction for a range of selected cases. The soil-water-balance and crop-growth model, AquaCrop, is used to estimate the effect on evapotranspiration and crop yield and thus WF of crop production due to different management packages. A management package is defined as specific combination of management practices: irrigation technique (furrow, sprinkler, drip or subsurface drip); irrigation strategy (full or deficit irrigation); and mulching practice (no, organic or synthetic mulching). The annual average cost for each management package is estimated as the annualised capital cost plus the annual costs of maintenance and operations (i.e. costs of water, energy, and labour). Different cases is considered, including: three crops (maize, tomato and potato); four types of environment; three hydrologic years (wet, normal and dry years) and three soil types (loam, silty clay loam and sandy loam). For each crop, alternative WF reduction pathways were developed, after which the most cost-effective pathway was selected to develop the MCC for WF reduction. When aiming at WF reduction one can best improve the irrigation strategy first, next the mulching practice and finally the irrigation technique. Moving from a full to deficit irrigation strategy is found to be a no-regret measure: it reduces the WF by reducing water consumption at negligible yield reduction, while reducing the cost for irrigation water and the associated costs for energy and labour. Next, moving from no to organic mulching has a high cost-effectiveness, reducing the WF significantly at low cost. Finally, changing from sprinkler or furrow to drip or sub-surface drip irrigation reduces the WF but at significant cost.
Identification of runoff formation with two dyes in a mid-latitude mountain headwater
Authors: Vlček Lukáš , Schneider Philipp , Falátková Kristýna
Published: February 2017

Abstract. Subsurface flow in Peat Bog areas and its role in the hydrological cycle has garnered increased attention as water scarcity and floods have increased due to a changing climate. In order to further probe the mechanisms in Peat Bog areas and contextualize them at the catchment scale, this experimental study identifies runoff formation at two opposite hillslopes in a peaty mountain headwater; a slope with organic Peat soils and a shallow phreatic zone (0.5 m below surface) and a slope with mineral Podzol soils and no detectable groundwater (> 2 m below surface). Similarities and differences in infiltration, percolation, and preferential flowpaths between both hillslopes could be identified by sprinkling experiments with Brilliant Blue and Sodium-Fluorescein. To our knowledge, this is the first time these two dyes have been compared in their ability to stain preferential flowpaths in soils. Dye-stained soil profiles within and downstream of the sprinkling areas were excavated parallel (lateral profiles) and perpendicular (frontal profiles) to the slopes' gradients. That way preferential flow patterns in the soil could be clearly identified. The results show that biomat flow, shallow subsurface flow in the organic topsoil layer, occurred at both hillslopes, however at the Peat Bog hillslope it was significantly more prominent. The dye solutions infiltrated into the soil and continued either as lateral subsurface pipeflow in the case of the Peat Bog, or percolated vertically towards the bedrock in the case of the Podzol. This study provides evidence that subsurface pipeflow, lateral preferential flow along decomposed tree roots or logs in the unsaturated zone, is a major runoff formation process at the Peat Bog hillslope and in the adjacent riparian zone.
Meteorological analysis of flash floods in Artvin (NE Turkey) on August 24, 2015
Authors: Baltaci Hakki
Published: February 2017

Abstract. On August 24, 2015 intense rainfall episodes generated flash floods and landslides on the eastern Black Sea coast of Turkey. As a consequence of the heavy rainstorm activity over Artvin and its surroundings (NE Turkey), 11 people died and economic losses totaled a million dollars. During the six hours of the event (from 05:00 UTC to 11:00 UTC), total accumulated rainfall of 136, 64, and 109 mm was measured in the Hopa, Arhavi, and Borçka settlements of Artvin city, respectively. This study comprehensively investigates the meteorological characteristics of those flash floods. In terms of synoptic mechanisms, the cut-off surface low from the summer Asian monsoon settled over the eastern Black Sea. After two days of quasi-stationary conditions of this cyclone, sea surface temperatures (SSTs) reached 27.5 °C (1.5 °C higher than normal) and low-level moisture convergence developed. In addition, transfer of moisture by warm northerly flows from the Black Sea and relatively cool southerly flows from the land coasts of the Artvin district exacerbated the unstable conditions, and thus, played a significant role in the development of deep convective cells. Severe rainstorms as well as the slope instability of the region triggered landslides and worsened flood damage in the Artvin.
Direct Transretinal Removal of Subfoveal Perfluorocarbon Liquid: The Role and Timing of Internal Limiting Membrane Peeling
Authors: De Cillà Stefano , Alkabes Micol , Radice Paolo , Carini Elisa , Mateo Carlos
Published: February 2017

Purpose

To describe a case series including 4 patients undergoing direct transretinal aspiration of subfoveal perfluorocarbon liquid (PFCL) and internal limiting membrane (ILM) peeling after macula-off retinal detachment surgery.

Methods

Four patients who had undergone vitreoretinal surgery due to primary rhegmatogenous retinal detachment were further treated because of retained subfoveal PFCL. Direct transretinal aspiration of PFCL through a self-sealing foveal retinotomy was performed in all cases using a 41-G needle placed on the top of the bubble. The ILM was peeled off prior to and after PFCL removal in 2 cases, respectively. Optical coherence tomography (OCT) scans were obtained preoperatively and postoperatively to assess the status of the macula.

Results

Subfoveal PFCL was successfully removed in all cases. Two patients had silicone oil tamponade at the time of the second surgery, which was temporarily removed in both cases and then reapplied in one. Best-corrected visual acuity improved in all cases. No postoperative macular hole was observed by OCT.

Conclusions

Direct transretinal aspiration of subfoveal PFCL with a 41-G cannula combined with conventional ILM peeling is a safe and effective technique to avoid long-term damage to the retinal layers with good functional outcomes. Performing the ILM peeling immediately before or after the PFCL aspiration does not seem to influence anatomic results.
Comparison of Visual Outcomes after Bilateral Implantation of Extended Range of Vision and Trifocal Intraocular Lenses
Authors: Ruiz-Mesa Ramón , Abengózar-Vela Antonio , Aramburu Ana , Ruiz-Santos María
Published: February 2017

Purpose

To compare visual outcomes after cataract surgery with bilateral implantation of 2 intraocular lenses (IOLs): extended range of vision and trifocal.

Methods

Each group of this prospective study comprised 40 eyes (20 patients). Phacoemulsification followed by bilateral implantation of a FineVision IOL (group 1) or a Symfony IOL (group 2) was performed. The following outcomes were assessed up to 1 year postoperatively: binocular uncorrected distance visual acuity (UDVA), binocular uncorrected intermediate visual acuity (UIVA) at 60 cm, binocular uncorrected near visual acuity (UNVA) at 40 cm, spherical equivalent (SE) refraction, defocus curves, mesopic and photopic contrast sensitivity, halometry, posterior capsule opacification (PCO), and responses to a patient questionnaire.

Results

The mean binocular values in group 1 and group 2, respectively, were SE -0.15 ± 0.25 D and -0.19 ± 0.18 D; UDVA 0.01 ± 0.03 logMAR and 0.01 ± 0.02 logMAR; UIVA 0.11 ± 0.08 logMAR and 0.09 ± 0.08 logMAR; UNVA 0.06 ± 0.07 logMAR and 0.17 ± 0.06 logMAR. Difference in UNVA between IOLs (p<0.05) was statistically significant. There were no significant differences in contrast sensitivity, halometry, or PCO between groups. Defocus curves were similar between groups from 0 D to -2 D, but showed significant differences from -2.50 D to -4.00 D (p<0.05).

Conclusions

Both IOLs provided excellent distance and intermediate visual outcomes. The FineVision IOL showed better near visual acuity. Predictability of the refractive results and optical performance were excellent; all patients achieved spectacle independence. The 2 IOLs gave similar and good contrast sensitivity in photopic and mesopic conditions and low perception of halos by patients.
Prevalence of Eyelid Laxity and its Association with Ophthalmic Findings and Disease Severity in Patients with Keratoconus
Authors: Naderan Mohammad , Jahanrad Ali , Farjadnia Mahgol
Published: February 2017

Purpose

To investigate the prevalence of eyelid laxity and quantify eyelid measurements in normal and keratoconic eyes and the correlations of these findings with ophthalmic parameters and disease severity in patients with keratoconus (KC).

Methods

In a prospective case-control study, prevalence of eyelid laxity and eyelid measurements were evaluated in 53 patients with KC and the same number of matched healthy controls. The eyelid measurements were compared between the groups, as well as mean keratometry (K), central and thinnest corneal thickness (CCT and TCT), astigmatism, manifest refraction spherical equivalent (MRSE), best spectacle-corrected visual acuity (BCVA), and severity of KC according to the Keratoconus Severity Score.

Results

Prevalence of eyelid laxity was 71.7% (38 patients) in patients with KC and 20.8% (11 patients) in normal participants (p<0.001, odds ratio 9.673 [95% confidence interval 3.959 to 23.631]). Comparison of the eyelid measurements in the patients with KC with and without eyelid laxity revealed significantly higher measurements of anterior eyelid distraction test, Hertel exophthalmometry measurements, lateral canthal angle to orbital rim and tendon movement, palpebral fissure width, retraction test (lower eyelid), and vertical lid pull (upper eyelid) in patients with KC with eyelid laxity (p<0.05). No significant difference was found regarding mean K, CCT, TCT, astigmatism, MRSE, or BCVA values of the patients with KC with and without eyelid laxity (p>0.05). Moreover, severity of KC was not associated with the presence of eyelid laxity or eyelid measurements (p>0.05).

Conclusions

Higher prevalence and greater eyelid laxity were found in patients with KC compared to healthy participants. However, eyelid laxity was not associated with severity of KC.
Incidence of Heterotopic Ossification in Minimally Invasive Short-Stem THA using the Modified Anterolateral Approach
Authors: Kutzner Karl P. , Hechtner Marlene , Pfeil Dominik , Rehbein Philipp , Kovacevic Mark P. , Schneider Michael , Siebert Werner , Pfeil Joachim
Published: February 2017

Introduction

Heterotopic ossification (HO) is known to be a common complication after total hip arthroplasty (THA). The minimal invasive (MIS) modified anterolateral approach has become popular in combination with a short stem. We analysed the incidence of HO following short-stem THA using this approach in combination with a postoperative administration of nonsteroidal anti-inflammatory drugs (NSAIDs).

Materials and methods

216 short stems were implanted in 162 patients. NSAIDs were administered for 2 weeks after surgery in 154 patients (95.1%). Standardised pre- and postoperative radiographic imaging was done at 2-year follow-up. HO was analysed according to the Brooker classification. Influence of age, gender, body mass index (BMI), and blood transfusion were analysed. Harris Hip Score (HHS) and visual analogue scale (VAS) of satisfaction were assessed. Operation time and blood-transfusion rate was documented. Short-term gastrointestinal side effects were recorded.

Results

The overall incidence of HO was 7.8% (16 cases). HO Brooker type 3 and 4 occurred in only 1 case (0.5%). No correlation with age, gender or BMI was revealed. HHS improved largely from 45.8 (SD 15.9) before surgery to 98.1 (SD 4.7) after a minimum of 2 years. At that point VAS satisfaction was 9.7 (SD 0.9). Mean operative time was 45.8 minutes (SD 18.7). 12 patients (7.4%) received at least 1 blood-transfusion. Gastrointestinal side effects occurred in 13 of 154 patients (8.4%).

Conclusions

The combination of short-stem THA, the MIS modified anterolateral approach and a postoperative application of NSAIDs resulted in the effective prevention of HO and excellent clinical results.
New Cross-Table Lateral Radiography Method for Measuring Acetabular Component Anteversion in Total Hip Arthroplasty: A Prospective Study of 93 Primary THA
Authors: Seo Hajime , Naito Masatoshi , Nakamura Yoshinari , Kinoshita Koichi , Nomura Tomohiro , Minokawa So , Minamikawa Tomohiko , Yamamoto Takuaki
Published: February 2017

Introduction

Various methods have been described for measuring acetabular component anteversion. However, accurate measurement of anteversion is difficult. We herein propose a new method using cross-table lateral (CL) radiography performed with the contralateral hip flexed to 45° (45° flexed CL radiography). The main purpose of this study was to evaluate the reliability and validity of this new method.

Methods

The study group included 93 patients who underwent total hip arthroplasty (THA). All hips were evaluated with computed tomography (CT) and both standard and 45° flexed CL radiographs to measure acetabular component anteversion the week after THA. The intraobserver and interobserver reliability of each measurement was assessed. Plain radiography measurements were compared with reference CT measurements to evaluate their validity.

Results

All measurements had excellent intraobserver and interobserver reliability, and plain radiography measurements correlated well with CT measurements. The mean measurements were 21.9° (3°-39°) with CT, 24.9° (7°-47°; p<0.001) with standard CL radiographs, and 22.5° (7°-43°; p = 0.112) with 45° flexed CL radiographs.

Discussion

The anteversion values measured with our new method were closer to the CT values used as a reference standard than those with standard CL radiographs. Our new method appears to be reliable and valid for measuring acetabular component anteversion.
Selection of a Surgical Approach for Total Hip Arthroplasty According to the Depth to the Surgical Site
Authors: Ohmori Takaaki , Kabata Tamon , Maeda Toru , Kajino Yoshitomo , Taga Tadashi , Hasegawa Kazuhiro , Inoue Daisuke , Yamamoto Takashi , Takagi Tomoharu , Tsuchiya Hiroyuki
Published: February 2017

Background

The surgical depths of approaches for total hip arthroplasty (THA) have not been reported previously. In this study, we investigate the relationships between the distances to the centre of the femoral head in different approaches and body mass index (BMI).

Methods

The study included patients with normal hip joints who presented to our hospital. We used the pelvic coordinate system relative to the anterior pelvic plane and the femur coordinate system relative to the posterior condylar plane. We assessed the anterior, anterolateral, lateral and posterior approaches, and defined each approach line. We evaluated each distance in terms of BMI and gender.

Results

164 hips were assessed. The distance to the centre of the femoral head was the longest in the posterior approach, followed by the lateral, anterolateral, and anterior approaches (p<0.05). Additionally, the distance in each approach increased as patients’ BMI increased. The approximated line tilts were almost the same. The correlation coefficients between BMI and the distance to the centre of the femoral head were high in all approaches. In the anterior and anterolateral approaches, men with low BMI had a short distance to the femoral head. The distance for each approach was measured according to the pelvic coordinate system and the femur coordinate system. The results showed no significant differences between them.

Conclusions

The distance to the centre of the femoral head is the shortest in the anterior approach, regardless of BMI and gender. The distance in each approach might increase with an increase in BMI. BMI has similar effects in all approaches.
Short Femoral Stem in Total Hip Arthroplasty: Stable Fixation and Low Complication Rates in Elderly Patients
Authors: Morales de Cano Jaime J. , Gordo Christian , Canosa Areste Jordi
Published: February 2017

Background

We present the result of our experience in using a short femoral stem in elderly patients (>70 years of age) compared to patients younger than 70 years.

Methods

Data were prospectively collected on 138 patients who underwent 148 primary total hip arthroplasty (THA), with a conservative short stem between November 2010 and June 2014. The cohort was divided into 2 groups: the study group (group 1) comprised 57 patients (60 THA) over 70 years of age at the time of surgery, with a mean age of 75.4 years (range 70-87 years) and a mean follow-up of 26.7 months (range 9-48 months). The control group (group 2) comprised 81patients (88 THA) less than 70 years of age with a mean age of 57.4 years (range 33-69 years) and a mean follow-up of 27.3 months (range 9-54 months). Hip function in the 2 groups was compared preoperatively and postoperatively using the Merle D'Aubigne hip score (MD) and Western Ontario and McMaster Universities Arthritis Index (WOMAC) score.

Results

At the latest follow-up, 1 calcar fracture was reported in a 54-year-old patient in the control group, which required fixation with a screw and had a favourable outcome. No cases of clinical or radiographic loosening were reported. Clinical results showed no statistically significant differences between the 2 groups.

Conclusions

The use of the GTS conservative short stem in patients over 70 years old has shown very good results and low complication rates, comparable to those for patients younger than 70 years.
Retrieval and Radiographic Analysis of the Contour Antiprotrusio Cage
Authors: Vigdorchik Jonathan M. , Yoon Richard S. , Gilbert Susannah L. , Lipman Joseph D. , Bostrom Mathias P.
Published: February 2017

Introduction

Acetabular reconstruction in the setting of severe bone loss or pelvic discontinuity remains a challenging problem. Multiple methods of treatment have been described including antiprotrusio cages (APCs). The objective of this study is to combine biomechanical analysis of retrieved APCs with radiographic and clinical data to determine which factors influence or predict APC failure.

Methods

41 APCs were identified. Sequential radiographs were examined for cage and polyethylene cup abduction angles, change in centre of rotation, screw placement, progression of cage failure, and failure mechanism. Cages were manually examined for gross macroscopic findings, breakage, and the location of breakage. High-resolution microscopy was used for further analysis.

Results

24 cages were included in the analysis. Mean age of patients was 64.5 years (range 43-85 years); average length of implantation was 42.5 months (range 3-108 months). Average cage abduction angles were 56°; abduction for the cemented polyethylene cup was 44°. 14 of 24 cages were broken; 10 were intact. Of the broken cages, 10/14 broke through a screw hole in the ischial flange or just superior to the ischial flange. In the intact group, 6/10 failed due to pullout of the ischial screws.

Discussion

All cages had superior and lateralised centres of rotation. The majority of cages failed due to breakage or pullout at the ischial flange. Pelvic discontinuity was a large risk factor for a broken cage. Future design and technique modifications may result in superior outcomes in these complex acetabular reconstructions.
Dialysis Access, Infections, and Hospitalisations in Unplanned Dialysis Start Patients: Results from the Options Study
Authors: Machowska Anna , Alscher Mark D. , Vanga Satyanarayana Reddy , Koch Michael , Aarup Michael , Qureshi Abdul R. , Lindholm Bengt , Rutherford Peter
Published: February 2017

Introduction

Unplanned dialysis start (UPS) associates with worse clinical outcomes, higher utilisation of healthcare resources, lower chances to select dialysis modality and UPS patients typically commenced in-centre haemodialysis (HD) with central venous catheter (CVC). We evaluated patient outcomes and healthcare utilisation depending on initial dialysis access (CVC or PD catheter) and subsequent pathway of UPS patients.

Methods

In this study patient demographics, access procedures, hospitalisations, and major infectious complications were analysed over 12 months in 270 UPS patients. PD technique survival and impact of switching from HD to PD was examined along with logistic regression to investigate factors predicting AV fistula formation.

Results

72 UPS patients started with PD catheter and 198 with CVC. PD patients were older and more comorbid but had a significantly lower number of access procedures while there was no difference in hospitalisation or major infections. 13/72 initial PD patients switched to HD and 1-year technique survival was 79%. 158/198 patients remained on HD and 73/158 reported permanent access formation. Older age, OR = 0.34 (CI, 0.17-0.68) and cardiac failure, OR = 0.31(CI, 0.13–0.78), were significant negative predictors of receiving fistula. Younger patients, OR = 0.29 (CI, 0.11–0.79) and those who received AVF, OR = 0.11 (CI, 0.03–0.38), had significantly lower odds of death.

Discussion

UPS with initial PD was possible in many patients and was associated with lower requirement for access procedures. AVF formation in UPS patients starting on HD was associated with better 1-year survival. Modality switching in UPS patients requires careful clinical management, including clinical practice patterns promoting permanent HD access formation.
An Insertion/Deletion Polymorphism within the Promoter of EGLN2 is Associated with Susceptibility to Colorectal Cancer
Authors: Li Chaoyang , Feng Lanjun , Niu Luwei , Li Teng Teng , Zhang Bin , Wan Huiping , Zhu Zhansheng , Liu Hao , Wang Kai , Fu Haixiao , Fu Wei
Published: February 2017

Objective

To investigate the association between susceptibility to colorectal cancer (CRC) and a 4-bp insertion/deletion polymorphism (rs10680577) in the proximal promoter of the EGLN2 gene.

Method

The first step in genotyping EGLN2 was PCR, then the PCR products were separated using 7% nondenaturing polyacrylamide gel electrophoresis and visualized by silver staining according to the final product band location and quantity to determine the genotype of the sample. The final count was done by two different pathologists.

Result

In the codominant model, compared with the ins/ins genotype, subjects with the heterozygous ins/del or homozygous del/del genotype had a significantly increased risk of CRC (adjusted OR = 1.45, p<0.0001 and OR = 2.44, p = 0.0001, respectively). Each additional copy of the 4-bp deletion allele conferred a significantly increased risk of CRC (OR = 1.47, 95% CI 1.28-1.66, p<0.0001). In the stratification analysis, we further proved that the association was more prominent in TNM stage III and IV cancer compared with stage I and II (adjusted OR = 1.43, 95% CI 1.07-1.93, p for heterogeneity = 0.02).

Conclusions

Our study provided initial evidence that the insertion/deletion polymorphism rs10680577 may play a functional role in the development of CRC in the Chinese population.
A national appraisal of haemodialysis vascular access provision in Scotland
Authors: Oliver Scott W. , Campbell Jacqueline , Kingsmore David B. , Kasthuri Ram , Metcalfe Wendy , Traynor Jamie P. , Fischbacher-Smith Denis , Jardine Alan G. , Thomson Peter C.
Published: February 2017

Purpose

Published registry data demonstrate longstanding variation in the utilisation of different vascular access (VA) modalities between Scottish renal units; this may reflect different clinical processes between centres. A comprehensive appraisal was undertaken to understand the processes underpinning VA creation and maintenance across Scotland.

Methods

A mixed methods approach was utilised. Fifty-two semi-structured interviews were conducted with patients and clinicians in all ten, adult and paediatric, Scottish renal units. Interview transcripts were subjected to thematic analysis. Clinical activity data were prospectively collected for six weeks, and correlated with registry data.

Results

VA accounts for a large clinical workload. There was significant inter-centre variation in the utilisation of different VA modalities, and patients described frustrating, dissatisfying experiences. VA creation and maintenance pathways functioned best when nephrologists, surgeons and radiologists were co-located on the same campus with close multi-disciplinary working, protected clinical time, and proactive VA maintenance. No unit routinely measured or discussed procedure outcomes or strategic aspects of their service.

Conclusions

Varied clinical outcomes reflected varied clinical processes. Optimised clinical pathways, staff education and measurement of clinical outcomes may improve VA service quality and facilitate safer, more effective, patient-centred care.
Negative-pressure wound therapy and early pedicle flap reconstruction of the chest wall after epirubicin extravasation
Authors: Papadakis Marios , Rahmanian-Schwarz Afshin , Bednarek Marzena , Arafkas Mohamed , Holschneider Philipp , Hübner Gunnar
Published: February 2017

Purpose

Accidental extravasation is a serious iatrogenic injury among patients receiving anthracycline-containing chemotherapy. The aim of this work is to present a combination therapy for chest wall reconstruction following epirubicin extravasation.

Methods

Herein, we report a 68-year-old woman with massive soft tissue necrosis of the anterolateral chest wall after epirubicin extravasation from a port implanted in the subclavicular area.

Results

The necrotic tissue was resected, the port was removed, and negative-pressure wound therapy was applied. Three weeks later, a latissimus dorsi pedicle flap was successfully used to cover the defect.

Conclusions

To the best of the authors’ knowledge, this is the first report of a strategy comprising the combination of negative-pressure wound therapy and a latissimus pedicle flap for reconstruction of the chest wall after soft tissue necrosis following epirubicin extravasation.
Sex, race, and hemodialysis vascular access processes
Authors: McGill Rita L. , Lacson Eduardo
Published: February 2017

Purpose

Hemodialysis (HD) patients who are female or black receive fewer arteriovenous fistulas (AVF) and more grafts (AVG). We evaluated race- and sex-based differences for three process exposures: access surgery, peripherally-inserted central catheters (PICCs), and vascular imaging.

Methods

US Renal Data System with linked Medicare claims for patients initiating HD between April 2010 – December 2011 were used to identify PICC placement, imaging, AVF and AVG surgeries, and the vascular accesses in use at individual HD treatments. Poisson, logistic, and Cox regression models adjusted for clinical and demographic variables were used to evaluate relationships between process exposures, vascular access outcomes, and sex.

Results

Among 18,883 individuals initiating HD with catheters with at least one surgical claim for AVF or AVG, women had 16% more PICC and 5% more imaging (p = 0.002), were 43% less likely to have AVF surgery and 68% more likely to have AVG surgery (p<0.001). The odds of AVF surgery producing a working AVF were 18% lower and of AVG surgery producing a working AVG 38% higher (p<0.001). Black patients had 24% more PICCs and 12% more imaging, were 48% less likely to have AVF surgery and 84% more likely to have AVG surgery (p<0.001). The odds of achieving a working AVF were 8% lower and of a working AVG were 38% higher. The hazard of future catheter use after AVF creation was 25% higher for women (p<0.001), but did not differ by race.

Conclusions

Divergences in vascular access by race and sex were partly related to differential process exposures. Black and female patients had more AVG and less AVF surgery, and more PICC and imaging. Success rates were lower for AVF surgery and higher for AVG surgery. Further work is needed to determine whether choices of process exposures arise from differential ability to detect veins on physical examination.
Physiological and psychological responses to surgery and non-surgery days in orthopaedic surgeons: A case study
Authors: Abatzoglou Sarantis , Milne Kevin , Howard James L. , Dobbin Emily , Zekic Filip , Lanting Brent
Published: February 2017

Objective: Performing surgical procedures can increase the physiological stress and mental strain experienced by practicing surgeons. This may affect negatively work capacity and quality of patient care by increasing the incidence of burnout, sleep disorders, fatigue and substance abuse. The purpose of this pilot case study was to track physiological and psychological responses to clinical duties in an expert arthroplasty orthopaedic surgeon.Methods: Heart rate (HR), breathing rate, heart rate variability (HRV) and anxiety ratings were observed in an expert orthopaedic surgeon using a wearable Equivital EQO2 physiological monitor and the state-trait anxiety inventory (STAI), respectively. Data was recorded for 8 surgery, 1 clinic and 1 rest day. Physiological data was recorded for 6-8 hours/day.Results: The surgeon spent significantly more time with elevated HRs on surgery days versus either clinic or rest days (10% of the day over 100 bpm). This was not the case for respiratory rate. STAI responses were significantly greater pre versus post surgery and at baseline. Psychological and physiological markers of stress were elevated prior to each surgery regardless of surgery type and task. Notably, the HR never returned to baseline on surgery days.Discussion: This study provides a baseline on which to compare procedural and trainee differences during surgical procedures. Expert surgeons may demonstrate elevated stress levels on days of surgery, as indicated by self-reported anxiety scores as well as physiologic measures. Understanding the stress and anxiety present may direct interventions that enable improved surgeon health, surgical performance, and an improved learning environment.
Variability among groups of nursing students’ utilization of a technological learning tool for clinical skills training: An observational study
Authors: Haraldseid Cecilie , Aase Karina
Published: February 2017

Background and objective: The use of technology has become the norm in nursing education. While technology has opened up for more flexible, active, student-focused teaching methods, its introduction has also brought challenges regarding its use and implementation. Recent literature has concentrated on how to best implement technology, but little attention has focused on observing student practices during technology use. Therefore, it is unknown how to optimize technology use within clinical skills training. The objective of this study was to investigate how groups of nursing students utilize a technology-based learning tool.Methods: An observational study with an exploratory design was implemented using video recordings as the data material.Results: The results indicated a high level of variability in nursing students’ performance and ability to utilize a technological tool while working in groups. The variability during clinical skills training was associated with four factors: level of competence, motivation to learn, role clarification, and collaborative problem-solving skills.Conclusions: The results of the study indicated variability in groups of nursing students’ ability to employ a technological tool during a selected procedure—namely, wound care and dressing. These findings suggest that a set of implications for faculty members should be developed. Specifically, staff and students should be prepared prior to using technology by focusing on group dynamics, group composition, development of collaborative problem-solving skills, and role modeling.
Personalization of Legal and Ethical Information in ICT Platforms: The Approach of Legal Decision Tree
Authors: Imeri Adnan , Khadraoui Abdelaziz , Dinh Thang Le , Khadraoui Djamel
Published: February 2017

This paper aims at presenting a theoretical approach for the representation of legal and ethical information in a personalized way in ICT platforms. The personalization process allows us to adapt the legal information for end- users of ICT platforms. This approach points out the key element for defining a complete legal and ethical corpus of documents. Based on the corresponding scenario, the legal information is selected, filtered and then presented in ICT platforms. For organizating and analyzing this legal and ethical information, we reuse the existing notion of the decision tree and enhance it with a set of legal parameters emerging from legal documents. This legal decision tree will help us to treat different types of legal cases, which may relate to different service scenarios.
Profitability on Albanian Supplementary Social Insurance Scheme: "Academic Titles" Case
Authors: Sharku Gentiana
Published: February 2017

The social insurance system in Albania is composed of three basic schemes: (i) mandatory scheme functioning on the "pay as you go" basis, (ii) voluntary scheme, protecting individuals who for specific reasons are not involved in the mandatory plan, and (iii) supplementary scheme, covering a specific category of individuals, who perform certain state functions and/or have academic titles. Regardless the classification, the supplementary scheme is a mandatory one. During 2015, Albanian government has revised the contribution rates for the supplementary scheme, as the scheme is suffering a deficit. The aim of this paper is to calculate the average rate of return on the contributions invested in this scheme, referring to the category of individuals having the "Professor" title. The calculations will be based on some actuarial assumptions. The data used in this paper will be of secondary type, based on the official statistics published by respective institutions.
Investigation of the Correlation of Family Resilience of Parents with a Child with Autism Spectrum Disorders, Parenting Stress and Social Support
Authors: Kavaliotis Paschalis
Published: February 2017

Stress is an extremely serious symptom in the care of an autistic child and it deteriorates mainly in women and depending on the seriousness of the autism symptoms. As a result, physical and mental health problems are caused in the children’s carers, having as a consequence the attack on family resilience. Social support, standard or non-standard, seems that it can be related to the parents’ reduced stress levels as well as to an increase in resilience, even though not all researches agree on this conclusion. The correlation of these parameters in this study comes from a wider quantitative research, the sample of which were the parents of 312 autistic children in Greece, all of them couples, namely 624 men and women, divided in equal numbers. The scales’ correlations in this research showed a strong correlation of the family communication and problem solving with the utilization of resources that concern the social and financial field, and also with important management strategies of autism, such as maintaining a positive outlook and the ability to make meaning of adversities.
Digital Environmentalism: A Case Study of PM2.5 Pollution Issue in Chinese Social Media
Authors: Zhang Yanshuang
Published: February 2017

The emergence of social media over the last decade has substantially altered not only the means people communicate with each other but also the whole online ecosystems. For the common public in particular, social media enables and broadens the social conversation that anyone interested can engage in on urgent social problems such as environmental pollution. In China, the ever-thickening air pollution smothering most urban cities in recent years has provoked a nationwide discussion, and popular social media like Weibo has been fully utilised by various social actors to participate in this “green speak”. This paper examines the civil discourse about the deteriorating air pollution on China’s largest microblogging platform-Sina Weibo, and seeks to understand how different social actors respond to and reconstruct the reality. Through a discourse analysis aided by a text analytics/ visualisation software—eximancer, this paper investigates the civil discourse from three angles: the demographics, the discursive strategies and the potential social effect. The result suggests that proactive civil engagement in this issue has produced an environmental discourse with a wide range of topics involved, and that the benign interactions between social actors could give rise to a proactive interactional mode between Chinese state and civil society which would definitely be beneficial to the democratisation process in contemporary China.
Estudio de las creencias de una futura maestra sobre la construcción del repertorio lingüístico a través de narrativas multimodales
Authors: Cabré Rocafort Míriam
Published: February 2017

La narrativa es una práctica reflexiva que permite (re)pensar y atribuir sentido a las experiencias y comprender la complejidad de los procesos de enseñanza y aprendizaje de lenguas. El objetivo es analizar las creencias de una maestra en formación inicial sobre la construcción del repertorio lingüístico e indagar sobre su proyección en las futuras prácticas docentes. La articulación de las creencias se lleva a cabo a partir de narrativas multimodales, de las que se explora y verifica su eficacia como herramienta metodológica.El estudio muestra que hay creencias arraigadas y otras más susceptibles de desestabilizar. El sujeto ha construido nuevos marcos interpretativos sobre la educación en lenguas: el foco que había sobre el dominio de una lengua se ha desplazado hacia la noción de desarrollo del repertorio lingüístico. Los procesos reflexivos han posibilitado atribuir sentido a sus experiencias y movilizar o desestabilizar creencias que guiarán sus futuras actuaciones en el aula.
Begonia elachista Moonlight & Tebbitt sp. nov., an enigmatic new species and a new section of Begonia (Begoniaceae) from Peru
Authors: Moonlight Peter Watson , Reynel Carlos , Tebbitt Mark
Published: February 2017

The world’s smallest Begonia, Begonia elachista Moonlight & Tebbitt sp. nov., is described and illustrated from a limestone outcrop in the Amazonian lowlands of Pasco Region, Peru. It is placed within the newly described, monotypic Begonia sect. Microtuberosa Moonlight & Tebbitt sect. nov. and the phylogenetic affinities of the section are examined. Begonia elachista sp. nov. is considered Critically Endangered under the International Union for the Conservation of Nature (IUCN) criteria.
Les femmes propriétaires à Pikine, au Sénégal : entre nouvelles responsabilités familiales et désir d’autonomie
Authors: Pinard Émilie
Published: February 2017

Cet article porte sur les femmes propriétaires des quartiers périphériques de Pikine, au Sénégal, et sur l’intégration de leur participation accrue à la production résidentielle dans les processus d’émancipation en cours. En s’appuyant sur des entretiens narratifs auprès de 17 propriétaires, l’auteure examine les évènements et les motivations qui ont mené ces femmes à acquérir une maison, de même que les normes et les logiques dans lesquelles s’inscrit une telle démarche. L’auteure met ainsi en lumière les processus de négociations particuliers par lesquels ces propriétaires ont élargi le champ de leurs responsabilités familiales, de la gestion de l’espace domestique à la mobilisation des ressources pour la construction, tout en faisant des investissements qui favorisent leur indépendance économique et résidentielle à long terme.
Le pouvoir aux marges : les femmes qui vivent avec le VIH, entre marginalité et mobilité sociale
Authors: De Rosis Carolina
Published: February 2017

L’auteure étudie les mobilités sociales engendrées par des dispositifs sociosanitaires de prévention et de prise en charge du VIH/sida parmi des femmes séropositives socialement marginalisées résidant dans la ville de Gondär, au nord-ouest de l’Éthiopie. Assujetties à un pouvoir de plus en plus orienté vers la prise en considération des individus se situant aux marges de la société pour faciliter leur autonomisation (empowerment), ces femmes entament des processus de construction identitaire au sein desquels leurs statuts sociaux sont le résultat d’arrangements et de compromis entre des rôles féminins traditionnels et les nouvelles formes de militantisme et de visibilité sociale auxquelles la lutte contre le VIH/sida a donné lieu.