bluuebunny/crossref_metadata_2025 huggingface dataset:
Enhancing Ecoefficiency in Shrimp Farming through Interconnected Ponds
Authors: Barraza-Guardado Ramón Héctor , Arreola-Lizárraga José Alfredo , Miranda-Baeza Anselmo , Juárez-García Manuel , Juvera-Hoyos Antonio , Casillas-Hernández Ramón
Published: October 2015

The future development of shrimp farming needs to improve its ecoefficiency. The purpose of this study was to evaluate water quality, flows, and nitrogen balance and production parameters on a farm with interconnected pond design to improve the efficiency of the semi-intensive culture ofLitopenaeus vannameiponds. The study was conducted in 21 commercial culture ponds during 180 days at densities of 30–35 ind m−2and daily water exchange <2%. Our study provides evidence that by interconnecting ponds nutrient recycling is favored by promoting the growth of primary producers of the pond as chlorophylla. Based on the mass balance and flow of nutrients this culture system reduces the flow of solid, particulate organic matter, and nitrogen compounds to the environment and significantly increases the efficiency of water (5 to 6.5 m3 kg−1cycle−1), when compared with traditional culture systems. With this culture system it is possible to recover up to 34% of the total nitrogen entering the system, with production in excess of 4,000 kg ha−1shrimp. We believe that the production system with interconnected ponds is a technically feasible model to improve ecoefficiency production of shrimp farming.
Recombinant Immunotoxin with T-cell Epitope Mutations That Greatly Reduce Immunogenicity for Treatment of Mesothelin-Expressing Tumors
Authors: Mazor Ronit , Zhang Jingli , Xiang Laiman , Addissie Selamawit , Awuah Prince , Beers Richard , Hassan Raffit , Pastan Ira
Published: October 2015

SS1P is a recombinant immunotoxin (RIT) that targets mesothelin. It consists of an antimesothelin Fv fused to a portion of Pseudomonas exotoxin A. In clinical studies, it has produced dramatic responses in patients with advanced mesothelioma, when combined with immunosuppressive therapy so that several treatment cycles could be given. Otherwise its activity is limited by its immunogenicity. In this work, we describe the development and characterization of LMB-T20, a highly potent RIT targeted at mesothelin-expressing cancers with low immunogenicity due to removal of its eight T-cell epitopes. LMB-T20 was more active than SS1P when tested on four different mesothelin-expressing cell lines as well as on cells obtained from patients with mesothelioma. It also has potent antitumor activity in mice, and has reduced immunogenicity as measured by cytokine secretion assays. In conclusion, LMB-T20 is a favorable candidate for evaluation in clinical trials due to its reduced immunogenicity and excellent activity. Mol Cancer Ther; 14(12); 2789–96. ©2015 AACR.
Quantifying the Benefit of Prehospital Rapid Treatment in Acute Stroke
Authors: Lorenz Matthias W. , Lauer Arne , Foerch Christian
Published: October 2015

Background and Purpose—

In acute ischemic stroke, time from onset to tissue-type plasminogen activator treatment (OTT) is a major determinant of outcome. To reduce OTT, clinical trials have been undertaken evaluating prehospital cerebral imaging with mobile computed tomographic scanners. Furthermore, blood biomarkers may allow rapid differentiation between ischemic stroke and intracerebral hemorrhage before hospital admission. How such treatment strategies translate into clinical benefit has not been specifically evaluated.

Methods—

We constructed decision models to estimate the net clinical benefit yielded by shorter OTT. In different scenarios, we estimated the proportion of patients with favorable outcome and the average quality of life.

Results—

An OTT reduction of 60 minutes increases the probability of favorable outcome by 6.6% in a mixed stroke population. For comparison, the average effect of tissue-type plasminogen activator itself is 7.0%. Prehospital mobile computed tomography gaining 25 to 40 minutes increases the probability of favorable outcome by 3.0% to 4.6%. The additional benefit of prehospital computed tomography to deliver patients with large vessel occlusion directly to endovascular treatment centers increases the probability of favorable outcome by another 0.2% to 1.0%. A blood test discriminating ischemic stroke and intracerebral hemorrhage may beneficially substitute brain scan before tissue-type plasminogen activator if >32 to 40 minutes are gained and if sensitivity for intracerebral hemorrhage is >75% to 80%.

Conclusions—

Reducing the OTT has robust beneficial effects for acute stroke patients. Prehospital tissue-type plasminogen activator treatment without brain imaging may become conceivable under several preconditions, including a point-of-care test with >75% to 80% sensitivity to detect intracerebral hemorrhage and a time gain of >32 to 40 minutes. Ethical implications remain to be addressed.
Alteplase Reduces Downstream Microvascular Thrombosis and Improves the Benefit of Large Artery Recanalization in Stroke
Authors: Desilles Jean-Philippe , Loyau Stephane , Syvannarath Varouna , Gonzalez-Valcarcel Jaime , Cantier Marie , Louedec Liliane , Lapergue Bertrand , Amarenco Pierre , Ajzenberg Nadine , Jandrot-Perrus Martine , Michel Jean-Baptiste , Ho-Tin-Noe Benoit , Mazighi Mikael
Published: October 2015

Background and Purpose—

Downstream microvascular thrombosis (DMT) is known to be a contributing factor to incomplete reperfusion in acute ischemic stroke. The aim of this study was to determine the timing of DMT with intravital imaging and to test the hypothesis that intravenous alteplase infusion could reduce DMT in a transient middle cerebral artery occlusion (MCAO) rat stroke model.

Methods—

Rats were subjected to 60-minute transient MCAO. Alteplase (10 mg/kg) was administered 30 minutes after the beginning of MCAO. Real-time intravital fluorescence microscopy through a dura-sparing craniotomy was used to visualize circulating blood cells and fibrinogen. Cerebral microvessel patency was quantitatively evaluated by fluorescein isothiocyanate-dextran perfusion.

Results—

Immediately after MCAO, platelet and leukocyte accumulation were observed mostly in the venous compartment. Within 30 minutes after MCAO, microthrombi and parietal fibrin deposits were detected in postcapillary microvessels. Alteplase treatment significantly (
P
=0.006) reduced infarct volume and increased the percentage of perfused vessels during MCAO (
P
=0.02) compared with saline. Plasma levels of fibrinogen from alteplase-treated rats showed a rapid and profound hypofibrinogenemia. In vitro platelet aggregation demonstrated that alteplase reduced platelet aggregation (
P
=0.0001) and facilitated platelet disaggregation (
P
=0.001). These effects were reversible in the presence of exogenous fibrinogen.

Conclusions—

Our data demonstrate that DMT is an early phenomenon initiated before recanalization. We further show that alteplase-dependent maintenance of downstream perfusion during MCAO improves acute ischemic stroke outcome through a fibrinogen-dependent platelet aggregation reduction. Our results indicate that early targeting of DMT represents a therapeutic strategy to improve the benefit of large artery recanalization in acute ischemic stroke.
A taxonomical revision of Ilex (Aquifoliaceae) in the Pan-Himalaya and unraveling its distribution patterns
Authors: HONG De-Yuan
Published: October 2015

All relevant specimens of the genus Ilex in 11 major herbaria: B, BM, CDBI, E, K, KUN, P, PE, SZ, W, WU, in addition to A (types), were critically examined. Field observations were conducted in E Himalaya (Bomi, Mêdog, and Zayü of Tibet) and the Hengduan Mountains (Tengchong, Yunnan). As a result of this taxonomic revision, 14 species and 12 varieties are reduced to synonyms and one species is reduced to a subspecies; one species, I. shweliensis, is restored with reservation; one new species, I. gansuensis, is described from SE Gansu, while records of five species supposedly present in the Pan-Himalaya are found to be due to misidentification or mislocation by previous authors. Thus 41 species are recognized in the Pan-Himalaya, not 60 species as reported in the literature. A key to these 41 species is presented. The types of six names are designated here. In addition, noteworthy disjunct distribution patterns are shown for four species.
Five new species of Jaspis (Porifera: Demospongiae: Tetractinellida:
Astrophorina) from Brazil with redescription of the type species Jaspis johnstonii (Schmidt, 1862)
Authors: LIRA JULIANA , PINHEIRO ULISSES
Published: October 2015

The genus Jaspis comprises 32 valid species, six of which were previously recorded from the Atlantic Ocean. Two species have already been recorded from the Brazilian coast: J. johnstonii and J. salvadori (Rio Grande do Sul and Espírito Santo States respectively). Their respective type specimens, deposited at Muséum National d’Historie Naturelle, Paris (Jaspis salvadori, holotype) and at Universalmuseum Joanneum, Zoology Center of Natural History, Austria (Jaspis johnstonii, syntype) were reexamined, but due to differences in spicule composition these records are considered to be invalid. The present paper describes five new species of Jaspis collected on the Brazilian coast (Jaspis atolensis sp. nov., J. iacuitaster sp. nov., J. corticomicroxea sp. nov., J. variaster sp. nov. and J. gigoxea sp. nov.) bringing the total number of species worldwide to 36, all of which were compared in tabular format. The type species, Jaspis johnstonii, was also redescribed.
Genetic differentiation among species of the genus Thermophis Malnate (Serpentes, Colubridae) and comments on T. shangrila
Authors: Hofmann Sylvia , Tillack Frank , Miehe Georg
Published: October 2015

The genus Thermophis includes the two species, T. baileyi and T. zhaoermii, which differ morphologically, geographically and molecularly. Recently, a third Thermophis species was described from Shangri-La, northern Yunnan Province, China, and named T. shangrila. The new species was based on morphological and genetic data derived from three specimens. However, the morphological features used to delimit this species seem vague, because they may fall within the range of intraspecific variation of T. zhaoermii. Furthermore, the reported genetic differences in nuclear data are questionable. They likely resulted from a misinterpretation probably due to alignment/analytical flaws or sample/sequence mix-up. Here, we used partial sequences of three mitochondrial (CO1, ND4, cytb) genes and one nuclear (c-mos) gene to analyse the genetic variation between and within species of Thermophis. We inferred the phylogeny using Bayesian Inference and Maximum Likelihood approaches and present additional morphological data that contribute to the knowledge on intraspecific variation in the genus. Our results indicate lacking robustness in the distinguishing morphological features and in the genetic differentiation of T. shangrila and highlight the need for more detailed morphological and molecular studies from a substantially larger sample.
Phlaeopterus Motschulsky, 1853 (Coleoptera: Staphylinidae: Omaliinae: Anthophagini)—a new genus for the Palaearctic: new combination
Authors: SHAVRIN ALEXEY V. , MULLEN LOGAN
Published: October 2015

The genus Phlaeopterus Motschulsky, 1853, which was previously known only from North America, is recorded for the Palaearctic fauna for the first time: P. czerskyi (Shavrin, 2001) comb. nov. (East Siberia: Khamar-Daban Mts.) is transferred from the genus Lesteva Latreille, 1797, redescribed, and illustrated.
New species and additional records of the subgenus Termidonia Motschulsky of the genus Zyras Stephens in China (Coleoptera, Staphylinidae, Aleocharinae)
Authors: YAN ZHU-QI , LI LI-ZHEN
Published: October 2015

Two new species are described from Yunnan: Zyras (Termidonia) baihuamontis sp. nov., and Z. (T.) nabanensis sp. nov. Additional records of two species of subgenus Termidonia Motschulsky, 1860 are reported. Adults of the four species are illustrated, and identification key is provided for Chinese species.
The Robinson-Patman Act and the Consumer Effects of Price Discrimination
Authors: DePasquale Christina
Published: October 2015

For almost eighty years, economists have repeatedly maligned the Robinson-Patman Act. While some of this is justified, I argue that it can improve and, at times, has improved, consumer surplus. In this article, I examine the consumer effects of price discrimination and discuss three Robinson-Patman cases and their positive effects on consumer welfare. I then discuss the recent theoretical and empirical literature on the welfare effects of price discrimination.
Reforming the Robinson-Patman Act to Serve Consumers and Control Powerful Buyers
Authors: Kirkwood John B.
Published: October 2015

The Robinson-Patman Act suffers from two major flaws. First, its fundamental goal is not to promote competition and benefit consumers but to protect small business. Second, it frequently fails to protect either consumers or small business. In particular, the Act’s defenses for meeting competition and cost justification ordinarily allow large buyers to extract discriminatory concessions from suppliers, even when the concessions harm both small competitors and consumers. To eliminate these flaws, three changes are needed. First, the Act’s injury language should be amended: a plaintiff should have to show harm to competition, not just injury to a competitor. Second, the Act’s meeting competition and cost justification defenses should be curtailed. Finally, though not the focus of this article, conforming changes should be made in the Act’s treatment of promotional discrimination. These reforms would create a statute that is much more likely to serve consumers and control powerful buyers. Indeed, if a large buyer such as Amazon or Wal-Mart induces a concession that threatens to harm competition, a reformed Robinson-Patman Act would provide the most desirable remedy. As a general rule, neither structural relief nor common carrier regulation is likely to be preferable. For this reason, the Robinson-Patman Act should be reformed, not repealed.
Understanding the Effect of Immunity on Over-Dispersed Criminal Victimizations: Zero-Inflated Analysis of Household Victimizations in the NCVS
Authors: Park Seong-min , Fisher Bonnie S.
Published: October 2015

This study aims to empirically test the immunity effect on the frequency distribution of household victimizations. To clarify the immunity effect, the statistical construction of zero-inflated models is reviewed and compared with that of non-zero-inflated models. The Benjamini and Hochberg correction is used to address the limitation of p values in multiple testing. Compared with the findings from the non-zero-inflated model, two sets of coefficients from the zero-inflated model reveal that there exist more complex and diverse statuses in the process of household victimization than predicted by risk heterogeneity and event dependence. With these findings, this study suggests that zero-inflated models should be introduced and compared with non-zero-inflated models for the clarification of victimization determinants.
Land conflict in peri-urban areas: Exploring the effects of land reform on informal settlement in Mexico
Authors: Lombard Melanie
Published: October 2015

Peri-urban areas are often subject to intensive construction, through both formal and informal processes. As land transitions from rural to urban status, different land tenure and administration systems may come into conflict, leading to disputes, contestation and, in some cases, violence. However, little is known about the precise causes of peri-urban land conflict. In Mexico, peri-urban growth has historically proceeded peacefully, owing to the control exerted by a corporatist system of government, and the political use of land tenure regularisation. However, the effects of land reforms on transactions at the peri-urban fringe, in the context of wider processes of liberalisation, may be increasing vulnerability to conflict over land. This paper explores these issues through a case study of an irregular settlement on the peri-urban fringe of the provincial Mexican city of Xalapa, where contestations over informally developed land have escalated into violent encounters between groups of settlers and the state. The findings show that vulnerability to conflict in peri-urban areas can be attributed to the interaction of macro-level processes with local-level factors, including diverse claims, overlapping legal and governance frameworks and, critically, local power relations.
Modeling Incidence of Nuptiality
Authors: Alho Juha
Published: October 2015

The statistical description of the formation of marriages is hampered by the fact that the intensity of marriage of one sex depends on the available supply of potential spouses from the other. Unlike the situation that occurs in the study of fertility, there is no reason to give a preference to either of the sexes. To address the fundamental problem caused by the two-sex nature of the process, a solution is proposed that considers the sexes jointly. The solution relies on a novel use of generalized averages. The model is formulated in stochastic terms, and it is parametrized in terms of the overall level of nuptiality, the relative propensity of nuptiality by age, and the mutual relative attraction of spouses at different ages. Although national statistics collection relies on data aggregated by age groups, the models are formulated at individual levels to show how estimation could also be carried out in small populations. In particular, examples of how maximum likelihood estimation can be carried out are given for specific parametric models. The methods are illustrated by both monthly and annual nuptiality data from Finland.
Where is Philemon? The Case for a Logical Fallacy in the Correlation of the Data in Philemon and Colossians 1.1-2; 4.7-18
Authors: Balabanski Vicky
Published: October 2015

Based on the internal evidence of the letters to Philemon and to the Colossians (Col. 1.1-2; 4.7-18), this article contends that there have been logical errors in how we have correlated the data between the two letters. Arguing that the two letters were not written to be sent simultaneously, this article demonstrates that syllogistic fallacies have shaped scholarly assumptions, leading to the view that the overlapping data necessarily indicate that Philemon, Apphia and the church in Philemon’s house were located in Colossae. Once the logical fallacies in correlating the data are recognized, the apparent problem of the lack of greeting to Philemon in Colossians is in fact no problem at all: Philemon and his house-church were located in Italy, possibly in Rome itself.
Sincerely James: Reconsidering Frederick Francis’s Proposed Health Wish Formula
Authors: Bowden Andrew M.
Published: October 2015

This article interacts with Frederick Francis’s well-known suggestion that Jas 5 contains a health wish formula. Based on more recent findings of epistolography, this article argues that the references to healing in Jas 5 contrast sharply with the first-century CE health wish formula(s). In addition to current research on Hellenistic epistolography, this article offers three further pieces of evidence which suggest that the letter of James does not conclude with a health wish formula, but rather with a promise of restoration from spiritual sickness.
The Moral Character Development of the Boy Jesus in the Infancy Gospel of Thomas
Authors: Whitenton Michael R.
Published: October 2015

Whether or not the boy Jesus in the Infancy Gospel of Thomas (IGT) is portrayed as an ‘idealized child’ or a true-to-life child is a question that, whether implicitly or explicitly, lies at the heart of some of the most recent contributions to this second-century supplement to the Gospel of Luke. However, the potential contribution of ancient conceptions of child development to this conundrum has remained thus far overlooked. This article addresses this lacuna by approaching the characterization of the boy Jesus in IGT from the perspective on ancient views of childhood development, tracing his age-speciﬁc acquisition of self-control and benevolence for others across the narrative. Cast in this light, IGT imagines what sort of child would develop into Luke’s Jesus and, in so doing, supplements what may have been perceived to be lacking in the third gospel.
Interdisciplinary Discrepancies Between Parenteral Nutrition Macronutrient Prescribing and Recommendations: Is Body Mass Index a Factor?
Authors: Elliott Katie L. , Kandiah Jay , Walroth Todd A.
Published: October 2015

Background:Formal nutrition training in medical schools and residencies is lacking and needed. Registered dietitians (RDs) are formally trained in nutrition support and considered experts in the nutrition field. Our purpose was to examine prescribing and recommending discrepancies of parenteral nutrition macronutrients between medical residents (MRs) and RDs and compare results with the ASPEN clinical care guidelines. We also looked at discrepancies among obese patients, due to their increased risk of mortality.Materials and Methods: The primary end point of this retrospective review was discrepancies in nonprotein calories (NPCs) and grams of protein (PRO) between MRs and RDs. The secondary end point was discrepancies in NPCs and PRO between MRs and RDs among patients stratified by body mass index category.Results: MRs prescribed 300 NPCs more versus RDs (P< .001). When compared with RDs, MRs prescribed fewer NPCs for underweight patients and more for obese patients (P< .001). The same analysis found that the PRO discrepancies significantly varied by body mass index classification as well (P= .022). When these results were compared with the ASPEN clinical care guidelines, RDs adhered closer to the guidelines than did MRs in terms of permissive underfeeding of obese patients.Conclusion: It is widely accepted that MRs are in need of increased formal training, and the results of our study confirm this need and suggest a short‐term solution of increasing order‐writing privileges for the RD. RDs with this privilege may adhere more closely to clinical care guidelines and therefore increase patient safety.
Risking peace in the ‘war against the poor’? Social exclusion and the legacies of the Northern Ireland conflict
Authors: Tomlinson Mike
Published: October 2015

Discourses around poverty, dependency and austerity take a particular form regarding Northern Ireland which is seen as ripe for economic ‘rebalancing’ and public sector reduction. The Welfare Reform Act 2012 is pivotal in that it provides the muscle for disciplining claimants for a low-waged, flexible labour market. But the Northern Ireland Assembly has not passed the Act or agreed a budget and the return of Direct Rule beckons as a result. The article sheds light on the stand-off over the Welfare Reform Act using data from the 2012 PSE Survey. It demonstrates that the impact of violent conflict is imprinted on the population in terms of high rates of deprivation, poor physical and mental health, and significant differences between those experiencing little or no conflict, and those with ‘high’ experience. In ignoring these legacies of the conflict, the Westminster government is risking peace in its ‘war against the poor’.
The ‘problem’ with single women
Authors: Budgeon Shelley
Published: October 2015

Despite increased acknowledgement of gender equality as a social good, there are some areas where the practice of women’s autonomy is apparently inconsistent with the normative prescriptions of a new ‘empowered’ form of femininity. Sexuality and personal relationship status are sites where women are positioned within neo-liberal and post-feminist discourse in such a way that their choices are subject to questioning. A model of gender hegemony is useful for understanding how and why choosing to be single may still constitute a ‘problem’ for women, despite the intensification of messages which also address women as autonomous, sexualized subjects. In cultures dominated by an ideology of marriage and family life, single women’s identity work resolves contradictions in the current gender order and in the process reinstates heteronormativity.
Epigenetics in Legg–Calvé–Perthes disease: A study of global DNA methylation
Authors: Zheng Pengfei , Yang Tao , Ju Li , Jiang Bo , Lou Yue
Published: October 2015

Objective

To examine the global methylation status of DNA in blood cells of children with Legg-Calvé-Perthes disease (LCPD), since the aetiopathogenesis of LCPD remains unclear, and many factors closely associated with DNA methylation may be linked to the occurrence of LCPD.

Methods

Children with LCPD and age-, sex- and body mass index-matched controls were evaluated. Methylation levels of the long interspersed nuclear element 1 (LINE-1), a biomarker of global DNA methylation, were quantified by methylation-specific polymerase chain reaction.

Results

Of 82 children with LCPD (68 male/14 female) and 120 matched controls (98 male/22 female), methylation of the LINE-1 promoter was significantly lower in patients with LCPD compared with controls. Subgroup analyses showed that methylation of the LINE-1 promoter was significantly lower in male patients with LCPD compared with male controls. No significant between-group differences were observed in female participants.

Conclusions

Reduced global DNA methylation may be associated with increased risk of LCPD in male children. Further research is required to understand whether detection of global DNA methylation may provide a basis for clinical diagnosis and early intervention of LCPD.
The collective sharing of emotions in a media process of communication – a pragmatist approach
Authors: Arquembourg Jocelyne
Published: October 2015

The article takes theoretical inspiration from Peirce’s views on emotion categorization and proposes to apply these ideas to the analysis of an historical episode. The latter is the resignation of former Egyptian President Hosni Mubarak, and more specifically the emotions that Egyptians expressed in Tahrir Square following Mubarak’s resignation. The article compares the dynamics of these emotional expressions as narrated by the media, on the one hand, and as they can be reconstructed from the direct witnessing of raw video materials, on the other.
Undergraduate Students’ Justifications for Source Selection in a Digital Academic Context
Authors: List Alexandra , Grossnickle Emily M. , Alexander Patricia A.
Published: October 2015

To complete any academic tasks using information from the Internet, undergraduate students first have to select the appropriate sources. However, the types of justifications that undergraduates provide for source selection and how these justifications may be impacted by task characteristics have been underexamined. This study explored undergraduates’ reported justifications for source selection when responding to questions in a digital academic context. Participants were first asked to answer two questions, one discrete and one open-ended, using an online library of eight sources varying in type and reliability. Subsequently, a guided retrospective interview was used to elicit undergraduates’ justifications for source selection. Source selection decisions were coded as epistemic (e.g., concerned with reliability or credibility) or nonepistemic (e.g., concerned with relevance or accessibility). Undergraduate students’ justifications were significantly more likely to be nonepistemic than epistemic. Further, the reasons for selection offered differed when participants responded to the discrete versus open-ended question, to a limited extent. Epistemic justifications for source selection were related to a number of outcome measures, while nonepistemic justifications were not. Findings are discussed in reference to research and practice pertaining to undergraduates’ multiple source use and task design.
May’s theorem in one dimension
Authors: Duggan John
Published: October 2015

This paper provides three versions of May’s theorem on majority rule, adapted to the one-dimensional model common in formal political modeling applications. The key contribution is that single peakedness of voter preferences allows us to drop May’s restrictive positive responsiveness axiom. The simplest statement of the result holds when voter preferences are single peaked and linear (no indifferences), in which case a voting rule satisfies anonymity, neutrality, Pareto, and transitivity of weak social preference if and only if the number of individuals is odd and the rule is majority rule.
How Do Hospital Palliative Care Teams Use the WHO Guidelines to Manage Unrelieved Cancer Pain? A 1-Year, Multicenter Audit in Japan
Authors: Yoshimoto Tetsusuke , Tomiyasu Shiro , Saeki Toshinari , Tamaki Tomohiro , Hashizume Takahiro , Murakami Masahiko , Matoba Motohiro ,   Symptom Control Research Group (SCORE-G)
Published: October 2015

It has been reported that pain relief for patients with cancer is suboptimal in Japan. This has been mainly attributed to inadequate dissemination of the World Health Organization (WHO) guidelines for cancer pain management. To better understand this problem, we reviewed how 6 hospital palliative care teams (HPCTs) used the WHO guidelines for unrelieved pain in a 1-year audit that included 534 patients. The HPCT interventions were classified according to the contents of the WHO guidelines. In our study, HPCT interventions involved opioid prescriptions in >80% of referred patients, and “For the Individual” and “Attention to Detail” were the 2 most important principles. Our study indicates which parts of the WHO guidelines should be most heavily emphasized, when disseminating them in Japan.
Pediatrician Ambiguity in Understanding Palliative Sedation at the End of Life
Authors: Henderson Carrie M. , FitzGerald Michael , Hoehn K. Sarah , Weidner Norbert
Published: October 2015

Context:

Palliative sedation is a means of relieving intractable symptoms at the end of life, however, guidelines about its use lack consistency. In addition, ethical concerns persist around the practice. There are reports of palliative sedation in the pediatric literature, which highlight various institutional perspectives.

Objectives:

This survey of 4786 pediatric providers sought to describe their knowledge of and current practices around pediatric palliative sedation.

Methods:

Our survey was administered to pediatricians who care for children at the end of life. The survey assessed agreement with a definition of palliative sedation, as well as thoughts about its alignment with aggressive symptom management. Bivariate analyses using χ2 and analysis of variance were calculated to determine the relationship between responses to closed-ended questions. Open-ended responses were thematically coded by the investigators and reviewed for agreement.

Results:

Nearly half (48.6%) of the respondents indicated that the stated definition of palliative sedation “completely” reflected their own views. Respondents were split when asked if they viewed any difference between palliative sedation and aggressive symptom management: Yes (46%) versus No (54%). Open-ended responses revealed specifics about the nature of variation in interpretation.

Conclusions:

Responses point to ambiguity surrounding the concept of palliative sedation. Pediatricians were concerned with a decreased level of consciousness as the goal of palliative sedation. Respondents were split on whether they view palliative sedation as a distinct entity or as one broad continuum of care, equivalent to aggressive symptom management. Institutional-based policies are essential to clarify acceptable practice, enable open communication, and promote further research.
Knowledge acquisition with forgetting: an incremental and developmental setting
Authors: Martínez-Plumed Fernando , Ferri Cèsar , Hernández-Orallo José , Ramírez-Quintana María J
Published: October 2015

Identifying the balance between remembering and forgetting is the key to abstraction in the human brain and, therefore, the creation of memories and knowledge. We present an incremental, lifelong view of knowledge acquisition which tries to improve task after task by determining what to keep, consolidate and forget, overcoming the stability–plasticity dilemma. Our framework can combine any rule-based inductive engine (which learns new rules) with a deductive engine (which derives a coverage graph for all rules) and integrate them into a lifelong learner. We rate rules by introducing several metrics through the first adaptation, to our knowledge, of the minimum message length (MML) principle to a coverage graph, a hierarchical assessment structure which handles evidence and rules in a unified way. The metrics are used to forget some of the worst rules and also to consolidate those selected rules that are promoted to the knowledge base. This mechanism is also mirrored by a demotion system. We evaluate the framework with a series of tasks in a chess rule learning domain.
Cognitive Rest
Authors: Schneider Kathleen H.
Published: October 2015

Cognitive rest has been suggested as a treatment for school athletes who have sustained a concussion, but the concept has rarely been defined. The purpose of this article is to provide a comprehensive definition of cognitive rest, based on an integrative literature review. The method of synthesis was guided by Avant and Walker’s concept analysis format. The importance of rest is discussed as a nursing intervention, and model cases are presented to clarify the concept. Three defining attributes of cognitive rest are established: freedom from physical or mental discomfort, abstinence from mental exertion, and mental and emotional balance. Empirical referents are given as well as a suggested protocol to enable school nurses to form cognitive rest and return-to-classroom protocols that can be adapted to individual school settings.
Solar PV Planning Toward Sustainable Development in Chile
Authors: Agostini Claudio A. , Nasirov Shahriyar , Silva Carlos
Published: October 2015

Over the past decade, the promotion of renewable energy projects in Chile, especially solar energy projects, has become increasingly important, as energy dependence from foreign fossil fuels has increased and concerns regarding climate change continue to grow, posing a significant challenge to the local economy. Even though recent developments toward a more sustainable energy matrix in Chile have significantly increased the investment in the solar energy sector, social and environmental fragilities, combined with the lack of well-functioning institutions and the historical marginalization of indigenous communities who have been affected by several energy projects, result in gradually increasing conflictive situations. Unless proper mechanisms are designed and implemented to rapidly and correctly address these challenges, Chile could miss the opportunities that solar energy projects can provide to the development of its communities and to the economic growth of its regions. This article studies solar photovoltaics planning in Chile, focusing on the recent developments and the main challenges ahead, and proposes policy recommendations for effectively addressing these challenges.
The philosophy of personal epistemology
Authors: Holma Katariina , Hyytinen Heidi
Published: October 2015

In higher education, personal epistemology is today a significant research area. Personal epistemology has been seen as promising particularly because it focuses on one of the general learning aims of many contemporary universities, namely, the development of students’ creative and critical thinking. The article identifies serious conceptual problems in the theoretical framework of personal epistemology. First, we argue – contrary to many promoters of personal epistemology – that personal epistemology’s theoretical models are not based merely on empirical data from developmental psychology, but clearly feature normative philosophical elements. Second, we consider the acceptance of relativism in the theoretical framework of personal epistemology. We argue that the concept of fallibilism has been overlooked, which has forced personal epistemology theorists to choose between naïve realism and relativism. Their choice of relativism has led – in addition to other philosophical problems – to a loss of adequate definitions for the epistemological notions of objectivity and certainty. The recognition of epistemological fallibilism would be beneficial both to personal epistemology’s theoretical framework and to personal epistemology–based university pedagogy.
Feasibility of a Modified Biopsy Needle for Irreversible Electroporation Ablation and Periprocedural Tissue Sampling
Authors: Wimmer Thomas , Srimathveeravalli Govindarajan , Silk Mikhail , Monette Sebastien , Gutta Narendra , Maybody Majid , Erinjery Joseph P. , Coleman Jonathan A. , Solomon Stephen B. , Sofocleous Constantinos T.
Published: October 2015

Objectives:

To test the feasibility of modified biopsy needles as probes for irreversible electroporation ablation and periprocedural biopsy.

Methods:

Core biopsy needles of 16-G/9-cm were customized to serve as experimental ablation probes. Computed tomography-guided percutaneous irreversible electroporation was performed in in vivo porcine kidneys with pairs of experimental (n = 10) or standard probes (n = 10) using a single parameter set (1667 V/cm, ninety 100 µs pulses). Two biopsy samples were taken immediately following ablation using the experimental probes (n = 20). Ablation outcomes were compared using computed tomography, simulation, and histology. Biopsy and necropsy histology were compared.

Results:

Simulation-suggested ablations with experimental probes were smaller than that with standard electrodes (455.23 vs 543.16 mm2), although both exhibited similar shape. Computed tomography (standard: 556 ± 61 mm2, experimental: 515 ± 67 mm2; P = .25) and histology (standard: 313 ± 77 mm2, experimental: 275 ± 75 mm2; P = .29) indicated ablations with experimental probes were not significantly different from the standard. Histopathology indicated similar morphological changes in both groups. Biopsies from the ablation zone yielded at least 1 core with sufficient tissue for analysis (11 of the 20).

Conclusions:

A combined probe for irreversible electroporation ablation and periprocedural tissue sampling from the ablation zone is feasible. Ablation outcomes are comparable to those of standard electrodes.
Above cuff vocalisation: A novel technique for communication in the ventilator-dependent tracheostomy patient
Authors: McGrath Brendan , Lynch James , Wilson Mark , Nicholson Leanne , Wallace Sarah
Published: October 2015

A significant proportion of patients admitted to intensive care units require tracheostomies for a variety of indications. Continual cuff inflation to facilitate mechanical ventilatory support may mean patients find themselves awake, cooperative and attempting to communicate but unable to do so effectively. Resulting frustration and anxiety can negatively impact upon care. Through participation in the Global Tracheostomy Collaborative, our unit rapidly implemented novel techniques facilitating communication in such patients. In carefully selected and controlled situations, the subglottic suction port of routinely available tracheostomy tubes can be used to deliver a retrograde flow of gas above the cuff to exit via the larynx, facilitating speech. The resulting above cuff vocalisation is described in detail for five general ICU patients at our institution, highlighting the benefits of multidisciplinary care and the increasingly important role of the speech and language therapists in the critically ill.
Absent circle of Willis with vascular pollarding in an adult with colpocephaly: A developmental perspective
Authors: Jayakumar Peruvumba N , Verghese Renjan , Paul Divyan
Published: October 2015

Absent circle of Willis (COW) has been described in cases of severe forms of cerebral developmental anomalies such as alobar prosencephaly. However, there are no reports of absent COW in patients with a milder form of cerebral abnormality such as colpocephaly. We report a unique case of an adult with colpocephaly and absent COW and discuss their association from a developmental perspective.
Fungal contamination of the respiratory tract and associated respiratory impairment among sawmill workers in India
Authors: Adhikari Asit , Sahu Subhashis , Bandyopadhyay Arghya , Blanc Paul D. , Moitra Subhabrata
Published: October 2015

Wood processing workers are exposed to wood-associated microbiological contaminants, including fungi. Our aim was to study the potential association between sputum fungus and adverse respiratory effects in such workers.

In a group of sawmill workers, we administered a respiratory questionnaire, performed lung function testing and quantified the proportions of leukocytes in spontaneously expectorated sputum samples. We identified fungal species by DNA sequencing.

Of 54 sawmill workers, 19 yielded fungal positive sputum samples (mean age 42.5±10.4 years) and 35 were negative for fungus (mean age 36.9±5.2 years). The fungus was identified asCandidasp. in all samples. Those with fungal-positive sputum, compared to others, reported more cough (26%versus63%) and haemoptysis (6%versus37%) (both p<0.05), manifested reduced forced midexpiratory flow rates (FEF25–75%) (82.3±4.5versus69.2±9.9% predicted, p<0.001), and had higher sputum eosinophil counts (median 9.25versus3.25%, p<0.01). Reduction of FEF25–75%was associated both with fungus detection in sputum (−12.7%, 95% CI−8.5– −16.9%) and sputum eosinophils (−2.1% per 1% increase in eosinophils, 95% CI −1.5– −2.8%) (both p<0.001).

In sawmill workers,Candidasp. detectable in sputum was associated with respiratory symptoms, sputum eosinophilia and reduced FEF25–75%.
Pulmonary rehabilitation and severe exacerbations of COPD: solution or white elephant?
Authors: Man William D-C. , Puhan Milo A. , Harrison Samantha L. , Jordan Rachel E. , Quint Jennifer K. , Singh Sally J.
Published: October 2015

Hospitalisations for severe exacerbations of chronic obstructive pulmonary disease are associated with significant physical and psychological consequences including an increase in symptom severity, severe reductions in physical activity, a deleterious effect on skeletal muscle, impaired exercise tolerance/ability to self-care, decline in quality of life, and increased anxiety and depression. As these consequences are potentially amenable to exercise training, there is a clear rationale for pulmonary rehabilitation in the peri/post-exacerbation setting. Although a 2011 Cochrane review was overwhelmingly positive, subsequent trials have shown less benefit and real-life observational studies have revealed poor acceptability. Qualitative studies have demonstrated that the patient experience is a determining factor while the presence of comorbidities may influence referral, adherence and response to pulmonary rehabilitation. Systematic reviews of less supervised interventions, such as self-management, have shown limited benefits in the post-exacerbation setting. The recent update of the Cochrane review of peri-exacerbation pulmonary rehabilitation showed that benefits were associated with the “comprehensive” nature of the intervention (the number of sessions received, the intensity of exercise training and education delivered, and the degree of supervision) but implementation is demanding. The challenge is to develop interventions that are deliverable and acceptable around the time of an acute exacerbation but also deliver the desired clinical impact.
High-resolution adaptive beamforming for borehole acoustic reflection imaging
Authors: Li Chao , Yue Wenzheng
Published: October 2015

Acoustic reflection imaging in boreholes is believed to be a vast improvement in the evaluation of heterogeneous reservoirs. However, only 2D azimuth information of reflectors can be achieved by conventional methods. To obtain 3D information, a new high-resolution adaptive beamforming method has been developed to apply to the borehole environment, using an array acoustic logging tool with azimuthally distributed receivers. Moreover, a migration method based on the Fourier finite difference method is introduced into the beamforming to effectively reduce computational complexity from 3D to 2D and to reduce the effects of noise caused by velocity changes in the vertical and horizontal planes. Resolution analysis of the imaging results indicates that the tool diameter and source frequency are the key factors in increasing the azimuth resolution. Furthermore, increasing the resolution with the new method can help improve the fidelity of reconstructed objects in the reflection image. A comparison of results obtained by the new method and the conventional method with simulation data demonstrates that the new method can achieve a reflection image of high azimuth resolution with extremely noisy signals. Application to field data also found a good agreement between the reflection image and the borehole resistivity image. Therefore, detailed information regarding the azimuth and the radial distance of reflectors to the borehole can be determined in 3D space.
Evaluation of district mental healthcare plans: The PRIME consortium methodology
Authors: De Silva Mary J. , Rathod Sujit D. , Hanlon Charlotte , Breuer Erica , Chisholm Dan , Fekadu Abebaw , Jordans Mark , Kigozi Fred , Petersen Inge , Shidhaye Rahul , Medhin Girmay , Ssebunnya Joshua , Prince Martin , Thornicroft Graham , Tomlinson Mark , Lund Crick , Patel Vikram
Published: October 2015

Background

Few studies have evaluated the implementation and impact of real-world mental health programmes delivered at scale in low-resource settings.

Aims

To describe the cross-country research methods used to evaluate district-level mental healthcare plans (MHCPs) in Ethiopia, India, Nepal, South Africa and Uganda.

Method

Multidisciplinary methods conducted at community, health facility and district levels, embedded within a theory of change.

Results

The following designs are employed to evaluate the MHCPs: (a) repeat community-based cross-sectional surveys to measure change in population-level contact coverage; (b) repeat facility-based surveys to assess change in detection of disorders; (c) disorder-specific cohorts to assess the effect on patient outcomes; and (d) multilevel case studies to evaluate the process of implementation.

Conclusions

To evaluate whether and how a health-system-level intervention is effective, multidisciplinary research methods are required at different population levels. Although challenging, such methods may be replicated across diverse settings.
Estimating the cost of implementing district mental healthcare plans in five low- and middle-income countries: The PRIME study
Authors: Chisholm Dan , Burman-Roy Soumitra , Fekadu Abebaw , Kathree Tasneem , Kizza Dorothy , Luitel Nagendra P. , Petersen Inge , Shidhaye Rahul , De Silva Mary , Lund Crick
Published: October 2015

Background

An essential element of mental health service scale up relates to an assessment of resource requirements and cost implications.

Aims

To assess the expected resource needs of scaling up services in five districts in sub-Saharan Africa and south Asia.

Method

The resource quantities associated with each site's specified care package were identified and subsequently costed, both at current and target levels of coverage.

Results

The cost of the care package at target coverage ranged from US$0.21 to 0.56 per head of population in four of the districts (in the higher-income context of South Africa, it was US$1.86). In all districts, the additional amount needed each year to reach target coverage goals after 10 years was below $0.10 per head of population.

Conclusions

Estimation of resource needs and costs for district-level mental health services provides relevant information concerning the financial feasibility of locally developed plans for successful scale up.