bluuebunny/crossref_metadata_2025 huggingface dataset:
Various patterns of the middle cerebral vein and preservation of venous drainage during the anterior transpetrosal approach
Authors: Shibao Shunsuke , Toda Masahiro , Orii Maaya , Fujiwara Hirokazu , Yoshida Kazunari
Published: August 2015

OBJECT

The drainage of the superficial middle cerebral vein (SMCV) has previously been classified into 4 subtypes. Extradural procedures and dural incisions during the anterior transpetrosal approach (ATPA) may interrupt the route of drainage from the SMCV. In this study, the authors examined the relationship between anatomical variations in the SMCV and the corresponding surgical modifications to the ATPA that are necessary for venous preservation.

METHODS

This study included 48 patients treated via the ATPA in whom the SMCV was examined using 3D CT venography. The drainage patterns of the SMCV were classified into 3 types: cavernous or absent (Type 1), sphenobasal (Type 2), and sphenopetrosal (Type 3). Type 2 was subdivided into medial (Type 2a) and lateral (Type 2b), and Type 3 was subdivided into vein (Type 3a), vein and sinus (Type 3b), and sinus (Type 3c). The authors performed 3 ATPA modifications to preserve the SMCV: epidural anterior petrosectomy with subdural visualization of the sphenobasal vein (SBV), modification of the dural incision, and subdural anterior petrosectomy. Standard ATPA can be performed with Type 1, Type 2a, and Type 3a drainage. With Type 2b drainage, an epidural anterior petrosectomy with subdural SBV visualization is appropriate. The dural incision should be modified in Type 3b. With Type 3c, a subdural anterior petrosectomy is required.

RESULTS

The frequency of each type was 68.7% (33/48) in Type 1, 8.3% (4/48) in Type 2a, 4.2% (2/48) in Type 2b, 14.6% (7/48) in Type 3a, 2.1% (1/48) in Type 3b, and 2.1% (1/48) in Type 3c. No venous complications were found.

CONCLUSIONS

The authors propose an SMCV modified classification based on ATPA modifications required for venous preservation.
Selective versus nonselective thoracic fusion in Lenke 1C curves: a meta-analysis of baseline characteristics and postoperative outcomes
Authors: Boniello Anthony J. , Hasan Saqib , Yang Sun , Jalai Cyrus M. , Worley Nancy , Passias Peter G.
Published: August 2015

OBJECT

Lenke 1C curves are challenging to manage surgically due to the structural thoracic deformity and nonstructural lumbar curve. Selective thoracic fusion (STF) is considered the standard of care because it preserves motion of the lumbar segment, yet nonselective STF (NSTF) remains prevalent. This study aims to identify baseline patient characteristics that drive treatment and to compare postoperative outcomes for both procedures.

METHODS

Studies that compared baseline and postoperative demographic data, health-related quality of life (HRQL) questionnaires, and radiographic parameters of patients with Lenke 1C curves undergoing STF or NSTF were identified for meta-analysis. The effect measure is expressed as a mean difference (MD) with 95% CI. A positive MD signifies a greater STF value, or a mean increase within the group.

RESULTS

One prospective and 6 retrospective case-control studies with sample size of 488 patients (344 STF and 144 NSTF) were identified. Baseline age, sex, and HRQLs were equivalent, except for better scores in the STF group for the Scoliosis Appearance Questionnaire (SAQ): Unrelated to Deformity item (3.47 vs 3.88, p = 0.01) and the Spine Research Society questionnaire, Item 22: Pain (4.13 vs 3.92, p = 0.04). Radiographic findings were significantly worse in NSTF, as measured by the thoracolumbar/lumbar (TL/L) Cobb angle (MD: −4.29°, p < 0.01) and TL/L apical vertebral translation (AVT) (MD: −6.08, p < 0.01). Radiographic findings significantly improved in STF, as measured in the main thoracic (MT) Cobb angle (MD: −27.78°, p < 0.01), TL/L Cobb angle (MD: −16.24°, p < 0.01), MT:TL/L Cobb ratio (MD: −0.21, p < 0.01), coronal balance (MD: 0.47, p = 0.02), and thoracic kyphosis (MD: 7.87°, p < 0.01); and in NSTF in proximal thoracic (PT) Cobb angle (24° vs 14.1°, p < 0.01), MT Cobb angle (53.5° vs 20.5°, p < 0.01), and TL/L Cobb angle (41.6° vs 16.6°, p < 0.01). Postoperative TL/L Cobb angle (23.1° vs 16.6°, p < 0.01) was significantly higher in STF; but PT Cobb angle, MT Cobb angle, and MT:TL/L Cobb ratio are equivalent.

CONCLUSIONS

Patients with larger lumbar compensatory curves displaying a larger degree of coronal translation, as measured by the TL/L AVT, are more likely to undergo an NSTF. Contrary to established guidelines, larger MT curve magnitudes and MT:TL/L Cobb angle ratios have not been found to influence the decision to pursue a selective thoracic fusion. Although overall both STF and NSTF groups are found to have effective postoperative coronal balance, the STF group has only modest improvements in the lumbar curve position as determined by a relatively unchanged TL/L AVT. Furthermore, surgeons may prefer NSTF in patients who may have a worse overall perception of their spinal deformity as measured by HRQL measures of pain and desire for appearance change.
Angiographic findings of in-stent intimal hyperplasia after stent-assisted coil embolization: are they permanent findings?
Authors: Kim Young Soo , Lee Sang Won , Yeom Jeong A , Yoon Chang Hyo , Baik Seung Kug
Published: August 2015

OBJECT

Stent-assisted coil embolization for the treatment of intracranial aneurysms has been used widely. This study aimed to investigate the effect of stent implantation in the nonatherosclerotic parent artery with cerebral aneurysms. The authors evaluated luminal changes and the related factors following stent-assisted coil embolization.

METHODS

This study included 97 patients harboring a total of 99 unruptured aneurysms of the distal internal carotid artery (ICA) who underwent single-stent implantation and more than 1 session of conventional angiography during follow-up (midterm follow-up only, n = 70; midterm and long-term follow-up, n = 29) between January 2009 and April 2014. The luminal narrowing point was measured using a local thickness map (ImageJ plug-in).

RESULTS

Stent-assisted coil embolization caused dynamic luminal narrowing of approximately 82% of the parent artery diameter on average after 8 months, which was reversed to 91% after 25 months. In addition, luminal narrowing greater than 40% was noticed in 2 (7%) of the 29 patients who experienced spontaneous reversion without additional management during follow-up. Most luminal narrowing changes seen were diffuse.

CONCLUSIONS

Luminal narrowing after aneurysm stent-assisted coil embolization is a dynamic process and appears to be a spontaneously reversible event. Routine management of luminal narrowing may not cause adverse events that require additional treatment.
Patient factors associated with 30-day morbidity, mortality, and length of stay after surgery for subdural hematoma: a study of the American College of Surgeons National Surgical Quality Improvement Program
Authors: Lukasiewicz Adam M. , Grant Ryan A. , Basques Bryce A. , Webb Matthew L. , Samuel Andre M. , Grauer Jonathan N.
Published: August 2015

OBJECT

Surgery for subdural hematoma (SDH) is a commonly performed neurosurgical procedure. This study identifies patient characteristics associated with adverse outcomes and prolonged length of stay (LOS) in patients who underwent surgical treatment for SDH.

METHODS

All patients in the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) who were treated via craniotomy or craniectomy for SDH between 2005 and 2012 were identified. Patient demographics, comorbidities, and 30-day outcomes were described. Multivariate regression was used to identify predictors of adverse events.

RESULTS

A total of 746 surgical procedures performed for SDH were identified and analyzed. Patients undergoing this procedure were 64% male with an average age (± SD) of 70.9 ± 14.1 years. The most common individual adverse events were death (17%) and intubation for more than 48 hours (19%). In total, 34% experienced a serious adverse event other than death, 8% of patients returned to the operating room (OR), and the average hospital LOS was 9.8 ± 9.9 days. In multivariate analysis, reduced mortality was associated with age less than 60 years (relative risk [RR] = 0.47, p = 0.017). Increased mortality was associated with gangrene (RR = 3.5, p = 0.044), ascites (RR = 3.00, p = 0.006), American Society of Anesthesiologists (ASA) Class 4 or higher (RR = 2.34, p = 0.002), coma (RR = 2.25, p < 0.001), and bleeding disorders (RR = 1.87, p = 0.003). Return to the OR was associated with pneumonia (RR = 3.86, p = 0.044), male sex (RR = 1.85, p = 0.015), and delirium (RR = 1.75, p = 0.016). Serious adverse events were associated with ventilator dependence preoperatively (RR = 1.86, p < 0.001), dialysis (RR = 1.44, p = 0.028), delirium (RR = 1.40, p = 0.005), ASA Class 4 or higher (RR = 1.36, p = 0.035), and male sex (RR = 1.29, p = 0.037). Similarly, LOS was increased in ventilator dependent patients by 1.56-fold (p = 0.002), in patients with ASA Class 4 or higher by 1.30-fold (p = 0.006), and in delirious patients by 1.29-fold (p = 0.008).

CONCLUSIONS

Adverse outcomes are common after surgery for SDH. In this study, 18% of the patients died within 30 days of surgery. Factors associated with adverse outcomes were identified. Patients and families should be counseled about the serious risks of morbidity and death associated with acute traumatic SDH requiring surgery.
A Phase I proof-of-concept and safety trial of sildenafil to treat cerebral vasospasm following subarachnoid hemorrhage
Authors: Washington Chad W. , Derdeyn Colin P. , Dhar Rajat , Arias Eric J. , Chicoine Michael R. , Cross DeWitte T. , Dacey Ralph G. , Han Byung Hee , Moran Christopher J. , Rich Keith M. , Vellimana Ananth K. , Zipfel Gregory J.
Published: August 2015

OBJECT

Studies show that phosphodiesterase-V (PDE-V) inhibition reduces cerebral vasospasm (CVS) and improves outcomes after experimental subarachnoid hemorrhage (SAH). This study was performed to investigate the safety and effect of sildenafil (an FDA-approved PDE-V inhibitor) on angiographic CVS in SAH patients.

METHODS

A2-phase, prospective, nonrandomized, human trial was implemented. Subarachnoid hemorrhage patients underwent angiography on Day 7 to assess for CVS. Those with CVS were given 10 mg of intravenous sildenafil in the first phase of the study and 30 mg in the second phase. In both, angiography was repeated 30 minutes after infusion. Safety was assessed by monitoring neurological examination findings and vital signs and for the development of adverse reactions. For angiographic assessment, in a blinded fashion, pre- and post-sildenafil images were graded as “improvement” or “no improvement” in CVS. Unblinded measurements were made between pre- and post-sildenafil angiograms.

RESULTS

Twelve patients received sildenafil; 5 patients received 10 mg and 7 received 30 mg. There were no adverse reactions. There was no adverse effect on heart rate or intracranial pressure. Sildenafil resulted in a transient decline in mean arterial pressure, an average of 17% with a return to baseline in an average of 18 minutes. Eight patients (67%) were found to have a positive angiographic response to sildenafil, 3 (60%) in the low-dose group and 5 (71%) in the high-dose group. The largest degree of vessel dilation was an average of 0.8 mm (range 0–2.1 mm). This corresponded to an average percentage increase in vessel diameter of 62% (range 0%–200%).

CONCLUSIONS

The results from this Phase I safety and proof-of-concept trial assessing the use of intravenous sildenafil in patients with CVS show that sildenafil is safe and well tolerated in the setting of SAH. Furthermore, the angiographic data suggest that sildenafil has a positive impact on human CVS.
Cocaine use as an independent predictor of seizures after aneurysmal subarachnoid hemorrhage
Authors: Chang Tiffany R. , Kowalski Robert G. , Carhuapoma J. Ricardo , Tamargo Rafael J. , Naval Neeraj S.
Published: August 2015

OBJECT

Seizures are relatively common after aneurysmal subarachnoid hemorrhage (aSAH). Seizure prophylaxis is controversial and is often based on risk stratification; middle cerebral artery (MCA) aneurysms, associated intracerebral hemorrhage (ICH), poor neurological grade, increased clot thickness, and cerebral infarction are considered highest risk for seizures. The purpose of this study was to evaluate the impact of recent cocaine use on seizure incidence following aSAH.

METHODS

Prospectively collected data from aSAH patients admitted to 2 institutional neuroscience critical care units between 1991 and 2009 were reviewed. The authors analyzed factors that potentially affected the incidence of seizures, including patient demographic characteristics, poor clinical grade (Hunt and Hess Grade IV or V), medical comorbidities, associated ICH, intraventricular hemorrhage (IVH), hydrocephalus, aneurysm location, surgical clipping and cocaine use. They further studied the impact of these factors on “early” and “late” seizures (defined, respectively, as occurring before and after clipping/coiling).

RESULTS

Of 1134 aSAH patients studied, 182 (16%) had seizures; 81 patients (7.1%) had early and 127 (11.2%) late seizures, with 26 having both. The seizure rate was significantly higher in cocaine users (37 [26%] of 142 patients) than in non-cocaine users (151 [15.2%] of 992 patients, p = 0.001). Eighteen cocaine-positive patients (12.7%) had early seizures compared with 6.6% of cocaine-negative patients (p = 0.003); 27 cocaine users (19%) had late seizures compared with 10.5% non-cocaine users (p = 0.001). Factors that showed a significant association with increased risk for seizure (early or late) on univariate analysis included younger age (< 40 years) (p = 0.009), poor clinical grade (p = 0.029), associated ICH (p = 0.007), and MCA aneurysm location (p < 0.001); surgical clipping was associated with late seizures (p = 0.004). Following multivariate analysis, age < 40 years (OR 2.04, 95% CI 1.355–3.058, p = 0.001), poor clinical grade (OR 1.62, 95% CI 1.124–2.336, p = 0.01), ICH (OR 1.95, 95% CI 1.164–3.273, p = 0.011), MCA aneurysm location (OR 3.3, 95% CI 2.237–4.854, p < 0.001), and cocaine use (OR 2.06, 95% CI 1.330–3.175, p = 0.001) independently predicted seizures.

CONCLUSIONS

Cocaine use confers a higher seizure risk following aSAH and should be considered during risk stratification for seizure prophylaxis and close neuromonitoring.
Treatment of posthemorrhagic ventricular dilation in preterm infants: a systematic review and meta-analysis of outcomes and complications
Authors: Badhiwala Jetan H. , Hong Chris J. , Nassiri Farshad , Hong Brian Y. , Riva-Cambrin Jay , Kulkarni Abhaya V.
Published: August 2015

OBJECT

The optimal clinical management of intraventricular hemorrhage (IVH) and posthemorrhagic ventricular dilation (PHVD)/posthemorrhagic hydrocephalus (PHH) in premature infants remains unclear. A common approach involves temporary treatment of hydrocephalus in these patients with a ventriculosubgaleal shunt (VSGS), ventricular access device (VAD), or external ventricular drain (EVD) until it becomes evident that the patient needs and can tolerate permanent CSF diversion (i.e., ventriculoperitoneal shunt). The present systematic review and meta-analysis aimed to provide a robust and comprehensive summary of the published literature regarding the clinical outcomes and complications of these 3 techniques as temporizing measures in the management of prematurity-related PHVD/PHH.

METHODS

The authors searched MEDLINE, EMBASE, CINAHL, Google Scholar, and the Cochrane Library for studies published through December 2013 on the use of VSGSs, VADs, and/or EVDs as temporizing devices for the treatment of hydrocephalus following IVH in the premature neonate. Data pertaining to patient demographic data, study methods, interventions, and outcomes were extracted from eligible articles. For each of the 3 types of temporizing device, the authors performed meta-analyses examining 6 outcomes of interest, which were rates of 1) obstruction; 2) infection; 3) arrest of hydrocephalus (i.e., permanent shunt independence); 4) mortality; 5) good neurodevelopmental outcome; and 6) revision.

RESULTS

Thirty-nine studies, representing 1502 patients, met eligibility criteria. All of the included articles were observational studies; 36 were retrospective and 3 were prospective designs. Nine studies (n = 295) examined VSGSs, 24 (n = 962) VADs, and 9 (n = 245) EVDs. Pooled rates of outcome for VSGS, VAD, and EVD, respectively, were 9.6%, 7.3%, and 6.8% for obstruction; 9.2%, 9.5%, and 6.7% for infection; 12.2%, 10.8%, and 47.3% for revision; 13.9%, 17.5%, and 31.8% for arrest of hydrocephalus; 12.1%, 15.3%, and 19.1% for death; and 58.7%, 50.1%, and 56.1% for good neurodevelopmental outcome.

CONCLUSIONS

This study provides robust estimates of outcomes for the most common temporizing treatments for IVH in premature infants. With few exceptions, the range of outcomes was similar for VSGS, VAD, and EVD.
Identification of complications that have a significant effect on length of stay after spine surgery and predictive value of 90-day readmission rate
Authors: Yadla Sanjay , Ghobrial George M. , Campbell Peter G. , Maltenfort Mitchell G. , Harrop James S. , Ratliff John K. , Sharan Ashwini D.
Published: August 2015

OBJECT

Complications after spine surgery have an impact on overall outcome and health care expenditures. The increased cost of complications is due in part to associated prolonged hospital stays. The authors propose that certain complications have a greater impact on length of stay (LOS) than others and that those complications should be the focus of future targeted prevention efforts. They conducted a retrospective analysis of a prospectively maintained database to identify complications with the greatest impact on LOS as well as the predictive value of these complications with respect to 90-day readmission rates.

METHODS

Data on 249 patients undergoing spine surgery at Thomas Jefferson University from May to December 2008 were collected by a study auditor. Any complications occurring within 30 days of surgery were recorded as was overall LOS for each patient. Stepwise regression analysis was performed to determine whether specific complications had a statistically significant effect on LOS. For correlation, all readmissions within 90 days were recorded and organized by complication for comparison with those complications affecting LOS.

RESULTS

The mean LOS for patients without postoperative complications was 6.9 days. Patients who developed pulmonary complications had an associated increase in LOS of 11.1 days (p < 0.005). The development of a urinary tract infection (UTI) was associated with an increase in LOS of 3.4 days (p = 0.002). A new neurological deficit was associated with an increase in LOS of 8.2 days (p = 0.004). Complications requiring return to the operating room (OR) showed a trend toward an increase in LOS of 4.7 days (p = 0.09), as did deep wound infections (3.3 days, p = 0.08). The most common reason for readmission was for wound drainage (n = 21; surgical drainage was required in 10 [4.01%] of these 21 cases). The most common diagnoses for readmission, in decreasing order of incidence, were categorized as hardware malpositioning (n = 4), fever (n = 4), pulmonary (n = 2), UTI (n = 2), and neurological deficit (n = 1). Complications affecting LOS were not found to be predictive of readmission (p = 0.029).

CONCLUSIONS

Postoperative complications in patients who have undergone spine surgery are not uncommon and are associated with prolonged hospital stays. In the current cohort, the occurrence of pulmonary complications, UTI, and new neurological deficit had the greatest effect on overall LOS. Further study is required to determine the causative factors affecting readmission. These specific complications may be high-yield targets for cost reduction and/or prevention efforts.
Delayed resolution of syrinx after posterior fossa decompression without dural opening in children with Chiari malformation Type I
Authors: Kennedy Benjamin C. , Nelp Taylor B. , Kelly Kathleen M. , Phan Michelle Q. , Bruce Samuel S. , McDowell Michael M. , Feldstein Neil A. , Anderson Richard C. E.
Published: August 2015

OBJECT

Chiari malformation Type I (CM-I) is associated with a syrinx in 25%–85% of patients. Although posterior fossa decompression (PFD) without dural opening is an accepted treatment option for children with symptomatic CM-I, many surgeons prefer to open the dura if a syrinx exists. The purpose of this study was to investigate the frequency and timing of syrinx resolution in children undergoing PFD without dural opening for CM-I.

METHODS

A retrospective review of 68 consecutive pediatric patients with CM-I and syringomyelia who underwent PFD without dural opening was conducted. Patient demographics, presenting symptoms and signs, radiographic findings, and intraoperative ultrasound and neuromonitoring findings were studied as well as the patients’ clinical and radiographic follow-up.

RESULTS

During the mean radiographic follow-up period of 32 months, 70% of the syringes improved. Syrinx improvement occurred at a mean of 31 months postoperatively. All patients experienced symptom improvement within the 1st year, despite only 26% of patients showing radiographic improvement during that period. Patients presenting with sensory symptoms or motor weakness had a higher likelihood of having radiographic syrinx improvement postoperatively.

CONCLUSIONS

In children with CM-I and a syrinx undergoing PFD without dural opening, syrinx resolution occurs in approximately 70% of patients. Radiographic improvement of the syrinx is delayed, but this does not correlate temporally with symptom improvement. Sensory symptoms or motor weakness on presentation are associated with syrinx resolution after surgery.
Preoperative ultrasound localization of the lambda in patients with scaphocephaly: a technical note for minimally invasive craniectomy
Authors: Bonfield Christopher M. , Cochrane D. Douglas , Singhal Ash , Steinbok Paul
Published: August 2015

Sagittal craniosynostosis, the most common single suture craniosynostosis, is treated by numerous surgical techniques. Minimally invasive endoscopy-assisted procedures with postoperative helmeting are being used with reports of good cosmetic outcomes with decreased morbidity, shortened hospital stay, and less blood loss and transfusion. This procedure uses small skin incisions, which must be properly placed to provide safe access to the posterior sagittal and lambdoid sutures. However, the lambda is often hard to palpate through the skin due to the abnormal head shape. The authors describe their experience with the use of intraoperative, preincision ultrasound localization of the lambda in patients with scaphocephaly undergoing a minimally invasive procedure. This simple technique can also be applied to other operations where proper identification of the cranial sutures is necessary.
Sir John and Lady Rita Cornforth: A Distinguished Chemical Partnership
Authors: Purchase Rupert , Hanson James R.
Published: August 2015

This review describes the life of Sir John Cornforth AC CBE FRS, who was awarded the Nobel Prize for Chemistry in 1975. It covers his early life in Australia, his work in Oxford, the National Institute for Medical Research, the Milstead Laboratory of Chemical Enzymology and the University of Sussex, together with the contributions made by his wife, Lady Rita Cornforth.
Applications of Synthetic Gene Networks
Authors: Wu Fuqing , Wang Xiao
Published: August 2015

Synthetic gene networks have evolved from simple proof-of-concept circuits to complex therapy-oriented networks over the past 15 years. This advancement has greatly facilitated the expansion of the emerging field of synthetic biology. In this review, we highlight the main applications of synthetic gene networks in understanding biological design principles, developing biosensors for diagnosis, producing industrial and biomedical compounds, and treating human diseases. Finally, we outline current challenges and future prospects of synthetic gene networks for advancing practical applications.
Between Pathways and Networks Lies Context: Implications for Precision Medicine
Authors: Laderas Ted , Wu Guanming , Mcweeney Shannon
Published: August 2015

Precision medicine, broadly defined as considering individual variability in genes, environment, and lifestyle for each person in disease prevention and selection of suitable medical intervention, shows strong promise in the treatment of cancer. Selecting therapies is complicated by multiple routes to gene dysregulation, which manifest in the individual patient within the many different types of genomic measurements. Additionally, multiple mutations exist in patients, a phenomenon known as oncogenic collaboration, which further complicates the selection of therapy. In this article, we discuss current approaches using biological pathways and networks to unify the many types of OMICs data. We argue that a contextual approach combining cancer pathways and networks could lead to a proper understanding of the biology of this significant disease.
Principles and Prospects of High-Energy Magnesium-Ion Batteries
Authors: Foot Peter J.S.
Published: August 2015

In the last decade or so, lithium batteries have gained important niche positions in the market for electrochemical storage systems. Their energy capacities per unit weight (or volume) are remarkably better than those of traditional batteries – yet they appear to be approaching their practical limit, and alternative cell systems are under active investigation. The potential advantages of replacing lithium by magnesium have long been recognised, but for years it was thought that materials limitations and technical problems would prevent them from being realised. However, a combination of commercial pressures and recent scientific breakthroughs has made it likely that magnesium batteries will soon be available for a wide range of applications; they are expected to be cheaper and safer than those based on lithium, with comparable performance. This article briefly reviews the current situation and looks at the general background, principles and cell components, outlining some of the technical problems and discussing some promising materials for magnesium-ion batteries.
Nutritional Scenario of Adolescent Boys in Dhaka University Campus
Authors: Nahar Latfun , Parvin Nazma
Published: August 2015

A cross sectional study was carried out among the adolescent boys (11-15 years) in two selective schools (University Laboratory School and Udoyan School) in Dhaka University campus to investigate the nutritional and health status as well as socioeconomic condition. Nutritional status was determined anthropometrically and biochemically (hemoglobin estimation). According to the body mass index, two-third of the boys (75.7%) were normal, 15.4% were over-weight and only 8.9% were found to be thinner. The percent prevalence of anemia was 7.1% based on WHO criteria and the mean hemoglobin level was 14.35 g/dl (±1.38). Energy intake of the boys aged 11-12 years met 79.31% of RDA and those of 13-15 years met 76.09% of RDA. Protein intake of all the boys was more than RDA. Dietary intake of vitamin A was more than 90% of RDA. and that for thiamin and niacin was more than RDA. Iron intake was 60.4% and 66.45% of RDA for the two groups of boys. Vitamin C intake was inadequate (46.76% and 36.06% RDA) for the respective group of boys. Nutritional status (anthropometric) is directly associated with expenditure on food. Percentage of thinness decreased as expenditure on food increased. Monthly expenditure on food had significant relation with hemoglobin level of the adolescents. Most of the participants (67 .5%) did not suffer from any disease. Rest of the boys suffered from fever (23.6%), diarrhea (10.9%), common, cold (29.1 %), respiratory infection (9.1 %), measles (3.6%), typhoid (5.5%) and others (18.2%).5
Quality of Working Life and Nutritional Status in a Sample of Industrial Workers
Authors: Hossain Mohammad Didar , Ahmed Luthfor
Published: August 2015

Linkages between diet habits and the quality of working life is a new phenomenon and continue to surface on many fronts. Evidences are there that dietary and non-dietary components are capable of influencing workplace activities, work life, and thereby work performance and productivity. This cross sectional study examined the quality of working life (QWL) and nutritional status of a representative group of sixty-five male workers in an industrial setting. Quality of work life index was measured by administering the scale developed by Yousuf. Nutritional status was assessed by 24-hr food recalls and anthropometric measures. The measured score for QWL ranged 185.0-212.0 with a mean of 193.83 ± 5.57, which is about seventy three percent of the totals, suggestive of medium quality of QWL. Older with longer job experience, having higher salary and poorly educated workers showed significantly higher QWL score (p<0.01). They seem content with their work life and are satisfied in their job. Food and nutrient intakes were inadequate both in quality and quantity. Mean calorie intake was 2196 ± 400 kcal (79% RDI). Cereals and roots/tubers were the major contributor of energy (65% of the total) and protein consumed. Intakes of egg, meat and milk products were very poor. About twenty percent of the workers measured undernourished (BMI<18.5). Moderate level of QWL compounded with poor and inadequate nourishment would certainly compromise work performance and thereby contribute to low productivity.
Exclusive Breast Feeding in a Bangladesh National Nutrition Program Area: The Case in Bhanga Upazila
Authors: Karim Rezaul , Khan Md Nazrul Islam , Akhtaruzzaman Md
Published: August 2015

A statistically selected representative sample of 482 households in Bhanga upazila was studied to observe mother's knowledge and practice of the right duration of exclusive breast-feeding in an NNP area. Although a large number of mothers knew the right duration of exclusive breast-feeding, fewer practiced it for their last infant. Apart from some health constratints, lack of knowledge and motivation were the main reasons for early and late introduction of supplementary feeding.Regular participation in GMP sessions improved mother's knowledge of the right duration of exclusive breast-feeding, and improved knowledge increased practice while higher levels of mother's literacy accelerated the learning. Literate mothers were three times more likely and mothers who participated in GMP sessions regularly were almost three times more likely to know the right duration of exclusive breast-feeding compared to illiterate mothers and mothers who never participated in GMP sessions respectively. Mothers who knew the right duration were about 28 times more likely to practice it compared to the mothers who did not know it.A strong public awareness campaign aimed at the mothers could better motivate them to participate in GMP sessions more regularly leading to improved knowledge and increased practice of the right duration of exclusive breast-feeding realizing the full potential of NNP.
Potential functional applications of extracellular vesicles: a report by the NIH Common Fund Extracellular RNA Communication Consortium
Authors: Quesenberry Peter J. , Aliotta Jason , Camussi Giovanni , Abdel‐Mageed Asim B. , Wen Sicheng , Goldberg Laura , Zhang Huang‐Ge , Tetta Ciro , Franklin Jeffrey , Coffey Robert J. , Danielson Kirsty , Subramanya Vinita , Ghiran Ionita , Das Saumya , Chen Clark C. , Pusic Kae M. , Pusic Aya D. , Chatterjee Devasis , Kraig Richard P. , Balaj Leonora , Dooner Mark
Published: August 2015

The NIH Extracellular RNA Communication Program's initiative on clinical utility of extracellular RNAs and therapeutic agents and developing scalable technologies is reviewed here. Background information and details of the projects are presented. The work has focused on modulation of target cell fate by extracellular vesicles (EVs) and RNA. Work on plant‐derived vesicles is of intense interest, and non‐mammalian sources of vesicles may represent a very promising source for different therapeutic approaches. Retro‐viral‐like particles are intriguing. Clearly, EVs share pathways with the assembly machinery of several other viruses, including human endogenous retrovirals (HERVs), and this convergence may explain the observation of viral‐like particles containing viral proteins and nucleic acid in EVs. Dramatic effect on regeneration of damaged bone marrow, renal, pulmonary and cardiovascular tissue is demonstrated and discussed. These studies show restoration of injured cell function and the importance of heterogeneity of different vesicle populations. The potential for neural regeneration is explored, and the capacity to promote and reverse neoplasia by EV exposure is described. The tremendous clinical potential of EVs underlies many of these projects, and the importance of regulatory issues and the necessity of general manufacturing production (GMP) studies for eventual clinical trials are emphasized. Clinical trials are already being pursued and should expand dramatically in the near future.
Ejector Refrigeration Cycles
Authors: Bergander Marek J
Published: August 2015

This chapter describes a collaborative effort of US private companies and various departments of the US Government to investigate the possibility of improving the efficiency of HVAC systems by use of one and two-phase ejectors. It is anticipated that this technology, when fully developed will result in attractive, energy saving products that significantly improve the performance of commercial and residential chiller/air-conditioning systems, refrigeration plants, and heat pumps (geothermal and air-source). Although the literature describing ejector applications in refrigeration dates back to the year of 1900, the ejector use was always considered as controversial, because the previous research had resulted with only theoretical results and without visible, commercial products. The research on the ejector application is consistent with present directions in the HVAC industry and it will attract more attention and research funding in the future. A classification of thermodynamic cycles where ejectors can be applied composed by three distinctive “categories” is suggested.
Advanced Exergetic Analysis is a Modern Tool for Evaluation and Optimization of Refrigeration Systems
Authors: Morosuk Tatiana , Tsatsaronis George
Published: August 2015

In the last decades an exergetic analysis became increasingly popular because this analysis identifies the location, magnitude and sources of thermodynamic inefficiencies. A conventional exergetic analysis, however, does not consider (a) the real potential for improving a system nor (b) the interactions among the components of the system. The interactions among different components of the same system can be estimated and the quality of the conclusions obtained from an exergetic evaluation can be improved, when the exergy destruction (irreversibilities) within each system component are split into endogenous/exogenous and avoidable/ unavoidable parts. We call this advanced exergetic analysis. The purpose of this chapter is to demonstrate that the advanced exergetic analysis is a practical method that allows engineers to extract useful information and conclusions and to develop ideas and solutions that cannot be suggested by other methods. In this chapter the conventional and advanced exergetic analysis are applied to an air refrigeration machine.
New Mechanisms for Cryogenic Solid-Gas Sublimation Refrigeration
Authors: Chen Lin
Published: August 2015

Sublimation is one phase change mechanism which usually happens under low-to-moderate temperatures and at the same time large amounts of latent heat is absorbed or released. Low temperature sublimation has been proposed in a lot of applications as one useful fast cooling/refrigeration mechanisms, such as medical cooling, food engineering, chemical synthesis, domestic cooling and many industrial sectors. In this brief chapter, the basic mechanisms of static sublimation process and sublimation two-phase flows are clarified and analyzed first, which covers the theoretical and physical problems of sublimation phase-change. Then the previous studies are classified into numerical modeling and experimental verifications. Representative refrigeration systems are also introduced and compared in this chapter, which may give useful indications for future innovations in this field. Future research focuses are also summarized and proposed in this chapter.
Ejection Refrigeration Cycles
Authors: Butrymowicz Dariusz Józef , Śmierciew Kamil Leszek , Gagan Jerzy , Karwacki Jarosław
Published: August 2015

The chapter presents the development of ejector refrigeration technology that strongly reduces the greenhouse gases emission by using natural refrigerants and also dramatically reduces the need for the electric power. This is accomplished by using free or inexpensive heat – either solar or waste heat, as the main source of energy instead of electricity. Nowadays, the thermal driven refrigeration system, especially with low-temperature heat source became more and more popular. The operation of the ejection cycle using low-temperature heat source can be considered as very attractive and the ejection cycles becomes truly competitive in comparison with the absorption refrigeration systems.
Capillary Tube as an Expansion Device in a CO2 (R744) Transcritical Heat Pump System
Authors: Agrawal Neeraj , Bhattacharyya Souvik
Published: August 2015

Natural refrigerants which are ecologically safe and were in use extensively in the pre-CFC era are witnessing a revival of CO2 (R744). Inherently being a low critical temperature (31.2 ?C) refrigerant, the CO2 cycle based system operates in transcritical mode offers an opportunity to obtain an optimum operating condition. Capillary tubes which are extensively used in small size vapour compression systems work very differently in a CO2 transcritical heat pump system. In this chapter it is described that installation of a capillary tube having an appropriately designed length replacing an expansion valve will result in a natural adjustment of the gas cooler pressure, so that the system balance always shifts to a favourable COP direction; this is contrary to the scepticism that exists on the capability of a capillary tube to attain the optimal pressure operation. There is an optimal length of capillary tube for a given diameter at which the heat pump runs optimally.
Study of Thermal and Microbiological Behavior of Foods Submitted to Evaporative Cooling Process
Authors: Santos da Silva Paulo Ricardo
Published: August 2015

Refrigeration is a widely used technique in the food industry to avoid microbiological spoilage of products. Several variables can affect the performance of chilling process, including the shape and the dimensions of the product, the thermophysical properties of the food and the cooling fluid. The evaporative cooling increases the rate at which the temperature of the products is reduced. However, it makes the refrigeration process more complex, since it involves the simultaneous mass and heat transfer. In this context, numerical simulation is a useful tool to analyze the processes because it allows investigating different operational conditions in a virtual environment, in a quick and inexpensive way. The goal of this chapter was to study the influence of process variables on thermal and microbiological behavior of minimally processed foods submitted to refrigeration process with and without evaporative cooling effect, by means of two case studies.
Effect of Hygienic Design and Operational Parameters on Frosting and Defrosting of Evaporators in Refrigerated Food Processing and Storage Facilities
Authors: Moerman Frank Theo , Fikiin Kostadin
Published: August 2015

Proper control and performance of evaporators in food refrigeration facilities are vital to provide a suitable temperature regime, safety, quality and wholesomeness of refrigerated products at minimum electricity costs. When humid air passes along the surfaces of a low-temperature evaporator, frost is usually formed, which decreases the heat transfer efficiency. Frosting and defrosting phenomena have been extensively investigated for different industrial scenarios and extensive literature exists in the matter. However, no studies have been published so far to address in a comprehensive way the methods and patterns of evaporator defrosting as affected by hygienic design implications and criteria. This book chapter is intended to fill in this gap by enforcing hygienic imperatives in the evaporator design. Various design solutions and conditions of operation are considered as decisive in determining the amount, thickness and structure of the frost build-up. Advantages and drawbacks of diverse defrost methods are outlined with regards to contamination risks in refrigeration facilities.
Cold Thermal Energy Storage
Authors: Kosi Franc Franc , Zivkovic Branislav , Komatina Mirko S. , Antonijevic Dragi , Galil Mohamed Abdul , Milovancevic Uros Milorad
Published: August 2015

The chapter gives an overview of cold thermal energy storage (CTES) technologies. Benefits as well as classification and operating strategies of CTES are discussed. Design consideration and sizing strategies based on calculated load profile for design day is presented. Some recommendation concernig designing of CTES equipment are given. Special attention was paid to the analysis of specific features of heat transfer phenomena in ice storage tank including the assessment of the duration and the rate of ice formation and melting. The methodology of sizing components of the ice thermal storage system included in an air conditioning system for a office building situated in hot wet and dry climate are presented. Based on hourly cooling load calculation that was carried out using Carrier's Hourly Analysis Program, sizing of ice thermal storage system for different operating strategies included full, chiller priority and ice priority storage operation for the design day are presented. Finally, an analysis of some operational characteristics of the system are analyzed.
Integration of Renewable Energy in Refrigerated Warehouses
Authors: Fikiin Kostadin , Stankov Borislav
Published: August 2015

Refrigerated warehouses are large energy consumers and account for a significant portion of the global energy demand. Nevertheless the opportunity for integration of renewable resources in the energy supply of large cold storage facilities is very often unjustifiably neglected, whereas the employment of renewable energy for many other industrial and comfort applications is actively promoted and explored. In that context, the purpose of this chapter is to bridge the existing gap by raising the public awareness of stakeholders, researchers, practicing engineers and policy makers about the availability of a number of smart engineering solutions and control strategies to exploit renewables of different nature (solar, wind, geothermal, biogas, etc.) in the food storage sector, as well as by calling the readers' attention to the specialised knowledge in the matter, which has been published so far.
Motivations behind Becoming a Blogger and Their Business Implications
Authors: Larraufie Anne-Flore Maman , Sommer Fabien
Published: August 2015

This chapter takes fashion blogs as a case to explain motivations behind becoming a blogger and then to keep being one on the long-term. It wraps up past research findings before presenting the result of an original study conducted recently with authors of successful blogs as interviewees. It presents the typology of motivations but also the nature of potential brand-blogger relationships. Understanding such points is key to successfully use blogs as part of a useful WoM communication strategy. Findings generalizable across other sectors of activity conclude the chapter.
Developing a Research Framework to Assess Online Consumer Behaviour Using Netnography in India
Authors: Deka Gautam , Rathore Sumangla , Panwar Avinash
Published: August 2015

Netnography is a specialized form of ethnographic research that has been adapted to the unique contingencies of various types of computer-mediated social interaction. With the tremendous growth in the number of Internet users in India, the potential of utilizing netnography to study various aspects of management and business has also increased. Several e-Commerce companies have started operating in India since 2007. Over time, the number of online consumers has also increased in India. Therefore it is important to know the online consumer behaviour towards e-Commerce companies operating in India. Keeping the above facts in view, this chapter proposes Netnogrpahy as an effective research method to assess online consumer behavior. The chapter not only helps in providing future agenda for research, but also presents a framework that may be adopted to carry out Netnogrpahy of e-commerce related websites in India.
Facebook Experience Is Different
Authors: Duhan Punita , Singh Anurag
Published: August 2015

Though the concept of experience was propounded decades ago, the terms such as Customer Experience Management, Brand Experience etc. have started gaining currency only recently. Renewed focus on the concept is the result of positive impacts of brand experience as evidenced by researches. Emergence of Social Media has provided the organizations with supplementary platforms to enhance customer experiences. The experiences of customers with various social media platforms may rub on to their experiences with the brands being promoted through these. Accordingly, present research studies the experience of select social media platforms in Indian context. Result revealed that the experience of Facebook was significantly favorable in comparison to the rest three platforms; however, a scope of improvement is evident. Result is important for platform developers as it helps them to improve their platforms and for Marketing managers as it guides them to associate their brands with the more favourable platforms in order to reap concomitant benefits.
Is It Worth Sharing?
Authors: Roy Moumita
Published: August 2015

Social media has been found to have created a paradigm shift in the digital marketplace by giving a new technological face to marketing, highlighting on brand awareness and effectiveness. In this digital marketplace, emotions lead users to like or dislike, share or not to share messages, thus evoking, influencing and shifting public opinions on everything from political parties to corporate reputations, brands, products etc. It is important to understand how emotions and content relevance make these messages go viral. To explore this relationship, in-depth interviews with people of Generation Y were conducted, who were shown two videos that have gone viral. Findings focus on how the content of these videos and emotions generated will lead the respondents to share them online. Further this study helped design a Emo-Cog (emotion –cognition) induced decision tree model which the generation Y consumers might frequently be using to decide on whether to share the videos or not. The discussion unveils future avenues highlighting emotions in viral marketing.