bluuebunny/crossref_metadata_2025 huggingface dataset:
DETERMINATION OF LEAD (Pb), IRON (Fe) AND MANGANESE (Mn) CONCENTRATION IN SEWAGE WATER AND VEGETABLE LEAF SAMPLES
Authors: Umar Hayat Muhammad , Waqas Abdul , Ali Shafaqat , Farid Mujahid , Ahmad Rehan , Muhammad Tauqeer Hafiz , Iftikhar Usman , Hannan Faakhir
Published: August 2015

Application of waste water for irrigation purposes has increased over the past years. This waste water contains high amounts of trace elements and heavy metals.Many of these are non-essential and toxic to plants, animals and human beings. The use of polluted water in the immediate surroundings of big cities in Pakistan is a common practice for growing of vegetables. When this water applied for long time in irrigation, these heavy metals may accumulate in soil and that may be toxic to plants and also cause deterioration of soil. The present study revealed that heavy metal content was above the toxicity level in leafy vegetables grown in the area of Lahore. This study showed that among the different tested plant species, the amount of heavy metals was more in leaves than fruits. Plants whose fruits grow below the soil showed higher concentration of heavy metals while other showed less concentration whose edible portion was above the ground level. Leafy vegetables (spinach, cabbage, coriander etc) showed higher concentration in leaves than in fruits. The concentration of heavy metals in upper layer of soil (0 -15 cm) is higher than the lower layer (15-30 cm). The reason behind is that the upper layer was receiving sewage water permanently while the penetration of sewage water below 15 cm was less. The increase in heavy metal accumulation in different plant species and their different parts is not constant and is not in proportion to the increase in heavy metal concentration in soil irrigated with sewage wastewater.
IMPROVEMENT OF NUTRITIONAL AND HEALTHY VALUES OF YOGHURT BY FORTIFICATION WITH RUTUB DATE
Authors: M. Ismail Magdy
Published: August 2015

As is well known, the date fruits are good sources of many nutrients. Also, yoghurt especially bio-yoghurt has a lot of nutritional and healthy benefits. The aim of this study was to combine the benefits of date and bio-yoghurt in one product which can be made by simple manner. Six treatments of yoghurt were made from cow's milk fortified with 10 and 15% rutub date and using classic or ABT-5 cultures. Changes in rheological, chemical, microbial and organoleptic properties of yoghurt were monitored during refrigerated storage (4°C) of yoghurt for 15 d. Results showed that fortification with date accelerates the rates of fermentation and lowered coagulation time. For rheological analyses, curd tension, viscosity and water holding capacity values increased whereas curd syneresis values decreased in bio-yoghurt fortified with date. Redox potential values were lower in date yoghurt as compared with control. Acidity, carbohydrate, total solids, dietary fiber and ash contents of yoghurt supplemented with date were higher than those of control. Supplementation of date increased mineral contents (K, Ca, P, Mg, Na and Fe), total nitrogen, water soluble nitrogen, total phenols and total volatile fatty acids of yoghurt. The addition of date improved the viability of lactic acid bacteria and bifidobacteria. The bifidobacteria counts were sufficient to yield numbers of beneficial organisms that were higher than the accepted threshold (106cfu.g-1) for a probiotic effect. Also, date adding improved the body, texture and flavor of the yoghurt.
Structural-linguistic approach to assessment of functional states of organism of elite sportsmen, who have symptoms of chronic tiredness
Authors: Abdulrahman Alwani.
Published: August 2015

Purpose: assessment of functional states of sportsmen’s, having symptoms of chronic tiredness, organism with the help of structural-linguistic approach. Material: Sportsmen of different kinds of sports participated in the research. For determination of degree of chronic tiredness questionnaire by Leonova was applied. For classification of functional states of sportsmen’s organism structural-linguistic approach was applied. Results: in 41% of the questioned sportsmen chronic tiredness was found. Appearance of their not stable states can be caused by reduction of organism’s resistance to loads and high risk of chronic tiredness syndrome. Conclusions: in sportsmen with chronic tiredness we observed functional tension of organism’s regulatory systems in rest and over-tension - after loads. We determined types of functional states of sportsmen’s with chronic tiredness organism.
Individualization of psychological training and its importance at different stages of many years’ perfection in tennis
Authors: Vysochina N.L. , Makuts T.B.
Published: August 2015

Purpose: to determine significance of individualized approach during psychological training at different stages of many years’ perfection in tennis. The tasks of the research were studying of place and role of psychological component in general system of tennis players’ sport training as well as determination of specificities of individualized approach during 14-15 years old and elite tennis players’ psychological training. Material: In the research 24 experts, coaches of combined teams and clubs, elite tennis players took part. Results: Role of psychological training in general system of many years’ perfection has been determined. We also found out that individualization of psychological training in modern tennis is not paid sufficient attention to at present. Most of the questioned respondents pointed, that such training is conducted mainly with elite sportsmen (42%). Only 14% noted that individual psychological training is carried out at basic stages of many years’ perfection. Conclusions: Principle of individualization is a determining one in the course of sportsmen’s training at stages of many years’ perfection. About 86% of experts stressed on significance of application of individualized approach in work with tennis players. Consideration of tennis players’ individual features during psychological training is a compulsory matter in increasing of effectiveness of sportsmen’s training and competition functioning.
Organizational-pedagogic technology of formation of motor functioning culture as mean of physical fitness improvement of 5 form
Authors: Deineko A.H.
Published: August 2015

Purpose: to analyze influence of organizational-pedagogic technology of formation of motor functioning’s culture of five form pupils in process of physical education; to test experimentally methodic of formation of motor functioning’s culture by means of general gymnastic in physical education system of comprehensive schools’ pupils. Material: The research was conducted in comprehensive school № 67, Kharkov. 57 pupils of five forms (5-А form - 30 pupils, 5-B - 27 pupils) participated in the research. Results: we worked out organizational-pedagogic technology of formation of motor functioning’s culture “Main gymnastic at school”, which positively influenced on development of physical fitness of experimental groups’ pupils. Conclusions: it was established that under influence of selected exercises of main gymnastic and introduced competitiveness elements pupils’ movements became more accurate, plastic, acquired higher amplitude, coordination.
Effectieness of junior form pupils’ training of gymnastic exercises in different modes of their fulfillment
Authors: Chernenko S.O.
Published: August 2015

Purpose: determination of junior pupils’ motor skills’ formation. Material: in the research 172 pupils participated: in every parallel of forms - 48 pupils. Results: effectiveness of 1 st form pupils’ is positively influenced (exercise - forward roll) by increase of attempts up to 12 times; quantity of repetitions in one attempt shall be within 1-3. For 2 nd form pupils (exercise - forward roll), 3 rd form (exercise - vault over the width of gymnastic horse) and 4 th form pupils (exercise - vault over width of gout with bent legs) positive influence was rendered by increase of repetitions in one attempt up to 3 times and quantity of attempts within 6-12 times. Attention shall be accentuated on quantity of exercise’s repetitions in one attempt (2 nd-4 th forms) and quantity of attempts (4 th from). Conclusions: Experiment of 2 3 type permitted to study multi-factorial structure of modes of 1-4 forms’ schoolchildren’s training to physical exercises; to specify optimal correlations of quantity of attempts, quantity of repetitions in one attempt and rest interval in period of acrobatic exercises’ and gymnastic vaults’ training at physical culture lessons.
Income and Earnings Mobility in U.S. Tax Data
Authors: Larrimore Jeff , Mortenson Jacob , Splinter David
Published: August 2015

We use a large panel of federal income tax data to investigate intragenerational income mobility in the United States. We have two primary objectives. First, we explore the determinants of two year changes in individual labor earnings and family incomes, such as job or industry changes, marriage, divorce, and geographic mobility. Second, we evaluate how federal income taxes stabilize or destabilize post-tax income changes relative to pre-tax changes. We find a relatively high degree of income mobility, with almost half of workers exhibiting earnings increases or decreases of at least 25 percent, and two-fifths of tax units experiencing income changes of this magnitude. Male and female labor income mobility patterns are remarkably similar, though marriage is associated with earnings gains among men, but is associated with modest earnings declines among women. We also observe that large income gains are most likely among families that add workers – either through marriage or through a second family member entering the workforce.
Trajectory Generation from Motion Capture for a Planar Biped Robot in Swing Phase
Authors: Bravo M. Diego A. , Rengifo R. Carlos F.
Published: August 2015

This paper proposes human motion capture to generate movements for theright leg in swing phase of a biped robot restricted to the sagittal plane.Such movements are defined by time functions representing the desiredangular positions for the joints involved. Motion capture performed witha Microsoft KinectTMcamera and from the data obtained joint trajec-tories were generated to control the robot’s right leg in swing phase. Theproposed control law is a hybrid strategy; the first strategyis based ona computed torque control to track reference trajectories,and the secondstrategy is based on time scaling control ensuring the robot’s balance. Thiswork is a preliminary study to generate humanoid robot trajectories frommotion capture.
Imagem
Authors: Mesquita Léa Nilce
Published: August 2015

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Imenso, cego, brutal
Authors: Reis Edgard Pereira dos
Published: August 2015

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Plant functional traits of dominant native and invasive species in mediterranean‐climate ecosystems
Authors: Funk Jennifer L. , Standish Rachel J. , Stock William D. , Valladares Fernando
Published: August 2015

The idea that dominant invasive plant species outperform neighboring native species through higher rates of carbon assimilation and growth is supported by several analyses of global data sets. However, theory suggests that native and invasive species occurring in low‐resource environments will be functionally similar, as environmental factors restrict the range of observed physiological and morphological trait values. We measured resource‐use traits in native and invasive plant species across eight diverse vegetation communities distributed throughout the five mediterranean‐climate regions, which are drought prone and increasingly threatened by human activities, including the introduction of exotic species. Traits differed strongly across the five regions. In regions with functional differences between native and invasive species groups, invasive species displayed traits consistent with high resource acquisition; however, these patterns were largely attributable to differences in life form. We found that species invading mediterranean‐climate regions were more likely to be annual than perennial: three of the five regions were dominated by native woody species and invasive annuals. These results suggest that trait differences between native and invasive species are context dependent and will vary across vegetation communities. Native and invasive species within annual and perennial groups had similar patterns of carbon assimilation and resource use, which contradicts the widespread idea that invasive species optimize resource acquisition rather than resource conservation.
Winter Wheat Genotype Effect on Canopy Reflectance: Implications for Using NDVI for In‐Season Nitrogen Topdressing Recommendations
Authors: Samborski Stanisław M. , Gozdowski Dariusz , Walsh Olga S. , Lamb David. W. , Stępień Michał , Gacek Edward S. , Drzazga Tadeusz
Published: August 2015

Active optical sensors (AOSs) measure crop reflectance at specific wavelengths and calculate vegetation indices (VIs) that are used to prescribe variable N fertilization. Visual observations of winter wheat (Triticum aestivumL.) plant greenness and density suggest that VI values may be genotype specific. Some sensor systems use correction coefficients to eliminate the effect of genotype on VI values. This study was conducted to assess the effects of winter wheat cultivars and growing conditions on canopy reflectance, as measured by red or amber normalized difference vegetative indices (NDVIs) derived from AOSs. Variations in NDVI values among three wheat cultivars were measured at three growth stages (Zadoks 31, 37, and 65) during 3 yr at three sites in Poland. GreenSeeker Model 505 and Crop Circle ACS‐210 sensors were utilized to measure red and amber NDVIs, respectively. Significant (p< 0.05) differences in both forms of NDVI associated with wheat genotypes were observed across years and sites at Zadoks 31, the time when canopy sensing and N fertilization decisions are often made. Lack of a genotype × site interaction for both red and amber NDVIs and the presence of a significant genotype × year interaction for both VIs suggested that (i) canopy greenness and density of the same genotype measured at the same growth stage are likely to be stable across different growing conditions, and (ii) NDVI values for a particular genotype tend to vary more across years than across sites. Because developing temporally variable correction coefficients is not practical, we strongly recommend that an in situ calibration (based on in‐field or a virtual reference strip) is utilized to normalize NDVI across genotypes, years, and sites.
Root Recovery Development and Activity of Cotton Plants after Waterlogging
Authors: Liu Ruixian , Yang Changqin , Zhang Guowei , Zhang Lei , Yang Fuqiang , Guo Wenqi
Published: August 2015

Cotton (Gossypium hirsutum L.) yield is severely limited by waterlogging in some global production areas. The objective was to study physiological and biochemical mechanisms of cotton root recovery after waterlogging during different reproductive stages. Cotton plants (cultivar Simian 3) were subjected to waterlogging for 10 d and then permitted to recover for 20 d. Waterlogging significantly reduced root dry matter, root vigor, and net photosynthetic rate (Pn). After the termination of waterlogging, root growth showed a significant recovery. Root dry matter of waterlogged plants increased quickly, but remained 20 to 30% lower than controls. Total N content in waterlogged cotton roots was the same as controls at 20 d after waterlogging during the squaring stage, but was significantly lower during the flowering and boll‐forming stage. The activities of superoxide dismutase, catalase, and peroxidase in waterlogged plants increased for 10 d after waterlogging, then declined slowly. The malondialdehyde content in waterlogged roots continued to increase for 5 d after waterlogging, then declined to a significantly lower level than the control. Root vigor recovered rapidly after waterlogging, and was much higher than the control during the squaring stage, but significantly lower during flowering and boll‐forming stage. Pn of waterlogged cotton was suppressed after a 10‐d recovery period, and remained lower than well‐watered controls. These results suggest (i) roots of waterlogged cotton recovered more quickly than shoots, (ii) cotton roots recover better from oxidant damage due to waterlogging during the squaring stage than during the flowering and boll‐forming stage.
Legume Proportion, Poultry Litter, and Tillage Effects on Cover Crop Decomposition
Authors: Poffenbarger Hanna J. , Mirsky Steven B. , Weil Raymond R. , Kramer Matthew , Spargo John T. , Cavigelli Michel A.
Published: August 2015

Cover crop residues and animal waste products can be important sources of N in cropping systems. The objectives of this research were to determine, under field conditions, the effects of hairy vetch (legume; Vicia villosa Roth)/cereal rye (grass; Secale cereale L.) proportion and pelletized poultry litter (PPL) management (no PPL, subsurface banded, broadcast, or incorporated with tillage) on the extent and rate of cover crop residue mass loss and N release during a subsequent growing season. Measuring cover crop residues placed in mesh litter bags, or residues+PPL in litter bags for the broadcast treatment, we found that increasing hairy vetch proportion led to greater proportional mass loss and N release (cumulative mass loss ranged from 40 to 80% and N release ranged from 0–90% of initial), as well as greater rates of mass loss in all PPL treatments. Nitrogen release rates were generally unaffected by species proportions; however, N release rates for pure cereal rye residue in all PPL treatments except broadcast could not be estimated due to minimal N release. Incorporation of residues and PPL increased the rates of mass loss and N release for pure hairy vetch and hairy vetch–cereal rye mixtures. Although broadcast PPL application and incorporation affected decomposition patterns, subsurface banded PPL application did not. Results suggest that cereal rye provides the greatest mulch persistence, hairy vetch provides the greatest N release, and mixtures provide moderate delivery of these two services. Subsurface banding is the recommended PPL application method to conserve surface residues.
The derivation of water quality criteria for nonylphenol considering its endocrine disrupting features
Authors: Gao Pei , Guo Lei , Li Zhengyan , Gibson Mark
Published: August 2015

Nonylphenol (NP) is an endocrine disruptor and causes feminization in various organisms. This study aims to determine the water quality criteria for NP in China based on species sensitivity distribution (SSD) models considering both reproductive and traditional toxicity effects. A total of 17 chronic values with reproductive endpoints and 14 chronic values with traditional endpoints tested with aquatic species resident in China were found in published literature, among which six values were from marine species. As chronic toxicity data for marine species were limited, the acute-to-chronic toxicity ratio methodology was employed to extrapolate from acute-to-chronic toxicity values. The SSD models were then built with a whole set of chronic toxicity values for NP. Based on model simulation, the chronic water quality criterion in fresh water was calculated as 1.37 μg/L and 4.29 μg/L for reproductive endpoints and traditional endpoints, respectively. The criterion in seawater was derived as 1.68 μg/L for traditional endpoints. Although these criteria were derived by a third-party organization not affiliated with the Chinese authority for criteria development, they were obtained from a scientific point of view and can be used to evaluate water quality and ecological risks of nonylphenol in various water bodies.
Field evaluation of the performance of different irrigation emitter types using treated wastewater
Authors: Al-Mefleh Naji K. , Bashabsheh Ibrahim , Talozi Samer , Al-Issa Taha A.
Published: August 2015

Experimental tests are carried out to evaluate the impact of treated wastewater (TWW) on the discharge of five different types of emitters which are commonly used. Two water qualities, fresh water (FW) and treated wastewater, and five types of emitters, GR, Nein (NE), Edin (ED), Corona (CO), and Rain Bird (RB) are tested. The values of chemical properties for FW show mostly low clogging potential on emitter performance. The clogging potential for TWW varied from low to medium. The exception was for pH where there was severe clogging potential for both water types. The performance of emitters was tested by measuring the emitter discharge and estimating the average emitter discharge (Qavg), coefficient of variation (CV), emission uniformity coefficient (EU), and Christiansen uniformity coefficient (CU). The average discharges for different types of emitters were analyzed and compared at P ≤ 0.05. The CO and RB emitter types did not show any signs of clogging whereas the GR, NE, and ED emitter types showed signs of clogging. The results of CV, EU, and CU values showed that the performances of emitter types GR, NE, ED were classified as low or moderate clogging potential. In contrast, the CO and RB emitters were classified as moderate or high clogging potential.
Bench-scale comparison of conventional and high rate clarification treatment processes for acid mine drainage
Authors: Mackie Allison L. , Walsh Margaret E.
Published: August 2015

Acid mine drainage (AMD) is characterized as having low pH and high concentrations of sulfate and dissolved metals. This study compared treated water quality and sludge properties of three process technologies for AMD: conventional sedimentation, high density sludge (HDS), and ballasted flocculation. All three processes were found to be capable of removing regulated metals to concentrations below current Canadian discharge guidelines. However, ballasted flocculation was the only technology found to be able to meet the more stringent federal guidelines proposed for future implementation under the Fisheries' Act's Metal Mining Effluent Regulations. Specifically, arsenic and zinc concentrations in AMD treated by the conventional and HDS processes were above proposed future guidelines of 0.10 and 0.25 mg/L, respectively, while lead, copper, and nickel all met respective guidelines. Concentrations of all regulated contaminants were below proposed guidelines when treated by ballasted flocculation. The HDS process was found to produce a significantly more concentrated sludge than conventional sedimentation (i.e., higher solids content (19 ± 1% versus 7 ± 4% wet solids) and lower sludge volume index (SVI; 8.4 ± 0.8 versus 230 ± 20 mL/g)).
Using linked electronic data to validate algorithms for health outcomes in administrative databases
Authors: Lee Wan-Ju , Lee Todd A , Pickard Alan Simon , Shoaibi Azadeh , Schumock Glen T
Published: August 2015

The validity of algorithms used to identify health outcomes in claims-based and administrative data is critical to the reliability of findings from observational studies. The traditional approach to algorithm validation, using medical charts, is expensive and time-consuming. An alternative method is to link the claims data to an external, electronic data source that contains information allowing confirmation of the event of interest. In this paper, we describe this external linkage validation method and delineate important considerations to assess the feasibility and appropriateness of validating health outcomes using this approach. This framework can help investigators decide whether to pursue an external linkage validation method for identifying health outcomes in administrative/claims data.
Costs and mortality of recurrent versus
de novo
hormone receptor-positive/HER2
-
metastatic breast cancer
Authors: Engel-Nitz Nicole M , Hao Yanni , Becker Laura K , Gerdes Randall
Published: August 2015

Aim:
To examine cost and mortality differences in postmenopausal women with HR
+
/HER2
-
advanced breast cancer.
Methods:
Using claims data (2007–2013), women with newly diagnosed (
de novo
) stage IV, or early- or late-recurring metastatic breast cancer were identified.
Results:
Compared with
de novo
(n = 121) and late-recurrent (n = 106), early-recurrent (n = 172) patients had significantly higher costs in total and for anticancer systemic agents. Adjusted per patient per month costs for early-recurrent patients were US$13,404, versus US$9955 (
de novo
) and US$9721 (late-recurrent; p = 0.02). Early-recurrent patients’ risk of death was twice that of
de novo
patients (p = 0.02).
Conclusion:
Compared with new diagnosis or late recurrence, early recurrence of HR+/HER2- metastatic breast cancer was associated with higher mortality and healthcare costs.
Antiplatelet therapies for secondary stroke prevention: an update on clinical and cost–effectiveness
Authors: Rothlisberger Julia M , Ovbiagele Bruce
Published: August 2015

Stroke exacts a huge toll physically, mentally and economically. Antiplatelet therapy is the cornerstone of secondary stroke prevention, and proven drugs available to successfully realize this therapeutic strategy for the long term include aspirin, dipyridamole plus aspirin and clopidogrel. However, government agencies, corporations, health plans and patients desire more information about the clinical- and cost–effectiveness of these established therapies in real-world settings. This paper provides an update on evidence-based secondary stroke prevention with antiplatelet medications, discusses cost-related issues and offers perspective about the future.
IMPACCT Kids’ Care: a real-world example of stakeholder involvement in comparative effectiveness research
Authors: Likumahuwa-Ackman Sonja , Angier Heather , Sumic Aleksandra , Harding Rose L , Cottrell Erika K , Cohen Deborah J , Nelson Christine A , Burdick Timothy E , Wallace Lorraine S , Gallia Charles , DeVoe Jennifer E
Published: August 2015

The Patient-Centered Outcomes Research Institute has accelerated conversations about the importance of actively engaging stakeholders in all aspects of comparative effectiveness research (CER). Other scientific disciplines have a history of stakeholder engagement, yet few empirical examples exist of how these stakeholders can inform and enrich CER. Here we present a case study which includes the methods used to engage stakeholders, what we learned from them, and how we incorporated their ideas in a CER project. We selected stakeholders from key groups, built relationships with them and collected their feedback through interviews, observation and ongoing meetings during the four research process phases: proposal development, adapting study methods, understanding the context and information technology tool design and refinement.
Real-world effectiveness of everolimus-based therapy versus fulvestrant monotherapy in HR
+
/HER2
-
metastatic breast cancer
Authors: Hao Yanni , Lin Peggy L , Xie Jipan , Li Nanxin , Koo Valerie , Ohashi Erika , Wu Eric Q , Rogerio Jaqueline
Published: August 2015

Aims:
Assessing real-world effectiveness of everolimus-based therapy (EVE) versus fulvestrant monotherapy (FUL) among postmenopausal women with hormone receptor-positive (HR
+
)/HER2
-
metastatic breast cancer (mBC) after progression on nonsteroidal aromatase inhibitor (NSAI).
Data & methods:
Medical charts of community-based patients who received EVE or FUL for mBC after NSAI were examined. Progression-free survival (PFS), time on treatment and time to chemotherapy were compared using Kaplan–Meier curves and Cox proportional hazards models adjusting for line of therapy and patient characteristics.
Results & conclusion:
192 patients received EVE and 156 FUL. After adjusting for patient characteristics, EVE was associated with significantly longer PFS than FUL (hazard ratio: 0.71; p = 0.045). EVE was associated with better PFS than FUL among NSAI-refractory postmenopausal HR
+
/HER2
-
mBC patients.
Laboratory Assessment of Diabetic Kidney Disease
Authors: Narva Andrew S. , Bilous Rudolf W.
Published: August 2015

IN BRIEF Regardless of etiology, chronic kidney disease (CKD) is identified by two laboratory tests: 1) estimated glomerular filtration rate (eGFR), a measure of kidney function, and 2) urine albumin-to-creatinine ratio (UACR), a measure of kidney damage. It is crucial for all health professionals to understand the significance and limitations of these tests to appropriately identify CKD patients, guide therapy, and determine prognosis. This article provides information that will enable diabetes educators and other clinicians to properly interpret eGFR and UACR laboratory results in the identification and management of CKD.
Novel Therapies for Diabetic Kidney Disease: Storied Past and Forward Paths
Authors: Dieter Brad P. , Alicic Radica Z. , Meek Rick L. , Anderberg Robert J. , Cooney Sheryl K. , Tuttle Katherine R.
Published: August 2015

IN BRIEF Current therapeutic approaches are only moderately efficacious at preventing the progression of diabetic kidney disease (DKD). As the number of people with DKD continues to rise worldwide, there is an urgent need for novel therapies. A better understanding of the root causes and molecular mechanisms of DKD pathogenesis has enabled the identification of numerous new therapeutic targets, including advanced glycation end products, reactive oxygen species, protein kinase C, and serum amyloid A. Although experimental studies have illustrated the potential of such approaches, challenges in clinical translation remain a barrier in therapeutic development. Advances in preclinical safety and efficacy evaluations and improved delivery systems may aid in clinical translation of novel DKD therapies.
Care Utilization Patterns and Diabetes Self-Management Education Duration
Authors: Johnson Tammie M. , Richards Jennifer , Churilla James R.
Published: August 2015

Objective. Previous studies have shown that receiving diabetes self-management education (DSME) is associated with increased care utilization. However, the relationship between DSME duration and care utilization patterns remains largely unexamined. Our purpose is to characterize DSME duration and examine the relationship between DSME duration and clinical- and self-care utilization patterns.

Methods. The study sample included 1,446 adults who were ≥18 years of age, had diabetes, and had participated in the 2008 Florida Behavioral Risk Factor Surveillance System survey. Clinical- and self-care outcomes were derived using responses to the survey’s diabetes module and were based on minimum standards of care established by the American Diabetes Association. The outcomes examined included self-monitoring of blood glucose at least once per day; receiving at least one eye exam, one foot exam, A1C tests, and an influenza vaccination in the past year; and ever receiving a pneumococcal vaccination. DSME duration was categorized as no DSME, >0 to <4 hours, 4–10 hours, and >10 hours.

Results. After adjusting for sociodemographic variables, compared to those who did not receive DSME, those who had 4–10 or 10+ hours of DSME were more likely to receive two A1C tests (odds ratio [95% CI] 2.69 [1.30–5.58] and 2.63 [1.10–6.31], respectively) and have a pneumococcal vaccination (1.98 [1.03–3.80] and 1.92 [1.01–3.64], respectively). Those receiving 10+ hours of DSME were 2.2 times (95% CI 1.18–4.09) as likely to have an influenza vaccination.

Conclusion. These data reveal a positive relationship between DSME duration and utilization of some diabetes clinical care services.
The Interlamellar Spacing of Pearlite
Authors: Vander Voort G. F.
Published: August 2015

The interlamellar spacing of pearlite is a very important microstructural parameter for steels containing pearlite, and becomes more important as the pearlite content increases towards a fully pearlitic microstructure. As the amount of pearlite in ferrite-pearlite microstructures increases, so does the strength, but toughness and ductility decrease. For a fully pearlitic steel, as the interlamellar spacing becomes finer, strength, toughness and ductility all increase. Consequently, in structure-property correlations it is important to measure the interlamellar spacing. This paper reviews procedures for performing such measurements. Due to the fineness of the spacing, either SEM images or TEM images of replicas or thin foils can be utilized. The range of spacings in a given specimen will be much narrower if the pearlite in the steel was formed isothermally rather than transformed over a range of temperatures, as in as-rolled or normalized steels.
Intraoperative MRI for optimizing electrode placement for deep brain stimulation of the subthalamic nucleus in Parkinson disease
Authors: Cui Zhiqiang , Pan Longsheng , Song Huifang , Xu Xin , Xu Bainan , Yu Xinguang , Ling Zhipei
Published: August 2015

OBJECT

The degree of clinical improvement achieved by deep brain stimulation (DBS) is largely dependent on the accuracy of lead placement. This study reports on the evaluation of intraoperative MRI (iMRI) for adjusting deviated electrodes to the accurate anatomical position during DBS surgery and acute intracranial changes.

METHODS

Two hundred and six DBS electrodes were implanted in the subthalamic nucleus (STN) in 110 patients with Parkinson disease. All patients underwent iMRI after implantation to define the accuracy of lead placement. Fifty-six DBS electrode positions in 35 patients deviated from the center of the STN, according to the result of the initial postplacement iMRI scans. Thus, we adjusted the electrode positions for placement in the center of the STN and verified this by means of second or third iMRI scans. Recording was performed in adjusted parameters in the x-, y-, and z-axes.

RESULTS

Fifty-six (27%) of 206 DBS electrodes were adjusted as guided by iMRI. Electrode position was adjusted on the basis of iMRI 62 times. The sum of target coordinate adjustment was −0.5 mm in the x-axis, −4 mm in the y-axis, and 15.5 mm in the z-axis; the total of distance adjustment was 74.5 mm in the x-axis, 88 mm in the y-axis, and 42.5 mm in the z-axis. After adjustment with the help of iMRI, all electrodes were located in the center of the STN. Intraoperative MRI revealed 2 intraparenchymal hemorrhages in 2 patients, brain shift in all patients, and leads penetrating the lateral ventricle in 3 patients.

CONCLUSIONS

The iMRI technique can guide surgeons as they adjust deviated electrodes to improve the accuracy of implanting the electrodes into the correct anatomical position. The iMRI technique can also immediately demonstrate acute changes such as hemorrhage and brain shift during DBS surgery.
Height of aneurysm neck and estimated extent of brain retraction: powerful predictors of olfactory dysfunction after surgery for unruptured anterior communicating artery aneurysms
Authors: Park Jaechan , Son Wonsoo , Goh Duck-Ho , Kang Dong-Hun , Lee Joomi , Shin Im Hee
Published: August 2015

OBJECT

The highest incidence of olfactory dysfunction following a pterional approach and its modifications for an intracranial aneurysm has been reported in cases of anterior communicating artery (ACoA) aneurysms. The radiological characteristics of unruptured ACoA aneurysms affecting the extent of retraction of the frontal lobe and olfactory nerve were investigated as risk factors for postoperative olfactory dysfunction.

METHODS

A total of 102 patients who underwent a pterional or superciliary keyhole approach to clip an unruptured ACoA aneurysm from 2006 to 2013 were included in this study. Those patients who complained of permanent olfactory dysfunction after their aneurysm surgery, during a postoperative office visit or a telephone interview, were invited to undergo an olfactory test, the Korean version of the Sniffin’ Sticks test. In addition, the angiographic characteristics of ACoA aneurysms, including the maximum diameter, the projecting direction of the aneurysm, and the height of the neck of the aneurysm, were all recorded based on digital subtraction angiography and sagittal brain images reconstructed using CT angiography. Furthermore, the extent of the brain retraction was estimated based on the height of the ACoA aneurysm neck.

RESULTS

Eleven patients (10.8%) exhibited objective olfactory dysfunction in the Sniffin’ Sticks test, among whom 9 were anosmic and 2 were hyposmic. Univariate and multivariate analyses revealed that the direction of the ACoA aneurysm, ACoA aneurysm neck height, and estimated extent of brain retraction were statistically significant risk factors for postoperative olfactory dysfunction. Based on a receiver operating characteristic (ROC) analysis, an ACoA aneurysm neck height > 9 mm and estimated brain retraction > 12 mm were chosen as the optimal cutoff values for differentiating anosmic/hyposmic from normosmic patients. The values for the area under the ROC curves were 0.939 and 0.961, respectively.

CONCLUSIONS

In cases of unruptured ACoA aneurysm surgery, the height of the aneurysm neck and the estimated extent of brain retraction were both found to be powerful predictors of the occurrence of postoperative olfactory dysfunction.
Endoscope-assisted endonasal versus supraorbital keyhole resection of olfactory groove meningiomas: comparison and combination of 2 minimally invasive approaches
Authors: Banu Matei A. , Mehta Alpesh , Ottenhausen Malte , Fraser Justin F. , Patel Kunal S. , Szentirmai Oszkar , Anand Vijay K. , Tsiouris Apostolos J. , Schwartz Theodore H.
Published: August 2015

OBJECT

Although the endonasal endoscopic approach has been applied to remove olfactory groove meningiomas, controversy exists regarding the efficacy and safety of this approach compared with more traditional transcranial approaches. The endonasal endoscopic approach was compared with the supraorbital (eyebrow) keyhole technique, as well as a combined “above-and-below” approach, to evaluate the relative merits of each approach in different situations.

METHODS

Nineteen cases were reviewed and divided according to operative technique into 3 different groups: purely endonasal (6 cases); supraorbital eyebrow (microscopic with endoscopic assistance; 7 cases); and combined endonasal endoscopic with either the bicoronal or eyebrow microscopic approach (6 cases). Resection was judged on postoperative MRI using volumetric analysis. Tumors were assessed based on the Mohr radiological classification and the presence of the lion’s mane sign.

RESULTS

The mean age at surgery was 61.4 years. The mean tumor volume was 19.6 cm3 in the endonasal group, 33.5 cm3 in the supraorbital group, and 37.8 cm3 in the combined group. Significant frontal lobe edema was identified in 10 cases (52.6%). The majority of tumors were either Mohr Grade II (moderate) (42.1%) or Grade III (large) (47.4%). Gross-total resection was achieved in 50% of the endonasal cases, 100% of the supraorbital eyebrow cases with endoscopic assistance, and 66.7% of the combined cases. The extent of resection was 87.8% for the endonasal cases, 100% for the supraorbital eyebrow cases, and 98.9% for the combined cases. Postoperative anosmia occurred in 100% of the endonasal and combined cases and only 57.1% of the supraorbital eyebrow cases. Excluding anosmia, permanent complications occurred in 83.3% of the cases in the endoscopic group, 0% of the cases in the supraorbital eyebrow group, and 16.7% of cases in the combined group (p = 0.017). There were 3 tumor recurrences: 2 in the endonasal group and 1 in the combined group.

CONCLUSIONS

The supraorbital eyebrow approach, with endoscopic assistance, leads to a higher extent of resection and lower rate of complications than the purely endonasal endoscopic approach. The endonasal endoscopic approach by itself may be suitable for a small percentage of cases. The combined above-and-below approaches are useful for large tumors with invasion of the ethmoid sinuses.
Postoperative subdural hygroma and chronic subdural hematoma after unruptured aneurysm surgery: age, sex, and aneurysm location as independent risk factors
Authors: Park Jaechan , Cho Jae-Hoon , Goh Duck-Ho , Kang Dong-Hun , Shin Im Hee , Hamm In-Suk
Published: August 2015

OBJECT

This study investigated the incidence and risk factors for the postoperative occurrence of subdural complications, such as a subdural hygroma and resultant chronic subdural hematoma (CSDH), following surgical clipping of an unruptured aneurysm. The critical age affecting such occurrences and follow-up results were also examined.

METHODS

The case series included 364 consecutive patients who underwent aneurysm clipping via a pterional or superciliary keyhole approach for an unruptured saccular aneurysm in the anterior cerebral circulation between 2007 and 2013. The subdural hygromas were identified based on CT scans 6–9 weeks after surgery, and the volumes were measured using volumetry studies. Until their complete resolution, all the subdural hygromas were followed using CT scans every 1–2 months. Meanwhile, the CSDHs were classified as nonoperative or operative lesions that were treated by bur-hole drainage. The age and sex of the patients, aneurysm location, history of a subarachnoid hemorrhage (SAH), and surgical approach (pterional vs superciliary) were all analyzed regarding the postoperative occurrence of a subdural hygroma or CSDH. The follow-up results of the subdural complications were also investigated.

RESULTS

Seventy patients (19.2%) developed a subdural hygroma or CSDH. The results of a multivariate analysis showed that advanced age (p = 0.003), male sex (p < 0.001), middle cerebral artery (MCA) aneurysm (p = 0.045), and multiple concomitant aneurysms at the MCA and anterior communicating artery (ACoA) (p < 0.001) were all significant risk factors of a subdural hygroma and CSDH. In addition, a receiver operating characteristic (ROC) curve analysis revealed a cut-off age of > 60 years, which achieved a 70% sensitivity and 69% specificity with regard to predicting such subdural complications. The female patients ≤ 60 years of age showed a negligible incidence of subdural complications for all aneurysm groups, whereas the male patients > 60 years of age showed the highest incidence of subdural complications at 50%–100%, according to the aneurysm location. The subdural hygromas detected 6–9 weeks postoperatively showed different follow-up results, according to the severity. The subdural hygromas that converted to a CSDH were larger in volume than the subdural hygromas that resolved spontaneously (28.4 ± 16.8 ml vs 59.6 ± 38.4 ml, p = 0.003). Conversion to a CSDH was observed in 31.3% (5 of 16), 64.3% (9 of 14), and 83.3% (5 of 6) of the patients with mild, moderate, and severe subdural hygromas, respectively.

CONCLUSIONS

Advanced age, male sex, and an aneurysm location requiring extensive arachnoid dissection (MCA aneurysms and multiple concomitant aneurysms at the MCA and ACoA) are all correlated with the occurrence of a subdural hygroma and CSDH after unruptured aneurysm surgery. The critical age affecting such an occurrence is 60 years.
Lateral supracerebellar infratentorial approach for microsurgical resection of large midline pineal region tumors: techniques to expand the operative corridor
Authors: Kulwin Charles , Matsushima Ken , Malekpour Mahdi , Cohen-Gadol Aaron A.
Published: August 2015

Pineal region tumors pose certain challenges in regard to their resection: a deep surgical field, associated critical surrounding neurovascular structures, and narrow operative working corridor due to obstruction by the apex of the culmen. The authors describe a lateral supracerebellar infratentorial approach that was successfully used in the treatment of 10 large (> 3 cm) midline pineal region tumors. The patients were placed in a modified lateral decubitus position. A small lateral suboccipital craniotomy exposed the transverse sinus. Tentorial retraction sutures were used to gently rotate and elevate the transverse sinus to expand the lateral supracerebellar operative corridor. This approach placed only unilateral normal structures at risk and minimized vermian venous sacrifice. The surgeon achieved generous exposure of the caudal midline mesencephalon through a “cross-court” oblique trajectory, while avoiding excessive retraction on the culmen. All patients underwent the lateral approach with no approach-related complication. The final pathological diagnoses were consistent with meningioma in 3 cases, pilocytic astrocytoma in 3 cases, intermediate grade pineal region tumor in 2 cases, and pineoblastoma in 2 cases. The entire extent of these tumors was readily reachable through the lateral supracerebellar route. Gross-total resection was achieved in 8 (80%) of the 10 cases; in 2 cases (20%) near-total resection was performed due to adherence of these tumors to deep diencephalic veins.

Large midline pineal region tumors can be removed through a unilateral paramedian suboccipital craniotomy. This approach is simple, may spare some of the midline vermian bridging veins, and may be potentially less invasive and more efficient.
Anatomy and approaches along the cerebellar-brainstem fissures
Authors: Matsushima Ken , Yagmurlu Kaan , Kohno Michihiro , Rhoton Albert L.
Published: August 2015

OBJECT

Fissure dissection is routinely used in the supratentorial region to access deeply situated pathology while minimizing division of neural tissue. Use of fissure dissection is also practical in the posterior fossa. In this study, the microsurgical anatomy of the 3 cerebellar-brainstem fissures (cerebellomesencephalic, cerebellopontine, and cerebellomedullary) and the various procedures exposing these fissures in brainstem surgery were examined.

METHODS

Seven cadaveric heads were examined with a microsurgical technique and 3 with fiber dissection to clarify the anatomy of the cerebellar-brainstem and adjacent cerebellar fissures, in which the major vessels and neural structures are located. Several approaches directed along the cerebellar surfaces and fissures, including the supracerebellar infratentorial, occipital transtentorial, retrosigmoid, and midline suboccipital approaches, were examined. The 3 heads examined using fiber dissection defined the anatomy of the cerebellar peduncles coursing in the depths of these fissures.

RESULTS

Dissections directed along the cerebellar-brainstem and cerebellar fissures provided access to the posterior and posterolateral midbrain and upper pons, lateral pons, floor and lateral wall of the fourth ventricle, and dorsal and lateral medulla.

CONCLUSIONS

Opening the cerebellar-brainstem and adjacent cerebellar fissures provided access to the brainstem surface hidden by the cerebellum, while minimizing division of neural tissue. Most of the major cerebellar arteries, veins, and vital neural structures are located in or near these fissures and can be accessed through them.