bluuebunny/crossref_metadata_2025 huggingface dataset:
Acceptable Plasma Concentrations of Raltegravir and Etravirine When Administered by Gastrostomy Tube in a Patient with Advanced Multidrug‐Resistant Human Immunodeficiency Virus Infection
Authors: Sandkovsky Uriel , Swindells Susan , Moore Ryan , Acosta Edward P. , Fletcher Courtney V.
Published: September 2012

Study Objective

To determine whether the absorption of four antiretroviral agents—raltegravir, etravirine, emtricitabine, and tenofovir—is compromised when administered by gastrostomy tube.

Design

Pharmacokinetic analysis.

Setting

University medical center.

Patient

A 52‐year‐old African‐American man coinfected with advanced multidrug‐resistant human immunodeficiency virus (HIV) and chronic hepatitis B, who was receiving treatment with raltegravir, etravirine, emtricitabine, and tenofovir, and developed ulcerative esophagitis with perforation, requiring a gastrostomy tube.

Measurements and Main Results

Due to the patient's esophageal perforations, all nutrition and drug therapy had to be provided by gastrostomy tube. As his antiretroviral regimen of raltegravir, etravirine, and emtricitabine‐tenofovir was not available in liquid or powder formulations, the oral tablets were crushed or dispersed and mixed with water, then administered by gastrostomy tube. To ensure that the absorption of the drugs was sufficient for antiretroviral response, plasma samples were collected at 2 hours and 12 hours after dosing, and drug concentrations were quantitated by using validated assays. The 2‐ and 12‐hour postdose plasma concentrations were 1220 and 446 ng/ml for raltegravir, 212 and 274 ng/ml for etravirine, 1148 and 164 ng/ml for emtricitabine, and 320 and 94 ng/ml for tenofovir, respectively. The patient's plasma concentrations were then compared with those in published pharmacokinetic studies of oral regimens administered to HIV‐infected persons and healthy volunteers. Overall, the plasma concentrations of the antiretrovirals administered by gastrostomy tube were similar to published values. No drug toxicities were observed in this patient.

Conclusion

These pharmacokinetic data suggest that absorption of raltegravir, etravirine, emtricitabine, and tenofovir was not compromised when the drugs were administered by gastrostomy tube. These findings provide a basis for further investigation of the pharmacokinetics, safety, tolerance, and antiretroviral response to raltegravir, etravirine, and emtricitabine‐tenofovir when the oral route of administration is not possible.
Acute Care Clinical Pharmacy Practice: Unit‐ versus Service‐Based Models
Authors: Haas Curtis E. , Eckel Stephen , Arif Sally , Beringer Paul M. , Blake Elizabeth W. , Lardieri Allison B. , Lobo Bob L. , Mercer Jessica M. , Moye Pamela , Orlando Patricia L. , Wargo Kurt
Published: September 2012

This commentary from the 2010 Task Force on Acute Care Practice Model of the American College of Clinical Pharmacy was developed to compare and contrast the “unit‐based” and “service‐based” orientation of the clinical pharmacist within an acute care pharmacy practice model and to offer an informed opinion concerning which should be preferred. The clinical pharmacy practice model must facilitate patient‐centered care and therefore must position the pharmacist to be an active member of the interprofessional team focused on providing high‐quality pharmaceutical care to the patient. Although both models may have advantages and disadvantages, the most important distinction pertains to the patient care role of the clinical pharmacist. The unit‐based pharmacist is often in a position of reacting to an established order or decision and frequently is focused on task‐oriented clinical services. By definition, the service‐based clinical pharmacist functions as a member of the interprofessional team. As a team member, the pharmacist proactively contributes to the decision‐making process and the development of patient‐centered care plans. The service‐based orientation of the pharmacist is consistent with both the practice vision embraced by ACCP and its definition of clinical pharmacy. The task force strongly recommends that institutions pursue a service‐based pharmacy practice model to optimally deploy their clinical pharmacists. Those who elect to adopt this recommendation will face challenges in overcoming several resource, technologic, regulatory, and accreditation barriers. However, such challenges must be confronted if clinical pharmacists are to contribute fully to achieving optimal patient outcomes.
Prescription Ergocalciferol Dosing for Vitamin D Repletion: A Retrospective Evaluation
Authors: Vande Griend Joseph P. , McQueen Robert B. , Linnebur Sunny A. , Vondracek Sheryl F.
Published: September 2012

Study Objectives

To determine the efficacy and safety of vitamin D repletion with prescription ergocalciferol and to determine patient‐specific factors that may influence the amount of ergocalciferol needed to attain vitamin D sufficiency.

Design

Retrospective medical record review.

Setting

University‐affiliated outpatient health system.

Patients

A total of 1446 patients aged 18–89 years who had a prescription for ergocalciferol 50,000 IU between January 1, 2007, and December 31, 2008, were identified; of these patients, 582 patients had a vitamin D concentration measured 120 days before their first prescription (baseline) and had another concentration measured 60–180 days after this prescription (follow‐up) and were deemed “first‐time users” of ergocalciferol.

Measurements and Main Results

Vitamin D sufficiency was defined as a 25‐hydroxyvitamin D (vitamin D) concentration of 30 ng/ml or higher. Twenty‐nine different ergocalciferol prescribing regimens were identified in the 1446 patients. For the 582 first‐time users of ergocalciferol, vitamin D concentrations increased from a mean ± SE of 17.7 ± 0.32 ng/ml at baseline to 32.9 ± 0.73 ng/ml at first follow‐up concentration, with a mean ± SE prescribed ergocalciferol dose of 63,876 ± 1973 IU given over an average of 17 weeks. Overall, 326 (56%) of the 582 first‐time users attained sufficiency with their prescribed regimen. With use of a logistic regression model to control for variables that could influence a patient's response to vitamin D, patients prescribed 50,000–100,000 IU/week were significantly more likely to attain vitamin D sufficiency compared with those prescribed less than 50,000 IU/week (OR 2.61, 95% CI 1.37–4.99). Body mass index of 30 kg/m2 or higher decreased the odds of attaining vitamin D sufficiency, whereas use of a loading dose did not increase the odds of attaining sufficiency.

Conclusion

Many different ergocalciferol regimens were used to replace vitamin D, and overall attainment of vitamin D sufficiency appeared to be moderate. Based on our findings, an ergocalciferol regimen of 50,000–100,000 IU/week with no loading dose could be considered as a starting point for vitamin D repletion.
Changes in supportive care needs after first‐line treatment for ovarian cancer: identifying care priorities and risk factors for future unmet needs
Authors: Beesley Vanessa L. , Price Melanie A. , Webb Penelope M. , O'Rourke Peter , Marquart Louise ,   Australian Ovarian Cancer Study Group,   Australian Ovarian Cancer Study–Quality of Life Study Investigators, Butow Phyllis N
Published: August 2012

Objective

The objective of this paper is to determine changes in supportive care needs after first‐line treatment for ovarian cancer and identify risk factors for future unmet needs.

Methods

Two hundred and nineteen women with ovarian cancer were asked to complete a baseline survey 6–12 months after diagnosis then follow‐up surveys every 6 months for up to 2 years. The validated Supportive Care Needs Survey‐Short Form measured 34 needs across five domains. Logistic regression identified baseline variables associated with future needs.

Results

At baseline, standardized median scores (possible range 0–100, least‐to‐greatest need) within the psychological, system/information, physical, patient care and sexuality need domains were 25, 20, 15, 15 and 8, respectively. The most frequently reported moderate‐to‐high unmet needs at baseline were needing help with fear about cancer spreading (25%), concerns about worries of those close (20%), being informed about things to help get well (20%), uncertainty about future (19%) and lack of energy (18%). All except the item about being informed were still reported as unmet needs by ≥15% of women 2 years later. Median health system/information, patient care and sexuality need scores decreased over 2 years (p < 0.05), whereas psychological and physical scores remained constant. Risk factors for having ≥1 moderate‐to‐high unmet overall, psychological or physical need 1–2 years after baseline included older age, advanced disease, unmet need, anxiety, depression, insomnia and less social support at baseline.

Conclusion

Women with ovarian cancer report needing ongoing assistance to deal with psychological and physical needs over the first 2 years after first‐line treatment. Targeting individuals at risk of future unmet needs should be prioritized. Copyright © 2012 John Wiley & Sons, Ltd.
Soil Nitrogen Transformations Associated with Small Patterned‐Ground Features along a North American Arctic Transect
Authors: Kelley Alexia M. , Epstein Howard E. , Ping Chien‐Lu , Walker Donald A.
Published: September 2012

Small patterned‐ground features (PGFs) in the Arctic have unique soil properties that vary with latitude and may greatly affect tundra biogeochemistry. Because nitrogen availability can strongly limit arctic vegetation growth, we examined how soil nitrogen transformations differ between PGFs and the surrounding inter‐PGF tundra along an arctic latitudinal gradient. We collected soils at eight sites from the Alaskan Low Arctic to the Canadian High Arctic. The soils were incubated for 21 days at 9 °C and 15 °C and analysed for changes in total inorganic nitrogen, nitrate and extractable organic nitrogen (EON). We found greater nitrogen immobilisation in the surrounding inter‐PGF soils than in the PGF soils. Along the latitudinal gradient, differences in net nitrogen mineralisation and EON cycling between PGF and inter‐PGF soils were strongly influenced by the presence of a pH boundary within the Low Arctic and the transition between the High and Low Arctic, with greater immobilisation in the nonacidic and Low Arctic sites, respectively. Incubation temperature affected EON flux but did not affect net nitrogen mineralisation or nitrification. These results show that spatial heterogeneity at several scales can influence soil nitrogen dynamics, and is therefore an important influence on arctic ecosystem function. Copyright © 2012 John Wiley & Sons, Ltd.
Low temperature growth of nanocrystalline and ultrananocrystalline diamond films: A comparison
Authors: Kulisch Wilhelm , Petkov Christo , Petkov Emil , Popov Cyril , Gibson P. Neil , Veres Miklos , Merz Rolf , Merz Birgit , Reithmaier Johann Peter
Published: August 2012

In this paper the low temperature deposition of nanocrystalline and ultrananocrystalline diamond (UNCD) films is compared and discussed. NCD films were prepared by hot filament chemical vapor deposition from a 1% CH4/H2 mixture, while microwave plasma chemical vapour deposition was used to deposit UNCD films from a mixture of 17% CH4/N2. The resulting films have been thoroughly characterized concerning their morphology and structure by scanning electron microscopy and concerning their crystalline properties by X‐ray diffraction. The composition was analyzed by X‐ray photoelectron spectroscopy (XPS), whereas XPS and Raman spectroscopy were applied to get information on the bonding structure of the films. The most important result of this study is that the composition, structure, morphology, and bonding environment of UNCD hardly change if the deposition temperature is lowered from 770 to 530 °C or even 450 °C. In contrast, there are drastic changes of the nature of NCD films if the temperature is reduced to 700 °C or even lower. Interestingly, the sp2/sp3 ratio of the NCD films remains low and constant in the temperature range investigated. Rather, the nature of the sp2 grain boundary material undergoes drastic changes if the temperature is lowered below 700 °C. In addition, the films become inhomogeneous on a micrometer (not nanometer) scale. Possible reasons for these observations will be discussed throughout the paper.
Role of phosphorus in contact formation on silicon solar cells
Authors: Kulushich Gordana , Zapf‐Gottwick Renate , Nguyen Viet X. , Werner Jürgen H.
Published: August 2012

We reveal the role of phosphorus in contact formation between screen‐printed silver paste and n‐type emitter of industrial silicon solar cells. A higher inactive phosphorus concentration at the emitter surface leads to a larger areal fraction of silver crystallites at the contact. Thus, the specific contact resistivity is reduced. Inactive P atoms support the growth of Ag crystallites into the emitter by leaving the silicon lattice and forming an alloy of Ag/P within the Ag crystallites.

magnified image

(© 2012 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)
High‐performance solution‐processed amorphous ZrInZnO thin‐film transistors
Authors: Chung Ya‐Wei , Chen Fang‐Chung , Chen Ying‐Ping , Chen Yu‐Ze , Chueh Yu‐Lun
Published: August 2012

We have developed amorphous zirconium‐indium‐zinc‐oxide (ZrInZnO) as the channel layer to fabricate thin film transistors through a solution process. The best ZrInZnO transistor exhibited a field effect mobility of 3.80 cm2/Vs, an on–off ratio of ∼107, a threshold voltage of 0.44 V and a subthreshold swing of 0.42 V/dec. The function of the Zr element was investigated through electrical and thin‐film characterization. We found that Zr atoms behaved as effective carrier suppressors and the presence of Zr elements inhibited the crystallization of the InZnO phase. (© 2012 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)
Systematic calculation of the surface excitation parameters for 22 materials
Authors: Da B. , Sun Y. , Mao S. F. , Ding Z. J.
Published: September 2012

Quantitative surface analysis requires knowledge of surface excitations by electrons. These excitations are characterized by the surface excitation parameter (SEP) which represents the surface excitation probability while an electron moves across a solid surface. In this work, a systematic calculation of a SEP database has been performed for 22 materials, including metals, oxides and semiconductors, for electron energies between 100 eV and 5000 eV, and for angles α of incidence/emission between 0.5o and 89.5o with respect to the surface normal. Surface excitations are considered for both sides of a solid–vacuum interface when an electron is incident on or emitted from a surface. These SEPs represent not only the appearance of surface excitations but also the inhibition of bulk excitations. Four common SEP formulas are evaluated, and we present best‐fit parameters for the most satisfactory formula. SEP can then be readily determined for about 22 materials and various energies and electron incidence or emission angles. Copyright © 2012 John Wiley & Sons, Ltd.
Stress Proneness in Molecularly Defined Long QT Syndrome: A Study Using Temperament Assessment by Behavioural Inhibition System Scale
Authors: Määttänen Ilmari , Keltikangas‐Järvinen Liisa , Swan Heikki , Toivonen Lauri , Kontula Kimmo , Hintsanen Mirka , Alatupa Saija , Hintsa Taina
Published: August 2012

The long QT syndrome (LQTS) is an inherited cardiac disorder that predisposes the mutation carrier to ventricular arrhythmias that can lead to sudden death. The objective of the present study was to replicate the previous finding in terms of stress‐related temperament trait, i.e. behavioural inhibition system (BIS).

The study subjects included 583 LQTS mutation carriers (256 symptomatic and 327 asymptomatic) from the Finnish LQTS registry and 79 healthy subjects randomly derived from the population‐based sample of the Young Finns Study.

Symptomatic and asymptomatic LQTS mutation carriers did not differ from each other on BIS (3.27 versus 3.24, p > 0.05), whereas LQTS mutation carriers scored higher on BIS than the comparison group derived from the representative population‐based sample (3.25 versus 2.99, p = 0.003, η² = 0.014). BIS was significantly higher in women than in men (3.32 versus 3.06, p < 0.001, η² = 0.017).

The results confirm our previous finding of higher stress proneness of LQTS mutation carriers. Their innate stress proneness may have relevance because it increases our understanding on the role of stress in the manifestation of symptoms. Copyright © 2012 John Wiley & Sons, Ltd.
The Role of Strategic and Tactical Flexibility in Managing Input Variability on Farms
Authors: Cowan Lisa , Kaine Geoff , Wright Victor
Published: August 2012

Accepting that increased climate variability will require that farmers make significant changes to their farm systems, we can see that maintaining flexibility is an important coping strategy. Using general systems theory, we offer a conceptual model for describing the tactical and strategic flexibility of farm systems to reveal the sensitivity of farm systems to variable critical inputs. The model is used to classify farm systems as rigid, robust, or elastic on the basis of two factors, the capacity of the farmer to reduce reliance on critical inputs by altering the following: (i) the use of critical inputs and (ii) farm output. The different production emphasis for the different types of systems has implications for how these farmers are able to respond to increased variability and on public policies that may support viable farm businesses in the face of increased variability. Copyright © 2012 John Wiley & Sons, Ltd.
Nachweisverfahren zur Tragfähigkeit überwiegend axial beanspruchter Grouted Joints in Offshore‐Tragstrukturen
Authors: Schaumann Peter , Bechtel Anne , Lochte‐Holtgreven Stephan
Published: September 2012

Grout verfüllte Rohr‐in‐Rohr‐Steckverbindungen, so genannte Grouted Joints, in aufgelösten Unterstrukturen von Offshore‐Windenergieanlagen in großen Wassertiefen verfügen installationsbedingt über große Spaltmaße und werden maßgeblich durch Axiallasten beansprucht. Der Nachweis ausreichender Trag‐ und Ermüdungsfestigkeit dieser Grout‐Verbindung erfolgt derzeit mittels in Offshore‐Richtlinien vorgeschlagenen Ingenieurmodellen und Nachweiskonzepten. Ursprung der Ingenieurmodelle für den Nachweis im Grenzzustand der Tragfähigkeit sind maßstäbliche Versuche unter Axial‐ und Biegebeanspruchung an Grouted Joints mit Portlandzement‐Füllung. Anhand der für definierte Gültigkeitsgrenzen verwendbaren Ingenieurmodelle werden die Druckstrebentragfähigkeit sowie das Versagen der Groutmatrix untersucht. Bei von den Gültigkeitsgrenzen abweichender Geometrie sowie bei Einsatz moderner Hochleistungsgrouts zeigen die Ergebnisse der Modelle signifikante Abweichung zu den tatsächlichen Tragfähigkeiten. Im Rahmen dieses Beitrags wird ein weiterentwickeltes mechanisches Ingenieurmodell vorgestellt, mit dem die Tragfähigkeiten moderner Groutmaterialien sowie Einflüsse der Umschnürungswirkung der Stahlrohre zutreffend berechnet werden können und eine einfache Abschätzung der Tragfähigkeit axial beanspruchter Grouted Joints in Offshore‐Tragstrukturen ermöglicht wird.

Design of axially loaded grouted joints of offshore support structures. Grouted joints in spatial substructures of offshore wind turbines in deeper waters are prevailing axially loaded and due to installation procedures equipped with large grout annulus. Current design standards recommend the verification of the structural and fatigue behaviour using engineering models. The engineering models originate from empirical analyses and scaled tests including combined loading with Portland cement core for defined ranges of validity. The design with these formulae includes the calculation of the compression strut and the grout matrix failure. In case of deviating geometries or use of ultra high performance grouts, the actual axial strength of grouted joints is underestimated. Within this paper an enhanced engineering model based on simple structural mechanics is presented which incorporates influences of high performance grouts and confinement effects. Thus, an appropriate estimation of the axial strength for axially loaded grouted joints in offshore substructures is possible.
Persistent hexavalent chromium exposure impaired the pubertal development and ovarian histoarchitecture in wistar rat offspring
Authors: Samuel Jawahar B. , Stanley Jone A. , Sekar Pasupathi , Princess Rajendran A. , Sebastian Maria S. , Aruldhas Michael M.
Published: August 2012

Hexavalent chromium (CrVI) is a highly toxic metal and a major environmental pollutant. Several studies indicate that CrVI exposure adversely affects reproductive function. We reported that maternal Cr exposure resulted in Cr accumulation in the reproductive organs of female offsprings. CrVI can cross the placental barrier and also can be passed through breastfeeding. The present investigation aimed to determine the persistent (in utero through puberal period) CrVI exposure‐induced toxic effects on the reproductive functions of mother and the offspring. Induction of oxidative stress is one of the plausible mechanisms behind Cr‐induced cellular deteriorations. Mother rats exposed to CrVI showed reduced reproductive outcome, while the offsprings showed higher accumulation of Cr in ovary, altered steroid, and peptide hormones. Specific activities of antioxidant enzymes were decreased and associated with increased levels of H2O2, and lipid peroxidation. CrVI exposure also damaged the ovarian histoarchitecture in various age groups studied. CrVI exposure also delayed the sexual maturation. Results from the present investigation suggest that CrVI exposure from in utero through puberal period significantly damaged the pubertal development through altered antioxidants, anemia, and altered hormone levels. These changes were associated with damaged ovarian histoarchitecture and extended estrous cycle in developing Wistar rats. © 2012 Wiley Periodicals, Inc. Environ Toxicol 29: 814–828, 2014.
Metallic and plastic dye solar cells
Authors: Miettunen Kati , Halme Janne , Lund Peter
Published: September 2012

Dye solar cells (DSCs) are quite a new technology in photovoltaics. The traditional DSCs are prepared on conductively coated glass substrates in high temperature using a batch process. Manufacturing the cells on low‐cost metal and plastic substrates would enable significant cost reductions as well as roll‐to‐roll mass production. There is a selection of metals and possible conducting coatings for plastics with varying electrical, optical, and chemical properties and price. The substrate has a dominant impact on the methods and materials that can be applied to make the cell and consequently on the resulting performance of the device. Furthermore, the substrates influence significantly the stability of the device. The main issue with plastics is their permeability whereas with metals, chemical stability in the electrolyte is themain concern. The leakage of electrolyte and the impact of water intake through the plastics can be affected by the material choices in particular with the electrolyte and dye composition. In the case of the metallic electrodes, the chemical stability can be improved by choosing a corrosion‐resistant metal, applying a blocking layer or changing to a less aggressive electrolyte. One major focus of the current research of the flexible DSCs is increasing the efficiency by improved low‐temperature preparation methods and materials especially for the photoelectrode. Another significant challenge is the development of noncorrosive electrolyte and dye combinations that work well even in the presence of significant amounts of water.

This article is categorized under:

Photovoltaics > Science and Materials

Energy Research & Innovation > Science and Materials
Top-mass effects in differential Higgs production through gluon fusion at $ O\left( {\alpha_s^4} \right) $
Authors: Harlander Robert V. , Neumann Tobias , Ozeren Kemal J. , Wiesemann Marius
Published: August 2012

Abstract

Effects from a finite top quark mass on differential distributions in the Higgs + jet production cross section through gluon fusion are studied at next-to-leading order in the strong coupling, i.e.$ O\left( {\alpha_s^4} \right) $. Terms formally subleading in 1/mtare calculated, and their influence on the transverse momentum and rapidity distribution of the Higgs boson are evaluated. We find that, for the differential K-factor, the heavy-top limit is valid at the 2-3% level as long as the transverse momentum of the Higgs remains below about 150 GeV.
Higgs production in a warped extra dimension
Authors: Carena Marcela , Casagrande Sandro , Goertz Florian , Haisch Ulrich , Neubert Matthias
Published: August 2012

Abstract

Measurements of the Higgs-boson production cross section at the LHC are an important tool for studying electroweak symmetry breaking at the quantum level, since the main production mechanism gg → h is loop-suppressed in the Standard Model (SM). Higgs production in extra-dimensional extensions of the SM is sensitive to the Kaluza-Klein (KK) excitations of the quarks, which can be exchanged as virtual particles in the loop. In the context of the minimal Randall-Sundrum (RS) model with bulk fields and a brane-localized Higgs sector, we derive closed analytical expressions for the gluon-gluon fusion process, finding that the effect of the infinite tower of virtual KK states can be described in terms of a simple function of the fundamental (5D) Yukawa matrices. Given a specific RS model, this will allow one to easily constrain the parameter space, once a Higgs signal has been established. We explain that discrepancies between existing calculations of Higgs production in RS models are related to the non-commutativity of two limits: taking the number of KK states to infinity and removing the regulator on the Higgs-boson profile, which is required in an intermediate step to make the relevant overlap integrals well defined. Even though the one-loop gg → h amplitude is finite in RS scenarios with a brane-localized Higgs sector, it is important to introduce a consistent ultraviolet regulator in order to obtain the correct result.
A Survey of Surgical Capacity in Rural Southern Nigeria: Opportunities for Change
Authors: Henry Jaymie A. , Windapo Olubayo , Kushner Adam L. , Groen Reinou S. , Nwomeh Benedict C.
Published: September 2012

Background

Despite growing recognition of the massive surgical burden of disease, unmet need, and disparities in access to care in many African countries, little is known about their capacity to deliver surgical, obstetric, emergency, and anesthetic care, particularly in the rural areas where up to 50 % of the population lives. This study aimed to quantify the surgical capacity of select healthcare facilities in rural southern Nigeria in five key areas: Workforce, Infrastructure, Skill, Equipment, and Supplies.

Methods

We assessed the surgical capacity of 41 private, rural hospitals in southern Nigeria using the Personnel, Infrastructure, Procedures, Equipment, and Supplies survey tool developed by Surgeons OverSeas. The survey was administered to surgical practitioners during their annual conference in November 2011.

Results

Among the 41 hospitals surveyed, general practitioners (52.1 %) constituted most of the surgical workforce. Only one anesthesiologist was available in 16 secondary hospitals. Although most of the primary and secondary hospitals had running water (82.3 %), a designated emergency room (80.5 %), and medical records (95.9 %), only 50.3 % of all hospitals had electricity through the power grid. Also, only 37.5 % of all facilities had a blood bank and 43.8 % had an X‐ray machine. Common surgical procedures were done by most of the facilities; however, cricothyroidotomy, clubfoot repair, and obstetric fistula repair were scarcely done. Less than half of the facilities provided general anesthesia, only 20 % have an anesthesia machine, and 44.5 % have a pulse oximeter.

Conclusion

Severe shortages in key areas should motivate stakeholders to devote more effort and resources to strengthening surgical capacity in rural southern Nigeria.
Increased Detection of Non‐recurrent Inferior Laryngeal Nerve (NRLN) During Thyroid Surgery Using Systematic Intraoperative Neuromonitoring (IONM)
Authors: Donatini G. , Carnaille B. , Dionigi G.
Published: September 2012

Background

Non‐recurrent inferior laryngeal nerve (NRLN) is a rare anatomical variant with a reported incidence of 0.6–1.3 %. It carries a higher risk of palsy during thyroid surgery. Its detection is mandatory in order to avoid such complication.

Methods

Systematic intraoperative neuromonitoring (IONM) was carried out for 806 consecutive nerve at risk (NAR) patients in two centers (Lille and Varese). In 402 patients surgery to the right side was performed with IONM. The IONM of the inferior laryngeal nerve (ILN) was conducted as recommended by international guidelines (V1/R1/V2/R2).

Results

A NRLN was detected in 11 of 402 NAR (2.7 %). In the first center (Lille) the incidence of NRLN was 6.0 % (7/117). No loss of signal (LOS) was reported in this group of patients. Postoperative laryngoscopy was normal in all patients with NRLN.

Conclusions

The true incidence of NRLN may be higher than expected. Neurophysiology helps the surgeon to better understand the anatomy and function of nervous structures. Intraoperative neuromonitoring is a useful tool that should be systematically implemented in thyroid surgery to better understand the anatomy and physiology of the inferior laryngeal nerve. Its use may allow the surgeon to decrease the incidence of nerve palsy especially in case of NRLN. The IONM adjunct does not add significantly to the costs for thyroid surgery.
English proficiency and peer interethnic relations as predictors of math achievement among Latino and Asian immigrant students
Authors: Barrett Alice N. , Barile John P. , Malm Esther K. , Weaver Scott R.
Published: September 2012

Studies show math achievement to be the best predictor of entering post‐secondary education. However, less is known about the predictors of math achievement, particularly among immigrant youth. This study examined English proficiency and peer interethnic relations as predictors of mathematics achievement among Latino and Asian high school students, postulating an interaction between the predictors and mediation by academic motivation. A multilevel moderated‐mediation model was used to analyze data from a national sample of 2113 non‐native English speaking Latino and Asian students attending high school in the U.S. We found that higher academic motivation mediated the relationship between English proficiency during their sophomore year and gains in senior math achievement scores for both Asian and Latino students. For Latino students however, this indirect path was only significant for students whose perceptions of positive peer interethnic relations at school were average or above average.
Fading absorption in non-linear elliptic equations
Authors: Marcus Moshe , Shishkov Andrey
Published: August 2012

We study the equation

−\mathrm{\Delta }u + h(x)|u|^{q−1}u = 0

,

q > 1

, in

\mathbb{R}_{ + }^{N} = \mathbb{R}^{N−1} \times \mathbb{R}_{ + }

where

h \in C(\overline{\mathbb{R}_{ + }^{N}})

,

h⩾0

. Let

(x_{1},…,x_{N})

be a coordinate system such that

\mathbb{R}_{ + }^{N} = [x_{N} > 0]

and denote a point

x \in \mathbb{R}^{N}

by

(x^{′},x_{N})

. Assume that

h(x^{′},x_{N}) > 0

when

x^{′} \neq 0

but

h(x^{′},x_{N})\rightarrow 0

as

|x^{′}|\rightarrow 0

. For this class of equations we obtain sharp necessary and sufficient conditions in order that singularities on the boundary do not propagate in the interior.
Amino acid determinants conferring stable sialidase activity at low pH for H5N1 influenza A virus neuraminidase
Authors: Takahashi Tadanobu , Nidom Chairul A. , Quynh Le Mai thi , Suzuki Takashi , Kawaoka Yoshihiro
Published: September 2012

Avian influenza A viruses (IAVs) and human 1918, 1957, and 1968 pandemic IAVs all have neuraminidases (NAs) that are stable at low pH sialidase activity, yet most human epidemic IAVs do not. We examined the pH stability of H5N1 highly pathogenic avian IAV (HPAI) NAs and identified amino acids responsible for conferring stability at low pH. We found that, unlike other avian viruses, most H5N1 IAVs isolated since 2003 had NAs that were unstable at low pH, similar to human epidemic IAVs. These H5N1 viruses are thus already human virus‐like and, therefore, have the frequent infections of humans.
Correlation of first‐trimester fetal crown–rump length with outcome of pregnancy and birth weight
Authors: Vafaei Homeira , Samsami Alamtaj , Zolghadri Jaleh , Hosseini‐Nohadani Azam
Published: August 2012

Objective

To examine the association of crown–rump length (CRL) in the first trimester with low birth weight and adverse pregnancy outcome.

Methods

In a prospective cross‐sectional study, CRL was measured in 876 healthy pregnant women undergoing ultrasound evaluation between 9 and 14 weeks of gestation. Birth weight and pregnancy outcomes were analyzed for the 544 participants who met the study criteria.

Results

Low (< 2500 g) and high (> 4000 g) birth weights were correlated with the difference between actual and expected CRL expressed in days of gestation, but no correlation was found between the difference between actual and expected CRL and premature delivery. Low birth weight (P = 0.005) and abortion (P = 0.03) were also correlated with the difference between actual and expected CRL.

Conclusion

Routinely measuring CRL during the first trimester to detect CRLs shorter than expected for gestational age could be useful to obstetricians. Anticipating a low birth weight and being warned about the possibility of abortion would enable them to manage prenatal care and delivery more appropriately.
State obligations to implement African abortion laws: Employing human rights in a changing legal landscape
Authors: Ngwena Charles G.
Published: August 2012

Women in the African region are overburdened with unsafe abortion. Abortion regimes that fail to translate any given abortion rights into tangible access are partly to blame. Historically, African abortion laws have been highly restrictive. However, the post‐independence era has witnessed a change toward liberalizing abortion law, even if incremental for many jurisdictions. Furthermore, Article 14 of the Protocol to the African Charter on Human and Peoples' Rights on the Rights of Women in Africa has significantly augmented the regional trend toward liberalization by recognizing abortion as a human right in given circumstances. However, states are failing to implement abortion laws. The jurisprudence that is emerging from the European Court of Human Rights and United Nations treaty bodies is a tool that can be used to render African governments accountable for failure to implement domestic abortion laws.
Cubic critical portraits and polynomials with wandering gaps
Authors: BLOKH ALEXANDER , CURRY CLINTON , OVERSTEEGEN LEX
Published: August 2012

Thurston introduced $\sigma _d$-invariant laminations (where $\sigma _d(z)$ coincides with $z^d:\mathbb S ^1\to \mathbb S ^1$, $d\ge 2$) and defined wandering $k$-gons as sets ${\mathbf {T}}\subset \mathbb S ^1$ such that $\sigma _d^n({\mathbf {T}})$ consists of $k\ge 3$ distinct points for all $n\ge 0$ and the convex hulls of all the sets $\sigma _d^n({\mathbf {T}})$ in the plane are pairwise disjoint. He proved that $\sigma _2$ has no wandering $k$-gons. Call a lamination with wandering $k$-gons a WT-lamination. In a recent paper, it was shown that uncountably many cubic WT-laminations, with pairwise non-conjugate induced maps on the corresponding quotient spaces $J$, are realizable as cubic polynomials on their (locally connected) Julia sets. Here we use a new approach to construct cubic WT-laminations with the above properties so that any wandering branch point of $J$ has a dense orbit in each subarc of $J$ (we call such orbits condense), and show that critical portraits corresponding to such laminations are dense in the space ${\mathcal A}_3$of all cubic critical portraits.
Stokes flow near the contact line of an evaporating drop
Authors: Gelderblom Hanneke , Bloemen Oscar , Snoeijer Jacco H.
Published: August 2012

The evaporation of sessile drops in quiescent air is usually governed by vapour diffusion. For contact angles below $9{0}^{\ensuremath{\circ} } $, the evaporative flux from the droplet tends to diverge in the vicinity of the contact line. Therefore, the description of the flow inside an evaporating drop has remained a challenge. Here, we focus on the asymptotic behaviour near the pinned contact line, by analytically solving the Stokes equations in a wedge geometry of arbitrary contact angle. The flow field is described by similarity solutions, with exponents that match the singular boundary condition due to evaporation. We demonstrate that there are three contributions to the flow in a wedge: the evaporative flux, the downward motion of the liquid–air interface and the eigenmode solution which fulfils the homogeneous boundary conditions. Below a critical contact angle of $133. {4}^{\ensuremath{\circ} } $, the evaporative flux solution will dominate, while above this angle the eigenmode solution dominates. We demonstrate that for small contact angles, the velocity field is very accurately described by the lubrication approximation. For larger contact angles, the flow separates into regions where the flow is reversing towards the drop centre.
Asymptotic calculation of the dynamics of self-sustained detonations in condensed phase explosives
Authors: Saenz J. A. , Taylor B. D. , Stewart D. S.
Published: August 2012

We use the weak-curvature, slow-time asymptotics of detonation shock dynamics (DSD) to calculate an intrinsic relation between the normal acceleration, the normal velocity and the curvature of a lead detonation shock for self-sustained detonation waves in condensed phase explosives. The formulation uses the compressible Euler equations for an explosive that is described by a general equation of state with multiple reaction progress variables. The results extend an earlier asymptotic theory for a polytropic equation of state and a single-step reaction rate model discussed by Kasimov (Theory of instability and nonlinear evolution of self-sustained detonation waves. PhD thesis, University of Illinois Urbana-Champaign, Urbana, Illinois) and by Kasimov & Stewart (Phys. Fluids, vol. 16, 2004, pp. 3566–3578). The asymptotic relation is used to study the dynamics of ignition events in solid explosive PBX-9501 and in porous PETN powders. In the case of porous or powdered explosives, two composition variables are used to represent the extent of exothermic chemical reaction and endothermic compaction. Predictions of the asymptotic formulation are compared against those of alternative DSD calculations and against shock-fitted direct numerical simulations of the reactive Euler equations.
The surface signature of internal waves
Authors: Craig W. , Guyenne P. , Sulem C.
Published: August 2012

Oceans that are stratified by density into distinct layers support internal waves. An internal soliton gives rise to characteristic features on the surface, a signature of its presence, in the form of a ‘rip’ region, as reported in Osborne & Burch (Science, vol. 208, 1980, pp. 451–460), which results in a change in reflectance as seen in NASA photographs from the space shuttle. In the present paper, we give a new analysis of this signature of an internal soliton, and the ‘mill pond’ effect of an almost completely calm sea after its passage. Our analysis models the resonant interaction of nonlinear internal waves with the surface modes, where the surface signature is generated by a process analogous to radiative absorption. These theoretical results are illustrated with numerical simulations that take oceanic parameters into account.
On the universality of turbulent axisymmetric wakes
Authors: Redford John A. , Castro Ian P. , Coleman Gary N.
Published: September 2012

Direct numerical simulations (DNS) of two time-dependent, axially homogeneous, axisymmetric turbulent wakes having very different initial conditions are presented in order to assess whether they reach a universal self-similar state as classically hypothesized by Townsend. It is shown that an extensive early-time period exists during which the two wakes are individually self-similar with wake widths growing like$\delta \propto {t}^{1/ 3} $, as predicted by classical dimensional analysis, but have very different growth rates and are thus not universal. Subsequently, however, the turbulence adjusts to yield, eventually, wakes that are structurally identical and have the same growth rate (also with$\delta \propto {t}^{1/ 3} $) so provide clear evidence of a universal, self-similar state. The former non-universal but self-similar state extends, in terms of a spatially equivalent flow behind a spherical body of diameter$d$, to a distance of$O(3000d)$whereas the final universal state does not appear before$O(5000d)$(and exists despite relatively low values of the Reynolds number and no evidence of a spectral${\kappa }^{\ensuremath{-} 5/ 3} $inertial subrange). Universal wake evolution is therefore likely to be rare in practice. Despite its low Reynolds number, the flow does not exhibit the sometime-suggested alternative self-similar behaviour with$\delta \propto {t}^{1/ 2} $(as for the genuinely laminar case) at large times (or, equivalently, distances), since the eddy viscosity remains large compared to the molecular viscosity and its temporal variations are not negligible.
Educing the source mechanism associated with downstream radiation in subsonic jets
Authors: Kerhervé F. , Jordan P. , Cavalieri A. V. G. , Delville J. , Bogey C. , Juvé D.
Published: August 2012

This work belongs to the ongoing debate surrounding the mechanism responsible for low-angle sound emission from subsonic jets. The flow, simulated by large eddy simulation (Bogey & Bailly,Comput. Fluids, vol. 35 (10), 2006a, pp. 1344–1358), is a Mach 0.9 jet with Reynolds number, based on the exit diameter, of$4\ensuremath{\times} 1{0}^{5} $. A methodology is implemented to educe, explore and model the flow motions associated with low-angle sound radiation. The eduction procedure, which is based on frequency–wavenumber filtering of the sound field and subsequent conditional analysis of the turbulent jet, provides access to space- and time-dependent (hydrodynamic) pressure and velocity fields. Analysis of these shows the low-angle sound emission to be underpinned by dynamics comprising space and time modulation of axially coherent wavepackets: temporally localized energization of wavepackets is observed to be correlated with the generation of high-amplitude acoustic bursts. Quantitative validation is provided by means of a simplified line-sourceAnsatz(Cavalieriet al. J. Sound Vib., vol. 330, 2011b, pp. 4474–4492). The dynamic nature of the educed field is then assessed using linear stability theory (LST). The educed pressure and velocity fields are found to compare well with LST: the radial structures of these match the corresponding LST eigenfunctions; the axial evolutions of their fluctuation energy are consistent with the LST amplification rates; and the relative amplitudes of the pressure and velocity fluctuations, which are educed independently of one another, are consistent with LST.
Giambattista Della Porta and the Roman Inquisition: censorship and the definition of Nature's limits in sixteenth-century Italy
Authors: TARRANT NEIL
Published: August 2012

It has long been noted that towards the end of the sixteenth century the Catholic Church began to use its instruments of censorship – the Inquisition and the Index of Forbidden Books – to prosecute magic with increased vigour. These developments are often deemed to have had important consequences for the development of modern science in Italy, for they delimited areas of legitimate investigation of the natural world. Previous accounts of the censorship of magic have tended to suggest that the Church as an institution was opposed to, and sought to eradicate, the practice of magic. I do not seek to contest the fact that ecclesiastical censors prosecuted various magical and divinatory practices with greater enthusiasm at this time, but I suggest that in order to understand this development more fully it is necessary to offer a more complex picture of the Church. In this article I use the case of the Neapolitan magus Giambattista Della Porta to argue that during the course of the century the acceptable boundaries of magical speculation became increasingly clearly defined. Consequently, many practices and techniques that had previously been of contested orthodoxy were categorically defined as heterodox and therefore liable to prosecution and censorship. I argue, however, that this development was not driven by the Church asserting a ‘traditional’ hostility towards magic, but was instead the result of one particular faction within the Church embedding their conception of orthodox philosophical investigation of the natural world within the machinery of censorship.
Recycling in early modern science
Authors: WERRETT SIMON
Published: August 2012

This essay follows recent work in environmental history to explore the history of recycling in physical sciences in Britain and North America since the seventeenth century. The term ‘recycling’ is here used broadly to refer to a variety of practices that extended the life of material resources for doing science in the early modern period. These included practices associated with maintenance, repair, exchange and the adaptation or reuse of material culture. The essay argues that such practices were common in early modern science, and informed experimental spaces and techniques and the ideas that they generated. The essay considers some of the varied motivations that led to such practices, and concludes by examining the endurance of recycling in science since the end of the eighteenth century, particularly in recent efforts to create sustainable scientific research practices.
Fossil dealers, the practices of comparative anatomy and British diplomacy in Latin America, 1820–1840
Authors: PODGORNY IRINA
Published: August 2012

This paper traces the trade routes of South American fossil mammal bones in the 1830s, thus elaborating both local and intercontinental networks that ascribed new meanings to objects with little intrinsic value. It analyses the role of British consuls, natural-history dealers, administrative instructions and naturalists, who took the bones from the garbage pits of ranches outside Buenos Aires and delivered them into the hands of anatomists. For several years, the European debates on the anatomy ofMegatheriumwere shaped by the arrival in London of a small living mammal and the ideas and evidence received from Montevideo on the existence of huge fossil bony armours. These debates culminated late in 1838 in the creation of the extinct genusGlyptodonby Richard Owen as a result of the exchange of letters, objects and depictions, and a series of contingent events. Based on primary sources and South American scholarship, this paper aims to contribute to the current debates among historians of science about the mobility of knowledge, as well as presenting the condition that made Charles Darwin's work possible.