bluuebunny/crossref_metadata_2025 huggingface dataset:
Multidisciplinary management of hepatoblastoma in children: Experience from a developing country
Authors: Shanmugam Naresh , Scott Julius Xavier , Kumar Vimal , Vij Mukul , Ramachandran Priya , Narasimhan Gomathy , Reddy Mettu Srinivas , Kota Venugopal , Munirathnam Deenadayalan , Kelgeri Chayarani , Sundaram Karthick , Rela Mohamed
Published: October 2016

Background

Advances in chemotherapy, liver resection techniques, and pediatric liver transplantation have vastly improved survival in children with hepatoblastoma (HB). These are best managed by a multidisciplinary team (MDT) in a setting where all treatment options are available. Until recently, this was difficult to achieve in India.

Methods

All children (<16 years) with HB treated in a pediatric liver surgery and transplantation unit between January 2011 and July 2016 were reviewed. Data regarding the clinical presentation, preoperative management, surgical treatment, postoperative course, and outcomes were extracted from a prospectively managed database.

Results

Thirty children were treated for HB during the study period. Nine children were PRETEXT 4, 7 were PRETEXT 3, 13 were PRETEXT 2, and 1 was PRETEXT 1 (where PRETEXT is pretreatment extension). All children received a neoadjuvant chemotherapy before surgery followed by an adjuvant chemotherapy. Nineteen children had complete resection, while six underwent primary living donor liver transplantation. There were six mortalities including five children who poorly responded to chemotherapy with progressive tumor extension. At a median follow‐up of 30 months, two children who underwent resection and one child who underwent liver transplant had disease recurrence.

Conclusion

Improved outcomes can be achieved in children with HB even in countries with limited resources when they are managed by MDTs with expertise in pediatric oncology, liver resection, and liver transplantation.
Hodgkin lymphoma, HIV, and Epstein–Barr virus in Malawi: Longitudinal results from the Kamuzu Central Hospital Lymphoma study
Authors: Westmoreland Katherine D. , Stanley Christopher C. , Montgomery Nathan D. , Kaimila Bongani , Kasonkanji Edwards , El‐Mallawany Nader Kim , Wasswa Peter , Mtete Idah , Butia Mercy , Itimu Salama , Chasela Mary , Mtunda Mary , Chikasema Maria , Makwakwa Victor , Kampani Coxcilly , Dhungel Bal M. , Sanders Marcia K. , Krysiak Robert , Tomoka Tamiwe , Liomba N. George , Dittmer Dirk P. , Fedoriw Yuri , Gopal Satish
Published: October 2016

Background

Contemporary descriptions of classical Hodgkin lymphoma (cHL) are lacking from sub‐Saharan Africa where human immunodeficiency virus (HIV) and Epstein–Barr virus (EBV) are prevalent.

Methods

We describe a prospective cHL cohort in Malawi enrolled from 2013 to 2015. Patients received standardized treatment and evaluation, including HIV status and EBV testing of tumors and plasma.

Results

Among 31 patients with confirmed cHL, the median age was 19 years (range, 2–51 years) and 22 (71%) were male. Sixteen patients (52%) had stage III/IV, 25 (81%) B symptoms, and 16 (52%) performance status impairment. Twenty‐three patients (74%) had symptoms >6 months, and 11 of 29 (38%) had received empiric antituberculosis treatment. Anemia was common with median hemoglobin 8.2 g/dL (range, 3.1‐17.1 g/dL), which improved during treatment. No children and 5 of 15 adults (33%) were HIV+. All HIV+ patients were on antiretroviral therapy for a median 15 months (range, 2–137 months), with median CD4 count 138 cells/μL (range, 23–329 cells/μL) and four (80%) having undetectable HIV. EBV was present in 18 of 24 (75%) tumor specimens, including 14 of 20 (70%) HIV− and 4 of 4 (100%) HIV+. Baseline plasma EBV DNA was detected in 25 of 28 (89%) patients, with median viral load 4.7 (range, 2.0–6.7) log10copies/mL, and subsequently declined in most patients. At 12 months, overall survival was 75% (95% confidence interval [CI], 55%–88%) and progression‐free survival 65% (95% CI, 42%–81%). Baseline plasma EBV DNA and persistent viremia during treatment were associated with poorer outcomes.

Conclusion

cHL in Malawi is characterized by delayed diagnosis and advanced disease. Most cases were EBV associated and one‐third of adults were HIV+. Despite resource limitations, 12‐month outcomes were good.
Reduced bulk and surface states densities in metal‐induced crystallized polycrystalline silicon nanowires
Authors: Le Borgne B. , Pichon L. , Thomas M. , Salaün A. C.
Published: October 2016

Polycrystalline silicon nanowires are fabricated following sidewall spacer approach using conventional UV lithography technique. Unfortunately, solid phase crystallization of nanowires implies low electrical properties due to the poor nanowires crystal quality. As polycrystalline silicon nanowires based field effect transistors find a lot of applications, improving nanowires crystalline quality is a technological challenge. One solution studied here is metal induced lateral crystallization method, using nickel as catalyst to create oriented crystals. The comparison is done between these two crystallization techniques. Indeed, we deeply investigate silicon nanowires/insulator interface and nanowires qualities by the determination of the energy distributions of the densities of states and the surface states using the Suzuki's incremental method. This calculation confirms that metal induced lateral crystallization significantly reduces bulk and surface states densities, compared to solid phase crystallized nanowires.
High coercivity in Fe–Nb–B–Dy bulk nanocrystalline magnets
Authors: Ziółkowski Grzegorz , Chrobak Artur , Klimontko Joanna , Chrobak Dariusz , Životský Ondřej , Hendrych Aleš , Rak Jan
Published: October 2016

The paper refers to structural and magnetic properties of the (Fe80Nb6B14)1−xDyx (x = 0.08, 0.10, 0.12, 0.16) bulk nanocrystalline alloys prepared by making use of the vacuum suction casting technique. The samples are in a form of rods with different diameters d = 1.5, 1, and 0.5 mm. The phase structure was investigated by XRD technique and reveals an occurrence of magnetically hard Dy2Fe14B as well as other relatively soft Dy–Fe, Fe–B, and Fe phases dependently on the Dy content. The alloys show hard magnetic properties with high coercive field up to 5.5 T (for x = 0.12 and d = 0.5 mm). The observed magnetic hardening effect with the increase of cooling rate (decrease of sample diameter d) can be attributed to a formation of ultra‐hard magnetic objects as well as increasing role of low dimensional microstructure.
Reliability of the Timed Up and Go Test in Fibromyalgia
Authors: Collado-Mateo Daniel , Domínguez-Muñoz Francisco J. , Adsuar José C. , Merellano-Navarro Eugenio , Olivares Pedro R. , Gusi Narcis
Published: October 2016

Purpose:

The aim of the study was to evaluate the test–retest reliability of the timed up and go test using manual and automatic chronometer (chronopic) in women with fibromyalgia.

Design:

Cross-sectional study with convenience sample.

Method:

A total of 49 women with fibromyalgia, aged 50.20 ± 10.01 participated in the study.

Findings:

The intraclass correlation coefficient was .935 with the manual stopwatch and .955 with the chronopic. The smallest real difference using manual stopwatch was 9.327%, whereas for the timed up and go using the chronopic it was 7.708%. Mean of the three repetitions was significantly different (p = .005) between both chronometers.

Conclusion:

Timed up and go is a reliable physical fitness test for assessing agility/dynamic balance in women with fibromyalgia.

Clinical Relevance:

The reliability is higher when the time is tracked using an automatic chronometer, which is easy to use and not expensive in terms of time and money, the use of this device is recommended in the nursing practice.
Robust multi‐rate modulation for cognitive radio communications over land mobile satellite channel at Ku‐band
Authors: Murroni Maurizio , Popescu Vlad , Fadda Mauro , Giusto Daniele
Published: October 2016

The usable satellite spectrum is becoming scarce because of continuously increasing demand for broadcast, multimedia and interactive services. Because of the extensive use of predictive coding, multimedia data exhibit different sensitivities to transmission errors, which makes them suitable for unequal error protection (UEP) techniques. UEP mainly relies on differentiated error control coding which raises the robustness of data, but also increases the transmission bandwidth, which can be unwanted in case of limited resources often occurring in satellite communications. In this context, cognitive radio (CR) satellite communications has received important attention lately in the research community. In multi‐rate modulations (MRM), the properties of dy‐homogeneous signals are exploited to transmit over multiple band frequencies and time scales. MRM have been proved to be effective on unknown channels either in bandwidth or time. These conditions occur in CR networks where opportunistic communications are set up while preserving primaries licensed users. In CR, the uncertainty of transmission opportunity makes the use of error correcting codes not trivial. Therefore, to achieve robustness, this work proposes unequal power allocation (UPA) over the symbols of MRM according to both data sensitivity to channel errors and spectrum availability. As optimization criterion, the mean square error between the original and the decoded message, which has shown strong correlation with subjective perception, is used. To assess the effectiveness of the proposed scheme in realistic condition for CR satellite networks, the Land Mobile Satellite (LMS) model at Ku‐band is used to reproduce the memory associated with real channels. The non‐linearity of the satellite channel because of high power amplifier (HPA) prior to transmission has been accounted using the Saleh model. Copyright © 2016 John Wiley & Sons, Ltd.
Reviews of strategic management research
Authors: Ethiraj Sendil K. , Gambardella Alfonso , Helfat Constance E.
Published: October 2016

SMJ welcomes high‐quality reviews of strategic management research that not only synthesize existing research, but also seek to stimulate new research. As the field of strategic management has matured, many new research streams and perspectives have emerged. Reviews contribute to greater shared understanding and can promote cross‐fertilization across different streams of research. Copyright © 2016 John Wiley & Sons, Ltd.
Vertically Formed Graphene Stripe for 3D Field‐Effect Transistor Applications
Authors: Hong Seul Ki , Bong Jae Hoon , Cho Byung Jin , Hwang Wan Sik
Published: October 2016

A 100‐nm wide, vertically formed graphene stripe (GS) is demonstrated for three‐dimensional (3D) electronic applications. The GS forms along the sidewall of a thin nickel film. It is possible to further scale down the GS width by engineering the deposited thickness of the atomic layer deposition (ALD) Ni film. Unlike a conventional GS or graphene nanoribbon (GNR), the vertically formed GS is made without a graphene transfer and etching process. The process integration of the proposed GS FETs resembles that of currently commercialized vertical NAND flash memory with a design rule of less than 20 nm, implying practical usage of this formed GS for 3D advanced FET applications.
Stillbirth and intrauterine fetal death: factors affecting determination of cause of death at autopsy
Authors: Man J. , Hutchinson J. C. , Heazell A. E. , Ashworth M. , Levine S. , Sebire N. J.
Published: October 2016

Objectives

There have been several attempts to classify cause of death (CoD) in stillbirth; however, all such systems are subjective, allowing for observer bias and making comparisons between systems challenging. This study aimed to examine factors relating to determination of CoD using a large dataset from two specialist centers in which observer bias had been reduced by classifying findings objectively and assigning CoD based on predetermined criteria.

Methods

Detailed autopsy reports from intrauterine deaths in the second and third trimesters during 2005–2013 were reviewed and findings entered into a specially designed database, in which CoD was assigned using predefined objective criteria. Data regarding CoD categories and factors affecting determination of CoD were examined.

Results

There were 1064 intrauterine deaths, including 246 early intrauterine fetal deaths (IUFD) (< 20 weeks), 179 late IUFDs (20–23 weeks) and 639 stillbirths (≥ 24 weeks' gestation). Overall, around 40% (n = 412) had a clear CoD identified, whilst around 60% (n = 652) were classified as ‘unexplained’, including around half with identified risk factors or lesions of uncertain significance, with the remaining half (n = 292 (45%)) being entirely unexplained. A stepwise increase in the proportion of unexplained deaths was observed with increasing maceration. Black and Asian women had significantly greater proportions of deaths due to ascending infection, whilst women aged over 40 years had significantly increased placenta‐related CoDs. There was no significant difference in CoD distribution according to maternal body mass index or with increasing postmortem interval. Around half of those with an identifiable CoD could be identified from clinical review and external fetal examination or imaging, with most of the remainder being determined following placental examination.

Conclusions

Based on objective criteria, many intrauterine deaths throughout gestation remain unexplained despite autopsy examination. The rate of unexplained death varies from around 30% to 60% depending on interpretation of the significance of features. CoD determination is dependent on both the classification system used and subjective interpretation, such that variation in the proportion of ‘unexplained’ cases is based largely on speculation regarding mechanisms of death. Novel methods to determine objectively the mechanism of death at postmortem examination are required. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.
Stillbirth and intrauterine fetal death: contemporary demographic features of >1000 cases from an urban population
Authors: Man J. , Hutchinson J. C. , Ashworth M. , Heazell A. E. , Jeffrey I. , Sebire N. J.
Published: October 2016

Objectives

Of 780 000 births annually in the UK, around 3300 are stillborn, a rate of approximately 4 per 1000 births. Traditional epidemiological associations are based on historic data. The aim of this study was to document contemporary demographic findings in a large series of > 1000 deaths in utero in London and compare these with national datasets.

Methods

From a dedicated database, including > 400 data fields per case, of fetal, infant and pediatric autopsies performed at Great Ormond Street Hospital and St George's Hospital, London, we extracted information on all intrauterine deaths, excluding terminations of pregnancy, from 2005 to 2013, inclusive. Demographic data were analyzed according to the gestational age at which fetal death occurred (second‐trimester intrauterine fetal death (IUFD), subdivided into early (< 20 weeks) and late (20–23 weeks) IUFD, and third‐trimester stillbirth (≥ 24 weeks)) and compared with national datasets when available, using Mann–Whitney U‐test and comparison of proportions testing as appropriate.

Results

Data were available from 1064 individual postmortem reports examining intrauterine deaths delivered between 12 and 43 weeks' gestation, including 425 IUFDs (246 early and 179 late) and 639 stillbirths. Compared with the overall UK pregnant population, women in whom an intrauterine death occurred were significantly older and more obese. White mothers had a higher proportion of stillbirths (as opposed to IUFDs) than did non‐white mothers, whereas black mothers had a higher proportion of IUFDs relative to stillbirths. Increased body mass index was associated with increased risk across all groups. Women who had uterine fibroids, those who had a history of vaginal bleeding in early pregnancy and those who had undergone assisted conception had a relatively higher proportion of IUFDs than stillbirths.

Conclusions

Based on a large series of >1000 autopsies in cases of intrauterine death, these data highlight the increased risk for fetal loss associated with maternal demographic factors in contemporary clinical practice, particularly associations with increased maternal age and body mass index. Among women in whom an intrauterine death occurs, maternal ethnicity, mode of conception and gynecological history are associated with differing timing of fetal loss. Further research is required to understand the mechanisms involved in such maternal factors in order to develop preventative strategies. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.
Opportunities to encourage mobilization of sustainable bioenergy supply chains
Authors: Smith C. Tattersall , Lattimore Brenna , Berndes Göran , Bentsen Niclas Scott , Dimitriou Ioannis , (Hans) Langeveld J.W.A. , Thiffault Evelyne
Published: October 2016

Significant opportunities exist to reduce greenhouse gas emissions, increase domestic energy security, boost rural economies, and improve local environmental conditions through the deployment of sustainable bioenergy and bio‐based product supply chains. There is currently a wide selection of possible feedstocks, a variety of conversion routes, and a number of different end products that can be produced at a range of scales. However, economic slowdown, low oil prices, lack of global political will, and lingering questions regarding land use change and the sustainability of bioenergy production systems provide a challenging global context to speed the pace of investment. The opinions expressed in this paper are derived from our collaboration within IEA Bioenergy to determine opportunities as well as barriers that need to be overcome to realize opportunities on a wider scale. This comprehensive and novel collaborative effort confirmed that feedstocks produced using logistically efficient production systems can be mobilized to make significant contributions to achieving global targets for bioenergy. At the same time, significant barriers to large‐scale implementation exist in many regions. The mobilization potential identified in the study will depend on both increases in supply chain efficiencies and profits and strong policy support to increase stakeholder and investor confidence. WIREs Energy Environ 2017, 6:e237. doi: 10.1002/wene.237

This article is categorized under:

Bioenergy > Economics and Policy

Energy Policy and Planning > Climate and Environment
Graphene oxide as a scaffold for bone regeneration
Authors: Holt Brian D. , Wright Zoe M. , Arnold Anne M. , Sydlik Stefanie A.
Published: October 2016

Graphene oxide (GO), the oxidized form of graphene, holds great potential as a component of biomedical devices, deriving utility from its ability to support a broad range of chemical functionalities and its exceptional mechanical, electronic, and thermal properties. GO composites can be tuned chemically to be biomimetic, and mechanically to be stiff yet strong. These unique properties make GO‐based materials promising candidates as a scaffold for bone regeneration. However, questions still exist as to the compatibility and long‐term toxicity of nanocarbon materials. Unlike other nanocarbons, GO is meta‐stable, water dispersible, and autodegrades in water on the timescale of months to humic acid‐like materials, the degradation products of all organic matter. Thus, GO offers better prospects for biological compatibility over other nanocarbons. Recently, many publications have demonstrated enhanced osteogenic performance of GO‐containing composites. Ongoing work toward surface modification or coating strategies could be useful to minimize the inflammatory response and improve compatibility of GO as a component of medical devices. Furthermore, biomimetic modifications could offer mechanical and chemical environments that encourage osteogenesis. So long as care is given to assure their safety, GO‐based materials may be poised to become the next generation scaffold for bone regeneration. WIREs Nanomed Nanobiotechnol 2017, 9:e1437. doi: 10.1002/wnan.1437

This article is categorized under:

Implantable Materials and Surgical Technologies > Nanomaterials and Implants

Implantable Materials and Surgical Technologies > Nanotechnology in Tissue Repair and Replacement
Factors influencing spatial heterogeneity of female white‐tailed deer harvest dynamics
Authors: Karns Gabriel R. , Gates Robert J. , Matthews Stephen N. , Bruskotter Jeremy T. , McCoy J. Clint , Tonkovich Michael J.
Published: October 2016

Successful management of exploited wildlife populations is contingent upon understanding what variables most affect mortality rates (e.g., legal harvest mortality) and adopting regulations that directly address those factors in a manner that accomplishes desired outcomes. We tested biological, ecological, and sociocultural variables related to female white‐tailed deer (Odocoileus virginianus) harvest densities in Ohio, USA, during 2007–2012. At the county level, the proportion of farmland (standardized‐β = −0.37, P < 0.001), the proportion of noncrop cover types within farmland (standardized‐β = 0.46, P < 0.001), and per capita deer permit sales (hunting pressure; standardized‐β = 0.32, P < 0.001) explained 76% of the variance in female white‐tailed deer harvest density. Available habitat likely influences harvest density through the direct relationship of deer abundance and forage availability and indirectly through the effect of cover on deer vulnerability and hunter access. The proxy for hunting pressure also was positively related to female deer harvest density, thereby underscoring the important role of hunters in Ohio's white‐tailed deer management. Understanding how county‐level factors are related to female deer harvest densities is a first step toward basing deer management units and management actions on a solid understanding of landscape–harvest dynamics. © 2016 The Wildlife Society.
Efficacy of surgical sterilization for managing overabundant suburban white‐tailed deer
Authors: Boulanger Jason R. , Curtis Paul D.
Published: October 2016

Based on decades of increasing deer effects on local biodiversity, agricultural damage, and deer–vehicle collisions, we implemented a suburban white‐tailed deer (Odocoileus virginianus) research and management program in 2007 on Cornell University lands in Tompkins County, New York, USA. We attempted to reduce deer numbers by surgically sterilizing female deer in the 445‐ha suburban core campus via tubal ligation and ovariectomy. From 2007 to 2013, we sterilized 93 deer and radiocollared 67 adult females to monitor fawning. Tubal ligation and ovariectomy surgeries appeared to prevent birth in 96% and 100% of treated female deer, respectively. We implemented a camera survey, used a mark–resight model in Program NOREMARK to estimate annual deer abundance, and observed no reduction in female abundance by winter 2013. Conversely, we noted a 38% and 79% decrease of total adult females and fawns visible in sampled photographs, respectively, and an 873% increase in adult male visitation to camera traps on core campus. Surgical sterilization appeared to be ineffective for reducing the abundance of a geographically open population of white‐tailed deer in the absence of lethal management. We do not recommend surgical sterilization as a stand‐alone method for communities wishing to pursue mitigation of deer impacts with nonlethal approaches. © 2016 The Wildlife Society.
A Cost-Effectiveness Analysis of Gemcitabine plus Cisplatin Versus Gemcitabine Alone for Treatment of Advanced Biliary Tract Cancer in Japan
Authors: Tsukiyama Ikuto , Ejiri Masayuki , Yamamoto Yoshihiro , Nakao Haruhisa , Yoneda Masashi , Matsuura Katsuhiko , Arakawa Ichiro , Saito Hiroko , Inoue Tadao
Published: October 2016

Objectives

This study assessed the cost-effectiveness of combination treatment with gemcitabine and cisplatin compared to treatment with gemcitabine alone for advanced biliary tract cancer (BTC) in Japan.

Methods

A monthly transmitted Markov model of three states was constructed based on the Japan BT-22 trial. Transition probabilities among the health states were derived from a trial conducted in Japan and converted to appropriate parameters for our model. The associated cost components, obtained from a receipt-based survey undertaken at the Aichi Medical University Hospital, were those related to inpatient care, outpatient care, and treatment for BTC. Costs for palliative care and treatment of adverse events were obtained from the National Health Insurance price list. We estimated cost-effectiveness per quality-adjusted life year (QALY) at a time horizon of 36 months. An annual discount of 3 % for both cost and outcome was considered.

Results

The base case outcomes indicated that combination therapy was less cost-effective than monotherapy when the incremental cost-effectiveness ratio (ICER) was approximately 14 million yen per QALY gained. The deterministic sensitivity analysis of the ICER revealed that the ICER of the base case was robust. A probabilistic analysis conducted with 10,000-time Monte Carlo simulations demonstrated efficacy at the willingness to pay threshold of 6 million yen per QALY gained for approximately 33 % of the population.

Conclusion

In Japan, combination therapy is less cost-effective than monotherapy for treating advanced BTC, regardless of the statistical significance of the two therapies. Useful information on the cost-effectiveness of chemotherapy is much needed for the treatment of advanced BTC in Japan.
What is science without replication?
Authors: Leppink Jimmie , Pérez-Fuster Patricia
Published: October 2016

None
Back to Basics: Patient Care Transitions
Authors: Spruce Lisa
Published: October 2016

One of the most critical aspects of high‐quality patient care is communication. If a breakdown in communication occurs, vital patient information may be overlooked and not communicated at the patient hand over. Breakdowns in communication contribute to a majority of errors in health care. Implementing a standardized hand‐over protocol serves to improve the safety and reliability of this process and help decrease the risk of patient harm. This Back to Basics article highlights the steps to a successful hand over and provides strategies for developing an effective standardized communication process to reduce health care errors.
Conscious Leadership
Authors: Ward Suzanne F. , Haase Beth
Published: October 2016

Health care leaders need to use leadership methodologies that support safe patient care, satisfy employees, and improve the bottom line. Conscious leaders help create desirable personal and professional life experiences for themselves using specific tools that include mindfulness, context, and the observer‐self, and they strive to help their employees learn to use these tools as well. In perioperative nursing, conscious leaders create an environment in which nurses are supported in their aim to provide the highest level of patient care and in which transformations are encouraged to take place; this environment ultimately promotes safety, contributes to fulfilling and meaningful work, and enhances a facility's financial viability. This article discusses some of the key concepts behind conscious leadership, how perioperative leaders can reach and maintain expanded consciousness, and how they can best assist their staff members in their own evolution to a more mindful state.
Creating Healing Environments Through the Theory of Caring
Authors: Norman Vivian , Rossillo Kim , Skelton Katie
Published: October 2016

We describe the journey of personnel at one hospital to create a healing environment for patients and staff members at all levels through the implementation of Watson's Theory of Human Caring and her Caritas Processes (ie, loving kindness, authentic presence, spirituality, being the environment, believing in miracles). We used experiential teaching and learning to explore the nursing theory with staff members. Positive outcomes include using Caritas Processes care plans in our electronic medical record, greater ease in the understanding and application of Watson's theory, integrating a blessing for nurses during National Nurses Week, inclusion of ministry formation courses to extend the mission of the hospital's founding religious order to current and future employees, and positive patient feedback. As a result of theory application, our nurses are more open to discussing caring, authentic presence and, when appropriate, prayer in their clinical narratives and how it is affecting patients and themselves.
Clinical Issues‐November 2016
Authors: Kovac Melissa
Published: October 2016

This Month

AORN guidelines in the National Guideline Clearinghouse

Key words: National Guideline Clearinghouse, AORN guidelines.

Role of medical librarians in developing AORN guidelines

Key words: medical librarians, systematic reviews, Institute of Medicine, National Guideline Clearinghouse.

Articles cited in AORN guidelines

Key words: AORN guidelines, National Library of Medicine, PubMed, interlibrary loan.
Multidisciplinary design optimization to identify additive manufacturing resources in customized product development
Authors: Yao Xiling , Moon Seung Ki , Bi Guijun
Published: October 2016

Additive manufacturing (AM) techniques are ideal for producing customized products due to their high design flexibility. Despite the previous studies on specific additive manufactured customized products such as biomedical implants and prostheses, the simultaneous optimization of components, materials, AM processes, and dimensions remains a challenge. Multidisciplinary design optimization (MDO) is a research area of solving complex design problems involving multiple disciplines which usually interact with each other. The objective of this research is to formulate and solve an MDO problem in the development of additive manufactured products customized for various customers in different market segments. Three disciplines, i.e. the customer preference modeling, AM production costing, and structural mechanics are incorporated in the MDO problem. The optimal selections of components, materials, AM processes, and dimensional parameters are searched with the objectives to maximize the functionality utility, match individual customers' personal performance requirements, and minimize the total cost. A multi-objective genetic algorithm with the proposed chromosome encoding pattern is applied to solve the MDO problem. A case study of designing customized trans-tibial prostheses with additive manufactured components is presented to illustrate the proposed MDO method. Clusters of multi-dimensional Pareto-optimal design solutions are obtained from the MDO, showing trade-offs among the objectives. Appropriate design decision can be chosen from the clusters based on the manufacturer's market strategy.

Highlights An optimization problem for additive manufactured customized products is solved. Three disciplines are incorporated in multidisciplinary design optimization (MDO). The selection of component, material, additive manufacturing process and dimensions are optimized. A multiobjective genetic algorithm is applied to solve the MDO problem. Pareto-optimal solutions with different utilities and costs are obtained.
No es aceptación, es sembrar la semilla para entender mejor una tensión educativa
Authors: Verge John
Published: October 2016

Respecto al artículo de Varela-Ruiz y Vives-Varela: «Autenticidad y calidad en la investigación educativa cualitativa: multivocalidad», creemos que es un aporte valioso para los investigadores latinoamericanos que realizamos estudios cualitativos en educación médica, debido a que con frecuencia nos frustramos cuando exponemos nuestros resultados a otros docentes médicos que, en su mayoría, equiparan la investigación a la epidemiología: «¡Eso es chisme!», «¡Para saber eso, no hay que hacer ningún estudio!», «¿Cómo demuestran que esas interpretaciones no son productos de sus prejuicios?», son algunos de los comentarios en nuestras reuniones de investigación y que intentamos argumentar basados en las estrategias de credibilidad.
Pressures of Wilderness Improvised Wound Irrigation Techniques: How Do They Compare?
Authors: Luck John B. , Campagne Danielle , Falcón Banchs Roberto , Montoya Jason , Spano Susanne J.
Published: October 2016

Objective

Compare the pressures measured by improvised irrigation techniques to a commercial device and to prior reports.

Methods

Devices tested included a commercial 500-mL compressible plastic bottle with splash guard, a 10-mL syringe, a 10-mL syringe with a 14-ga angiocatheter (with needle removed), a 50-mL Sawyer syringe, a plastic bag punctured with a 14-ga needle, a plastic bottle with cap punctured by a 14-ga needle, a plastic bottle with sports top, and a bladder-style hydration system. Each device was leveled on a support, manually compressed, and aimed toward a piece of glass. A high-speed camera placed behind the glass recorded the height of the stream upon impact at its highest and lowest point. Measurements were recorded 5 times for each device. Pressures in pounds per square inch (psi) were calculated.

Results

The syringe and angiocatheter pressures measured the highest pressures (16–49 psi). The 50-mL syringe (7–11 psi), 14-ga punctured water bottle (7–25 psi), and water bottle with sports top (3–7 psi) all measured at or above the commercial device (4–5 psi). Only the bladder-style hydration system (1–2 psi) and plastic bag with 14-ga needle puncture (2–3 psi) did not reach pressures generated by the commercial device.

Conclusions

Pressures are consistent with those previously reported. All systems using compressible water bottles and all syringe-based systems provided pressures at or exceeding a commercial wound irrigation device. A 14-ga punctured plastic bag and bladder-style hydration pack failed to generate similar irrigation pressures.
The Laws of Globalization and Business Applications
Authors: Ghemawat Pankaj
Published: October 2016

The Laws of Globalization and Business Applications employs a variety of empirical methodologies to establish two broad regularities that apply to international activity at the firm, industry, and country levels - the law of semiglobalization and the law of distance - and explores some of their implications for business. Part I presents evidence in support of the law of semiglobalization at the country and the business levels historically and up to the present. Part II performs an analogous function regarding the second law of globalization, showing that the gravity models that international economists have used to analyze merchandise trade between countries also apply to other types of international interactions - and at the industry and firm levels as well. Part III applies these laws to various challenges and opportunities that distance along various dimensions presents to multinational firms. A free online appendix provides additional data, analysis, and documentation to support research applications.
Investigation of tone generation in ideally expanded supersonic planar impinging jets using large-eddy simulation
Authors: Gojon Romain , Bogey Christophe , Marsden Olivier
Published: October 2016

The generation of tones in a supersonic planar jet impinging on a flat plate normally has been investigated by performing compressible large-eddy simulations using low-dissipation and low-dispersion finite differences. At the exit of a straight nozzle of height$h$, the jet is ideally expanded, and has a Mach number of 1.28 and a Reynolds number of$5\times 10^{4}$. Four distances between the nozzle and the plate between$3.94h$and$9.1h$have been considered. Flow snapshots and mean velocity fields are first presented. The variations of turbulence intensities and of the convection velocity in the jet shear layers are then examined. The properties of the jet near fields are subsequently described, in particular by applying Fourier decomposition to the pressure fields. Several coexisting tones appear to be generated by aeroacoustic feedback loops establishing between the nozzle lip and the flat plate, which also lead to the presence of hydrodynamic–acoustic standing waves. The tone frequencies are consistent with those given by the aeroacoustic feedback model and with measurements for high-aspect-ratio rectangular jets. The jet oscillation modes at these frequencies are characterized, and found to agree with experimental data. Their symmetric or antisymmetric natures are shown to be well predicted by a wave analysis carried out using a vortex sheet model of the jet, providing the allowable frequency ranges for the upstream-propagating acoustic waves. Thus, it is possible, for an ideally expanded impinging planar jet to predict both the frequencies of the tones and the symmetric or antisymmetric nature of the corresponding oscillation modes by combining the aeroacoustic feedback model and the wave analysis.
Fighting Fire with Fire: The Implications of (Not) Going Negative in a Multiparty Election Campaign
Authors: Roy Jason , Alcantara Christopher
Published: October 2016

This paper draws upon data collected from an online voting experiment to test the implications of “going negative” in a multiparty election campaign. Specifically, we investigate two sets of questions: First, does the attention and vote share that candidates receive vary according to the tone (positive/negative) of their election campaign? Second, does the attention and vote share that candidates receive vary according to whether or not all candidates engage in similar (positive/negative) campaigns? While studies of “negative campaigning” have been prominent in the American context, our work builds upon this literature by using an experimental design to test for their effects in a multiparty setting.
C.B. Macpherson and Philosophy, “Crypto” or Otherwise: A Response to Frank Cunningham
Authors: Hansen Phillip
Published: October 2016

I have a high regard for Frank Cunningham and his work, on socialism, on democratic theory—and on C.B. Macpherson. To take one example, his new introductions to the recent reissues of Macpherson's books from Oxford University Press, including The Political Theory of Possessive Individualism and Democratic Theory: Essays in Retrieval, are excellent. Lucid and informative, they highlight the value Macpherson's ideas hold for contemporary political thought. So I am grateful that he has offered so fulsome a critical response to my book—even though he finds my approach, based on the idea that there is a suppressed philosophical dimension in Macpherson's work, though (dubiously) audacious, to be of limited accuracy or usefulness—indeed ultimately misguided. It results, he claims, in an analysis that “detracts from Macpherson's political-theoretical and political strengths.”
Eliminating Indigenous Jurisdictions: Federalism, the Supreme Court of Canada, and Territorial Rationalities of Power
Authors: McCrossan Michael , Ladner Kiera L.
Published: October 2016

This paper examines judicial reasoning in the area of Aboriginal title, paying particular attention to the Supreme Court of Canada'sTsilhqot'in Nation(2014) decision. While the decision has been heralded as a ‘game-changer’ within media circles and legal commentaries for its recognition of a claim to title under section 35(1) of theConstitution Act, 1982, the authors argue that the decision does not depart substantially from prior judicial logics predicated upon the production of Crown sovereignty and the denial of Indigenous legal orders. In fact, the authors argue that the decision displays a clear judicial orientation towards the present jurisdictional divisions of Canadian federalism which not only serves to eliminate Indigenous legal orders and territorial responsibilities, but also provides federal and provincial governments with enhanced powers of ‘incursion’ into Aboriginal title lands.
CHLOETEMPESTIVA, MISERA, DOCTAANDARROGANS(HORACE,ODES1.23, 3.7, 3.9 AND 3.26)
Authors: McCune Blanche Conger
Published: October 2016

The name ‘Chloe’ appears four times in Horace'sOdes, once in Book 1 (1.23) and three times in Book 3 (3.7, 3.9, 3.26). Whether the ‘Chloes’ represent a woman or women from Horace's real life is probably not something we could know. Furthermore, there is no obvious reason to assume that all the ‘Chloes’ are the same person. However, there is likewise no obvious reasonnotto read the odes in which the name ‘Chloe’ appears, as some scholars have done, as referring to the same woman, fictional or otherwise. This article argues both that ‘Chloe’ is a consistent character in theOdesand that the portrayal of Chloe is not only connected across odes but also sequential. Taking the poems in order, we see Chloe grow up from a girl who is inexperienced in the world of men to a mature mistress who plays the dominant role in her love affairs.
CICERO,PHILIPPICS9.5 AND THE PORTICUS OCTAVIA
Authors: Tansey Patrick
Published: October 2016

On or shortly after 4 February 43b.c.Cicero delivered theNinth Philippicin an effort to persuade the Senate to honour Ser. Sulpicius Rufus (cos. 51). He argued that Sulpicius, who had died of natural causes while acting as the Senate's envoy, was nevertheless entitled to the same recognition aslegatikilledob rem publicam. In the course of the speech Cicero discussed various historic precedents, including Cn. Octavius (cos. 165) who was assassinated in Syria in 162b.c.while doing the Senate's bidding and was consequently honoured with a statue on the rostra. The statue was still extant in 43b.c.and Cicero reminded his audience that it was now the only memorial to this great family. Cicero's observation has unanimously been interpreted as signifying that the family of the consul of 165b.c.was extinct in February 43b.c.In fact, Cicero actually meant that the statue on the rostra was now the sole surviving monument associated with the family of Cn. Octavius because the other two monuments that had served as a concrete reminder of the family had latterly been destroyed.
HERCVLEVS LABOR – LABOR LIMAE: EPIC ARITHMETIC AT VIRGIL,AENEID8.230-2
Authors: Mader Gottfried
Published: October 2016

A distinctive feature ofAeneid8 is the constant interplay and fluctuation of registers, with high epic and thegenus grandealternating with the lighter strains or learned allusions associated with thegenus tenue. As one commentator has remarked, ‘Man darf das Buch allein schon wegen seines Reichtums an Aitien als das ‘kallimacheischste’ derAeneisbezeichnen.’ Beyond the emphasis on aetiology—the Cacus myth in particular is presented asaitionfor the consecration of the Ara Maxima—the Callimachean complexion comes out also in several smaller not-so-serious or learned touches, typically at unlikely moments to infuse an element of humour in an otherwise intensely dramatic narrative. The Hercules–Cacus episode conflates high drama and low comedy as the cattle rustler's slightly ridiculous stratagem becomes a gigantic clash resonating with the primal gigantomachy. Among the rudimentary weapons of mass destruction unleashed by Hercules upon Cacus (omniaque arma|aduocat et ramis uastisque molaribus instat, 8.249-50), the hapaxmolaris(massive boulder, lit. millstone) echoes its Homeric equivalent μύλαξ (Il. 12.161), itself a hapax, with the recherché term then reappearing (again as hapax) at Ovid,Metamorphoses3.59: missiles and diction are equally outlandish. When Hercules in a reprise of the celebrated Empedoclean leap plungesper ignemin pursuit of Cacus (8.256-8), an (incongruous) evocation of the Sicilian philosopher's fiery exit adds a touch of comedy at the heated moment. And from this inferno Virgil moves to Olympus, lowering the tone but raising the temperature as Venus in a domestic comedy seduces the uxorious Vulcan into preparing new armour for Aeneas: now she kindles flames of a different sort in the fire-god (8.388-92, 8.404-6) in a scene marked by witty double entendre that provides a playful contrast with the unfolding drama at Pallanteum. At moments like these, a lighter strain is audible through the epic thunder,Vergilius ludensis hard at work (or play).
Bitemporal v. high-dose right unilateral electroconvulsive therapy for depression: a systematic review and meta-analysis of randomized controlled trials
Authors: Kolshus E. , Jelovac A. , McLoughlin D. M.
Published: October 2016

Background

Brief-pulse electroconvulsive therapy (ECT) is the most acutely effective treatment for severe depression though concerns persist about cognitive side-effects. While bitemporal electrode placement is the most commonly used form worldwide, right unilateral ECT causes less cognitive side-effects though historically it has been deemed less effective. Several randomized trials have now compared high-dose (>5× seizure threshold) unilateral ECT with moderate-dose (1.0–2.5× seizure threshold) bitemporal ECT to investigate if it is as effective as bitemporal ECT but still has less cognitive side-effects. We aimed to systematically review these trials and meta-analyse clinical and cognitive outcomes where appropriate.

Method

We searched PubMed, PsycINFO, Web of Science, Cochrane Library and EMBASE for randomized trials comparing these forms of ECT using the terms ‘electroconvulsive’ OR ‘electroshock’ AND ‘trial’.

Results

Seven trials (n = 792) met inclusion criteria. Bitemporal ECT did not differ from high-dose unilateral ECT on depression rating change scores [Hedges's g = −0.03, 95% confidence interval (CI) −0.17 to 0.11], remission (RR 1.06, 95% CI 0.93–1.20), or relapse at 12 months (RR 1.42, 95% CI 0.90–2.23). There was an advantage for unilateral ECT on reorientation time after individual ECT sessions (mean difference in minutes = −8.28, 95% CI −12.86 to −3.70) and retrograde autobiographical memory (Hedges's g = −0.46, 95% CI −0.87 to −0.04) after completing an ECT course. There were no differences for general cognition, category fluency and delayed visual and verbal memory.

Conclusions

High-dose unilateral ECT does not differ from moderate-dose bitemporal ECT in antidepressant efficacy but has some cognitive advantages.
The efficacy of psychotherapy, pharmacotherapy and their combination on functioning and quality of life in depression: a meta-analysis
Authors: Kamenov K. , Twomey C. , Cabello M. , Prina A. M. , Ayuso-Mateos J. L.
Published: October 2016

Background

There is growing recognition of the importance of both functioning and quality of life (QoL) outcomes in the treatment of depressive disorders, but the meta-analytic evidence is scarce. The objective of this meta-analysis of randomized controlled trials (RCTs) was to determine the absolute and relative effects of psychotherapy, pharmacotherapy and their combination on functioning and QoL in patients with depression.

Method

One hundred and fifty-three outcome trials involving 29 879 participants with depressive disorders were identified through database searches in Pubmed, PsycINFO and the Cochrane Central Register of Controlled Trials.

Results

Compared to control conditions, psychotherapy and pharmacotherapy yielded small to moderate effect sizes for functioning and QoL, ranging fromg= 0.31 tog= 0.43. When compared directly, initial analysis yielded no evidence that one of them was superior. After adjusting for publication bias, psychotherapy was more efficacious than pharmacotherapy (g= 0.21) for QoL. The combination of psychotherapy and medication performed significantly better for both outcomes compared to each treatment alone yielding small effect sizes (g= 0.32 tog= 0.39). Both interventions improved depression symptom severity more than functioning and QoL.

Conclusion

Despite the small number of comparative trials for some of the analyses, this study reveals that combined treatment is superior, but psychotherapy and pharmacotherapy alone are also efficacious for improving functioning and QoL. The overall relatively modest effects suggest that future tailoring of therapies could be warranted to better meet the needs of individuals with functioning and QoL problems.