bluuebunny/crossref_metadata_2025 huggingface dataset:
Cost‐benefit analysis of using biochar to improve cereals agriculture
Authors: Dickinson Dane , Balduccio Ludovico , Buysse Jeroen , Ronsse Frederik , van Huylenbroeck Guido , Prins Wolter
Published: February 2014

Biochar has received considerable scientific attention in the past decade as a possible method for carbon storage and increasing agricultural yields. Despite this promise, however, economic assessments of biochar are yet to definitively establish the value of the technology, primarily due to discrepancy between observed short‐term agronomic benefits and expectations of biochar as a lasting soil improver. This study investigated the economic value of biochar as an agricultural technology for long‐term improvement of arable farming. From presently available field trial data, the costs and benefits of using biochar technology to enhance cereals agriculture were evaluated in two generalized geo‐economic agricultural scenarios: North‐Western Europe (NWE) and Sub‐Saharan Africa (SSA). Cost models were developed to estimate the total cost of biochar from initial biomass feedstock acquisition to final soil application for each agricultural setting. Benefits of biochar application were estimated by statistical meta‐analysis of crop yield data from published biochar field trials to find the increase in cereal grain yield attributable to biochar application for both NWE (+0.07 to +0.28 t ha−1 yr−1) and SSA (+0.18 to +1.00 t ha−1 yr−1). The grain yield improvement from a one‐time biochar application was assumed to persist without decay for an independently varying time period, and the increase in grain production then monetised using projected future commodity prices. The Net Present Value (NPV) of applying biochar was then calculated by setting present total costs against present total benefits as a function of biochar performance longevity. Biochar application was found to carry a positive NPV for cereal cropping in SSA in several scenarios where the duration of the biochar yield effect was assumed to extend 30 years into the future. Conversely, NWE biochar scenarios were all found to have negative NPVs even when the benefits time span was indefinitely stretched.
Explaining European Emission Allowance Price Dynamics: Evidence from Phase II
Authors: Rickels Wilfried , Görlich Dennis , Peterson Sonja
Published: February 2014

We empirically investigate potential determinants of the allowance price dynamics in the European Union Emission Trading Scheme during Phase II. In contrast to previous studies, we place particular emphasis on the fuel price selection. We show that results are extremely sensitive to choosing different price series of potential determinants, such as coal and gas prices. In general, only the influence of economic activity in Europe and hydropower provision in Norway is robustly explaining allowance price dynamics. The influence of fuel switching on allowance prices and, therefore, equalization of marginal abatement costs - in particular in the long run - is still rather small.
Desert boundaries: the once and future Gobi
Authors: Sternberg Troy
Published: February 2014

When Marco Polo journeyed to the court of Kublai Khan in 1271 he traversed a great sandy desert filled with ‘extraordinary illusions’ that became known as the Gobi desert. The continued use of term Gobi, first appearing in 1706, is a rare case of Mongolian ascendancy over the Chinese. Exploration of the Gobi as a mapping term seeks to understand how the desert was conceptualised and identified as a geographical region, an economic sphere and a political presence. Historically contested between China and Russia with Mongolia as a proxy, the desert is now home to 25 million people, mineral wealth and rapid development. As attention increases and the strategic region integrates into global systems, knowledge of the perceived desert boundaries becomes germane. In our era of data and demarcation with place names used to confer prior possession we examine how the Mongolian term ‘gobi’ rather than the Chinese equivalent ‘shamo’ prevailed. China dominates the region without asserting physical control; in fact, the term ‘Gobi desert’ is not recognised in China's geographical lexicon. Does past suzerainty offer insight to the present and potential future scenarios in the desert? New contextualisation presents the Gobi as a multi‐dimensional space that, rather than a past construction, portends an emergent consciousness no longer isolated and insulated from regional and global currents.
Seasonal carbon dynamics and the effects of manure application on carbon budget of a managed grassland in a temperate, humid region in Japan
Authors: Matsuura Shoji , Miyata Akira , Mano Masayoshi , Hojito Masayuki , Mori Akinori , Kano Shunpei , Sasaki Hiroyuki , Kohyama Kazunori , Hatano Ryusuke
Published: February 2014

We conducted a field experiment from 2004 to 2007 in a temperate, humid region in Japan to investigate seasonal carbon dynamics and their interaction with vegetation. We also examined the effect of composted livestock manure application on the carbon budget in an intensively managed grassland. Two experimental plots were established for the study: one receiving only chemical fertilizer and the other receiving composted cattle manure and supplementary chemical fertilizer. Carbon dioxide flux was measured continuously using the eddy covariance technique, and net ecosystem production (NEP) and net biome production (NBP) were evaluated. We found that the seasonal variations of carbon dynamics were affected not only by climatic conditions but also by vegetation. NEP during the first crop increased rapidly to a high value, which resulted in positive cumulative NEP. In contrast, cumulative NEP during the second to the fourth crop and during winter was only slightly positive or even negative. Thus, NEP during the first crop made a significant contribution to annual NEP. It also occupied an important place in annual NBP via carbon stock into the belowground biomass. The different fertilization regimes between the plots resulted in no significant differences in harvest or NEP on an annual basis. However, the chemically fertilized grassland plot lost carbon, whereas the plot receiving composted cattle manure and supplementary chemical fertilizer accumulated carbon. These results suggest that manure application results in sustainable grassland management enhancing carbon sequestration.
Geographic disparities in arteriovenous fistula placement in patients approaching hemodialysis in the United States
Authors: Goldfarb‐Rumyantzev Alexander S. , Syed Wajih , Patibandla Bhanu K. , Narra Akshita , Desilva Ranil , Chawla Varun , Hod Tammy , Vin Yael
Published: February 2014

Arteriovenous fistula (AVF) is the preferred vascular access for hemodialysis (HD). Several factors associated with AVF placement have been identified (e.g., age, sex, race, comorbidities). We hypothesized that geographic location of patient residence might be associated with the probability of AVF placement as the initial access. We used the data from the United States Renal Data System (USRDS) database (2005–2008) linked to Medicare claims (2003–2008). Logistic regression was used to estimate specific characteristics of population associated with the AVF as first access placed or attempted for HD initiation. Our primary variable of interest was the geographic location, and the multivariate model was adjusted for age, sex, race, body mass index, primary cause of end‐stage renal disease (ESRD), duration of pre‐ESRD nephrology care, comorbidities, employment status, substance abuse, and income. Geographic location was determined using the data collected by the RUCA project and divided population into metropolitan, micropolitan, and rural categories. Patients (n = 111,953) identified from the USRDS database with linked Medicare claims were examined. Rates of fistula placement in the metropolitan, micropolitan, and rural population were 18.5%, 22.4%, and 21.6%, respectively. In comparison, patients who received catheter as the first access were 81.5%, 77.6% and 78.4%, respectively. The odds ratio of AVF placement as a first HD access in the rural and metropolitan population compared with the micropolitan population were 0.96 (0.90–1.03; P = 0.26) and 0.80 (0.76–0.84; P < 0.001), respectively. Our results indicate the presence of geographic disparities in AVF placement with decreased rates of AVF as the first access created in the metropolitan (but not rural) populations compared with the micropolitan communities.
Classification of the etiologies of acute liver failure in Japan: A report by the Intractable Hepato‐Biliary Diseases Study Group of Japan
Authors: Mochida Satoshi , Takikawa Yasuhiro , Nakayama Nobuaki , Oketani Makoto , Naiki Takafumi , Yamagishi Yoshiyuki , Fujiwara Keiichi , Ichida Takafumi , Tsubouchi Hirohito
Published: February 2014

The Intractable Liver Diseases Study Group of Japan, supported by the Ministry of Health, Labor and Welfare, established novel diagnostic criteria for “acute liver failure” in 2011. In these criteria, patients without histological findings of hepatitis are included in the disease entity of “acute liver failure”, as in Europe and the USA. In this report, classification criteria for the etiologies of “acute liver failure” in Japan are proposed.
Clinical outcome of intentional replantation with preoperative orthodontic extrusion: a retrospective study
Authors: Choi Y. H. , Bae J. H. , Kim Y. K. , Kim H. Y. , Kim S. K. , Cho B. H.
Published: February 2014

Aim

To evaluate retrospectively the clinical outcomes of intentional replantation (IR) of teeth in terms of tooth survival and periradicular healing and to investigate their prognostic factors.

Methodology

Two hundred and eighty‐seven teeth treated by IR were analysed retrospectively. Clinical outcomes between the cases with preoperative orthodontic extrusion for 2–3 week and those without extrusion were analysed. The outcomes of IR were determined by clinical and radiographic evaluation. Tooth survival and periradicular healing estimates were compared using Kaplan–Meier analysis. The contribution of a patient's age and gender, tooth type and location, and preoperative orthodontic extrusion was investigated using the multivariate Cox proportional hazard model.

Results

The mean follow‐up period was 25.4 ± 9.3 months. The overall success rate of IR was 89.5% based on periradicular healing. The overall survival rate was 95.1%. The survival rates were 91.2% for the teeth extracted without extrusion and 98.1% for those extracted with extrusion. Amongst the variables tested, only the extraction technique with preoperative orthodontic extrusion significantly affected the survival rate (P = 0.016). Other prognostic variables, such as age and gender, tooth type and location, did not affect the survival of intentionally replanted teeth.

Conclusions

Intentional replantation was a viable treatment option for teeth with previously failed nonsurgical root canal treatment, regardless of a patient's age and gender, and tooth type and location. Preoperative orthodontic extrusion for 2–3 weeks reduced root resorption and tooth fracture and can be recommended to enhance the outcome of IR.
Durability of SiO2–TiO2 Photocatalytic Coatings on Ceramic Tiles
Authors: Sciancalepore Corrado , Bondioli Federica
Published: February 2014

The aim of this investigation was the evaluation of the durability of photocatalytic sol–gel coating deposited on industrial ceramic tiles. In particular, the effect of substrate roughness on photocatalytic performance before and after different aging tests was determined. The results showed that the photodegradation process was clearly affected by the surface roughness of the substrate. In particular, the smoother surface had a higher photocatalytic activity, faster hydrophilicity but a lower durability to abrasion with respect to the matt surface.
Ultra‐High‐Temperature Ceramic HfB2‐SiC Coating for Oxidation Protection of SiC‐Coated Carbon/Carbon Composites
Authors: Ren Xuanru , Li Hejun , Chu Yanhui , Fu Qiangang , Li Kezhi
Published: February 2014

To protect the carbon/carbon (C/C) composites from oxidation, an outer ultra‐high‐temperature ceramics (UHTCs) HfB2‐SiC coating was prepared on SiC‐coated C/C composites by in situ reaction method. The outer HfB2‐SiC coating consists of HfB2 and SiC, which are synchronously obtained. During the heat treatment process, the formed fluid silicon melt is responsible for the preparation of the outer HfB2‐SiC coating. The HfB2‐SiC/SiC coating could protect the C/C from oxidation for 265 h with only 0.41 × 10−2 g/cm2 weight loss at 1773 K in air. During the oxidation process, SiO2 glass and HfO2 are generated. SiO2 glass has a self‐sealing ability, which can cover the defects in the coating, thus blocking the penetration of oxygen and providing an effective protection for the C/C substrate. In addition, SiO2 glass can react with the formed HfO2, thus forming the HfSiO4 phase. Owing to the “pinning effect” of HfSiO4 phase, crack deflecting and crack termination are occurred, which will prevent the spread of cracks and effectively improve the oxidation resistance of the coating.
Lack of IgG antibody seropositivity to Borrelia burgdorferi in patients with Parry–Romberg syndrome and linear morphea en coup de sabre in Mexico
Authors: Gutiérrez‐Gómez Claudia , Godínez‐Hana Ana L. , García‐Hernández Marisela , Suárez‐Roa María de Lourdes , Toussaint‐Caire Sonia , Vega‐Memije Elisa , Gutiérrez‐Mendoza Daniela , Pérez‐Dosal Marcia , Medina‐De la Garza Carlos E.
Published: February 2014

Background

Progressive hemifacial atrophy or Parry–Romberg Syndrome (PRS) is a rare, acquired, progressive dysplasia of subcutaneous tissue and bone characterized by unilateral facial involvement. Its etiology is unknown, but theories about its pathogenesis include infectious, degenerative, autoimmune, and traumatic causes among others. The causal relationship of PRS and linear morphea en coup de sabre (LMCS) with Borrelia burgdorferi infection remains controversial. Our goal was to serologically determine anti‐B. burgdorferi antibodies in patients diagnosed with PRS and LMCS to establish a possible association as a causative agent.

Methods

We conducted a serology study with patients belonging to a group of 21 individuals diagnosed with PRS, six with LMCS, and 21 matched controls. Anti‐Borrelia IgG antibodies were determined by ELISA. A descriptive statistical analysis and Fischer's exact test were done.

Results

In serological tests, only two cases had borderline values and were further analyzed by Western blot with non‐confirmatory results. For both the PRS and LMCS group, the association test was not significant, suggesting a lack of association between PRS or LMCS and the presence of anti‐Borrelia antibodies.

Conclusion

In Mexico there are no previous studies on Borrelia infection and its relationship between PRS or LMCS. Our result showed a lack of association of either clinical entities with anti‐Borrelia‐antibodies. Former reports of this association may suggest coincidental findings without causal relationship.
Assessment of tissue FoxP3+, CD4+ and CD8+ T‐cells in active and stable nonsegmental vitiligo
Authors: Abdallah Marwa , Lotfi Ranya , Othman Wessam , Galal Riham
Published: February 2014

Background

The exact etiology of vitiligo remains obscure. Studies have indicated a role for cellular immunity in the pathogenesis of vitiligo. The aim of this study is to assess tissue FoxP3+ natural regulatory T‐cells (Tregs), as well as CD4+ and CD8+ T‐cells in active vs. stable nonsegmental vitiligo.

Materials and methods

Immunohistochemical double‐staining for expression of CD4+ and CD8+ T‐cells with immunostaining for expression of FoxP3 in lesional, marginal, and nonlesional skin of nonsegmental vitiligo was used to evaluate the abundance of Tregs among CD4+ and CD8+ T‐cells in active and stable cases of vitiligo.

Results

A significant increase in the number of CD4+ and CD8+ T‐cells and a highly significant reduction in the number of FoxP3‐expressing Tregs were detected in marginal skin in both stable and active vitiligo cases. FoxP3+ cells were decreased in tissue of patients with vitiligo compared with healthy controls. The number of CD8+ T‐cells was increased in the epidermis and dermoepidermal junction (DEJ) in comparison with the number of CD4+ T‐cells. Tregs were mostly present at the DEJ.

Conclusion

The reduction in the number of FoxP3+ cells in the marginal skin suggests that this is the site where regulatory activity is needed to suppress the activity of helper and cytotoxic T‐cells that are actively contributing to depigmentation.
Unidentified drugs in traditional medications causing toxic epidermal necrolysis: a developing country experience
Authors: Das Kishore Kumar , Khondokar Sazzad , Rahman Ashrafur , Chakraborty Anjana
Published: February 2014

Background

Drugs are by far the most common cause of toxic epidermal necrolysis (TEN), but unidentified drugs and chemicals present in herbal and traditional medications may also be responsible for this reaction, which manifests as widespread epidermal detachment of the skin and mucous membrane. In contexts in which a subject has used an herbal or traditional medication, it is very difficult to diagnose the condition, identify the offending agent, and prevent the disease from recurring.

Methods

This prospective study was conducted at a tertiary burn center between July 2004 and October 2012. All patients were referred to this unit by the local department of medicine at least one week after the eruption of vesicles. On arrival, all patients demonstrated a severe form of disease with features of sepsis and electrolyte imbalance (SCORTEN scores of ≥4). All non‐fatal cases were followed to observe long‐term sequelae and recurrences.

Results

About 34% of patients had developed the condition after ingesting traditional herbal medications and were unable to identify the responsible drug by name. Nineteen (66%) of the 29 patients referred to the unit with TEN died within the first week after being transferred. Nine patients achieved complete recovery, and one developed corneal haziness and alopecia. One patient experienced recurrence within three months but recovered.

Conclusions

Illiteracy and financial vulnerability were major factors in driving patients towards the use of traditional medications, which were often prepared and preserved improperly. Mortality and other complications could be reduced by the prompt recognition of the condition, immediate withdrawal of the culprit drug, and quick referral to proper care.
Polytetrafluoroethylene expanded prosthesis as replacement of the inferior vena cava in renal cell carcinoma with caval thrombus
Authors: Benkirane Ahmed , Khodari Muhieddine , Yakoubi Rachid , Lambert Marc , Koussa Mohamad , Ghoneim Tarek , Haulon Stephan , Villers Arnauld , Lemaitre Laurent , Zini Laurent
Published: February 2014

Objective

To assess the outcomes of inferior vena cava replacement with polytetrafluoroethylene expanded prosthesis in patients with renal cell carcinoma and caval thrombosis.

Methods

All patients who underwent radical nephrectomy with inferior vena cava replacement by polytetrafluoroethylene expanded prosthesis for renal cancer associated with inferior vena cava thrombosis and a suspicion of inferior vena cava wall invasion from January 2000 to June 2011 were considered for this study. Demographic data, postoperative course, graft patency and survival data were evaluated.

Results

A total of 26 patients (median age 59.5 years, range 19.9–85.6 years) were included in the analysis. The median tumor diameter was 10 cm (range 5–14 cm). Histological invasion of the wall of the inferior vena cava was found in 16 (61.5%) cases. The median follow up was 28 months (range 1–136). A graft thrombosis occurred in five (19.2%) patients within the first year. Four of these patients died before the end of the second year. Patency of the inferior vena cava graft at 6 and 12 months was 88% and 79%, respectively. Overall survival probability at 3 years was 64%.

Conclusion

Prosthetic replacement of the inferior vena cava can be carried out when invasion of the wall of the inferior vena cava is suspected. The postoperative complication rate in this subset of high‐risk patients undergoing radical nephrectomy seems acceptable, and the patency of the prostheses is good in most of the cases.
Scavenger receptor‐mediated endocytosis facilitates RNA interference in the desert locust, Schistocerca gregaria
Authors: Wynant N. , Santos D. , Van Wielendaele P. , Vanden Broeck J.
Published: February 2014

RNA interference (RNAi) has become a widely used loss‐of‐function tool in eukaryotes; however, the delivery of double‐stranded (ds)RNA) to the target cells remains a major challenge when exploiting the RNAi‐technology. In insects, the efficiency of RNAi is highly species‐dependent. Yet, the mechanism of cell entry in insects has only been characterized in a cell line of the fruit fly, Drosophila melanogaster, a species that is well known to be poorly amenable to environmental RNAi. In the present paper, we demonstrate that silencing vacuolar H‐ATPase 16 (vha16) and clathrin heavy chain (clath), two components of the Clathrin‐dependent endocytosis pathway, together with pharmacological inhibition of scavenger receptors with polyinosine and dextran sulphate, can significantly attenuate the highly robust RNAi response in the desert locust, Schistocerca gregaria.
Inpatient antibiotic consumption in a regional secondary hospital in New Zealand
Authors: Hopkins C. J.
Published: February 2014

Background

Reporting of antibiotic consumption in hospitals is a crucial component of antibiotic stewardship, but data from Australasian secondary hospitals are scarce. The hypothesis of this audit is that antibiotic consumption in secondary hospitals would be lower than in tertiary centres.

Aims

The study aims to present the first published audit of antibiotic consumption from a secondary hospital in New Zealand compared with two tertiary centres.

Methods

Hospital population‐level data were retrospectively accessed to identify all systemic antibiotics dispensed to adult inpatients at Taranaki District Health Board during 2011. Consumption was calculated in defined daily doses per 100 inpatient‐days and per 100 admissions, stratified by drug class. Comparison was against published data from two tertiary centres.

Results

Total consumption was lower, but that of high‐risk antibiotic classes was higher than both tertiary centres. The relative consumption of lincosamides was 4.0 and 2.6 times higher than the two tertiary centres, with an associated 14% incidence of Clostridium difficile associated diarrhoea within 3 months.

Conclusion

Our secondary hospital appears to consume the wrong types of antibiotic rather than too much. Data from all Australasian hospitals, stratified by clinical service area and hospital level, are required for clinically relevant benchmarking.
Modification of the National Inpatient Medication Chart improves venous thromboembolism prophylaxis rates in high‐risk medical patients
Authors: Yates M. , Reddy M. , Machumpurath B. , Phelps G. , Hampson S.‐A.
Published: February 2014

Background

Venous thromboembolism (VTE) is a significant contributor to morbidity and mortality in Australia. While there is well‐established evidence for the use of VTE prophylaxis in hospital inpatients, adherence to such guidelines is poor.

Aim

The aim of the present study is to assess the impact of education and system change on improving rates of VTE prophylaxis in hospital inpatients.

Methods

We performed four consecutive audits of inpatient medical records of a regional hospital service over 2 years. The audits aimed to test the impact of serial interventions at increasing the appropriate use of VTE prophylaxis (based on risk assessment). The interventions were (i) staff education and (ii) a process change that mandated a prophylaxis decision by modifying the National Inpatient Medication Chart with ‘VTE avoidance’ preprinted in the first medication box.

Results

Our results from the baseline study showed that of the 236 medical inpatients reviewed, 80% were at high risk of VTE. Of this high‐risk cohort, 34.9% (confidence interval (CI) 28–42%) had appropriate prophylaxis decisions. Post the education intervention, 43.2% (CI 37–49%) of the high‐risk cohort received appropriate VTE prophylaxis, an improvement of 8.3% (CI −1% to 18%) from baseline. With the subsequent introduction of a process change, 82.1% (CI 66–92%) of the high‐risk cohort received appropriate prophylaxis, an improvement of 47.2% and 38.8% (CI 24–54%) when compared with baseline and education respectively. Retention rates at 11 months postsystem change were 73% (CI 55–86%).

Conclusions

This study therefore concluded that while education has an impact on rates of appropriate VTE prophylaxis, it is system change that has the most marked and sustained effect.
Two‐faced haemophagocytic lymphohistiocytosis: comparative review of two cases of adult haemophagocytic lymphohistiocytosis
Authors: Mayson E. , Saverimuttu J. , Warburton P.
Published: February 2014

Haemophagocytic lymphohistiocytosis (HLH) is a rare but potentially fatal disease of children and adults. Cytokine dysfunction, uncontrolled accumulation of activated T‐cells and histiocytes, and the inability to terminate the immune response lead to the clinical manifestations of extreme inflammation and end‐organ damage. HLH is notoriously underreported because of its ability to mimic many other common diseases. Here, we outline two cases of HLH, one primary and the other secondary, to highlight some of the differences and to discuss therapeutic principles and emerging concepts.
Procalcitonin, a valuable biomarker assisting clinical decision‐making in the management of community‐acquired pneumonia
Authors: Lindstrom S. T. , Wong E. K. C.
Published: February 2014

Background and Aim

Community‐acquired pneumonia (CAP) is a leading cause of mortality, morbidity and hospital admission, which places strain on our healthcare system. Procalcitonin (PCT) is a biomarker of bacterial infection which may help gauge the severity and prognosis of patients with CAP. In addition to clinical predictors, PCT may assist in decisions pertaining to timing of discharge from hospital and the discontinuation of antibiotics. This study aimed to determine the predictive role of PCT measurement in reducing hospital admissions, length of stay (LOS) and antibiotic (AB) usage in patients with CAP.

Methods

A prospective, single‐blinded, externally controlled study of consenting adult patients admitted with CAP. PCT levels were obtained on day 1 and day 3 (when indicated). Investigator‐evaluated clinical parameters, together with results of PCT levels, determined the timing of oral AB switch and discharge from hospital. This process was compared against standard practice, but was not actually implemented, for the purpose of this study.

Results

Sixty patients were included in the study. The mean age was 66.5 ± 21.2 years (56.3% male). The average Pneumonia Severity Index was 93 ± 39 (class IV) and the median CURB‐65 was 2. The mean LOS for the standard practice cohort was 5.3 ± 4.6 days versus calculated LOS using the PCT guidance pathway of 3.7 ± 2.8 days. (P = 0.00006).

Conclusions

Our study supports the hypothesis that by incorporation of PCT levels, hospital admission and LOS in patients with CAP can be reduced. A randomised prospective clinical trial is planned in an attempt to help confirm these findings.
Suboptimal management of unfractionated heparin compared with low‐molecular‐weight heparin in the management of pulmonary embolism
Authors: Khor Y. H. , Smith R. , McDonald C. F.
Published: February 2014

Background

Both low‐molecular‐weight heparin (LMWH) and unfractionated heparin (UFH) have been shown to be equivalent in efficacy and safety profiles for the management of pulmonary embolism (PE).

Aims

To assess the real world management of anticoagulation in PE in a tertiary hospital setting.

Methods

An audit of patients with a new diagnosis of PE from March 2011 to March 2012. Data collected included patient demographics, anticoagulant, complication, mortality, time to first administration, frequency of monitoring and dose adjustment for UFH, time to therapeutic range for UFH (based on activated partial thromboplastin time) and length of hospital stay.

Results

Of the 211 patients who were included, 139 were admitted through the Emergency Department, and 45 were managed with UFH. There was no significant difference in time to initial dose between those treated with LMWH and UFH (192 vs 98 min, P = 0.16). For UFH, average time to therapeutic range was 594 min (range 87–2257 min). During the course of UFH therapy, only 22% of activated partial thromboplastin time was within therapeutic range, while 44% was above and 33% was below therapeutic range. Average number of UFH dose adjustment was 5. Increasing weight and higher baseline fibrinogen levels significantly delayed time to therapeutic range for patients on UFH (P = 0.02 and 0.04 respectively). Up to 18 months following PE, overall mortality rate was 28%, with no significant difference between LMWH and UFH (28% vs 29%).

Conclusion

PE was predominantly managed with LMWH. UFH was suboptimally managed when used, although there was no impact on mortality rate.
Care of the dying cancer patient in the emergency department: findings from a National survey of Australian emergency department clinicians
Authors: Marck C. H. , Weil J. , Lane H. , Weiland T. J. , Philip J. , Boughey M. , Jelinek G. A.
Published: February 2014

Background

Patients with cancer are presenting to emergency departments (ED) for end‐of‐life care with increasing frequency. Little is known about this experience for patients and ED clinicians in Australia.

Aims

To assess the barriers and enablers regarding end‐of‐life care for cancer patients as perceived by Australian ED clinicians.

Methods

There were 4501 Australian ED clinicians invited through their professional colleges to complete an online survey, using multiple‐choice and free‐text responses.

Results

A total of 681 ED clinicians responded, most (84.2%) felt comfortable providing care to the dying and found it to be rewarding (70.9%). Although 83.8% found caring for the dying a reasonable demand on their role as clinician, 83.8% also agreed that the ED is not the right place to die. Respondents demonstrated a wide range of views regarding caring for this patient group in ED through free‐text responses. In addition, 64.5% reported that futile treatment is frequently provided in the ED; the main reasons reported were that limitations of care were not clearly documented, or discussed with the patient or their family. Almost all (94.6%) agreed that advance care plans assist in caring for dying patients in the ED.

Conclusions

Our findings provide important new insights into a growing area of care for ED. Barriers and enablers to optimal care of the dying patient in ED were identified, and especially the reported high occurrence of futile care, likely a result of these barriers, is detrimental to both optimal patient care and allocation of valuable healthcare resources.
Job insecurity and job satisfaction in the United States: the case of public sector union workers
Authors: Artz Benjamin , Kaya Ilker
Published: February 2014

We measure the association between perceived job insecurity and job satisfaction in the United States and focus on public sector union workers. Job satisfaction decreases with perceived job insecurity among union workers in the public sector and primarily when tenure with an employer is high.
Towards a Method for Quantitative LA‐ICP‐MS Imaging of Multi‐Phase Assemblages: Mineral Identification and Analysis Correction Procedures
Authors: Paul Bence , Woodhead Jon D. , Paton Chad , Hergt Janet M. , Hellstrom John , Norris C. Ashley
Published: February 2014

Here, we present an approach to laser ablation ICP‐MS mapping of multi‐phase assemblages that permits the use of different internal standard elements, concentration values and reference materials for each mineral. In this way, we obtain not only broad pictures of elemental distributions within samples but can also extract high accuracy concentration data for any user‐selected region. This is accomplished by assigning regions of an image to corresponding mineral phases on a pixel‐by‐pixel basis. In this way, accurate trace element concentrations can be determined for each mineral phase, despite potential variations in their ablation characteristics. We present an example where elemental maps are constructed from ablation of a gabbroic sample that includes the phases apatite, amphibole and plagioclase. This work represents an important first step towards development of a method to produce highly accurate LA‐ICP‐MS elemental maps of multi‐phase samples.
Effect of Cobalt Doping on the Structural, Microstructure and Microwave Dielectric Properties of MgTiO3 Ceramics Prepared by Semi Alkoxide Precursor Method
Authors: Santhosh Kumar Thatikonda , Gogoi Pallabi , Perumal Alagarsamy , Sharma Pramod , Pamu Dobbidi
Published: February 2014

We report a systematic investigation on crystal structure, microstructure, and microwave dielectric properties of (Mg1−xCox)TiO3 (x = 0–0.07) ceramics prepared by semialkoxide precursor method. All the as‐made samples exhibit an ilmenite structure with an incredible reduction in sintering temperature from 1350°C to 1200°C. Lattice parameter increases with increasing Co content due to the larger ionic radius of Co2+ as compared to Mg2+. The relative density, dielectric constant, and Q × f0 values increase with increasing Co up to 0.05 and decreases for x > 0.05. This is attributed to local lattice distortion, maximum relative density, and uniform grain growth. Q × f0 values were enhanced from 126 THz for x = 0 to a maximum value 170 THz for x = 0.05. A best combination of microwave dielectric properties (εr ~ 17.03, Q × f0 ~ 170 THz @ 9.4 GHz and τf of −40 ppm/°C) was obtained for (Mg0.95Co0.05)TiO3 ceramic sintered at 1200°C for 3 h. The observed results reveal (Mg0.95Co0.05)TiO3 ceramic as one of the promising dielectric materials for low‐loss and millimeter‐microwave applications.
Molecular dating of Winteraceae reveals a complex biogeographical history involving both ancient Gondwanan vicariance and long‐distance dispersal
Authors: Thomas Nanette , Bruhl Jeremy J. , Ford Andrew , Weston Peter H.
Published: February 2014

Aim

Our aim was to implement a molecular dating analysis and assess divergence times among taxa of Winteraceae. This enabled us to test hypotheses of vicariance versus long‐distance dispersal to explain intercontinental disjunctions in the family.

Location

Madagascar, Australia (including Lord Howe Island), New Zealand, New Caledonia and South America.

Methods

We sampled all Australian species and subspecies of Winteraceae. We also included the monotypic Takhtajania perrieri and at least two species of each genus from New Zealand, New Caledonia and South America. Three sets of sequences were combined into one data matrix, including two internal transcribed spacer (ITS) data sets and a trnL–F data set. Both ITS data sets included all genera of Winteraceae, and the paralogous genes identified in Zygogynum s.l. in a previous study were sequenced and aligned in separate ITS data sets. A Bayesian molecular phylogenetic tree of extant Winteraceae was used as a backbone constraint in paup* to establish the placement of fossils. Bayesian analyses were performed using beast, implementing fossil priors to fit lognormal distributions, to test a maximum‐parsimony phylogeny and assess divergence times.

Results

Interspecific relationships generally agreed with previous analyses. In particular, Bubbia comptonii was found to be sister to the rest of the Bubbia/Zygogynum clade, but our analysis has uniquely found sister clades within this group: one from New Caledonia, and one from Australia including Lord Howe Island. The phylogeny yields an age of 91.2 Ma with a 95% confidence interval of 118–67 Ma for crown‐group Winteraceae.

Main conclusions

The estimated age of Takhtajania is consistent with its origin in Madagascar as a result of Gondwanan vicariance – the only angiosperm for which this has been demonstrated with confidence. Differentiation of the rest of this ancient clade is a complicated story of vicariance as a result of the rifting, submergence and exhumation of continents and of long‐distance dispersal and extinctions.
Minimum wood density of Juniperus thurifera is a robust proxy of spring water availability in a continental Mediterranean climate
Authors: Camarero Jesús Julio , Rozas Vicente , Olano José Miguel
Published: February 2014

Aim

The Mediterranean Basin is considered to be a climate‐change hotspot, for which rising temperatures and associated aridification have been forecast. Such trends could affect the performance and growth of conifers in these drought‐prone areas. We evaluated whether radial growth and wood density can act as proxy measures of precipitation and drought in a Mediterranean conifer.

Location

Iberian Juniperus thurifera forests in northern and eastern Spain.

Methods

We sampled 10 stands encompassing J. thurifera's distributional area. We related four annually resolved tree‐ring variables (earlywood and latewood width, and maximum and minimum wood density) to climatic factors (temperature, precipitation and drought index) for the period 1951–2000. We then analysed the spatial and temporal patterns of those associations.

Results

Of all the four tree‐ring variables analysed, minimum wood density presented the strongest response to climate. Higher values of minimum wood density were related to drier spring conditions, particularly in the most xeric sites, confirming that a drought‐induced reduction in the radial expansion of tracheids increases earlywood density.

Main conclusions

Minimum wood density is a biogeographically meaningful proxy of spring water availability for the Mediterranean conifer J. thurifera.
Suborbital climatic variability and centres of biological diversity in the Cape region of southern Africa
Authors: Huntley Brian , Midgley Guy F. , Barnard Phoebe , Valdes Paul J.
Published: February 2014

Aim

To explore the magnitude and spatial patterns of last glacial stage orbitally forced climatic changes and suborbital climatic fluctuations in southern Africa, and to evaluate their potential roles in determining present biodiversity patterns.

Location

Africa south of 15° S.

Methods

Palaeoclimate scenarios for southern Africa were derived for 17 time slices using outputs from HadCM3 atmosphere–ocean general circulation model experiments, including five designed to mimic Heinrich events. Species distribution models for birds of Karoo (45) or Fynbos (31) were used to simulate species' potential past distributions. Species‐richness patterns were assessed for each time slice, and minimum species richness for regional endemics of each biome determined for each grid cell. Areas of greatest ‘stability’ for endemics of each biome were identified using grid cells with greatest minimum richness.

Results

Simulated suborbital climatic fluctuations were of greater magnitude than orbitally forced changes and had anomalies of opposite sign in many areas. The principal local drivers of suborbital fluctuations were marked contrasts in South Atlantic circulation and temperature between experiments mimicking Heinrich events and those with only slow forcings. These contrasts in ocean circulation and temperature were consistent with marine sediment core evidence of changes in the South Atlantic coincident with Heinrich events in the North Atlantic. Whereas orbitally forced last glacial climates generally resulted in range expansions and increased species richness in many grid cells compared with the present, the contrasting conditions of Heinrich events resulted in much reduced ranges and species richness, especially for Karoo species. Very few grid cells remained suitable for larger numbers of endemic species of either biome under all palaeoclimate scenarios examined, but this minority of ‘stable’ grid cells correspond to present diversity centres.

Main conclusions

Suborbital climatic fluctuations during the last glacial stage were probably of considerable magnitude in southern Africa. This may account for apparent inconsistencies between regional palaeoclimate records, as well as being key to determining present biodiversity patterns.
Diagnosis in Young Children: How a Father's Perceptions of Mental Health Change
Authors: Morris Marian
Published: February 2014

Purpose

This case study's purpose was to understand how diagnosing mental illness in a child affects a parent's perception of mental health, using Denzin's interpretive interactionism.

Sources

Two interviews from a case study were analyzed.

Conclusions

Emergent themes were alienation from peers, ambivalence, shifting orientation to mental illness, school system stigmatization and conflict with mental health care, and discovery of mental healthcare specialists and new peers. Perceptions were influenced by peers, education, and mental healthcare systems, and by the disease model paradigm of mental illness. Future research should explore the effect of the diagnostic process on parents of very young children, and expand on consequences of undergoing current diagnostic and treatment practices.
Outcomes of Atrioesophageal Fistula Following Catheter Ablation of Atrial Fibrillation Treated with Surgical Repair versus Esophageal Stenting
Authors: MOHANTY SANGHAMITRA , SANTANGELI PASQUALE , MOHANTY PRASANT , BIASE LUIGI DI , TRIVEDI CHINTAN , BAI RONG , HORTON RODNEY , BURKHARDT J. DAVID , SANCHEZ JAVIER E. , ZAGRODZKY JASON , BAILEY SHANE , GALLINGHOUSE JOSEPH G. , HRANITZKY PATRICK M. , SUN ALBERT Y. , HONGO RICHARD , BEHEIRY SALWA , NATALE ANDREA
Published: February 2014

Management of Atrioesophageal Fistula Post‐AF Ablation

Introduction

Atrioesophageal fistula (AEF) is a rare but devastating complication of radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF). Surgical repair and esophageal stents are available treatment options for AEF. We report outcomes of these 2 management strategies.

Methods

Nine patients with AEF post‐RFCA for AF were included in this study. AEF was diagnosed based on symptoms and chest CT imaging. Of the 9 patients, 5 received stents and 4 underwent surgical repair of fistula.

Results

AF ablation was performed under general anesthesia (n = 4) or conscious sedation (n = 5). During ablation, RF power was maintained between 25 and 35 Watts in areas close to the esophagus and energy delivery discontinued when esophageal temperature reached 38 °C. Seven patients underwent ablation with 3.5‐mm open‐irrigated catheter, 1 with 8‐mm nonirrigated catheter, and 1 had surgical epicardial ablation. Seven patients received proton pump inhibitor and sucralfate before and after procedure. AEF symptoms developed within 2–6 weeks from ablation. Esophageal stenting was performed in 5 patients (median age 58 years, median time from RFCA 4 weeks) and 4 underwent surgical repair (median age 54 years, median time from RFCA 4 weeks) within 2–4 hours from diagnosis. All 5 patients receiving stents died within 1 week of the procedure due to cerebral embolism, septic shock, or respiratory failure. On the other hand, the 4 patients that received surgical repair were alive at median follow‐up of 2.1 years (P = 0.005).

Conclusions

Esophageal stenting should be discouraged and prompt surgical repair is crucial for survival in patients with atrioesophageal fistula.
Reprogramming to a pluripotent state modifies mesenchymal stem cell resistance to oxidative stress
Authors: Asensi Karina D. , Fortunato Rodrigo S. , dos Santos Danúbia S. , Pacheco Thaísa S. , de Rezende Danielle F. , Rodrigues Deivid C. , Mesquita Fernanda C. P. , Kasai‐Brunswick Tais H. , de Carvalho Antonio C. Campos , Carvalho Denise P. , Carvalho Adriana B. , Goldenberg Regina C. dos S.
Published: February 2014

Properties of induced pluripotent stem cells (iPSC) have been extensively studied since their first derivation in 2006. However, the modification in reactive oxygen species (ROS) production and detoxification caused by reprogramming still needs to be further elucidated. The objective of this study was to compare the response of iPSC generated from menstrual blood–derived mesenchymal stem cells (mb‐iPSC), embryonic stem cells (H9) and adult menstrual blood–derived mesenchymal stem cells (mbMSC) to ROS exposure and investigate the effects of reprogramming on cellular oxidative stress (OS). mbMSC were extremely resistant to ROS exposure, however, mb‐iPSC were 10‐fold less resistant to H2O2, which was very similar to embryonic stem cell sensitivity. Extracellular production of ROS was also similar in mb‐iPSC and H9 and almost threefold lower than in mbMSC. Furthermore, intracellular amounts of ROS were higher in mb‐iPSC and H9 when compared with mbMSC. As the ability to metabolize ROS is related to antioxidant enzymes, we analysed enzyme activities in these cell types. Catalase and superoxide dismutase activities were reduced in mb‐iPSC and H9 when compared with mbMSC. Finally, cell adhesion under OS conditions was impaired in mb‐iPSC when compared with mbMSC, albeit similar to H9. Thus, reprogramming leads to profound modifications in extracellular ROS production accompanied by loss of the ability to handle OS.
Compliance of cigarette smokers with scheduled visits for supportive periodontal therapy
Authors: Ramseier Christoph A. , Kobrehel Salome , Staub Petra , Sculean Anton , Lang Niklaus P. , Salvi Giovanni E.
Published: February 2014

Aim

To evaluate the compliance of cigarette smokers with scheduled visits for supportive periodontal therapy (SPT).

Materials and Methods

Qualitative and quantitative analyses of compliance with scheduled SPT visits were performed using retrospective data from patients undergoing dental hygiene treatment at the Medi School of Dental Hygiene (MSDH), Bern, Switzerland 1985–2011.

Results

A total of 1336 patients were identified with 32.1% (n = 429) being smokers, 23.1% (n = 308) former smokers and 44.8% (n = 599) non‐smokers. Qualitatively, significantly less smokers returned for SPT than non‐smokers or former smokers (p = 0.0026), whereas 25.9% (n = 346) never returned for SPT. Further quantitative analysis of patients returning twice or more (n = 883) revealed that the overall mean %‐compliance was 69.8% (SD ±22.04),whereas smokers complied with 67.0% (SD ±22.00), former smokers with 69.7% (SD ±22.03), and non‐smokers with 71.7% (SD ±21.92) reaching statistical significance (p = 0.0111). Confounder adjusted analysis, however, revealed that older age (p = 0.0001), female gender (p = 0.0058), longer SPT intervals (p < 0.0001) and higher severity of periodontal disease (p < 0.0001) had a much greater impact on %‐compliance than smoking (p = 0.7636).

Conclusions

This study suggests that qualitatively, smokers return less likely for SPT than non‐smokers or former smokers while quantitatively, a lower mean %‐compliance of smokers attending scheduled SPT visits may be attributed to confounders.