bluuebunny/crossref_metadata_2025 huggingface dataset:
Risk Factors for Mortality and Morbidity in Elderly Patients Presenting with Digestive Surgical Emergencies
Authors: Hentati Hassen , Salloum Chady , Caillet Philippe , Lahat Eylon , Disabato Mara , Levesque Eric , Compagnon Philippe , Lim Chetana , Azoulay Daniel
Published: December 2017

Background

Emergency digestive surgery is being increasingly performed in elderly patients. The aim of the present study was to identify the predictors of mortality and morbidity following emergency digestive surgery in patients aged 80 years and older.

Methods

A single‐center retrospective review was performed of consecutive patients aged ≥65 years operated for a digestive surgical emergency between January 2011 and December 2013. Two groups were compared: group A (aged 65–79 years) and group B (aged ≥80 years).

Results

The study population included 185 patients: 76 patients in group A and 109 in group B. The mean age was 79.9 years (65–104 years). The overall 90‐day mortality rate was 23.2 and 31.9% at 1 year, which was similar between groups. The overall morbidity was 28.6%. No differences were noted between the two groups in overall, minor (Dindo I–II) or major (Dindo III–IV) morbidity rates. Multivariate analysis identified pulmonary disease (odds ratio, OR = 6.43, p = 0.02), bowel ischemia (OR = 11.41, p = 0.01), postoperative ICU stay (OR = 7.37, p < 0.0001) and the occurrence of postoperative complications (OR = 2.66, p = 0.03) as predictors of 90‐day mortality. Predictors of in‐hospital morbidity were preoperative hemoglobin <12 g/dL (OR = 2.49, p = 0.02) and postoperative intensive care unit (ICU) stay (OR = 6.69, p < 0.0001). An age ≥80 year was not associated with mortality or morbidity in this study.

Conclusions

The decision to perform abdominal surgery in the emergency setting should be based on physiological status, which accounts for a patient’s comorbidities and health status, rather than on chronological age per se.
Characteristics, Stratification and Time to Death in a Population‐Based Cohort of Patients with Ruptured Abdominal Aortic Aneurysms Not Undergoing Surgery
Authors: Vetrhus Morten , Reite Andreas , Vennesland Jørgen B. , Søreide Kjetil
Published: December 2017

Background

The available literature on ruptured abdominal aortic aneurysms (rAAA) centers on survival after operation and commonly, reasons why some patients do not undergo surgery are not addressed. The aim of the present study is to examine, in a population‐based cohort, the characteristics, stratification and time to death of patients admitted to hospital, but not undergoing operation for rAAA.

Methods

A retrospective, single‐center study. All patients admitted to Stavanger University Hospital from the primary catchment area with rAAA on admission or in‐hospital from 2000 to 2014 were included.

Results

Altogether 214 patients with rAAA were identified; 57 (27%) patients did not undergo surgery. The proportion of women was significantly higher (37 vs. 14%; p <. 001) in patients not having surgery. The reasons for not undergoing operation were patient ‘not fit for surgery’ (30%), ‘dying or agonal’ at time of diagnosis (26%), ‘did not want operation’ (21%) and ‘diagnosed at autopsy’ (23%). Of the non‐operated patients, 45 had rAAA on arrival to hospital, 12 had in‐hospital rupture and 21 patients had previously been diagnosed with an abdominal aortic aneurysm. Non‐operative treatment was uniformly fatal. The 45 patients with rAAA on arrival were scored using four scoring systems, the predicted mortality varied widely, and the median time from admission to death was 7.4 h (range 0–1337).

Conclusion

In about half of patients, a decision not to operate was made by the consultant vascular surgeon or the patient. In the subgroup of patients not diagnosed until autopsy or having an in‐hospital rupture, an earlier diagnosis might have altered the outcome.
Effect of impaired twitching motility and biofilm dispersion on performance of Pseudomonas aeruginosa-powered microbial fuel cells
Authors: Shreeram Devesh D , Panmanee Warunya , McDaniel Cameron T , Daniel Susan , Schaefer Dale W , Hassett Daniel J
Published: December 2017

Pseudomonas aeruginosa is a metabolically voracious bacterium that is easily manipulated genetically. We have previously shown that the organism is also highly electrogenic in microbial fuel cells (MFCs). Polarization studies were performed in MFCs with wild-type strain PAO1 and three mutant strains (pilT, bdlA and pilT bdlA). The pilT mutant was hyperpiliated, while the bdlA mutant was suppressed in biofilm dispersion chemotaxis. The double pilT bdlA mutant was expected to have properties of both mutations. Polarization data indicate that the pilT mutant showed 5.0- and 3.2-fold increases in peak power compared to the wild type and the pilT bdlA mutant, respectively. The performance of the bdlA mutant was surprisingly the lowest, while the pilT bdlA electrogenic performance fell between the pilT mutant and wild-type bacteria. Measurements of biofilm thickness and bacterial viability showed equal viability among the different strains. The thickness of the bdlA mutant, however, was twice that of wild-type strain PAO1. This observation implicates the presence of dead or dormant bacteria in the bdlA mutant MFCs, which increases biofilm internal resistance as confirmed by electrochemical measurements.
Synthetic biology, genome mining, and combinatorial biosynthesis of NRPS-derived antibiotics: a perspective
Authors: Baltz Richard H
Published: December 2017

Combinatorial biosynthesis of novel secondary metabolites derived from nonribosomal peptide synthetases (NRPSs) has been in slow development for about a quarter of a century. Progress has been hampered by the complexity of the giant multimodular multienzymes. More recently, advances have been made on understanding the chemical and structural biology of these complex megaenzymes, and on learning the design rules for engineering functional hybrid enzymes. In this perspective, I address what has been learned about successful engineering of complex lipopeptides related to daptomycin, and discuss how synthetic biology and microbial genome mining can converge to broaden the scope and enhance the speed and robustness of combinatorial biosynthesis of NRPS-derived natural products for drug discovery.
Conservation of the Mekong Delta wetlands through hydrological management
Authors: Quan Nguyen Hong , Toan To Quang , Dang Phan Doan , Phuong Nguyen Luu , Anh Tran Thi Hoang , Quang Ngo Xuan , Quoc Dao Phu , Quoi Le Phat , Hanington Peter , Sea William B.
Published: December 2017

The Vietnamese Mekong Delta (VMD) comprises extensive river and canal networks, both natural and man‐made, and has a history of extensive land use change and development. The delta's wetlands are under considerable ecological stress because of hydrological changes, agricultural and aquaculture development, urban and industrial pollution, climate change, and upstream water resource development. In this paper, we review the current threats and challenges to the conservation and management of the wetlands in the VMD. We recommend that the current water management practices of the Ramsar‐listed Lang Sen Wetland Reserve are changed so that the natural flood regimes are reinstated and the risks to the community from forest fires are managed. Ongoing investment is needed to support further research, set up long‐term monitoring, and to develop hydrodynamic models for the Lang Sen Wetland Reserve so that management and conservation efforts can achieve the specific objectives for the wetland. This approach may be useful for managing other wetlands across the VMD.
A Study on the Nonmetallic Inclusion Motions in a Swirling Flow Submerged Entry Nozzle in a New Cylindrical Tundish Design
Authors: Ni Peiyuan , Ersson Mikael , Jonsson Lage Tord Ingemar , Jönsson Pär Göran
Published: December 2017

Different sizes and shapes of nonmetallic inclusions in a swirling flow submerged entry nozzle (SEN) placed in a new tundish design were investigated by using a Lagrangian particle tracking scheme. The results show that inclusions in the current cylindrical tundish have difficulties remaining in the top tundish region, since a strong rotational steel flow exists in this region. This high rotational flow of 0.7 m/s provides the required momentum for the formation of a strong swirling flow inside the SEN. The results show that inclusions larger than 40 µm were found to deposit to a smaller extent on the SEN wall compared to smaller inclusions. The reason is that these large inclusions have Separation number values larger than 1. Thus, the swirling flow causes these large size inclusions to move toward the SEN center. For the nonspherical inclusions, large size inclusions were found to be deposited on the SEN wall to a larger extent, compared to spherical inclusions. More specifically, the difference of the deposited inclusion number is around 27 pct. Overall, it was found that the swirling flow contains three regions, namely, the isotropic core region, the anisotropic turbulence region and the near-wall region. Therefore, anisotropic turbulent fluctuations should be taken into account when the inclusion motion was tracked in this complex flow. In addition, many inclusions were found to deposit at the SEN inlet region. The plotted velocity distribution shows that the inlet flow is very chaotic. A high turbulent kinetic energy value of around 0.08 m2/s2 exists in this region, and a recirculating flow was also found here. These flow characteristics are harmful since they increase the inclusion transport toward the wall. Therefore, a new design of the SEN inlet should be developed in the future, with the aim to modify the inlet flow so that the inclusion deposition is reduced.
Radio Londra 1943-1945: Italian society at the microphones of the BBC
Authors: Lo Biundo Ester
Published: December 2017

Propaganda from the BBC directed at Italy during the Second World War played a dual role. The ‘Radio Londra’ programmes, on the one hand a propaganda tool of the British government and on the other moral support to many Italians, are part of the cultural heritage of the war. This article explores what topics and types of programme were broadcast during the period of the Allied occupation of Italy (1943–1945) in order to engage the support of different social categories, including ordinary men and women, soldiers, factory workers, former Fascists, and intellectuals. The first part analyses some of the programmes in order to determine their propaganda strategies, while the second part focuses on the letters sent by listeners in Italy to the BBC broadcaster Colonel Stevens. It will be seen how both the use of cultural stereotypes and the attention to the detail of daily life for Italian civilians contributed to the success of the programmes.
Extension of temperature anisotropy Weibel instability to non-Maxwellian plasmas by 2D PIC simulation
Authors: Ghorbanalilu Mohammad , Abdollahazadeh Elahe
Published: December 2017

The Weibel instability driven by temperature anisotropy is investigated in a two-dimensional (2D) particle-in-cell simulation in non-extensive statistics in the relativistic regime. In order to begin the simulation, we introduced a new 2D anisotropic distribution function in the context of non-extensive statistics. The heavy ions considered to be immobile and form the neutralizing background. The numerical results show that non-extensive parameterqplays an important role on the magnetic field saturation time, the time of reduction temperature anisotropy, evolution time to the quasi-stationary state, and the peak energy density of magnetic field. We observe that the instability saturation time increases by increasing the non-extensive parameterq. It is shown that structures with superthermal electrons (q< 1) could generate strong magnetic fields during plasma thermalization. The simulation results agree with the previous simulations for an anisotropic Maxwellian plasma (q= 1).
Extreme ultraviolet holography using a laser-plasma source based on xenon/helium gas puff target
Authors: Wachulak P. , Sarzyński A. , Bartnik A. , Fok T. , Fiedorowicz H.
Published: December 2017

In this paper, we present the application of partially spatially coherent extreme ultraviolet (EUV) radiation from xenon plasma from a laser-plasma source, based on a double stream gas puff target, in coherent imaging. The radiation at the wavelength of 13.5 ± 0.5 nm was employed to record Gabor-type holograms. An iterative algorithm, based on a phase retrieval technique, was developed and used to remove the twin image from the reconstructed EUV image of test objects. Using partially coherent radiation from a compact, laser-plasma source based on a double stream gas puff target, which is intrinsically incoherent, a Gabor EUV holography was successfully demonstrated.
Landmark lecture in nursing: a life-cycle perspective on CHD: What happens beyond your clinic?
Authors: Moons Philip
Published: December 2017

Over the past decades, survival of patients with CHD improved significantly, making it a life-cycle disease. Hence, there is a need for a workforce that can take up the care for afflicted individuals in the different phases of the life spectrum. Each life phase is associated with specific challenges. Topics that should receive more attention in clinical care or in CHD research are parenting styles of parents of children, transfer and transition of adolescents, cumulative burden of injury in the brain in adults, and geriatric care for older persons with CHD. Nurses, along with other healthcare professionals, will play a pivotal role in building up expertise in these areas and taking up these challenges.
The 2017 Seventh World Congress of Pediatric Cardiology & Cardiac Surgery: week in review – ambulatory pediatric cardiology
Authors: Chowdhury Devyani
Published: December 2017

The Seventh World Congress of Pediatric Cardiology was held in Barcelona in July, 2017. The central philosophy of the congress was “bridging together” all major specialties in the field. This article summarises the highlights of the meeting as it relates to ambulatory paediatric cardiology. There is a now a more unified approach to children with CHD, including assessment of neuro-developmental outcomes. The new World Heart Foundation criteria for the diagnosis of rheumatic fever remain controversial.
The 2017 Seventh World Congress of Pediatric Cardiology & Cardiac Surgery: week in review: congenital cardiac anaesthesia
Authors: Twite Mark , Miller-Hance Wanda
Published: December 2017

The seventh meeting of the World Congress of Pediatric Cardiology and Cardiac Surgery was an opportunity for healthcare professionals from around the world to meet and discuss current issues affecting patients with acquired and CHD. A dedicated anaesthesia track facilitated the exchange of ideas and fostered many new friendships. This review highlights the congenital cardiac anaesthesia track and the involvement of the Congenital Cardiac Anesthesia Society in the congress.
The 2017 Seventh World Congress of Pediatric Cardiology & Cardiac Surgery: week in review – adults with CHD
Authors: Roos-Hesselink Jolien W. , Tobler Daniel , Warnes Carole
Published: December 2017

For the first time in 2017 adults with CHD was included in the World Congress of Pediatric Cardiology & Cardiac Surgery. With growing numbers and more complex patients reaching adulthood, there is a growing need for more attention to this subspecialty. Although survival is excellent and now over 90% of patients reach adulthood, many have residual problems and complications. Heart failure and arrhythmias are most commonly encountered. Life-expectancy is nearly normal for mild lesions, but remains reduced in moderate-complex lesions and re-interventions are often needed. As most patients want to live a normal life, sports participation and pregnancy become very important issues. Finally, although innovative treatments are being developed, including for end-stage heart failure, we have to refine strategies for optimal care, including during the end-stage lives of our patients. This article provides an overview of a selection of topics in the field of adults with CHD presented during the 2017 Seventh World Congress of Pediatric Cardiology & Cardiac Surgery (WCPCCS) in Barcelona.
Key events in the history of cardiac surgery and paediatric cardiology
Authors: Karl Tom R. , Martin Gerard R. , Jacobs Jeffrey P. , Wernovsky Gil
Published: December 2017

In this report, the authors prepared an opinion poll regarding the most important people, events, technologies, concepts, discoveries, and therapies in paediatric cardiology and cardiac surgery. The results were presented in continuous slide show format at the 2017 Seventh World Congress of Pediatric Cardiology & Cardiac Surgery (WCPCCS 2017), Barcelona, Spain. The presentation (under international copyright) is made available herein for educational purposes.
Medical Emergencies Related to Ethanol and Illicit Drugs at an Annual, Nocturnal, Indoor, Electronic Dance Music Event
Authors: Calle Paul , Sundahl Nora , Maudens Kristof , Wille Sarah MR , Van Sassenbroeck Diederik , De Graeve Koen , Gogaert Stefan , De Paepe Peter , Devriese Dieter , Arno Geert , Blanckaert Peter
Published: December 2017

Introduction

Medical problems are frequently encountered during electronic dance music (EDM) events.

Problem

There are uncertainties about the frequencies and severity of intoxications with different types of recreational drugs: ethanol, “classical” illicit party drugs, and new psychoactive substances (NPS).

Methods

Statistical data on the medical problems encountered during two editions of an indoor electronic dance event with around 30,000 attendants were retrieved from the Belgian Red Cross (Mechelen, Belgium) database. Data on drug use were prospectively collected from the patient (or a bystander), the clinical presentation, and/or toxicological screening.

Results

In the on-site medical station, 487 patients were treated (265 in 2013 and 222 in 2014). The most frequent reasons were trauma (n=171), headache (n=36), gastro-intestinal problems (n=44), and intoxication (n=160). Sixty-nine patients were transferred to a hospital, including 53 with severe drug-related symptoms. Analysis of blood samples from 106 intoxicated patients detected ethanol in 91.5%, 3,4-methylenedioxymethamphetamine (MDMA) in 34.0%, cannabis in 30.2%, cocaine in 7.5%, amphetamine in 2.8%, and gamma-hydroxybutyric acid (GHB) in 0.9% of patients (alone or in combination). In only six of the MDMA-positive cases, MDMA was the sole substance found. In 2014, the neuroleptic drug clozapine was found in three cases and ketamine in one. Additional analyses for NPS were performed in 20 cases. Only in one agitated patient, the psychedelic phenethylamines 25B-NBOMe and 25C-NBOMe were found.

Conclusions

At this particular event, recreational drug abuse necessitated on-site medical treatment in one out of 350 attendants and a hospital transfer in one out of 1,000. Ethanol remains the most frequently abused (legal) drug, yet classical illicit recreational drugs are also frequently (co-) ingested. The most worrying observation was high-risk poly-drug use, especially among MDMA users. Regarding NPS, the number of cases was low and the clinical presentations were rather mild. It should be stressed that these observations only apply to this particular event and cannot be generalized to other EDM events.

CalleP, SundahlN, MaudensK, WilleSMR, Van SassenbroeckD, De GraeveK, GogaertS, De PaepeP, DevrieseD, ArnoG, BlanckaertP. Medical emergencies related to ethanol and illicit drugs at an annual, nocturnal, indoor, electronic dance music event. Prehosp Disaster Med. 2018;33(1):71–76.
Lexical and semantic connections in number words translation
Authors: HERRERA AMPARO
Published: December 2017

The present study investigated the influence of lexical links and conceptual mediation in number word translation. In four experiments, a semantic blocking paradigm was used with numerical stimuli and stimuli from other non-number categories. The performance of Spanish L1–English L2 bilinguals was examined in backward and forward translation (Experiment 1 and 3), in naming Arabic digits and pictures (Experiment 2A) and in reading L1 and L2 words (Experiment 2B). The blocked context produced a facilitatory effect for numerical stimuli in the lower range. This result contrasts with the interference effect observed for stimuli from non-number categories in translation and naming tasks. These results are interpreted to mean that the translation of number words, particularly those in the lower range of the numeric sequence, takes place with a large influence of the lexical connections. It supports the suggestions that the influence of processing routes depends on the type of items.
Family care conferences in long-term care: Exploring content and processes in end-of-life communication
Authors: Durepos Pamela , Kaasalainen Sharon , Sussman Tamara , Parker Deborah , Brazil Kevin , Mintzberg Susan , Te Alyssa
Published: December 2017

Objective:

End-of-life (EoL) communication in long-term care (LTC) homes is often inadequate and delayed, leaving residents dying with unknown preferences or goals of care. Poor communication with staff contributes to families feeling unprepared, distressed, and dissatisfied with care. Family care conferences (FCCs) aim to increase structured systematic communication around goals and plans for the end of life. As part of the Strengthening a Palliative Approach to Care (SPA–LTC) project, FCCs were implemented in four LTC sites in Ontario, Canada. The purpose of this substudy was to examine FCC content and such guiding processes as documentation and multidisciplinary staff participation.

Method:

A total of 24 FCCs were held for residents with a Palliative Performance Scale score of 40% (nearing death). Data were collected from conference forms (i.e., Family Questionnaires, Care Plan Conference Summaries), site-specific electronic chart documents, and fieldnotes. Directed content analysis of data was informed by the Canadian Hospice Palliative Care Association's Square of Care Model, which describes eight domains of care: disease management, physical, psychological, social, practical, spiritual, EoL, and loss/bereavement.

Results:

The FCCs addressed an average of 71% of the content domains, with physical and EoL care addressed most frequently and loss/bereavement addressed the least. Two goals and five interventions were documented and planned on average per FCC. Examination of the processes supporting EoL communication found: (1) advantages to using FCC forms versus electronic charts; and (2) high levels of multidisciplinary participation overall but limited participation of personal support workers (PSWs) and physicians.

Significance of Results:

Communication around the end of life in LTC can be supported through the use of FCCs. Description of content and FCC processes provides guidance to persons implementing FCCs. Recommendations for tailoring conferences to optimize communication include use of specific conference forms, increased bereavement discussion, and further engagement of PSWs and physicians.
A Rights Turn in Climate Change Litigation?
Authors: Peel Jacqueline , Osofsky Hari M.
Published: December 2017

In 2015, a Pakistani court in the case ofLeghariv.Federation of Pakistanmade history by accepting arguments that governmental failures to address climate change adequately violated petitioners’ rights. This case forms part of an emerging body of pending or decided climate change-related lawsuits that incorporate rights-based arguments in several countries, including the Netherlands, the Philippines, Austria, South Africa, and the United States (US). These decisions align with efforts to recognize the human rights dimensions of climate change, which received important endorsement in the Paris Agreement. The decisions also represent a significant milestone in climate change litigation. Although there have been hundreds of climate-based cases around the world over the past two decades – especially in the US – past and much of the ongoing litigation focuses primarily on statutory interpretation avenues. Previous efforts to bring human rights cases have also failed to achieve formal success. The new cases demonstrate an increasing trend for petitioners to employ rights claims in climate change lawsuits, as well as a growing receptivity of courts to this framing. This ‘rights turn’ could serve as a model or inspiration for rights-based litigation in other jurisdictions, especially those with similarly structured law and court access.
The Power of Water, Wind, and Solar (and Nothing Else)
Authors: Witman Sarah
Published: December 2017

Road map for improving climate calls for 100% clean, renewable energy by 2050.
Phenotypic memory in Bacillus subtilis links dormancy entry and exit by a spore quantity-quality tradeoff
Authors: Mutlu Alper , Trauth Stephanie , Ziesack Marika , Nagler Katja , Bergeest Jan-Philip , Rohr Karl , Becker Nils , Höfer Thomas , Bischofs Ilka B.
Published: December 2017

Some bacteria, such as Bacillus subtilis, withstand starvation by forming dormant spores that revive when nutrients become available. Although sporulation and spore revival jointly determine survival in fluctuating environments, the relationship between them has been unclear. Here we show that these two processes are linked by a phenotypic “memory” that arises from a carry-over of molecules from the vegetative cell into the spore. By imaging life histories of individual B. subtilis cells using fluorescent reporters, we demonstrate that sporulation timing controls nutrient-induced spore revival. Alanine dehydrogenase contributes to spore memory and controls alanine-induced outgrowth, thereby coupling a spore’s revival capacity to the gene expression and growth history of its progenitors. A theoretical analysis, and experiments with signaling mutants exhibiting altered sporulation timing, support the hypothesis that such an intrinsically generated memory leads to a tradeoff between spore quantity and spore quality, which could drive the emergence of complex microbial traits.
Human macrophages differentially produce specific resolvin or leukotriene signals that depend on bacterial pathogenicity
Authors: Werz Oliver , Gerstmeier Jana , Libreros Stephania , De la Rosa Xavier , Werner Markus , Norris Paul C. , Chiang Nan , Serhan Charles N.
Published: December 2017

Proinflammatory eicosanoids (prostaglandins and leukotrienes) and specialized pro-resolving mediators (SPM) are temporally regulated during infections. Here we show that human macrophage phenotypes biosynthesize unique lipid mediator signatures when exposed to pathogenic bacteria. E. coli and S. aureus each stimulate predominantly proinflammatory 5-lipoxygenase (LOX) and cyclooxygenase pathways (i.e., leukotriene B4 and prostaglandin E2) in M1 macrophages. These pathogens stimulate M2 macrophages to produce SPMs including resolvin D2 (RvD2), RvD5, and maresin-1. E. coli activates M2 macrophages to translocate 5-LOX and 15-LOX-1 to different subcellular locales in a Ca2+-dependent manner. Neither attenuated nor non-pathogenic E. coli mobilize Ca2+ or activate LOXs, rather these bacteria stimulate prostaglandin production. RvD5 is more potent than leukotriene B4 at enhancing macrophage phagocytosis. These results indicate that M1 and M2 macrophages respond to pathogenic bacteria differently, producing either leukotrienes or resolvins that further distinguish inflammatory or pro-resolving phenotypes.
Highly selective hydrosilylation of olefins and acetylenes by platinum(0) complexes bearing bulky N-heterocyclic carbene ligands
Authors: Żak P. , Bołt M. , Kubicki M. , Pietraszuk C.
Published: December 2017

Platinum(0) complexes bearing bulky N-heterocyclic carbene ligands, catalyse selective hydrosilylation of terminal olefins as well as terminal and internal acetylenes.
A comparison of the sensory and rheological properties of different cellulosic fibres for food
Authors: Agarwal Deepa , Hewson Louise , Foster Tim J.
Published: December 2017

The impact of cellulosic dietary fibres on taste perception & application of softwood cellulosic fibres with a unique network structure for food.
Assessing the consumption of berries and associated factors in the United States using the National Health and Nutrition Examination Survey (NHANES), 2007–2012
Authors: Burton-Freeman Britt M. , Guenther Patricia M. , Oh Miyoung , Stuart David , Jensen Helen H.
Published: December 2017

Intake of berries was assessed relative to other fruit and fruit juices and total fruit intake in the U.S. population age 2 years and older using the National Health and Nutrition Examination Survey, 2007–2012.
Tuning the sensitivity of lanthanide-activated NIR nanothermometers in the biological windows
Authors: Cortelletti P. , Skripka A. , Facciotti C. , Pedroni M. , Caputo G. , Pinna N. , Quintanilla M. , Benayas A. , Vetrone F. , Speghini A.
Published: December 2017

Lanthanide-activated SrF2 nanoparticles with a multishell architecture were investigated as optical thermometers in the biological windows.
Computational characterisation of dried and hydrated graphene oxide membranes
Authors: Williams C. D. , Carbone P. , Siperstein F. R.
Published: December 2017

A multi-step molecular dynamics procedure was developed to construct and characterise fully flexible atomistic models of graphene oxide (GO) membranes.
Enhanced green upconversion luminescence in tetrahedral LiYF4:Yb/Er nanoparticles by manganese(ii)-doping: the key role of the host lattice
Authors: Zhou Bin , Xu Bing , He Huimei , Gu Zhanjun , Tang Bing , Ma Ying , Zhai Tianyou
Published: December 2017

We highlight enhanced green upconversion luminescence in tetrahedral LiYF4:Yb/Er nanoparticles by manganese(ii)-doping and the key role of the host lattice.
Synthesis and mechanical exfoliation of imine-linked two-dimensional conjugated polymers
Authors: Liu Haining , Li Qing , Zhu Yiming , Zhang Mei , Liu Runjing , Li Xiaoming , Kang Xiao , Li Zheng , Qiao Shanlin
Published: December 2017

A conjugated 2D polymer PryDA was synthesized using a solvothermal approach and mechanically exfoliated into thin sheets of 3–40 nm.
Structure and thermoelectric properties of 2D Cr2Se3−3xS3x solid solutions
Authors: Zhang Tingting , Su Xianli , Yan Yonggao , Liu Wei , You Yonghui , Xie Hongyao , Yang Dongwang , Uher Ctirad , Tang Xinfeng
Published: December 2017

S substitution improves the ZT value of Cr2Se3−3xS3x which has a two-dimensional layered structure by 32%.
Architecting a nonlinear hybrid crystal–glass metamaterial fiber for all-optical photonic integration
Authors: Lai Chien-Chih , Lo Chia-Yao , Huang Jian-Zhi , Fan Chiang Chien-Chou , Nguyen Duc Huy , Chen Yu-Peng , Liao Chun-Da
Published: December 2017

A hybrid crystal–glass metamaterial fiber architecture foregrounds the prospect of intracavity and resonant SHG conversions for monolithically integrated photonic circuits.
Matching the Mode, the Time, and the Situation
Authors: McCarthy John W. , Hajjar David J.
Published: December 2017

In this article, we consider how musical and adapted sport experiences not only create multiple opportunities for communication, but also encapsulate different demands, purposes, and contexts for communication leading to a wide range of modalities possible to express messages and support social exchange.
Multimodal Behaviors in Autism Spectrum: Insights From Typical Development Inform AAC
Authors: Braddock Barbara A. , Hilton Jane , Loncke Filip
Published: December 2017

Individuals with Autism Spectrum Disorder (ASD) who have limited natural speech may communicate using unaided and/or aided augmentative and alternative communication (AAC) and may combine potentially communicative behaviors in multimodal ways. Unaided AAC refers to the use of an alternative and augmentative system of communication that does not require aids external to the communicator's body. Aided AAC relies on the use of aids external to the body, such as pictures or a speech-generating device (SGD). Potential communicative acts refer to any behavior that others interpret as meaningful, including informal (unconventional) behaviors, such as body or hand movement, as well as a few words or (conventional) symbols, such as pointing to pictures. Foundational skills, such as communicative gesture and joint attention, can inform multimodal AAC practices in young children with or at risk for ASD. A data tracker of motor hand, oral-motor/vocal/verbal behaviors, and AAC is provided based on past research in children with or at risk for ASD. The data tracker highlights behaviors ranging from informal to conventional communication forms that may be produced in multimodal ways.
Microcephaly with Simplified Gyral Pattern Associated with Partial Rhombencephalosynapsis: A Case Report
Authors: Mesquita Jamila , Lucas Junior Ademar
Published: December 2017

Congenital microcephaly with simplified gyral pattern has been well documented in the literature. It is characterized by a head circumference of less than two standard deviations for age associated with abnormal sulcation. In its mild presentation, this entity is usually described as an isolated anomaly. It presumably results from a brain insult associated with hypoxic–ischemic damage, intracranial infection, or metabolic disease. Rhombencephalosynapsis is a rare condition usually consisting of vermian agenesis or severe hypogenesis, fusion of the cerebellar hemispheres, and apposition or fusion of the dentate nuclei. There are several recent studies focusing on each one of those entities individually, but they do not show any correlation/association between the two of them. This is a case report of an 8-year-old child with neurodevelopmental delay who had episodes of seizures up to 3 years of age. An MRI scan showed marked craniofacial disproportion with dominance of the face over the skull, simplified gyral pattern associated with hypogenesis of the cerebellar vermis, and communication of the folia in the posterior segments of the cerebellar hemispheres. In this case report, we will briefly discuss cerebellar embryology and the process of cortical differentiation, as well as possible associations between rhombencephalosynapsis and other brain abnormalities.
Procalcitonin as Predictor of Bacterial Infection in Meconium Aspiration Syndrome
Authors: K. Mahendiran , Faridi M. , Singh N. , Batra Prerna
Published: December 2017

Background There is a lack of definite consensus on indications for initiating antibiotics in neonates with meconium aspiration syndrome (MAS), instigating researchers to search for a biomarker that can help differentiate MAS from MAS with bacterial infection.

Objective Our primary objective was to compare serum procalcitonin (PCT) levels in full-term vigorous neonates having MAS with or without bacterial infection.

Materials and Methods Seventy term vigorous neonates with diagnosis of MAS were enrolled. Blood samples were taken for sepsis screen, C-reactive protein (CRP), PCT, and blood culture at 6 ± 2 hours of respiratory distress. Neonates were categorized into group 1 (MAS without bacterial infection) and group 2 (MAS with bacterial infection) based on blood culture. The duration of our study was 18 months.

Results Mean ± standard deviation PCT level was 2.52 ± 3.99 in group 1 and 2.71 ± 4.22 in group 2, which was comparable. At cutoff of 0.1 ng/mL, PCT had a sensitivity of 90% and specificity of 8% in detecting bacterial infection. Mean total leukocyte count, absolute neutrophil count, immature to total leucocyte ratio, microerythrocyte sedimentation rate, and CRP were comparable.

Conclusion Though PCT is an early and reliable marker of neonatal infection, the levels were increased in neonates with MAS irrespective of the presence of bacterial infection.
Polyhydramnios Affecting a Recipient-like Twin: Risk of Progression to Twin–Twin Transfusion Syndrome and Outcomes
Authors: Sparks Teresa , Gosnell Kristen , Rand Larry , Gonzalez Juan , Feldstein Vickie , Washburn Erin
Published: December 2017

Objective The significance of polyhydramnios of one twin in the absence of oligohydramnios of the cotwin in monochorionic diamniotic (MCDA) twin pregnancies (polyhydramnios affecting a recipient-like twin [PART]) is unknown. Our aim is to assess the risk of progression to twin–twin transfusion syndrome (TTTS) with PART, progression to ≥ stage II TTTS, and neonatal survival.

Study Design This study was a retrospective cohort study of MCDA twin pregnancies with PART evaluated at a referral center from 2008 to 2015.

Results Sixty-four MCDA twin pregnancies with PART were identified. Fifteen (23.4%) progressed to TTTS, including 10 (15.6%) who progressed to ≥ stage II TTTS. Three pregnancies were terminated and one underwent selective reduction by radiofrequency ablation. Overall survival was 113 out of 128 (88.3%). Of those who remained stable, 91.8% (N = 45) had survival of both neonates. In multivariate analysis, the presence of arterioarterial (A-A) anastomosis by in utero Doppler ultrasound was associated with decreased risk of progression to TTTS (odds ratio: 0.12, p = 0.03, 95% confidence interval: 0.02–0.78).

Conclusion Most MCDA twin pregnancies with PART do not progress to TTTS and have a favorable prognosis. Progression rates are higher than observed in uncomplicated MCDA twins; however, so close surveillance is warranted. The presence of an A-A anastomosis appears to confer decreased risk of progression to TTTS.
A Systematic Review on the Use of Aspirin in the Prevention of Deep Vein Thrombosis in Major Elective Lower Limb Orthopedic Surgery: An Update from the Past 3 Years
Authors: Mistry Dylan , Chandratreya Amit , Lee Paul
Published: December 2017

Introduction Currently there are no consensuses in the national guidance on thromboprophylaxis following major elective lower limb surgery. Emerging clinical evidence suggests that aspirin could be just as effective as anticoagulants with a lower cost. The aim of this study was to provide an update based on literature of the past 3 years for the use of aspirin as thromboprophylaxis after knee and hip arthroplasty.

Materials and Methods MEDLINE/EMBASE search was performed with appropriate terms for original articles from 2014 to 2017.

Results Eight articles were found. Five articles concluded that aspirin was an effective prophylactic. The collation of results on the deep vein thrombosis rate involved 43,012 patients who were prescribed aspirin, of which 283 (0.66%) suffered from symptomatic deep vein thromboses. Aspirin was noted for its good side effect profile and cost effectiveness. It was noted that anticoagulants had a higher rate of complications, including bleeding and wound-oozing.

Conclusion Aspirin is an effective and safe prophylactic against deep vein thrombosis following major elective lower limb arthroplasty surgery.
Accuracy of Ultrasound Estimated Fetal Weight in Small for Gestational Age and Appropriate for Gestational Age Grown Periviable Neonates
Authors: Himes Katherine , Haragan Adriane
Published: December 2017

Objective Clinicians use estimated fetal weight (EFW) as a proxy for birth weight (BW) in the antenatal period. Our objective was to compare the accuracy of EFW obtained by ultrasound to BW among infants born during the periviable period and determine if accuracy of EFW varied among small for gestational age (SGA) versus appropriate for gestational age (AGA) grown neonates.

Study Design We included women who delivered between 230/7 and 256/7 weeks' gestation and had an EFW within 7 days of delivery. Mean percentage difference and median absolute percentage difference between EFW and BW were calculated.

Results Our cohort included 226 neonates with a mean gestational age of 241/7 ± 0.8 weeks and median BW of 653 g (interquartile range [IQR]: 580–750 g). The median absolute percentage difference between EFW and BW of fetal weight estimates was 9.2% (IQR: 3.6–17.2). EFW overestimated BW for 75% (n = 171) of the cohort. Among SGA infants, the mean percentage difference in EFW and BW was 16.2 ± 19.4% versus 6.9% ± 13.1% in AGA infants (p = 0.019).

Conclusion EFW overestimated BW in this cohort. In addition, ultrasound was less accurate among infants born SGA. These data are important to consider when counseling families facing periviable delivery.
Epidurals and the Modern Labor Curve: How Epidural Timing Impacts Fetal Station during Active Labor
Authors: Tuuli Methodius , Stout Molly , Woolfolk Candice , Roehl Kimberly , Macones George , Cahill Alison , Lewkowitz Adam
Published: December 2017

Objective The objective of this study was to estimate epidural timing's impact on fetal station during active labor.

Study Design This secondary analysis of a single-institution prospective cohort study included all term singleton pregnancies, stratified by parity. Those with early epidurals (placed at <6 cm) were compared with those with late epidurals (placed at ≥6 cm). The primary outcome was median fetal station from 6 to 10 cm. Secondary outcomes included rate of prolonged first or second stage of labor (>95%). Multivariable logistic regression adjusted for labor type.

Results Among 7,647 women, 3,434 were nulliparous (2,983 with early epidurals and 451 with late epidurals) and 4,213 multiparous (3,141 with early epidurals and 1,072 with late epidurals). Interquartile ranges (IQRs) suggested fetal station at 6 cm was likely lower among those with early epidurals (nulliparous: median head station −1 [IQR: −1 to 0] for early epidural vs. −1 [IQR: −2 to 0] for late epidural, p < 0.01; multiparous: −1 (IQR: −2 to 0] for early epidural vs. −1 [IQR: −3 to −1] for late epidural, p < 0.01). Early epidurals were not associated with increased risk of prolonged first stage, but among nulliparous were associated with decreased risk of prolonged second stage (adjusted odds ratio: 0.66 [95% confidence interval: 0.44–0.99]).

Conclusion Early epidurals were associated with lower fetal station in active labor but not prolonged first stage.
Digitale Gesundheitsanwendungen – Rahmenbedingungen zur Nutzung in Versorgung, Strukturentwicklung und Wissenschaft – Positionspapier der AG Digital Health des DNVF
Authors: Vollmar Horst , Kramer Ursula , Müller Hardy , Griemmert Maria , Noelle Guido , Schrappe Matthias
Published: December 2017

Der Begriff Digital Health (digitale Gesundheitsanwendungen) ist zurzeit der umfassendste und schließt alle Informations- und Kommunikationstechnologien aus dem Gesundheitsbereich mit ein, inkl. E-Health, Mobile Health, Telemedizin, Big Data, Gesundheits-Apps und anderen. Digital Health kann als ein Paradebeispiel für den Einsatz des Konzeptes und der Methodik der Versorgungsforschung gelten, wo es um das Zusammenspiel von komplexen Interventionen und komplexem Kontext geht. Das Positionspapier betrachtet 1) Digital Health als Gegenstand der Versorgungsforschung und 2) Digital Health als methodische und wissenschaftsethische Herausforderung für die Versorgungsforschung. Der häufig postulierte Nutzen, der von Digital Health-Interventionen erwartet wird, sollte durch gute Studien nachweisbar sein. Erste systematische Evaluationen von Apps zur „Behandlungsunterstützung“ liefern teilweise Ergebnisse, die eher auf einen Schaden, denn auf einen Nutzen hinweisen. Die Forderung eines Nachweises von Nutzen bzw. Risiken gilt erst recht für Big Data-gestützte Interventionen, die Entscheidungsprozesse im Behandlungsablauf unter Zuhilfenahme von Künstlicher Intelligenz unterstützen. Natürlich ist es aus Sicht der Versorgungsforschung anstrebenswert, möglichst an dem durch Digital Health verfügbaren Datenzugang zu partizipieren und „Big Data“ zu nutzen. Es besteht allerdings die Gefahr, dass es durch eine unkritische Anwendung von Digital Health und Big Data zu einer Rückkehr zum linearen, naturwissenschaftlich-biomedizinischen Forschungsverständnis kommt, der bestenfalls komplizierte Verhältnisse unter der Annahme multivariater Modelle akzeptiert und komplexe Sachverhalte nicht zur Kenntnis nimmt. Es geht für die Versorgungsforschung nicht nur darum, wissenschaftsethischen Anforderungen zu genügen, indem statt unnötiger Forschung („reducing waste“) bessere Forschung gemacht wird, sondern vor allem darum, die gesellschaftlichen Konsequenzen (Systemebene) der wissenschaftlichen Analyse und Evaluation zu antizipieren. Dies birgt für die Versorgungsforschung die anspruchsvolle, gleichseitig aber attraktive Option, sich über die Kompetenz, eine solche Diskussion zu initiieren und zu führen, als reifes und verantwortungsvolles Wissenschaftsgebiet zu präsentieren.
Zum Jahreswechsel 2017/2018
Authors: Giunta Riccardo
Published: December 2017

Liebe Leserinnen und Leser,

zum Abschluss des Jahres haben wir wieder mal ein ausgesprochen spannendes und abwechslungsreiches Heft zum Thema Plastische Chirurgie
zusammengestellt: In diesem Jahr haben wir nach Herrn Prof. Hanno Millesi im August auch eine weitere Pionierin der Plastischen Chirurgie mit
Frau Prof. Ursula Schmidt-Tintemann aus München Vaterstetten verloren. Wir haben diesmal einen Nachruf aus unterschiedlichen Perspektiven
verfasst, um ihrer Bedeutung für die Plastische Chirurgie in Deutschland gerecht zu werden und dies für die nachfolgenden Generationen
festzuhalten.
Investigation of multi-cone geometry imaging with laser lights
Authors: Shi J. , Bitter M. , Hill K. W. , Gao L. , Ma J. , Xiao S.
Published: December 2017

A new x-ray imaging crystal spectrometer is developed for time-resolved measurements of x-ray line spectra. One of the main advantages is that it produces perfect images of a point source for each wavelength in a selectable spectral range. The other advantage is that the detector plane can have an arbitrary orientation with respect to the crystal surface. These unique imaging properties are obtained by bending the crystal into a certain shape, which is generated by arranging multiple cones from different aperture angles on a common nodal line. The test results were presented from optical tests of the multi-cone and single-cone structures. The numerical results on the deteriorations of the spectral and spatial resolutions are obtained due to the potential misalignments of the source. The concept of the configuration is considered to be particularly useful for high-power laser experiments where the size of the source is small and a wide spectral range would be diagnosed.