bluuebunny/crossref_metadata_2025 huggingface dataset:
Refinement of current monitoring methodology for electroosmotic flow assessment under low ionic strength conditions
Authors: Saucedo-Espinosa Mario A. , Lapizco-Encinas Blanca H.
Published: June 2016

Current monitoring is a well-established technique for the characterization of electroosmotic (EO) flow in microfluidic devices. This method relies on monitoring the time response of the electric current when a test buffer solution is displaced by an auxiliary solution using EO flow. In this scheme, each solution has a different ionic concentration (and electric conductivity). The difference in the ionic concentration of the two solutions defines the dynamic time response of the electric current and, hence, the current signal to be measured: larger concentration differences result in larger measurable signals. A small concentration difference is needed, however, to avoid dispersion at the interface between the two solutions, which can result in undesired pressure-driven flow that conflicts with the EO flow. Additional challenges arise as the conductivity of the test solution decreases, leading to a reduced electric current signal that may be masked by noise during the measuring process, making for a difficult estimation of an accurate EO mobility. This contribution presents a new scheme for current monitoring that employs multiple channels arranged in parallel, producing an increase in the signal-to-noise ratio of the electric current to be measured and increasing the estimation accuracy. The use of this parallel approach is particularly useful in the estimation of the EO mobility in systems where low conductivity mediums are required, such as insulator based dielectrophoresis devices.
Photo-controllable memristive behavior of graphene/diamond heterojunctions
Authors: Ueda K. , Aichi S. , Asano H.
Published: June 2016

Graphene/diamond (carbon sp2-sp3) heterojunctions are demonstrated as photo-controllable memristors with photoswitchable multiple resistance states and nonvolatile memory functions. The ratio of conductivity change between the higher and lower resistance states of the junctions was ∼103. The junctions exhibit light wavelength selectivity, and the resistance states can be switched only by blue or violet light irradiation. The mechanism for the change in photoconductivity is considered to be caused by oxidation-reduction of the graphene and/or graphene-diamond (sp2-sp3) interfaces through the movement of oxygen ions by bias with photo-irradiation because they have wavelength selectivity and require air exposure for several days to exhibit memristive behavior. These results indicate that graphene-diamond, carbon sp2-sp3 heterojunctions can be used as photo-controllable devices with both photomemory and photoswitching functions.
A tunable coupler for superconducting microwave resonators using a nonlinear kinetic inductance transmission line
Authors: Bockstiegel C. , Wang Y. , Vissers M. R. , Wei L. F. , Chaudhuri S. , Hubmayr J. , Gao J.
Published: June 2016

We present a tunable coupler scheme that allows us to tune the coupling strength between a feedline and a superconducting resonator in situ over a wide range. In this scheme, we shunt the feedline with a 50-Ω lumped-element nonlinear transmission line made from a 20 nm NbTiN film. By injecting a DC current, the nonlinear kinetic inductance changes and the effective impedance shunting the resonator periodically varies from a short to an open, which tunes the coupling strength and coupling quality factor Qc. We have demonstrated Qc tuning over a factor of 40, between Qc∼5.5×104 and Qc∼2.3×106, for a 4.5 GHz resonator by applying a DC current less than 3.3 mA. Our tunable coupler scheme is easy to implement and may find broad applications in superconducting detector and quantum computing/information experiments.
Laser material processing with tightly focused cylindrical vector beams
Authors: Drevinskas Rokas , Zhang Jingyu , Beresna Martynas , Gecevičius Mindaugas , Kazanskii Andrey G. , Svirko Yuri P. , Kazansky Peter G.
Published: June 2016

We demonstrate a comprehensive modification study of silica glass, crystalline silicon, and amorphous silicon film, irradiated by tightly focused cylindrical vector beams with azimuthal and radial polarizations. The evidence of the longitudinal field associated with radial polarization is revealed by second harmonic generation in z-cut lithium niobate crystal. Despite the lower threshold of ring-shaped modification of silicon materials, the modification in the center of single pulse radially polarized beam is not observed. The phenomenon is interpreted in terms of the enhanced reflection of longitudinal component at the interface with high-index contrast, demonstrating that the longitudinal component is inefficient for the flat surface modification. Enhanced interaction of the longitudinal light field with silicon nanopillar structures produced by the first pulse of double-pulse irradiation is also demonstrated.
Effects of nutrient addition, recovery thereafter and the role of macrophytes in nutrient dynamics of a Mediterranean shallow lake: a mesocosm experiment
Authors: Ferriol Carmen , Miracle Maria Rosa , Vicente Eduardo
Published: June 2016

Eutrophication in coastal wetlands has increased greatly because of human impact, reducing water quality and affecting aquatic plants. The aim of the present study was to investigate the eutrophication of Mediterranean wetlands and their possible recovery. An in situ mesocosm nutrient enrichment experiment was performed in a coastal shallow lake from eastern Spain, holding dense Chara meadows. In this lake, 36 mesocosms were installed and fertilised weekly with four levels of N and P addition over an 8-week period from June to August. Mesocosms fertilised with the two higher levels (N:P ≥5:0.5mgL–1) shifted to turbid status with macrophyte loss before Week 4. Saturation concentrations were similar under these two conditions, with averages ~1.0mgL–1 total particulate P and 700µgL–1chlorophyll-a reached in the last 3 weeks. After 5 weeks of the experiment, macrophytes were removed from the mesocosms without nutrient addition and those fertilised with 1:0.1mgL–1 N:P. Macrophyte removal resulted in a release of phosphate and ammonium from sediments, enhancing eutrophication. Three months after stopping nutrient addition, high nutrient and chlorophyll concentrations persisted in the highly fertilised mesocosms, but decreased in the low fertilised mesocoms, which shows that restoration of eutrophic Mediterranean shallow lakes depends to a great extent on previous external loads.
Potential of submerged macrophytes to support food webs in lowland agricultural streams
Authors: Paice Robyn L. , Chambers Jane M. , Robson Belinda J.
Published: June 2016

Submerged plants are often abundant in lowland streams in agricultural landscapes, but little is known of their role in stream ecosystems compared to riparian vegetation. We investigated the importance of submerged macrophytes as a basal resource of food webs in stream reaches with good and poor riparian vegetation condition, using mixing model analysis with stable carbon and nitrogen isotopes. Epilithic periphyton and terrestrial detritus were important basal resources in good condition reaches, although where macrophytes were present they contributed to food webs. Higher assimilation of either the macrophyte Cycnogeton huegelii or conspicuous epiphytes on C. huegelii leaves was associated with poor riparian condition. Where Potamogeton ochreatus and Ottelia ovalifolia occurred in poor condition reaches, these macrophytes contributed moderately to the food web, but were probably of greater importance as substrates for epiphytic algae. Mixing models indicated invertebrates commonly had generalist feeding strategies, feeding on the most available resource at each reach. Thus, where riparian vegetation is limited, submerged macrophytes may support opportunistic consumers both directly and as a substrate for epiphytes, thereby partially compensating for the loss of allochthonous resources in lowland agricultural streams.
An assessment of animal welfare for the culling of peri-urban kangaroos
Authors: Hampton Jordan O. , Forsyth David M.
Published: June 2016

Context Shooting is used to reduce the abundance of kangaroo (Macropus sp.) populations in many peri-urban areas in Australia, but there is uncertainty surrounding the animal welfare outcomes of this practice. Aim We assessed the animal welfare outcomes of night shooting for peri-urban eastern grey kangaroos (Macropus giganteus). We quantified the duration of stress for: (1) shot animals; (2) euthanased pouch young; and (3) other animals in the same social group. Methods An independent observer collected thermal imagery data, enabling four key animal welfare parameters to be quantified: instantaneous death rate, median time to death, wounding rate and flight duration of conspecifics. The duration between pouch removal and insensibility was recorded for pouch young. Post-mortem data were recorded to confirm the location and extent of pathology from shooting. Key results Of the 136 kangaroos that were shot at, two were missed. The wounding rate was zero, with a 98% instantaneous death rate. The median time to death for the three animals not killed instantaneously was 12 s. For pouch young considered sentient, the median stress time was 4 s. Kaplan–Meier survival analysis revealed that the median flight duration of conspecifics was 5 s. Conclusions Our results indicate that night shooting produces a very short duration of stress to shot kangaroos, their pouch young and their conspecifics. Implications When compared to other wildlife shooting methods, night shooting is a humane method for culling peri-urban kangaroos.
Adaptable history biases in human perceptual decisions
Authors: Abrahamyan Arman , Silva Laura Luz , Dakin Steven C. , Carandini Matteo , Gardner Justin L.
Published: June 2016

Significance

Adapting to the environment requires using feedback about previous decisions to make better future decisions. Sometimes, however, the past is not informative and taking it into consideration leads to worse decisions. In psychophysical experiments, for instance, humans use past feedback when they should ignore it and thus make worse decisions. Those choice history biases persist even in disadvantageous contexts. To test this persistence, we adjusted trial sequence statistics. Subjects adapted strongly when the statistics confirmed their biases, but much less in the opposite direction; existing biases could not be eradicated. Thus, even in our simplest sensory decisions, we exhibit a form of confirmation bias in which existing choice history strategies are easier to reinforce than to relinquish.
A premeiotic function for
boule
in the planarian
Schmidtea mediterranea
Authors: Iyer Harini , Issigonis Melanie , Sharma Prashant P. , Extavour Cassandra G. , Newmark Phillip A.
Published: June 2016

Significance

The Deleted in Azoospermia (DAZ) family of RNA-binding proteins, consisting of Boule, Daz-like (Dazl), and DAZ, plays important roles in gametogenesis. Here we demonstrate that
boule2
in the freshwater planarian
Schmidtea mediterranea
is necessary for the maintenance of early male germ cells, similar to the function of its vertebrate ortholog,
Dazl
.
Our results are significant in that a premeiotic role for an invertebrate
boule
homolog has not been described to date. Furthermore, we functionally characterize planarian homologs of human DAZL/DAZ-associated proteins and mRNA targets. Our study alters the current understanding of DAZ family evolution and establishes
S. mediterranea
as a tractable model organism for the study of premeiotic functions of the DAZ family, and its binding partners and targets.
Descriptive translation studies of audiovisual translation
Authors: Assis Rosa Alexandra
Published: June 2016

This paper aims to identify theoretical and methodological issues, challenges and opportunities posed by the specific nature of research on audiovisual translation (AVT) developed within the framework of Descriptive Translation Studies (DTS). For this purpose, it offers a brief presentation of the overarching principles of DTS; a selective overview of research on AVT in the 21st century, considering the main achievements and challenges involved in such research; and a discussion of some theoretical and methodological issues, challenges and opportunities faced by Descriptive Audiovisual Translation Studies.
Action research
Authors: Neves Josélia
Published: June 2016

In this article Action Research (AR) is addressed to determine its limitations and affordances as a research approach in audiovisual translation studies. A specific case of Participatory Action Research (PAR) is presented in the context of a Museum Project in Portugal – the MCCB project –, serving as a focus for the discussion of the main characteristics of AR: planning, putting into action, reflecting upon and starting anew, in spiralling continuums that start with the AR project itself but that go beyond it to spin off into new research and development projects.
From Translation Studies and audiovisual translation to media accessibility
Authors: Remael Aline , Reviers Nina , Vandekerckhove Reinhild
Published: June 2016

Recent developments in Translation Studies and translation practice have not only led to a profusion of approaches, but also to the development of new text forms and translation modes. Media Accessibility, particularly audio description (AD) and subtitling for the deaf and hard-of-hearing (SDH), is an example of such a ‘new’ mode. SDH has been evolving quickly in recent decades and new developments such as interlingual SDH and live subtitling with speech recognition bring it closer to established forms of translation and interpreting. On the one hand, interlingual SDH reintroduces Jakobson’s (1959) ‘translation proper’ while the use of speech recognition has led to the creation of a hybrid form that has affinities with both subtitling and interpreting. Audio description, for its part, cannot even be fitted into Jakobson’s ‘intersemiotic translation’ model since it involves translation from images into words. Research into AD is especially interesting since it rallies methods from adjacent disciplines, much in the same way that Holmes ([1972] 1988) described TS when it was a fledgling discipline. In 2008, Braun set out a research agenda for AD and the wealth of topics and research approaches dealt with in her article illustrate the immense complexity of this field and the work still to be done. Although AD and SDH research have developed at different paces and are concerned with different topics, converging trends do appear. Particularly the role of technology and the concept of multimodality seem to be key issues. This article aims to give an overview of current research trends in both these areas. It illustrates the possibilities of technology-driven research – particularly popular in SDH and live-subtitling research – while at the same time underlining the value of individual, human-driven approaches, which are still the main ‘modus operandi’ in the younger discipline of AD where much basic research is still required.
Psycholinguistics and audiovisual translation
Authors: Kruger Jan-Louis
Published: June 2016

Psycholinguistic investigations of translated audiovisual products have been conducted since at least the 1980s. These mainly concerned the role of subtitles in the processing of language in the context of language acquisition, literacy, and education. This article provides an overview of some of the most productive lines of research from a psycholinguistic angle in audiovisual translation (AVT), focussing on studies that investigated the positive effects of subtitles on language performance, but also on a growing body of behavioural research on the cognitive processing of the language of subtitles. The article evaluates a number of methodologies in some of the most prominent studies on the processing of subtitles, primarily making use of eye tracking, and then provides some thoughts on future directions in psycholinguistic studies on the processing of the language of AVT.
Women and state socialism: failed promises and radical changes revisited
Authors: Bucur Maria
Published: June 2016

Imagine all history written as if all people, even women, mattered. Until a couple of decades ago, that was at most an aspiration for those of us working on East European history. Since then, however, and especially with the fall of Communism, feminist scholars have made significant inroads toward achieving this goal. This review essay reflects on the contributions made by five such studies that focus on different aspects of women's lives under state socialism in Bulgaria, Czechoslovakia, the German Democratic Republic (GDR), Poland, and Romania. In one way or another, each author asks similar questions about the relationship between the Communist ideological emphasis on gender equality as a core moral value, on the one hand, and the policies and actions of these regimes with regard to women, on the other hand. Moreover, all studies focus on how women themselves participated in articulating, reacting to, and in some cases successfully challenging these policies. In short, they present us with excellent examples of how pertinent gender analysis is for understanding the most essential aspects of the history of Communism in Eastern Europe: how this authoritarian regime transformed individual identity and social relations.
The lower body muscle activation of intermediate to experienced kayakers when navigating white water
Authors: Murtagh Misha , Brooks Darrell , Sinclair Jonathan , Atkins Stephen
Published: June 2016

In white‐water kayaking, the legs play a vital part in turning, stabilising and bracing actions. To date, there has been no reported information on neuromuscular activation of the legs in an authentic white‐water environment. The aim of the current study was to identify lower body muscle activation, using ‘in‐boat’ electromyography (EMG), whilst navigating a white‐water run. Ten experienced male kayakers (age 31.5 ± 12.5 yr, intermediate to advanced experience) completed three successful runs of an international standard white‐water course (grade 3 rapids), targeting right and left sides of the course, in a zigzag formation. Surface EMG (sEMG) outputs were generated, bilaterally, for the rectus femoris (RF), vastus lateralis, biceps femoris and gastrocnemius, expressed as a percentage of a dynamic maximal voluntary contraction (dMVC). Only RF showed significantly higher activation than any muscle on the left side of the body, and only on the left side of the course (P = .004; ETA2 = 0.56). Other results showed no significant difference between muscle activation in the right and left legs during each run, nor when assessed at either the right or left side of the course (P > .05). These findings indicate that contralateral symmetry in lower limb muscle activation is evident during white‐water kayaking. This symmetry may provide a stable base to allow more asymmetrical upper body and trunk movements to be fully optimised. Lower body symmetry development should be considered useful in targeted training programmes for white‐water kayakers.
Diagnostic application of magnetic islands rotation in JET
Authors: Buratti P. , Alessi E. , Baruzzo M. , Casolari A. , Giovannozzi E. , Giroud C. , Hawkes N. , Menmuir S. , Pucella G.
Published: June 2016

Measurements of the propagation frequency of magnetic islands in JET are compared with diamagnetic drift frequencies, in view of a possible diagnostic application to the determination of markers for the safety factor profile. Statistical analysis is performed for a database including many well-diagnosed plasma discharges. Propagation in the plasma frame, i.e. with subtracted E  ×  B Doppler shift, results to be in the ion diamagnetic drift direction, with values ranging from 0.8 (for islands at the q  =  2 resonant surface) to 1.8 (for more internal islands) times the ion diamagnetic drift frequency. The diagnostic potential of the assumption of island propagation at exactly the ion diamagnetic frequency is scrutinised. Rational-q locations obtained on the basis of this assumption are compared with the ones measured by equilibrium reconstruction including motional Stark effect measurements as constraints. Systematic shifts and standard deviations are determined for islands with (poloidal, toroidal) periodicity indexes of (2, 1), (3, 2), (4, 3) and (5, 3) and possible diagnostic applications are indicated.
Empirical Identification of Behavioral Choice Models under Risk
Authors: Just David R. , Just Richard E.
Published: June 2016

The generalized expected utility literature typically assumes an absence of judgment bias in the individual perception of probabilities when inferring risk preferences. This assumption is in disagreement with many other studies that document such bias. We show that models of preference anomalies are mathematically equivalent to models of perception anomalies when estimating perceptions and/or preferences based on observable risky choice data. Empirical models admitting both involve multiplicative functions of common variables and are discernible only by assuming specifications that arbitrarily separate the two. This inability to separately identify preferences and probability perceptions is not readily solved by experimental means. Vastly different combinations of preference and perception modifications fit behavioral data identically, implying that Arrow‐Pratt risk aversion estimates are arbitrary. In contrast, the risk premium and certainty equivalent are identifiable without unverifiable and untestable separating assumptions, and provide sufficient statistics for policy and welfare analysis regardless.
Effects of the Great Recession on the U.S. Agricultural Labor Market
Authors: Fan Maoyong , Pena Anita Alves , Perloff Jeffrey M.
Published: June 2016

We empirically test four hypotheses regarding differences between agricultural worker earnings (wages and bonuses) during recession and non‐recessionary times, between agricultural worker time use during recession and non‐recession times, between outcomes for undocumented and documented workers, and between outcomes for agricultural workers versus those working in other sectors of interest. Regression analyses show that the wages of documented (legal) seasonal agricultural workers increased more during the last three recessions than did the wages of undocumented agricultural workers and low‐skilled nonagricultural workers. Bonus pay and weekly hours also increased for some workers, suggesting general increases in the financial wellbeing of employed agricultural workers during recessions.
Variability in the amount of homoeologous pairing among F1 hybrids
Authors: Poggio Lidia , Greizerstein Eduardo , Ferrari María
Published: June 2016

Genes involved in the exclusive pairing of homologous chromosomes have been described in several polyploid species but little is known about the activity of these genes in diploids (which have only one dose of each homoeologous genome). Analysis of the meiotic behaviour of species, natural and artificial hybrids and polyploids of Glandularia suggests that, in allopolyploids where homoeologous genomes are in two doses, regulator genes prevent homoeologous pairing. The different meiotic phenotypes in diploid F1 hybrids between Glandularia pulchella and Glandularia incisa strongly suggest that these pairing regulator genes possess an incomplete penetrance when homoeologous genomes are in only one dose. Moreover, the meiotic analysis of natural and artificial F1 hybrids suggests that the genetic constitution of parental species influences the activity of pairing regulator genes and is mainly responsible for variability in the amount of homoeologous pairing observed in diploid hybrids. In Glandularia , the pairing regulator genes originated in South American diploid species. The cytogenetic characteristics of this genus make it a good model to analyse and explore in greater depth the activity of pairing regulator genes at different ploidy levels.
The structure of legume–rhizobium interaction networks and their response to tree invasions
Authors: Le Roux Johannes J. , Mavengere Natasha R. , Ellis Allan G.
Published: June 2016

Establishing mutualistic interactions in novel environments is important for the successful establishment of some non-native plant species. These associations may, in turn, impact native species interaction networks as non-natives become dominant in their new environments. Using phylogenetic and ecological interaction network approaches we provide the first report of the structure of belowground legume–rhizobium interaction networks and how they change along a gradient of invasion (uninvaded, semi invaded and heavily invaded sites) by Australian Acacia species in South Africa’s Cape Floristic Region. We found that native and invasive legumes interact with distinct rhizobial lineages, most likely due to phylogenetic uniqueness of native and invasive host plants. Moreover, legume–rhizobium interaction networks are not nested, but significantly modular with high levels of specialization possibly as a result of legume–rhizobium co-evolution. Although network topology remained constant across the invasion gradient, composition of bacterial communities associated with native legumes changed dramatically as acacias increasingly dominated the landscape. In stark contrast to aboveground interaction networks (e.g. pollination and seed dispersal) we show that invasive legumes do not infiltrate existing native legume–rhizobium networks but rather form novel modules. This absence of mutualist overlap between native and invasive legumes suggests the importance of co-invading rhizobium–acacia species complexes for Acacia invasion success, and argues against a ubiquitous role for the formation and evolutionary refinement of novel interactions.
Prescribe to Prevent: Overdose Prevention and Naloxone Rescue Kits for Prescribers and Pharmacists
Authors: Lim Jamie K. , Bratberg Jeffrey P. , Davis Corey S. , Green Traci C. , Walley Alexander Y.
Published: June 2016

In March of 2015, the United States Department of Health and Human Services identified 3 priority areas to reduce opioid use disorders and overdose, which are as follows: opioid-prescribing practices; expanded use and distribution of naloxone; and expansion of medication-assisted treatment. In this narrative review of overdose prevention and the role of prescribers and pharmacists in distributing naloxone, we address these priority areas and present a clinical scenario within the review involving a pharmacist, a patient with chronic pain and anxiety, and a primary care physician. We also discuss current laws related to naloxone prescribing and dispensing. This review was adapted from the Prescribe to Prevent online continuing medical education module created for prescribers and pharmacists (http://www.opioidprescribing.com/naloxone_module_1-landing).
Cerebral Oxygenation Under General Anesthesia Can Be Safely Preserved in Patients in Prone Position: A Prospective Observational Study
Authors: Babakhani Babak , Heroabadi Arash , Hosseinitabatabaei Narges , Schott Martin , Yekaninejad Saeed , Jantzen Jan-Peter , Baumert Jan-Hinrich
Published: June 2016

Background:

The effects of prone position (PP) on cerebral tissue metabolism are not well known. The aim of this investigation was to evaluate regional cerebral oxygen desaturation in patients undergoing lumbar spine surgery in PP during routine anesthesia management.

Materials and Methods:

Between July 2013 and October 2013, 50 consecutive patients undergoing lumbar spine surgery under general anesthesia in PP were enrolled. The anesthetic technique was standardized. Using near-infrared spectroscopy, bilateral regional cerebrovascular oxygen saturation was recorded during the surgery.

Results:

After 30 and 60 minutes of prone repositioning, significant decreases in bilateral regional cerebral oxygen saturation were observed compared with the values in the supine position (from 76.24% to 73.18% at 30 min and 72.76% at 60 min on the right side and from 77.06% to 73.76% at 30 min and 72.92% at 60 min on the left side; P<0.05). These changes were not clinically important and returned to supine values after 90 minutes of prone positioning. Decreases in cerebral oxygen saturation were accompanied by reductions in heart rate and mean arterial pressure (P<0.05). Older age and higher perioperative risk had a significant effect on the reduction of cerebral oxygen values (P<0.05).

Conclusions:

The results of our study show that margin of safety against impaired cerebral oxygenation can be maintained in PP. Preventing bradycardia and arterial hypotension is crucial. Older patients and those at higher perioperative risk need more meticulous attention.
Correction of Angular Deformities Due to Focal Fibrocartilaginous Dysplasia Using Guided Growth: A Preliminary Report
Authors: Welborn Michelle C. , Stevens Peter
Published: June 2016

Background:

Focal fibrocartilaginous dysplasia (FFCD) is a rare benign disorder that may result in tethering of the physis. These most commonly occur around the knee and may result in angular deformities of the involved extremity. To date treatment has ranged from observation, to curettage, to osteotomy. Our goal with this study is to evaluate the efficacy of guided growth in treating patients with angular deformity due to FFCD.

Methods:

This is a retrospective review, we included 3 patients with angular deformities due to FFCD who had undergone 8 plate placement. We reviewed their preoperative and postoperative radiographs, assessed their sagittal and coronal balance and number of procedures.

Results:

Three patients with FFCD of the femur with an average of 14 months underwent guided growth to correct their angular deformity. Once appropriate correction was achieved the hardware was removed. At final follow-up none of the patients required further surgical intervention for their angular deformity nor had they shown any evidence of recurrence.

Conclusions:

FFCD is a rare benign disorder, they most commonly affects the proximal tibia and distal femur and can result in significant angular deformities. Our review of the literature found all of the cases involving the femur progressed to the point where they needed surgical intervention. This ranged from curettage to osteotomy. In this case series we present 3 cases of FFCD of the distal femur that were treated minimally invasively with guided growth.

Level of Evidence:

Level 4.
Incidence of and Risk Factors for Loss of 1 Blood Volume During Spinal Fusion Surgery in Patients With Cerebral Palsy
Authors: Jain Amit , Sponseller Paul D. , Shah Suken A. , Yaszay Burt , Njoku Dolores B. , Miyanji Firoz , Newton Peter O. , Bastrom Tracey P. , Marks Michelle C.
Published: June 2016

Background:

Spinal fusion surgery is associated with greater blood loss in patients with cerebral palsy (CP) than in patients with adolescent idiopathic scoliosis. Risk factors for loss of 1 blood volume (LOBV) in patients with CP have not been well studied. We investigated the incidence of and risk factors for LOBV during spinal fusion surgery in young patients with CP.

Methods:

We queried a multicenter registry of CP patients for all patients 21 years or younger who had undergone spinal fusion from 2008 through 2013; 272 patients met these criteria. We analyzed data on patient characteristics, preoperative laboratory values, radiographic measures, and surgical characteristics. For univariate analysis, we used χ2 tests and logistic regression models. Factors that were significant in the univariate analysis were used to construct a multivariate logistic regression model. Significance was set at P<0.01.

Results:

Incidence of LOBV was 39.7%. On multivariate analysis, unit rod construct and coronal curve magnitude were significantly associated with LOBV (P<0.01). The multivariate model accounted for 32.2% of variance in LOBV. Compared with patients with pedicle screw-rod constructs, patients with unit rod constructs had 12.6-fold higher odds of LOBV (P<0.01). For each 1-degree increase in coronal curve magnitude, odds of LOBV increased 1.03-fold (P<0.01).

Conclusions:

In patients with CP, there is a substantial risk of LOBV during spinal fusion surgery. Use of unit rod constructs and greater preoperative coronal curves were significant risk factors for LOBV during surgery.

Level of Evidence:

Level II.
Academic Peer Detailing—The Preparation and Experience of Detailers Involved in a Project to Disseminate a Comparative Effectiveness Module
Authors: Morrow Robert W. , Tattelman Ellen , Purcell Jennifer M. , King Jason , Fordis Michael
Published: June 2016

Introduction:

Academic detailing uses communication skills, relationship building, and feedback to facilitate behavior change. This report, part of a larger initiative to disseminate evidence summaries of systematic reviews, demonstrates the feasibility of disseminating a comparative effectiveness module to physicians using peer detailers and examines the development of faculty for this process. We describe planning and implementation of a train-the-detailer session, detailer reactions to the process, and results of the dissemination project.

Methods:

We recruited 10 experienced primary care clinical faculties in Family and Social Medicine at the Albert Einstein College of Medicine. Detailers attended a 90-minute train-the-detailer session and detailed 150 practitioners at community practices. We evaluated the experiences of the learners and detailers with questionnaires, a focus group, and individual interviews of the detailers.

Results:

The experiences of detailing in different contexts were uniformly positive. Learners felt the materials were valuable, and that they would implement them or already had implemented them. In the postsurvey completed by 65 of the 150 detailed learners, 97% percent stated that they changed their practice or had already incorporated the practice change before the detailing. All detailers reported a change in their own practice. Detailers found the teaching materials and detailers' guide helpful. Some initially expressed a concern about not knowing enough, which lessened with detailing experience.

Discussion:

Peer detailing seems doable and well received, especially with the availability of high quality, previously prepared, and tested evidence-based content and materials. Detailers were easily recruited and trained to apply their teaching skills in this new format. The amount of time spent in training sessions on detailing training as opposed to content mastery can be adjusted depending on faculty needs.
Performance of Certification and Recertification Examinees on Multiple Choice Test Items: Does Physician Age Have an Impact?
Authors: Shen Linjun , Juul Dorthea , Faulkner Larry R.
Published: June 2016

Introduction:

The development of recertification programs (now referred to as Maintenance of Certification or MOC) by the members of the American Board of Medical Specialties provides the opportunity to study knowledge base across the professional lifespan of physicians. Research results to date are mixed with some studies finding negative associations between age and various measures of competency and others finding no or minimal relationships.

Methods:

Four groups of multiple choice test items that were independently developed for certification and MOC examinations in psychiatry and neurology were administered to certification and MOC examinees within each specialty. Percent correct scores were calculated for each examinee. Differences between certification and MOC examinees were compared using unpaired t tests, and logistic regression was used to compare MOC and certification examinee performance on the common test items.

Results:

Except for the neurology certification test items that addressed basic neurology concepts, the performance of the certification and MOC examinees was similar. The differences in performance on individual test items did not consistently favor one group or the other and could not be attributed to any distinguishable content or format characteristics of those items.

Discussion:

The findings of this study are encouraging in that physicians who had recently completed residency training possessed clinical knowledge that was comparable to that of experienced physicians, and the experienced physicians' clinical knowledge was equivalent to that of recent residency graduates. The role testing can play in enhancing expertise is described.
Dissemination of Evidence From Systematic Reviews Through Academic CME Providers: A Feasibility Study
Authors: Fordis Michael , King Jason E. , Bonaduce de Nigris Francesca , Morrow Robert , Baron Robert B. , Kues John R. , Norton James C. , Kessler Harold , Mazmanian Paul E. , Colburn Lois
Published: June 2016

Introduction:

Although systematic reviews represent a source of best evidence to support clinical decision-making, reviews are underutilized by clinicians. Barriers include lack of awareness, familiarity, and access. Efforts to promote utilization have focused on reaching practicing clinicians, leaving unexplored the roles of continuing medical education (CME) directors and faculty in promoting systematic review use. This study explored the feasibility of working with CME directors and faculty for that purpose.

Methods:

A convenience sample of five academic CME directors and faculty agreed to participate in a feasibility study exploring use in CME courses of systematic reviews from the Agency for Healthcare Research and Quality (AHRQ-SRs). AHRQ-SR topics addressed the comparative effectiveness of health care options. Participants received access to AHRQ-SR reports, associated summary products, and instructional resources. The feasibility study used mixed methods to assess 1) implementation of courses incorporating SR evidence, 2) identification of facilitators and barriers to integration, and 3) acceptability to CME directors, faculty, and learners.

Results:

Faculty implemented 14 CME courses of varying formats serving 1700 learners in urban, suburban, and rural settings. Facilitators included credibility, conciseness of messages, and availability of supporting materials; potential barriers included faculty unfamiliarity with SRs, challenges in maintaining review currency, and review scope. SR evidence and summary products proved acceptable to CME directors, course faculty, and learners by multiple measures.

Discussion:

This study demonstrates the feasibility of approaches to use AHRQ-SRs in CME courses/programming. Further research is needed to demonstrate generalizability to other types of CME providers and other systemic reviews.
Methodological Approach to Use Fresh and Cryopreserved Vessels as Tools to Analyze Pharmacological Modulation of the Angiogenic Growth
Authors: Vicente Diana , Hernández Blanca , Segura Vanessa , Pascual Desirée , Fornaciari Giacomo , Monto Fermí , Mirabet Vicente , Montesinos M. Carmen , D'Ocon Pilar
Published: June 2016

The sprouting of new vessels is greatly influenced by the procedure chosen. We sought to optimize the experimental conditions of the angiogenic growth of fresh and cryopreserved vessels cultured in Matrigel with the aim to use this system to analyze the pharmacological modulation of the process. Segments of second-order branches of rat mesenteric resistance arteries, thoracic aorta of rat or mouse, and cryopreserved rat aorta and human femoral arteries were cultured in Matrigel for 7–21 days in different mediums, as well as in the absence of endothelial or adventitia layer. Quantification of the angiogenic growth was performed by either direct measurement of the mean length of the neovessels or by calcein AM staining and determination of fluorescence intensity and area. Fresh and cryopreserved arterial rings incubated in Matrigel exhibited a spontaneous angiogenic response that was strongly accelerated by fetal calf serum. Addition of vascular endothelial growth factor, fibroblast growth factor, endothelial growth factor, or recombinant insulin-like growth factor failed to increase aortic sprouting, unless all were added together. Removal of adventitia, but not the endothelial layer, abrogated the angiogenic response of aortic rings. Determination of the mean neovessel length is an easy and accurate method to quantify the angiogenic growth devoid of confounding factors, such as inclusion of other cellular types surrounding the neovessels. Activity of a α1-adrenoceptor agonist (phenylephrine) and its inhibition by a selective antagonist (prazosin) were analyzed to prove the usefulness of the Matrigel system to evaluate the pharmacological modulation of the angiogenic growth.
Back schools for the treatment of chronic low back pain: possibility of benefit but no convincing evidence after 47 years of research—systematic review and meta-analysis
Authors: Straube Sebastian , Harden Markus , Schröder Heiko , Arendacka Barbora , Fan Xiangning , Moore R. Andrew , Friede Tim
Published: June 2016

Back schools are interventions that comprise exercise and education components. We aimed to systematically review the randomized controlled trial evidence on back schools for the treatment of chronic low back pain. By searching MEDLINE, Embase, and Cochrane Central as well as bibliographies, we identified 31 studies for inclusion in our systematic review and 5 of these for inclusion in meta-analyses. Meta-analyses for pain scores and functional outcomes revealed statistical superiority of back schools vs no intervention for some comparisons but not others. No meta-analysis was feasible for the comparison of back schools vs other active treatments. Adverse events were poorly reported so that no reliable conclusions regarding the safety of back schools can be drawn, although some limited reassurance in this regard may be derived from the fact that few adverse events and no serious adverse events were reported in the back school groups in the studies that did report on safety. Overall, the evidence base for the use of back schools to treat chronic low back pain is weak; in nearly a half-century since back schools were first trialled, no unequivocal evidence of benefit has emerged.
Usefulness of mean corpuscular volume as a surrogate marker for monitoring thiopurine treatment in inflammatory bowel disease
Authors: Dujardin Romein W.G. , Meijer Berrie , de Boer Nanne K.H. , D’Haens Geert R. , Löwenberg Mark
Published: June 2016

Background

Thiopurines are commonly used drugs in inflammatory bowel disease. Intracellular levels of thiopurine metabolites [i.e. 6-thioguaninenucleotides (6-TGN)] are associated with efficacy and toxicity. Because 6-TGN measurement is not globally available, the mean corpuscular volume (MCV) has been proposed as a surrogate marker for monitoring thiopurine therapy.

Aims

To analyze the relationship between MCV and efficacy of thiopurines, defined as either response to therapy or 6-TGN levels.

Methods

A systematic search on PubMed was performed.

Results

Fifteen studies were included. In six studies, a positive association was found between ΔMCV and 6-TGN. In four studies, it was suggested that ΔMCV can be used to predict clinical remission. In five articles, no association was found.

Conclusion

In the majority of articles, it was reported that ΔMCV is useful in guiding intracellular metabolite levels. However, there is insufficient evidence showing that ΔMCV can predict clinical remission.
Reproducibility and Inter‐rater Reliability of 2 Paediatric Nutritional Screening Tools
Authors: Galera‐Martínez Rafael , Moráis‐López Ana , Rivero de la Rosa Maria del C. , Escartín‐Madurga Laura , López‐Ruzafa Encarnación , Ros‐Arnal Ignacio , Ruiz‐Bartolomé Hector , Rodríguez‐Martínez Gerardo , Lama‐More Rosa A.
Published: June 2016

Objectives:

The aim of the present study was to assess reproducibility and inter‐rater reliability of 2 nutritional screening tools (NST): Screening Tool for Risk on Nutritional Status and Growth (STRONGkids) and Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP).

Methods:

Prospective observational multicentre study. Patients ages 1 month or older admitted to paediatric or surgical wards were tested within 24 hours of admission by 2 independent observers: experts specialized in paediatric nutrition (physicians or dieticians) and clinical staff nonexpert in nutrition. Diagnosis on admission, underlying diseases, and length of stay were registered. Statistical analysis: Kappa index (κ) to evaluate agreement between observers.

Results:

A total of 223 patients were included (53.4% boys), with mean age of 5.59 (95% confidence interval 4.94–6.22) years. Experts classified 9.9% of patients at high risk with STRONGkids and 19.7% using STAMP, whereas nonexpert staff assigned 6.7% of patients to the high‐risk category with STRONGkids and 21.9% with STAMP. Agreement between expert and nonexpert staff was good: 94.78% for STRONGkids (κ 0.72 [P < 0.001]); 92.55% for STAMP (κ 0.74 [P < 0.001]). The rate of malnutrition was significantly higher among high‐risk patients with both NST, independent of examiner experience. After adjusting for age, both STRONGkids and STAMP high‐risk scores predicted longer length of stay, whether assessed by experts or nonexperts, although differences were higher with STRONGkids.

Conclusions:

Agreement between experts and nonexpert staff in nutrition was good, producing a similar high‐risk patient profile. Our results demonstrate that these NSTs are appropriate for nutritional screening in settings in which users have no previous experience in the field.
Effect of Intravenous Ondansetron on the QT Interval of Patients' Electrocardiograms
Authors: Krammes Sarah Kline , Jacobs Todd , Clark John M. , Lutes R. Esther
Published: June 2016

Objective

Ondansetron improves the success of oral rehydration in children with gastroenteritis. In postoperative adults, ondansetron has been shown to prolong the corrected QT (QTc). The aim of the study was to evaluate the effect of ondansetron on the QT at peak effect and at 1-hour postpeak effect in pediatric patients.

Methods

This was an observational study looking at patients aged 6 months to 18 years receiving intravenous ondansetron for nausea, vomiting, or the inability to take fluids in the emergency department. Patients had electrocardiogram performed at baseline, at ondansetron's peak effect, and 1 hour postpeak effect. A paired samples Student t test compared QTc change at peak effect to zero. Peak effect of intravenous ondansetron is 3 minutes.

Results

One hundred patients were included. Fifty-five percent of patients were female with a mean age of 8.3 years. The mean (range) baseline QTc was 435 (388 to 501) milliseconds. The mean (range) change in QTc at peak effect of ondansetron was 3 (−40 to 65) milliseconds (P = 0.072). The change in QTc 1-hour postpeak effect of ondansetron was 3 (−43 to 45) milliseconds (P = 0.082). No change at peak effect or 1-hour postpeak effect was clinically significant.

Conclusions

Ondansetron does not affect the QTc of pediatric patients receiving the medication for nausea, vomiting, or inability to take fluids in the emergency department. No changes in the QTc are clinically significant. To date, there have been no studies evaluating the effect of ondansetron in this acutely ill population; therefore, a larger study should be completed to confirm these data.