bluuebunny/crossref_metadata_2025 huggingface dataset:
The 1857 Indian Uprising and the British Empire
Authors: Bender Jill C.
Published: February 2016

Situating the 1857 Indian uprising within an imperial context, Jill C. Bender traces its ramifications across the four different colonial sites of Ireland, New Zealand, Jamaica, and southern Africa. Bender argues that the 1857 uprising shaped colonial Britons' perceptions of their own empire, revealing the possibilities of an integrated empire that could provide the resources to generate and 'justify' British power. In response to the uprising, Britons throughout the Empire debated colonial responsibility, methods of counter-insurrection, military recruiting practices, and colonial governance. Even after the rebellion had been suppressed, the violence of 1857 continued to have a lasting effect. The fears generated by the uprising transformed how the British understood their relationship with the 'colonized' and shaped their own expectations of themselves as 'colonizer'. Placing the 1857 Indian uprising within an imperial context reminds us that British power was neither natural nor inevitable, but had to be constructed.
Isolated Singularities in Partial Differential Inequalities
Authors: Ghergu Marius , Taliaferro Steven D.
Published: February 2016

In this monograph, the authors present some powerful methods for dealing with singularities in elliptic and parabolic partial differential inequalities. Here, the authors take the unique approach of investigating differential inequalities rather than equations, the reason being that the simplest way to study an equation is often to study a corresponding inequality; for example, using sub and superharmonic functions to study harmonic functions. Another unusual feature of the present book is that it is based on integral representation formulae and nonlinear potentials, which have not been widely investigated so far. This approach can also be used to tackle higher order differential equations. The book will appeal to graduate students interested in analysis, researchers in pure and applied mathematics, and engineers who work with partial differential equations. Readers will require only a basic knowledge of functional analysis, measure theory and Sobolev spaces.
Landscape, Nature, and the Sacred in Byzantium
Authors: della Dora Veronica
Published: February 2016

Nature is as much an idea as a physical reality. By 'placing' nature within Byzantine culture and within the discourse of Orthodox Christian thought and practice, Landscape, Nature and the Sacred in Byzantium explores attitudes towards creation that are utterly and fascinatingly different from the modern. Drawing on Patristic writing and on Byzantine literature and art, the book develops a fresh conceptual framework for approaching Byzantine perceptions of space and the environment. It takes readers on an imaginary flight over the Earth and its varied topographies of gardens and wilderness, mountains and caves, rivers and seas, and invites them to shift from the linear time of history to the cyclical time and spaces of the sacred - the time and spaces of eternal returns and revelations.
Building New Ways to Think About Arctic Freshwater
Authors: Shultz David
Published: February 2016

A new literature review summarizes the complex role of freshwater in the Arctic and its impact on climate and biogeochemical systems as a whole.
The Forgotten Water Vapor at High Altitudes
Authors: Sullivan Cody
Published: February 2016

Scientists find that estimations of high-altitude atmospheric water, critical for the greenhouse effect, are not as accurate as previously thought.
Sediment Transport Capacity Carries Many Meanings
Authors: Strelich Lily
Published: February 2016

The current definitions of sediment transport capability don't match up with observations of actual geomorphic systems.
Restoring a nearly free-standing character of graphene on Ru(0001) by oxygen intercalation
Authors: Voloshina Elena , Berdunov Nikolai , Dedkov Yuriy
Published: February 2016

Realization of a free-standing graphene is always a demanding task. Here we use scanning probe microscopy and spectroscopy to study the crystallographic structure and electronic properties of the uniform nearly free-standing graphene layers obtained by intercalation of oxygen monolayer in the “strongly” bonded graphene/Ru(0001) interface. Spectroscopic data show that such graphene layer is heavily p-doped with the Dirac point located at 552 meV above the Fermi level. Experimental data are understood within density-functional theory approach and the observed effects are in good agreement with the theoretical data.
Thermoelectric Power in Bilayer Graphene Device with Ionic Liquid Gating
Authors: Chien Yung-Yu , Yuan Hongtao , Wang Chang-Ran , Lee Wei-Li
Published: February 2016

The quest for materials showing large thermoelectric power has long been one of the important subjects in material science and technology. Such materials have great potential for thermoelectric cooling and also high figure of merit ZT thermoelectric applications. We have fabricated bilayer graphene devices with ionic-liquid gating in order to tune its band gap via application of a perpendicular electric field on a bilayer graphene. By keeping the Fermi level at charge neutral point during the cool-down, we found that the charge puddles effect can be greatly reduced and thus largely improve the transport properties at low T in graphene-based devices using ionic liquid gating. At (Vig, Vbg) = (−1 V, +23 V), a band gap of about 36.6 ± 3 meV forms and a nearly 40% enhancement of thermoelectric power at T = 120 K is clearly observed. Our works demonstrate the feasibility of band gap tuning in a bilayer graphene using ionic liquid gating. We also remark on the significant influence of the charge puddles effect in ionic-liquid-based devices.
First-Principles Investigation to Ionization of Argon Under Conditions Close to Typical Sonoluminescence Experiments
Authors: Kang Wei , Zhao Shijun , Zhang Shen , Zhang Ping , Chen Q. F. , He Xian-Tu
Published: February 2016

Mott effect, featured by a sharp increase of ionization, is one of the unique properties of partially ionized plasmas and thus of great interest to astrophysics and inertial confinement fusion. Recent experiments of single bubble sonoluminescence (SBSL) revealed that strong ionization took place at a density two orders lower than usual theoretical expectation. We show from the perspective of electronic structures that the strong ionization is unlikely the result of Mott effect in a pure argon plasma. Instead, first-principles calculations suggest that other ion species from aqueous environments can energetically fit in the gap between the continuum and the top of occupied states of argon, making the Mott effect possible. These results would help to clarify the relationship between SBSL and Mott effect and further to gain an better understanding of partially ionized plasmas.
Probing of multiple magnetic responses in magnetic inductors using atomic force microscopy
Authors: Park Seongjae , Seo Hosung , Seol Daehee , Yoon Young-Hwan , Kim Mi Yang , Kim Yunseok
Published: February 2016

Even though nanoscale analysis of magnetic properties is of significant interest, probing methods are relatively less developed compared to the significance of the technique, which has multiple potential applications. Here, we demonstrate an approach for probing various magnetic properties associated with eddy current, coil current and magnetic domains in magnetic inductors using multidimensional magnetic force microscopy (MMFM). The MMFM images provide combined magnetic responses from the three different origins, however, each contribution to the MMFM response can be differentiated through analysis based on the bias dependence of the response. In particular, the bias dependent MMFM images show locally different eddy current behavior with values dependent on the type of materials that comprise the MI. This approach for probing magnetic responses can be further extended to the analysis of local physical features.
Indented Cu2MoS4 nanosheets with enhanced electrocatalytic and photocatalytic activities realized through edge engineering
Authors: Chen Bang-Bao , Ma De-Kun , Ke Qing-Ping , Chen Wei , Huang Shao-Ming
Published: February 2016

Indented Cu2MoS4 nanosheets obtained through edge engineering could achieve enhanced electrocatalytic and photocatalytic activities.
Synthesis and spectroscopic properties of novel N–N linked bis-(diphenylboron) complexes
Authors: Gai Lizhi , Xu Jialiang , Wu Yanping , Lu Hua , Shen Zhen
Published: February 2016

Novel five-membered-ring and six-membered-ring bis-(diphenylboron) complexes are reported.
Facile and scalable route to sheets-on-sheet mesoporous Ni–Co-hydroxide/reduced graphene oxide nanocomposites and their electrochemical and magnetic properties
Authors: Subramani K. , Lakshminarasimhan N. , Kamaraj P. , Sathish M.
Published: February 2016

Sheets-on-sheet mesoporous Ni–Co-hydroxide/RGO nanocomposite with a specific capacitance of 835 F g−1was obtained by the chemical decomposition of nickel cobalt hexacyanoferrate complex.
Enhanced photocatalytic activity of hierarchical three dimensional metal oxide@CuO nanostructures towards the degradation of Congo red dye under solar radiation
Authors: Malwal Deepika , Gopinath P.
Published: February 2016

In the present study, we report a two step method for the synthesis of metal oxide (ZnO and Fe3O4) deposited on CuO nanowire arrays over 3D copper foam using thermal oxidation followed by microwave-assisted deposition.
Miniaturised multiband directional dipole antenna
Authors: Lee Kwang‐jae , Lee Taek‐kyung
Published: February 2016

A miniaturised multiband directional dipole antenna for mobile communication applications is proposed. The proposed antenna consists of electromagnetically coupled two‐dipoles with a folded reflector and inverted L‐shape stubs on the edge of the folded reflector. The stubs are used to obtain a reduction of the antenna size. The occupied volume of the proposed antenna is 0.34 λ0 × 0.29 λ0 × 0.10 λ0. (λ0 is the wavelength at 900 MHz) To provide multiband characteristics, the radiator designed electromagnetically coupled two‐dipoles with dual resonance frequencies. The performance of the proposed structure successfully covers the frequency bands of 700–1000 MHz and 1700–2700 MHz.
TiN/PECVD‐Si3N4/TiN diaphragm‐based capacitive‐type MEMS acoustic sensor
Authors: Lee J. , Jeon J.H. , Kim Y.‐G. , Lee S.Q. , Yang W.S. , Lee J.S. , Lee S.‐G.
Published: February 2016

A capacitive‐type MEMS acoustic sensor with a planarised TiN/plasma‐enhanced chemical vapour deposition ‐Si3N4/TiN diaphragm based on a polyimide sacrificial layer is presented. The multi‐layer diaphragm has the effective residual stress of +31.5 MPa. Furthermore, this sensor features a 21% lower parasitic capacitance and a 56% lower air‐gap resistance in comparison with those of a sensor fabricated without planarisation. Five photomasks were used. In addition, to evaluate the frequency response, both an effective capacitance model and an equivalent circuit model equipped with a voltage‐controlled voltage source are newly proposed and compared with conventional models. The open‐circuit sensitivity is modelled to −45.4 dBV/Pa at 1 kHz with 9.6 V, indicating a difference of 0.9 dB in comparison with the open‐circuit sensitivity of the conventional model.
Feature selection based on geometric distance for high‐dimensional data
Authors: Lee J.‐H. , Oh S.‐Y.
Published: February 2016

A novel feature selection method based on geometric distance is proposed. It utilises both the average distance between classes along with the evenness of these distances to evaluate feature subsets. The feature evaluation and selection process used therein is very easy to understand, because it lends itself to a simple geometrical analysis. Moreover, because the method does not calculate the relevance or redundancy between features, it is faster than other filter methods that use information or statistical dependency concepts. The experiments demonstrate its markedly better classification performance as well as fast computation compared with existing methods.
Stability of perturbed switched homogeneous systems with delays and uncertainties
Authors: Liu Xingwen
Published: February 2016

This study addresses the stability problem of perturbed switched systems with time‐varying delays and uncertainties. The considered switching signals include five classes and the uncertainties take values on compact sets. It is assumed that the nominal system (perturbation‐free system) is robustly uniformly exponentially stable and that the perturbations satisfy vanishing condition plus one of the following three constraints: being locally Lipschitz at origin, globally Lipschitz, and differentiable at origin. By ‘vanishing’, the authors mean that the perturbation is zero at origin. With these assumptions, it is first revealed that for switched systems being homogeneous of degree one, if the perturbation is sufficiently small, then the perturbed system preserves the stability property of the nominal system, locally or globally, depending on perturbation itself. These results are then applied to switched linear systems with delays, showing that the same conclusion holds for such systems with four types of most frequently encountered uncertainties. Finally, an example is provided to illustrate the proposed theoretical results.
Parallel parking of a car‐like mobile robot based on the P‐domain path tracking controllers
Authors: Naderi Samani Nasrin , Danesh Mohammad , Ghaisari Jafar
Published: February 2016

This study presents high‐precision path tracking controllers to follow a parking path in which change in the movement direction is required along it. Compared with other existing path tracking controllers, the automatic control of the movement direction and the necessity of zero velocity at the switching and end points of the parking manoeuvre are considered in the controller design. To this aim, two time‐domain functions are proposed depending on the movement direction. Then, two function‐domain tracking controllers based on feedback linearisation control and sliding mode control (SMC) structures are designed. The stability of the tracking controllers is analysed and guaranteed. Unlike the conventional SMC, the control signals of the function‐domain SMC are very smooth. Moreover, designing the tracking controller in the function‐domain can be a solution to modify the tracking controllers that have problem in the control law for the steering angle at zero speed. In the proposed controllers, the steering angle and the driving velocity are fully controlled by the controllers, and the robot automatically stops at the critical points independent of the position estimation and velocity tracking errors. Simulation results demonstrate the effectiveness of the proposed controllers to steer the robot along the reference path.
Optimal coordination of distance and overcurrent relays considering a non‐standard tripping characteristic for distance relays
Authors: Damchi Yaser , Sadeh Javad , Rajabi Mashhadi Habib
Published: February 2016

The aim of relay coordination is to obtain the optimal relay settings which result in minimum operating times of the relays, satisfying selectivity constraints. In combined coordination of distance and directional overcurrent relays (D&DOCRs), operating times of the second zone of distance relays (TZ2) are typically increased in order to satisfy the selectivity constraints. In this study, a new operating characteristic (OPC) for distance relays is proposed which decreases TZ2s. In the proposed OPC, the common characteristic for the second zone is divided into two sections: the first section protects the main line beyond the first zone with delay time TZ2n1 and the second one protects 50% of the adjacent line with delay time TZ2n2. A new formulation is then proposed for the non‐linear problem of D&DOCRs coordination based on the proposed OPC. The presented method is tested on three test systems: namely, the 8‐bus, the IEEE 14‐bus, and the IEEE 30‐bus test systems. The simulation results show that the method can be used to achieve a faster protection especially when robust coordination is desired.
Characterisation of anomalous forces on asymmetric high‐voltage capacitors
Authors: Porcelli Elio Battista , Filho Victo dos Santos
Published: February 2016

In this study, the authors analysed an anomalous force observed in asymmetric capacitors, working in high electric potentials. From a lot of experimental measurements performed in their asymmetric capacitor, they detected real variations of the device inertia. An empirical formula of the developed force according to Clausius–Mossotti relation explained the experimental results with good agreement, suggesting that the anomalous force can be related directly to the electric dipoles inside the capacitor dielectric. They could also explain why that force always points toward the small electrode when it is subjected to a convergent electric field. Such simple electrical propulsion systems could allow in the future the substitution of the fuel propulsion technology.
Uso do prontuário eletrônico na assistência pré-natal às portadoras de diabetes na gestação
Authors: Feitosa Alina Coutinho Rodrigues , Ávila Amado Nizarala de
Published: February 2016

Objetivo Apresentar e validar um registro eletrônico de saúde (RES) multifuncional para atendimento ambulatorial a portadoras de endocrinopatias na gestação e comparar a taxa de preenchimento de informações de saúde com o prontuário convencional.

Métodos Desenvolvemos um RES denominado Ambulatório de Endocrinopatias na Gestação eletrônico (AMBEG) para registro sistematizado das informações de saúde. O AMBEG foi utilizado para atendimento obstétrico e endocrinológico de gestantes acompanhadas no ambulatório de endocrinopatias na gestação na maternidade referência em gestação de alto risco na Bahia, no período de janeiro de 2010 a dezembro de 2013. Aleatoriamente foram selecionadas 100 pacientes atendidas com o AMBEG e 100 pacientes atendidas com prontuário convencional com registro em papel e comparou-se a taxa de preenchimento de informações clínicas.

Resultados Foram realizados 1461 atendimentos com o AMBEG: 253, 963 e 245 respectivamente, admissões, consultas de seguimento e puerpério. Eram portadoras de diabetes 77,2% e sendo 60,1% portadoras de diabetes pré-gestacional. O AMBEG substituiu, satisfatoriamente, o prontuário convencional. O percentual de informações clínicas registradas em ambos os prontuários foi significativamente maior no AMBEG: queixas clínicas (100 versus 87%, p < 0,01), altura uterina (89 versus 75%, p = 0,01), ganho de peso total (91 versus 40%, p < 0,01) e dados específicos sobre o diabetes (dieta, esquema de insulina, controle glicêmico e manejo de hipoglicemias) revelando diferença significativa (p < 0,01). A possibilidade de exportar dados clínicos para planilhas facilitou e agilizou a análise estatística de dados.

Conclusões O AMBEG é uma ferramenta útil no atendimento clínico a mulheres portadoras de endocrinopatias na gestação. A taxa de preenchimento de informações clínicas foi superior à do prontuário convencional.
Synthesis and properties of light weight magnesium–cenosphere composite
Authors: Nguyen Q. B. , Sharon Nai M. L. , Nguyen A. S. , Seetharaman S. , Wai Leong E. W. , Gupta M.
Published: February 2016

Significantly light weight magnesium composite foams are synthesised by addition of fly ash cenosphere particles (waste from coal-fired power plants) in biocompatible pure magnesium using solidification-based disintegrated melt deposition technique. The density of the composite foams synthesised in this study approaches that of plastics- and polymer-based composites. Microstructure development of Mg/cenosphere composite foams was favourable as they exhibited better dimensional stability (reduced coefficient of thermal expansion) and remarkable improvements in tensile strengths, compressive strengths, compressive total strain and microhardness. The present study highlights the processing, microstructure and mechanical properties of Mg/cenosphere composite foams which hold great potential as light weight metal-based green materials for diverse weight critical applications spanning from engineering to biomedical sector.
Fabrication and characterisation of copper–alumina nanocomposites prepared by high-energy fast milling
Authors: Salahi E. , Rajabi A.
Published: February 2016

Two different methods are used to prepare Cu–20 vol-% Al2O3 nanocomposite powders via high-energy planetary fast milling. In the solid solution method, CuO powder was added to the Cu–Al solid solution powder, and the composite was fabricated by milling after 100 h. In the direct mixing method, Cu and Al2O3 powders were mechanically milled via high-energy planetary fast milling for 100 h. The transition electron micrographs (dark and white fields) revealed the presence of Al2O3 nanoparticles in crystalline Cu matrices for both methods. However, the density and bending strength of the nanocomposites produced via the solid solution method were higher than those of the samples produced via the direct mixing method.
Abnormal expansion due to pearlite-to-austenite transformation in high aluminium-added steels
Authors: Chen P. , Wang G. D. , Xiong X. C. , Yi H. L.
Published: February 2016

Addition of alloying elements usually moves eutectoid point to left whilst aluminium enhances eutectoid carbon content. The carbon expands lattice parameters of austenite. High aluminium addition in steels led to volume expansion at pearlite-to-austenite transformation since specific volume of austenite is larger than that of mother phases, which is proposed to determine the volume expansion or contraction. It has been proven by calculations based on thermodynamics as well as accurate experimental observations of dilatometry study.
Microstructure and mechanical properties of molybdenum–iron–boron–chromium cladding using argon arc welding
Authors: Wang H. Q. , Sun J. S. , Li C. N. , Geng S. N. , Sun H. G. , Wang G. L.
Published: February 2016

The molybdenum–iron–boron–chromium claddings with different Mo/B atomic ratios were produced on Q235 steel using argon arc welding. The microstructure and crystalline phases were studied by optical microscopy, scanning electron microscopy and XRD. In addition, the formation mechanism of hard phase was investigated by thermodynamic calculations and phase diagrams. The results showed that the claddings were composed of the Mo2FeB2, M3B2 (M: Mo, Fe and Cr) hard phases and σ-FeMoCr solid solution. In addition, calculated results revealed that the M3B2, MB and σ-FeMoCr were successively precipitated from the melting pool. Moreover, the maximum microhardness value of the cladding was about 1600 HV0.5. Wearing test indicated that claddings of lower Mo/B ratios have better wear resistance.
R76 in transmembrane domain 3 of the aspartate:alanine transporter AspT is involved in substrate transport
Authors: Suzuki Satomi , Nanatani Kei , Abe Keietsu
Published: February 2016

The l-aspartate:l-alanine antiporter of Tetragenococcus halophilus (AspT) possesses an arginine residue (R76) within the GxxxG motif in the central part of transmembrane domain 3 (TM3)—a residue that has been estimated to transport function. In this study, we carried out amino acid substitutions of R76 and used proteoliposome reconstitution for analyzing the transport function of each substitution. Both l-aspartate and l-alanine transport assays showed that R76K has higher activity than the AspT-WT (R76), whereas R76D and R76E have lower activity than the AspT-WT. These results suggest that R76 is involved in AspT substrate transport.
Combined impacts of elevated CO2 and anthropogenic noise on European sea bass (Dicentrarchus labrax)
Authors: Poulton Danielle A. , Porteus Cosima S. , Simpson Stephen D.
Published: February 2016

Ocean acidification (OA) and anthropogenic noise are both known to cause stress and induce physiological and behavioural changes in fish, with consequences for fitness. OA is also predicted to reduce the ocean's capacity to absorb low-frequency sounds produced by human activity. Consequently, anthropogenic noise could propagate further under an increasingly acidic ocean. For the first time, this study investigated the independent and combined impacts of elevated carbon dioxide (CO2) and anthropogenic noise on the behaviour of a marine fish, the European sea bass (Dicentrarchus labrax). In a fully factorial experiment crossing two CO2 levels (current day and elevated) with two noise conditions (ambient and pile driving), D. labrax were exposed to four CO2/noise treatment combinations: 400 µatm/ambient, 1000 µatm/ambient, 400 µatm/pile-driving, and 1000 µatm/pile-driving. Pile-driving noise increased ventilation rate (indicating stress) compared with ambient noise conditions. Elevated CO2 did not alter the ventilation rate response to noise. Furthermore, there was no interaction effect between elevated CO2 and pile-driving noise, suggesting that OA is unlikely to influence startle or ventilatory responses of fish to anthropogenic noise. However, effective management of anthropogenic noise could reduce fish stress, which may improve resilience to future stressors.
Leveraging cues from person-generated health data for peer matching in online communities
Authors: Hartzler Andrea L , Taylor Megan N , Park Albert , Griffiths Troy , Backonja Uba , McDonald David W , Wahbeh Sam , Brown Cory , Pratt Wanda
Published: February 2016

Objective Online health communities offer a diverse peer support base, yet users can struggle to identify suitable peer mentors as these communities grow. To facilitate mentoring connections, we designed a peer-matching system that automatically profiles and recommends peer mentors to mentees based on person-generated health data (PGHD). This study examined the profile characteristics that mentees value when choosing a peer mentor.

Materials and Methods Through a mixed-methods user study, in which cancer patients and caregivers evaluated peer mentor recommendations, we examined the relative importance of four possible profile elements: health interests, language style, demographics, and sample posts. Playing the role of mentees, the study participants ranked mentors, then rated both the likelihood that they would hypothetically contact each mentor and the helpfulness of each profile element in helping the make that decision. We analyzed the participants’ ratings with linear regression and qualitatively analyzed participants’ feedback for emerging themes about choosing mentors and improving profile design.

Results Of the four profile elements, only sample posts were a significant predictor for the likelihood of a mentee contacting a mentor. Communication cues embedded in posts were critical for helping the participants choose a compatible mentor. Qualitative themes offer insight into the interpersonal characteristics that mentees sought in peer mentors, including being knowledgeable, sociable, and articulate. Additionally, the participants emphasized the need for streamlined profiles that minimize the time required to choose a mentor.

Conclusion Peer-matching systems in online health communities offer a promising approach for leveraging PGHD to connect patients. Our findings point to interpersonal communication cues embedded in PGHD that could prove critical for building mentoring relationships among the growing membership of online health communities.
ULXs: Neutron stars versus black holes
Authors: King Andrew , Lasota Jean–Pierre
Published: February 2016

We consider ultraluminous X–ray systems (ULXs) where the accretor is a neutron star rather than a black hole. We show that the recently discovered example (M82 X–2) fits naturally into the simple picture of ULXs as beamed X–ray sources fed at super-Eddington rates, provided that its magnetic field is weaker (≃1011G) than a new-born X-ray pulsar, as expected if there has been mass gain. Continuing accretion is likely to weaken the field to the point that pulsing stops, and make the system indistinguishable from a ULX containing a black hole. Accordingly we suggest that a significant fraction of all ULXs may actually contain neutron star accretors rather than black holes, reflecting the neutron-star fraction among their X-ray binary progenitors. We emphasize that neutron-star ULXs are likely to have higher apparent luminosities than black hole ULXs for a given mass transfer rate, as their tighter beaming outweighs their lower Eddington luminosities. This further increases the likely proportion of neutron-star accretors among all ULXs. Cygnus X–2 is probably a typical descendant of neutron-star ULXs, which may therefore ultimately end as millisecond pulsar binaries with massive white dwarf companions.
p16 Immunohistochemistry in Colposcope-Directed and Random Cervical Biopsies of CIN2 and CIN3
Authors: Arvizo Cynthia , Chen Qing , Du Hui , Wang Chun , Tang Jinlong , Yang Bin , Pretorius Robert G. , Wu Ruifang , Belinson Jerome Leslie
Published: February 2016

Objective

The aim of this study was to determine if there is a different p16 expression pattern between colposcope-directed and random (colposcope-undetectable) biopsies of cervical intraepithelial neoplasia (CIN2) and CIN3.

Methods

Cervical biopsies that were positive for CIN2 or CIN3 were selected from a database of samples acquired during a large population-based clinical trial in Guangdong Province in China (Shenzhen Cervical Cancer Screening Study II). Blocks were recut, reread, and then immunostained for p16. Biopsies were categorized as either colposcope-directed or random biopsies. Diffuse staining was considered p16 positive, whereas focal or no staining was considered p16 negative. Differences were determined by the Fisher exact test.

Results

Among the patients with CIN3, there were 232 individual biopsies of CIN3. Sixty were randomly collected, and 172 were colposcopy directed. p16 positivity for the colposcope-directed and random biopsies was 97.7% and 91.7%, respectively (p = 0.052). Like the CIN3 biopsies, colposcope-directed and random CIN2 samples expressed p16 similarly (86.8% [46/53] and 82.6% [19/23], p = .73, respectively).

Conclusions

Based on our data, even small colposcope-undetectable biopsies of CIN3 are significant. Random biopsies of CIN2 or CIN3 demonstrate similar p16 positivity as visible lesions and therefore might be expected to have a similar natural history.
High-Grade Cervical Intraepithelial Neoplasia Detected by Colposcopy-Directed or Random Biopsy Relative to Age, Cytology, Human Papillomavirus 16, and Lesion Size
Authors: Chen Qing , Du Hui , Pretorius Robert G. , Wang Chun , Yang Bin , Wang Guixiang , Tang Jinlong , Belinson Jerome L. , Wu Ruifang
Published: February 2016

Objective

The aim of the study was to determine whether p16 positive/cervical intraepithelial neoplasia (CIN) 2, 3, and cancer (p16 + CIN 2/3+) detected by colposcopy-directed or random biopsy differ by age, referral cytology, human papillomavirus (HPV) 16, and lesion size.

Materials and Methods

Data from the Shenzhen Cervical Cancer Screening Trial II where, at colposcopy, women who had directed and random cervical biopsies were reviewed to find women with CIN 2, 3, or cancer; 227 such women identified had their paraffin-embedded tissue blocks recut, reviewed, and then immune stained for p16. Data were analyzed by χ2, Fisher exact test, and linear regression.

Results

After histopathologic review and p16 staining of CIN 2, 175 women were diagnosed with p16 + CIN 2/3+. When compared with those diagnosed by colposcopy-directed biopsy (n = 138), those diagnosed by random biopsy (n = 37) were more likely to have Cytology-Lo (cytology of negative, atypical squamous cells of undetermined significance, or low-grade squamous intraepithelial lesion; p = .07), less likely to have HPV 16 (p = .041), more likely to be 51 years or older (p = .022), and more likely to have 1 quadrant lesions (p < .001). Logistic regression analysis showed p16 + CIN 2/3+ diagnosed by random biopsy was predicted by 1 quadrant lesions (p < .0001) and age of 51 years or older (p = .03) but not by Cytology-Lo (p = .71) nor HPV 16 (p = .26).

Conclusions

Women with p16 + CIN 2/3+ diagnosed by random biopsy are older and less likely to have HPV 16; hence, CIN diagnosed by random biopsy may not be as virulent as CIN diagnosed by colposcopy-directed biopsy. Regardless, we advise that CIN diagnosed by random biopsy be viewed like CIN diagnosed by colposcopy-directed biopsy.
ABCD
Authors: Brookes Denise S.K. , Briody Julie N. , Davies Peter S.W. , Hill Rebecca J.
Published: February 2016

Background:

Young individuals with Crohn disease (CD) are at risk of poor bone mineral density (BMD) and reduced lean tissue mass (LTM). The importance of LTM for maintaining skeletal health, in both incident and established CD, is evidenced. We used dual‐energy x‐ray absorptiometry assessment to identify areal BMD and LTM in individuals with CD.

Methods:

In 57 patients with CD (15F; 12.99–14.16 years) anthropometric, disease activity, bone age assessment, and total body dual‐energy x‐ray absorptiometry measurements were acquired. A 4‐step algorithm was used to assess simultaneous bone and body composition data: areal BMD and height z scores, and LTM for height and bone mineral content (BMC) for LTM z scores were calculated. Low z score cut‐off values were defined as ≤1 standard deviations below the population means.

Results:

The CD cohort showed: low areal BMD z scores (P = 0.00); and low LTM for height (P = 0.00) according to defined cut‐off values. BMC appeared to be adapting for the lower amount of LTM. Correcting for bone age eliminated the low areal BMD z scores. As expected, LTM for height and BMC for LTM z scores remained unchanged.

Conclusions:

We present a useful clinical algorithm to show significant LTM for height deficits, regardless of chronological or bone age, in this CD cohort. BMC seemed to adapt to the reduced LTM, indicating clinically “normal” areal BMD for age when considered for height. The ongoing deficits in LTM may, however, create chronic long‐term consequences for bone health. Improving LTM should be a focus of clinical treatment in individuals with CD.
Intestinal Microbiota in Pediatric Surgical Cases Administered Bifidobacterium Breve
Authors: Okazaki Tadaharu , Asahara Takashi , Yamataka Atsuyuki , Ogasawara Yuki , Lane Geoffrey J. , Nomoto Koji , Nagata Satoru , Yamashiro Yuichiro
Published: February 2016

The efficacy of perioperative probiotic administration has been reported in adults. We examined the effects of orally administered Bifidobacterium breve strain Yakult (BBG‐01) on outcomes in pediatric surgical cases by assessing intestinal and blood microbiota. BBG‐01 was well tolerated without adverse effects, and postoperative infectious complications were significantly decreased. Fecal analysis showed increased Bifidobacterium and decreased Enterobacteriaceae, Clostridium difficile, and Pseudomonas. Concentrations of fecal acetic acid were significantly increased, maintaining fecal pH at <7.0. The incidence of detecting bacteria in blood was significantly reduced. BBG‐01 improved the intestinal environment, and may be implicated in suppressing bacterial translocation.
Ustekinumab in Pediatric Crohn Disease Patients
Authors: Bishop Casey , Simon Hayley , Suskind David , Lee Dale , Wahbeh Ghassan
Published: February 2016

Objectives:

We describe the use of ustekinumab for 4 patients with pediatric Crohn disease treated at the Seattle Children's Hospital Inflammatory Bowel Disease Center.

Methods:

A retrospective chart review was done to identify patients’ clinical data, disease phenotype, treatment history, and laboratory and growth parameters before treatment with ustekinumab and at last follow‐up. Adverse events while on ustekinumab were also recorded.

Results:

Four adolescent patients with Crohn disease at our center received ustekinumab. All had previously received corticosteroids, methotrexate, azathioprine/6‐mercaptopurine, and both infliximab and adalimumab. Patients had varying disease phenotypes. Ages at ustekinumab initiation were 12, 13, 16, and 17 years. Weight ranged from 40.5 to 57.8 kg, mean 49.5 kg. Two patients showed clinical response and remain on ustekinumab. Two patients discontinued therapy because of continued symptoms and disease complications and required multiple hospitalizations.

Conclusions:

Ustekinumab was used in 4 children with pediatric Crohn disease with 2 of 4 patients showing clinical response (1 with persistently elevated C‐reactive protein). A prospective study is needed to define its efficacy, safety, and placement in managing pediatric Crohn disease in the future.
The conserved two-component systems orchestrate the pathophysiology of Mycobacterium tuberculosis
Authors: Mishra Alok K.
Published: February 2016

Pathogenic bacteria have to adapt to the various microenvironmental conditions encountered during its infective cycle. Therefore, an efficient transcriptional regulatory mechanism becomes a precondition to ensure survival of bacteria inside the host. Intracellular pathogenic bacteria basically rely on two-component signalling systems (TCSs) for this purpose. However, the reductive evolution of Mycobacterium tuberculosis (Mtb) complex encompassed a significant reduction in the number of TCSs. Nevertheless, the 11 conserved TCSs, selected under the evolutionary pressure of Mtb, play crucial roles in the successful establishment of TB infection. The basic histidine-aspartate phosphorelay mechanism and structural aspects of the TCSs have been reviewed. It has also been discussed how the conserved histidine kinases tune the transcription of specific bacterial genes in response to environmental stimulus and ensures the intracellular survival of Mtb.
Development of Pediatric Neurologic Emergency Life Support Course
Authors: Haque Anwarul , Arif Fehmina , Abass Qalab , Ahmed Khalid
Published: February 2016

Background

Acute neurological emergencies (ANEs) in children are common life-threatening illnesses and are associated with high mortality and severe neurological disability in survivors, if not recognized early and treated appropriately. We describe our experience of teaching a short, novel course “Pediatric Neurologic Emergency Life Support” to pediatricians and trainees in a resource-limited country.

Methods

This course was conducted at 5 academic hospitals from November 2013 to December 2014. It is a hybrid of pediatric advance life support and emergency neurologic life support. This course is designed to increase knowledge and impart practical training on early recognition and timely appropriate treatment in the first hour of children with ANEs. Neuroresuscitation and neuroprotective strategies are key components of this course to prevent and treat secondary injuries. Four cases of ANEs (status epilepticus, nontraumatic coma, raised intracranial pressure, and severe traumatic brain injury) were taught as a case simulation in a stepped-care, protocolized approach based on best clinical practices with emphasis on key points of managements in the first hour.

Results

Eleven courses were conducted during the study period. One hundred ninety-six physicians including 19 consultants and 171 residents participated in these courses. The mean (SD) score was 65.15 (13.87%). Seventy percent (132) of participants were passed (passing score > 60%). The overall satisfaction rate was 85%.

Conclusions

Pediatric Neurologic Emergency Life Support was the first-time delivered educational tool to improve outcome of children with ANEs with good achievement and high satisfaction rate of participants. Large number courses are required for future validation.
Spontaneous Subclavian Vein Thrombosis in a Healthy Adolescent Cheerleader
Authors: Chu Andrew S. , Harkness Julia , Witmer Char M.
Published: February 2016

We present the case of a healthy 13-year-old female adolescent who developed acute progressive swelling and pain in her right upper extremity that was secondary to an acute deep venous thrombosis of her right subclavian vein. Dynamic imaging revealed subclavian vein compression at the junction of the first rib and proximal third of the clavicle consistent with Paget-Schroetter syndrome, also known as effort-related thrombosis. The compressive etiology of her thrombus was most likely related to her cheerleading activity, in which she served as the pyramid base. The patient received multimodal therapy including anticoagulation, mechanical and site-directed thrombolysis, and a first rib resection. This case illustrates that frontline providers should have a high index of suspicion for an upper extremity thrombosis in pediatric patients who present with unilateral arm swelling.
Jinx or Not?
Authors: Fabre Alexandre , Mancini Julien
Published: February 2016

Objective

The aim of this study was to ascertain the validity of the widespread belief in the existence of jinxed physicians during night duty in emergency department (ED).

Methods

We conducted a retrospective study involving 13 pediatricians with more than 12 spells of night duty (8 pm to 8.30 am) in the ED at the “La Timone” Medical School Hospital in Marseilles, France, during the inclusion period (from November 1, 2010, to October 31, 2011) and 8 night nurses in the same ED. The 13 pediatricians rated themselves as jinxed and were rated as such by their peers and the night nurses. The number of ED visits (total, medical, and after midnight) and the number of hospitalizations were compared according to the jinx rating of the 13 pediatricians. The secondary outcome was a comparison of the self-assessed jinxed pediatrician group with the other group.

Results

Four pediatricians rated themselves as jinxes. Despite a nonperfect match, self-assessed jinxed pediatricians were also more often rated as being jinxed by their peers or the nurses. There was no difference (for the 13 pediatricians) regarding total ED visits (31.6 [14–57], P = 0.98), ED visits after midnight (10.37 [1–26], P = 0.876), and the number of hospitalizations (4.5 [0–12], P = 0.179). The number of ED visits (total, medical, after midnight) did not differ from the jinxed physicians (all P >0.20) to the other pediatricians, but the mean number of hospitalizations was higher when the pediatrician was rated as a jinx (4.9 vs 4.3, P = 0.034).

Conclusions

We found no evidence of a jinx effect on workload in a pediatric ED.
Urinary Tract Infection and Antimicrobial Stewardship in the Emergency Department
Authors: Watson Joshua R. , Sánchez Pablo J. , Spencer John David , Cohen Daniel M. , Hains David S.
Published: February 2016

Objectives

The aims of this study were to assess empiric antibiotic use for presumed urinary tract infection (UTI) in the emergency department (ED) and to determine how often urine culture results subsequently do not confirm the diagnosis.

Methods

This study is a retrospective cohort study of patients aged 21 years or younger in the Nationwide Children's Hospital ED from May 1, 2012, to October 31, 2012, who had a urinalysis and urine culture performed and were discharged home with empiric antibiotic therapy for presumed UTI. Patients with known urinary tract anomaly or antibiotic use in the previous 7 days were excluded. Confirmed UTI was defined as pyuria (>5 white blood cells per high-power field or dipstick positive for leukocyte esterase) and a positive urine culture (≥50,000 colony-forming units/mL of a uropathogen).

Results

Of the 175 enrolled patients, urine was obtained by clean catch in 138 (79%), catheterization in 35 (20%), first-pass void in 1 (0.6%), and undocumented method in 1 (0.6%). Pyuria was demonstrated in 164 patients (94%), but only 97 (55%) had a positive urine culture. The combination of pyuria and a positive urine culture confirmed UTI in 90 patients (51%). The most commonly prescribed antibiotics were cefdinir in 103 patients (59%), trimethoprim/sulfamethoxazole in 40 (23%), and ciprofloxacin in 23 (13%). The median duration of prescribed therapy was 10 days (interquartile range, 7–10 days). Treatment duration was correlated negatively with age (r = −0.53, P < 0.01).

Conclusions

The current management of suspected UTI in ED patients results in unnecessary antibiotic exposure, highlighting an important opportunity for outpatient antimicrobial stewardship efforts.
Electronic Health Record Adoption and Rates of In-hospital Adverse Events
Authors: Furukawa Michael F. , Eldridge Noel , Wang Yun , Metersky Mark
Published: February 2016

Objective

Nationwide initiatives have focused on improving patient safety through greater use of health information technology. We examined the association of hospitals’ electronic health record (EHR) adoption and occurrence rates of adverse events among exposed patients.

Methods

We conducted a retrospective analysis of patient discharges using data from the 2012 and 2013 Medicare Patient Safety Monitoring System. The sample included patients age 18 and older that were hospitalized for one of 3 conditions: acute cardiovascular disease, pneumonia, or conditions requiring surgery. The main outcome measures were in-hospital adverse events, including hospital-acquired infections, adverse drug events (based on selected medications), general events, and postprocedural events. Adverse event rates and patient exposure to a fully electronic EHR were determined through chart abstraction.

Results

Among the 45,235 patients who were at risk for 347,281 adverse events in the study sample, the occurrence rate of adverse events was 2.3%, and 13.0% of patients were exposed to a fully electronic EHR. In multivariate modeling adjusted for patient and hospital characteristics, patient exposure to a fully electronic EHR was associated with 17% to 30% lower odds of any adverse event for cardiovascular (odds ratio [OR], 0.80; 95% confidence interval [CI], 0.72–0.90), pneumonia (OR, 0.70; CI, 0.62–0.80), and surgery (OR, 0.83; CI, 0.72–0.96) patients. The associations of EHR adoption and adverse events varied by event type and by medical condition.

Conclusions

Cardiovascular, pneumonia, and surgery patients exposed to a fully electronic EHR were less likely to experience in-hospital adverse events.
Market transaction characteristics and pricing effect of accounting valuation models
Authors: Hu Yiming , Tian Xinmin , Zhu Zhiyong
Published: February 2016

Purpose

– In capital market, share prices of listed companies generally respond to accounting information. In 1995, Ohlson proposed a share valuation model based on two accounting indicators: company residual income and book value of net asset. In 2000, Zhang introduced the thought of option pricing and developed a new accounting valuation model. The purpose of this paper is to investigate the valuation deviation and the influence of some market transaction characteristics on pricing models.

Design/methodology/approach

– The authors use listed companies from 1999 to 2013 as samples, and conduct comparative analysis with multiple regression.

Findings

– The main findings are: first, the accounting valuation model is applicable to the capital market as a whole, and its pricing effect increases as years go by; second, in the environment of out capital market, the maturity of investors is one of important factors that causes the information content of residual income less than that of profit per share and lower pricing effect of valuation models; third, when the price earning (PE) of listed companies reaches certain level, the overall explanation capacity of accounting valuation models will become lower as PE gets higher; fourth, as for companies with higher turnover rate and more active transaction, the pricing effect of accounting valuation model is obviously lower; fifth, the pricing effect of accounting valuation models in a bull market is lower than in a bear market.

Originality/value

– These findings establish connection between accounting valuation and market transaction characteristics providing an explorable orientation for the future development of accounting valuation theories and models.