bluuebunny/crossref_metadata_2025 huggingface dataset:
Anal canal squamous carcinoma
Authors: Magalhães Maricruz Nunes , Barbosa Laura Elisabete Ribeiro
Published: September 2016

Background Anal canal carcinoma is a rare neoplasm, representing 2% of the digestive tumors, and the most common is squamous cell carcinoma, with an increasing incidence.

Objective The study aims to elucidate the pathogenesis of an increasingly prevalent disease, as well as to update treatment and prognosis.

Methods A literature search in Pubmed database, including articles from 2005 to 2015 and cross-research articles with the initial research.

Results Several studies prove the role of HPV as a major risk factor in the development of squamous cell carcinoma of anal canal, as well as a greater prevalence of this neoplasia in HIV-positive people and in those who practice receptive anal intercourse. In the last two decades chemoradiotherapy remains the treatment of choice, and abdominoperineal resection is reserved for those cases of treatment failure or recurrence. Evidence advances in order to adapt the treatment to each patient, taking into account individual prognostic factors and biological tumor characteristics.

Conclusions Squamous cell carcinoma of the anal canal is a neoplasm associated with HPV; therefore, screening and vaccination programs of male individuals, by way of prevention, should be started. Many studies are needed in order to achieve development in the treatment as well as in the evaluation of the biological characteristics of the tumor.
Inappropriate shocks from a subcutaneous implantable cardioverter‐defibrillator due to oversensing during periods of rate‐related bundle branch block
Authors: Sousa Maria João , Betts Tim
Published: September 2016

The subcutaneous implantable cardioverter‐defibrillator (S‐ICD) is a novel technology with proven efficacy in sudden cardiac death prevention; however, there is a lack of long‐term safety data. We describe the case of a 55‐year‐old female patient implanted with an S‐ICD due to idiopathic ventricular fibrillation, who subsequently presented with inappropriate shocks leading to ventricular fibrillation that was successfully terminated by another shock. Inappropriate shocks were due to intermittent T wave oversensing during periods of rate‐dependent right bundle branch block. Assessment of the S‐ICD electrograms during an exercise test allowed successful reprogramming of the device's sensing vector with no further events.
Seeing the forest for the trees: Institutional environment impacts on reimbursement processes and healthcare operations
Authors: Lee Seung Jun , Abbey James D. , Heim Gregory R. , Abbey Duane C.
Published: September 2016

Healthcare reimbursement processes perform an annual multi‐trillion dollar task to remunerate healthcare organizations, physicians, and patients. Healthcare reimbursement entails coding, billing, and payment processes based on care provided to patients. As this research note highlights, though often implicitly assumed to be independent of care delivery processes, reimbursement processes are distinctly connected to the efficacy of care delivery. Prior research tends to examine neither antecedents nor consequences of healthcare reimbursement processes and their operational implications, even though these issues can lead to unproductive externalities affecting healthcare systems and patients. Most extant literature tends to focus on medical task environments, with far less attention given to how institutional environment structures reimbursement and thus drives stakeholder incentives and behaviors. Because of a wide diversity of institutional environments, reimbursement processes differ on a nation‐by‐nation basis, and within nations on a state, province, city, or even within‐city basis. The varied and complex reimbursement processes drive divergent stakeholder incentives, varying use of healthcare protocols and processes, and differing patient outcomes. Even within a single reimbursement regime, a multitude of reimbursement policies, required processes, and payer institutions creates operational complexity for physicians and their professional staff, which ultimately affects patient care delivery processes and outcomes. The task environment focus of extant healthcare OM research suggests a need to understand institutional environment antecedents, natures, and impacts of reimbursement processes. This research note illustrates the seemingly simple structural nature of reimbursement processes, yet also reminds researchers how diverse institutional environments, built to accomplish different healthcare aims, can lead to similar levels of enormous process complexity. The research note further motivates how such phenomena may affect research findings and the quest for operational solutions to healthcare dilemmas. By focusing on healthcare reimbursement and its operational implications, the note provides useful insights for continued studies of healthcare operations.
Hepatitis D virus infections among injecting drug users with and without human immunodeficiency virus infection in Taiwan
Authors: Hsieh Meng‐Hsuan , Wang Shu‐Chi , Hsieh Ming‐Yen , Huang Chung‐Feng , Yeh Ming‐Lun , Yang Jeng‐Fu , Chang Ko , Lin Wei‐Ru , Lin Chun‐Yu , Chen Tun‐Chieh , Huang Jee‐Fu , Dai Chia‐Yen , Tsai Jih‐Jin , Chuang Wan‐Long , Yu Ming‐Lung
Published: September 2016

In Taiwan, injecting drug use has been the main route of human immunodeficiency virus (HIV) transmission since 2005, with hepatitis B virus (HBV) and hepatitis D virus (HDV) also having similar transmission routes. This has now become an important public health issue. The aim of this study is to explore the conditions of HDV infections between injecting drug users (IDUs) with and without HIV infection in Southern Taiwan. In this study, 87 IDUs were enrolled, including 27 anti‐HDV seronegative IDUs and 60 anti‐HDV seropositive IDUs, and the results of their liver function tests, CD4 cell counts, and anti‐HIV and HIV RNA levels were analyzed. The prevalence of anti‐HDV seropositivity among hepatitis B surface antigen (HBsAg) seropositive IDUs in this study was 68.9% (60/87). The prevalence rate of anti‐HDV seropositive IDUs among anti‐HIV seronegative and anti‐HIV seropositive cases was 40.0% (12/30) and 84.2% (48/57), respectively. Anti‐HIV seropositivity was related to anti‐HDV seropositivity (odds ratio = 9.34, 95% confidence interval = 2.67–31.59, p < 0.001). Among IDUs with HIV infection, there was no significant difference in CD4 cell counts and HIV RNA viral load between HBsAg‐positive patients with anti‐HDV seronegativity and those with anti‐HDV seropositivity. In conclusion, the prevalence of HDV infection among IDUs is higher among IDUs with HIV infection. Because anti‐HIV seropositivity is significantly related to anti‐HDV seropositivity, HDV infection among IDUs is still important. We suggest that for IDUs, HBsAg and anti‐HDV should be monitored closely.
Comunidades virtuales en el curso de Fisiopatología Renal: percepción de la experiencia de los estudiantes
Authors: Segura-Azuara Nancy De los Ángeles , Eraña Rojas Irma Elisa , López Cabrera Mildred Vanessa
Published: September 2016

Introducción: Los ambientes de aprendizaje construidos en un grupo tienen efectos directos sobre el desempeño de sus integrantes. En la actualidad, los estudiantes de medicina se encuentran inmersos en redes de colaboración.

Objetivo: El objetivo de este estudio fue evaluar el impacto de la participación en una comunidad de aprendizaje virtual acoplada en las redes sociales, particularmente en la percepción de los estudiantes al terminar su participación en el curso.

Método: El estudio se realizó con una muestra de 80 estudiantes de tercer año estudiantes del curso de Fisiopatología Renal de una universidad privada. La metodología utilizada es de carácter descriptivo y transeccional a partir de un instrumento para evaluar la implementación realizada en el curso.

Resultados: De acuerdo a los resultados, los estudiantes consideran que se favorece una mayor oportunidad de interacción (49%), un mayor efecto en el aprendizaje (52%), motivación del aprendizaje (46%) y un mayor reto (44%). La participación fue más alta en la red de Facebook, registrando un 64%. Las aportaciones en tribuna libre e imágenes (71%) fueron las más utilizadas.

Conclusiones: Los alumnos perciben que el uso de comunidades de aprendizaje favorece el desarrollo de sus habilidades como: análisis desde múltiples perspectivas y la autodirección en el aprendizaje, las cuales son la base del aprendizaje a lo largo de la vida.
New aspects of the interpretation of the loess magnetic fabric, Cérna Valley succession, Hungary
Authors: Bradák-Hayashi Balazs , Biró Tamás , Horváth Erzsébet , Végh Tamás , Csillag Gábor
Published: September 2016

Anisotropy of magnetic susceptibility (AMS) is a frequently applied method in sedimentology, especially in the determination of the orientation of transport processes. We present an analysis of magnetic fabric (MF) studies on loess. New aspects of fabric development reveal: i) The deposition of the aeolian sediments was controlled by gravity, low-energy transport and local geomorphology, hence no clarified wind direction can be defined. ii) The influence of phyllosilicates is also significant among the magnetic components. iii) While the primary MF is relatively well-defined, the secondary MF is influenced by several processes. The analysis of stereoplots combined with the q—β diagram and photostatistics showed encouraging results during the characterization of various secondary MF such as redeposited MF and pedogenic fabric. iv) Changes in processes from aeolian to water-lain deposition and the increasing transportation energy were reflected by the connection between AMS and observed micro-scale sedimentary features. v) A relationship was obvious between the degree of pedogenesis and the transformation of sedimentary MF into a vertical MF typical for paleosols. vi) The significant role of very fine grained magnetite on the formation of inverse MF could not be excluded.
Physical measures for infinitely renormalizable Lorenz maps
Authors: MARTENS M. , WINCKLER B.
Published: September 2016

A physical measure on the attractor of a system describes the statistical behavior of typical orbits. An example occurs in unimodal dynamics: namely, all infinitely renormalizable unimodal maps have a physical measure. For Lorenz dynamics, even in the simple case of infinitely renormalizable systems, the existence of physical measures is more delicate. In this article, we construct examples of infinitely renormalizable Lorenz maps which do not have a physical measure. A priori bounds on the geometry play a crucial role in (unimodal) dynamics. There are infinitely renormalizable Lorenz maps which do not have a priori bounds. This phenomenon is related to the position of the critical point of the consecutive renormalizations. The crucial technical ingredient used to obtain these examples without a physical measure is the control of the position of these critical points.
Volume hyperbolicity and wildness
Authors: BONATTI CHRISTIAN , SHINOHARA KATSUTOSHI
Published: September 2016

It is known that volume hyperbolicity (partial hyperbolicity and uniform expansion or contraction of the volume in the extremal bundles) is a necessary condition for robust transitivity or robust chain recurrence and hence for tameness. In this paper, on any $3$-manifold we build examples of quasi-attractors which are volume hyperbolic and wild at the same time. As a main corollary, we see that, for any closed $3$-manifold $M$, the space $\text{Diff}^{1}(M)$ admits a non-empty open set where every $C^{1}$-generic diffeomorphism has no attractors or repellers. The main tool of our construction is the notion of flexible periodic points introduced in the authors’ previous paper. In order to eject the flexible points from the quasi-attractor, we control the topology of the quasi-attractor using the notion of partially hyperbolic filtrating Markov partitions, which we introduce in this paper.
Entropy of systems
Authors: MUNTEANU RADU B.
Published: September 2016

In this paper we show that any ergodic measure preserving transformation of a standard probability space which is $\text{AT}(n)$ for some positive integer $n$ has zero entropy. We show that for every positive integer $n$ any Bernoulli shift is not $\text{AT}(n)$. We also give an example of a transformation which has zero entropy but does not have property $\text{AT}(n)$ for any integer $n\geq 1$.
Commuting pairs of endomorphisms of
Authors: KAUFMANN LUCAS
Published: September 2016

We consider commuting pairs of holomorphic endomorphisms of $\mathbb{P}^{2}$ with disjoint sequence of iterates. The case that has not been completely studied is when their degrees coincide after some number of iterations. We show in this case that they are either commuting Lattès maps or commuting homogeneous polynomial maps of $\mathbb{C}^{2}$ inducing a Lattès map on the line at infinity.
Discontinuity of Lyapunov exponents near fiber bunched cocycles
Authors: BUTLER CLARK
Published: September 2016

We give examples of locally constant $\text{SL}(2,\mathbb{R})$-cocycles over a Bernoulli shift that are discontinuity points for Lyapunov exponents in the Hölder topology and are arbitrarily close to satisfying the fiber bunching inequality. Backes, Brown, and the author [Continuity of Lyapunov exponents for cocycles with invariant holonomies. Preprint, 2015, arXiv:1507.08978] have shown that the Lyapunov exponents vary continuously when restricted to the space of fiber bunched Hölder continuous cocycles. Our examples give evidence that this theorem is optimal within certain families of Hölder cocycles.
Zero-temperature phase diagram for double-well type potentials in the summable variation class
Authors: BISSACOT RODRIGO , GARIBALDI EDUARDO , THIEULLEN PHILIPPE
Published: September 2016

We study the zero-temperature limit of the Gibbs measures of a class of long-range potentials on a full shift of two symbols $\{0,1\}$. These potentials were introduced by Walters as a natural space for the transfer operator. In our case, they are constant on a countable infinity of cylinders and are Lipschitz continuous or, more generally, of summable variation. We assume that there exist exactly two ground states: the fixed points $0^{\infty }$ and $1^{\infty }$. We fully characterize, in terms of the Peierls barrier between the two ground states, the zero-temperature phase diagram of such potentials, that is, the regions of convergence or divergence of the Gibbs measures as the temperature goes to zero.
RELAY SOWING OF WHEAT IN THE COTTON–WHEAT CROPPING SYSTEM IN NORTH-WEST INDIA: TECHNICAL AND ECONOMIC ASPECTS
Authors: SINGH MANPREET , SIDHU H. S. , MAHAL J. S. , MANES G. S. , JAT M. L. , MAHAL A. K. , SINGH PARVINDER , SINGH YADVINDER
Published: September 2016

Cotton–wheat (CW) is an important cropping system in South Asia. Wheat yields under a conventional CW system are generally lower compared to a rice–wheat system due to delayed seeding. Relay seeding of wheat can help timely sowing, capturing residual soil moisture of last irrigation to cotton, and increase the productivity and profitability of CW system. The field experiment included two Bt-cotton genotypes having different canopy cover (RCH 776 and MRC 7017), two types of relay seeders (RSs) for cotton planted at 67.5-cm and 101-cm row spacing and four types of relay seeding methods (manual broadcast, strip rotor (SR) and zero-till double disc and conventional till). Relay planting of wheat allowed one additional boll picking, which increased seed cotton yield by 12% compared with conventional tillage wheat. Cotton genotypes and RSs had no effect on emergence and yield of wheat. The RSs with SR and zero till double disc furrow openers performed better in terms of wheat emergence and grain yield compared to zero-till tine openers. Under relay seeding, wheat sowing was advanced by 31 days, which increased grain yield by 18.8% compared with conventional tillage practice. Net returns from the CW system with relay seeding of wheat were higher by US$ 311 to 425 ha−1 compared with the conventional CW system.
Hard X-ray emission from pulsar-wind nebulae
Authors: Reynolds Stephen P.
Published: September 2016

Pulsar-wind nebulae emit an extremely broad spectrum of continuum radiation, from low radio frequencies to TeV gamma rays. The part of the spectral energy distribution (SED) from radio through MeV gamma rays is due to synchrotron emission from a distribution of relativistic electrons (or pairs) which can be described by one or more power laws. This spectrum exhibits that particle energy distribution, responsible also for the higher-energy (GeV–TeV) part of the SED, due to inverse-Compton upscattering of one of three photon fields: the synchrotron spectrum, the cosmic microwave background, or ambient optical/infrared photons. However, in a few sources, primary hadrons may produce GeV–TeV gamma rays through the decay of neutral pions produced in inelastic cosmic-ray collisions with thermal gas. The higher-energy end of the particle spectrum, producing synchrotron photons above approximately 10 keV, holds clues to the particle acceleration process. However, its detailed study requires imaging spectroscopy in this energy range, not available until the NuSTAR mission beginning in 2012, which performs true imaging between 3 and 78 keV with ${\sim}1^{\prime }$ angular resolution. I review NuSTAR observations of the first three pulsar-wind nebulae (PWNe) to be examined in this way: the Crab Nebula, G21.5–0.9 and MSH 15–52. All three show spectral structure not previously known: spectral steepening in certain locations and overall source shrinkage with increasing photon energy. The Crab Nebula has different shrinkage rates along the torus and along the northwest counter-jet. The latter rate is similar to that for both the other sources (FWHM $\propto E^{m}$ with $m\sim -0.2$). I discuss implications of these results for models of particle transport in PWNe.
X-ray powder diffraction data for deferasirox, C21H15N3O4
Authors: Du Qiaohong , Wang Qing , Xiong Xinnuo , Zeng Xia , Li Hui
Published: September 2016

X-ray powder diffraction data, unit-cell parameters, and space group for deferasirox, C21H15N3O4, are reported [a = 8.821(7) Å, b = 26.798(2) Å, c = 7.540(4) Å, α = 90°, β = 94.655(2)°, γ = 90°, unit-cell volume V = 1776.7(3) Å3, Z = 4, ρcal = 1.396 g cm−3, and space group P21/c]. All measured lines were indexed and are consistent with the P21/c space group. No detectable impurity was observed.
The HOME Team: Evaluating the Effect of an EMS-based Outreach Team to Decrease the Frequency of 911 Use Among High Utilizers of EMS
Authors: Tangherlini Niels , Villar Julian , Brown John , Rodriguez Robert M. , Yeh Clement , Friedman Benjamin T. , Wada Paul
Published: September 2016

Objectives

The San Francisco Fire Department’s (SFFD; San Francisco, California USA) Homeless Outreach and Medical Emergency (HOME) Team is the United States’ first Emergency Medical Services (EMS)-based outreach effort using a specially trained paramedic to redirect frequent users of EMS to other types of services. The effectiveness of this program at reducing repeat use of emergency services during the first seven months of the team’s existence was examined.

Methods

A retrospective analysis of EMS use frequency and demographic characteristics of frequent users was conducted. Clients that used emergency services at least four times per month from March 2004 through May 2005 were contacted for intervention. Patterns for each frequent user before and after intervention were analyzed. Changes in EMS use during the 15-month study interval was the primary outcome measurement.

Results

A total of 59 clients were included. The target population had a median age of 55.1 years and was 68% male. Additionally, 38.0% of the target population was homeless, 43.4% had no primary care, 88.9% had a substance abuse disorder at time of contact, and 83.0% had a history of psychiatric disorder. The HOME Team undertook 320 distinct contacts with 65 frequent users during the study period. The average EMS use prior to HOME Team contact was 18.72 responses per month (SD=19.40), and after the first contact with the HOME Team, use dropped to 8.61 (SD=10.84), P<.001.

Conclusion

Frequent users of EMS suffer from disproportionate comorbidities, particularly substance abuse and psychiatric disorders. This population responds well to the intervention of a specially trained paramedic as measured by EMS usage.

TangherliniN, VillarJ, BrownJ, RodriguezRM, YehC, FriedmanBT, WadaP. The HOME Team: evaluating the effect of an EMS-based outreach team to decrease the frequency of 911 use among high utilizers of EMS. Prehosp Disaster Med. 2016;31(6):603–607.
Intubation of Profoundly Agitated Patients Treated with Prehospital Ketamine
Authors: Olives Travis D. , Nystrom Paul C. , Cole Jon B. , Dodd Kenneth W. , Ho Jeffrey D.
Published: September 2016

Background

Profound agitation in the prehospital setting confers substantial risk to patients and providers. Optimal chemical sedation in this setting remains unclear.

Objective

The goal of this study was to describe intubation rates among profoundly agitated patients treated with prehospital ketamine and to characterize clinically significant outcomes of a prehospital ketamine protocol.

Methods

This was a retrospective cohort study of all patients who received prehospital ketamine, per a predefined protocol, for control of profound agitation and who subsequently were transported to an urban Level 1 trauma center from May 1, 2010 through August 31, 2013. Identified records were reviewed for basic ambulance run information, subject characteristics, ketamine dosing, and rate of intubation. Emergency Medical Services (EMS) ambulance run data were matched to hospital-based electronic medical records. Clinically significant outcomes are characterized, including unadjusted and adjusted rates of intubation.

Results

Overall, ketamine was administered 227 times in the prehospital setting with 135 cases meeting study criteria of use of ketamine for treatment of agitation. Endotracheal intubation was undertaken for 63% (85/135) of patients, including attempted prehospital intubation in four cases. Male gender and late night arrival were associated with intubation in univariate analyses (χ2=12.02; P=.001 and χ2=5.34; P=.021, respectively). Neither ketamine dose, co-administration of additional sedating medications, nor evidence of ethanol (ETOH) or sympathomimetic ingestion was associated with intubation. The association between intubation and both male gender and late night emergency department (ED) arrival persisted in multivariate analysis. Neither higher dose (>5mg/kg) ketamine nor co-administration of midazolam or haloperidol was associated with intubation in logistic regression modeling of the 120 subjects with weights recorded. Two deaths were observed. Post-hoc analysis of intubation rates suggested a high degree of provider-dependent variability.

Conclusions

Prehospital ketamine is associated with a high rate of endotracheal intubation in profoundly agitated patients; however, ketamine dosing is not associated with intubation rate when adjusted for potential confounders. It is likely that factors not included in this analysis, including both provider comfort with post-ketamine patients and anticipated clinical course, play a role in the decision to intubate patients who receive prehospital ketamine.

OlivesTD, NystromPC, ColeJB, DoddKW, HoJD. Intubation of profoundly agitated patients treated with prehospital ketamine. Prehosp Disaster Med. 2016;31(6):593–602.
Preparing Emergency Physicians for Acute Disaster Response: A Review of Current Training Opportunities in the US
Authors: Hansoti Bhakti , Kellogg Dylan S. , Aberle Sara J. , Broccoli Morgan C. , Feden Jeffrey , French Arthur , Little Charles M. , Moore Brooks , Sabato Joseph , Sheets Tara , Weinberg R. , Elmes Pat , Kang Christopher
Published: September 2016

Study Objective

This study aimed to review available disaster training options for health care providers, and to provide specific recommendations for developing and delivering a disaster-response-training program for non-disaster-trained emergency physicians, residents, and trainees prior to acute deployment.

Methods

A comprehensive review of the peer-reviewed and grey literature of the existing training options for health care providers was conducted to provide specific recommendations.

Results

A comprehensive search of the Pubmed, Embase, Web of Science, Scopus, and Cochrane databases was performed to identify publications related to courses for disaster preparedness and response training for health care professionals. This search revealed 7,681 unique titles, of which 53 articles were included in the full review. A total of 384 courses were found through the grey literature search, and many of these were available online for no charge and could be completed in less than six hours. The majority of courses focused on management and disaster planning; few focused on clinical care and acute response.

Conclusion

There is need for a course that is targeted toward emergency physicians and trainees without formal disaster training. This course should be available online and should utilize a mix of educational modalities, including lectures, scenarios, and virtual simulations. An ideal course should focus on disaster preparedness, and the clinical and non-clinical aspects of response, with a focus on an all-hazards approach, including both terrorism-related and environmental disasters.

HansotiB, KelloggDS, AberleSJ, BroccoliMC, FedenJ, FrenchA, LittleCM, MooreB, SabatoJJr., SheetsT, WeinbergR, ElmesP, KangC. Preparing emergency physicians for acute disaster response: a review of current training opportunities in the US. Prehosp Disaster Med. 2016;31(6):643–647.
Thoracic Spine Fracture in a Survivor of Out-of-Hospital Cardiac Arrest with Mechanical CPR
Authors: Marshall Robert Trevor , Kotecha Hemang , Chiba Takuyo , Tennyson Joseph
Published: September 2016

This is a report of a thoracic vertebral fracture in a 79-year-old male survivor of out-of-hospital cardiac arrest with chest compressions provided by a LUCAS 2 (Physio-Control Inc.; Lund Sweden) device. This is the first such report in the literature of a vertebral fracture being noted in a survivor of cardiac arrest where an automated compression device was used.

MarshallRT, KotechaH, ChibaT, TennysonJ. Thoracic spine fracture in a survivor of out-of-hospital cardiac arrest with mechanical CPR. Prehosp Disaster Med. 2016;31(6):684–686.
An Observational Study Using English Syndromic Surveillance Data Collected During the 2012 London Olympics – What did Syndromic Surveillance Show and What Can We Learn for Future Mass-gathering Events?
Authors: Todkill Dan , Hughes Helen E. , Elliot Alex J. , Morbey Roger A. , Edeghere Obaghe , Harcourt Sally , Hughes Tom , Endericks Tina , McCloskey Brian , Catchpole Mike , Ibbotson Sue , Smith Gillian
Published: September 2016

Introduction

In preparation for the London 2012 Olympic Games, existing syndromic surveillance systems operating in England were expanded to include daily general practitioner (GP) out-of-hours (OOH) contacts and emergency department (ED) attendances at sentinel sites (the GP OOH and ED syndromic surveillance systems: GPOOHS and EDSSS).

Hypothesis/Problem

The further development of syndromic surveillance systems in time for the London 2012 Olympic Games provided a unique opportunity to investigate the impact of a large mass-gathering event on public health and health services as monitored in near real-time by syndromic surveillance of GP OOH contacts and ED attendances. This can, in turn, aid the planning of future events.

Methods

The EDSSS and GPOOHS data for London and England from July 13 to August 26, 2012, and a similar period in 2013, were divided into three distinct time periods: pre-Olympic period (July 13-26, 2012); Olympic period (July 27 to August 12); and post-Olympic period (August 13-26, 2012). Time series of selected syndromic indicators in 2012 and 2013 were plotted, compared, and risk assessed by members of the Real-time Syndromic Surveillance Team (ReSST) in Public Health England (PHE). Student’s t test was used to test any identified changes in pattern of attendance.

Results

Very few differences were found between years or between the weeks which preceded and followed the Olympics. One significant exception was noted: a statistically significant increase (P value = .0003) in attendances for “chemicals, poisons, and overdoses, including alcohol” and “acute alcohol intoxication” were observed in London EDs coinciding with the timing of the Olympic opening ceremony (9:00 pm July 27, 2012 to 01:00 am July 28, 2012).

Conclusions

Syndromic surveillance was able to provide near to real-time monitoring and could identify hourly changes in patterns of presentation during the London 2012 Olympic Games. Reassurance can be provided to planners of future mass-gathering events that there was no discernible impact in overall attendances to sentinel EDs or GP OOH services in the host country. The increase in attendances for alcohol-related causes during the opening ceremony, however, may provide an opportunity for future public health interventions.

TodkillD, HughesHE, ElliotAJ, MorbeyRA, EdeghereO, HarcourtS, HughesT, EndericksT, McCloskeyB, CatchpoleM, IbbotsonS, SmithG. An observational study using English syndromic surveillance data collected during the 2012 London Olympics – what did syndromic surveillance show and what can we learn for future mass-gathering events?Prehosp Disaster Med. 2016;31(6):628–634.
Epidemiology of Emergency Medical Services (EMS) Utilization in Four Indian Emergency Departments
Authors: Wijesekera Olindi , Reed Amanda , Chastain Parker S. , Biggs Shauna , Clark Elizabeth G. , Kole Tamorish , Chakrapani Anoop T. , Ashish Nandy , Rajhans Prasad , Breaud Alan H. , Jacquet Gabrielle A.
Published: September 2016

Introduction

Without a universal Emergency Medical Services (EMS) system in India, data on the epidemiology of patients who utilize EMS are limited. This retrospective chart review aimed to quantify and describe the burden of disease and patient demographics of patients who arrived by EMS to four Indian emergency departments (EDs) in order to inform a national EMS curriculum.

Methods

A retrospective chart review was performed on patients transported by EMS over a three-month period in 2014 to four private EDs in India. A total of 17,541 patient records were sampled from the four sites over the study period. Of these records, 1,723 arrived by EMS and so were included for further review.

Results

A range of 1.4%-19.4% of ED patients utilized EMS to get to the ED. The majority of EMS patients were male (59%-64%) and adult or geriatric (93%-99%). The most common chief complaints and ED diagnoses were neurological, pulmonary, cardiovascular, gastrointestinal, trauma, and infectious disease.

Conclusions

Neurological, pulmonary, cardiovascular, gastrointestinal, trauma, and infectious disease are the most common problems found in patients transported by EMS in India. Adult and geriatric male patients are the most common EMS utilizers. Emergency Medical Services curricula should emphasize these knowledge areas and skills.

WijesekeraO, ReedA, ChastainPS, BiggsS, ClarkEG, KoleT, ChakrapaniAT, AshishN, RajhansP, BreaudAH, JacquetGA. Epidemiology of Emergency Medical Services (EMS) utilization in four Indian emergency departments. Prehosp Disaster Med. 2016;31(6):675–679.
Emergency Medical Services Utilization in EMS Priority Conditions in Beirut, Lebanon
Authors: El Sayed Mazen , Tamim Hani , Chehadeh Ahel Al-Hajj , Kazzi Amin A.
Published: September 2016

Background

Early activation and use of Emergency Medical Services (EMS) are associated with improved patient outcomes in EMS priority conditions in developed EMS systems. This study describes patterns of EMS use and identifies predictors of EMS utilization in EMS priority conditions in Lebanon

Methods

This was a cross-sectional study of a random sample of adult patients presenting to the emergency department (ED) of a tertiary care center in Beirut with the following EMS priority conditions: chest pain, major trauma, respiratory distress, cardiac arrest, respiratory arrest, and airway obstruction. Patient/proxy survey (20 questions) and chart review were completed. The responses to survey questions were “disagree,” “neutral,” or “agree” and were scored as one, two, or three with three corresponding to higher likelihood of EMS use. A total scale score ranging from 20 to 60 was created and transformed from 0% to 100%. Data were analyzed based on mode of presentation (EMS vs other).

Results

Among the 481 patients enrolled, only 112 (23.3%) used EMS. Mean age for study population was 63.7 years (SD=18.8 years) with 56.5% males. Mean clinical severity score (Emergency Severity Index [ESI]) was 2.5 (SD=0.7) and mean pain score was 3.1 (SD=3.5) at ED presentation. Over one-half (58.8%) needed admission to hospital with 21.8% to an intensive care unit care level and with a mortality rate of 7.3%. Significant associations were found between EMS use and the following variables: severity of illness, degree of pain, familiarity with EMS activation, previous EMS use, perceived EMS benefit, availability of EMS services, trust in EMS response times and treatment, advice from family, and unavailability of immediate private mode of transport (P≤.05). Functional screening, or requiring full assistance (OR=4.77; 95% CI, 1.85-12.29); acute symptoms onset ≤ one hour (OR=2.14; 95% CI, 1.08-4.26); and higher scale scores (OR=2.99; 95% CI, 2.20-4.07) were significant predictors of EMS use. Patients with lower clinical severity (OR=0.53; 95% CI, 0.35-0.81) and those with chest pain (OR=0.05; 95% CI, 0.02-0.12) or respiratory distress (OR=0.15; 95% CI, 0.07-0.31) using cardiac arrest as a reference were less likely to use EMS.

Conclusion

Emergency Medical Services use in EMS priority conditions in Lebanon is low. Several predictors of EMS use were identified. Emergency Medical Services initiatives addressing underutilization should result from this proposed assessment of the perspective of the EMS system’s end user.

El SayedM, TamimH, Al-Hajj ChehadehA, KazziAA. Emergency Medical Services utilization in EMS priority conditions in Beirut, Lebanon. Prehosp Disaster Med. 2016;31(6):621–627.
PARTIAL INDEFINITE THETA IDENTITIES
Authors: KIM BYUNGCHAN , LOVEJOY JEREMY
Published: September 2016

Using a result of Warnaar, we prove a number of single- and multi-sum identities in the spirit of Ramanujan’s partial theta identities, but with partial indefinite binary theta functions in the role of partial theta functions. We also calculate the corresponding residual identities and use a result of Ji and Zhao to recast our identities in terms of indefinite ternary theta functions.
NONDECREASABLE AND WEAKLY NONDECREASABLE DILATATIONS
Authors: YAO GUOWU
Published: September 2016

Zhou et al. [‘On weakly non-decreasable quasiconformal mappings’, J. Math. Anal. Appl.386 (2012), 842–847] proved that, in a Teichmüller equivalence class, there exists an extremal quasiconformal mapping with a weakly nondecreasable dilatation. They asked whether a weakly nondecreasable dilatation is a nondecreasable dilatation. The aim of this paper is to give a negative answer to their problem. We also construct a Teichmüller class such that it contains an infinite number of weakly nondecreasable extremal representatives, only one of which is nondecreasable.
Twin studies for the investigation of the relationships between genetic factors and brain abnormalities in bipolar disorder
Authors: Squarcina L. , Fagnani C. , Bellani M. , Altamura C. A. , Brambilla P.
Published: September 2016

The pathogenesis of bipolar disorder (BD) is to date not entirely clear. Classical genetic research showed that there is a contribution of genetic factors in BD, with high heritability. Twin studies, thanks to the fact that confounding factors as genetic background or family environment are shared, allow etiological inferences. In this work, we selected twin studies, which focus on the relationship between BD, genetic factors and brain structure, evaluated with magnetic resonance imaging. All the studies found differences in brain structure between BD patients and their co-twins, and also in respect to healthy controls. Genetic effects are predominant in white matter, except corpus callosum, while gray matter resulted more influenced by environment, or by the disease itself. All studies found no interactions between BD and shared environment between twins. Twin studies have been demonstrated to be useful in exploring BD pathogenesis and could be extremely effective at discriminating the neural mechanisms underlying BD.
Major depressive disorder is associated with subsequent adult-onset asthma: a population-based cohort study
Authors: Shen T-C. , Lin C-L. , Liao C.H. , Wei C-C. , Sung F-C. , Kao C-H.
Published: September 2016

Aim.

To examine the incidence of asthma in adult patients with major depressive disorder (MDD).

Methods.

From the National Health Insurance database of Taiwan, we identified 30 169 adult patients who were newly diagnosed with MDD between 2000 and 2010. Individuals without depression were randomly selected four times and frequency matched for sex, age and year of diagnosis. Both cohorts were followed-up for the occurrence of asthma up to the end of 2011. Adjusted hazard ratios (aHRs) of asthma were estimated using the Cox proportional hazards method.

Results.

The overall incidence of asthma was 1.91-fold higher in the MDD cohort than in the non-depression cohort (7.55 v. 3.96 per 1000 person-years), with an aHR of 1.66 (95% confidence interval (CI) 1.55–1.78). In both cohorts, the incidence of asthma was higher in patients and controls who were female, aged, with comorbidities and users of aspirin or beta-adrenergic receptor blockers. No significant difference was observed in the occurrence of asthma between patients with MDD treated with selective serotonin reuptake inhibitors (SSRIs) and those treated with non-SSRIs (SSRIs to non-SSRIs aHR = 1.03, 95% CI 0.91–1.17).

Conclusion.

Adult patients with MDD are at a higher risk of asthma than those without depression are.
The Use of Testosterone/Cortisol Ratio in Response to Acute Stress as an Indicator of Propensity to Anger in Informal Caregivers
Authors: Romero-Martínez Ángel , Moya-Albiol Luis
Published: September 2016

Caring for an offspring diagnosed with a psychological chronic disorder is used in research as a model of chronic stress. Indeed, it is usually associated with disturbances in the salivary cortisol (Csal) levels of the caregiver. An imbalance between salivary testosterone (Tsal) and Csal levels is a marker of proneness to social aggression. Given this, we aimed to establish whether the salivary testosterone/cortisol (Tsal/Csal) ratio response to acute stress could be employed as a marker of proneness to anger in informal caregivers of offspring with autism spectrum (ASD). Tsal/Csal ratio and anger responses to a set of different cognitive tasks as well as anger trait and expression were compared in these informal caregivers and controls. Caregivers, particularly those of offspring with ASD, had higher Tsal/Csal ratios than controls in response to acute stress, concretely after the stress in the case of fathers (p = .05) and before stress when analyzing mothers (p = .05). Moreover, ASD fathers and mothers obtained higher magnitude of the T/C ratio response to stress (p = .03 and p =.04, respectively), anger state (p = .02 and p = .02, respectively) and expression scores (p = .05 and p = .05, respectively) than controls. Finally, high Tsal/Csal ratio levels and response to stress were significantly associated with high anger feelings increases (p < .01 and p < .001, respectively), trait (p < .001 and p > .05, respectively) and expression (p < .05 and p > .05, respectively) in caregivers.
Next President Must Name Science Leaders Fast, Report Urges
Authors: Showstack Randy
Published: September 2016

The report steers clear of providing guidance for how the next president should deal with specific science and technology issues, but it calls out climate change as a key policy area.
Erratum: Phosphorus Doping in Si Nanocrystals/SiO2 Multilayers and Light Emission with Wavelength Compatible for Optical Telecommunication
Authors: Lu Peng , Mu Weiwei , Xu Jun , Zhang Xiaowei , Zhang Wenping , Li Wei , Xu Ling , Chen Kunji
Published: September 2016

Scientific Reports 6: Article number: 22888; published online: 09 March 2016; updated: 21 September 2016 The original version of this Article contained an error in the title of the paper, where the word ‘‘multilayers” was incorrectly given as ‘‘msultilayers”. This has now been corrected in the PDF and HTML versions of the Article.
Molecular imaging of brain localization of liposomes in mice using MALDI mass spectrometry
Authors: Fülöp Annabelle , Sammour Denis A. , Erich Katrin , von Gerichten Johanna , van Hoogevest Peter , Sandhoff Roger , Hopf Carsten
Published: September 2016

Phospholipids have excellent biocompatibility and are therefore often used as main components of liposomal drug carriers. In traditional bioanalytics, the in-vivo distribution of liposomal drug carriers is assessed using radiolabeled liposomal constituents. This study presents matrix-assisted laser desorption/ionization mass spectrometry imaging (MALDI MSI) as an alternative, label-free method for ex-vivo molecular imaging of liposomal drug carriers in mouse tissue. To this end, indocyanine green as cargo and two liposomal markers, 1,2-dipalmitoyl-sn-glycero-3-phosphoglycerol (DPPG) and 1,2-distearoyl-sn-glycero-3-phosphoethanolamine conjugated with monodisperse polyethylene glycol (PEG36-DSPE) were incorporated into liposomal carriers and administered to mice. We used MALDI MSI of the two lipid markers in both positive and negative ion mode for visualization of liposome integrity and distribution in mouse organs. Additional MSI of hemoglobin in the same tissue slice and pixel-by-pixel computational analysis of co-occurrence of lipid markers and hemoglobin served as indicator of liposome localization either in parenchyma or in blood vessels. Our proof-of-concept study suggests that liposomal components and indocyanine green distributed into all investigated organs.
Wild chimpanzees modify modality of gestures according to the strength of social bonds and personal network size
Authors: Roberts Anna Ilona , Roberts Sam George Bradley
Published: September 2016

Primates form strong and enduring social bonds with others and these bonds have important fitness consequences. However, how different types of communication are associated with different types of social bonds is poorly understood. Wild chimpanzees have a large repertoire of gestures, from visual gestures to tactile and auditory gestures. We used social network analysis to examine the association between proximity bonds (time spent in close proximity) and rates of gestural communication in pairs of chimpanzees when the intended recipient was within 10 m of the signaller. Pairs of chimpanzees with strong proximity bonds had higher rates of visual gestures, but lower rates of auditory long-range and tactile gestures. However, individual chimpanzees that had a larger number of proximity bonds had higher rates of auditory and tactile gestures and lower rates of visual gestures. These results suggest that visual gestures may be an efficient way to communicate with a small number of regular interaction partners, but that tactile and auditory gestures may be more effective at communicating with larger numbers of weaker bonds. Increasing flexibility of communication may have played an important role in managing differentiated social relationships in groups of increasing size and complexity in both primate and human evolution.
Tunability of the two-dimensional electron gas at the LaAlO3/SrTiO3 interface by strain-induced ferroelectricity
Authors: Guo Hongli , Saidi Wissam A. , Zhao Jin
Published: September 2016

Under compressive strain, 2DEG at LAO/STO interface can be tuned by reversing the STO polarization orientation.
Crystal structure, luminescence properties, energy transfer and thermal properties of a novel color-tunable, white light-emitting phosphor Ca9−x−yCe(PO4)7:xEu2+,yMn2+
Authors: Wang Chao , Li Panlai , Wang Zhijun , Sun Yuansheng , Cheng Jinge , Li Zhenling , Tian Miaomiao , Yang Zhiping
Published: September 2016

A series of Ca9−x−yCe(PO4)7:xEu2+,yMn2+ phosphors were synthesized by a high-temperature solid-state reaction method.
Donor-substituted phosphanes – surprisingly weak Lewis donors for phosphenium cation stabilisation
Authors: Clark Ewan R. , Borys Andryj M. , Pearce Kyle
Published: September 2016

Paradoxically, N- and O-donor substituted tri-arylphosphanes are shown to be weaker donors than PPh3 when binding the soft Lewis acid moiety [PPh2]+. This arises from internal solvation and rehybridisation as phosphorus, precluding chelation and increasing steric demand, in direct contrast to coordination modes observed for metal complexes.
Impacts of coal ash on methylmercury production and the methylating microbial community in anaerobic sediment slurries
Authors: Schwartz Grace E. , Redfern Lauren K. , Ikuma Kaoru , Gunsch Claudia K. , Ruhl Laura S. , Vengosh Avner , Hsu-Kim Heileen
Published: September 2016

Coal ash can stimulate the growth of methylating microorganisms and increase methylmercury concentrations in anaerobic sediments.
Groove modification of siRNA duplexes to elucidate siRNA–protein interactions using 7-bromo-7-deazaadenosine and 3-bromo-3-deazaadenosine as chemical probes
Authors: Saito-Tarashima Noriko , Kira Hirotaka , Wada Tomoya , Miki Kazuya , Ide Shiho , Yamazaki Naoshi , Matsuda Akira , Minakawa Noriaki
Published: September 2016

The chemical probes, comprising Br7C7A and Br3C3A, to investigate RNA–protein interactions were developed.
A new Co(ii) metal–organic framework with enhanced CO2 adsorption and separation performance
Authors: Liu Xiao-Ting , Jia Yan-Yuan , Zhang Ying-Hui , Ren Guo-Jian , Feng Rui , Zhang Shi-Yu , Zaworotko Michael J. , Bu Xian-He
Published: September 2016

A new MOF was synthesized with a functional ligand, which features 1D polar channels and reveals enhanced CO2 adsorption and separation performance.
A microporous Cu2+MOF based on a pyridyl isophthalic acid Schiff base ligand with high CO2uptake
Authors: Kourtellaris Andreas , Moushi Eleni E. , Spanopoulos Ioannis , Tampaxis Christos , Charalambopoulou Georgia , Steriotis Theodore A. , Papaefstathiou Giannis S. , Trikalitis Pantelis N. , Tasiopoulos Anastasios J.
Published: September 2016

A new microporous Cu2+MOF is reported containing a pyridyl-isophthalic acid Schiff base ligand which exhibits a significant BET area and high CO2sorptbion capacity.
Room-temperature fabrication of a three-dimensional reduced-graphene oxide/polypyrrole/hydroxyapatite composite scaffold for bone tissue engineering
Authors: Song Fuxiang , Jie Weibo , Zhang Ting , Li Wen , Jiang Yanjiao , Wan Liu , Liu Wenjuan , Li Xiaocheng , Liu Bin
Published: September 2016

The development of tissue engineering (TE) provides a promising alternative strategy for bone healing and regeneration.
Novel nanoparticle-assembled Bi12GeO20 hierarchical structures: facile hydrothermal synthesis and excellent photocatalytic activity
Authors: Huang Xin-Hua , Zhang Lei , Song Jian , Cao Xiao-Feng , Guo Yan-Chuan
Published: September 2016

Novel nanoparticle-assembled Bi12GeO20 hierarchical structures with excellent UV-visible light driven photocatalytic performance have been successfully prepared via a facile hydrothermal route.
Rod-like micelles of octadecyltrimethylammonium bromide and their freezing upon solubilised styrene polymerisation
Authors: Zhao Jianxi , Yu Hongbin , Deng Shenglu
Published: September 2016

C18TABr formed rod-like micelles in ethanol/water (10/90 wt%) with the assistance of SNphs and styrene was then solubilised and polymerised in situ, by which means the mono-dispersed, rod-like micelles were frozen.