bluuebunny/crossref_metadata_2025 huggingface dataset:
Building personal resources through interventions: An integrative review
Authors: Gilbert Elisabeth , Foulk Trevor , Bono Joyce
Published: May 2017

In recent years, a variety of disparate literatures have emerged to test interventions intended to increase individuals' psychological, cognitive, and physiological resources. Although many of these interventions were originally designed for individual or clinical use, a growing number of commentators have called for their adoption in organizations. But controversy remains about their efficacy in the workplace. We review the research literature on 6 interventions that have been used to build volatile personal resources: malleable, individual‐level constructs that are vital for withstanding work stress and proximal to work outcomes. In so doing, we evaluate the generalizability of these interventions to organizational settings, along with their potential benefits and costs. Our findings highlight new opportunities for both research and practice.
The table grape ‘Victoria’ with a long shaped berry: a potential mutation with attractive characteristics for consumers
Authors: Ferrara Giuseppe , Gallotta Alessandra , Pacucci Carmela , Matarrese Angela Maria Stella , Mazzeo Andrea , Giancaspro Angelica , Gadaleta Agata , Piazzolla Francesca , Colelli Giancarlo
Published: May 2017

BACKGROUND

Puglia is the most important region in Italy for table grape production. Since consumers look for new products, the number of table grape varieties has greatly increased in recent years.

RESULTS

In a survey in the Puglia region, we identified several years ago a potential mutation of the cv. Victoria. We described this accession in comparison with the standard Victoria for some amphelographic traits. All the characteristics were very similar to the standard Victoria except for the berry shape, which was significantly more elongated. Moreover, the berry of the mutated Victoria showed higher firmness, lightness and chroma than the standard one, with a more intense yellow colour of the skin (appreciated by consumers). The molecular characterisation with 25 SSR markers showed that normal and mutant Victoria were genetically identical at all the analysed loci, thus suggesting that the two accessions could be considered as clones with the difference in berry shape probably due to a somatic mutation.

CONCLUSIONS

This mutation of the cv. Victoria may have interesting perspective for the market since consumers are always attracted by different shape and colour of the fruits (consumers buy with eyes). This accession can be an alternative clone of the already known standard Victoria. © 2017 Society of Chemical Industry
Reducing anti‐nutritional factor and enhancing yield with advancing time of planting and zinc application in grasspea in Ethiopia
Authors: Sarker Ashutosh , Fikre Asnake , El‐Moneim Ali M Abd , Nakkoul Hani , Singh Murari
Published: May 2017

BACKGROUND

Grasspea (Lathyrus sativus L.) is an important pulse crop for food, feed and sustainable crop production systems in Ethiopia. Despite its advantages in nutrition and adaptability to harsh climate and low fertile soil, it contains a neurotoxin, β‐N‐oxalyl‐α,β‐diamiono propionic acid (β‐ODAP), which paralyses the lower limbs and is affected by genotypic and agronomic factors. To determine the effect of zinc application and planting date on yield and β‐ODAP content of two genotypes, experiments were conducted in two regions of Ethiopia.

RESULTS

The main effects of variety, sowing date and zinc and their interactions were significant (P < 0.001) for β‐ODAP and seed yield, which had a linear relationship with zinc. For the improved grasspea variety, an application of 20 kg ha−1 zinc showed a reduction of β‐ODAP from 0.15% to 0.088% at Debre Zeit and 0.14% to 0.08% at Sheno and increased its yield from 841 kg ha−1 to 2260 kg ha−1 at Debre Zeit and from 715 to 1835 kg ha−1 at Sheno. Early sowing showed a reduction in ODAP content in relation to the late sowing.

CONCLUSION

An application of Zn beyond even 20 kg ha−1 with an early sowing is recommended for the improved variety. © 2017 Society of Chemical Industry
Harvesting and blending options for lower alcohol wines: a sensory and chemical investigation
Authors: Longo Rocco , Blackman John W , Antalick Guillaume , Torley Peter J , Rogiers Suzy Y , Schmidtke Leigh M
Published: May 2017

BACKGROUND

Lower alcohol wines often have a poor reputation among consumers, in part due to their unsatisfactory flavours such as reduced overall aroma intensity or herbaceous characters. The aim of this study, performed on Verdelho and Petit Verdot, was to quantify the effectiveness of a monovarietal blend in which wines made from less ripe grapes were blended with an equivalent volume of a wine vinified from riper fruit to produce wines with a lower alcohol content and desirable ripe fruit flavours.

RESULTS

Eleven and 13 attributes, for Verdelho and Petit Verdot, respectively, were selected during sensory descriptive analysis. Intensities of perceived ‘acidity’, ‘sweetness’ and ‘alcohol’ attributes were significantly different (P ≤ 0.05) between the blend (8.8 ± 0.1% v/v) and mature Verdelho (10.3 ± 0.1% v/v) wines, while no significant differences were found between the Petit Verdot blend (11.0 ± 0.1% v/v) and mature (12.6 ± 0.2% v/v) treatments. Volatile composition of wines was assessed using HS‐SPME‐GC‐MS. Partial least square regression suggested relationships between sensory descriptors and chemical attributes in the wines, as well as the modifications of sensory and compositional profiles following blending.

CONCLUSIONS

The blending practice described allowed the production of wines with lower alcohol content while retaining similar sensory profiles of the later harvested, riper fruit wines. © 2017 Society of Chemical Industry
Ultrasound‐Guided Injection of the Temporalis Tendon: A Novel Technique
Authors: Bressler Hart B. , Friedman Talia , Friedman Lawrence
Published: May 2017

A novel technique, ultrasound‐guided injection of the temporalis tendon in adults, is described. Ultrasound‐guided injection of the temporalis tendon is based on visualization of the temporalis muscle, temporalis tendon, and coronoid process. A practical step‐by‐step guide to doing the procedure is given. This technique is effective and reproducible. Two patients successfully treated with this technique will be briefly discussed. The anatomic location and size of the temporalis tendon make it mandatory to use ultrasound to ensure precision.
Dissolved organic carbon in the Ross Sea: Deep enrichment and export
Authors: Bercovici Sarah K. , Huber Bruce A. , DeJong Hans B. , Dunbar Robert B. , Hansell Dennis A.
Published: May 2017

Antarctica's continental shelves generate the densest waters in the world and are responsible for the formation of Antarctic Bottom Water (AABW), a water mass with the potential to sequester carbon in the deep ocean for millennia. One such form of marine carbon is dissolved organic carbon (DOC), the ocean's largest standing stock of reduced carbon. In this study, we quantify DOC enrichment in dense shelf waters (DSW) in the Ross Sea and assess the potential for DOC to be sequestered from Antarctic shelves into AABW. We find that Ross Sea DSW is enriched in DOC by ∼7 μmol kg−1 relative to the incoming source waters (initial conditions), which is primarily caused by vertical mixing. The total DOC excess in DSW suggests that 4.0 ± 0.6 Tg DOC yr−1 is exported off the shelf. However, this exported fraction does not appear to persist in newly formed AABW and is likely remineralized, sequestering this carbon as TCO2 in the deep ocean.
Dual pH‐Sensitive DOX‐Conjugated Cyclodextrin‐Core Star Nano‐Copolymer Prodrugs
Authors: Hou Yu , Liu Yuyang , Sun Shuangshuang , Liang Jianghu
Published: May 2017

Herein this study reports dual pH‐sensitive doxorubicin (DOX)‐conjugated β‐cyclodextrin‐core star copolymers with tailoring properties such as direct water‐solubility and stability prior to reaching target sites. For these purposes, three kinds of novel well‐defined β‐cyclodextrin‐core poly(2‐(diethylamino)ethyl methacrylate‐co‐4‐formylphenyl methacrylate)‐b‐poly(poly(ethylene glycol) methyl ether methacrylate) star copolymers (CD‐star‐P(DEA‐co‐FPMA)‐b‐PPEGMA, SPDFP1–3) with different poly(ethylene glycol) methyl ether methacrylate contents are designed and synthesized by atom transfer radical polymerization (ATRP) strategy. 4‐Formylphenyl methacrylate is introduced into the inner arm block of the star copolymers for conjugating DOX by imine bond formation. Interestingly, the DOX‐conjugated β‐cyclodextrin‐core star copolymers not only can directly dissolve in aqueous buffer solution of pH 7.0 to form unimolecular micelles without any aid of organic solvent, but also exhibit strong pH‐dependent DOX release. At normal pH 7.4 the DOX amount released is very small, whereas at pH 5.0 DOX can be released. By selecting SPDFP2–DOX as a representative, it is found that the SPDFP2–DOX micelles show less cytotoxicity compared to carrier‐free DOX and can be internalized by HeLa cells. It is expected that the exploration can provide new strategy for preparing drug delivery system.

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Homoclinic solutions for nonlinear general fourth‐order differential equations
Authors: Carrasco Hugo , Minhós Feliz
Published: May 2017

This work provides sufficient conditions for the existence of homoclinic solutions of fourth‐order nonlinear ordinary differential equations. Using Green's functions, we formulate a new modified integral equation that is equivalent to the original nonlinear equation. In an adequate function space, the corresponding nonlinear integral operator is compact, and it is proved an existence result by Schauder's fixed point theorem. Copyright © 2017 John Wiley & Sons, Ltd.
Vanishing viscosity limit for the 3D nonhomogeneous incompressible Navier–Stokes equations with a slip boundary condition
Authors: Chen Pengfei , Xiao Yuelong , Zhang Hui
Published: May 2017

In this paper, we investigate the vanishing viscosity limit for the 3D nonhomogeneous incompressible Navier–Stokes equations with a slip boundary condition. We establish the local well‐posedness of the strong solutions for initial boundary value problems for such systems. Furthermore, the vanishing viscosity limit process is established, and a strong rate of convergence is obtained as the boundary of the domain is flat. In addition, it is needed to add some additional condition for density to match well the boundary condition. Copyright © 2017 John Wiley & Sons, Ltd.
Microheterogeneity in imidazolium and piperidinium cation‐based ionic liquids: 1D and 2D NMR studies
Authors: Panja Sumit Kumar , Saha Satyen
Published: May 2017

Existence of microheterogeneity of imidazolium and piperidinium cation‐based ionic liquids (ILs) containing PF6 and NTf2 anions has been investigated by 1D and 2D NMR spectroscopy. 2D NMR (especially NOESY and HOESY) has been employed for studying the interactions present between cation and anion as well as the intermolecular interaction among cations. HOESY spectrum shows that fluorine of anion (
and
) significantly interacts with proton of the cations. Combined results of HOESY and NOESY for imidazolium IL indicate that the
and imidazolium cation are distributed in organized manner, resulting a heterogeneous environment in liquid state. We have also observed existence of heterogeneous environment for piperidinium cation‐based ILs which is different from imidazolium ILs. It appears that existence of microheterogeneity in IL is ubiquitous and therefore open up the ILs field to revisit. Copyright © 2017 John Wiley & Sons, Ltd.
Oxygen extraction fraction mapping at 3 Tesla using an artificial neural network: A feasibility study
Authors: Domsch Sebastian , Mürle Bettina , Weingärtner Sebastian , Zapp Jascha , Wenz Frederik , Schad Lothar R.
Published: May 2017

Purpose

The oxygen extraction fraction (OEF) is an important biomarker for tissue‐viability. MRI enables noninvasive estimation of the OEF based on the blood‐oxygenation‐level‐dependent (BOLD) effect. Quantitative OEF‐mapping is commonly applied using least‐squares regression (LSR) to an analytical tissue model. However, the LSR method has not yet become clinically established due to the necessity for long acquisition times. Artificial neural networks (ANNs) recently have received increasing interest for robust curve‐fitting and might pose an alternative to the conventional LSR method for reduced acquisition times. This study presents in vivo OEF mapping results using the conventional LSR and the proposed ANN method.

Methods

In vivo data of five healthy volunteers and one patient with a primary brain tumor were acquired at 3T using a gradient‐echo sampled spin‐echo (GESSE) sequence. The ANN was trained with simulated BOLD data.

Results

In healthy subjects, the mean OEF was 36 ± 2% (LSR) and 40 ± 1% (ANN). The OEF variance within subjects was reduced from 8% to 6% using the ANN method. In the patient, both methods revealed a distinct OEF hotspot in the tumor area, whereas ANN showed less apparent artifacts in surrounding tissue.

Conclusion

In clinical scan times, the ANN analysis enables OEF mapping with reduced variance, which could facilitate its integration into clinical protocols. Magn Reson Med 79:890–899, 2018. © 2017 International Society for Magnetic Resonance in Medicine.
Linear smoothed extended finite element method
Authors: Surendran M. , Natarajan Sundararajan , Bordas Stéphane P. A. , Palani G. S.
Published: May 2017

The extended finite element method was introduced in 1999 to treat problems involving discontinuities with no or minimal remeshing through appropriate enrichment functions. This enables elements to be split by a discontinuity, strong or weak, and hence requires the integration of discontinuous functions or functions with discontinuous derivatives over elementary volumes. A variety of approaches have been proposed to facilitate these special types of numerical integration, which have been shown to have a large impact on the accuracy and the convergence of the numerical solution. The smoothed extended finite element method (XFEM), for example, makes numerical integration elegant and simple by transforming volume integrals into surface integrals. However, it was reported in the literature that the strain smoothing is inaccurate when non‐polynomial functions are in the basis. In this paper, we investigate the benefits of a recently developed Linear smoothing procedure which provides better approximation to higher‐order polynomial fields in the basis. Some benchmark problems in the context of linear elastic fracture mechanics are solved and the results are compared with existing approaches. We observe that the stress intensity factors computed through the proposed linear smoothed XFEM is more accurate than that obtained through smoothed XFEM.
Extended isogeometric analysis based on PHT‐splines for crack propagation near inclusions
Authors: Nguyen‐Thanh Nhon , Zhou Kun
Published: May 2017

Adaptive local refinement is one of the main issues for isogeometric analysis (IGA). In this paper, an adaptive extended IGA (XIGA) approach based on polynomial splines over hierarchical T‐meshes (PHT‐splines) for modeling crack propagation is presented. The PHT‐splines overcome certain limitations of nonuniform rational B‐splines–based formulations; in particular, they make local refinements feasible. To drive the adaptive mesh refinement, we present a recovery‐based error estimator for the proposed method. The method is based on the XIGA method, in which discontinuous enrichment functions are added to the IGA approximation and this method does not require remeshing as the cracks grow. In addition, crack propagation is modeled by successive linear extensions that are determined by the stress intensity factors under linear elastic fracture mechanics. The proposed method has been used to analyze numerical examples, and the stress intensity factors results were compared with reference results. The findings demonstrate the accuracy and efficiency of the proposed method.
What Is ‘Kariera’? Detecting Systems and Overlap in Australian Kinship Using the AustKin Database
Authors: McConvell Patrick , Hendery Rachel
Published: May 2017

Radcliffe‐Brown introduced the concept of a ‘Kariera’ type of kinship system in proposing his highly influential typology of Australian social organization, building on his earlier reports of fieldwork in the Pilbara of northern Western Australia, in which the Kariera (Kariyarra) people were taken to represent a widespread type. Radcliffe‐Brown's and other typologies of Australian kinship have generally disregarded the universalist categorizations (going back to Fison and Howitt's assignment of Kariera‐type systems to the Dravidian category), in favour of a scheme based on Australia alone. In the spirit of Radcliffe‐Brown's typology, we propose a diagnostic pattern of kinship term equivalences for grandkin such as FF = MMB (father's father is equivalent to mother's mother's brother), which can be operationalized in search‐map routines of a database known as AustKin and closely approximates to the set of systems generally recognized as ‘Kariera’. However another property of many Kariera grandkin systems which has been claimed to be criterial by some scholars – equivalence between grandkin and grandchild generations (+2 and −2), or Alternate Generation Equivalence – is shown to be more widespread than Kariera and independent of it. With regard to the −1 generation (children and niblings), the pattern among the Kariyarra and more generally in the western Pilbara and Western Desert (where ‘son’ and ‘daughter’ are distinguished) is radically different from the pattern found in the other ‘Kariera’ systems across the rest of the continent, (where ‘woman's child’ vs. ‘man's child’ is the prime distinction). This prompts analysis of the child patterns as independent of the Kariera system. This article also shows how the Kariera system is independent of the four‐section system with which it has been claimed to be related functionally, with sections being a later development. We also encounter overlaps, where more than one equivalence pattern intersect in one language, and overlays, where the variation between more than one equivalence also has social contextual functions. Examples of overlaps analysed here are (1) between Kariera and Aluridja (the Western Desert pattern with cross‐parallel neutralization); and (2) between Kariera and a more radical kind of Alternate Generation Equivalence, where parallel grandkin and grandchildren kin‐types are called siblings (generation 0).
Effects of thinner on RTV silicone rubber nanocomposites reinforced with GR and CNTs
Authors: Kumar Vineet , Lee Dong‐Joo
Published: May 2017

The effects of thinner on rubber specimens with carbon nanotubes (CNTs) and graphitic nanofillers (GR) was studied for robotics applications. Rubber specimens were prepared by dispersing GR, CNTs and thinner in room temperature vulcanized (RTV) silicone rubber through solution mixing. Microscopic studies have confirmed occurrence of swelling in polymer chains due to migration of thinner. It results an increase in topological depth from 40 nm (no thinner) to 120 nm (40 phr of thinner). An elastic modulus of ~4.4 MPa (without thinner) was higher than 2.8 MPa (10 phr of thinner). At 100% strain, the lower dissipation losses of 110% (without thinner) and 70% (40 phr of thinner) were obtained. The resistance increases from 4.6 kΩ (without thinner) to 5.7 kΩ (10 phr of thinner). At 0.4‐mm‐thick elastomer slab, an actuation displacement of 0.81 mm (without thinner) was obtained which increased to 1.1 mm (60 phr of thinner). Thus, the thinner can be useful for easier processing, controlled stiffness, minimizing dissipation losses, increasing the actuation displacement and decreasing the cost of the device. Copyright © 2017 John Wiley & Sons, Ltd.
Analgesic and anti‐inflammatory properties of novel, selective, and potent EP4 receptor antagonists
Authors: Chandrasekhar Srinivasan , Yu Xiao‐Peng , Harvey Anita K. , Oskins Jennifer L. , Lin Chaohua , Wang Xushan , Blanco Maria‐Jesus , Fisher Matthew J. , Kuklish Steven L. , Schiffler Matthew A. , Vetman Tatiana , Warshawsky Alan M. , York Jeremy S. , Bendele Alison M. , Chambers Mark G.
Published: May 2017

Prostaglandin (PG) E2 is the key driver of inflammation associated with arthritic conditions. Inhibitors of PGE2 production (NSAIDs and Coxibs) are used to treat these conditions, but carry significant side effect risks due to the inhibition of all prostanoids that play important physiological function. The activities of PGE2 are transduced through various receptor sub‐types. Prostaglandin E2 type 4 receptor (EP4) is associated with the development of inflammation and autoimmunity. We therefore are interested in identifying novel EP4 antagonists to treat the signs and symptoms of arthritis without the potential side effects of PGE2 modulators such as NSAIDs and Coxibs. Novel EP4 antagonists representing distinct chemical scaffolds were identified using a variety of in vitro functional assays and were shown to be selective and potent. The compounds were shown to be efficacious in animal models of analgesia, inflammation, and arthritis.
Luminescent electrospun nanofibers doped with organic dye: Toward a disentangled deposition
Authors: Haru Yuki , Tomioka Akihiro
Published: May 2017

Luminescent organic nanofibers were fabricated by electrospinning the mixture of polar polymer polyacrylonitrile and rhodamine 6G dissolved in polar solvent dimethylformamide. SEM observations revealed that large volumes of nanofibers were successfully fabricated at the line velocity of 8 m s−1 with constant diameter along the whole length of nanofibers. Fluorescence optical microscopy revealed that homogeneously luminescent nanofibers were deposited on a rotating cylinder electrode with reduced entanglement, opening a novel usage as detached separate nanofibers: when intentionally embedded in commercial textiles, they will function as, for example, forensic tracking owing to the invisibility to naked eyes.
“The Way That I Look at Things [Is] Different Because It's Me”: Constructing and Deconstructing Narratives About Racialized Sexual Selves
Authors: Montemurro Beth
Published: May 2017

Many gender scholars have abandoned the notion that we can explore women's experiences without attention to other identities such as race, class, and/or sexual orientation. Until now, the ways race influences the development of sexual selves has been underexplored. In this paper, I focus on heterosexual women's accounts of the interplay of race, gender, and sexualities. Based on in‐depth interviews with sixty‐two white and African American heterosexual women between the ages of twenty and sixty‐eight, I examine the ways in which narrative work tells a story about the presentation of public sexual selves. I also explore how women's personal narratives are impacted by larger cultural narratives about race. Specifically, through a study of sexuality, I focus on the social construction of “postracialism.”
Investigation of the NREL phase VI experiment with the incompressible CFD solver THETA
Authors: Länger‐Möller A. , Löwe J. , Kessler R.
Published: May 2017

DLR's incompressible flow solver THETA is introduced for wind turbine applications on the isolated NREL phase VI Unsteady Aerodynamic Experiment rotor. The optimization of parameter settings for the prediction of attached and separated flows on the rotor is performed, including time step size, spatial discretization scheme, turbulence models and Chimera overset grid technique. Afterwards, a systematic study on the pressure distributions, rotor thrust and rotor torque for experimental series S, I and J is performed. The accuracy of results for wind velocities between 7 and 25 m s[[EQUATION1]], covering attached, partly separated and deep stalled flow conditions, is discussed. While good to excellent agreement between THETA sectional pressure distributions and the experimental reference data is achieved in attached flow and deep stall configurations, more efforts are needed to predict partly separated flow cases with comparable accuracy. A code‐to‐code comparison with DLR's compressible flow solver TAU enabled the quantification of differences in pressure prediction because of the use of incompressible and compressible flow solvers. Copyright © 2017 John Wiley & Sons, Ltd.
The Presence of Postoperative Infectious Complications is Associated with the Risk of Early Postoperative Clinical Recurrence of Crohn’s Disease
Authors: Guo Zhen , Cao Lei , Guo Feilong , Gong Jianfeng , Li Yi , Gu Lili , Zhu Weiming , Li Jieshou
Published: May 2017

Background

The purpose of the study was to identify risk factors for early clinical and surgical recurrence in Crohn’s disease (CD) patients who underwent intestinal resection.

Method

This was a retrospective study. Consecutive patients who underwent intestinal resection with a primary anastomosis from January 2011–December 2014 were enrolled. Gender, age at surgery, clinical phenotypes of CD, serum albumin and C‐reactive protein level the day before surgery, smoking status at surgery, anastomosis technique, number of anastomoses, details of postoperative complications, the postoperative prophylactic treatment were assessed to figure out risk factors for postoperative clinical and surgical recurrence within 1 year after the initial resection by univariate and then multivariate analysis.

Results

Two hundred and thirty‐seven patients were analyzed. The risk of early postoperative clinical recurrence was 2.99 times higher in patients suffered postoperative infectious complications [odds ratio (OR) 2.99; 95% CIs, 1.42–6.32; p = 0.004], while never‐smoking was found to be a protective factor for early clinical recurrence (OR 0.326; 95% CIs, 0.18–0.59; p < 0.0001). For surgical recurrence within 1 year after resection, the presence of postoperative intra‐abdominal septic complications might be a risk factor (OR 6.77; 95% CIs, 1.61–28.5; p = 0.009). Smoker at surgery was also a risk factor for early surgical recurrence (OR 5.41; 95% CIs, 1.36–21.5; p = 0.017).

Conclusion

The presence of postoperative infectious complications was identified as a possible risk factor for early postoperative clinical recurrence after resection in CD patients.
Shoulder Arthroplasty for Humeral Head Avascular Necrosis is Associated with Increased Postoperative Complications
Authors: Tyrrell Burrus M. , Cancienne Jourdan M. , Boatright Jeffrey D. , Yang Scott , Brockmeier Stephen F. , Werner Brian C.
Published: May 2017

Background

Humeral head avascular necrosis (AVN) of differing etiologies may lead to shoulder arthroplasty due to subchondral bone collapse and deformity of the articular surface. There have been no large studies evaluating the complications for these patients after they undergo total shoulder arthroplasty (TSA).

Questions/Purposes

The first objective of this study is to evaluate the complication rate after TSA in patients with humeral head AVN. The secondary objective is to compare the complication rates among the different etiologies of the AVN.

Methods

Patients who underwent TSA were identified in the PearlDiver database using ICD-9 codes. Patients who underwent shoulder arthroplasty for humeral head AVN were identified using ICD-9 codes and were subclassified according to AVN etiology (posttraumatic, alcohol use, chronic steroid use, and idiopathic). Complications evaluated included postoperative infection within 6 months, dislocation within 1 year, revision shoulder arthroplasty up to 8 years postoperatively, shoulder stiffness within 1 year, and periprosthetic fracture within 1 year and systemic complications within 3 months. Postoperative complication rates were compared to controls.

Results

The study cohorts included 4129 TSA patients with AVN with 141, 778 control TSA patients. Patients with posttraumatic AVN were significantly more likely to have a postoperative infection (OR 2.47, P < 0.001), dislocation (OR 1.45, P = 0.029), revision surgery (OR 1.53, P = 0.001), stiffness (OR 1.24, P = 0.042), and systemic complication (OR 1.49, P < 0.001). Steroid-associated AVN was associated with a significantly increased risk for a postoperative infection (OR 1.72, P = 0.004), revision surgery (OR 1.33, P = 0.040), fracture (OR 2.76, P = 0.002), and systemic complication (OR 1.59, P < 0.001). Idiopathic and alcohol-associated AVN were not significantly associated with any of the postoperative evaluated complications.

Conclusions

TSA in patients with humeral head AVN is associated with significantly increased rates of numerous postoperative complications compared to patients without a diagnosis of AVN, including infection, dislocation, revision arthroplasty, stiffness, periprosthetic fracture, and medical complications. Specifically, AVN due to steroid use or from a posttraumatic cause appears to be associated with the statistically highest rates of postoperative TSA complications. Given these findings, orthopedic surgeons should be increasingly aware of this association, which should influence the shared decision-making process of undergoing TSA in patients with humeral head AVN.
Modeling of Ti-W Solidification Microstructures Under Additive Manufacturing Conditions
Authors: Rolchigo Matthew R. , Mendoza Michael Y. , Samimi Peyman , Brice David A. , Martin Brian , Collins Peter C. , LeSar Richard
Published: May 2017

Additive manufacturing (AM) processes have many benefits for the fabrication of alloy parts, including the potential for greater microstructural control and targeted properties than traditional metallurgy processes. To accelerate utilization of this process to produce such parts, an effective computational modeling approach to identify the relationships between material and process parameters, microstructure, and part properties is essential. Development of such a model requires accounting for the many factors in play during this process, including laser absorption, material addition and melting, fluid flow, various modes of heat transport, and solidification. In this paper, we start with a more modest goal, to create a multiscale model for a specific AM process, Laser Engineered Net Shaping (LENS™), which couples a continuum-level description of a simplified beam melting problem (coupling heat absorption, heat transport, and fluid flow) with a Lattice Boltzmann-cellular automata (LB-CA) microscale model of combined fluid flow, solute transport, and solidification. We apply this model to a binary Ti-5.5 wt pct W alloy and compare calculated quantities, such as dendrite arm spacing, with experimental results reported in a companion paper.
Fatty Acids Have Different Adipogenic Differentiation Potentials in Stromal Vascular Cells Isolated from Abdominal Fat in Laying Hens
Authors: Regassa Alemu , Suh Miyoung , Datar Jutika , Chen Chongxiao , Kim Woo Kyun
Published: May 2017

This study was conducted to examine the effects of fatty acids (FA) with/without chicken serum (CS) on the expression of adipogenic transcripts and adipogenesis in chicken stromal vascular cells (SVC). In experiment 1, SVC were grown in DMEM containing 10% FBS (Control) and treated with 300 µM oleic acid (OLA) + FBS, linoleic acid (LNA) + FBS, palmitic acid (PAM) + FBS, or stearic acid (STA) + FBS for 48 h. In experiment 2, cells were grown in DMEM containing 5% CS and treated with 300 µM OLA (CS + OLA), PAM (CS + PAM), STA (CS + STA) or 200 µM LNA (CS + LNA) for 48 h. Adipogenesis was determined using Oil Red O staining and glycerol‐3‐phosphate dehydrogenase (GPDH) activity. The proportion of OLA, PAM, or STA was increased (P < 0.05) in SVC grown in either FBS or CS with OLA, PAM or STA. Adipogenesis was induced in FBS + OLA, FBS + LNA, FBS + PAM, FBS + STA, CS + OLA, CS + LNA, CS + PAM, or CS + SAT compared to FBS. GPDH activity was significantly higher in FBS + OLA and FBS + LNA than one in FBS. Compared to FBS, the expression of FABP4 mRNA increased (P < 0.05) in FBS + OLA, FBS + LNA, or FBS + PAM, whereas that of C/EBPα, C/EBPβ, and ATGL increased (P < 0.05) in FBS + OLA or FBS + LNA cells. Expression of FABP4 and C/EBPβ mRNA was higher in CS, CS + OLA, CS + LNA, CS + PAM, or CS + SAT compared with (FBS, whereas the expression of ATGL and C/EBPα was higher in CS, CS + OLA, or CS + LNA than FBS cells. In conclusion, these results showed that FA have different potentials to induce adipogenesis, LNA is the most potent among the tested FA, and these potentials can be improved in the presence of CS.
Basic Biostatistical Concepts for the Fetal Physician—II: Population, Sample, and Hypothesis Testing
Authors: Manikandan K. , Suresh Sudarshan , Seshadri Suresh
Published: May 2017

In the ever expanding field of fetal medicine, the practitioners need to be equipped with the basic knowledge of the biostatistical concepts that are used in biomedical research. In this series, we explain these concepts that are relevant to day to day practice using simple clinician’s language, illustrated with examples from the fetal medicine literature. In this paper, we explain the concepts of population, sample, inferential statistics, and hypothesis testing.
Combined mnemonic strategy training and high‐definition transcranial direct current stimulation for memory deficits in mild cognitive impairment
Authors: Hampstead Benjamin M. , Sathian Krishnankutty , Bikson Marom , Stringer Anthony Y.
Published: May 2017

Introduction

Memory deficits characterize Alzheimer's dementia and the clinical precursor stage known as mild cognitive impairment. Nonpharmacologic interventions hold promise for enhancing functioning in these patients, potentially delaying functional impairment that denotes transition to dementia. Previous findings revealed that mnemonic strategy training (MST) enhances long‐term retention of trained stimuli and is accompanied by increased blood oxygen level–dependent signal in the lateral frontal and parietal cortices as well as in the hippocampus. The present study was designed to enhance MST generalization, and the range of patients who benefit, via concurrent delivery of transcranial direct current stimulation (tDCS).

Methods

This protocol describes a prospective, randomized controlled, four‐arm, double‐blind study targeting memory deficits in those with mild cognitive impairment. Once randomized, participants complete five consecutive daily sessions in which they receive either active or sham high definition tDCS over the left lateral prefrontal cortex, a region known to be important for successful memory encoding and that has been engaged by MST. High definition tDCS (active or sham) will be combined with either MST or autobiographical memory recall (comparable to reminiscence therapy). Participants undergo memory testing using ecologically relevant measures and functional magnetic resonance imaging before and after these treatment sessions as well as at a 3‐month follow‐up. Primary outcome measures include face‐name and object‐location association tasks. Secondary outcome measures include self‐report of memory abilities as well as a spatial navigation task (near transfer) and prose memory (medication instructions; far transfer). Changes in functional magnetic resonance imaging will be evaluated during both task performance and the resting‐state using activation and connectivity analyses.

Discussion

The results will provide important information about the efficacy of cognitive and neuromodulatory techniques as well as the synergistic interaction between these promising approaches. Exploratory results will examine patient characteristics that affect treatment efficacy, thereby identifying those most appropriate for intervention.
LO42: Ice Cream Rounds: the adaptation and implementation of a peer-support wellness rounds in an emergency medicine residency training program
Authors: Calder-Sprackman S.M. , Kumar T. , Sampsel K. , Gerin-Lajoie C.
Published: May 2017

Introduction/Innovation Concept: Emergency Medicine (EM) is a specialty that requires physicians to deal with acutely ill patients in a fast-paced environment, which can create stress, mental exhaustion and burnout. Continually changing working teams in the Emergency Department does not always allow appropriate debriefing for difficult patient encounters and outcomes on shift. To address these challenges, we sought to adapt and implement a peer-support rounds called ‘Ice Cream Rounds’ used in some Pediatric training programs for an EM training program. Methods: CCFP and Royal College EM residents were surveyed to determine interest and need for Ice Cream Rounds. Of the 31/50 respondents, 87% (26/31) identified their co-residents as their main source of support after difficult patient encounters and 71% (22/31) felt that current opportunities to debrief after difficult experiences were only “sometimes” or “rarely” adequate. Overall, 84% (26/31) were interested in attending Ice Cream Rounds. Residents expressed that they did not want staff present for Ice Cream Rounds so two residents (SCS and TK) obtained training to lead peer-support sessions from The Faculty of Medicine Wellness Program. Attendance at rounds was voluntary and the EM program provided funding for refreshments. Two Ice Cream Rounds were piloted. Attendance and feedback was recorded from pilot sessions. Curriculum, Tool, or Material: Resident-only, peer-run confidential debriefing sessions. Sessions were voluntary and lasted one hour. Approximately 20-30/50 residents attended each Ice Cream Rounds. Discussions were confidential but include topics such as difficult patient encounters, poor patient outcomes, challenges in residency, and ethical issues. In response to positive attendance and feedback, the EM program provided 3-4 one-hour protected time slots with a stipend for refreshments for future academic years. Comments from residents consistently reaffirmed that Ice Cream Rounds was a helpful forum to discuss important issues with colleagues and provided a safe and confidential resource to help cope with residency challenges. Conclusion: We adapted, implemented, and evaluated a novel Peer-Support Wellness Rounds for debriefing resident issues and difficult patient encounters in a EM training program. To our knowledge this is the first Canadian initiative to implement such rounds in an EM training program. We believe that this template can be easily adopted by any EM training program and will effectively address wellness challenges faced by residents during their training.
LO52: Combination of easily measurable real time variables to predict ED crowding
Authors: Clouston R.V. , Howlett M. , Stoica G. , Fraser J. , Atkinson P.R.
Published: May 2017

Introduction: Almost every domain of quality is reduced in crowded emergency departments (ED), with significant challenges around the definition, measurement and interventions for ED crowding. We wished to determine if a combination of 3 easily measurable variables could perform as well as standard tools (NEDOCS score and a NEDOCS-derived LOCAL tool) in predicting ED crowding at a tertiary hospital with 57,000 visits per year. Methods: Over a 2-week period, we recorded ED crowding predictor variables and calculated NEDOCS and LOCAL scores. These were compared every 2 hours to a reference standard Physician Visual Analog Scale (range 0 to 10) impression of crowding to determine if any combination of variables outperformed NEDOCS and LOCAL (crowded=5 or greater). Five numeric variables performed well under univariate analysis: i) Total ED Patients; ii) Patients in ED beds + Waiting Room; iii) Boarded Patients; iv) Waiting Room Patients; v) Patients in beds To Be Seen. These underwent multivariate, log regression with stratification and bootstrapping to account for incomplete data and seasonal and daily effect. Results: 143 out of a possible 168 observations were completed. Two different combinations of 3 variables outperformed NEDOCS and LOCAL. The most powerful combination was: Boarded Patients; plus Waiting Room Patients; plus Patients in beds To Be Seen, with Sensitivity 81% and Specificity 76% (r=0.844, β=0.712, p<0.0001, strong positive correlation). This compared favourably with NEDOCS and LOCAL, each with Sensitivity 71% and Specificity 64%[PA1] (r=0.545 and r=0.640 respectively). We will also present a sensitivity and specificity analysis of all combinations of predictor variables, using various reference standard cut-offs for crowding. Conclusion: A combination of 3 easily measurable ED variables (Boarded Patients; plus Waiting Room Patients; plus Patients in beds To Be Seen) performed better than the validated NEDOCS tool and a NEDOCS-derived LOCAL score at predicting ED crowding. Work is on going to design a simple tool that can predict crowding in real time and facilitate early interventions. Correlation with ED system and clinical outcomes should be studied in different ED environments.
LO55: A pilot evaluation of medical scribes in a Canadian emergency department
Authors: Graves P.S. , Graves S.R. , Minhas T. , Lewinson R.E. , Vallerand I.A. , Lewinson R.T.
Published: May 2017

Introduction: Improving emergency department productivity has been a priority across Canada. In the United States, medical scribes have been utilized to increase the number of patients seen per hour (PPH) per physician; however, it is not well known if these outcomes can be translated to Canada. The purpose of this pilot evaluation was to (a) establish proof-of-concept of medical scribes in Canada and (b) gain experience in scribe implementation so as to inform future directions for the use of scribes in Canada. It was hypothesized that use of medical scribes would result in a greater PPH per physician. Methods: We conducted a four-month pilot evaluation of medical scribes in the emergency department of the Queensway-Carleton Hospital in Ottawa, Ontario. Eleven scribes were utilized in the study ranging in age from 18 to 23 years old. Following scribe training and an initial two-month acclimation period for both scribes and physicians, data collection began January 2015. Twenty-two full or part time emergency physicians were followed in this study, who received shifts with and without a scribe over the next four months. Physician work hours as well as the number of patients seen by each physician on each shift was documented. From these metrics, PPH per physician was calculated for each shift. Across the four months, the average PPH was determined for each physician during shifts with a scribe and shifts without a scribe. Two-tailed paired-samples t-tests (α=0.05) were used to compare mean (SD) PPH within physicians based on presence or absence of a scribe. Results: A total of 463 physician hours were documented without use of a scribe and 693.75 physician hours were documented with use of a scribe. Across all 22 physicians in the study, 18 (81.8%) demonstrated a greater PPH with use of a scribe. Overall, PPH per physician was significantly greater (12.9%) during shifts with a scribe (mean 2.81, SD 0.78) compared to shifts without a scribe (mean 2.49, SD 0.60) (p=0.006). Sensitivity analyses revealed that PPH per physician during shifts without a scribe during the study period were similar to the year prior, before scribes were introduced to the hospital (p=0.315). Conclusion: Use of medical scribes resulted in an increased PPH per physician in our hospital. While these results were from an evaluation at a single centre, they support broader implementation and evaluation of scribes in more centres across Canada.
LO56: Novel role of physician navigators on performance indicators in the emergency department
Authors: Leung A. , Puri G. , Chen B. , Gong Z. , Chan E. , Feng E. , Duic M.
Published: May 2017

Introduction: Burnout rates for emergency physicians (EP) continue to be amongst the highest in medicine. One of the commonly cited sources of stress contributing to disillusionment is bureaucratic tasks that distract EPs from direct patient care in the emergency department (ED). The novel position of Physician Navigator was created to help EPs decrease their non-clinical workload during shifts, and improve productivity. Physician Navigators are non-licensed healthcare team members that assist in activities which are often clerical in nature, but directly impact patient care. This program was implemented at no net-cost to the hospital or healthcare system. Methods: In this retrospective study, 6845 clinical shifts worked by 20 EPs over 39 months from January 1, 2012 to March 31, 2015 were evaluated. The program was implemented on April 1, 2013. The primary objective was to quantify the effect of Physician Navigators on measures of EP productivity: patient seen per hour (Pt/hr), and turn-around-time (TAT) to discharge. Secondary objectives included examining the impact of Physician Navigators on measures of ED throughput for non-resuscitative patients: emergency department length of stay (LOS), physician-initial-assessment times (PIA), and left-without-being-seen rates (LWBS). A mixed linear model was used to evaluate changes in productivity measures between shifts with and without Physician Navigators in a clustered design, by EP. Autoregressive modelling was performed to compare ED throughput metrics before and after the implementation of Physician Navigators for non-resuscitative patients. Results: Across 20 EPs, 2469 shifts before, and 4376 shifts after April 1, 2013 were analyzed. Daily patient volumes increased 8.7% during the period with Physician Navigators. For the EPs who used Physician Navigators, Pt/hr increased by 1.07 patients per hour (0.98 to 1.16, p<0.001), and TAT to discharge decreased by 10.6 minutes (-13.2 to -8.0, p<0.001). After the implementation of the Physician Navigators, overall LOS for non-resuscitative patients decreased by 2.6 minutes (1.0%, p=0.007), and average PIA decreased by 7.4 minutes (12.0%, p<0.001). LBWS rates decreased by 43.9% (0.50% of daily patient volume, p<0.001). Conclusion: The use of a Physician Navigator was associated with increased EP productivity as measured by Pt/hr, and TAT to discharge, and reductions in ED throughput metrics for non-resuscitative patients.