bluuebunny/crossref_metadata_2025 huggingface dataset:
Real‐Time Monitoring of Phosphorylation Kinetics with Self‐Assembled Nano‐oscillators
Authors: Fang Yimin , Chen Shan , Wang Wei , Shan Xiaonan , Tao Nongjian
Published: January 2015

Phosphorylation is a post‐translational modification that is involved in many basic cellular processes and diseases, but is difficult to detect in real time with existing technologies. A label‐free detection of phosphorylation is reported in real time with self‐assembled nano‐oscillators. Each nano‐oscillator consists of a gold nanoparticle tethered to a gold surface with a molecular linker. When the nanoparticle is charged, the nano‐oscillator can be driven into oscillation with an electric field and detected with a plasmonic imaging approach. The nano‐oscillators measure charge change associated with phosphorylation of peptides attached onto a single nanoparticle, allowing us to study the dynamic process of phosphorylation in real time without antibodies down to a few molecules, from which Michaelis and catalytic rate constants are determined.
Fabrication of amphiphilic copolymeric gels with enhanced activity of immobilized enzymes in organic media
Authors: Sato Ryuichi , Sato Ayumi , Tokuyama Hideaki
Published: January 2015

Novel amphiphilic copolymeric gels were developed to immobilize lipase. NIPA‐co‐PEGMEA gels were prepared by copolymerizing N‐isopropylacrylamide (NIPA) as a thermosensitive and amphiphilic component and poly(ethylene glycol) methyl ether acrylate (PEGMEA) as a hydrophilic component in aqueous media. The gels can absorb organic solvents at temperatures higher than the lower critical solution temperature owing to the thermosensitive and amphiphilic properties of poly(NIPA). The lipase immobilized within the NIPA‐co‐PEGMEA gel, which had a NIPA : PEGMEA composition of 950 : 50 mol/m3, successfully catalyzed the esterification of oleic acid and ethanol without loss of activity during repeated use within 20–40°C. The activity of the immobilized lipase was considerably higher than that of free lipase. The NIPA‐co‐PEGMEA gels provide a structure that allows the immobilized lipase to work actively in an aqueous environment and with the dispersed state of the lipase in the gels. © 2015 Wiley Periodicals, Inc. J. Appl. Polym. Sci. 2015, 132, 41905.
Impact of pre‐ and post‐procedural anemia on the incidence of acute kidney injury and 1‐year mortality in patients undergoing transcatheter aortic valve implantation (from the French Aortic National CoreValve and Edwards 2 [FRANCE 2] Registry)
Authors: Arai Takahide , Morice Marie‐Claude , O'Connor Stephen A. , Yamamoto Masanori , Eltchaninoff Hélène , Leguerrier Alain , Leprince Pascal , Laskar Marc , Iung Bernard , Fajadet Jean , Prat Alain , Lièvre Michel , Donzeau‐Gouge Patrick , Chevreul Karine , Teiger Emmanuel , Lefèvre Thierry , Gilard Martine ,   on behalf of FRANCE 2 Registry Investigators
Published: January 2015

Objectives

The relationship between anemia, renal insufficiency, and the outcomes of TAVI patients has not been thoroughly studied. We aimed to evaluate the influence of pre‐ and post‐procedural anemia on the incidence of renal insufficiency, especially AKI, and on the outcomes of TAVI.

Methods

Data from the French national TAVI registry were collected in 3,472 patients who underwent TAVI between January 2010 and December 2012. Of these 2,137 were in the no/mild anemia group, 748 were in the moderate anemia group, and 587 were in the severe anemia group before TAVI. Furthermore, we divided the 3,472 patients into three groups according to post‐procedural anemia, measured as post‐procedural hemoglobin (Hb) drop: <2 g/dl (n = 1,633, group 1), 2 to <4 g/dl (n = 1,458, group 2), and >4 g/dl (n = 381, group 3). Procedure and outcome variables were compared.

Results

Increased severity of anemia before TAVI was associated with significantly different rates of 1‐year mortality (15%, 19%, and 24%, P < 0.01), with similar differences in the incidence of AKI (5%, 8%, and 10%, P < 0.01). Increased severity of Hb drop was associated with significantly different rates of 1‐year mortality (16%, 18%, and 23%, P < 0.01), and with similar differences in the incidence of AKI (6%, 7%, and 10%, P = 0.04). Both pre‐ and post‐procedural anemia were predictors of the incidence of AKI (OR 1.82, P < 0.01; OR 1.82, P < 0.01, respectively) and 1‐year mortality (HR 1.44, P < 0.01; HR 1.50, P < 0.01, respectively).

Conclusions

Both pre‐ and post‐procedural anemia were significantly associated AKI and 1‐year mortality. © 2015 Wiley Periodicals, Inc.
Das didaktische Potential der Rastertunnelmikroskopie in der Hochschullehre
Authors: Penner Simon , Möst Thomas , Scheier Paul , Kaleve Antonia
Published: January 2015

Dem Rastertunnelmikroskop kommt in der Hochschulausbildung eine immer größere Bedeutung zu, erlaubt es doch einen relativ einfachen Zugang nicht nur zur Sichtbarmachung der atomaren und elektronischen Struktur von Festkörpern, sondern auch zu verwandten, meist schwer fasslichen physikalisch‐chemischen Themen und Phänomenen. Dazu gehört auch der quantenmechanische Tunneleffekt, welcher der Messmethode zugrunde liegt. Didaktisch wertvoll, erlaubt die neue Generation der eigens für den Unterricht konzipierten Rastertunnelmikroskope eine einfache Bedienung und Datenanalyse durch Studierende selbst. Im vorliegenden Manuskript werden die Möglichkeiten des Einsatzes solcher Mikroskope in der universitären Lehre kritisch beleuchtet und durch einen Ausblick auf den Schulunterricht ergänzt.
Adaptive plasticity and epigenetic variation in response to warming in an Alpine plant
Authors: Nicotra Adrienne B. , Segal Deborah L. , Hoyle Gemma L. , Schrey Aaron W. , Verhoeven Koen J. F. , Richards Christina L.
Published: January 2015

Environmentally induced phenotypic plasticity may be a critical component of response to changing environments. We examined local differentiation and adaptive phenotypic plasticity in response to elevated temperature in half‐sib lines collected across an elevation gradient for the alpine herb, Wahlenbergia ceracea. Using Amplified Fragment Length Polymorphism (AFLP), we found low but significant genetic differentiation between low‐ and high‐elevation seedlings, and seedlings originating from low elevations grew faster and showed stronger temperature responses (more plasticity) than those from medium and high elevations. Furthermore, plasticity was more often adaptive for plants of low‐elevation origin and maladaptive for plants of high elevation. With methylation sensitive‐AFLP (MS‐AFLP), we revealed an increase in epigenetic variation in response to temperature in low‐elevation seedlings. Although we did not find significant direct correlations between MS‐AFLP loci and phenotypes, our results demonstrate that adaptive plasticity in temperature response to warming varies over fine spatial scales and suggest the involvement of epigenetic mechanisms in this response.
Selection of CO2 sorbent used in bio‐oil steam reforming process for hydrogen production
Authors: Xie Huaqing , Yu Qingbo , Duan Wenjun , Yao Xin , Li Xinhui , Qin Qin
Published: January 2015

Through thermodynamic analysis, the CO2 sorbent(s) used in the steam reforming process of ethanol as the model compounds of bio‐oil was selected from nine common metal oxides. Among them, calcium oxide shows the best CO2 adsorption capacity in the condition of the co‐existence of CO2 and H2O in the temperature zone (600–1100 K) where ethanol steam reforming can obtain a higher hydrogen yield, and its carbonate (CaCO3) can easily decompose at slightly higher temperature. Compared to the ethanol steam reforming process with the addition of no any sorbent, the hydrogen yield and purity in the process with CaO as a sorbent were obviously improved, and the temperature range of more than 90% hydrogen yield is widened from 860–1010 K to 705–1085 K. Before the sorbent addition, the maximum hydrogen concentration appear at over 750 K, yet just around 74%, but the hydrogen concentration can overtake 90% in the range of 590–935 K after the addition of CaO. With thermogravimetric analysis, CaO from calcinated calcium acetate shows the highest CO2 adsorption capacity and the best cycle stability, as compared to the other two kinds of CaO, with analytical pure and from calcinated calcium hydroxide. © 2014 American Institute of Chemical Engineers Environ Prog, 34: 1208–1214, 2015
An unusual presentation of a rare benign tumor in the head and neck: A review of hibernomas
Authors: Trujillo Oscar , Cui Isabelle H. , Malone Melanie , Suurna Maria
Published: January 2015

Hibernomas are rare benign tumors that may present in the head and neck in an unusual manner similar to more common malignant tumors such as lymphoma. Our case report describes several characteristics of a patient and benign tumor presentation that is atypical for the usual presentation of hibernomas as reviewed in the literature. Although hibernomas are rare, our report and review of the literature highlights a particular patient population and important key findings that should make one consider these benign tumors in the differential diagnosis of a young patient presenting with a neck mass.

Laryngoscope, 125:1656–1659, 2015
Improve remediation to help students earn credentials
Authors: Palmer Sandra
Published: January 2015

Many students start college needing developmental courses, and few of them ever earn credentials. If that's a problem on your campus, consider whether a solution we developed at Manchester Community College in Connecticut could work for your students.
Influence of ultrasound determination of fetal head position on mode of delivery: a pragmatic randomized trial
Authors: Popowski T. , Porcher R. , Fort J. , Javoise S. , Rozenberg P.
Published: January 2015

Objective

To evaluate the influence of ultrasound determination of fetal head position on mode of delivery.

Methods

This was a pragmatic open‐label randomized controlled trial that included women with a singleton pregnancy in the vertex presentation at ≥ 37 weeks' gestation, cervical dilation ≥ 8 cm and who received epidural anesthesia. Women were assigned randomly to undergo either digital vaginal examination (VE group) or both digital vaginal and ultrasound examinations (VE+US group) to determine fetal head position. When the ultrasound and digital vaginal findings were inconsistent in the VE+US group, the ultrasound result was used for clinical management. The primary outcome assessed was operative delivery (Cesarean or instrumental vaginal delivery), and maternal and fetal morbidity were also assessed.

Results

The VE and VE+US groups included 959 and 944 women, respectively. The overall rate of operative delivery was significantly higher in the VE+US group than in the VE group: 33.7% vs 27.1%, respectively (relative risk (RR), 1.24 (95% CI, 1.08–1.43)), as was the rate of Cesarean delivery: 7.8% vs 4.9%, respectively (RR, 1.60 (95% CI, 1.12–2.28)). The rate of instrumental vaginal delivery was also higher, albeit not significantly: 25.8% in the VE+US group vs 22.2% in the VE group (RR, 1.16 (95% CI, 0.99–1.37)). Neonatal outcomes did not differ between the two groups. When analysis was restricted to instrumental vaginal deliveries only, maternal and neonatal morbidity outcomes were similar in both groups.

Conclusion

Correction of fetal occiput position, determined initially by digital vaginal examination, using systematic ultrasound examination did not improve management of labor and increased the rate of operative delivery without decreasing maternal and neonatal morbidity. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.
Management of Retropharyngeal Node Metastases from Thyroid Carcinoma
Authors: Hartl Dana M. , Leboulleux Sophie , Vélayoudom‐Céphise Fritz‐Line , Mirghani Haïtham , Déandréis Désirée , Schlumberger Martin
Published: January 2015

Background

Lymph node metastases are relatively common in thyroid carcinoma, but retropharyngeal nodes (RPN) are rare. Management may be surgical or non‐surgical, according to the context of the disease.

Methods

Systematic review of cases reported in the literature and report of 5 cases.

Results

Most case series report surgical management, via a cervical or transoral approach. RPN was the specific object of 26 case series, with a total of 85 patients, with surgery performed in 22/26 studies. Our 5 cases illustrated various strategies in the multidisciplinary management, with surgery for three patients (also with 131I in one case), targeted therapy for one patient with concurrent distant metastases, and watch and wait for one elderly patient.

Conclusions

Management of RPN is not always surgical. Discussion of options in a multidisciplinary tumor board setting may optimize care.
A 2-year follow-up study of patients participating in our transcranial pulsating electromagnetic fields augmentation in treatment-resistant depression
Authors: Bech Per , Lindberg Lone , Straasø Birgit , Larsen Erik Roj
Published: January 2015

Objective

We have made a 2-year follow-up study to evaluate the effect of repeated transcranial pulsating electromagnetic fields (T-PEMF) augmentation in patients who had achieved remission but later on relapsed, as well as to identify factors contributing to treatment-resistant depression in patients who did not respond to T-PEMF.

Methods

Using the Longitudinal Expert Assessment of All Data approach the patients were classified in four groups: A: patients who achieved remission; B: patients with doubtful effect; C: patients with no effect; and D: patients who were hard-to-assess.

Results

In group A, comprising 27 patients, 13 had relapsed; they obtained a clear remission after a repeated course of T-PEMF augmentation. In group D, comprising 16 patients, we identified misdiagnostic factors both concerning the event of remission after the previous T-PEMF augmentation and concerning the aetiology (psychosocial stressors and co-morbid conditions). Compared with the other groups, the group D patients had a smaller number of previous episodes (p=0.09) and a longer duration of the current episode (p=0.01).

Conclusion

T-PEMF has an effect among patients who relapsed after remission with the first series of T-PEMF. Treatment-resistant depression is a condition that has a high degree of multivariate problems. Misuse of alcohol or drugs, severe somatic disorders and other psychosocial problems may need other kinds of treatment before T-PEMF augmentation.
Play Dead: Dance, Museums, and the “Time-Based Arts”
Authors: Lista Marcella
Published: January 2015

This article examines some recent dance exhibitions where a strong speculative involvement of choreographers from the so-called trend of “conceptual dance” has been at stake. Both the open question of the history of dance and performance and the possibility for choreographic thinking to engage with the forms of the exhibition display became objects of experimentation in important projects and museum pieces conceived by Boris Charmatz, Xavier Le Roy, and La Ribot. In turn, the latter activated further concerns around the way dancers and choreographers address the question of heritage and its transmission; in this regard, examples of Richard Move and Jérôme Bel are also brought in the discussion. The article considers these shifts within the hypothesis of a dance museum currently engaging with a wider statement and critique about the “time-based arts” (a term first coined in the context of film, video, and new media museum conservation) and the ongoing new, time-related configurations of the exhibition space.
Stability of proposed biomarkers of prenatal androgen exposure over the menstrual cycle
Authors: Barrett E. S. , Parlett L. E. , Swan S. H.
Published: January 2015

The prenatal hormonal milieu is widely believed to shape health later in life; however, there are considerable methodological challenges associated with measuring thein uterohormonal environment. Two potential biomarkers of prenatal androgen exposure that can be measured postnatally have been proposed: anogenital distance (AGD) and the ratio of the second to fourth digits of the hand (2D:4D). Although both measures are widely used research tools, their use in adult women may be complicated by the dramatic fluctuations in reproductive hormones across the menstrual cycle. To determine whether there is cyclical variation in these biomarkers, we conducted a longitudinal study of 12 naturally cycling, nulliparous adult women. Trained examiners assessed two measures of AGD [anus to clitoris (AGD-AC) and anus to fourchette (AGD-AF)] and 2D:4D in both hands for the duration of three menstrual cycles, taking measurements during the follicular, peri-ovulatory and luteal phases of each cycle. Despite the small sample size, longer (more masculine) AGD was associated with lower (more masculine) digit ratios, as predicted by the literature. Using multi-level linear regression models, we found that AGD and 2D:4D measurements did not differ significantly across cycle phases. AGD-AF and digit ratios in both hands were associated with age at menarche, suggesting a possible common developmental trajectory. These results demonstrate that AGD and 2D:4D are stable across the menstrual cycle. In addition, research is needed to determine how reliably these measures reflect thein uterohormonal milieu.
(E)-α,β-unsaturated amides from tertiary amines, olefins and CO via Pd/Cu-catalyzed aerobic oxidative N-dealkylation
Authors: Shi Renyi , Zhang Hua , Lu Lijun , Gan Pei , Sha Yuchen , Zhang Heng , Liu Qiang , Beller Matthias , Lei Aiwen
Published: January 2015

A novel Pd/Cu-catalyzed chemoselective aerobic oxidative N-dealkylation/carbonylation reaction has been developed for the efficient and straightforward construction of synthetically useful and bioactive (E)-α,β-unsaturated amide derivatives.
Highly sensitive detection of low-level water content in organic solvents and cyanide in aqueous media using novel solvatochromic AIEE fluorophores
Authors: Chen Wei , Zhang Zhiyun , Li Xin , Ågren Hans , Su Jianhua
Published: January 2015

Two novel solvatochromic AIEE probes, BDM and BDBM have been successfully developed, which can be utilized as fluorescent sensors for the qualitative and quantitative low-level water content in THF or dioxane and cyanide in aqueous media.
Magnetostrophic balance as the optimal state for turbulent magnetoconvection
Authors: King Eric M. , Aurnou Jonathan M.
Published: January 2015

Significance

What sets the strength of a planet’s magnetic field? Theory suggests that there exists a “sweet spot” for magnetic field generation, in which the constraining influences of the Coriolis force (from planetary rotation) and Lorentz force (from the magnetic field) partially cancel, and the convective flow that generates magnetic energy is maximally efficient. However, this predicted optimal state, termed the magnetostrophic regime, has not yet been observed in computational dynamo simulations and has never been tested in a real, turbulent liquid metal, and so its existence has recently been called into question. Here, we report the first-ever, to our knowledge, turbulent magnetostrophic convection experiments. We observe that the magnetostrophic regime is, in fact, maximally efficient, substantiating the application of magnetostrophic theory to planets.
Mean curvature flow
Authors: Colding Tobias , Minicozzi William , Pedersen Erik
Published: January 2015

Mean curvature flow is the negative gradient flow of volume, so any hypersurface flows through hypersurfaces in the direction of steepest descent for volume and eventually becomes extinct in finite time. Before it becomes extinct, topological changes can occur as it goes through singularities. If the hypersurface is in general or generic position, then we explain what singularities can occur under the flow, what the flow looks like near these singularities, and what this implies for the structure of the singular set. At the end, we will briefly discuss how one may be able to use the flow in low-dimensional topology.
Adaptation and Resistance to Diseases in Brazil of Putative Sources of Common Bean Resistance to White Mold
Authors: Lehner M. S. , Teixeira H. , Paula Júnior T. J. , Vieira R. F. , Lima R. C. , Carneiro J. E. S.
Published: January 2015

Common bean breeding programs for white mold (WM) resistance are in their initial stages in Brazil. Sources of partial resistance to WM are available abroad but their performance in Brazil is unknown. In two greenhouse (straw test) and three field experiments conducted in three districts in the state of Minas Gerais, Brazil, we evaluated a total of 23 lines with putative WM resistance with the objective to select lines with resistance to WM and other diseases associated with high yield potential. Two field-resistant local lines, two susceptible local cultivars, and two susceptible international lines were also included in the study. In the greenhouse, Cornell 605, A 195, and G122 were among the lines with the highest partial resistance to WM. In the field, these three lines were highly resistant to WM and had intermediate resistance or were resistant to anthracnose, angular leaf spot, rust, and Fusarium wilt. Cornell 605 and A 195 had high-yield potential but G122 yielded 47% less than the local lines under WM pressure. Our results suggest that Cornell 605 and A 195 are the most useful sources of resistance to WM for use in common bean breeding programs in Brazil.
Unsteady aerodynamic analysis for offshore floating wind turbines under different wind conditions
Authors: Xu B. F. , Wang T. G. , Yuan Y. , Cao J. F.
Published: January 2015

A free-vortex wake (FVW) model is developed in this paper to analyse the unsteady aerodynamic performance of offshore floating wind turbines. A time-marching algorithm of third-order accuracy is applied in the FVW model. Owing to the complex floating platform motions, the blade inflow conditions and the positions of initial points of vortex filaments, which are different from the fixed wind turbine, are modified in the implemented model. A three-dimensional rotational effect model and a dynamic stall model are coupled into the FVW model to improve the aerodynamic performance prediction in the unsteady conditions. The effects of floating platform motions in the simulation model are validated by comparison between calculation and experiment for a small-scale rigid test wind turbine coupled with a floating tension leg platform (TLP). The dynamic inflow effect carried by the FVW method itself is confirmed and the results agree well with the experimental data of a pitching transient on another test turbine. Also, the flapping moment at the blade root in yaw on the same test turbine is calculated and compares well with the experimental data. Then, the aerodynamic performance is simulated in a yawed condition of steady wind and in an unyawed condition of turbulent wind, respectively, for a large-scale wind turbine coupled with the floating TLP motions, demonstrating obvious differences in rotor performance and blade loading from the fixed wind turbine. The non-dimensional magnitudes of loading changes due to the floating platform motions decrease from the blade root to the blade tip.
Managing public−private partnerships: dealing with business-culture influences
Authors: Tijhuis Wilco
Published: January 2015

Purpose

– The purpose of this paper is to investigate and analyze actual developments within PPP-projects, and the influences of business-cultures in the management-processes of such international PPP-projects. The paper focusses especially on the procurement, during which potential project-partners are being selected.

Design/methodology/approach

– The researcher adopted a recent model from literature for analyzing business-cultures within construction processes; especially the so called “3C-Model” was used, earlier developed and published within construction-management literature. Based on analysis of literature and comparable situations, conclusions and recommendations have been made for managing international PPP-projects, especially in the project-partners selection phase.

Findings

– Actual approaches within international PPP-projects do need a more structured approach during the selection of the project-partners. It is suggested to use more past-performance information, not only based on financials and/or organizational data/experiences, but also on behavioral (business-culture) data/experiences. This information needs to be structured in a proper way. Suggestions are given focussing on discussion and future-outlook.

Research limitations/implications

– It would be useful to test the findings on further actual cases, testing the further implications of the outcome.

Practical implications

– A better understanding of business-cultures’ influences increases the awareness of project-participants for the advantage of the suggested extra selection-criteria. This might reduce the risk for conflicts during the project-execution in the total project life-cycle.

Social implications

– When improving the actual practices of selection suitable parties for actual and future PPP-projects, it is of great value to be as effective as possible within this selection process. Especially, because this approach can prevent for several unpleasant situations afterwards during the operation-time (life-cycle) of the PPP-project. In this way, a proper handling of business-culture’s influence can save clients and other stakeholders involved (society) a large amount of possible conflicts (claims, etc.) afterwards.

Originality/value

– The proposed approach contributes to a better understanding of project-processes and its stakeholders (i.e. especially the – foreseen – project-participants). Current selection-processes still do not adopt a structured approach for incorporating past-performance behavioral data/experiences; so structuring and using them properly can result in more successful PPP-projects within a fast growing international PPP-market.
Effect of ISO 9001 non-conformity process on cost of poor quality in capital-intensive sectors
Authors: Chiarini Andrea
Published: January 2015

Purpose

– The purpose of this paper is to investigate whether there are differences in terms of the effect of the ISO 9001 non-conformity process on the cost of poor quality in different sectors. In particular, to investigate the effect on six sectors of companies which manufacture their products mainly through machines and plant (i.e. capital-intensive companies). An additional aim is to understand what the reasons for these differences are and why ISO 9001 has limitations in reducing the different categories of costs of poor quality.

Design/methodology/approach

– The paper is based on a questionnaire administered to a sample of 42 companies divided into six different sectors: chemical, pharmaceutical, mechanical, food, ceramic and steel. Respondents were asked to give a percentage score for the contribution the ISO 9001 non-conformity process makes to the reduction in total cost of poor quality and to its categories: scrap, rework, machine stoppage, re-inspections, rejected products and recall cost. A one-way Anova test was applied to the means of the percentage scores to determine whether there are differences between the means of the total cost of poor quality and its categories. Qualitative comments and suggestions from the companies provided information that helped explain the reasons for such differences.

Findings

– The results of the research show that there is no difference within and between the sectors in the means of the total cost of poor quality and scrap cost, whereas there are significant differences in the means of the other costs of poor quality between the six sectors. The ISO 9001 non-conformity process has limitations in reducing the costs of poor quality and suggestions concerning the limitations of ISO 9001 in the Research and Development process emerge.

Research limitations/implications

– The generalizability of the research findings is limited because of the use of just six sectors of capital-intensive companies. Further research about differences in different sectors is needed.

Practical implications

– The implications of this research are useful for consultants and managers who want to understand what the limitations of the ISO 9001 non-conformity process are on the cost of poor quality in the six sectors. The findings clearly show how, together with ISO 9001, they should take into account other improvement processes such as periodic maintenance and revamping.

Originality/value

– The paper discusses in a quantitative way and for the first time the effects of the ISO 9001 non-conformity process on the cost of poor quality.
A systemic approach to quality improvement in public health services
Authors: Sahel Amina , Alaoui Belghiti Abdelali , DeBrouwere Vincent , Valente Soares Filomena , Kegels Guy , Belkaab Nejoua , Godin Isabelle , Ablefoni Sabine , Schneider Anselm , Dujardin Bruno
Published: January 2015

Purpose

– The purpose of this paper is to discuss the results of the first four years of implementation of a quality program called “Quality Contest” (QC). This program was implemented from 2007 onward to improve the quality of hospital services by the Moroccan Ministry of Health. The peculiarity of this intervention, held every 18 months, is that it combines several approaches (self-evaluation, external audits with feedback, hospital ranking, awards and performance disclosure) and focuses on the quality of management.

Design/methodology/approach

– The assessment tool used to evaluate the quality of hospital management consists of 80 items. In each contest, a score is attributed to each item based on the score given for self-evaluation and the score given by external auditors. The sum of these scores allows the global performance score of the hospital to be obtained. To compare the performances over time and among hospitals, Wilcoxon signed-rank, Wilcoxon–Mann–Whitney and Kruskal–Wallis statistical tests were used.

Findings

– The results of the QC organized between 2007 and 2010 revealed that the hospitals participating in all the three contests had significantly improved their performance levels in terms of the quality of management. There was also a significant association between the number of times hospitals participated in the QC and the performance scores attained.

Originality/value

– The paper reports an original quality improvement approach in a developing country that succeeded in triggering sustainable improvement dynamics by combining support (feedback) with reward (prizes) and pressure measures (ranking, performance disclosure).
Self‐reported preparedness of New Zealand acute care providers to mass emergencies before the Canterbury Earthquakes: A national survey
Authors: Al‐Shaqsi Sultan , Gauld Robin , McBride David , Al‐Kashmiri Ammar , Al‐Harthy Abdullah
Published: January 2015

Introduction

Disasters occur more frequently. Acute care providers are the first to respond to mass emergencies from the healthcare sector. The preparedness of acute care providers in New Zealand to respond to mass emergencies has not been previously studied.

Objective

To assess the self‐reported training and experience of New Zealand acute care providers to respond to mass emergencies and the factors associated with strong preparedness.

Methods

A cross‐sectional national survey of 1500 acute care providers in New Zealand carried out between 2009 and 2010. The survey assessed experience, training and self‐reported preparedness. It also determined the factors associated with strong perceived preparedness.

Results

The response rate to this survey was 60.7%. Nurses had a higher response rate than doctors or paramedics. Only 29.2% of acute care providers reported responding to a previous mass emergency event. There were 53.5% of acute care providers who reported having formal training in how to deal with mass emergencies, whereas 58.1% of participants reported that they were aware of their role during a healthcare mass emergency response. The factors associated with self‐reported strong preparedness to deal with mass emergencies included: being a paramedic, previous training, participation in a drill, willingness to report to work during an infection or man‐made emergency, ability to triage and general awareness of the role during a mass emergency.

Conclusion

Almost half of New Zealand acute healthcare providers have no training in dealing with mass emergency events. Training and general awareness of the role during a mass emergency response were the main factors associated with strong self‐reported preparedness of acute care providers. The apparent efficacy of training allied to lack of availability means that it should be a national priority.
Redesigning emergency patient flow with timely quality care at the Alfred
Authors: Lowthian Judy , Curtis Andrea , Straney Lahn , McKimm Amy , Keogh Martin , Stripp Andrew
Published: January 2015

Objectives

The 4 h National Emergency Access Target was introduced in 2011. The Alfred Hospital in Melbourne implemented a hospital‐wide clinical service framework, Timely Quality Care (TQC), to enhance patient experience and care quality by improving timeliness of interventions and investigations through the emergency episode and admission to discharge in 2012. We evaluated TQC's effect on achieving the National Emergency Access Target and associated safety and quality indicators.

Methods

Retrospective analysis with piecewise regression of 215 125 ED attendances before/after implementation, November 2009 to August 2013; with comparison of proportions of patients discharged, admitted or transferred from ED within 4 h of arrival; left at risk; unplanned ED re‐attendances up to 28 days; ED length of stay; and in‐hospital mortality.

Results

The percentage of patients admitted, discharged or transferred within 4 h rose from 60% in 2010, to 74% in 2013. Median ED length of stay decreased significantly. Rate of unplanned ED re‐presentations decreased by 27%, 22% and 17% within 24 h, 48 h and 7 days, respectively; and patient numbers leaving at risk halved from 8% to 4%. Mortality for admitted patients declined from 3.5% to 2.2%. All results were statistically significant.

Conclusions and future directions

TQC resulted in improvement in timeliness of care for emergency patients without compromising safety and quality. Success is attributed to effective engagement of stakeholders with a hospital‐wide approach to redesigning the care pathway and establishing a new set of principles that underpin care from the time of ED arrival.
Paediatric ECMO at low‐volume paediatric cardiac centres in the Nordic countries
Authors: VEIEN M. , LINDBERG L. , TYNKKYNEN P. , RAVN H. B.
Published: January 2015

Background

Extracorporeal membrane oxygenation (ECMO) is a life‐saving resource‐intensive technology for patients with respiratory and/or circulatory failure. We aimed to evaluate outcome data from three Nordic paediatric centres comparing with data from the International Registry of the Extracorporeal Life Support Organization (ELSO) and selected high‐volume single‐centre studies.

Methods

One‐hundred nineteen patients < 19 years from 2002 to 2012 were enrolled. Data on demographics and outcome were collected using a standardised registration form. Outcome data were compared with the ELSO registry and high‐volume single‐centre studies.

Results

Demographics, indications and diagnosis were similar to the ELSO register. Survival after ECMO was similar to outcome data from the ELSO register, apart from paediatric cardiac ECMO, where a significantly better survival to discharge was seen in the Nordic centres (68% vs. 49%; P = 0.03). Comparison with high‐volume centres in the period after 2005 demonstrated a significantly better survival after cardiac ECMO in a single high‐volume centre study, whereas four studies had significantly lower survival after cardiac ECMO. No significant difference was seen in children receiving respiratory ECMO in the Nordic centres and high‐volume centres.

Conclusions

Survival after ECMO in three low‐volume Nordic centres demonstrated comparable outcome data with ELSO data and data from high‐volume centres. We believe regular quality assurance surveys, as the present study, should be performed in order to maintain excellent therapy within the individual ECMO centres.
Duration of untreated psychosis and pathway to care in Riyadh, Saudi Arabia
Authors: Al Fayez Hanan , Lappin Julia , Murray Robin , Boydell Jane
Published: January 2015

Aim

Recent studies of ‘duration of untreated psychosis’ (DUP) indicate that some patients remain untreated in the community for some time. Considerable emphasis has been placed on reducing the DUP. However, most studies investigating DUP have been conducted in Western countries, where well‐developed primary care systems are available. This study aims to describe DUP and its association with both demographic factors and pathways to care in Riyadh, Saudi Arabia.

Methods

A retrospective study of 421 new case records of all Saudi schizophrenia patients over a 2‐year period in six governmental hospitals in Riyadh, Saudi Arabia.

Results

The median DUP was 1.41 years (interquartile range 0.35–2.81 years). The longest time to contact was 9.86 years but 90% had a DUP shorter than 5 years. Older age at onset, single marital status and higher educational level were associated with shorter DUP. Long DUP was associated with help seeking from traditional healers.

Conclusion

In Saudi Arabia, it usually takes longer for patients to seek help from psychiatric services after their first psychosis onset than it does in Western countries. The results suggest that the DUP is influenced by both demographic factors and pathways to care.
Hemodialysis catheter insertion using transrenal approach
Authors: Law Wai Ping , Cheung Chi Yuen , Chan Hoi Wong , Kwok Philip Chong‐hei , Chak Wai Leung , Chau Ka Foon
Published: January 2015

We report a patient suffering from end‐stage renal disease (ESRD) because of lupus nephritis presented with exhausted vascular access after multiple arteriovenous grafts creation and hemodialysis catheters insertion. A rare percutaneous transrenal approach was finally used for the insertion of dialysis catheter. After 2 years, this hemodialysis catheter was complicated by blockage but was successfully replaced by a new catheter via the same site. Our report shows that the transrenal route of hemodialysis catheter insertion can provide a glimpse of hope for those ESRD patients with exhausted vascular access.
Purification of Helicobacter suis Strains From Biphasic Cultures by Single Colony Isolation: Influence on Strain Characteristics
Authors: Liang Jungang , De Bruyne Ellen , Ducatelle Richard , Smet Annemieke , Haesebrouck Freddy , Flahou Bram
Published: January 2015

Background

Helicobacter (H.) suis causes gastritis and decreased weight gain in pigs. It is also the most prevalent non‐Helicobacter pylori Helicobacter species in humans with gastric disease. H. suis is extremely fastidious, and so far, biphasic culture conditions were essential for isolation and culture, making it impossible to obtain single colonies. Hence, cultures obtained from an individual animal may contain multiple H. suis strains, which is undesirable for experiments aiming for instance at investigating H. suis strain differences.

Materials and Methods

Pure cultures of H. suis were established by growing bacteria as colonies on 1% brucella agar plates, followed by purification and enrichment by biphasic subculture. Characteristics of these single colony‐derived strains were compared with those of their parent strains using multilocus sequence typing (MLST) and by studying bacterium–host interactions using a gastric epithelial cell line and Mongolian gerbil model.

Results

The purification/enrichment procedure required a nonstop culture of several weeks. For 4 of 17 H. suis strains, MLST revealed differences between parental and single colony‐derived strains. For three of four single colony‐derived strains tested, the cell death‐inducing capacity was higher than for the parental strain. One single colony‐derived strain lost its capacity to colonize Mongolian gerbils. For the four other strains tested, colonization capacity and histopathologic changes were similar to what has been described when using strains with only a history of limited biphasic culture.

Conclusions

A method was developed to obtain single colony‐derived H. suis strains, but this procedure may affect the bacterial genotype and phenotype.
Profile of plasma amino acids values as a predictor of sepsis in patients following living donor liver transplantation: Special reference to sarcopenia and postoperative early nutrition
Authors: Toshima Takeo , Shirabe Ken , Kurihara Takeshi , Itoh Shinji , Harimoto Norifumi , Ikegami Toru , Yoshizumi Tomoharu , Kawanaka Hirofumi , Ikeda Tetsuo , Maehara Yoshihiko
Published: January 2015

Aim

Sarcopenia is an independent predictor of mortality and sepsis after living donor liver transplantation (LDLT). However, the exact mechanisms by which sarcopenia affects poor prognosis or worse immunity against postoperative sepsis are unclear, particularly regarding muscular amino acid metabolism, and the authors aimed to identify the role of plasma amino acids in sarcopenia by retrospective study.

Methods

The area of the psoas muscle in 228 recipients of LDLT was retrospectively measured by dynamic computed tomography. Additionally, plasma amino acid levels were measured both pre‐ and postoperatively. The impact of plasma amino acids for postoperative sepsis and the relationship between sarcopenia and early nutrition after LDLT were analyzed.

Results

Among the plasma amino acids, only leucine, isoleucine and glutamine in patients with sarcopenia were significantly lower than those without sarcopenia (each, P < 0.05). Multivariate analysis identified the lower plasma glutamine levels as a risk factor of postoperative sepsis after LDLT (odds ratio 5.371, P = 0.002). In sarcopenia patients, plasma glutamine levels after LDLT were significantly decreased compared with before LDLT in patients both with and without postoperative early nutrition. However, in non‐sarcopenia patients with early nutrition, plasma glutamine levels after LDLT were comparable with those before LDLT.

Conclusion

This is the first report to study the profile of plasma amino acid change before and after LDLT. Low preoperative glutamine values were an independent risk factor for predicting postoperative sepsis. The efficacy of postoperative early nutrition may prevent postoperative sepsis by improving glutamine levels.
Immunoglobulin Gene Organization and the Mechanism of Repertoire Development
Authors: Butler J. E.
Published: January 2015

Recombinant DNA technology has made it possible to comparatively examine the immunoglobulin (Ig) gene constitution of numerous species. These studies reveal that many species diverge from the pattern seen in rodents and primates while revealing a number of interesting correlations involving Ig gene organization, B‐cell lymphogenesis and the mechanism of repertoire development; many of these fail to correlate with traditional phylogenetic relationships. These correlates pose new questions regarding repertoire developments, which suggest that considerable diversity exists in the process. These findings also allow new questions to emerge regarding the role of IgD, the size of the B‐cell repertoire, and the role that antigen may or may not play in repertoire development. These issues are discussed with the intention of stimulating experimentation to test a number of speculative hypotheses regarding B‐cell and repertoire development.
Wheat Yield as Affected by Length of Exposure to Waterlogging During Stem Elongation
Authors: Marti J. , Savin R. , Slafer G. A.
Published: January 2015

Waterlogging, if occurring within the stem elongation period (SE), is particularly critical for yield determination. We quantified for the first time the effect of waterlogging duration during SE on yield and studied whether the effects were only direct on resource capture or whether there were feed‐forward effects as well. We grew wheat (cv. Soissons) outdoors in long tubes (1.25 m deep) forming a normal canopy and imposed different treatments in SE to finish simultaneously around anthesis (0, 4, 8, 12, 16, 20 and 24 days) plus two complementary treatments (8 and 16 days) starting 10 days after the onset of SE. Yield was reduced linearly with the duration of waterlogging c. 2 % dwaterlogging−1. Treatments mainly affected pre‐anthesis spike growth reducing the number of fertile florets and grains, not affecting fruiting efficiency. The magnitude of grain number loss was inversely proportional to the hierarchy of the spikes and spikelets. Grain weight was more marginally reduced, likely through the effects on the size of the ovaries of the developing florets. This reveals a direct effect of waterlogging on the capture of resources with no major feed‐forward effects. Losses were in agreement with those from other studies for particular durations of waterlogging.
Sequential Reflow-Process Optimization to Reduce Die-Attach Solder Voids
Authors: Yu Youmin , Chiriac Victor , Jiang Yingwei , Wang Zhijie
Published: January 2015

Solder voids are detrimental to the thermal, mechanical, and reliability performance of integrated circuit (IC) packages and must be controlled within certain specifications. A sequential method of optimizing solder-reflow process to reduce die-attach solder voids in power quad flat no-lead (QFN) packages is presented. The sequential optimization consists, in turn, of theoretical prediction, heat transfer comparison, and experimental validation. First, the theoretical prediction uses calculations to find the optimal pause location and time for a lead frame strip (with dies bonded to it by solder paste) to receive uniform heat transfer during the solder-reflow stage. Next, reflow profiles at different locations on the lead frame strip are measured. Heat transfer during the reflow stage at these locations is calculated from the measured reflow profiles and is compared to each other to confirm the theoretical prediction. Finally, only a minimal number of actual trials are conducted to verify the predicted and confirmed optimal process. Since the theoretical prediction and heat transfer comparison screens out most of the unnecessary trials which must be conducted in common design of experiment (DoE) and trial-and-error methods, the sequential optimization method saves significant time and cost.
Research of Performance Comparison of Topology Structure of Cross-Spring Flexural Pivots
Authors: Liu Lang , Zhao Hongzhe , Bi Shusheng , Yu Jingjun
Published: January 2015

Cross-Spring Flexural Pivot (CSFP) has some advantages compared with rigid bearing. However, this kind of flexural pivot is limited in the field of precision positioning due to its small motion stroke, large axis drift, and sensitivity to temperature, etc. In this paper, topology structures of the CSFP were analyzed through defining different geometric parameters λ, spring crossing angle α, and spring number N. Characteristics of stiffness, axis drift, maximum stress, and temperature drift were compared and summarized by the Finite Element Analysis (FEA). Ultimately, a class of flexural pivots, called Inner and Outer Ring Flexural Pivots (IORFP), were selected for their excellent comprehensive performances. This type of flexural pivots has some significant advantages, such as large stroke, approximate zero axis drift and no temperature drift. Finally, the stiffness characteristic of IORFP with different geometrical parameters λ was compared by FEA, and law of stiffness variation was obtained. When λ is 0.1273, the IORFP has linear stiffness characteristics.